Sample records for discrepancy reporting management

  1. The Clinical Impact of Resident-attending Discrepancies in On-call Radiology Reporting: A Retrospective Assessment.

    PubMed

    McWilliams, Sebastian R; Smith, Christopher; Oweis, Yaseen; Mawad, Kareem; Raptis, Constantine; Mellnick, Vincent

    2018-06-01

    The purpose of this study is to quantify the clinical impact of resident-attending discrepancies at a tertiary referral academic radiology residency program by assessing rates of intervention, discrepancy confirmation, recall rate, and management change rate; furthermore, a discrepancy categorization system will be assessed. Retrospective review of the records was performed for n = 1482 discrepancies that occurred in the 17-month study period to assess the clinical impact of discrepancies. Discrepancies were grouped according to a previously published classification system. Management changes were recorded and grouped by severity. The recall rate was estimated for discharged patients. Any confirmatory testing was reviewed to evaluate the accuracy of the discrepant report. Categorical variables were compared to the chi-square test. The 1482 discrepancies led to management change in 661 cases (44.6%). The most common management change was follow-up imaging. Procedural interventions including surgery occurred in 50 cases (3.3%). The recall rate was 2.6%. Management changes were more severe with computed tomography examinations, inpatients, and when the discrepancy was in the chest and abdomen subspecialty. Also, management changes correlated with the discrepancy category assigned by the attending at the time of review. Resident-attending discrepancies do cause management changes in 44.6% of discrepancies (0.62% overall); the most frequent change is follow-up imaging. The discrepancy categorization assigned by the attending correlated with the severity of management change. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Mother-father informant discrepancies regarding diabetes management: Associations with diabetes-specific family conflict and glycemic control

    PubMed Central

    Sood, Erica D.; Pendley, Jennifer Shroff; Delamater, Alan; Rohan, Jennifer M.; Pulgaron, Elizabeth; Drotar, Dennis

    2014-01-01

    Objective To examine the relationship of mother-father informant discrepancies regarding diabetes management to diabetes-specific family conflict and glycemic control. Methods 136 mothers and fathers of youth with type 1 diabetes reported on the youth's diabetes management, diabetes-specific family conflict, and amount of paternal involvement in diabetes care. Glycosylated hemoglobin A1c (HbA1c) was used to measure glycemic control. Results As hypothesized, mother-father discrepancies regarding diabetes management were positively associated with frequency of diabetes-specific family conflict. Contrary to hypotheses, mother-father discrepancies regarding diabetes management predicted poorer glycemic control for youth with less involved fathers only. Conclusions Results highlight the importance of caregivers being consistent about pediatric illness management and support the idea that informant discrepancies represent an important window into the functioning of the family system. PMID:22823070

  3. Mother-father informant discrepancies regarding diabetes management: associations with diabetes-specific family conflict and glycemic control.

    PubMed

    Sood, Erica D; Pendley, Jennifer Shroff; Delamater, Alan M; Rohan, Jennifer M; Pulgaron, Elizabeth R; Drotar, Dennis

    2012-09-01

    To examine the relationship of mother-father informant discrepancies regarding diabetes management to diabetes-specific family conflict and glycemic control. One hundred thirty-six mothers and fathers of youth with Type 1 diabetes reported on the youth's diabetes management, diabetes-specific family conflict, and amount of paternal involvement in diabetes care. Glycosylated hemoglobin A1c (HbA1c) was used to measure glycemic control. As hypothesized, mother-father discrepancies regarding diabetes management were positively associated with frequency of diabetes-specific family conflict. Contrary to hypotheses, mother-father discrepancies regarding diabetes management predicted poorer glycemic control for youth with less involved fathers only. Results highlight the importance of caregivers being consistent about pediatric illness management and support the idea that informant discrepancies represent an important window into the functioning of the family system. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  4. Discrepancy Reporting Management System

    NASA Technical Reports Server (NTRS)

    Cooper, Tonja M.; Lin, James C.; Chatillon, Mark L.

    2004-01-01

    Discrepancy Reporting Management System (DRMS) is a computer program designed for use in the stations of NASA's Deep Space Network (DSN) to help establish the operational history of equipment items; acquire data on the quality of service provided to DSN customers; enable measurement of service performance; provide early insight into the need to improve processes, procedures, and interfaces; and enable the tracing of a data outage to a change in software or hardware. DRMS is a Web-based software system designed to include a distributed database and replication feature to achieve location-specific autonomy while maintaining a consistent high quality of data. DRMS incorporates commercial Web and database software. DRMS collects, processes, replicates, communicates, and manages information on spacecraft data discrepancies, equipment resets, and physical equipment status, and maintains an internal station log. All discrepancy reports (DRs), Master discrepancy reports (MDRs), and Reset data are replicated to a master server at NASA's Jet Propulsion Laboratory; Master DR data are replicated to all the DSN sites; and Station Logs are internal to each of the DSN sites and are not replicated. Data are validated according to several logical mathematical criteria. Queries can be performed on any combination of data.

  5. Enhancing DSN Operations Efficiency with the Discrepancy Reporting Management System (DRMS)

    NASA Technical Reports Server (NTRS)

    Chatillon, Mark; Lin, James; Cooper, Tonja M.

    2003-01-01

    The DRMS is the Discrepancy Reporting Management System used by the Deep Space Network (DSN). It uses a web interface and is a management tool designed to track and manage: data outage incidents during spacecraft tracks against equipment and software known as DRs (discrepancy Reports), to record "out of pass" incident logs against equipment and software in a Station Log, to record instances where equipment has be restarted or reset as Reset records, and to electronically record equipment readiness status across the DSN. Tracking and managing these items increases DSN operational efficiency by providing: the ability to establish the operational history of equipment items, data on the quality of service provided to the DSN customers, the ability to measure service performance, early insight into processes, procedures and interfaces that may need updating or changing, and the capability to trace a data outage to a software or hardware change. The items listed above help the DSN to focus resources on areas of most need.

  6. Deep Space Network equipment performance, reliability, and operations management information system

    NASA Technical Reports Server (NTRS)

    Cooper, T.; Lin, J.; Chatillon, M.

    2002-01-01

    The Deep Space Mission System (DSMS) Operations Program Office and the DeepSpace Network (DSN) facilities utilize the Discrepancy Reporting Management System (DRMS) to collect, process, communicate and manage data discrepancies, equipment resets, physical equipment status, and to maintain an internal Station Log. A collaborative effort development between JPL and the Canberra Deep Space Communication Complex delivered a system to support DSN Operations.

  7. Adolescents' and Their Mothers' Perceptions of Parental Management of Peer Relationships

    ERIC Educational Resources Information Center

    Mounts, Nina S.

    2007-01-01

    The purpose of the present investigation was to examine the relation of level and discrepancy in mothers' and adolescents' reports of parental management of peer relationships and parent-child conflict about peer relationships to mothers' and adolescent's reports of adolescents' drug use, delinquent behavior, and grade-point-average (GPA). An…

  8. Any value in a specialist review of liver biopsies? Conclusions of a 4-year review.

    PubMed

    Paterson, Anna L; Allison, Michael E D; Brais, Rebecca; Davies, Susan E

    2016-08-01

    Liver pathology is a challenging subspeciality, with histopathologists frequently seeking specialist opinions. This study aims to determine the impact of specialist reviews on the final diagnosis and patient management. Agreement with the initial reporting centre in the histopathological diagnosis of 1265 liver biopsies was determined. The nature of differences was explored in more depth for 103 discrepant cases. Differences in the histopathological interpretation were present in 749 of 1265 (59%) biopsies, of which 505 of 749 (67%) were predicted at the time of reporting to impact upon patient management. Agreement was good in cases with chronic viral hepatitis, fatty liver disease, malignancy and minimal pathological changes, while diagnostic differences occurred in more than 70% with biliary disease, autoimmune hepatitis or vascular/architectural changes. A clinical review of a subset of reports with histopathological differences predicted changes in patient management in 63 of 103 (61%). Clinically significant differences in liver biopsy interpretation between local pathologists and subspecialists are common. Diagnoses with frequent discrepancies, such as biliary disease, may benefit from a specialist review as standard when diagnosed initially, while cases requiring specialist advice from disease subgroups where discrepancies are less common, such as chronic viral hepatitis, could be selected during the clinicopathological conference process. © 2016 John Wiley & Sons Ltd.

  9. Value of Specialist Pathology Review in a Single Statewide Gynecologic Cancer Service.

    PubMed

    Melon, Jerome; Leung, Yee; Salfinger, Stuart G; Tan, Jason; Mohan, Ganendra; Cohen, Paul A

    2017-01-01

    A case review by specialist diagnostic pathologists as part of a Gynecologic Oncology Multi-disciplinary Tumor group has the potential to influence the management of patients with cancer. The primary aim of this study was to determine the frequency of diagnostic discrepancies between the initial (nonspecialist) and final pathological diagnoses in cases referred to the Gynecologic Oncology Tumor Conference (TC) in Western Australia and the impact of such revised diagnosis on clinical management. A secondary aim was to assess the evolving workload encountered by the TC during a 5-year interval. The records of the weekly TC for the 2 calendar years 2008 and 2013 were examined, and histological and cytological specimens that had been initially assessed by "outside" (nonspecialist) pathology departments, and subsequently reviewed by specialist pathologists, were assessed. The initial and final diagnoses were compared, and where the pathological findings were amended upon review, it was determined whether the change affected clinical management. Diagnostic discrepancies that resulted in a change in patient management were classified as major, whereas discrepancies that did not affect patient management were classified as minor. A total of 481 outside cases were included among 2387 cases presented for histological review at the TC during the 2 years. For outside cases alone, the incidence of major diagnostic discrepancies was 3.4% in 2008, 5.5% in 2013 (no significant difference, P = 0.3787), and 4.6% for the 2 years combined. A recommendation for surgery was the most common change in clinical management as a result of major discrepancy. The minor discrepancy rate was 4.4% of outside cases for both years combined. Pathological discrepancies (major and minor) of the uterine corpus and cervix were most frequent, followed by those of the vulva and ovary. There was a 48.4% increase in total case discussions at the TC during the interval period with a significant rise in nonmalignant cases, 29.8% of the total cases in 2008 compared with 36.8% in 2013 (P = 0.0004). Nonspecialist pathology departments maintained a high level of reporting accuracy during the interval period, with the major discrepancy rate not changing significantly between 2008 and 2013. Specimens from the uterine corpus and cervix in particular may prove diagnostically challenging on occasion. A pathology review of outside cases by a tertiary-based laboratory in conjunction with a TC can identify a small but clinically significant number of cases that lead to a change in clinical management. It is uncertain whether this affects patient outcomes.

  10. 41 CFR 101-26.800 - Scope of subpart.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Scope of subpart. 101-26... Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND... Scope of subpart. This subpart prescribes a uniform system for reporting discrepancies or deficiencies...

  11. 41 CFR 101-26.800 - Scope of subpart.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Scope of subpart. 101-26... Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND... Scope of subpart. This subpart prescribes a uniform system for reporting discrepancies or deficiencies...

  12. 41 CFR 101-26.800 - Scope of subpart.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Scope of subpart. 101-26... Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND... Scope of subpart. This subpart prescribes a uniform system for reporting discrepancies or deficiencies...

  13. Discrepancies in Leader and Follower Ratings of Transformational Leadership: Relationship with Organizational Culture in Mental Health.

    PubMed

    Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Sklar, Marisa; Horowitz, Jonathan

    2017-07-01

    The role of leadership in the management and delivery of health and allied health services is often discussed but lacks empirical research. Discrepancies are often found between leaders' self-ratings and followers' ratings of the leader. To our knowledge no research has examined leader-follower discrepancies and their association with organizational culture in mental health clinics. The current study examines congruence, discrepancy, and directionality of discrepancy in relation to organizational culture in 38 mental health teams (N = 276). Supervisors and providers completed surveys including ratings of the supervisor transformational leadership and organizational culture. Polynomial regression and response surface analysis models were computed examining the associations of leadership discrepancy and defensive organizational culture and its subscales. Discrepancies between supervisor and provider reports of transformational leadership were associated with a more negative organizational culture. Culture suffered more where supervisors rated themselves more positively than providers, in contrast to supervisors rating themselves lower than the provider ratings of the supervisor. Leadership and leader discrepancy should be a consideration in improving organizational culture and for strategic initiatives such as quality of care and the implementation and sustainment of evidence-based practice.

  14. Discrepancies in Leader and Follower Ratings of Transformational Leadership: Relationship with Organizational Culture in Mental Health

    PubMed Central

    Ehrhart, Mark G.; Farahnak, Lauren R.; Sklar, Marisa; Horowitz, Jonathan

    2015-01-01

    The role of leadership in the management and delivery of health and allied health services is often discussed but lacks empirical research. Discrepancies are often found between leaders’ self-ratings and followers’ ratings of the leader. To our knowledge no research has examined leader–follower discrepancies and their association with organizational culture in mental health clinics. The current study examines congruence, discrepancy, and directionality of discrepancy in relation to organizational culture in 38 mental health teams (N = 276). Supervisors and providers completed surveys including ratings of the supervisor transformational leadership and organizational culture. Polynomial regression and response surface analysis models were computed examining the associations of leadership discrepancy and defensive organizational culture and its subscales. Discrepancies between supervisor and provider reports of transformational leadership were associated with a more negative organizational culture. Culture suffered more where supervisors rated themselves more positively than providers, in contrast to supervisors rating themselves lower than the provider ratings of the supervisor. Leadership and leader discrepancy should be a consideration in improving organizational culture and for strategic initiatives such as quality of care and the implementation and sustainment of evidence-based practice. PMID:26164567

  15. The Annual Condition of Iowa's Community Colleges, 2015

    ERIC Educational Resources Information Center

    Bassis, Vladimir, Comp.; Burroughs, Monte, Comp.; Burrows, Barbara, Comp.; Gard, Lisa, Comp.; Harris, Alex, Comp.; Nissen, Paula, Comp.; St Clair, Eric, Comp.

    2015-01-01

    Data reported in the Condition Report comes primarily from each of Iowa's 15 community colleges, transmitted each fall to the division's Management Information System (MIS). Upon receipt, division staff review the data for discrepancies and return summary reports to the colleges to confirm accuracy. After confirmation, data files are aggregated…

  16. Discrepant Perspectives on Conflict Situations Among Urban Parent-Adolescent Dyads.

    PubMed

    Parker, Elizabeth M; Lindstrom Johnson, Sarah R; Jones, Vanya C; Haynie, Denise L; Cheng, Tina L

    2016-03-01

    Parents influence urban youths' violence-related behaviors. To provide effective guidance, parents should understand how youth perceive conflict, yet little empirical research has been conducted regarding parent and youth perceptions of conflict. The aims of this article are to (a) report on the nature of discrepancies in attribution of fault, (b) present qualitative data about the varying rationales for fault attribution, and (c) use quantitative data to identify correlates of discrepancy including report of attitudes toward violence, parental communication, and parents' messages about retaliatory violence. Interviews were conducted with 101 parent/adolescent dyads. The study population consisted of African American female caretakers (n = 92; that is, mothers, grandmothers, aunts) and fathers (n = 9) and their early adolescents (mean age = 13.6). A total of 53 dyads were discrepant in identifying instigators in one or both videos. When discrepancy was present, the parent was more likely to identify the actor who reacted to the situation as at fault. In the logistic regression models, parental attitudes about retaliatory violence were a significant correlate of discrepancy, such that as parent attitudes supporting retaliatory violence increased, the odds of discrepancy decreased. The results suggest that parents and adolescents do not always view conflict situations similarly, which may inhibit effective parent-child communication, parental advice, and discipline. Individuals developing and implementing family-based violence prevention interventions need to be cognizant of the complexity of fault attribution and design strategies to promote conversations around attribution of fault and effective conflict management. © The Author(s) 2014.

  17. Discrepant Perspectives On Conflict Situations Among Urban Parent-Adolescent Dyads

    PubMed Central

    Parker, Elizabeth M.; Lindstrom Johnson, Sarah R.; Jones, Vanya C.; Haynie, Denise L.; Cheng, Tina L.

    2015-01-01

    Parents influence urban youths’ violence-related behaviors. To provide effective guidance, parents should understand how youth perceive conflict, yet little empirical research has been conducted regarding parent and youth perceptions of conflict. The aims of this paper were to: (1) report on the nature of discrepancies in attribution of fault, (2) present qualitative data about the varying rationales for fault attribution, and (3) use quantitative data to identify correlates of discrepancy including report of attitudes towards violence, parental communication, and parents’ messages about retaliatory violence. Interviews were conducted with 101 parent/adolescent dyads. The study population consisted of African American female caretakers (n= 92; i.e., mothers, grandmothers, aunts) and fathers (n=9) and their early adolescents (mean age=13.6). A total of 53 dyads were discrepant in identifying instigators in one or both videos. When discrepancy was present, the parent was more likely to identify the actor who reacted to the situation as at fault. In the logistic regression models, parental attitudes about retaliatory violence were a significant correlate of discrepancy, such that as parent attitudes supporting retaliatory violence increased the odds of discrepancy decreased. The results suggest that parents and adolescents do not always view conflict situations similarly, which may inhibit effective parent-child communication, parental advice, and discipline. Individuals developing and implementing family-based violence prevention interventions need to be cognizant of the complexity of fault attribution and design strategies to promote conversations around attribution of fault and effective conflict management. PMID:25535252

  18. Predictors of Nightly Subjective-Objective Sleep Discrepancy in Poor Sleepers over a Seven-Day Period

    PubMed Central

    Herbert, Vanessa; Pratt, Daniel; Emsley, Richard; Kyle, Simon D.

    2017-01-01

    This study sought to examine predictors of subjective/objective sleep discrepancy in poor sleepers. Forty-two individuals with insomnia symptoms (mean age = 36.2 years, 81% female) were recruited to take part in a prospective study which combined seven days of actigraphy with daily assessment of sleep perceptions, self-reported arousal, sleep effort, and mood upon awakening. A high level of intra-individual variability in measures of sleep discrepancy was observed. Multilevel modelling revealed that higher levels of pre-sleep cognitive activity and lower mood upon awakening were significantly and independently predictive of the underestimation of total sleep time. Greater levels of sleep effort predicted overestimation of sleep onset latency. These results indicate that psychophysiological variables are related to subjective/objective sleep discrepancy and may be important therapeutic targets in the management of insomnia. PMID:28282912

  19. Convergence of Self-Reports and Informant Reports on the Personality Assessment Screener.

    PubMed

    Kelley, Shannon E; Edens, John F; Morey, Leslie C

    2017-12-01

    The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener-Other. Among a sample of undergraduate roommate dyads ( N = 174), self-report and informant report total scores on the Personality Assessment Screener/Personality Assessment Screener-Other moderately converged ( r = 0.45), with generally greater agreement between perspectives observed for externalizing behaviors compared with internalizing distress. In addition, selves tended to report more psychological difficulties relative to informant ratings ( d = 0.45) with an average absolute discrepancy between sources of 6.31 ( SD = 4.96) out of a possible range of 66. Discrepancies between self-report and informant report were significantly associated with characteristics of the dyadic relationship (e.g., length of acquaintanceship) as well as the severity of self-reported psychological difficulties and positive impression management.

  20. Collecting sexual assault history and forensic evidence from adult women in the emergency department: a retrospective study.

    PubMed

    Tozzo, Pamela; Ponzano, Elena; Spigarolo, Gloria; Nespeca, Patrizia; Caenazzo, Luciana

    2018-05-29

    The objective of this retrospective study was to examine the discrepancy between information derived from written medical reports and the results of forensic DNA analyses on swabs collected from the victims in 122 cases of alleged sexual assault treated at the Emergency Department of Padua Hospital. The examination of discrepant results has proved useful to support a broader application of sexual assault management, particularly during the taking of case history. The Laboratory of Forensic Genetics of Padua University have processed samples from 122 sexual assault cases over a period of 5 years. Of the 103 cases in which the victim reported a penetration and ejaculation, only 67 (55% of all the samples) correlated with positive feedback match from the laboratory. In 36 cases in which the patient reported penetration with ejaculation, no male DNA was found in the samples collected. Therefore, there was a total of 41 cases in which the patient's report were not supported by laboratory data. In the remaining ten cases, which had an ambiguous history, 3 tested positively for the presence of male DNA. To avoid discrepancies between the medical reporting and reconstruction of sex crimes, it is crucial to deploy strategies which focus not only on the technical aspects of evidence collection, but also on how the victim's story is recorded; such efforts could lead to better management of sexual assault victims, and to a strengthened legal impact of forensic evidence and of crime reconstruction.

  1. Management of Pediatric Nonalcoholic Fatty Liver Disease by Academic Hepatologists in Canada: A Nationwide Survey.

    PubMed

    Mouzaki, Marialena; Ling, Simon C; Schreiber, Richard A; Kamath, Binita M

    2017-10-01

    The literature on the optimal clinical management of pediatric patients with nonalcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to identify discrepancies in the care provided to patients with NAFLD by hepatologists practicing in academic centers across Canada. A nationwide survey was distributed electronically to all pediatric hepatologists practicing in university-affiliated hospitals using the infrastructure of the Canadian Pediatric Hepatology Research Group. The responses were anonymous. The response rate to the survey was 79%. Everyone reported diagnosing NAFLD based on a combination of elevated transaminases and imaging suggestive of steatosis in the context of an otherwise negative workup for other liver diseases. Only 14% use liver biopsy to confirm the diagnosis. There are significant discrepancies in the frequency of screening for other comorbidities (eg, hypertension, sleep apnea, etc) and in the frequency of laboratory investigations (eg, lipid profile, transaminases, international normalized ratio, etc). Frequency of outpatient clinic follow-up varies significantly. Treatment is consistently based on lifestyle modifications; however, reported patient outcomes in terms of body mass index improvements are poor. There are significant discrepancies in the care provided to children with NAFLD by hepatologists practicing in academic centers across Canada.

  2. Quality Management Tools: Facilitating Clinical Research Data Integrity by Utilizing Specialized Reports with Electronic Case Report Forms

    PubMed Central

    Trocky, NM; Fontinha, M

    2005-01-01

    Data collected throughout the course of a clinical research trial must be reviewed for accuracy and completeness continually. The Oracle Clinical® (OC) data management application utilized to capture clinical data facilitates data integrity through pre-programmed validations, edit and range checks, and discrepancy management modules. These functions were not enough. Coupled with the use of specially created reports in Oracle Discoverer® and Integrated Review TM, both ad-hoc query and reporting tools, research staff have enhanced their ability to clean, analyze and report more accurate data captured within and among Case Report Forms (eCRFs) by individual study or across multiple studies. PMID:16779428

  3. Sleep-wake time perception varies by direct or indirect query.

    PubMed

    Alameddine, Y; Ellenbogen, J M; Bianchi, M T

    2015-01-15

    The diagnosis of insomnia rests on self-report of difficulty initiating or maintaining sleep. However, subjective reports may be unreliable, and possibly may vary by the method of inquiry. We investigated this possibility by comparing within-individual response to direct versus indirect time queries after overnight polysomnography. We obtained self-reported sleep-wake times via morning questionnaires in 879 consecutive adult diagnostic polysomnograms. Responses were compared within subjects (direct versus indirect query) and across groups defined by apnea-hypopnea index and by self-reported insomnia symptoms in pre-sleep questionnaires. Direct queries required a time duration response, while indirect queries required clock times from which we calculated time durations. Direct and indirect queries of sleep latency were the same in only 41% of cases, and total sleep time queries matched in only 5.4%. For both latency and total sleep, the most common discrepancy involved the indirect value being larger than the direct response. The discrepancy between direct and indirect queries was not related to objective sleep metrics. The degree of discrepancy was not related to the presence of insomnia symptoms, although patients reporting insomnia symptoms showed underestimation of total sleep duration by direct response. Self-reported sleep latency and total sleep time are often internally inconsistent when comparing direct and indirect survey queries of each measure. These discrepancies represent substantive challenges to effective clinical practice, particularly when diagnosis and management depends on self-reported sleep patterns, as with insomnia. Although self-reported sleep-wake times remains fundamental to clinical practice, objective measures provide clinically relevant adjunctive information. © 2015 American Academy of Sleep Medicine.

  4. Exploring the concept of medication discrepancy within the context of patient safety to improve population health.

    PubMed

    Murphy, Catherine R; Corbett, Cynthia L; Setter, Stephen M; Dupler, Alice

    2009-01-01

    Medication discrepancy is a concept often used in discussions about medication safety but has neither been fully explained nor clearly defined in the literature. This article explores medication discrepancy as it relates to patient safety and population health in the management of medications. Literature review reveals 2 main aspects of discrepancies in medication management; prescribing issues and patient adherence to regimens. Further development of the concept of medication discrepancy can be beneficial to the theorist, researcher, or clinician. Conceptual clarity about the various aspects of medication discrepancy in the context of patient safety has the potential to enhance quality improvement efforts and patient outcomes to improve population health.

  5. Management of post midface distraction occlusal discrepancy using temporary anchorage devices in a cleft patient

    PubMed Central

    Koteswara Prasad, N. K.; Hussain, Syed Altaf; Chitharanjan, Arun B.; Murthy, Jyotsna

    2015-01-01

    Open bite deformity following a successful midface advancement by distraction osteogenesis is a common complication. Temporary anchorage devices can be deployed during the distraction and post-distraction settling phases for restoring the occlusion even in severe cases. The following report describes the management of severe anterior open bite following maxillary distraction. PMID:25991895

  6. Reporter Discrepancies Among Parents, Adolescents, and Peers: Adolescent Attachment and Informant Depressive Symptoms as Explanatory Factors

    PubMed Central

    Ehrlich, Katherine B.; Cassidy, Jude; Dykas, Matthew J.

    2010-01-01

    The issue of informant discrepancies about child and adolescent functioning is an important concern for clinicians, developmental psychologists, and others who must consider ways of handling discrepant reports of information, but reasons for discrepancies in reports have been poorly understood. Adolescent attachment and informant depressive symptoms were examined as two explanations for absolute and directional discrepancies about adolescent symptoms, relationships, and social behavior in a sample of 189 eleventh-grade students (mean age = 16.5 years). Adolescent attachment predicted absolute discrepancies, with greater attachment coherence associated with fewer discrepancies in reports of adolescent depressive symptoms, parent-adolescent conflict, and adolescent externalizing behavior. Parents’ but not adolescents’ depressive symptoms sometimes predicted absolute discrepancies. Mothers’ depressive symptoms and adolescent attachment predicted the direction of discrepancies for mother-peer reports only. PMID:21410916

  7. Drug therapy problems and medication discrepancies during care transitions in super-utilizers.

    PubMed

    Surbhi, Satya; Munshi, Kiraat D; Bell, Paula C; Bailey, James E

    First, to investigate the prevalence and types of drug therapy problems and medication discrepancies among super-utilizers, and associated patient characteristics. Second, to examine the outcomes of pharmacist recommendations and estimated cost avoidance through care transitions support focused on medication management. Retrospective analysis of the pharmacist-led interventions as part of the SafeMed Program. A large nonprofit health care system serving the major medically underserved areas in Memphis, Tennessee. Three hundred seventy-four super-utilizing SafeMed participants with multiple chronic conditions and polypharmacy. Comprehensive medication review, medication therapy management, enhanced discharge planning, home visits, telephone follow-up, postdischarge medication reconciliation, and care coordination with physicians. Types of drug therapy problems, outcomes of pharmacist recommendations, estimated cost avoided, medication discrepancies, and self-reported medication adherence. Prevalence of drug therapy problems and postdischarge medication discrepancies was 80.7% and 75.4%, respectively. The most frequently occurring drug therapy problems were enrollee not receiving needed medications (33.4%), underuse of medications (16.9%), and insufficient dose or duration (11.2%). Overall 50.8% of the pharmacist recommendations were accepted by physicians and patients, resulting in an estimated cost avoidance of $293.30 per drug therapy problem identified. Multivariate analysis indicated that participants with a higher number of comorbidities were more likely to have medication discrepancies (odds ratio 1.23 [95% CI 1.05-1.44]). Additional contributors to postdischarge medication discrepancies were difficulty picking up and paying for medications and not being given necessary prescriptions before discharge. Drug therapy problems and medication discrepancies are common in super-utilizers with multiple chronic conditions and polypharmacy during transitions of care, and greater levels of comorbidity magnify risk. Pharmacist-led interventions in the SafeMed Program have demonstrated success in resolving enrollees' medication-related issues, resulting in substantial estimated cost savings. Preliminary evidence suggests that the SafeMed model's focus on medication management has great potential to improve outcomes while reducing costs for vulnerable super-utilizing populations nationwide. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  8. Histopathological Diagnostic Discrepancies in Soft Tissue Tumours Referred to a Specialist Centre: Reassessment in the Era of Ancillary Molecular Diagnosis

    PubMed Central

    Thway, Khin; Mubako, Taka

    2014-01-01

    Introduction. Soft tissue tumour pathology is a highly specialised area of surgical pathology, but soft tissue neoplasms can occur at virtually all sites and are therefore encountered by a wide population of surgical pathologists. Potential sarcomas require referral to specialist centres for review by pathologists who see a large number of soft tissue lesions and where appropriate ancillary investigations can be performed. We have previously assessed the types of diagnostic discrepancies between referring and final diagnosis for soft tissue lesions referred to our tertiary centre. We now reaudit this 6 years later, assessing changes in discrepancy patterns, particularly in relation to the now widespread use of ancillary molecular diagnostic techniques which were not prevalent in our original study. Materials and Methods. We compared the sarcoma unit's histopathology reports with referring reports on 348 specimens from 286 patients with suspected or proven soft tissue tumours in a one-year period. Results. Diagnostic agreement was seen in 250 cases (71.8%), with 57 (16.4%) major and 41 (11.8%) minor discrepancies. There were 23 cases of benign/malignant discrepancies (23.5% of all discrepancies). 50 ancillary molecular tests were performed, 33 for aiding diagnosis and 17 mutational analyses for gastrointestinal stromal tumour to guide therapy. Findings from ancillary techniques contributed to 3 major and 4 minor discrepancies. While the results were broadly similar to those of the previous study, there was an increase in frequency of major discrepancies. Conclusion. Six years following our previous study and notably now in an era of widespread ancillary molecular diagnosis, the overall discrepancy rate between referral and tertiary centre diagnosis remains similar, but there is an increase in frequency of major discrepancies likely to alter patient management. A possible reason for the increase in major discrepancies is the increasing lack of exposure to soft tissue cases in nonspecialist centres in a time of subspecialisation. The findings support the national guidelines in which all suspected soft tissue tumour pathology specimens should be referred to a specialist sarcoma unit. PMID:25165418

  9. Histopathological diagnostic discrepancies in soft tissue tumours referred to a specialist centre: reassessment in the era of ancillary molecular diagnosis.

    PubMed

    Thway, Khin; Wang, Jayson; Mubako, Taka; Fisher, Cyril

    2014-01-01

    Introduction. Soft tissue tumour pathology is a highly specialised area of surgical pathology, but soft tissue neoplasms can occur at virtually all sites and are therefore encountered by a wide population of surgical pathologists. Potential sarcomas require referral to specialist centres for review by pathologists who see a large number of soft tissue lesions and where appropriate ancillary investigations can be performed. We have previously assessed the types of diagnostic discrepancies between referring and final diagnosis for soft tissue lesions referred to our tertiary centre. We now reaudit this 6 years later, assessing changes in discrepancy patterns, particularly in relation to the now widespread use of ancillary molecular diagnostic techniques which were not prevalent in our original study. Materials and Methods. We compared the sarcoma unit's histopathology reports with referring reports on 348 specimens from 286 patients with suspected or proven soft tissue tumours in a one-year period. Results. Diagnostic agreement was seen in 250 cases (71.8%), with 57 (16.4%) major and 41 (11.8%) minor discrepancies. There were 23 cases of benign/malignant discrepancies (23.5% of all discrepancies). 50 ancillary molecular tests were performed, 33 for aiding diagnosis and 17 mutational analyses for gastrointestinal stromal tumour to guide therapy. Findings from ancillary techniques contributed to 3 major and 4 minor discrepancies. While the results were broadly similar to those of the previous study, there was an increase in frequency of major discrepancies. Conclusion. Six years following our previous study and notably now in an era of widespread ancillary molecular diagnosis, the overall discrepancy rate between referral and tertiary centre diagnosis remains similar, but there is an increase in frequency of major discrepancies likely to alter patient management. A possible reason for the increase in major discrepancies is the increasing lack of exposure to soft tissue cases in nonspecialist centres in a time of subspecialisation. The findings support the national guidelines in which all suspected soft tissue tumour pathology specimens should be referred to a specialist sarcoma unit.

  10. Characteristics of effective health and safety committees: survey results.

    PubMed

    Morse, Tim; Bracker, Anne; Warren, Nicholas; Goyzueta, Jeanette; Cook, Matthew

    2013-02-01

    Although perhaps the most common worker-management structure, there has been surprisingly little research on describing and evaluating the characteristics of health and safety committees. A survey of 380 health and safety committee members from 176 manufacturing workplaces was supplemented with administrative data and compared with reported workers' compensation rates. Survey respondents also reported perceptions of overall safety, committee, effectiveness, committee activities, and "best practices." Extensive descriptive data is presented, including a mean of 8.7 members per committee spending 1,167 hr per year on committee business for an estimate of $40,500 worth of time per committee. Higher speed to correct action items, a focus on ergonomics, and planning for safety training was associated with lower injury rates. The discrepancy between managers and hourly committee members in estimating overall safety was strongly positively associated with injury rates. Communications and worker involvement may be important to address discrepancy issues. Prospective studies are needed to distinguish directionality of associations. Copyright © 2012 Wiley Periodicals, Inc.

  11. Management of a growing Skeletal Class II Patient: A Case Report.

    PubMed

    Sharma, Narendra Shriram

    2013-01-01

    Sagittal and transverse discrepancies often coexist in skeletal class II malocclusions. Orthopedic growth modification can work well in such cases, provided that the remaining pubertal growth is adequate and that the clinician can provide timely treatment to coincide with the peak growth period. The transverse discrepancy is generally corrected first, establishing a proper base for the sagittal correction to follow. For example, in a skeletal class II case with a narrow maxillary arch and retrusive mandible, maxillary expansion is performed initially to facilitate functional mandibular advancement. The present article illustrates an exception to this rule, in a case where sagittal correction was undertaken before transverse correction to make optimal use of the patient's pubertal growth spurt in first phase followed by a second phase of fixed appliance therapy during adolescence to achieve optimal results. How to cite this article: Sharma NS. Management of a growing Skeletal Class II Patient: A Case Report. Int J Clin Pediatr Dent 2013;6(1):48-54.

  12. Three parallel information systems for malaria elimination in Swaziland, 2010-2015: are the numbers the same?

    PubMed

    Zulu, Z; Kunene, S; Mkhonta, N; Owiti, P; Sikhondze, W; Mhlanga, M; Simelane, Z; Geoffroy, E; Zachariah, R

    2018-04-25

    Background: To be able to eliminate malaria, accurate, timely reporting and tracking of all confirmed malaria cases is crucial. Swaziland, a country in the process of eliminating malaria, has three parallel health information systems. Design: This was a cross-sectional study using country-wide programme data from 2010 to 2015. Methods: The Malaria Surveillance Database System (MSDS) is a comprehensive malaria database, the Immediate Disease Notification System (IDNS) is meant to provide early warning and trigger case investigations to prevent onward malaria transmission and potential epidemics, and the Health Management Information Systems (HMIS) reports on all morbidity at health facility level. Discrepancies were stratified by health facility level and type. Results: Consistent over-reporting of 9-85% was noticed in the HMIS, principally at the primary health care level (clinic and/or health centre). In the IDNS, the discrepancy went from under-reporting (12%) to over-reporting (32%); this was also seen at the primary care level. At the hospital level, there was under-reporting in both the HMIS and IDNS. Conclusions: There are considerable discrepancies in the numbers of confirmed malaria cases in the HMIS and IDNS in Swaziland. This may misrepresent the malaria burden and delay case investigation, predisposing the population to potential epidemics. There is an urgent need to improve data integrity in order to guide and evaluate efforts toward elimination.

  13. Three parallel information systems for malaria elimination in Swaziland, 2010–2015: are the numbers the same?

    PubMed Central

    Kunene, S.; Mkhonta, N.; Owiti, P.; Sikhondze, W.; Mhlanga, M.; Simelane, Z.; Geoffroy, E.; Zachariah, R.

    2018-01-01

    Background: To be able to eliminate malaria, accurate, timely reporting and tracking of all confirmed malaria cases is crucial. Swaziland, a country in the process of eliminating malaria, has three parallel health information systems. Design: This was a cross-sectional study using country-wide programme data from 2010 to 2015. Methods: The Malaria Surveillance Database System (MSDS) is a comprehensive malaria database, the Immediate Disease Notification System (IDNS) is meant to provide early warning and trigger case investigations to prevent onward malaria transmission and potential epidemics, and the Health Management Information Systems (HMIS) reports on all morbidity at health facility level. Discrepancies were stratified by health facility level and type. Results: Consistent over-reporting of 9–85% was noticed in the HMIS, principally at the primary health care level (clinic and/or health centre). In the IDNS, the discrepancy went from under-reporting (12%) to over-reporting (32%); this was also seen at the primary care level. At the hospital level, there was under-reporting in both the HMIS and IDNS. Conclusions: There are considerable discrepancies in the numbers of confirmed malaria cases in the HMIS and IDNS in Swaziland. This may misrepresent the malaria burden and delay case investigation, predisposing the population to potential epidemics. There is an urgent need to improve data integrity in order to guide and evaluate efforts toward elimination. PMID:29713588

  14. Feminine Discrepancy Stress and Psychosocial Maladjustment Among Adolescent Girls.

    PubMed

    Reidy, Dennis E; Kernsmith, Poco D; Malone, Carolyn A; Vivolo-Kantor, Alana M; Smith-Darden, Joanne P

    2018-04-01

    Discrepancy stress, stress about being perceived to not conform to one's gender role (i.e., gender role discrepancy), has demonstrated effects on risky sexual and violent behaviors. However, evidence of these effects has been limited to men and boys, neglecting the impact gender role discrepancy and discrepancy stress may have on girls. In addition, no study to date, has assessed the mental health correlates of gender role discrepancy and discrepancy stress. In the current study, we sought to elucidate the relationship between perceived feminine discrepancy and feminine discrepancy stress and psychosocial maladjustment while controlling for trauma symptoms stemming from the potential repercussions of feminine discrepancy. Maladjustment was measured by creating a second-order latent factor derived from four first-order latent constructs: sexual behavior, substance use, mood disorder symptoms, and hopelessness. Data are drawn from a cross-sectional sample of female students in middle and high school (N = 643) who completed self-report questionnaires. Using structural equation modeling, we found girls reporting feminine discrepancy (i.e., less feminine than the average girl) were more likely to report feminine discrepancy stress and trauma symptomatology. Controlling for feminine discrepancy and trauma symptoms, the relationship between discrepancy stress and maladjustment was positive and significant. Additionally, girls reporting feminine discrepancy scored higher on trauma symptomatology, and trauma demonstrated a strong direct effect on psychosocial maladjustment. These data suggest that developing trauma focused prevention strategies that incorporate social norms around gender socialization may have an impact on multiple behavioral and mental health problems.

  15. Reporter Discrepancies among Parents, Adolescents, and Peers: Adolescent Attachment and Informant Depressive Symptoms as Explanatory Factors

    ERIC Educational Resources Information Center

    Ehrlich, Katherine B.; Cassidy, Jude; Dykas, Matthew J.

    2011-01-01

    The issue of informant discrepancies about child and adolescent functioning is an important concern for clinicians, developmental psychologists, and others who must consider ways of handling discrepant reports of information, but reasons for discrepancies in reports have been poorly understood. Adolescent attachment and informant depressive…

  16. Difficulty in detecting discrepancies in a clinical trial report: 260-reader evaluation

    PubMed Central

    Cole, Graham D; Shun-Shin, Matthew J; Nowbar, Alexandra N; Buell, Kevin G; Al-Mayahi, Faisal; Zargaran, David; Mahmood, Saliha; Singh, Bharpoor; Mielewczik, Michael; Francis, Darrel P

    2015-01-01

    Background: Scientific literature can contain errors. Discrepancies, defined as two or more statements or results that cannot both be true, may be a signal of problems with a trial report. In this study, we report how many discrepancies are detected by a large panel of readers examining a trial report containing a large number of discrepancies. Methods: We approached a convenience sample of 343 journal readers in seven countries, and invited them in person to participate in a study. They were asked to examine the tables and figures of one published article for discrepancies. 260 participants agreed, ranging from medical students to professors. The discrepancies they identified were tabulated and counted. There were 39 different discrepancies identified. We evaluated the probability of discrepancy identification, and whether more time spent or greater participant experience as academic authors improved the ability to detect discrepancies. Results: Overall, 95.3% of discrepancies were missed. Most participants (62%) were unable to find any discrepancies. Only 11.5% noticed more than 10% of the discrepancies. More discrepancies were noted by participants who spent more time on the task (Spearman’s ρ = 0.22, P < 0.01), and those with more experience of publishing papers (Spearman’s ρ = 0.13 with number of publications, P = 0.04). Conclusions: Noticing discrepancies is difficult. Most readers miss most discrepancies even when asked specifically to look for them. The probability of a discrepancy evading an individual sensitized reader is 95%, making it important that, when problems are identified after publication, readers are able to communicate with each other. When made aware of discrepancies, the majority of readers support editorial action to correct the scientific record. PMID:26174517

  17. Mother-son discrepant reporting on parenting practices: The contribution of temperament and depression.

    PubMed

    Shishido, Yuri; Latzman, Robert D

    2017-06-01

    Despite low to moderate convergent correlations, assessment of youth typically relies on multiple informants for information across a range of psychosocial domains including parenting practices. Although parent-youth informant discrepancies have been found to predict adverse youth outcomes, few studies have examined contributing factors to the explanation of informant disagreements on parenting practices. The current study represents the first investigation to concurrently examine the role of mother and son's self-reported affective dimensions of temperament and depression as pathways to informant discrepancies on parenting practices. Within a community sample of 174 mother-son dyads, results suggest that whereas mother's self-reported temperament evidenced no direct effects on discrepancies, the association between the product term of mother's negative and positive temperament and discrepancies on positive parenting was fully mediated by mother's depression (a mediated moderation). In contrast, son's self-reported temperament evidenced both direct and indirect effects, partially mediated by depression, on rating discrepancies for positive parenting. All told, both son's self-reported affective dimensions of temperament and depression contributed to the explanation of discrepant reporting on parenting practices; only mother's self-reported depression, but not temperament, uniquely contributed. Results highlight the importance of considering both parent and youth's report in the investigation of informant discrepancies on parenting practices. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. The medication reconciliation process and classification of discrepancies: a systematic review.

    PubMed

    Almanasreh, Enas; Moles, Rebekah; Chen, Timothy F

    2016-09-01

    Medication reconciliation is a part of the medication management process and facilitates improved patient safety during care transitions. The aims of the study were to evaluate how medication reconciliation has been conducted and how medication discrepancies have been classified. We searched MEDLINE, EMBASE, CINAHL, PubMed, International Pharmaceutical Abstracts (IPA), and Web of Science (WOS), in accordance with the PRISMA statement up to April 2016. Studies were eligible for inclusion if they evaluated the types of medication discrepancy found through the medication reconciliation process and contained a classification system for discrepancies. Data were extracted by one author based on a predefined table, and 10% of included studies were verified by two authors. Ninety-five studies met the inclusion criteria. Approximately one-third of included studies (n = 35, 36.8%) utilized a 'gold' standard medication list. The majority of studies (n = 57, 60%) used an empirical classification system and the number of classification terms ranged from 2 to 50 terms. Whilst we identified three taxonomies, only eight studies utilized these tools to categorize discrepancies, and 11.6% of included studies used different patient safety related terms rather than discrepancy to describe the disagreement between the medication lists. We suggest that clear and consistent information on prevalence, types, causes and contributory factors of medication discrepancy are required to develop suitable strategies to reduce the risk of adverse consequences on patient safety. Therefore, to obtain that information, we need a well-designed taxonomy to be able to accurately measure, report and classify medication discrepancies in clinical practice. © 2016 The British Pharmacological Society.

  19. A Social Domain Approach to Informant Discrepancies in Parental Solicitation and Family Rules.

    PubMed

    Metzger, Aaron; Babskie, Elizabeth; Olson, Rebecca; Romm, Katelyn

    2016-10-01

    An extensive body of research has explored the effects of parental monitoring on adolescent outcomes, but studies consistently find substantial discrepancies between parent and adolescent reports of different monitoring behaviors. Little research has examined whether parents and adolescents are more or less discrepant when reporting on parents' rules or solicitation for different adolescent problem and health risk behaviors and few studies have explored potential explanatory variables to explicate individual variability in parent-adolescent discrepant reporting. To address this gap in the literature, the current study examined discrepancies in mother-adolescent reports of family rules and solicitation across five distinct adolescent behaviors: personal behaviors and four different risk behaviors (alcohol-related, cyber, over- and under-eating). Participants were 143 mother-adolescent dyads (Adolescent M age  = 14.42, SD = 1.73, range = 12-18, 81 % white, 60 % female). Mean-level discrepancies between maternal and adolescent reports significantly differed by category of adolescent behavior and also varied as a function of reported parental monitoring behavior (rules vs. solicitation). Discrepancies in mother-adolescent reports of behavior-specific rules and solicitation were positively associated with discrepancies in mother and adolescent judgments of the harmfulness of the activities. The results demonstrate that discrepancies in mother-adolescent reports of family process differ by category of adolescent behavior and may be undergirded by differences in mother and adolescent informational assumptions about the potential harm involved with different activities.

  20. Internal Consistency and Associated Characteristics of Informant Discrepancies in Clinic Referred Youths Age 11 to 17 Years

    PubMed Central

    De Los Reyes, Andres; Youngstrom, Eric A.; Pabón, Shairy C.; Youngstrom, Jennifer K.; Feeny, Norah C.; Findling, Robert L.

    2011-01-01

    In this study, we examined the internal consistency of informant discrepancies in reports of youth behavior and emotional problems and their unique relations with youth, caregiver, and family characteristics. In a heterogeneous multisite clinic sample of 420 youths (ages 11 to 17 years), high internal consistency estimates were observed across measures of informant discrepancies. Further, latent profile analyses identified systematic patterns of discrepancies, characterized by their magnitude and direction (i.e., which informant reported greater youth problems). Additionally, informant discrepancies systematically and uniquely related to informants' own perspectives of youth mood problems, and these relations remained significant after taking into account multiple informants' reports of informant characteristics widely known to relate to informant discrepancies. These findings call into the question the prevailing view of informant discrepancies as indicative of unreliability and/or bias on the part of informants' reports of youths' behavior. PMID:21229442

  1. Medication discrepancies associated with subsequent pharmacist-performed medication reconciliations in an ambulatory clinic.

    PubMed

    Philbrick, Ann M; Harris, Ila M; Schommer, Jon C; Fallert, Christopher J

    2015-01-01

    To describe the number of medication discrepancies associated with subsequent medication reconciliations by a clinical pharmacist in an ambulatory family medicine clinic and the proportion of subsequent medication reconciliation visits that were associated with hospital discharge, long-term anticoagulation management, or both. Data on medication reconciliations were collected over a 2-year time period in an ambulatory family medicine clinic for patients taking 10 or more medications. Medication reconciliation was performed 752 times for 500 patients. A total of 5,046 discrepancies were identified, with more than one-half deemed clinically important. A mean (± SD) of 6.7 ± 4.6 discrepancies per visit (3.5 ± 3.2 clinically important) were identified. The findings showed that the distribution of total discrepancies identified by pharmacist-performed medication reconciliation was significantly different over the course of subsequent medication reconciliations. However, the distribution of clinically important discrepancies was not significantly different; important discrepancies were as likely to be found in later reconciliations as in earlier ones. As subsequent medication reconciliation visits were performed, an increasing proportion consisted of post-hospital discharge visits, long-term anticoagulation managed by a clinical pharmacist, or both. Patients with a recent hospital discharge, on long-term anticoagulation management, or both, were more likely to have multiple sessions with a clinical pharmacist for medication reconciliation. These findings can help identify patients for whom medication reconciliation is warranted.

  2. Organizational Leaders’ and Staff Members’ Appraisals of Their Work Environment Within a Children’s Social Service System

    PubMed Central

    Patterson, David A.; Dulmus, Catherine; Maguin, Eugene; Keesler, John; Powell, Byron

    2014-01-01

    Several studies have demonstrated the effect of an organization’s culture and climate on the delivery of services to clients and the success of clinical outcomes. Workers’ perceptions are integral components of organizational social context, and in order to create a positive organizational culture and climate, managers and frontline staff need to have a shared understanding of the social context. The existing literature does not adequately address that discrepancies in perceptions of culture and climate between frontline staff and managers impact the implementation of policies and services. The purpose of this study is to compare the workgroup-level culture and climate of a single, large child and family social services organization, based on the reported experiences of front-line workers and senior managers. The results showed that, as a group, senior managers rated the organization as having a culture that was much more proficient and much less rigid and a climate that was more engaged and more functional than the average frontline workgroup. The discrepancies between the perceptions of upper management and workgroup-level staff indicate the need for interventions that can improve communication and cohesiveness between these two groups. PMID:25101308

  3. Helping the auto repair industry manage hazardous wastes: an education project in King County, Washington.

    PubMed

    McKenrick, Laurence L; Ii, Keiko; Lawrence, Bill; Kaufmann, Michael; Marshall, Mark

    2003-11-01

    From January 1, 2000, to August 31, 2001, a team of environmental health specialists from Public Health-Seattle & King County, a partner in King County's Local Hazardous Waste Management Program, made educational visits to 981 automotive repair shops. The purpose was to give the auto repair industry technical assistance on hazardous waste management without using enforcement action. Through site inspections and interviews, the environmental health staff gathered information on the types and amounts of conditionally exempt small-quantity generator (CESQG) hazardous wastes and how they were handled. Proper methods of hazardous waste management, storage, and disposal were discussed with shop personnel. The environmental health staff measured the impact of these educational visits by noting changes made between the initial and follow-up visits. This report focuses on nine major waste streams identified in the auto repair industry. Of the 981 shops visited, 497 were already practicing proper hazardous waste management and disposal. The remaining 484 shops exhibited 741 discrepancies from proper practice. Environmental health staff visited these shops again within six months of the initial visit to assess changes in their practices. The educational visits and technical assistance produced a 76 percent correction of all the discrepancies noted.

  4. Differences between orthopaedic evaluation and radiological reports of conventional radiographs in patients with minor trauma admitted to the emergency department.

    PubMed

    Catapano, Michele; Albano, Domenico; Pozzi, Grazia; Accetta, Riccardo; Memoria, Sergio; Pregliasco, Fabrizio; Messina, Carmelo; Sconfienza, Luca Maria

    2017-11-01

    During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of delayed diagnosis in terms of patient management and therapeutic strategy. We retrospectively reviewed all cases of discrepancy between orthopaedists and radiologists, which were categorized according to anatomical location of injury, initial diagnosis and treatment, change in diagnosis and treatment. We used the Chi square test to compare the frequencies of discrepancies between patients ≤14 and >14years of age. From January to December 2016, 19,512 patients admitted to our emergency department performed at least an imaging examination; among these patients, 13,561 underwent XR in absence of an attending radiologist. A discrepant diagnosis was found in 337/13,561 (2.5%; 184 males; mean age: 36.7±23.7, range 2-95); 151/337 (45%) discrepancies were encountered in the lower limbs, with ankle being the most common site of misdiagnosis (64/151), and 103/337 (30%) in the upper limbs, with the elbow being the most frequent site in this district (35/103). We found 293/337 false negatives (87%) and 44/337 false positives (13%), with 134 and 13 patients needing treatment change, respectively. We found 85/337 discrepancies (25%) in patients ≤14 years of age, and 252/337 (75%) in those >14years. The distribution of discrepancies per anatomic district was significantly different (P<0.001) in these two groups of patients. A low rate of discrepancy between orthopaedists and radiologists in evaluating images of patients admitted to our emergency department was found, although treatment change occurred in about half of cases. A thorough and accurate clinical evaluation is crucial to provide a correct treatment and prognosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. 41 CFR 101-26.803-3 - Reporting of discrepancies in transportation, shipments, material, or billings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... discrepancies in transportation, shipments, material, or billings. 101-26.803-3 Section 101-26.803-3 Public... REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.8-Discrepancies or Deficiencies in GSA or DOD Shipments, Material, or Billings § 101-26.803-3 Reporting of discrepancies in...

  6. Diagnostic Discrepancies in Mandatory Slide Review of Extradepartmental Head and Neck Cases: Experience at a Large Academic Center.

    PubMed

    Mehrad, Mitra; Chernock, Rebecca D; El-Mofty, Samir K; Lewis, James S

    2015-12-01

    Medical error is a significant problem in the United States, and pathologic diagnoses are a significant source of errors. Prior studies have shown that second-opinion pathology review results in clinically major diagnosis changes in approximately 0.6% to 5.8% of patients. The few studies specifically on head and neck pathology have suggested rates of changed diagnoses that are even higher. Objectives .- To evaluate the diagnostic discrepancy rates in patients referred to our institution, where all such cases are reviewed by a head and neck subspecialty service, and to identify specific areas with more susceptibility to errors. Five hundred consecutive, scanned head and neck pathology reports from patients referred to our institution were compared for discrepancies between the outside and in-house diagnoses. Major discrepancies were defined as those resulting in a significant change in patient clinical management and/or prognosis. Major discrepancies occurred in 20 cases (4% overall). Informative follow-up material was available on 11 of the 20 patients (55.0%), among whom, the second opinion was supported in 11 of 11 cases (100%). Dysplasia versus invasive squamous cell carcinoma was the most common (7 of 20; 35%) area of discrepancy, and by anatomic subsite, the sinonasal tract (4 of 21; 19.0%) had the highest rate of discrepant diagnoses. Of the major discrepant diagnoses, 12 (12 of 20; 60%) involved a change from benign to malignant, one a change from malignant to benign (1 of 20; 5%), and 6 involved tumor classification (6 of 20; 30%). Head and neck pathology is a relatively high-risk area, prone to erroneous diagnoses in a small fraction of patients. This study supports the importance of second-opinion review by subspecialized pathologists for the best care of patients.

  7. Understanding and Using Informants Reporting Discrepancies of Youth Victimization: A Conceptual Model and Recommendations for Research

    ERIC Educational Resources Information Center

    Goodman, Kimberly L.; De Los Reyes, Andres; Bradshaw, Catherine P.

    2010-01-01

    Discrepancies often occur among informants' reports of various domains of child and family functioning and are particularly common between parent and child reports of youth violence exposure. However, recent work suggests that discrepancies between parent and child reports predict subsequent poorer child outcomes. We propose a preliminary…

  8. Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

    PubMed

    Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care facilities. The accuracy and safety of these systems has not been studied. What does this paper add? The present study identified discrepancies between general practitioners' orders and pharmacy-prepared electronic medication administration charts, back-up paper medication charts and dose-administration aids, as well as delays between ordering, charting and administering medicines. Discrepancies and delays sometimes led to medication administration errors. What are the implications for practitioners? Facilities that use hybrid systems need to implement robust systems for communicating medication changes to their pharmacy and reconciling prescribers' orders against pharmacy-generated medication charts and dose-administration aids. Fully integrated, paperless medication management systems, in which prescribers' electronic medication orders directly populate an electronic medication administration chart and are automatically communicated to the facility's pharmacy, could improve patient safety.

  9. Continuing discrepancy between patient perception of asthma control and real-world symptoms: a quantitative online survey of 1,083 adults with asthma from the UK.

    PubMed

    Fletcher, Monica; Hiles, David

    2013-12-01

    Previous studies have identified a discrepancy between patient perception of asthma control and real-world symptoms; despite several hypotheses, the reasons remain unclear. To explore patients' experiences of asthma symptoms and disease management and their educational needs in the UK; to assess recent progress in asthma control and management. A quantitative questionnaire-based online survey of UK patients aged >18 years with self-reported asthma. Of the 1,083 individuals (55% female, 49% aged >55 years) who completed the survey, 79% described their asthma control as 'good' or 'very good'. Despite this, in the previous 2 years, 65% had experienced 'frequent' day-time symptoms, 37% had 'frequent' night-time symptoms, and 25% had used oral steroids for asthma; 41% of those prescribed a reliever inhaler used it >1 a day. Overall, 76% had a 'good' or 'very good' relationship with their healthcare professional (HCP); 32% had not attended regular asthma reviews and only 12% were using a personal asthma action plan. Moreover, 70% of respondents felt that they had the 'main responsibility' for managing their asthma; 29% believed this responsibility to be shared with their HCP. This survey indicates a continuing discrepancy between patient perception of asthma control and real-world symptoms, with little change from previous studies. Many patients accept symptoms as the norm. The diversity among respondents' attitudes demonstrates a need to help patients change some of their beliefs and understanding about asthma, and to improve asthma management with better education about the understanding of control for patients and HCPs.

  10. Discrepancy in reports of support exchanges between parents and adult offspring: within- and between-family differences.

    PubMed

    Kim, Kyungmin; Zarit, Steven H; Birditt, Kira S; Fingerman, Karen L

    2014-04-01

    Using data from 929 parent-child dyads nested in 458 three-generation families (aged 76 for the oldest generation, 50 for the middle generation, and 24 for the youngest generation), this study investigated how discrepancies in reports of support that parents and their adult offspring exchanged with one another vary both within and between families, and what factors explain variations in dyadic discrepancies. We found substantial within- and between-family differences in dyadic discrepancies in reports of support exchanges. For downward exchanges (from parents to offspring), both dyad-specific characteristics within a family (e.g., gender composition, relative levels of relationship quality, and family obligation) and shared family characteristics (e.g., average levels of relationship quality) showed significant effects on dyadic discrepancies. For upward exchanges (from offspring to parents), however, only dyad-specific characteristics (e.g., gender composition, coresidence, relative levels of positive relationship quality, and family obligation) were significantly associated with discrepancies. Discrepancies in support exchanges were mainly associated with dyad-specific characteristics, but they also appeared to be influenced by family emotional environments. The use of multiple informants revealed that families differ in discrepancies in reports of exchanges, which has implications for quality of family life as well as future exchanges. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  11. Discrepancy in Reports of Support Exchanges between Parents and Adult Offspring: Within- and Between-Family Differences

    PubMed Central

    Kim, Kyungmin; Zarit, Steven H.; Birditt, Kira S.; Fingerman, Karen L.

    2014-01-01

    Using data from 929 parent-child dyads nested in 458 three-generation families (aged 76 for the oldest generation, 50 for the middle generation, and 24 for the youngest generation), this study investigated how discrepancies in reports of support that parents and their adult offspring exchanged with one another vary both within and between families, and what factors explain variations in dyadic discrepancies. We found substantial within- and between-family differences in dyadic discrepancies in reports of support exchanges. For downward exchanges (from parents to offspring), both dyad-specific characteristics within a family (e.g., gender composition, relative levels of relationship quality, and family obligation) and shared family characteristics (e.g., average levels of relationship quality) showed significant effects on dyadic discrepancies. For upward exchanges (from offspring to parents), however, only dyad-specific characteristics (e.g., gender composition, coresidence, relative levels of positive relationship quality, and family obligation) were significantly associated with discrepancies. Discrepancies in support exchanges were mainly associated with dyad-specific characteristics, but they also appeared to be influenced by family emotional environments. The use of multiple informants revealed that families differ in discrepancies in reports of exchanges, which has implications for quality of family life as well as future exchanges. PMID:24548009

  12. Evidence of selective reporting bias in hematology journals: A systematic review

    PubMed Central

    Scheckel, Caleb; Hicks, Chandler; Nissen, Timothy; Leduc, Linda; Som, Mousumi; Vassar, Matt

    2017-01-01

    Introduction Selective reporting bias occurs when chance or selective outcome reporting rather than the intervention contributes to group differences. The prevailing concern about selective reporting bias is the possibility of results being modified towards specific conclusions. In this study, we evaluate randomized controlled trials (RCTs) published in hematology journals, a group in which selective outcome reporting has not yet been explored. Methods Our primary goal was to examine discrepancies between the reported primary and secondary outcomes in registered and published RCTs concerning hematological malignancies reported in hematology journals with a high impact factor. The secondary goals were to address whether outcome reporting discrepancies favored statistically significant outcomes, whether a pattern existed between the funding source and likelihood of outcome reporting bias, and whether temporal trends were present in outcome reporting bias. For trials with major outcome discrepancies, we contacted trialists to determine reasons for these discrepancies. Trials published between January 1, 2010 and December 31, 2015 in Blood; British Journal of Haematology; American Journal of Hematology; Leukemia; and Haematologica were included. Results Of 499 RCTs screened, 109 RCTs were included. Our analysis revealed 118 major discrepancies and 629 total discrepancies. Among the 118 discrepancies, 30 (25.4%) primary outcomes were demoted, 47 (39.8%) primary outcomes were omitted, and 30 (25.4%) primary outcomes were added. Three (2.5%) secondary outcomes were upgraded to a primary outcome. The timing of assessment for a primary outcome changed eight (6.8%) times. Thirty-one major discrepancies were published with a P-value and twenty-five (80.6%) favored statistical significance. A majority of authors whom we contacted cited a pre-planned subgroup analysis as a reason for outcome changes. Conclusion Our results suggest that outcome changes occur frequently in hematology trials. Because RCTs ultimately underpin clinical judgment and guide policy implementation, selective reporting could pose a threat to medical decision making. PMID:28570573

  13. Adolescent and parent diabetes distress in type 1 diabetes: the role of self-efficacy, perceived consequences, family responsibility and adolescent-parent discrepancies.

    PubMed

    Law, G Urquhart; Walsh, Jennifer; Queralt, Victoria; Nouwen, Arie

    2013-04-01

    To examine the association of adolescent and parent diabetes distress with perceived consequences, dietary self-efficacy, and discrepancies in diabetes family responsibility, in type 1 diabetes (T1D). 203 adolescents with T1D, aged 12-18, and their parents completed self-report questionnaires cross-sectionally. Higher HbA1c, greater perceived negative consequences of diabetes, and reduced self-efficacy predicted adolescent diabetes distress. Higher HbA1c predicted parental diabetes distress, as did diabetes family responsibility disagreements when both family members claimed responsibility, and parents' perception of reduced adolescent self-efficacy. Dietary self-efficacy and perceived negative consequences of diabetes are important factors to consider in assessing and managing adolescent diabetes distress. Perceptions of family responsibility for self-care tasks and parental confidence in adolescents' self-management have implications for parental diabetes distress. Clinical implications support long-held recommendations of taking a family-perspective of T1D care. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Discrepancy between Mother and Child Reports of Parental Knowledge and the Relation to Risk Behavior Engagement

    ERIC Educational Resources Information Center

    Reynolds, Elizabeth K.; MacPherson, Laura; Matusiewicz, Alexis K.; Schreiber, Whitney M.; Lejuez, C. W.

    2011-01-01

    The study examined discrepancies in mother and child reports of parental knowledge (PK) of a child's whereabouts, activities, and companions, as well as the extent to which discrepancies in reports of PK are related to child risk-taking behavior concurrently and prospectively across two time points. The sample consisted of 219 mother and early…

  15. Assessing dependency using self-report and indirect measures: examining the significance of discrepancies.

    PubMed

    Cogswell, Alex; Alloy, Lauren B; Karpinski, Andrew; Grant, David A

    2010-07-01

    The present study addressed convergence between self-report and indirect approaches to assessing dependency. We were moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to 2 self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology and identified implicit dependency as contributing unique variance in predicting past major depression.

  16. The Glass Half Empty: How Emotional Exhaustion Affects the State-Trait Discrepancy in Self-Reports of Teaching Emotions

    PubMed Central

    Goetz, Thomas; Becker, Eva S.; Bieg, Madeleine; Keller, Melanie M.; Frenzel, Anne C.; Hall, Nathan C.

    2015-01-01

    Following from previous research on intensity bias and the accessibility model of emotional self-report, the present study examined the role of emotional exhaustion in explaining the discrepancy in teachers’ reports of their trait (habitual) versus state (momentary, “real”) emotions. Trait reports (habitual emotions, exhaustion) were assessed via trait questionnaires, and state reports (momentary emotions) were assessed in real time via the experience sampling method by using personal digital assistants (N = 69 high school teachers; 1,089 measures within teachers). In line with our assumptions, multi-level analyses showed that, as compared to the state assessment, teachers reported higher levels of habitual teaching-related emotions of anger, anxiety, shame, boredom, enjoyment, and pride. Additionally, the state-trait discrepancy in self-reports of negative emotions was accounted for by teachers’ emotional exhaustion, with high exhaustion levels corresponding with a greater state-trait discrepancy. Exhaustion levels did not moderate the state-trait discrepancy in positive emotions indicating that perceived emotional exhaustion may reflect identity-related cognitions specific to the negative belief system. Implications for research and educational practice are discussed. PMID:26368911

  17. The Glass Half Empty: How Emotional Exhaustion Affects the State-Trait Discrepancy in Self-Reports of Teaching Emotions.

    PubMed

    Goetz, Thomas; Becker, Eva S; Bieg, Madeleine; Keller, Melanie M; Frenzel, Anne C; Hall, Nathan C

    2015-01-01

    Following from previous research on intensity bias and the accessibility model of emotional self-report, the present study examined the role of emotional exhaustion in explaining the discrepancy in teachers' reports of their trait (habitual) versus state (momentary, "real") emotions. Trait reports (habitual emotions, exhaustion) were assessed via trait questionnaires, and state reports (momentary emotions) were assessed in real time via the experience sampling method by using personal digital assistants (N = 69 high school teachers; 1,089 measures within teachers). In line with our assumptions, multi-level analyses showed that, as compared to the state assessment, teachers reported higher levels of habitual teaching-related emotions of anger, anxiety, shame, boredom, enjoyment, and pride. Additionally, the state-trait discrepancy in self-reports of negative emotions was accounted for by teachers' emotional exhaustion, with high exhaustion levels corresponding with a greater state-trait discrepancy. Exhaustion levels did not moderate the state-trait discrepancy in positive emotions indicating that perceived emotional exhaustion may reflect identity-related cognitions specific to the negative belief system. Implications for research and educational practice are discussed.

  18. Assessing Dependency using Self-report and Indirect Measures: Examining the Significance of Discrepancies

    PubMed Central

    Cogswell, Alex; Alloy, Lauren B.; Karpinski, Andrew; Grant, David

    2011-01-01

    The present study addressed convergence between self-report and indirect approaches to assessing dependency. The study was moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to two self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology, and identified implicit dependency as contributing unique variance in predicting past major depression. PMID:20552505

  19. Second-opinion interpretations of neuroimaging studies by oncologic neuroradiologists can help reduce errors in cancer care.

    PubMed

    Hatzoglou, Vaios; Omuro, Antonio M; Haque, Sofia; Khakoo, Yasmin; Ganly, Ian; Oh, Jung Hun; Shukla-Dave, Amita; Fatovic, Robin; Gaal, Joshua; Holodny, Andrei I

    2016-09-01

    The purpose of this study was to investigate the utility and clinical impact of second-opinion interpretations of outside neuroimaging studies by oncologic neuroradiologists at a National Cancer Institute-designated cancer center. We performed a retrospective analysis of initial outside and second-opinion radiology reports from 300 computed tomography and magnetic resonance imaging studies and identified cases with discrepancies between the two reports. An adult neuro-oncologist, pediatric neuro-oncologist, and head and neck surgeon reviewed each pair of discrepant reports based on their area of expertise, patient age, and the type of study performed. The clinicians were blinded to the origin of each report and recorded whether the differences in the reports would have led to a change in patient management and/or disease staging. Histopathologic analysis, clinical assessment, and/or minimum 3-month imaging follow-up served as the reference standards to establish which of the 2 reports was correct. Among the 283 cases that met our study criteria, there were 55 neuroimaging studies with disagreements (19%) between the initial outside report and second-opinion interpretation. Patient management and/or disease stage would have been altered in 42 of 283 cases (15%) based on report differences as determined by the 2 neuro-oncologists and the surgeon participating in the study. Sufficient follow-up was available in 35 of 42 cases (83%). The second-opinion interpretation was correct 100% of the time (35/35). Second-opinion interpretations of neuroimaging studies by subspecialized oncologic neuroradiologists provide added value by reducing error and optimizing the care of cancer patients. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2708-2714. © 2016 American Cancer Society. © 2016 American Cancer Society.

  20. The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method.

    PubMed

    Issa, Ghada; Taslakian, Bedros; Itani, Malak; Hitti, Eveline; Batley, Nicholas; Saliba, Miriam; El-Merhi, Fadi

    2015-05-01

    At teaching hospitals, radiology residents give preliminary reports for imaging studies requested from the Emergency Department (ED). Discrepancy rates between preliminary and final reports represent an important performance indicator. To present a system for feedback and follow-up of discrepancies, identify the variables associated with the rate and severity of such discrepancies, target the weaknesses, and suggest the need of a standard reference value for comparison among institutions. A monitoring and communication system between the Department of Diagnostic Radiology and Emergency Department was initiated to mark and follow all studies from the ED for which the official reading was different than the preliminary interpretation. Data analysis was performed on all studies from 1 June 2011 to 31 May 2012, based on the severity of the discrepancy, imaging modality, resident training level, and organ system. The distribution of the number of discrepancies among the different resident levels and imaging modalities was determined, as well as the distribution of three severity scores in correlation with other variables. The overall discrepancy rate was 1.62%. The discrepancy rate was higher for first and second year residents (1.62% and 1.96%) than for third and fourth year residents (1.35% and 1.24%). It was higher for computed tomography (2.13%) than for radiographs (1.29%) and ultrasound (0.8%) (P value < 0.01), and higher for musculoskeletal (1.61%) than non-musculoskeletal (0.99%) radiographs (P value = 0.0003). Discrepancies with severity score one constituted 35.5% of the total discrepancies, those with severity scores two and three constituted 22.9% and 41.6%, respectively. We have demonstrated a system for follow-up of discrepancy in interpreting emergency radiology studies, and recorded the discrepancy rate, with further analysis based on different variables. In terms of quality assurance, a periodical analysis might help to reduce the number of discrepant reports by targeted intervention. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Instructional and behavior management practices implemented by elementary general education teachers.

    PubMed

    Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis

    2013-12-01

    This investigation examined 317 general education kindergarten through fifth-grade teachers' use of instructional and behavioral management strategies as measured by the Classroom Strategy Scale (CSS)-Observer Form, a multidimensional tool for assessing classroom practices. The CSS generates frequency of strategy use and discrepancy scores reflecting the difference between recommended and actual frequencies of strategy use. Hierarchical linear models (HLMs) suggested that teachers' grade-level assignment was related to their frequency of using instructional and behavioral management strategies: Lower grade teachers utilized more clear 1 to 2 step commands, praise statements, and behavioral corrective feedback strategies than upper grade teachers, whereas upper grade teachers utilized more academic monitoring and feedback strategies, content/concept summaries, student focused learning and engagement, and student thinking strategies than lower grade teachers. Except for the use of praise statements, teachers' usage of instructional and behavioral management strategies was not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. HLMs suggested that teachers' grade level was related to their discrepancy scores of some instructional and behavioral management strategies: Upper grade teachers had higher discrepancy scores in academic performance feedback, behavioral feedback, and praise than lower grade teachers. Teachers' discrepancy scores of instructional and behavioral management strategies were not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. Implications of results for school psychology practice are outlined. © 2013.

  2. Principles Underlying the Use of Multiple Informants’ Reports

    PubMed Central

    De Los Reyes, Andres; Thomas, Sarah A.; Goodman, Kimberly L.; Kundey, Shannon M.A.

    2014-01-01

    Researchers use multiple informants’ reports to assess and examine behavior. However, informants’ reports commonly disagree. Informants’ reports often disagree in their perceived levels of a behavior (“low” vs. “elevated” mood), and examining multiple reports in a single study often results in inconsistent findings. Although researchers often espouse taking a multi-informant assessment approach, they frequently address informant discrepancies using techniques that treat discrepancies as measurement error. Yet, recent work indicates that researchers in a variety of fields often may be unable to justify treating informant discrepancies as measurement error. In this paper, the authors advance a framework (Operations Triad Model) outlining general principles for using and interpreting informants’ reports. Using the framework, researchers can test whether or not they can extract meaningful information about behavior from discrepancies among multiple informants’ reports. The authors provide supportive evidence for this framework and discuss its implications for hypothesis testing, study design, and quantitative review. PMID:23140332

  3. Discrepancy rates in reporting of acute stroke CT.

    PubMed

    Astill, Christopher Sj; Agzarian, Marc J

    2017-06-01

    With increasing after-hours workloads there has been reliance on registrars to report after-hours acute stroke CT scans at our institution. This practice was reviewed for the perceived possibility of error and poor patient outcomes by the reliance on after-hours registrar reports. Through an audit of 3 years of these studies, we proposed to investigate if our current practice is safe and whether it results in poor patient outcomes. Following ethics approval, all after-hours acute stroke CT scan reports from September 2012 to August 2015 were identified using the PACS. All reports were reviewed with data recorded on a written worksheet then transferred to an Excel spreadsheet for analysis. The consultant report was used as the gold standard. In cases where discrepancies occurred, medical records were reviewed. Eight hundred and ninety-four acute stroke CT scans were identified in the audit period with a subset of 316 studies identified where a registrar report was issued at time of scan and checked the following day by a radiology consultant. There were 114 discrepancies (10 were major, 51 were minor, and 53 other). In three discrepancy cases, the patient's clinical course was altered. There were no adverse outcomes as a result of a discrepancy. Using a radiology consultant as the gold standard the major discrepancy rate was ≈3% in the after-hours setting. Our 3 year retrospective audit demonstrates that our practice of registrar report issued at the time of CT scan checked the following day by a radiologist has a low major discrepancy rate and that patient safety was not compromised. These results support the continuation of our current practice. © 2016 The Royal Australian and New Zealand College of Radiologists.

  4. Evidence for the Selective Reporting of Analyses and Discrepancies in Clinical Trials: A Systematic Review of Cohort Studies of Clinical Trials

    PubMed Central

    Dwan, Kerry; Altman, Douglas G.; Clarke, Mike; Gamble, Carrol; Higgins, Julian P. T.; Sterne, Jonathan A. C.; Williamson, Paula R.; Kirkham, Jamie J.

    2014-01-01

    Background Most publications about selective reporting in clinical trials have focussed on outcomes. However, selective reporting of analyses for a given outcome may also affect the validity of findings. If analyses are selected on the basis of the results, reporting bias may occur. The aims of this study were to review and summarise the evidence from empirical cohort studies that assessed discrepant or selective reporting of analyses in randomised controlled trials (RCTs). Methods and Findings A systematic review was conducted and included cohort studies that assessed any aspect of the reporting of analyses of RCTs by comparing different trial documents, e.g., protocol compared to trial report, or different sections within a trial publication. The Cochrane Methodology Register, Medline (Ovid), PsycInfo (Ovid), and PubMed were searched on 5 February 2014. Two authors independently selected studies, performed data extraction, and assessed the methodological quality of the eligible studies. Twenty-two studies (containing 3,140 RCTs) published between 2000 and 2013 were included. Twenty-two studies reported on discrepancies between information given in different sources. Discrepancies were found in statistical analyses (eight studies), composite outcomes (one study), the handling of missing data (three studies), unadjusted versus adjusted analyses (three studies), handling of continuous data (three studies), and subgroup analyses (12 studies). Discrepancy rates varied, ranging from 7% (3/42) to 88% (7/8) in statistical analyses, 46% (36/79) to 82% (23/28) in adjusted versus unadjusted analyses, and 61% (11/18) to 100% (25/25) in subgroup analyses. This review is limited in that none of the included studies investigated the evidence for bias resulting from selective reporting of analyses. It was not possible to combine studies to provide overall summary estimates, and so the results of studies are discussed narratively. Conclusions Discrepancies in analyses between publications and other study documentation were common, but reasons for these discrepancies were not discussed in the trial reports. To ensure transparency, protocols and statistical analysis plans need to be published, and investigators should adhere to these or explain discrepancies. Please see later in the article for the Editors' Summary PMID:24959719

  5. The Counterintuitive Psychological Benefits of Intergenerational Discrepancies in Family Prioritization for Jamaican Adolescent-Parent Dyads

    ERIC Educational Resources Information Center

    Ferguson, Gail M.

    2013-01-01

    The current study tests a prediction of Relational Discrepancy Theory (RDT; i.e., emotional distress will not accompany discrepancies in hierarchical relationships) for family obligations discrepancies among adolescent-parent dyads in Jamaica, a moderately collectivistic and hierarchical society. Ninety-five dyads reported psychological adjustment…

  6. Subjective-Objective Sleep Discrepancy Is Associated With Alterations in Regional Glucose Metabolism in Patients With Insomnia and Good Sleeper Controls.

    PubMed

    Kay, Daniel B; Karim, Helmet T; Soehner, Adriane M; Hasler, Brant P; James, Jeffrey A; Germain, Anne; Hall, Martica H; Franzen, Peter L; Price, Julie C; Nofzinger, Eric A; Buysse, Daniel J

    2017-11-01

    Sleep discrepancies are common in primary insomnia (PI) and include reports of longer sleep onset latency (SOL) than measured by polysomnography (PSG) or "negative SOL discrepancy." We hypothesized that negative SOL discrepancy in PI would be associated with higher relative glucose metabolism during nonrapid eye movement (NREM) sleep in brain networks involved in conscious awareness, including the salience, left executive control, and default mode networks. PI (n = 32) and good sleeper controls (GS; n = 30) completed [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans during NREM sleep, and relative regional cerebral metabolic rate for glucose (rCMRglc) was measured. Sleep discrepancy was calculated by subtracting PSG-measured SOL on the PET night from corresponding self-report values the following morning. We tested for interactions between group (PI vs. GS) and SOL discrepancy for rCMRglc during NREM sleep using both a region of interest mask and exploratory whole-brain analyses. Significant group by SOL discrepancy interactions for rCMRglc were observed in several brain regions (pcorrected < .05 for all clusters). In the PI group, more negative SOL discrepancy (self-reported > PSG-measured SOL) was associated with significantly higher relative rCMRglc in the right anterior insula and middle/posterior cingulate during NREM sleep. In GS, more positive SOL discrepancy (self-reported < PSG-measured SOL) was associated with significantly higher relative rCMRglc in the right anterior insula, left anterior cingulate cortex, and middle/posterior cingulate cortex. Although preliminary, these findings suggest regions of the brain previously shown to be involved in conscious awareness, and the perception of PSG-defined states may also be involved in the phenomena of SOL discrepancy. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  7. Adaptive self-regulation: meeting others' expectations of leadership and performance.

    PubMed

    Sosik, John J; Potosky, Denise; Jung, Dong I

    2002-04-01

    The authors used longitudinal multisource field data to examine core aspects of the adaptive self-regulation model (A. S. Tsui & S. J. Ashford, 1994) in terms of linkages between self-monitoring, discrepancy in manager match-to-position, 5 measures of leadership, and manager performance. At Time 1, 64 superiors of focal managers rated the managers' matches to their positions within the organization; at Time 3, they rated the managers' performance. At Time 2, the 64 focal managers completed a measure of self-monitoring, and 192 subordinates rated the focal managers' leadership behaviors. Results of partial least squares analysis revealed that discrepancy in manager match-to-position was associated with reductions in laissez faire and passive management-by-exception behaviors and increases in transformational leadership behavior. Self-monitoring was positively associated with all 5 leadership behaviors. Performance was related positively to transformational leadership behavior and negatively to passive management-by-exception and contingent-reward behaviors

  8. 12 CFR 222.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FEDERAL RESERVE SYSTEM FAIR CREDIT REPORTING (REGULATION V) Duties of Users of Consumer Reports Regarding... a user of consumer reports (user) that receives a notice of address discrepancy from a consumer... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

  9. Stabilizing Iraq: DoD Cannot Ensure That U.S.-Funded Equipment Has Reached Iraqi Security Forces

    DTIC Science & Technology

    2007-07-01

    searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments...discrepancy of at least 190,000 weapons between data reported by the former MNSTC-I commander and the property books. Former MNSTC-I officials stated...property books consist of extensive electronic spreadsheets, which are an inefficient management tool given the large amount of data and limited

  10. 48 CFR 47.207-10 - Discrepancies incident to shipments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Discrepancies incident to shipments. 47.207-10 Section 47.207-10 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT TRANSPORTATION Contracts for Transportation or for Transportation-Related Services 47...

  11. 48 CFR 242.1405 - Discrepancies incident to shipment of supplies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Discrepancies incident to shipment of supplies. 242.1405 Section 242.1405 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES...

  12. Using electronic data interchange to report product quality

    NASA Astrophysics Data System (ADS)

    Egan, Donald F.; Frank, Donald T.

    1993-03-01

    The Product Quality Deficiency Report (PQDR) is a Department of Defense form that identifies deficiencies in the manufacture, repair, or procurement of materiel. It may be used by DoD employees or contractors to identify defects at any point in the item's life. DoD generates nearly 75,000 such deficiency reports each year. In most cases, when a defect is identified, Standard Form (SF) 368 is completed and sent to the activity managing the contract under which the materiel was procured. That activity, usually in conjunction with the contractor, investigates the complaint, attempts to determine a cause and a corrective action, and must make some disposition of the defective materiel. The process is labor- and paper-intensive and time-consuming. Technology can reduce the costs of the process and at the same time improve timeliness by electronically exchanging discrepancy data between activities. Electronic data interchange (EDI) is one technology for electronically passing PQDR data. It is widely used in industry and increasingly within DoD. DMRD 941 defines DoD's commitment to use EDI and cites the PQDR and other discrepancy reports as early candidates for EDI. In this report, we describe how EDI can be linked to changes in PQDR processing practices to provide further improvements.

  13. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.210 Manifest discrepancies. (a) Manifest... commercial storage or disposal facility shall attempt to reconcile the discrepancy with the waste generator... Section 761.210 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES...

  14. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.210 Manifest discrepancies. (a) Manifest... commercial storage or disposal facility shall attempt to reconcile the discrepancy with the waste generator... Section 761.210 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES...

  15. Intraoperative pulse oximetry: frequency and distribution of discrepant data.

    PubMed

    Pan, P H; Gravenstein, N

    1994-01-01

    To determine the types of discrepant data during intraoperative pulse oximetry and their frequency and duration. Prospective study. University medical center. 46 consecutive ASA physical status I-III patients undergoing general anesthesia for elective surgical operations. With an integrated computer algorithm on the pulse oximeter and another computer linked to it, data were screened and the frequency and distribution of the following oximeter signals recorded: absent; low quality or interrupted, as detected by the pulse oximeter algorithm; nonphysiologic, identified by the personal computer as a heart rate change greater than 10 beats per minute within 2 consecutive 2-second samples, with no similar abrupt change reported simultaneously on ECG. The number of episodes per hour of discrepant oximeter data and the duration of the episodes were recorded by phase of anesthesia: induction, maintenance, and emergence. Discrepant data occurred most frequently and lasted longest during emergence (p < 0.05); the majority of episodes of discrepant data during emergence lasted less than 12 seconds. Excluding discrepant data that lasted less than 12 seconds decreased the frequency of discrepant data by 63% and excluding those that lasted less than 30 seconds decreased the frequency of discrepant data by 93%. Pulse oximeters frequently report discrepant data intraoperatively, most frequently during emergence from anesthesia. An alarm delay triggered by discrepant data and lasting 12 to 30 seconds would keep most discrepant data from becoming false alarms and, thus, may reduce distracting sound pollution in the operating room.

  16. Subjective-objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment.

    PubMed

    Kay, Daniel B; Buysse, Daniel J; Germain, Anne; Hall, Martica; Monk, Timothy H

    2015-02-01

    Discrepancy between subjective and objective measures of sleep is associated with insomnia and increasing age. Cognitive behavioural therapy for insomnia improves sleep quality and decreases subjective-objective sleep discrepancy. This study describes differences between older adults with insomnia and controls in sleep discrepancy, and tests the hypothesis that reduced sleep discrepancy following cognitive behavioural therapy for insomnia correlates with the magnitude of symptom improvement reported by older adults with insomnia. Participants were 63 adults >60 years of age with insomnia, and 51 controls. At baseline, participants completed sleep diaries for 7 days while wearing wrist actigraphs. After receiving cognitive behavioural therapy for insomnia, insomnia patients repeated this sleep assessment. Sleep discrepancy variables were calculated by subtracting actigraphic sleep onset latency and wake after sleep onset from respective self-reported estimates, pre- and post-treatment. Mean level and night-to-night variability in sleep discrepancy were investigated. Baseline sleep discrepancies were compared between groups. Pre-post-treatment changes in Insomnia Severity Index score and sleep discrepancy variables were investigated within older adults with insomnia. Sleep discrepancy was significantly greater and more variable across nights in older adults with insomnia than controls, P ≤ 0.001 for all. Treatment with cognitive behavioural therapy for insomnia was associated with significant reduction in the Insomnia Severity Index score that correlated with changes in mean level and night-to-night variability in wake after sleep onset discrepancy, P < 0.001 for all. Study of sleep discrepancy patterns may guide more targeted treatments for late-life insomnia. © 2014 European Sleep Research Society.

  17. The NASA Program Management Tool: A New Vision in Business Intelligence

    NASA Technical Reports Server (NTRS)

    Maluf, David A.; Swanson, Keith; Putz, Peter; Bell, David G.; Gawdiak, Yuri

    2006-01-01

    This paper describes a novel approach to business intelligence and program management for large technology enterprises like the U.S. National Aeronautics and Space Administration (NASA). Two key distinctions of the approach are that 1) standard business documents are the user interface, and 2) a "schema-less" XML database enables flexible integration of technology information for use by both humans and machines in a highly dynamic environment. The implementation utilizes patent-pending NASA software called the NASA Program Management Tool (PMT) and its underlying "schema-less" XML database called Netmark. Initial benefits of PMT include elimination of discrepancies between business documents that use the same information and "paperwork reduction" for program and project management in the form of reducing the effort required to understand standard reporting requirements and to comply with those reporting requirements. We project that the underlying approach to business intelligence will enable significant benefits in the timeliness, integrity and depth of business information available to decision makers on all organizational levels.

  18. Needs Assessment in Education: More Discrepancy than Analysis.

    ERIC Educational Resources Information Center

    Kominski, Edward S.

    Significant discrepancies between ideal and real methods of needs assessment need to be rectified. Essential principles for managing an educational assessment have been set down by recognized educators. Experts' recommendations include such requirements as using a clear definition of need (as opposed to want), precise quantifiable methods, an…

  19. Development of a Work Control System for Propulsion Testing at Stennis Space Center (SSC)

    NASA Technical Reports Server (NTRS)

    Messer, Elizabeth A.

    2004-01-01

    In 1996, Stennis Space Center was given management authority for all Propulsion Testing for NASA. Over the next few years several research and development (R&D) test facilities were completed and brought up to full operation in what is known as the E-Complex Test Facility at Stennis Space Center. This paper will explain the requirements and steps taken to develop the current Test Operations' electronic work control system. The Work Control System developed includes work authorization documents such as test preparation sheets, discrepancy reports, pre-test briefing reports, and test requests.

  20. 77 FR 58994 - Agency Information Collection Activities; Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ... certain circumstances. The Address Discrepancy Rule provides guidance on what users of consumer reports... likely covered by the Address Discrepancy Rule totaled 2,449,605 users of consumer reports. That... inputs, staff estimates that Section 315 affects approximately 1,757,385 users of consumer reports...

  1. Information Seeking in Uncertainty Management Theory: Exposure to Information About Medical Uncertainty and Information-Processing Orientation as Predictors of Uncertainty Management Success.

    PubMed

    Rains, Stephen A; Tukachinsky, Riva

    2015-01-01

    Uncertainty management theory outlines the processes through which individuals cope with health-related uncertainty. Information seeking has been frequently documented as an important uncertainty management strategy. The reported study investigates exposure to specific types of medical information during a search, and one's information-processing orientation as predictors of successful uncertainty management (i.e., a reduction in the discrepancy between the level of uncertainty one feels and the level one desires). A lab study was conducted in which participants were primed to feel more or less certain about skin cancer and then were allowed to search the World Wide Web for skin cancer information. Participants' search behavior was recorded and content analyzed. The results indicate that exposure to two health communication constructs that pervade medical forms of uncertainty (i.e., severity and susceptibility) and information-processing orientation predicted uncertainty management success.

  2. 78 FR 48418 - Proposed Information Collection; Comment Request; Nautical Discrepancy Reporting System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Nautical Discrepancy Reporting System AGENCY: National Oceanic and Atmospheric... and Atmospheric Administration (NOAA) Office of Coast Survey is the nation's nautical chartmaker...

  3. Longitudinal Associations Between Parental Monitoring Discrepancy and Delinquency: An Application of the Latent Congruency Model.

    PubMed

    Ksinan, Albert J; Vazsonyi, Alexander T

    2016-12-01

    Studies have shown that discrepancies (relative concordance or discordance) between parent and adolescent ratings are predictive of problem behaviors; monitoring, in particular, has been consistently linked to them. The current study tested whether discrepancies in perceptions of maternal monitoring, rated by mothers and youth at age 12, foretold delinquency (rule breaking) at age 15, and whether parental closeness and conflict predicted higher discrepancies, and indirectly, higher delinquency. The final study sample used the NICHD longitudinal dataset with N = 966 youth (50.1 % female) and their mothers (80.1 % European American, 12.9 % African American, 7 % other ethnicity). The analytic approach consisted of an extension and application of the Latent Congruency Model (LCM) to estimate monitoring discrepancies as well as age 15 delinquency scores. Findings showed that age 12 monitoring discrepancy was predictive of age 15 delinquency for both boys and girls based on youth reports, but not for maternal reports. Age 11 closeness predicted age 12 monitoring discrepancy, which served as a mediator for its effect on age 15 adolescent-reported delinquency. Thus, based on the rigorous LCM analytic approach which seeks to minimize the effects by competing explanations and to maximize precision in providing robust estimates, rates of perceived discordance in parenting behaviors during early adolescence matter in understanding variability in adolescent delinquency during middle adolescence.

  4. 40 CFR 761.210 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.210 Manifest discrepancies. (a) Manifest discrepancies are differences between the quantity or type of PCB waste designated on the manifest or shipping paper and the quantity or type of PCB waste actually delivered to and received by a designated facility...

  5. Accuracy Between AJSM Author-Reported Disclosures and the Centers for Medicare and Medicaid Services Open Payments Database.

    PubMed

    Boddapati, Venkat; Fu, Michael C; Nwachukwu, Benedict U; Ranawat, Anil S; Zhen, Wilson Y; Dines, Joshua S

    2018-03-01

    Inaccurate disclosures of physician and industry relationships in scientific reporting may create an asymmetry of information by hiding potential biases. The accuracy of conflict of interest disclosure in sports medicine research is unknown. To compare author financial disclosures in published articles in 2016 in the American Journal of Sports Medicine ( AJSM) with the Centers for Medicare and Medicaid Services' Open Payments Database (OPD) to determine the percentage of payments values and percentage of eligible authors with discrepancies. Cross-sectional study; no level of evidence (nonclinical). All articles published in 2016 in AJSM were screened to identify eligible authors. On the basis of OPD reporting, physician authors affiliated with a US institution were included. Stated disclosures in AJSM publications for these authors were identified and compared with industry-reported payments on OPD. A total of 434 authors were included in this study. Mean and median total payments per author per year were $76,941 and $1692, respectively. The most commonly received payment was for food and beverage (81.3% of authors), followed by travel and lodging (45.4%) and consulting (31.8%). Authors with higher total payments were less likely to be discrepant in their reporting-notably, authors earning >$500,000 had 16.1% of payment values with discrepancy, as opposed to 85.3% for those earning <$10,000 ( P < .001). First authors had a lower percentage of payment values with discrepancy (13.8%) versus middle authors (31.9%, P = .001). Finally, men had a lower percentage of payment values with discrepancy (418 authors, 22.3% of payment values with discrepancy) as compared with women (16 authors, 95.3%; P < .001). Regarding industry payments specifically requested on the AJSM disclosure form for authors (royalties, consulting, research payments, and ownership and investments), only 25.3% of authors had a discrepancy in these payment categories in aggregate. Discrepancies exist between disclosures reported by authors publishing in AJSM and what is reported in the OPD. Authors receiving lower total payments, middle authors, and women are more likely to have disclosure discrepancies. Additionally, industry research funding support and ownership interest are most likely to go unreported. However, this study did not assess whether authors with industry payments preferentially published studies pertaining to products from companies from which they received funding. As national registries such as the OPD are increasingly utilized, physicians may benefit from referencing such databases before submitting conflict of interest disclosures.

  6. Agreement in Youth-Parent Perceptions of Parenting Behaviors: A Case for Testing Measurement Invariance in Reporter Discrepancy Research.

    PubMed

    Russell, Justin D; Graham, Rebecca A; Neill, Erin L; Weems, Carl F

    2016-10-01

    While conventional wisdom suggests that parents and their adolescent offspring will often disagree, the nature of discrepancies in informant reports of parenting behaviors is still unclear. This article suggests testing measurement invariance in an effort to clarify if discrepancies in informant scores reflect true differences in perspectives on the same construct, or if the instrument is simply not measuring the same construct across parents and youth. The study provides an example by examining invariance and discrepancy across child, adolescent, and parent reports on the Alabama Parenting Questionnaire. The sample for this study was 255 youth (51.4 % male) aged 6-17 years (M age  = 12.3 years) and an accompanying parent. A five-factor model of the measure was found to provide approximately equivalent measurement across four participant groups (children under 12 years, adolescents aged 12-18 years, and parents of each group, respectively). Latent mean levels of reported parenting constructs varied greatly across informants. Age moderated the association between reports of two subscales, Parental Involvement and Positive Parenting, such that adolescents were more consistent with parents. The findings highlight the utility of testing measurement invariance across informants prior to evaluating differences in their reports, and demonstrate the benefits of considering invariance in the larger conversation over informant discrepancies.

  7. Understanding Parent-Child Social Informant Discrepancy in Youth with High Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Lerner, Matthew D.; Calhoun, Casey D.; Mikami, Amori Yee; De Los Reyes, Andres

    2012-01-01

    We investigated discrepancies between parent- and self-reported social functioning among youth with autism spectrum disorders (ASD). Three distinct samples showed discrepancies indicating that parents viewed their children as performing one standard deviation below a standardization mean, while youth viewed themselves as comparably-skilled…

  8. 41 CFR 101-26.307 - Processing overages, shortages, and damages.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... United States, when other than GSA or DOD pays the transportation charges. (b) Reporting discrepancies or..., shortages, and damages. (a) Transportation-type discrepancies shall be processed in accordance with the instructions in subpart 101-40.7 when the discrepancies are the fault of the carrier and occur while the...

  9. The paradox of adult asthma control: “Who’s in control anyway?”

    PubMed Central

    Hodder, Rick

    2007-01-01

    Surveys of Canadian patients with asthma and their physicians consistently report satisfaction with asthma management; however, when objective indicators are used, these same surveys also observe very poor levels of asthma control. The reasons for this apparent discrepancy, with an emphasis on the factors influencing adherence to therapy, are explored in the present review. Clues to the identification of patients at risk of dying from asthma and an approach to difficult asthma are discussed. PMID:17551599

  10. Systematic review: Outcome reporting bias is a problem in high impact factor neurology journals

    PubMed Central

    Scott, Jared T.; Blubaugh, Mark; Roepke, Brie; Scheckel, Caleb; Vassar, Matt

    2017-01-01

    Background Selective outcome reporting is a significant methodological concern. Comparisons between the outcomes reported in clinical trial registrations and those later published allow investigators to understand the extent of selection bias among trialists. We examined the possibility of selective outcome reporting in randomized controlled trials (RCTs) published in neurology journals. Methods We searched PubMed for randomized controlled trials from Jan 1, 2010 –Dec 31, 2015 published in the top 3 impact factor neurology journals. These articles were screened according to specific inclusion criteria. Each author individually extracted data from trials following a standardized protocol. A second author verified each extracted element and discrepancies were resolved. Consistency between registered and published outcomes was evaluated and correlations between discrepancies and funding, journal, and temporal trends were examined. Results 180 trials were included for analysis. 10 (6%) primary outcomes were demoted, 38 (21%) primary outcomes were omitted from the publication, and 61 (34%) unregistered primary outcomes were added to the published report. There were 18 (10%) cases of secondary outcomes being upgraded to primary outcomes in the publication, and there were 53 (29%) changes in timing of assessment. Of 82 (46%) major discrepancies with reported p-values, 54 (66.0%) favored publication of statistically significant results. Conclusion Across trials, we found 180 major discrepancies. 66% of major discrepancies with a reported p-value (n = 82) favored statistically significant results. These results suggest a need within neurology to provide more consistent and timely registration of outcomes. PMID:28727834

  11. Systematic review: Outcome reporting bias is a problem in high impact factor neurology journals.

    PubMed

    Howard, Benjamin; Scott, Jared T; Blubaugh, Mark; Roepke, Brie; Scheckel, Caleb; Vassar, Matt

    2017-01-01

    Selective outcome reporting is a significant methodological concern. Comparisons between the outcomes reported in clinical trial registrations and those later published allow investigators to understand the extent of selection bias among trialists. We examined the possibility of selective outcome reporting in randomized controlled trials (RCTs) published in neurology journals. We searched PubMed for randomized controlled trials from Jan 1, 2010 -Dec 31, 2015 published in the top 3 impact factor neurology journals. These articles were screened according to specific inclusion criteria. Each author individually extracted data from trials following a standardized protocol. A second author verified each extracted element and discrepancies were resolved. Consistency between registered and published outcomes was evaluated and correlations between discrepancies and funding, journal, and temporal trends were examined. 180 trials were included for analysis. 10 (6%) primary outcomes were demoted, 38 (21%) primary outcomes were omitted from the publication, and 61 (34%) unregistered primary outcomes were added to the published report. There were 18 (10%) cases of secondary outcomes being upgraded to primary outcomes in the publication, and there were 53 (29%) changes in timing of assessment. Of 82 (46%) major discrepancies with reported p-values, 54 (66.0%) favored publication of statistically significant results. Across trials, we found 180 major discrepancies. 66% of major discrepancies with a reported p-value (n = 82) favored statistically significant results. These results suggest a need within neurology to provide more consistent and timely registration of outcomes.

  12. Parent and Adolescent Agreement for Reports of Life Stressors.

    PubMed

    Kushner, Shauna C; Tackett, Jennifer L

    2017-03-01

    In this article, we investigated the extent and nature of informant discrepancies on parent- and adolescent self-report versions of a checklist measuring youth exposure to life stressors. Specifically, we examined (a) mean-level differences, relative consistency, and consensus for family-level and youth-specific stressors and (b) the utility of parent-youth discrepancies in accounting for variance in youth temperament and psychopathology. Participants were 106 parent-child dyads (47 male, 59 female; 90.6% mothers) aged 13 to 18 years old ( M = 16.01, SD = 1.29). The results revealed evidence for both congruence and divergence in parent and youth reports, particularly with respect to respondents' accounts of youth-specific stressors. Discrepancies for youth-specific stressors were associated with adolescents' negative affectivity, surgency, effortful control, and internalizing problems. Discrepancies for youth stressors may therefore reveal individual differences in emotionality and self-regulation, thus reflecting meaningful variance in adolescents' functioning.

  13. Parent-Child Discrepancies in Reports of Parental Monitoring and Their Relationship to Adolescent Alcohol-Related Behaviors.

    PubMed

    Abar, Caitlin C; Jackson, Kristina M; Colby, Suzanne M; Barnett, Nancy P

    2015-09-01

    Discrepancies between parents and adolescents regarding parenting behaviors have been hypothesized to represent a deficit in the parent-child relationship and may represent unique risk factors for poor developmental outcomes. The current study examined the predictive utility of multiple methods for characterizing discrepancies in parents' and adolescents' reports of parental monitoring on youth alcohol use behaviors in order to inform future study design and predictive modeling. Data for the current study came from a prospective investigation of alcohol initiation and progression. The analyzed sample consisted of 606 adolescents (6th-8th grade; 54 % female) and their parents were surveyed at baseline, with youth followed up 12 months later. A series of hierarchical logistic regressions were performed for each monitoring-related construct examined (parental knowledge, parental control, parental solicitation, and child disclosure). The results showed that adolescents' reports were more closely related to outcomes than parents' reports, while greater discrepancies were frequently found to be uniquely associated with greater likelihood of alcohol use behaviors. Implications for future work incorporating parents' and adolescents' reports are discussed.

  14. The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

    ERIC Educational Resources Information Center

    De Los Reyes, Andres; Alfano, Candice A.; Beidel, Deborah C.

    2010-01-01

    Discrepancies between informants' reports of children's behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between…

  15. Hazardous waste management and weight-based indicators--the case of Haifa Metropolis.

    PubMed

    Elimelech, E; Ayalon, O; Flicstein, B

    2011-01-30

    The quantity control of hazardous waste in Israel relies primarily on the Environmental Services Company (ESC) reports. With limited management tools, the Ministry of Environmental Protection (MoEP) has no applicable methodology to confirm or monitor the actual amounts of hazardous waste produced by various industrial sectors. The main goal of this research was to develop a method for estimating the amounts of hazardous waste produced by various sectors. In order to achieve this goal, sector-specific indicators were tested on three hazardous waste producing sectors in the Haifa Metropolis: petroleum refineries, dry cleaners, and public hospitals. The findings reveal poor practice of hazardous waste management in the dry cleaning sector and in the public hospitals sector. Large discrepancies were found in the dry cleaning sector, between the quantities of hazardous waste reported and the corresponding indicator estimates. Furthermore, a lack of documentation on hospitals' pharmaceutical and chemical waste production volume was observed. Only in the case of petroleum refineries, the reported amount was consistent with the estimate. Copyright © 2010 Elsevier B.V. All rights reserved.

  16. Management of severe skeletal Class III malocclusion with bimaxillary orthognathic surgery

    PubMed Central

    Haryani, Jitesh; Nagar, Amit; Mehrotra, Divya; Ranabhatt, Rani

    2016-01-01

    Orthognathic surgery in conjunction with fixed orthodontics is a common indication for interdisciplinary management of severe skeletal Class III malocclusion. A thorough analysis of pretreatment investigations and development of a surgical visual treatment objective is essential to plan the type of surgical technique required. Bimaxillary orthognathic surgery is the most common type of surgical procedure for severe skeletal discrepancies. The present case report is a combined ortho-surgical team management of a skeletally Class III patient. The severity of the case required bilateral upper first premolar extraction for dentoalveolar decompensation and simultaneous “Two-jaw surgery” with maxillary advancement of 4 mm and mandibular setback of 7 mm. Postsurgery, a pleasing good facial profile was achieved with Class II molar relation and positive overjet. PMID:27994433

  17. Effects of the TCARE® intervention on caregiver burden and depressive symptoms: preliminary findings from a randomized controlled study.

    PubMed

    Montgomery, Rhonda J V; Kwak, Jung; Kosloski, Karl; O'Connell Valuch, Katharine

    2011-09-01

    We examined the effects of a manualized care management protocol specifically designed for care managers working with caregivers, the Tailored Caregiver Assessment and Referral® (TCARE®) protocol, on caregiver identity discrepancy, burden, and depressive symptoms. Preliminary data from a longitudinal, randomized, controlled intervention study with 266 family caregivers served by 52 care managers in 4 states were analyzed using repeated measures random effects regression procedures. Caregivers in the intervention and control groups were repeatedly assessed for up to 9 months on caregiver identity discrepancy, 3 areas of caregiving burden-objective, relationship, and stress burdens; depression; and intention for nursing home placement. We found significant group by time interaction effects for caregiver identity discrepancy, relationship burden, stress burden, depression, and intention for nursing home placement. Caregivers in the intervention group experienced significant improvement on these measures, whereas caregivers in the control group worsened on these measures over time. The preliminary findings provide strong support for effectiveness of the TCARE® protocol on improving caregiver well-being and mental health outcomes.

  18. Effects of the TCARE® Intervention on Caregiver Burden and Depressive Symptoms: Preliminary Findings From a Randomized Controlled Study

    PubMed Central

    Kwak, Jung; Kosloski, Karl; O’Connell Valuch, Katharine

    2011-01-01

    Objectives. We examined the effects of a manualized care management protocol specifically designed for care managers working with caregivers, the Tailored Caregiver Assessment and Referral® (TCARE®) protocol, on caregiver identity discrepancy, burden, and depressive symptoms. Methods. Preliminary data from a longitudinal, randomized, controlled intervention study with 266 family caregivers served by 52 care managers in 4 states were analyzed using repeated measures random effects regression procedures. Caregivers in the intervention and control groups were repeatedly assessed for up to 9 months on caregiver identity discrepancy, 3 areas of caregiving burden—objective, relationship, and stress burdens; depression; and intention for nursing home placement. Results. We found significant group by time interaction effects for caregiver identity discrepancy, relationship burden, stress burden, depression, and intention for nursing home placement. Caregivers in the intervention group experienced significant improvement on these measures, whereas caregivers in the control group worsened on these measures over time. Discussion. The preliminary findings provide strong support for effectiveness of the TCARE® protocol on improving caregiver well-being and mental health outcomes. PMID:21840840

  19. Telemedicine-based system for quality management and peer review in radiology.

    PubMed

    Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

    2018-06-01

    Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p < 0.05). The telemedicine-based peer review system allows improving radiology departments' network effectiveness. • "Scoring" approach to radiologists' performance assessment must be changed. • Telemedicine peer review and personalized elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

  20. Dyadic Taxonomy of Delinquent Youth: Exploring Risks and Outcomes Associated With Maternal-Youth Reporting Discrepancies of Delinquent Behavior

    ERIC Educational Resources Information Center

    Reid, Joan A.; Sullivan, Christopher J.

    2016-01-01

    Using latent class analysis (LCA), this study identified a dyadic taxonomy of delinquent youth categorized by varying types of maternal-youth reporting discrepancies (i.e., youth < maternal, youth > maternal) within a sample of 764 14-year-old high-risk youth. Four distinctive subgroups of youth were identified, two of which reported more…

  1. 33 CFR 62.65 - Procedure for reporting defects and discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

  2. 33 CFR 62.65 - Procedure for reporting defects and discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

  3. 33 CFR 62.65 - Procedure for reporting defects and discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

  4. 33 CFR 62.65 - Procedure for reporting defects and discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

  5. 33 CFR 62.65 - Procedure for reporting defects and discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

  6. An audit about clinical governance skills in Italian medical managers.

    PubMed

    Tafuri, S; Martinelli, D; Vece, M M; Prato, R; Germinario, C

    2013-01-01

    The objective of this study is to describe the knowledge and skills of managers working in health organizations in the Region of Puglia (South of Italy) on the principles and tools of clinical governance. A KAP (Knowledge, Attitudes and Practice) survey was conducted using a questionnaire. The target population of the survey was represented by Hospital Directors and Managers of local health care structures (Primary Care Districts, Public Health Departments, and Mental Health Departments). 92 managers participated at the study (response rate was 90.2%). 98.9% of respondents reported being aware of the concept of clinical governance and believe that clinical governance is an appropriate strategy for the continuous improvement in quality of services. 96.7% of respondents had heard of Evidence Based Practice and 80.6% reported using the method of EBP in nursing practice. The availability of guidelines for consultation was reported by 54.9% of respondents. Of those interviewed, 79.8% knew about Health Technology Assessment. 95.5% reported they have heard of clinical audit and 98.9% knowing the concept of risk management. In our survey, an high value judgment about clinical governance was reported by medical managers. The lower attitudes towards the use of the tools of clinical governance highlights an important discrepancy with respect to knowledge and opinions, which becomes more evident in community care structures. Above and beyond training managers, it is also necessary to change training methods used on all health personnel, which should be oriented towards EBM in order to build an adaptable organizational climate.

  7. Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children

    PubMed Central

    Ni, Hsing-Chang; Liang, Sophie Hsin-Yi; Lin, Hsiang-Yuan; Lin, Chiao-Fan; Tseng, Yu-Han

    2017-01-01

    Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4–6 years) from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress—parent-child dysfunctional interaction and parents’ stress resulted from their child’s temperament—were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores. PMID:29016602

  8. The accuracy of clinical malaria case reporting at primary health care facilities in Honiara, Solomon Islands

    PubMed Central

    Kunimitsu, Ayano

    2009-01-01

    Background The accuracy of malaria case reporting is challenging due to restricted human and material resources in many countries. The reporting often depends on the clinical diagnosis because of the scarcity of microscopic examinations. Particularly, clinical malaria case reporting by primary health care facilities (local clinics), which constitutes the baseline data of surveillance, has never previously been sufficiently evaluated. In order to improve the malaria reporting system to the level required to eventually eliminate this disease, this study estimates the gaps between the records of clinics and government statistics regarding the incidence of clinical malaria, and then also examines some factors that might explain the data discrepancy, including such variables as clinic staffing and record keeping. Methods All medical records for outpatients in 2007, handwritten by nurses, were collected from local clinics in Honiara, the capital of the Solomon Islands. The all-monthly clinical malaria cases were then recalculated. The corresponding monthly data in official statistics were provided by the government. Next, in order to estimate any data discrepancy, the ratio of the cases recorded at clinics to the cases reported to the government was determined on the monthly basis. Finally, the associations between the monthly discrepancy and other variables were evaluated by a multiple regression analysis. Results The mean data discrepancy between the records of clinics and government statistics was 21.2% (n = 96). Significant associations were observed between the discrepancy and the average number of patients (coefficient: 0.05, 95%CI: 0.31, 0.07), illegible handwriting (coefficient: 0.09, 95%CI: 0.04, 0.15), the use of tally sheets (coefficient:-0.38, 95%CI: -0.54, -0.22), and the clinic level (coefficient:-0.48, 95%CI:-0.89,-0.06). Conclusion The findings of this study demonstrate the huge data discrepancy between the records of clinics and government statistics in regard to clinical malaria case reporting. Moreover, the high numbers of patients, illegible writing, the disuse of tally sheets, and insufficient resources at some clinics are likely to be related to the increase in the discrepancy. The clinical malaria case reporting at the local clinic level therefore urgently needs improvement, in order to achieve both better malaria surveillance and to also eventually eliminate this disease in the Solomon Islands. PMID:19389239

  9. Discrepancies Between Youth and Mothers' Perceptions of Their Mother-Child Relationship Quality and Self-Disclosure: Implications for Youth- and Mother-Reported Youth Adjustment

    ERIC Educational Resources Information Center

    Reidler, Esther B.; Swenson, Lance P.

    2012-01-01

    Recently, researchers have devoted greater attention to understanding how disagreement between mothers and their children regarding parent-child relationship quality and functioning impacts youth adjustment. While some view discrepancies as indices of developmentally appropriate individuation, discrepancies regarding family functioning also have…

  10. A Longitudinal Test of the Parent-Adolescent Family Functioning Discrepancy Hypothesis: A Trend toward Increased HIV Risk Behaviors Among Immigrant Hispanic Adolescents.

    PubMed

    Córdova, David; Schwartz, Seth J; Unger, Jennifer B; Baezconde-Garbanati, Lourdes; Villamar, Juan A; Soto, Daniel W; Des Rosiers, Sabrina E; Lee, Tae Kyoung; Meca, Alan; Cano, Miguel Ángel; Lorenzo-Blanco, Elma I; Oshri, Assaf; Salas-Wright, Christopher P; Piña-Watson, Brandy; Romero, Andrea J

    2016-10-01

    Parent-adolescent discrepancies in family functioning play an important role in HIV risk behaviors among adolescents, yet longitudinal research with recent immigrant Hispanic families remains limited. This study tested the effects of trajectories of parent-adolescent family functioning discrepancies on HIV risk behaviors among recent-immigrant Hispanic adolescents. Additionally, we examined whether and to what extent trajectories of parent-adolescent family functioning discrepancies vary as a function of gender. We assessed family functioning of 302 Hispanic adolescents (47 % female) and their parent (70 % female) at six time points over a three-year period and computed latent discrepancy scores between parent and adolescent reports at each timepoint. Additionally, adolescents completed measures of sexual risk behaviors and alcohol use. We conducted a confirmatory factor analysis to determine the feasibility of collapsing parent and adolescent reported family functioning indicators onto a single latent discrepancy variable, tested model invariance over time, and conducted growth mixture modeling (GMM). GMM yielded a three-class solution for discrepancies: High-Increasing, High-Stable, and Low-Stable. Relative to the Low-Stable class, parent-adolescent dyads in the High-Increasing and High-Stable classes were at greater risk for adolescents reporting sexual debut at time 6. Additionally, the High-Stable class was at greater risk, relative to the Low-Stable class, in terms of adolescent lifetime alcohol use at 30 months post-baseline. Multiple group GMM indicated that trajectories of parent-adolescent family functioning trajectories did not vary by gender. Implications for future research and practice are discussed.

  11. A Longitudinal Test of the Parent–Adolescent Family Functioning Discrepancy Hypothesis: A Trend toward Increased HIV Risk Behaviors among Immigrant Hispanic Adolescents

    PubMed Central

    Cordova, David; Schwartz, Seth J.; Unger, Jennifer B.; Baezconde-Garbanati, Lourdes; Villamar, Juan A.; Soto, Daniel W.; Des Rosiers, Sabrina E.; Lee, Tae Kyoung; Meca, Alan; Cano, Miguel Ángel; Lorenzo-Blanco, Elma I.; Oshri, Assaf; Salas-Wright, Christopher P.; Piña-Watson, Brandy M.; Romero, Andrea J.

    2016-01-01

    Parent-adolescent discrepancies in family functioning play an important role in HIV risk behaviors among adolescents, yet longitudinal research with recent immigrant Hispanic families remains limited. This study tested the effects of trajectories of parent–adolescent family functioning discrepancies on HIV risk behaviors among recent-immigrant Hispanic adolescents. Additionally, we examined whether and to what extent trajectories of parent-adolescent family functioning discrepancies vary as a function of gender. We assessed family functioning of 302 Hispanic adolescents (47% female) and their parent (70% female) at six time points over a three-year period and computed latent discrepancy scores between parent and adolescent reports at each timepoint. Additionally, adolescents completed measures of sexual risk behaviors and alcohol use. We conducted a confirmatory factor analysis to determine the feasibility of collapsing parent and adolescent reported family functioning indicators onto a single latent discrepancy variable, tested model invariance over time, and conducted growth mixture modeling (GMM). GMM yielded a three-class solution for discrepancies: High-Increasing, High-Stable, and Low-Stable. Relative to the Low-Stable class, parent–adolescent dyads in the High-Increasing and High-Stable classes were at greater risk for adolescents reporting sexual debut at time 6. Additionally, the High-Stable class was at greater risk, relative to the Low-Stable class, in terms of adolescent lifetime alcohol use at 30 months post-baseline. Multiple group GMM indicated that trajectories of parent-adolescent family functioning trajectories did not vary by gender. Implications for future research and practice are discussed. PMID:27216199

  12. Predictive validity of the classroom strategies scale-observer form on statewide testing scores: an initial investigation.

    PubMed

    Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis

    2013-12-01

    The present study examined the validity of a teacher observation measure, the Classroom Strategies Scale--Observer Form (CSS), as a predictor of student performance on statewide tests of mathematics and English language arts. The CSS is a teacher practice observational measure that assesses evidence-based instructional and behavioral management practices in elementary school. A series of two-level hierarchical generalized linear models were fitted to data of a sample of 662 third- through fifth-grade students to assess whether CSS Part 2 Instructional Strategy and Behavioral Management Strategy scale discrepancy scores (i.e., ∑ |recommended frequency--frequency ratings|) predicted statewide mathematics and English language arts proficiency scores when percentage of minority students in schools was controlled. Results indicated that the Instructional Strategy scale discrepancy scores significantly predicted mathematics and English language arts proficiency scores: Relatively larger discrepancies on observer ratings of what teachers did versus what should have been done were associated with lower proficiency scores. Results offer initial evidence of the predictive validity of the CSS Part 2 Instructional Strategy discrepancy scores on student academic outcomes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. The association between automatic thoughts about eating, the actual-ideal weight discrepancies, and eating disorders symptoms: a longitudinal study in late adolescence.

    PubMed

    Zarychta, Karolina; Luszczynska, Aleksandra; Scholz, Urte

    2014-06-01

    This study tested the reciprocal relationships between automatic thoughts about eating and the actual-ideal weight discrepancies, and their role in the formation and maintenance of eating disorders (ED) symptoms in a non-clinical sample of adolescents. In particular, we investigated whether thoughts about eating mediated the effects of weight discrepancies on ED formation and whether weight discrepancies mediated the effects of thoughts about eating on ED formation were investigated. Data were collected three times, with a 2-month interval between Time 1 (T1) and Time 2 (T2), and a 9-month interval between T2 and Time 3 (T3). Adolescents (N = 55) aged 15-18 filled out the SCOFF Questionnaire, assessing eating disorders symptoms, and the Eating Disorder Thoughts Questionnaire, evaluating automatic thoughts. To assess weight discrepancies questions about actual (subjectively reported) and ideal body weight were asked followed by objective measurement of height and weight. Negative thoughts about eating (T2) mediated the relation between weight discrepancies (T1) and symptoms of anorexia and bulimia (T3). In addition, the association between negative thoughts (T1) and eating disorders symptoms (T3) was mediated by weight discrepancies (T2). The negative thoughts and the actual (both subjectively reported and objectively measured)-ideal weight discrepancies constitute a vicious cycle, related to higher ED symptoms. Prevention of eating disorders should be directed to adolescents who manifest large weight discrepancies or high levels of negative thoughts about eating, as they are at risk for developing eating disorder symptoms.

  14. What Students Think They Feel Differs from What They Really Feel – Academic Self-Concept Moderates the Discrepancy between Students’ Trait and State Emotional Self-Reports

    PubMed Central

    Bieg, Madeleine; Goetz, Thomas; Lipnevich, Anastasiya A.

    2014-01-01

    This study investigated whether there is a discrepancy pertaining to trait and state academic emotions and whether self-concept of ability moderates this discrepancy. A total of 225 secondary school students from two different countries enrolled in grades 8 and 11 (German sample; n = 94) and grade 9 (Swiss sample; n = 131) participated. Students’ trait academic emotions of enjoyment, pride, anger, and anxiety in mathematics were assessed with a self-report questionnaire, whereas to assess their state academic emotions experience-sampling method was employed. The results revealed that students’ scores on the trait assessment of emotions were generally higher than their scores on the state assessment. Further, as expected, students’ academic self-concept in the domain of mathematics was shown to partly explain the discrepancy between scores on trait and state emotions. Our results indicate that there is a belief-driven discrepancy between what students think they feel (trait assessment) and what they really feel (state assessment). Implications with regard to the assessment of self-reported emotions in future studies and practical implications for the school context are discussed. PMID:24647760

  15. Audit of tumour histopathology reviewed by a regional oncology centre.

    PubMed Central

    Prescott, R J; Wells, S; Bisset, D L; Banerjee, S S; Harris, M

    1995-01-01

    AIMS--To analyse the diagnostic differences in reporting tumour histopathology between a district general hospital and a regional oncology centre. METHODS--Tumour histopathology reports (n = 227) extracted from Bolton General Hospital files between 1988 and 1992 were compared with the corresponding Christie Hospital (oncology centre) reports, the same material having been seen at both hospitals. RESULTS--Diagnostic agreement existed in 77% of all cases. The incidence of major discrepancies was 8.37%. Of the diagnoses, 19 (36%) cases involved major discrepancies and 34 (64%) cases minor discrepancies. Most discrepancies occurred in the lymphoma group and involved subclassification of Hodgkin's and non-Hodgkin's lymphoma. Ki1 anaplastic large cell lymphoma and T cell rich B cell lymphoma were problematic diagnoses. The correct grading of follicle centre cell lymphomas using the Kiel classification was another problem area. In 19 cases certain aspects of immunohistochemistry produced discrepancies. In one case an incorrect diagnosis was made at the oncology centre and in another both centres gave an incorrect diagnosis. CONCLUSIONS--Areas of diagnostic difficulty mainly involve the subclassification of lymphomas. Review of tumour pathology by experts is recommended, at least in certain categories, to ensure correct diagnosis and uniformity in subclassification of tumours. PMID:7730487

  16. A simple model for DSS-14 outage times

    NASA Technical Reports Server (NTRS)

    Rumsey, H. C.; Stevens, R.; Posner, E. C.

    1989-01-01

    A model is proposed to describe DSS-14 outage times. Discrepancy Reporting System outage data for the period from January 1986 through September 1988 are used to estimate the parameters of the model. The model provides a probability distribution for the duration of outages, which agrees well with observed data. The model depends only on a small number of parameters, and has some heuristic justification. This shows that the Discrepancy Reporting System in the Deep Space Network (DSN) can be used to estimate the probability of extended outages in spite of the discrepancy reports ending when the pass ends. The probability of an outage extending beyond the end of a pass is estimated as around 5 percent.

  17. The effect of maternal psychopathology on parent-child agreement of child anxiety symptoms: A hierarchical linear modeling approach.

    PubMed

    Affrunti, Nicholas W; Woodruff-Borden, Janet

    2015-05-01

    The current study examined the effects of maternal anxiety, worry, depression, child age and gender on mother and child reports of child anxiety using hierarchical linear modeling. Participants were 73 mother-child dyads with children between the ages of 7 and 10 years. Reports of child anxiety symptoms, including symptoms of specific disorders (e.g., social phobia) were obtained using concordant versions of the Screen for Anxiety and Related Emotional Disorders (SCARED). Children reported significantly higher levels of anxiety symptoms relative to their mothers. Maternal worry and depression predicted for significantly lower levels of maternal-reported child anxiety and increasing discrepant reports. Maternal anxiety predicted for higher levels of maternal-reported child anxiety and decreasing discrepant reports. Maternal depression was associated with increased child-reported child anxiety symptoms. No significant effect of child age or gender was observed. Findings may inform inconsistencies in previous studies on reporter discrepancies. Implications and future directions are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. The mediation roles of discrepancy stress and self-esteem between masculine role discrepancy and mental health problems.

    PubMed

    Yang, Xue; Lau, Joseph T F; Wang, Zixin; Ma, Yee-Ling; Lau, Mason C M

    2018-08-01

    Masculine role discrepancy and discrepancy stress occur when men perceive that they fail to live up to the ideal manhood derived from societal prescriptions. The present study examined the associations between masculine role discrepancy and two emotional and mental health problems (social anxiety and depressive symptoms), and potential mediation effects through discrepancy stress and self-esteem in a male general population. Based on random population-based sampling, 2000 male residents in Hong Kong were interviewed. Levels of masculine role discrepancy, discrepancy stress, self-esteem, social anxiety, and depressive symptoms were assessed by using validated scales. Results of structural equation modeling analysis indicated that the proposed model fit the sample well. (χ 2 (118) = 832.34, p < .05, CFI = 0.94, NNFI = 0.91, RMSEA = 0.06). Those who were young, single and less educated were vulnerable to masculine role discrepancy, discrepancy stress, and emotional/mental health problems. We found that discrepancy stress significantly mediated the association between masculine role discrepancy and social anxiety, while self-esteem significantly mediated the associations between masculine role discrepancy and both social anxiety and depression. Study limitations mainly included the cross-sectional design and reliance on self-reported questionnaires. The associations between masculine discrepancy and social anxiety/depressive symptoms among men may be explained by the increase in discrepancy stress and decrease in self-esteem. The findings suggest needs and directions for future research for the relationship between masculine role discrepancy and men's mental health, mechanisms involved, and interventions for improvement. Copyright © 2018. Published by Elsevier B.V.

  19. 12 CFR 1022.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Duties of users regarding address discrepancies... the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop... belief that a consumer report relates to the consumer about whom it has requested the report, when the...

  20. 12 CFR 1022.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Duties of users regarding address discrepancies... the consumer. (c) Reasonable belief. (1) Requirement to form a reasonable belief. A user must develop... belief that a consumer report relates to the consumer about whom it has requested the report, when the...

  1. 12 CFR 1022.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Duties of users regarding address discrepancies... the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop... belief that a consumer report relates to the consumer about whom it has requested the report, when the...

  2. Variable Reporting by Authors Presenting Arthroplasty Research at Multiple Annual Conferences.

    PubMed

    Choo, Kevin J; Yi, Paul H; Burns, Robert; Mohan, Rohith; Wong, Kevin

    2017-01-01

    Prior studies have demonstrated discrepancies in financial conflict of interest (COI) disclosure among authors presenting research at multiple spine and sports medicine conferences. The purpose of this study was to quantify the variability of self-reported financial disclosures of individual authors presenting at multiple arthroplasty conferences during the same year. The author disclosure information published for the 2012 annual meetings of the American Academy of Orthopaedic Surgeons (AAOS), American Association of Hip and Knee Surgeons, the Hip Society, and the Knee Society were compiled. We tabulated the author disclosures, the number of companies/entities represented, and the types of disclosures reported. The disclosures made by authors presenting at more than one meeting were then compared for discrepancies. Of the 209 authors who presented at both the AAOS and American Association of Hip and Knee Surgeons meetings, 79 (37.79%) demonstrated discrepancies in their disclosures with 7 (8.8%) reporting no disclosures to the AAOS. Of the 84 authors who presented at both the AAOS and Hip Society meetings, 1 (1.19%) had discrepancies in their disclosures. Of the 52 authors who presented at both the AAOS and Knee Society meetings, 2 (3.84%) had discrepancies in their disclosures. There is variability in reported financial COIs by authors presenting at multiple arthroplasty conferences within the same year. Further work is warranted to improve transparency of COI disclosures among arthroplasty surgeons presenting research at national meetings. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Investment in body image for self-definition results in greater vulnerability to the thin media than does investment in appearance management.

    PubMed

    Ip, Karen; Jarry, Josée L

    2008-03-01

    This study investigated the effect of thin images according to two dimensions of body-image (BI) investment. Ninety-five females were classified as high or low investors based on the Appearance Schemas Inventory-Revised Self-Evaluative Salience (SES) and Motivational Salience (MS) subscales. Participants viewed advertisements portraying either the thin ideal or products. Results indicated that both women high in SES and MS reported lowered appearance self-esteem but greater BI importance following thin exposures. However, only the high SES group reported greater BI dissatisfaction and importance of current-ideal discrepancies after seeing thin images. Although highly invested women (regardless of their motivation for investment) are more responsive to thin media images than are women low in investment, those invested for self-definition are affected on more dimensions than are those invested for appearance management.

  4. Patient-rated versus proxy-rated cognitive and functional measures in older adults

    PubMed Central

    Howland, Molly; Allan, Kevin C; Carlton, Caitlin E; Tatsuoka, Curtis; Smyth, Kathleen A; Sajatovic, Martha

    2017-01-01

    Objectives Patients with cognitive impairment may have difficulty reporting their functional and cognitive abilities, which are important clinical outcomes. Health care proxies may be able to corroborate patient self-reports. Several studies reported discrepancy between patient and proxy ratings, though the literature is sparse on changes over time of these ratings. Our goals in this 12-month study were to compare patient and proxy reports on functioning, cognition, and everyday executive function, and to further elucidate correlates of patient–proxy discrepancy. Methods This was a prospective cohort study of individuals older than 70 years who ranged from having no cognitive impairment to having moderate dementia who had a proxy available to complete instruments at baseline (N=76). Measurements included Alzheimer’s Disease Cooperative Study–Activities of Daily Living Inventory (ADCS-ADLI), Neuro-QOL Executive Function, PROMIS Applied Cognition (PROMIS-Cog), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale. Results Patient- and proxy-rated ADCS-ADLI were correlated at baseline and at 1-year follow-up. Patient and proxy ratings were discrepant on Neuro-QOL Executive Function and PROMIS-Cog. Greater patient–proxy discrepancy on PROMIS-Cog was associated with younger age and less depression, and greater patient–proxy discrepancy on Neuro-QOL Executive Function was associated with less depression and worse cognitive impairment. Patient–proxy discrepancy increased over time for everyday executive function. Changes in proxy-rated but not patient-rated ADCS-ADLI correlated with MMSE changes. Conclusion Patients and proxies generally agree in reporting on activities of daily living. Patient and proxy reports differ in their respective evaluation of cognitive functioning and everyday executive function. Ratings from both sources may be preferred for these two domains, though studies using gold standard measures are necessary. It is important that clinicians are aware of the differences between patient and proxy perspective to create an accurate clinical picture and guide treatment. PMID:28352208

  5. 41 CFR 109-27.5007-2 - Inventory adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Inventory adjustments... PROCUREMENT 27-INVENTORY MANAGEMENT 27.50-Inventory Management Policies, Procedures, and Guidelines § 109-27.5007-2 Inventory adjustments. Discrepancies between physical inventories and stock records shall be...

  6. False consensus and adolescent peer contagion: examining discrepancies between perceptions and actual reported levels of friends' deviant and health risk behaviors.

    PubMed

    Prinstein, Mitchell J; Wang, Shirley S

    2005-06-01

    Adolescents' perceptions of their friends' behavior strongly predict adolescents' own behavior, however, these perceptions often are erroneous. This study examined correlates of discrepancies between adolescents' perceptions and friends' reports of behavior. A total of 120 11th-grade adolescents provided data regarding their engagement in deviant and health risk behaviors, as well as their perceptions of the behavior of their best friend, as identified through sociometric assessment. Data from friends' own report were used to calculate discrepancy measures of adolescents' overestimations and estimation errors (absolute value of discrepancies) of friends' behavior. Adolescents also completed a measure of friendship quality, and a sociometric assessment yielding measures of peer acceptance/rejection and aggression. Findings revealed that adolescents' peer rejection and aggression were associated with greater overestimations of friends' behavior. This effect was partially mediated by adolescents' own behavior, consistent with a false consensus effect. Low levels of positive friendship quality were significantly associated with estimation errors, but not overestimations specifically.

  7. Medication discrepancy: a concordance problem between dialysis patients and caregivers.

    PubMed

    Lindberg, Magnus; Lindberg, Per; Wikström, Björn

    2007-01-01

    Extensive drug utilization, and non-concordance between the patient and the caregiver about prescriptions and actual medicine intake, are associated with the risk of non-adherence to medication as well as medication-related illness. To achieve reliable estimates of drug use, it is important to consider the patient's self-reported drug utilization as well as to consult his/her medical record. The present multicentre study was conducted with the aim of examining the self-reported drug consumption of dialysis patients and its congruence with medical records. Consumption of pharmaceutical agents was recorded by 204 patients undergoing haemo- or peritoneal dialysis at 10 Swedish clinics. Drug record discrepancies were identified by comparing the self-reported use of prescribed medicines with the subsequently obtained medication lists. The median drug intake was 11 prescribed medicines and by including on-demand drugs this increased to 12. Discrepancies between the self-reported use of prescribed drugs and the medical record were prevalent in 80.4% of cases, with a median of three discrepancies per patient. Dialysis patients have an extensive need for medication but there is an undesirable deviation between consumption and prescription. A single medication list, accessible for the patient and for all prescribers, is a possible solution to achieve concordance but other measures, such as analysis of the reasons for discrepancy and tailored measures, would also benefit concordant medicine-taking.

  8. Autologous bone marrow-derived stem cell therapy in heart disease: discrepancies and contradictions.

    PubMed

    Francis, Darrel P; Mielewczik, Michael; Zargaran, David; Cole, Graham D

    2013-10-09

    Autologous bone marrow stem cell therapy is the greatest advance in the treatment of heart disease for a generation according to pioneering reports. In response to an unanswered letter regarding one of the largest and most promising trials, we attempted to summarise the findings from the most innovative and prolific laboratory. Amongst 48 reports from the group, there appeared to be 5 actual clinical studies ("families" of reports). Duplicate or overlapping reports were common, with contradictory experimental design, recruitment and results. Readers cannot always tell whether a study is randomised versus not, open-controlled or blinded placebo-controlled, or lacking a control group. There were conflicts in recruitment dates, criteria, sample sizes, million-fold differences in cell counts, sex reclassification, fractional numbers of patients and conflation of competitors' studies with authors' own. Contradictory results were also common. These included arithmetical miscalculations, statistical errors, suppression of significant changes, exaggerated description of own findings, possible silent patient deletions, fractional numbers of coronary arteries, identical results with contradictory sample sizes, contradictory results with identical sample sizes, misrepresented survival graphs and a patient with a negative NYHA class. We tabulate over 200 discrepancies amongst the reports. The 5 family-flagship papers (Strauer 2002, STAR, IACT, ABCD, BALANCE) have had 2665 citations. Of these, 291 citations were to the pivotal STAR or IACT-JACC papers, but 97% of their eligible citing papers did not mention any discrepancies. Five meta-analyses or systematic reviews covered these studies, but none described any discrepancies and all resolved uncertainties by undisclosed methods, in mutually contradictory ways. Meta-analysts disagreed whether some studies were randomised or "accepter-versus-rejecter". Our experience of presenting the discrepancies to journals is that readers may remain unaware of such problems. Modern reporting of clinical research can still be imperfect. The scientific literature absorbs such reports largely uncritically. Even meta-analyses seem to resolve contradictions haphazardly. Discrepancies communicated to journals are not guaranteed to reach the scientific community. Journals could consider prioritising systematic reporting of queries even if seemingly minor, and establishing a policy of "habeas data". Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Parent-Adolescent Discrepancies in Adolescents’ Competence and the Balance of Adolescent Autonomy and Adolescent and Parent Well-Being in the Context of Type 1 Diabetes

    PubMed Central

    Butner, Jonathan; Berg, Cynthia A.; Osborn, Peter; Butler, Jorie M.; Godri, Carine; Fortenberry, Katie T.; Barach, Ilana; Le, Hai; Wiebe, Deborah J.

    2009-01-01

    We examined whether intra-family discrepancies in perceptions of the adolescent’s competence and independence were associated with autonomy and also well-being for adolescents and parents. The latent discrepancy model was used to examine the ways that mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding type 1 diabetes, a stressful context for families. One-hundred and eighty-five mothers, fathers, and adolescents (M age= 12.5 SD= 1.3) completed measures of the adolescent’s independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescent’s competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy, but also poorer metabolic control, and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy, but associated with disruptions in well-being in the short term. PMID:19413435

  10. Parent-adolescent discrepancies in adolescents' competence and the balance of adolescent autonomy and adolescent and parent well-being in the context of Type 1 diabetes.

    PubMed

    Butner, Jonathan; Berg, Cynthia A; Osborn, Peter; Butler, Jorie M; Godri, Carine; Fortenberry, Katie T; Barach, Ilana; Le, Hai; Wiebe, Deborah J

    2009-05-01

    This study examined whether intrafamily discrepancies in perceptions of the adolescent's competence and independence were associated with autonomy and well-being for adolescents and parents. The ways in which mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding Type 1 diabetes, a stressful context for families, were examined with the latent discrepancy model. A sample of 185 adolescents (mean age = 12.5 years, SD = 1.3), their mothers, and participating fathers completed measures of the adolescent's independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescent's competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy but also to poorer metabolic control and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy but as being associated with disruptions in well-being in the short term. Copyright 2009 APA, all rights reserved

  11. Dietary restraint and self-discrepancy in male university students.

    PubMed

    Orellana, Ligia; Grunert, Klaus G; Sepúlveda, José; Lobos, Germán; Denegri, Marianela; Miranda, Horacio; Adasme-Berríos, Cristian; Mora, Marcos; Etchebarne, Soledad; Salinas-Oñate, Natalia; Schnettler, Berta

    2016-04-01

    Self-discrepancy describes the distance between an ideal and the actual self. Research suggests that self-discrepancy and dietary restraint are related, causing a significant impact on the person's well-being. However, this relationship has been mostly reported in female and mixed populations. In order to further explore dietary behaviors and their relations to self-discrepancy and well-being-related variables in men, a survey was applied to a non-probabilistic sample of 119 male students from five Chilean state universities (mean age=21.8, SD=2.75). The questionnaire included the Revised Restraint Scale (RRS) with the subscales weight fluctuations (WF) and diet concern (DC), the Satisfaction with Life Scale (SWLS), the Satisfaction with Food-Related Life Scale (SWFL), the Nutrition Interest Scale (NIS), and the Self-discrepancy Index (SDI). Questions were asked about socio-demographic characteristics, eating and drinking habits, and approximate weight and height. A cluster analysis applied to the Z-scores of the RRS classified the following typologies: Group 1 (22.7%), men concerned about weight fluctuations; Group 2 (37.0%), men concerned about diet and weight fluctuations; Group 3 (40.3%), unconcerned about diet and weight fluctuations. The typologies differed in their SDI score, restriction on pastry consumption and reported body mass index (BMI). Students with higher DC and WF scores had a higher BMI, and tended to report high self-discrepancy not only on a physical level, but also on social, emotional, economic and personal levels. This study contributes to the literature on subjective well-being, dietary restraint and self-discrepancy in men from non-clinical samples. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. False Consensus and Adolescent Peer Contagion: Examining Discrepancies between Perceptions and Actual Reported Levels of Friends' Deviant and Health Risk Behaviors.

    ERIC Educational Resources Information Center

    Prinstein, Mitchell J.; Wang, Shirley S.

    2005-01-01

    Adolescents' perceptions of their friends' behavior strongly predict adolescents' own behavior, however, these perceptions often are erroneous. This study examined correlates of discrepancies between adolescents' perceptions and friends' reports of behavior. A total of 120 11th-grade adolescents provided data regarding their engagement in deviant…

  13. Predicting the Grades of Low-Income--Ethnic-Minority Students from Teacher-Student Discrepancies in Reported Motivation

    ERIC Educational Resources Information Center

    Harvey, Kristin Emilia; Suizzo, Marie-Anne; Jackson, Karen Moran

    2016-01-01

    The aims of this study were to investigate the effects of discrepancies between teachers' perceptions of students' motivation and students' reports of their motivation on math and English grades and to identify possible gender and ethnic differences. Participants included 215 low-income, ethnic-minority students and their teachers in academically…

  14. “It Depends on What You Mean by ‘Disagree’”: Differences between Parent and Child Perceptions of Parent–Child Conflict

    PubMed Central

    Thomas, Sarah A.; Swan, Anna J.; Ehrlich, Katherine B.; Reynolds, Elizabeth K.; Suarez, Liza; Dougherty, Lea R.; MacPherson, Laura; Pabón, Shairy C.

    2014-01-01

    We examined a new structured interview of parent–child conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17 years (M=13.5 years, 52 males, 57 % African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent–child conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent–child conflict and psychosocial outcomes. PMID:25210227

  15. "It Depends on What You Mean by 'Disagree'": Differences between Parent and Child Perceptions of Parent-Child Conflict.

    PubMed

    De Los Reyes, Andres; Thomas, Sarah A; Swan, Anna J; Ehrlich, Katherine B; Reynolds, Elizabeth K; Suarez, Liza; Dougherty, Lea R; MacPherson, Laura; Pabón, Shairy C

    2012-09-01

    We examined a new structured interview of parent-child conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17 years ( M =13.5 years, 52 males, 57 % African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent-child conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent-child conflict and psychosocial outcomes.

  16. Brief Report: IQ Split Predicts Social Symptoms and Communication Abilities in High-Functioning Children with Autism Spectrum Disorders

    PubMed Central

    Wallace, Gregory L.; Sokoloff, Jennifer L.; Kenworthy, Lauren

    2011-01-01

    We investigated the relationship of discrepancies between VIQ and NVIQ (IQ split) to autism symptoms and adaptive behavior in a sample of high-functioning (mean FSIQ = 98.5) school-age children with autism spectrum disorders divided into three groups: discrepantly high VIQ (n = 18); discrepantly high NVIQ (n = 24); and equivalent VIQ and NVIQ (n = 36). Discrepantly high VIQ and NVIQ were associated with autism social symptoms but not communication symptoms or repetitive behaviors. Higher VIQ and NVIQ were associated with better adaptive communication but not socialization or Daily Living Skills. IQ discrepancy may be an important phenotypic marker in autism. Although better verbal abilities are associated with better functional outcomes in autism, discrepantly high VIQ in high-functioning children may also be associated with social difficulties. PMID:19572193

  17. University Program Management Information System

    NASA Technical Reports Server (NTRS)

    2001-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA' objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well being. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data.

  18. University Program Management Information System

    NASA Technical Reports Server (NTRS)

    Gans, Gary (Technical Monitor)

    2004-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA's objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well being. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data.

  19. Comparison of clinical causes of death with autopsy diagnosis using discrepency classification.

    PubMed

    Ullah, Khalil; Alamgir, Wasim

    2006-12-01

    To determine the usefulness of autopsy findings in the quality improvement of patients care. An observational study. Departments of Pathology and Medicine, Combined Military Hospital (CMH) Kharian, a tertiary care hospital, from January 2001 to December 2003. The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described. The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non-classifiable. This study showed the usefulness of autopsy findings in the quality improvement of the diagnosis and management of the disease by showing only a minority of cases with discrepant diagnosis of the cause of death.

  20. Discrepancies in reporting the CAG repeat lengths for Huntington's disease

    PubMed Central

    Quarrell, Oliver W; Handley, Olivia; O'Donovan, Kirsty; Dumoulin, Christine; Ramos-Arroyo, Maria; Biunno, Ida; Bauer, Peter; Kline, Margaret; Landwehrmeyer, G Bernhard

    2012-01-01

    Huntington's disease results from a CAG repeat expansion within the Huntingtin gene; this is measured routinely in diagnostic laboratories. The European Huntington's Disease Network REGISTRY project centrally measures CAG repeat lengths on fresh samples; these were compared with the original results from 121 laboratories across 15 countries. We report on 1326 duplicate results; a discrepancy in reporting the upper allele occurred in 51% of cases, this reduced to 13.3% and 9.7% when we applied acceptable measurement errors proposed by the American College of Medical Genetics and the Draft European Best Practice Guidelines, respectively. Duplicate results were available for 1250 lower alleles; discrepancies occurred in 40% of cases. Clinically significant discrepancies occurred in 4.0% of cases with a potential unexplained misdiagnosis rate of 0.3%. There was considerable variation in the discrepancy rate among 10 of the countries participating in this study. Out of 1326 samples, 348 were re-analysed by an accredited diagnostic laboratory, based in Germany, with concordance rates of 93% and 94% for the upper and lower alleles, respectively. This became 100% if the acceptable measurement errors were applied. The central laboratory correctly reported allele sizes for six standard reference samples, blind to the known result. Our study differs from external quality assessment (EQA) schemes in that these are duplicate results obtained from a large sample of patients across the whole diagnostic range. We strongly recommend that laboratories state an error rate for their measurement on the report, participate in EQA schemes and use reference materials regularly to adjust their own internal standards. PMID:21811303

  1. Personality characteristics and cognitive appraisals associated with self-discrepancy after severe traumatic brain injury.

    PubMed

    Beadle, Elizabeth Jane; Ownsworth, Tamara; Fleming, Jennifer; Shum, David H K

    2018-05-09

    Although changes to self-identity or self-discrepancy are common after severe traumatic brain injury (TBI), the mechanisms underlying these changes are poorly understood. This study aimed to examine the influence of personality characteristics and cognitive appraisals on self-discrepancy. Participants were 51 adults (74% male) with severe TBI (M age = 36.22 years; SD = 12.65) who were on average 34 months (SD = 40.29) post-injury. They completed self-report measures of personality style (optimism and defensiveness), cognitive appraisals (threat appraisals, rumination and reflection and perceived coping resources), and self-discrepancy (Head Injury Semantic Differential Scale - III). Correlation analyses identified that higher levels of optimism, defensiveness and perceived coping resources were significantly associated with more positive self-discrepancy (r = .29-.47, p < .05), whereas higher threat appraisals and rumination were significantly related to more negative self-discrepancy (r = -.50-.57, p < .001). After controlling for personality characteristics, cognitive appraisals significantly accounted for self-discrepancy (R 2 change = .15). Moreover, rumination significantly mediated the relationship between optimism and self-discrepancy. In summary, cognitive appraisals were found to be related to self-discrepancy, independent of personality characteristics. Rumination in particular may be an important target of psychological intervention for individuals experiencing negative self-discrepancy.

  2. Readers' use of source information in text comprehension.

    PubMed

    Braasch, Jason L G; Rouet, Jean-François; Vibert, Nicolas; Britt, M Anne

    2012-04-01

    In two experiments, we examined the role of discrepancy on readers' text processing of and memory for the sources of brief news reports. Each story included two assertions that were attributed to different sources. We manipulated whether the second assertion was either discrepant or consistent with the first assertion. On the basis of the discrepancy-induced source comprehension (D-ISC) assumption, we predicted that discrepant stories would promote deeper processing and better memory for the sources conveying the messages, as compared to consistent stories. As predicted, readers mentioned more sources in summaries of discrepant stories, recalled more sources, made more fixations, and displayed longer gaze times in source areas when reading discrepant than when reading consistent stories. In Experiment 2, we found enhanced memory for source-content links for discrepant stories even when intersentential connectors were absent, and regardless of the reading goals. Discussion was focused on discrepancies as one mechanism by which readers are prompted to encode source-content links more deeply, as a method of integrating disparate pieces of information into a coherent mental representation of a text.

  3. Mother-Child Discrepancy in Perceived Family Functioning and Adolescent Developmental Outcomes in Families Experiencing Economic Disadvantage in Hong Kong.

    PubMed

    Leung, Janet T Y; Shek, Daniel T L; Li, Lin

    2016-10-01

    Though growing attention has been devoted to examining informant discrepancies of family attributes in social science research, studies that examine how interactions between mother-reported and adolescent-reported family functioning predict adolescent developmental outcomes in underprivileged families are severely lacking. The current study investigated the difference between mothers and adolescents in their reports of family functioning, as well as the relationships between mother-reported and adolescent-reported family functioning and adolescent developmental outcomes in a sample of 432 Chinese single-mother families (mean age of adolescents = 13.7 years, 51.2 % girls, mean age of mothers = 43.5 years, 69.9 % divorced) experiencing economic disadvantage in Hong Kong. Polynomial regression analyses were conducted to assess whether discrepancy in family functioning between mother reports and adolescent reports predicted resilience, beliefs in the future, cognitive competence, self-efficacy and self-determination of adolescents. The results indicated that adolescents reported family functioning more negatively than did their mothers. Polynomial regression analyses showed that the interaction term between mothers' reports and adolescents' reports of family functioning predicted adolescent developmental outcomes in Chinese single-mother families living in poverty. Basically, under poor adolescent-reported family functioning, adolescent development would be relatively better if their mothers reported more positive family functioning. In contrast, under good adolescent-reported family functioning, adolescents expressed better developmental outcomes when mothers reported lower levels of family functioning than those mothers who reported higher levels of family functioning. The findings provide insights on how congruency and discrepancy between informant reports of family functioning would influence adolescent development. Theoretical and practical implications of the findings are discussed.

  4. Conflicting but close: Readers' integration of information sources as a function of their disagreement.

    PubMed

    Saux, Gaston; Britt, Anne; Le Bigot, Ludovic; Vibert, Nicolas; Burin, Debora; Rouet, Jean-François

    2017-01-01

    According to the documents model framework (Britt, Perfetti, Sandak, & Rouet, 1999), readers' detection of contradictions within texts increases their integration of source-content links (i.e., who says what). This study examines whether conflict may also strengthen the relationship between the respective sources. In two experiments, participants read brief news reports containing two critical statements attributed to different sources. In half of the reports, the statements were consistent with each other, whereas in the other half they were discrepant. Participants were tested for source memory and source integration in an immediate item-recognition task (Experiment 1) and a cued recall task (Experiments 1 and 2). In both experiments, discrepancies increased readers' memory for sources. We found that discrepant sources enhanced retrieval of the other source compared to consistent sources (using a delayed recall measure; Experiments 1 and 2). However, discrepant sources failed to prime the other source as evidenced in an online recognition measure (Experiment 1). We argue that discrepancies promoted the construction of links between sources, but that integration did not take place during reading.

  5. Missing and discrepant data on the Eating Disorder Examination Questionnaire (EDE-Q): Quantity, quality, and implications.

    PubMed

    Kelly, Nichole R; Cotter, Elizabeth W; Lydecker, Janet A; Mazzeo, Suzanne E

    2017-01-01

    The aim of this study was to examine relations among missing and discrepant data on the Eating Disorders Examination Questionnaire (EDE-Q; Fairburn & Beglin, 1994) and individual demographic factors and eating disorder symptoms. Data from 3968 men and women collected in five independent studies were examined. Descriptive statistics were used to detect the quantity of missing and discrepant data, as well as independent samples t-tests and chi-square analyses to examine group differences between participants with and without missing or discrepant data. Results indicated significant differences in data completeness by participant race/ethnicity and severity of eating disorder symptoms. White participants were most likely to provide complete survey responses, and Asian American participants were least likely to provide complete survey responses. Participants with incomplete surveys reported greater eating disorder symptoms and behaviors compared with those with complete surveys. Similarly, those with discrepant responses to behavioral items reported greater eating disorder symptoms and behaviors compared with those with congruent responses. Practical implications and recommendations for reducing and addressing incomplete data on the EDE-Q are discussed. Copyright © 2016. Published by Elsevier Ltd.

  6. Masculine discrepancy stress, substance use, assault and injury in a survey of US men

    PubMed Central

    Reidy, Dennis E; Berke, Danielle S; Gentile, Brittany; Zeichner, Amos

    2018-01-01

    To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon’s Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; p<0.05). There was no association of discrepancy stress to substance abuse, but there was a protective effect of gender role discrepancy for DWI among men low on discrepancy stress (B=−1.19, SE=0.48; IRR=0.30; p=0.01). These findings suggest that gender role discrepancy and associated discrepancy stress, in particular, represent important injury risk factors and that prevention of discrepancy stress may prevent acts of violence with the greatest consequences and costs to the victim, offender and society. PMID:26303670

  7. Assessing the quality of life of children with sickle cell anaemia using self-, parent-proxy, and health care professional-proxy reports.

    PubMed

    Constantinou, Christina; Payne, Nicola; Inusa, Baba

    2015-05-01

    The quality of life (QoL) of children with sickle cell anaemia (SCA) in the United Kingdom has not been examined, and a discrepancy measure based on Gap theory has rarely been used. This study investigated whether (1) child self-reports of QoL using a discrepancy measure (the Generic Children's QoL Measure; GCQ) are lower than those from healthy children, (2) proxy reports from parents and health care professionals are lower than child self-reports, and (3) demographic and disease severity indicators are related to QoL. An interdependent groups, cross-sectional design was implemented. Seventy-four children with SCA, their parent, and members of their health care team completed the GCQ. Demographic and disease severity indicators were recorded. GCQ data from healthy children were obtained from the UK Data Archive. Contrary to past research, when examining generic discrepancy QoL, children with SCA did not report a lower QoL than healthy children, and parent- and health care professional-proxy reports were not lower than child self-reports. Few of the demographic and disease severity indicators were related to QoL. Proxy reports may be used to gain a more complete picture of QoL, but should not be a substitute for self-reports. The explanation for the relatively high levels of QoL reported is not clear, but children with SCA may have realistic expectations about their ideal-self, place greater emphasis on aspects other than health in shaping their QoL, and define achievements within the limits of their illness. Future research should focus on psychological factors in explaining QoL. Statement of contribution What is already known on this subject? Children with sickle cell disease (SCD) generally have a reduced QoL compared with healthy children, but there appears to be no research measuring QoL in paediatric SCD in the United Kingdom. Proxy QoL reports from parents are often lower than child self-reports, but there is less research examining proxy reports from health care professionals. Previous research has measured paediatric QoL using measures of current health-related QoL, but this is not in line with the WHO's definition of QoL as the discrepancy between current state and expectations. What does this study add? Children with Sickle cell anaemia do not have an impaired discrepancy QoL; they may have realistic expectations about their ideal-self and define achievements within the limits of their illness. Health care professionals are able to gauge a SCA child's discrepancy QoL better than parents. The GCQ (a generic discrepancy measure of QoL) takes into account expectations about ideal QoL and does not emphasize health; it may be of use to Psychologists working with SCA children. © 2014 The British Psychological Society.

  8. Discrepancies between patients' and partners' perceptions of unsupportive behavior in chronic obstructive pulmonary disease.

    PubMed

    Snippe, Evelien; Maters, Gemma A; Wempe, Johan B; Hagedoorn, Mariët; Sanderman, Robbert

    2012-06-01

    The literature on chronic diseases indicates that partner support, as perceived by patients, contributes to well-being of patients in either a positive or a negative way. Previous studies indicated that patients' and partners' perceptions of unsupportive partner behavior are only moderately related. Our aim was (1) to investigate whether discrepancies between patients' and partners' perceptions of two types of unsupportive partner behavior-overprotection and protective buffering-were associated with the level of distress reported by patients with chronic obstructive pulmonary disease (COPD) and (2) to evaluate whether the direction of the differences between patients' and partners' perceptions was associated with distress (i.e., whether patient distress was associated with greater patient or greater partner reports of unsupportive partner behavior). A cross-sectional study was performed using the data of a sample of 68 COPD patients and their spouses. Distress was assessed using the Hopkins Symptom Checklist-25. Patients' and partners' perceptions of unsupportive partner behavior were assessed with a questionnaire measuring overprotection and protective buffering. Distress was independently associated with patients' perceptions of protective buffering and discrepancies in spouses' perceptions of overprotection. Regarding the direction of the discrepancy, we found that greater partner reports of overprotection as compared with patient reports were related to more distress in COPD patients. Our study showed that patients' distress was associated not only with patients' perceptions, but also with discrepancies between patients' and partners' perceptions of unsupportive partner behavior. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  9. Using education and support strategies to improve the way nurses assess regular and transient pain - A quality improvement study of three hospitals.

    PubMed

    Peterson, Anna; Carlfjord, Siw; Schaller, Anne; Gerdle, Björn; Larsson, Britt

    2017-07-01

    Systematic and regular pain assessment has been shown to improve pain management. Well-functioning pain assessments require using strategies informed by well-established theory. This study evaluates documented pain assessments reported in medical records and by patients, including reassessment using a Numeric Rating Scale (NRS) after patients receive rescue medication. Documentation surveys (DS) and patient surveys (PS) were performed at baseline (BL), after six months, and after 12 months in 44 in-patient wards at the three hospitals in Östergötland County, Sweden. Nurses and nurse assistants received training on pain assessment and support. The Knowledge to Action Framework guided the implementation of new routines. According to DS pain assessment using NRS, pain assessment increased significantly: from 7% at baseline to 36% at 12 months (p<0.001). For PS, corresponding numbers were 33% and 50% (p<0.001). According to the PS, the proportion of patients who received rescue medication and who had been reassessed increased from 73% to 86% (p=0.003). The use of NRS to document pain assessment after patients received rescue medication increased significantly (4% vs. 17%; p<0.001). After implementing education and support strategies, systematic pain assessment increased, an encouraging finding considering the complex contexts of in-patient facilities. However, the achieved assessment levels and especially reassessments related to rescue medication were clinically unsatisfactory. Future studies should include nursing staff and physicians and increase interactivity such as providing online education support. A discrepancy between documented and reported reassessment in association with given rescue medication might indicate that nurses need better ways to provide pain relief. The fairly low level of patient-reported pain via NRS and documented use of NRS before and 12 months after the educational programme stresses the need for education on pain management in nursing education. Implementations differing from traditional educational attempts such as interactive implementations might complement educational programmes given at the work place. Standardized routines for pain management that include the possibility for nurses to deliver pain medication within well-defined margins might improve pain management and increase the use of pain assessments. Further research is needed that examines the large discrepancy between patient-reported pain management and documentation in the medical recording system of transient pain. Copyright © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  10. Sensitivity to detect change and the correlation of clinical factors with the Hamilton Depression Rating Scale and the Beck Depression Inventory in depressed inpatients.

    PubMed

    Schneibel, Rebecca; Brakemeier, Eva-Lotta; Wilbertz, Gregor; Dykierek, Petra; Zobel, Ingo; Schramm, Elisabeth

    2012-06-30

    Discrepancies between scores on the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI), as well as differences regarding their sensitivity to detect change, have been reported. This study investigates discrepancies and their potential prediction on the basis of demographic, personality, and clinical factors in depressed inpatients and analyzes the sensitivity to change. The HAMD and the BDI were administered to 105 inpatients with major depressive disorder randomized to 5 weeks of either interpersonal psychotherapy or clinical management. Personality was assessed with the NEO Five-Factor Inventory. Low extraversion and high neuroticism were associated with relatively higher endorsement of depressive symptoms on the BDI compared with the HAMD. The HAMD presented a greater reduction of symptom scores than the BDI. Patients with high BDI scores, high HAMD scores or both revealed the greatest change, possibly due to a statistical effect of regression to the mean. Restricted by sample size, analyses were not differentiated by treatment condition. Regression to the mean cannot be tested directly, but it might be considered as a possible explanation. The HAMD and the BDI should be regarded as two complementary rather than redundant or competing instruments as the discrepancy is associated with personality characteristics. Attributing large effect sizes solely to effective treatment and a sensitive measure may be misleading. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Software control and system configuration management - A process that works

    NASA Technical Reports Server (NTRS)

    Petersen, K. L.; Flores, C., Jr.

    1983-01-01

    A comprehensive software control and system configuration management process for flight-crucial digital control systems of advanced aircraft has been developed and refined to insure efficient flight system development and safe flight operations. Because of the highly complex interactions among the hardware, software, and system elements of state-of-the-art digital flight control system designs, a systems-wide approach to configuration control and management has been used. Specific procedures are implemented to govern discrepancy reporting and reconciliation, software and hardware change control, systems verification and validation testing, and formal documentation requirements. An active and knowledgeable configuration control board reviews and approves all flight system configuration modifications and revalidation tests. This flexible process has proved effective during the development and flight testing of several research aircraft and remotely piloted research vehicles with digital flight control systems that ranged from relatively simple to highly complex, integrated mechanizations.

  12. Software control and system configuration management: A systems-wide approach

    NASA Technical Reports Server (NTRS)

    Petersen, K. L.; Flores, C., Jr.

    1984-01-01

    A comprehensive software control and system configuration management process for flight-crucial digital control systems of advanced aircraft has been developed and refined to insure efficient flight system development and safe flight operations. Because of the highly complex interactions among the hardware, software, and system elements of state-of-the-art digital flight control system designs, a systems-wide approach to configuration control and management has been used. Specific procedures are implemented to govern discrepancy reporting and reconciliation, software and hardware change control, systems verification and validation testing, and formal documentation requirements. An active and knowledgeable configuration control board reviews and approves all flight system configuration modifications and revalidation tests. This flexible process has proved effective during the development and flight testing of several research aircraft and remotely piloted research vehicles with digital flight control systems that ranged from relatively simple to highly complex, integrated mechanizations.

  13. Testing Informant Discrepancies as Predictors of Early Adolescent Psychopathology: Why Difference Scores Cannot Tell You What You Want to Know and How Polynomial Regression May

    ERIC Educational Resources Information Center

    Laird, Robert D.; De Los Reyes, Andres

    2013-01-01

    Multiple informants commonly disagree when reporting child and family behavior. In many studies of informant discrepancies, researchers take the difference between two informants' reports and seek to examine the link between this difference score and external constructs (e.g., child maladjustment). In this paper, we review two reasons why…

  14. How to report and monitor the performance of waiting list management.

    PubMed

    Torkki, Markus; Linna, Miika; Seitsalo, Seppo; Paavolainen, Pekka

    2002-01-01

    Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in-first out) and another a poor queue discipline (random) queue. There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations. A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.

  15. Explaining parent-child (dis)agreement in generic and short stature-specific health-related quality of life reports: do family and social relationships matter?

    PubMed

    Quitmann, Julia; Rohenkohl, Anja; Sommer, Rachel; Bullinger, Monika; Silva, Neuza

    2016-10-21

    In the context of health-related quality of life (HrQoL) assessment in pediatric short stature, the present study aimed to examine the levels of agreement/disagreement between parents' and children's reports of generic and condition-specific HrQoL, and to identify socio-demographic, clinical and psychosocial variables associated with the extent and direction of parent-child discrepancies. This study was part of the retest phase of the QoLISSY project, which was a multicenter study conducted simultaneously in France, Germany, Spain, Sweden and UK. The sample comprised 137 dyads of children/adolescents between 8 and 18 years of age, diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS), and one of their parents. The participants completed child- and parent-reported questionnaires on generic (KIDSCREEN-10 Index) and condition-specific HrQoL (QoLISSY Core Module). Children/adolescents also reported on social support (Oslo 3-items Social Support Scale) and parents assessed the parent-child relationships (Parental Role subscale of the Social Adjustment Scale) and burden of short stature on parents (QoLISSY- additional module). The parent-child agreement on reported HrQoL was strong (intraclass correlation coefficients between .59 and .80). The rates of parent-child discrepancies were 61.5 % for generic and 35.2 % for condition-specific HrQoL, with the parents being more prone to report lower generic (42.3 %) and condition-specific HrQoL (23.7 %) than their children. The extent of discrepancies was better explained by family and social relationships than by clinical and socio-demographic variables: poorer parent-child relationships and better children's social support were associated with larger discrepancies in generic HrQoL, while more parental burden was associated with larger discrepancies in condition-specific HrQoL reports. Regarding the direction of discrepancies, higher parental burden was significantly associated with parents' underrating, and better children's social support was significantly associated with parents' overrating of condition-specific HrQoL. Routine assessment of pediatric HrQoL in healthcare and research contexts should include child- and parent-reported data as complementary sources of information, and also consider the family and social context.

  16. Participative management: a contingency approach.

    PubMed

    Callahan, C B; Wall, L L

    1987-09-01

    The participative management trend has been misinterpreted by staff to mean that they make all the decisions. To decrease the discrepancy between the management philosophy of participation and the subordinate interpretation of the system, the selection of appropriate decision participation procedures is essential. When the leaders communicate the degree of influence that subordinates will have, the staff learn to trust and support the participative management system.

  17. University Program Management Information System

    NASA Technical Reports Server (NTRS)

    Gans, Gary (Technical Monitor)

    2002-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA's objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well-being. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data. This report was prepared by the Education Division/FE, Office of Human Resources and Education.

  18. University Program Management Information System: NASA's University Program Active Projects

    NASA Technical Reports Server (NTRS)

    Gans, Gary (Technical Monitor)

    2003-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA's objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well being. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data. This report was prepared by the Office of Education/N.

  19. Self-discrepancies in work-related upper extremity pain: relation to emotions and flexible-goal adjustment.

    PubMed

    Goossens, Mariëlle E; Kindermans, Hanne P; Morley, Stephen J; Roelofs, Jeffrey; Verbunt, Jeanine; Vlaeyen, Johan W

    2010-08-01

    Recurrent pain not only has an impact on disability, but on the long term it may become a threat to one's sense of self. This paper presents a cross-sectional study of patients with work-related upper extremity pain and focuses on: (1) the role of self-discrepancies in this group, (2) the associations between self-discrepancies, pain, emotions and (3) the interaction between self-discrepancies and flexible-goal adjustment. Eighty-nine participants completed standardized self-report measures of pain intensity, pain duration, anxiety, depression and flexible-goal adjustment. A Selves Questionnaire was used to generate self-discrepancies. A series of hierarchical regression analyses showed relationships between actual-ought other, actual-ought self, actual-feared self-discrepancies and depression as well as a significant association between actual-ought other self-discrepancy and anxiety. Furthermore, significant interactions were found between actual-ought other self-discrepancies and flexibility, indicating that less flexible participants with large self-discrepancies score higher on depression. This study showed that self-discrepancies are related to negative emotions and that flexible-goal adjustment served as a moderator in this relationship. The view of self in pain and flexible-goal adjustment should be considered as important variables in the process of chronic pain. Copyright (c) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  20. Masculine discrepancy stress, substance use, assault and injury in a survey of US men.

    PubMed

    Reidy, Dennis E; Berke, Danielle S; Gentile, Brittany; Zeichner, Amos

    2016-10-01

    To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon's Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; p<0.05). There was no association of discrepancy stress to substance abuse, but there was a protective effect of gender role discrepancy for DWI among men low on discrepancy stress (B=-1.19, SE=0.48; IRR=0.30; p=0.01). These findings suggest that gender role discrepancy and associated discrepancy stress, in particular, represent important injury risk factors and that prevention of discrepancy stress may prevent acts of violence with the greatest consequences and costs to the victim, offender and society. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Discrepancies Between Perceptions of the Parent-Adolescent Relationship and Early Adolescent Depressive Symptoms: An Illustration of Polynomial Regression Analysis.

    PubMed

    Nelemans, S A; Branje, S J T; Hale, W W; Goossens, L; Koot, H M; Oldehinkel, A J; Meeus, W H J

    2016-10-01

    Adolescence is a critical period for the development of depressive symptoms. Lower quality of the parent-adolescent relationship has been consistently associated with higher adolescent depressive symptoms, but discrepancies in perceptions of parents and adolescents regarding the quality of their relationship may be particularly important to consider. In the present study, we therefore examined how discrepancies in parents' and adolescents' perceptions of the parent-adolescent relationship were associated with early adolescent depressive symptoms, both concurrently and longitudinally over a 1-year period. Our sample consisted of 497 Dutch adolescents (57 % boys, M age = 13.03 years), residing in the western and central regions of the Netherlands, and their mothers and fathers, who all completed several questionnaires on two occasions with a 1-year interval. Adolescents reported on depressive symptoms and all informants reported on levels of negative interaction in the parent-adolescent relationship. Results from polynomial regression analyses including interaction terms between informants' perceptions, which have recently been proposed as more valid tests of hypotheses involving informant discrepancies than difference scores, suggested the highest adolescent depressive symptoms when both the mother and the adolescent reported high negative interaction, and when the adolescent reported high but the father reported low negative interaction. This pattern of findings underscores the need for a more sophisticated methodology such as polynomial regression analysis including tests of moderation, rather than the use of difference scores, which can adequately address both congruence and discrepancies in perceptions of adolescents and mothers/fathers of the parent-adolescent relationship in detail. Such an analysis can contribute to a more comprehensive understanding of risk factors for early adolescent depressive symptoms.

  2. United Information Services, Inc. , CRAY 1-s/2000, FORTRAN CFT 1. 10. Validation summary report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1983-12-13

    This Validation Summary Report (VSR) for the United Information Services, Inc., FORTRAN CFT 1.10 running under the COS Level C12 1.11 provides a consolidated summary of the results obtained from the validation of the subject compiler against the 1978 FORTRAN Standard (X3.9-1978/FIPS PUB 69). The compiler was validated against the Full Level FORTRAN level of FIPS PUB 69. The VSR is made up of several sections showing all the discrepancies found -if any. These include an overview of the validation which lists all categories of discrepancies within X3.9-1978, and a detailed listing of discrepancies together with the tests which failed.

  3. Diabetes Educators' Intended and Reported Use of Common Diabetes-Related Technologies: Discrepancies and Dissonance.

    PubMed

    James, Steven; Perry, Lin; Gallagher, Robyn; Lowe, Julia

    2016-11-01

    Technology provides adjuvant and/or alternative approaches to care and may promote self-care, communication, and engagement with health care services. Common recent technologies for diabetes include continuous subcutaneous insulin infusions (insulin pumps), continuous glucose monitoring systems, smartphone and tablet applications, and telehealth (video conferencing). This study reports Australian diabetes educators' intentions and reported professional use of these technologies for people with type 1 diabetes, and factors predictive of this. An anonymous, web-based questionnaire based on the technology acceptance model was distributed to members of the Australian Diabetes Educators Association through their electronic newsletter. Exploratory factor analysis revealed a 5-factor solution comprising confidence and competence, improving clinical practice, preparation (intentions and training), ease of use, and subjective norms. Logistic regression analyses identified factors predicting intention and use of technology. Respondents (n = 228) had high intentions to use technology. The majority reported using continuous subcutaneous insulin infusions, continuous glucose monitoring systems, and applications with patients, but usage was occasional. Confidence and competence independently predicted both intentions and use of all 4 technologies. Preparation (intentions and training) independently predicted use of each technology also. Discrepancies and dissonance appear between diabetes educators' intentions and behavior (intentions to use and reported technology use). Intentions were higher than current use, which was relatively low and not likely to provide significant support to people with type 1 diabetes for disease management, communication, and engagement with health care services. Continuing education and experiential learning may be key in supporting diabetes educators to align their intentions with their practice. © 2016 Diabetes Technology Society.

  4. “I Have No Clue What I Drunk Last Night” Using Smartphone Technology to Compare In-Vivo and Retrospective Self-Reports of Alcohol Consumption

    PubMed Central

    Monk, Rebecca Louise; Heim, Derek; Qureshi, Adam; Price, Alan

    2015-01-01

    Aim This research compared real-time measurements of alcohol consumption with retrospective accounts of alcohol consumption to examine possible discrepancies between, and contextual influences on, the different accounts. Method Building on previous investigations, a specifically designed Smartphone technology was utilized to measure alcohol consumption and contextual influences in de facto real-time. Real-time data (a total of 10,560 data points relating to type and number of drinks and current social / environmental context) were compared with daily and weekly retrospective accounts of alcohol consumption. Results Participants reported consuming more alcoholic drinks during real-time assessment than retrospectively. For daily accounts a higher number of drinks consumed in real-time was related to a higher discrepancy between real-time and retrospective accounts. This effect was found across all drink types but was not shaped by social and environmental contexts. Higher in-vivo alcohol consumption appeared to be related to a higher discrepancy in retrospectively reported weekly consumption for alcohol beverage types other than wine. When including contextual factors into the statistical models, being with two or more friends (as opposed to being alone) decreased the discrepancy between real-time and retrospective reports, whilst being in the pub (relative to being at home) was associated with greater discrepancies. Conclusions Overall, retrospective accounts may underestimate the amount of actual, real-time alcohol consumed. Increased consumption may also exacerbate differences between real-time and retrospective accounts. Nonetheless, this is not a global effect as environmental and social contexts interact with the type of alcohol consumed and the time frame given for reporting (weekly vs. daily retrospective). A degree of caution therefore appears warranted with regards to the use of retrospective self-report methods of recording alcohol consumption. Whilst real-time sampling is unlikely to be completely error free, it may be better able to account for social and environmental influences on self-reported consumption. PMID:25992573

  5. Melorheostosis of Leri: report of a case in a young African.

    PubMed

    Adeyomoye, A A O; Awosanya, G O G; Arogundade, R A

    2004-09-01

    Melorheostosis of Leri is a non-familial condition of hyperostosis of the cortical bone that usually presents unilaterally in long bones of the upper and lower limbs, but may also present in vertebra, ribs, skull and jaw. The incidence of this disease is quite rare, only about 300 cases have been reported worldwide. We present a case, which may be the first documented case in sub-Saharan Africa. S.K. is a 14 year old male student who presented to the hospital with an 18 month history of persistent pain in the joints of the right upper limb and a limb length discrepancy since birth which has worsened with growth. Examination revealed generalised hypoplasia of the right upper limb with shortening of the limb and atrophy of the muscles, also hypoplasia and contracture of the thumb was observed. The radiographs of the limb showed multiple areas of dense hyperostosis and scleroderma, which showed a linear distribution along the radial half of the bones. In children presentation of melorheostosis, is more likely be as limb length discrepancy, deformity or joint contractures which may be seen before radiographic evidence of any bony changes. Improvement in imaging techniques will therefore result in early diagnosis and greater success with conservative management. Also the increased frequency of tumours necessitates long-term follow up. melorheostosis, scleroderma.

  6. Personal and family perfectionism of Taiwanese college students: relationships with depression, self-esteem, achievement motivation, and academic grades.

    PubMed

    Wang, Kenneth T

    2012-01-01

    An increasing number of perfectionism studies have been conducted across different countries outside of the Western framework. Using an international egalitarian approach that adopts indigenous frameworks and concepts from the cultural context of the population studied is imperative. This study examines different groups of perfectionists with a sample of 348 Taiwanese college students, emphasizing the collectivistic culture. In particular, this is a follow-up study to further explore characteristics of a group with low standards/high discrepancy--a feeling that they are not good enough despite having low standards--found in a previous study with Taiwanese students. More specifically, this study investigates whether the source of the high discrepancy scores among this group is related to having higher perfectionistic standards from their family. Perfectionism was examined not only from a personal/individualistic perspective, but also from a familistic dimension to reflect Taiwanese collectivistic cultural values. Results partially supported the hypotheses--this group reported having higher family discrepancy, but not family standards, than nonperfectionists. However, this group of participants reported lower academic grades, which implies the possibility of their discrepancy being associated with poorer performance. Four cluster groups--adaptive perfectionists, maladaptive perfectionists, nonperfectionists, and those with low standards/high discrepancy--were compared on their levels of depression, self-esteem, achievement motivation, and academic grades. Maladaptive perfectionists reported the highest depression level, while adaptive perfectionists reported the highest self-esteem. Results also show that aspects of personal perfectionism and family perfectionism related to self-esteem differently among this sample. Findings and implications are discussed with consideration of the collectivistic cultural context in Taiwan.

  7. The discrepancy between subjective and objective measures of sleep in older adults receiving CBT for comorbid insomnia.

    PubMed

    Lund, Hannah G; Rybarczyk, Bruce D; Perrin, Paul B; Leszczyszyn, David; Stepanski, Edward

    2013-10-01

    To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia. Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment. Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy. This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I. © 2012 Wiley Periodicals, Inc.

  8. Weight-related actual and ideal self-states, discrepancies, and shame, guilt, and pride: examining associations within the process model of self-conscious emotions.

    PubMed

    Castonguay, Andree L; Brunet, Jennifer; Ferguson, Leah; Sabiston, Catherine M

    2012-09-01

    The aim of this study was to examine the associations between women's actual:ideal weight-related self-discrepancies and experiences of weight-related shame, guilt, and authentic pride using self-discrepancy (Higgins, 1987) and self-conscious emotion (Tracy & Robins, 2004) theories as guiding frameworks. Participants (N=398) completed self-report questionnaires. Main analyses involved polynomial regressions, followed by the computation and evaluation of response surface values. Actual and ideal weight self-states were related to shame (R2 = .35), guilt (R2 = .25), and authentic pride (R2 = .08). When the discrepancy between actual and ideal weights increased, shame and guilt also increased, while authentic pride decreased. Findings provide partial support for self-discrepancy theory and the process model of self-conscious emotions. Experiencing weight-related self-discrepancies may be important cognitive appraisals related to shame, guilt, and authentic pride. Further research is needed exploring the relations between self-discrepancies and a range of weight-related self-conscious emotions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Discrepancy in Motivation for Weight Loss and Exercise in Rural Patients.

    PubMed

    Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

    2017-11-01

    We explored the extent to which discrepancy between motivation for weight loss and exercise is related to obesity among rural patients with chronic disease, and identified the psychosocial correlates of this discrepancy. 497 patients with diabetes and/or hypertension were recruited from a network of Federally Qualified Health Centers in the rural South and completed a battery of assessments. Most persons in the sample (83.1%) were overweight and 65.0% were obese. For motivation for change, 70.8% reported being in the Action stage or higher for weight loss, whereas only 24.9% reported being in the Action stage or higher for motivation for exercise. When controlling for age, education level, income, sex, and race/ethnicity, individuals who were motivated for weight loss but not exercise were twice as likely to be obese (p = .005). Race and sex were significantly associated with this discrepancy, with African-American patients 1.7 times as likely (p = .05) and women 2.3 times as likely to be discrepant (p = .001). Findings underscore the importance of focusing not simply on weight loss among rural patients with chronic disease, but rather to incorporate specific activities designed to build simultaneous motivation for engaging in exercise.

  10. 40 CFR 761.215 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.215 Manifest discrepancies. (a) Manifest... Section 761.215 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES... quantity or type of PCB waste designated on the manifest or shipping paper, and the quantity and type of...

  11. 40 CFR 761.215 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PROHIBITIONS PCB Waste Disposal Records and Reports § 761.215 Manifest discrepancies. (a) Manifest... Section 761.215 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES... quantity or type of PCB waste designated on the manifest or shipping paper, and the quantity and type of...

  12. A STUDY OF THE DISCREPANCY BETWEEN FEDERAL AND STATE MEASUREMENTS OF ON-HIGHWAY FUEL CONSUMPTION

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hwang, HL

    2003-08-11

    Annual highway fuel taxes are collected by the Treasury Department and placed in the Highway Trust Fund (HTF). There is, however, no direct connection between the taxes collected by the Treasury Department and the gallons of on-highway fuel use, which can lead to a discrepancy between these totals. This study was conducted to determine how much of a discrepancy exists between the total fuel usages estimated based on highway revenue funds as reported by the Treasury Department and the total fuel usages used in the apportionment of the HTF to the States. The analysis was conducted using data from Highwaymore » Statistics Tables MF-27 and FE-9 for the years 1991-2001. It was found that the overall discrepancy is relatively small, mostly within 5% difference. The amount of the discrepancy varies from year to year and varies among the three fuel types (gasoline, gasohol, special fuels). Several potential explanations for these discrepancies were identified, including issues on data, tax measurement, gallon measurement, HTF receipts, and timing. Data anomalies caused by outside forces, such as deferment of tax payments from one fiscal year to the next, can skew fuel tax data. Fuel tax evasion can lead to differences between actual fuel use and fuel taxes collected. Furthermore, differences in data collection and reporting among States can impact fuel use data. Refunds, credits, and transfers from the HTF can impact the total fuel tax receipt data. Timing issues, such as calendar year vs. fiscal year, can also cause some discrepancy between the two data sources.« less

  13. [Medication reconciliation at hospital admission: Results and identification of target patients].

    PubMed

    San José Ruiz, B; Serrano De Lucas, L; López-Giménez, L R; Baza Martínez, B; Sautua Larreategi, S; Bustinza Txertudi, A; Sebastián Leza, Á; Chirivella Ramón, M T; Fonseca Legrand, J L; de Miguel Cascon, M

    2016-06-01

    To quantify and to classify the discrepancies between the admission treatment and the usual patient treatment. To determine the variables that predict those patients that will have more benefit from medication reconciliation. A prospective medication reconciliation study was conducted in the Vascular Surgery Unit from March 2014 to December 2014. When the patients were admitted to the Vascular Surgery Unit, they were informed about the study and asked to prepare information about their chronic treatment. The pharmacist then checked their clinical records, outpatient prescriptions, and also interviewed the patient, obtaining the best pharmacotherapeutic history available. The discrepancies with the admission treatment were written into the patient electronic clinical records. Finally, the physician classified the discrepancies, and changed the treatment, if needed. The statistical analysis included a comparison between patients with and without a non-justified discrepancy (NJD). The statistically different characteristics were used to plot Receiver Operating Characteristic curves, in order to determine the sensitivity and the specificity of these variables to select patients with discrepancies. A total of 380 patients were included. There were 845 non-justified, 600 justified non-documented, and 439 justified documented discrepancies. At least one NJD was identified in 293 patients (77%), with 65 patients (17%) having only justified discrepancies, and 22 patients (6%) having no discrepancies. NJD were: different dose, route or schedule (51%), omission (39%), wrong drug (8%) and commission (2%). The variables associated with discrepancies were number of chronic medications drugs and provider of information. In most studies, omission is the most frequent error. In contrast, in our study the most frequent error is different dose, route, or schedule. The variable that allows selecting patients at higher risk of discrepancies is the number of chronic drugs. This risk is also increased if the patients are not the manager of their own medication. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  14. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety.

    PubMed

    Bieg, Madeleine; Goetz, Thomas; Wolter, Ilka; Hall, Nathan C

    2015-01-01

    Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary) math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait vs. state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain) was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (N within = 6207). As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students' self-concept (i.e., a lower discrepancy for students with higher self-concepts). Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  15. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety

    PubMed Central

    Bieg, Madeleine; Goetz, Thomas; Wolter, Ilka; Hall, Nathan C.

    2015-01-01

    Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary) math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait vs. state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain) was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2–3 weeks (Nwithin = 6207). As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students' self-concept (i.e., a lower discrepancy for students with higher self-concepts). Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed. PMID:26441778

  16. Water use for electricity in the United States: an analysis of reported and calculated water use information for 2008

    NASA Astrophysics Data System (ADS)

    Averyt, K.; Macknick, J.; Rogers, J.; Madden, N.; Fisher, J.; Meldrum, J.; Newmark, R.

    2013-03-01

    Water use by the electricity sector represents a significant portion of the United States water budget (41% of total freshwater withdrawals; 3% consumed). Sustainable management of water resources necessitates an accurate accounting of all water demands, including water use for generation of electricity. Since 1985, the Department of Energy (DOE) Energy Information Administration (EIA) has collected self-reported data on water consumption and withdrawals from individual power generators. These data represent the only annual collection of water consumption and withdrawals by the electricity sector. Here, we compile publically available information into a comprehensive database and then calculate water withdrawals and consumptive use for power plants in the US. In effect, we evaluate the quality of water use data reported by EIA for the year 2008. Significant differences between reported and calculated water data are evident, yet no consistent reason for the discrepancies emerges.

  17. Reliability of cervical radiculopathy, its congruence between patient history and medical imaging evidence of disc herniation and its role in surgical decision.

    PubMed

    Mostofi, Keyvan; Khouzani, Reza Karimi

    2016-10-01

    The incidence of cervical disc herniation is estimated about 5.5/100,000, and they lead to surgical intervention in 26 %. Cervical disc herniation causes radiculopathy, which defines by radicular pain and sensory deficit and maybe weakness following the path of the affected nerves. Classically, cervical radiculopathy is expected to follow its specific dermatome-C4, C5, C6, C7 and C8. We investigate patients who present with discrepancy between classical radiculopathy and imaging findings in the daily practice of our profession. We reviewed the medical records of 102 patients with cervical radiculopathy, caused by cervical disc herniation. All patients had surgery. We found an apparent discrepancy between clinical and radiological findings, patients complained of radiculopathy on one side, and magnetic resonance imaging (MRI) scan or CT scan finding on the other side in ten patients (10.2 %). We did not found any other abnormalities in preoperative and post-operative period. All patients underwent cervical diskectomy via anterior approach. Six weeks after surgery eight patients (80 %) recovered completely, and 3 months after all ten patients (100 %) had been relieved totally. The aim of this paper is review of this medical concept and management of radiculopathy in patients with this discrepancy. As far as we know, the subject has not yet been touched in this light in medical literature. The discrepancy between clinical radiculopathy and disc herniation level on MRI or on CT scan is not rare. Management of this discrepancy requires further investigation to avoid missing diagnosis and treatment failure.

  18. The discrepancy between implicit and explicit attitudes in predicting disinhibited eating.

    PubMed

    Goldstein, Stephanie P; Forman, Evan M; Meiran, Nachshon; Herbert, James D; Juarascio, Adrienne S; Butryn, Meghan L

    2014-01-01

    Disinhibited eating (i.e., the tendency to overeat, despite intentions not to do so, in the presence of palatable foods or other cues such as emotional stress) is strongly linked with obesity and appears to be associated with both implicit (automatic) and explicit (deliberative) food attitudes. Prior research suggests that a large discrepancy between implicit and explicit food attitudes may contribute to greater levels of disinhibited eating; however this theory has not been directly tested. The current study examined whether the discrepancy between implicit and explicit attitudes towards chocolate could predict both lab-based and self-reported disinhibited eating of chocolate. Results revealed that, whereas neither implicit nor explicit attitudes alone predicted disinhibited eating, absolute attitude discrepancy positively predicted chocolate consumption. Impulsivity moderated this effect, such that discrepancy was less predictive of disinhibited eating for those who exhibited lower levels of impulsivity. The results align with the meta-cognitive model to indicate that attitude discrepancy may be involved in overeating. © 2013.

  19. Factors influencing discrepancies in self-reported memory and performance on memory recall in the Canadian Community Health Survey-Healthy Aging, 2008-09.

    PubMed

    Sohel, Nazmul; Tuokko, Holly; Griffith, Lauren; Raina, Parminder

    2016-03-01

    the objectives of this study were: (i) to estimate the rate of discrepancy between participant single-item self-reports of good memory and poor performance on a list-learning task and (ii) to identify the factors including age, gender and health status that influence these discrepant classifications. in total, 14,172 individuals, aged 45-85, were selected from the 2008-09 Canadian Community Health Survey on Healthy Aging. We examined the individual characteristics of participants with and without discrepancies between memory self-reports and performance with a generalised linear model, adjusting for potential covariates. the mean age of respondents was 62.9 years with 56.7% being female, 53.8% having post-secondary graduation and 83% being born in Canada. Higher discrepant classification rates we observed for younger people (6.77 versus 3.65 for lowest and highest group), female (5.90 versus 3.68) and with higher education (6.17 versus 3.52). Discrepant classification rates adjusted with all covariates were higher for those without chronic diseases (5.37 [95% Confidence Interval (CI): 4.16, 6.90] versus 4.05 95% CI: 3.38, 4.86; P = 0.0127), those who did not drink alcohol (5.87 95% CI: 4.69, 7.32 versus 3.70 95% CI: 3.00, 4.55; P < 0.0001), lonely participants (5.45 95% CI: 4.20, 7.04 versus 3.99 95% CI: 3.36, 4.77; P = 0.0081) and bilingual participants (5.67 95% CI: 4.18, 7.64 versus 3.83 95% CI: 3.27, 4.50; P = 0.0102). the findings of this study suggest that the self-reported memory and memory performance differ in a substantial proportion of the population. Therefore, relying on a self-reported memory status may not accurately capture those experiencing memory difficulties. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Medication regimens of frail older adults after discharge from home health care

    PubMed Central

    Lancaster, Rachelle; Marek, Karen Dorman; Bub, Linda Denison; Stetzer, Frank

    2015-01-01

    The purpose of this study was to examine the number and types of discrepancy errors present after discharge from home health care in older adults at risk for medication management problems following an episode of home healthcare. More than half of the 414 participants had at least one medication discrepancy error (53.2%, n=219) with the participant’s omission of a prescribed medication (n=118, 30.17%) occurring most frequently. The results of this study support the need for home health clinicians to perform frequent assessments of medication regimens to ensure that the older adults are aware of the regimen they are prescribed, and have systems in place to support them in managing their medications. PMID:25268528

  1. Intense Imagery Movements (IIM): More to motor stereotypies than meets the eye.

    PubMed

    Robinson, Sally; Woods, Martin; Cardona, Francesco; Hedderly, Tammy

    2016-01-01

    A subgroup of children who present with motor stereotypies in the context of episodes of intense imagery have recently been described in the literature,(1) termed Intense Imagery Movements (IIM). All children report conscious engagement in acts of imagery or imagination, with stereotyped movements occurring simultaneously with limited conscious awareness. This article reports preliminary cognitive data to inform clinical management and guide future research. Intellectual functioning was assessed for ten children with IIM (7 boys, 3 girls; mean age = 10;01, age range = 6;06 to 14;04). In-depth neuropsychological assessments were conducted for four of these cases (3 boys, 1 girls; mean age = 9;05), with standardised questionnaires completed to assess mood, behaviour, attention/concentration, sensory functioning, motor functioning and stereotyped movements. All children exhibited discrepant intellectual profiles, especially on perceptual reasoning tasks, with significant impairments in processing speed. In-depth neuropsychological assessments indicated impaired performance on tests of attention and inhibition, but strengths in memory or oral expression. Three of the four children had sensory processing impairments, two had features of developmental co-ordination disorder and one had poor general well-being. None of the children had emotional or behavioural problems. Children with IIM exhibit uneven intellectual and cognitive profiles, with particular discrepancies in perceptual reasoning skills. The case studies suggest that weaker attention, inhibition and processing speed skills may contribute to engagement in IIM, with good memory and/or language skills potentially contributing to the complexity of imagery abilities. Implications for the identification and management of these children in clinical practice, and future research ideas, are discussed. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  2. Added value of double reading in diagnostic radiology,a systematic review.

    PubMed

    Geijer, Håkan; Geijer, Mats

    2018-06-01

    Double reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading. A systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers. The literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports. The systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects. • In double reading, two or more radiologists read the same images. • A systematic literature review was performed. • The discrepancy rates varied from 0.4 to 22% in various studies. • Double reading by sub-specialists found high discrepancy rates.

  3. 48 CFR 47.207-10 - Discrepancies incident to shipments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., shortage, loss, damage, and other discrepancies between the quantity and/or condition of supplies received from commercial carrier and the quantity and/or condition of these supplies as shown on the covering bill of lading or other transportation document. Regulations and procedures for reporting and adjusting...

  4. Development and Evaluation of Reference Standards for Image-based Telemedicine Diagnosis and Clinical Research Studies in Ophthalmology

    PubMed Central

    Ryan, Michael C.; Ostmo, Susan; Jonas, Karyn; Berrocal, Audina; Drenser, Kimberly; Horowitz, Jason; Lee, Thomas C.; Simmons, Charles; Martinez-Castellanos, Maria-Ana; Chan, R.V. Paul; Chiang, Michael F.

    2014-01-01

    Information systems managing image-based data for telemedicine or clinical research applications require a reference standard representing the correct diagnosis. Accurate reference standards are difficult to establish because of imperfect agreement among physicians, and discrepancies between clinical vs. image-based diagnosis. This study is designed to describe the development and evaluation of reference standards for image-based diagnosis, which combine diagnostic impressions of multiple image readers with the actual clinical diagnoses. We show that agreement between image reading and clinical examinations was imperfect (689 [32%] discrepancies in 2148 image readings), as was inter-reader agreement (kappa 0.490-0.652). This was improved by establishing an image-based reference standard defined as the majority diagnosis given by three readers (13% discrepancies with image readers). It was further improved by establishing an overall reference standard that incorporated the clinical diagnosis (10% discrepancies with image readers). These principles of establishing reference standards may be applied to improve robustness of real-world systems supporting image-based diagnosis. PMID:25954463

  5. Discrepancies in mother and child perceptions of spina bifida medical responsibilities during the transition to adolescence: associations with family conflict and medical adherence.

    PubMed

    Psihogios, Alexandra M; Holmbeck, Grayson N

    2013-09-01

    This study investigated mother-child discrepancies over perceptions of who is responsible for spina bifida (SB) medical tasks in relation to family conflict and medical adherence. 140 youth with SB and their mothers completed questionnaires regarding who is responsible for specific SB medical tasks, family conflict, and medical adherence. An observational measure was also used to assess family conflict. Although children viewed themselves as more responsible for medical management than mothers did, mother-child discrepancies were not associated with family conflict or medical adherence. Interaction effects revealed that adherence was better when family conflict was low and when parents were responsible for medical tasks. Parental involvement in SB medical care is essential for optimal medical adherence during adolescence. The presence of family conflict also plays an influential role on SB medical adherence. Future research should evaluate the relations between discrepancies, family conflict, and medical adherence across time.

  6. Discrepancies in Mother and Child Perceptions of Spina Bifida Medical Responsibilities During the Transition to Adolescence: Associations With Family Conflict and Medical Adherence

    PubMed Central

    Psihogios, Alexandra M.

    2013-01-01

    Objective This study investigated mother–child discrepancies over perceptions of who is responsible for spina bifida (SB) medical tasks in relation to family conflict and medical adherence. Method 140 youth with SB and their mothers completed questionnaires regarding who is responsible for specific SB medical tasks, family conflict, and medical adherence. An observational measure was also used to assess family conflict. Results Although children viewed themselves as more responsible for medical management than mothers did, mother–child discrepancies were not associated with family conflict or medical adherence. Interaction effects revealed that adherence was better when family conflict was low and when parents were responsible for medical tasks. Conclusions Parental involvement in SB medical care is essential for optimal medical adherence during adolescence. The presence of family conflict also plays an influential role on SB medical adherence. Future research should evaluate the relations between discrepancies, family conflict, and medical adherence across time. PMID:23843631

  7. The challenges of everyday technology in the workplace for persons with acquired brain injury.

    PubMed

    Kassberg, Ann-Charlotte; Prellwitz, Maria; Larsson Lund, Maria

    2013-07-01

    To explore and describe how persons with an acquired brain injury (ABI) managed the everyday technology (ET) that they needed to use in their workplace and how this use influences their opportunities to work. Nine persons with an ABI were interviewed and observed when managing ET in their workplace. The data were analysed qualitatively with a constant comparative method. The main category, "The challenge of managing ET in the workplace", consisted of three categories, all of which reflected different kinds of discrepancies between the participants' ability to manage ET and the demands that ET imposes on them in work: "Struggling with ET to be able to continue to work; "Depending on strategies to cope with ET to continue in a particular profession", and "Managing ET at work but concerned about keeping up with the changes". The result revealed discrepancies between the abilities of the persons with ABI to manage ET in relation to the demands that technology imposed on them in their work setting. This indicated that professionals need to consider the role of ET when designing interventions supporting a person's return to work after an ABI.

  8. Psychosocial factors and sleep efficiency: discrepancies between subjective and objective evaluations of sleep.

    PubMed

    Jackowska, Marta; Dockray, Samantha; Hendrickx, Hilde; Steptoe, Andrew

    2011-01-01

    Self-reported sleep efficiency may not precisely reflect objective sleep patterns. We assessed whether psychosocial factors and affective responses are associated with discrepancies between subjective reports and objective measures of sleep efficiency. Participants were 199 working women aged 20 to 61 years. Standardized questionnaires were used to assess psychosocial characteristics and affect that included work stress, social support, happiness, and depressive symptoms. Objective measures of sleep were assessed on one week and one leisure night with an Actiheart monitor. Self-reported sleep efficiency was derived from the Jenkins Sleep Problems Scale. Discrepancies between self-reported and objective measures of sleep efficiency were computed by contrasting standardized measures of sleep problems with objectively measured sleep efficiency. Participants varied markedly in the discrepancies between self-reported and objective sleep measures. After adjustment for personal income, age, having children, marital status, body mass index, and negative affect, overcommitment (p = .002), low level of social support (p = .049), and poor self-rated heath (p = .02) were associated with overreporting of sleep difficulties and underestimation of sleep efficiency. Self-reported poor sleep efficiency was more prevalent among those more overcommitted at work (p = .009) and less happy (p = .02), as well as among those with lower level of social support (p = .03) and more depressive symptoms (p = .048), independently of covariates. Objective sleep efficiency was unrelated to psychosocial characteristics or affect. The extent to which self-reported evaluations of sleep efficiency reflect objective experience may be influenced by psychosocial characteristics and affect. Unless potential moderators of self-reported sleep efficiency are taken into account, associations between sleep and psychosocial factors relevant to health may be overestimated.

  9. Primary school accident reporting in one education authority

    PubMed Central

    Latif, A; Williams, W; Sibert, J

    2002-01-01

    Background: Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. Aims: To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Methods: Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Results: Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. Conclusions: The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection. PMID:11827900

  10. Primary school accident reporting in one education authority.

    PubMed

    Latif, A H A; Williams, W R; Sibert, J

    2002-02-01

    Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection.

  11. In Every Marriage There Are Two Marriages

    ERIC Educational Resources Information Center

    Frank, Ellen; Kupfer, David J.

    1976-01-01

    As part of a continuing study of the differences between couples seeking marital therapy and those seeking sexual dysfunction therapy, this report examines these two clinical populations on the dimension of discrepant views of the marriage. Results suggest overall discrepancy scores may be an important indicator of stress between partners. (Author)

  12. Correlates of Creative Problem Solving

    DTIC Science & Technology

    1992-10-01

    companion literature review. The report also documents the effectiveness of a genre of training that embodies factors sug- gested by this research and the...All Participants ......... ................ 22 3. Relationship of Overall Profile Discrepancy Measure to Each Criterion ...... ........... .. 27 4...24 3. Relationship of overall profile discrepancy measure to each criterion ............................ 27 4. Correlations among

  13. Linking Informant Discrepancies to Observed Variations in Young Children's Disruptive Behavior

    ERIC Educational Resources Information Center

    De Los Reyes, Andres; Henry, David B.; Tolan, Patrick H.; Wakschlag, Lauren S.

    2009-01-01

    Prior work has not tested the basic theoretical notion that informant discrepancies in reports of children's behavior exist, in part, because different informants observe children's behavior in different settings. We examined patterns of observed preschool disruptive behavior across varying social contexts in the laboratory and whether they…

  14. Fine root heterogeneity by branch order: exploring the discrepancy in root turnover estimates between minirhizotron and carbon isotopic methods

    Treesearch

    Dali Guo; Harbin Li; Robert J. Mitchell; Han Wenxuan; Joseph J. Hendricks; Timothy J. Fahey; Ronald L. Hendrick

    2008-01-01

    Fine roots constitute a large and dynamic component of the carbon cycles of terrestrial ecosystems. The reported fivefold discrepancy in turnover estimates between median longevity (ML) from minirhizotrons and mean residence time (MRT) using carbon isotopes may have global consequences.

  15. Magnitude and Direction of WISC-R Verbal-Performance IQ Discrepancies among Adjudicated Male Delinquents.

    ERIC Educational Resources Information Center

    Hubble, L. M.; Groff, M.

    1981-01-01

    A field study is reported in which the discrepancy between verbal and nonverbal skills among 150 adjudicated male delinquents was assessed by the Wechsler Intelligence Scale for Children-Revised, and evaluated with regard to three interpretations of the observed differences. (Author/GK)

  16. Congruence of Parents’ and Children’s Perceptions of Parenting: A Meta-analysis

    PubMed Central

    Korelitz, Katherine E.; Garber, Judy

    2016-01-01

    Parents and children often report different perspectives about parents’ behaviors. Such lack of congruence is important because it may reflect problems in their relationship and may be associated with children’s maladjustment. We conducted a systematic, quantitative review of parent-child agreement and discrepancy about parenting behaviors, and potential moderators (e.g., children’s age, race, clinical status, family intactness) of the extent of mother-child and father-child congruence. The meta-analyses included 85 studies with 476 effect sizes of the degree of agreement and discrepancy in parent-child reports of three parenting behaviors: acceptance, psychological control, and behavioral control assessed with one of the most widely-used measures of parenting – the Children’s Report of Parent Behavior Inventory (CRPBI). Mother-child and father-child dyads exhibited significant but modest levels of agreement (r) across parenting constructs. The amount and direction of discrepancy (Hedges’ g) varied by the parenting construct and parents’ sex. Overall, parents’ reports were more favorable than their children’s report about the parents’ behaviors. Significant associations were found between the magnitude of agreement/discrepancy and children’s age, race, clinical status, and family intactness. Moderators differed by parenting construct, parents’ sex, and type of effect size. Implications of these findings for researchers and clinicians are discussed and highlight the need for further research about the meaning of parent-child incongruence, its relation to children’s psychopathology, and interventions for reducing it. PMID:27380467

  17. Neuroticism and Extraversion Magnify Discrepancies Between Retrospective and Concurrent Affect Reports.

    PubMed

    Lay, Jennifer C; Gerstorf, Denis; Scott, Stacey B; Pauly, Theresa; Hoppmann, Christiane A

    2017-12-01

    Although research often relies on retrospective affect self-reports, little is known about personality's role in retrospective reports and how these converge or deviate from affect reported in the moment. This micro-longitudinal study examines personality (Neuroticism, Extraversion) and emotional salience (peak and recent affect) associations with retrospective-momentary affect report discrepancies over different time frames. Participants were 179 adults aged 20-78 (M = 48.7 years; 73.7% Caucasian/White) who each provided up to 60 concurrent affect reports over 10 days, then retrospectively reported overall intensity of each affective state after 1 day and again after 1-2 months. Multilevel models revealed that individuals retrospectively overreported or underreported various affective states, exhibiting peak associations for high arousal positive and negative affect, recency associations for low arousal positive affect, and distinct personality profiles that strengthened over time. Individuals high in both Extraversion and Neuroticism exaggerated high arousal positive and negative affect and underreported low arousal positive affect, high Extraversion/low Neuroticism individuals exaggerated high arousal positive affect and underreported low arousal positive affect, and low Extraversion/high Neuroticism individuals exaggerated high and low arousal negative affect. This study is the first to identify arousal-specific retrospective affect report discrepancies over time and suggests retrospective reports also reflect personality differences in affective self-knowledge. © 2016 Wiley Periodicals, Inc.

  18. Determining the Accuracy of Self-Report Versus Informant-Report Using the Conners' Adult ADHD Rating Scale.

    PubMed

    Alexander, Lisa; Liljequist, Laura

    2016-04-01

    The present research examined the validity of self-report versus informant-report in relation to a performance-based indicator of adult ADHD. Archival data from 118 participants (52 males, 66 females) were used to compare Conners' Adult ADHD Rating Scale-Self-Report: Long Format (CAARS-S:L) and Conners' Adult ADHD Rating Scale-Observer Report: Long Format (CAARS-O:L) with discrepancy scores calculated between the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) Verbal Comprehension Index - Working Memory Index (VCI - WMI) and Perceptual-Organizational Index - Processing Speed Index (POI - PSI) scaled scores. Neither the self- nor informant-report formats of the CAARS were better predictors of discrepancies between WAIS-III Index scores. Intercorrelations between the CAARS-S:L and CAARS-O:L revealed generally higher correlations between the same scales of different formats and among scales measuring externally visible symptoms. Furthermore, regression analysis indicated that both the CAARS-S:L and CAARS-O:L clinical scales contributed a significant proportion of variance in WAIS-III VCI - WMI discrepancy scores (14.7% and 16.4%, respectively). Results did not establish greater accuracy of self-report versus informant-report of ADHD symptomatology, rather demonstrate the need for multimodal assessment of ADHD in adults. © The Author(s) 2013.

  19. Analysis of the 2015 American and European guidelines for the management of infective endocarditis.

    PubMed

    Tattevin, P; Mainardi, J-L

    2016-12-01

    The optimal management of infective endocarditis requires a broad range of expertise (infectious disease specialists, cardiologists, microbiologists, cardiac surgeons, and intensivists). Given the low level of evidence currently available to support the management of infective endocarditis, international guidelines have always been particularly awaited and rather well implemented. Their cautious analysis of the medical literature and the range of expertise combined within the groups in charge of these guidelines are usually broadly acknowledged and respected. The publications, a few weeks apart, of the 2015 updates of the American and European guidelines, was quite disturbing. Indeed, several discrepancies on major therapeutic propositions were observed, including empirical treatment (penicillin M+penicillin A+gentamicin for Europeans in acutely ill patients; penicillin A+beta-lactamase inhibitor+gentamicin for Americans), or first-line treatment for the most common pathogen responsible for endocarditis in 2016, Staphylococcus aureus (trimethoprim-sulfamethoxazole+clindamycin as an alternative in the European guidelines, while this regimen is not even mentioned in the American guidelines). Other discrepancies were observed, although less significant: the role of positron emission tomography labelled with 18 F-fluorodeoxyglucose and administration modalities for aminoglycosides. We aimed to detail the main changes brought upon by these guidelines, their discrepancies, and the 'pros' and 'cons' that may help you select the best treatment regimen for your patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Challenges in Hospital-Associated Infection Management: A Unit Perspective.

    PubMed

    Stacy, Kathleen M

    2015-01-01

    Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results. Each initiative presents its own unique set of challenges; however, common issues influence all initiatives. These common issues include organization and unit culture, current clinical practice guidelines being used to drive the initiatives, performance discrepancies on the part of nursing staff, availability of resources including equipment and supplies, monitoring of the data, and conflicting quality improvement priorities.

  1. The Surgical Management of Skeletal Disproportion with Lingual Orthodontics and Three-dimensional Planning

    PubMed Central

    Patel, Krutiben; Kau, Chung How; Waite, Peter D; Celebi, Ahmet Arif

    2017-01-01

    This case report describes the successful treatment of a 26-year-old Caucasian male with skeletal and dental Class III malocclusion associated with mild maxillary and mandibular crowding. The patient had anteroposterior and transverse discrepancies with a reverse overjet and bilateral posterior crossbites. The nonextraction treatment plan included aligning and leveling of the teeth in both arches, Le Fort I and bilateral sagittal split osteotomies, and postsurgical correction of the malocclusion. Orthodontic treatment was initiated with custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Treatment was concluded with detailed orthodontic finishing, achieving optimum esthetics and function. PMID:28713747

  2. The development of a theoretically driven generic measure of quality of life for children aged 6-12 years: a preliminary report.

    PubMed

    Eiser, C; Vance, Y H; Seamark, D

    2000-11-01

    To report the development and psychometric properties of a generic computer-delivered measure of quality of life (QoL) suitable for children aged 6-12 years: the Exqol. The theoretical model adopted is based on an assumption that poorer QoL is the result of discrepancies between an individual's actual ('like me') and ideal self ('how I would like to be'). The Exqol consists of 12 pictures, each of which is rated twice; first in terms of 'like me' and second as 'I would like to be'. The Exqol is delivered using a Macintosh Powerbook and takes approximately 20 min to complete. Data are reported for 58 children with asthma (Mage = 8.95 years) and 69 healthy children (Mage = 749 years). In order to determine validity of the Exqol, children with asthma also completed the Childhood Asthma Questionnaire (CAQ) and their mothers completed a measure of child vulnerability and caregiver QoL. Higher discrepancies were found for children with asthma compared with healthy children (P < 0.05). For children with asthma, significant correlations were found between discrepancy scores and two of the four subscales of the CAQ. Children who rated their asthma to be more severe also had higher discrepancy scores (P < 0.05). The Exqol has acceptable internal reliability and validity and distinguishes between children with asthma and healthy children. These data provide preliminary support for the theoretical assumption that QoL reflects perceived discrepancies between an individual's actual and ideal self. Methodological refinements to the Exqol are suggested.

  3. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Duties of users regarding address discrepancies... belief. (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable the user to form a reasonable belief that a consumer report...

  4. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  5. 12 CFR 571.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  6. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief— (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  7. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief. (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  8. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Duties of users regarding address discrepancies... belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable the user to form a reasonable belief that a consumer report relates...

  9. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  10. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief— (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  11. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Duties of users regarding address discrepancies... belief. (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable the user to form a reasonable belief that a consumer report...

  12. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Duties of users regarding address discrepancies... belief.—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable the user to form a reasonable belief that a consumer report...

  13. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief. (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  14. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  15. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  16. 12 CFR 571.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 6 2012-01-01 2012-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  17. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  18. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  19. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Duties of users regarding address discrepancies... belief. (1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable the user to form a reasonable belief that a consumer report...

  20. 12 CFR 571.82 - Duties of users regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Duties of users regarding address discrepancies... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures...

  1. Learner-Centered Principles in Teacher-Centered Practices?

    ERIC Educational Resources Information Center

    Schuh, K.L.

    2004-01-01

    In the study reported here, I compare Learner-Centered Battery (a questionnaire of students' perceptions of the classroom) results and the observation and interview data gathered in one sixth-grade classroom noting first a discrepancy between the descriptions of the classroom that stems from each. I review this discrepancy, highlighting a need for…

  2. Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation.

    PubMed Central

    Keong, Nicole; Ricketts, David; Alakeson, Nuki; Rust, Philippa

    2004-01-01

    OBJECTIVE: To assess the reliability of reporting protocols regarding pressure sores. METHODS: Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital. RESULTS: Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital). CONCLUSIONS: This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings. PMID:15140301

  3. Asthma Management Practices and Education Needs of Head Start Directors and Staff.

    ERIC Educational Resources Information Center

    Huss, Karen; Winkelstein, Marilyn; Calabrese, Barbara; Butz, Arlene; Reshef, Shoshana; Rand, Cynthia; Gilpin, Adele

    2002-01-01

    Surveyed Baltimore Head Start directors and staff participating in an asthma education intervention at 15 Head Start programs to determine their asthma management practices and education needs. Results revealed discrepancies between staff and directors regarding location of asthma medications and presence of asthma action plans in programs. Both…

  4. Discrepancy between Self-Reported and Urine-Cotinine Verified Smoking Status among Korean Male Adults: Analysis of Health Check-Up Data from a Single Private Hospital.

    PubMed

    Kim, Youngju; Choi, Yoon-Jung; Oh, Seung-Won; Joh, Hee-Kyung; Kwon, Hyuktae; Um, Yoo-Jin; Ahn, Sang Hyun; Kim, Hyun Joo; Lee, Cheol Min

    2016-05-01

    Enquiry into smoking status and recommendations for smoking cessation is an essential preventive service. However, there are few studies comparing self-reported (SR) and cotinine-verified (CV) smoking statuses, using medical check-up data. The rates of discrepancy and under-reporting are unknown. We performed a cross-sectional study using health examination data from Healthcare System Gangnam Center, Seoul National University Hospital in 2013. We analyzed SR and CV smoking statuses and discrepancies between the two in relation to sociodemographic variables. We also attempted to ascertain the factors associated with a discrepant smoking status among current smokers. In the sample of 3,477 men, CV smoking rate was 11.1% higher than the SR rate. About 1 in 3 participants either omitted the smoking questionnaire or gave a false reply. The ratio of CV to SR smoking rates was 1.49 (95% confidence interval [CI], 1.38-1.61). After adjusting for confounding factors, older adults (≥60 years) showed an increased adjusted odds ratio (aOR) for discrepancy between SR and CV when compared to those in their twenties and thirties (aOR, 5.43; 95% CI, 2.69-10.96). Educational levels of high school graduation or lower (aOR, 2.33; 95% CI, 1.36-4.01), repeated health check-ups (aOR, 1.45; 95% CI, 1.03-2.06), and low cotinine levels of <500 ng/mL (aOR, 2.03; 95% CI, 1.33-3.09), were also associated with discordance between SR and CV smoking status. Omissions and false responses impede the accurate assessment of smoking status in health check-up participants. In order to improve accuracy, it is suggested that researcher pay attention to participants with greater discrepancy between SR and CV smoking status, and formulate interventions to improve response rates.

  5. Reasons for discrepancy between incidence and prevalence of epilepsy in lower income countries: Epilepsia's survey results.

    PubMed

    Mathern, Gary W; Beninsig, Laurie; Nehlig, Astrid

    2015-02-01

    From July to August 2014, Epilepsia conducted an online survey seeking opinions that explained the discrepancy between the incidence and prevalence of epilepsy in lower income countries. Data on cumulative incidence suggest a higher rate of active epilepsy than reported in lifetime prevalence surveys. This study reports the findings of that poll addressing the proposal in our Controversy in Epilepsy series that it could be from increased death rates. The survey consisted of a question addressing possible reasons to explain the discrepancy between the incidence and prevalence of epilepsy. Another four questions addressed demographic information. There were 34 responders who completed the survey. Half (50%) of the responders felt that the discrepancy between cumulative incidence and lifetime prevalence was due to lack of uniform definitions and misclassification of patients in study design, 23.5% said the discrepancy was due to a higher mortality from diseases and conditions such as trauma and infections associated with epilepsy, 23.5% indicated that the stigma of epilepsy prevented people from acknowledging their disease in prevalence surveys, and 2.9% felt it was from poor access to qualified medical personal and utilization of medical treatments that increased death rates directly related to epilepsy. Within the limitations of sample size, the results of this survey support that the discrepancy between the incidence and prevalence of epilepsy in lower income regions of the world is due to problems in acquiring the data and stigma rather than higher mortality from diseases associated with epilepsy and repeated seizures. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  6. Discrepancies in medication entries between anesthetic and pharmacy records using electronic databases.

    PubMed

    Vigoda, Michael M; Gencorelli, Frank J; Lubarsky, David A

    2007-10-01

    Accurate recording of disposition of controlled substances is required by regulatory agencies. Linking anesthesia information management systems (AIMS) with medication dispensing systems may facilitate automated reconciliation of medication discrepancies. In this retrospective investigation at a large academic hospital, we reviewed 11,603 cases (spanning an 8-mo period) comparing records of medications (i.e., narcotics, benzodiazepines, ketamine, and thiopental) recorded as removed from our automated medication dispensing system with medications recorded as administered in our AIMS. In 15% of cases, we found discrepancies between dispensed versus administered medications. Discrepancies occurred in both the AIMS (8% cases) and the medication dispensing system (10% cases). Although there were many different types of user errors, nearly 75% of them resulted from either an error in the amount of drug waste documented in the medication dispensing system (35%); or an error in documenting the medication in the AIMS (40%). A significant percentage of cases contained data entry errors in both the automated dispensing and AIMS. This error rate limits the current practicality of automating the necessary reconciliation. An electronic interface between an AIMS and a medication dispensing system could alert users of medication entry errors prior to finalizing a case, thus reducing the time (and cost) of reconciling discrepancies.

  7. Profile of a cell test database and a corresponding reliability database

    NASA Technical Reports Server (NTRS)

    Brearley, George R.; Klein, Glenn C.

    1992-01-01

    The development of computerized control, and data retrieval for aerospace cell testing affords an excellent opportunity to incorporate three specific concepts to both manage the test area and to track product performance on a real-time basis. The adoption and incorporation of precepts fostered by this total quality management (TQM) initiative are critical to us for retaining control of our business while substantially reducing the separate quality control inspection activity. Test discrepancies are all 'equally bad' in cell acceptance testing because, for example, we presently do not discriminate between 1 or 25 mV for an overvoltage condition. We must take leadership in classifying such discrepancies in order to expedite their clearance and redirect our resources for prevention activities. The development and use of engineering alerts (or guardbanding) which more closely match our product capabilities and are toleranced tighter than the required customer specification are paramount to managing the test unit in order to remain both quality and cost effective.

  8. Media ideals and early adolescents' body image: Selective avoidance or selective exposure?

    PubMed

    Rousseau, Ann; Eggermont, Steven

    2018-06-05

    The present study combines selective exposure theory with body image coping literature to study effects of media internalization in early adolescence. The main objective was to explore how early adolescents selectively internalize media body ideals to manage their body image. To examine the role of media internalization in early adolescents' body image management, we used two-wave panel data (N Wave1  = 1986) gathered among 9- to 14-year-olds. Structural equation analyses indicated that media internalization (Wave 1) positively related to body surveillance (Wave 2). Body surveillance (Wave 2), in turn, was associated with more body image self-discrepancy (Wave 2). In addition, body image self-discrepancy (Wave 1) related to higher body surveillance (Wave 1). Body surveillance, in turn, related to more media internalization cross-sectionally, but less media internalization six months later. Taken together, these results suggest a role for media internalization in early adolescents' body image management. Theoretical and practical implications are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

    PubMed

    Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2015-01-01

    Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

  10. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison

    PubMed Central

    BAMBERGER, Simon Grandjean; LARSEN, Anelia; VINDING, Anker Lund; NIELSEN, Peter; FONAGER, Kirsten; NIELSEN, René Nesgaard; RYOM, Pia; OMLAND, Øyvind

    2015-01-01

    Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees’ assessment of work environment. PMID:25752252

  11. Justice involvement among homeless individuals with mental illnesses: Are self-report and administrative measures comparable?

    PubMed

    Lemieux, Ashley J; Roy, Laurence; Martin, Michael S; Latimer, Eric A; Crocker, Anne G

    2017-04-01

    Individuals with mental illnesses who experience homelessness have frequent interactions with the criminal justice system. Correctly measuring this involvement is essential to develop and evaluate the efficacy of intervention programs. Criminal justice involvement is typically assessed through administrative records or self-reported accounts. The aims of this study are to: 1) assess agreement between self-report and administrative data related to court appearances, and 2) identify individual characteristics that affect discrepancies between sources. Participants were 468 homeless persons with mental illness from the Montreal site of the At Home/Chez Soi randomized controlled trial, in Canada. Self-reported data was collected through an interviewer-administered questionnaire. Administrative data was collected through provincial and municipal court databases. Overall, agreement was good. Discrepancies were more common among those with a diagnosis of mood disorder with psychotic features, and those with a criminal history. Increased age and interviewer's perception of sincerity and interest increased likelihood of concordance. Generally, high agreement between self-report and administrative data suggests that either source can provide reliable information. Further work to understand predictors of discrepancies could further enhance the quality of data collected through these different sources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Statistical controversies in clinical research: comparison of primary outcomes in protocols, public clinical-trial registries and publications: the example of oncology trials.

    PubMed

    Perlmutter, A S; Tran, V-T; Dechartres, A; Ravaud, P

    2017-04-01

    Protocols are often unavailable to peer-reviewers and readers. To detect outcome reporting bias (ORB), readers usually have to resort to publicly available descriptions of study design such as public clinical trial registries. We compared primary outcomes in protocols, ClinicalTrials.gov and publications of oncology trials and evaluated the use of ClinicalTrials.gov as compared with protocols in detecting discrepancies between planned and published outcomes. We searched for phase III oncology trials registered in ClinicalTrials.gov and published in the Journal of Clinical Oncology and New England Journal of Medicine between January 2014 and June 2015. We extracted primary outcomes reported in the protocol, ClinicalTrials.gov and the publication. First, we assessed the quality of primary outcome descriptions by using a published framework. Second, we evaluated modifications of primary outcomes between each source. Finally, we evaluated the agreement, specificity and sensitivity of detecting modifications between planned and published outcomes by using protocols or ClinicalTrials.gov. We included 65 trials, with 81 primary outcomes common among the 3 sources. The proportion of primary outcomes reporting all items from the framework was 73%, 22%, and 75% for protocols, ClinicalTrials.gov and publications, respectively. Eight (12%) trials presented a discrepancy between primary outcomes reported in the protocol and in the publication. Twelve (18.5%) trials presented a discrepancy between primary outcomes registered at ClinicalTrials.gov and in publications. We found a moderate agreement in detecting discrepant reporting of outcomes by using protocols or ClinicalTrials.gov [κ = 0.53, 95% confidence interval (0.25-0.81)]. Using ClinicalTrials.gov to detect discrepant reporting of outcomes showed high specificity (89.5%) but lacked sensitivity (75%) as compared with use of protocols. In oncology trials, primary outcome descriptions in ClinicalTrials.gov are often of low quality and may not reflect what is in the protocol, thus limiting the detection of modifications between planned and published outcomes. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. A possible explanation for the population size discrepancy in tuna (genus Thunnus) estimated from mitochondrial DNA and microsatellite data.

    PubMed

    Qiu, Fan; Kitchen, Andrew; Beerli, Peter; Miyamoto, Michael M

    2013-02-01

    A recent study using both mitochondrial DNA (mtDNA) and microsatellite data reported on a population size discrepancy in the eastern tiger salamander where the effective population size (N(e)) estimate of the former exceeded that of the latter. That study suggested, among other hypotheses, that homoplasy of microsatellite alleles is responsible for the discrepancy. In this investigation, we report 10 new cases of a similar discrepancy in five species of tuna. These cases derive from our Bayesian inferences using data from Pacific Bluefin Tuna (Thunnus orientalis) and Yellowfin Tuna (Thunnus albacares), as well as from published estimates of genetic diversity for additional populations of Yellowfin Tuna and three other tuna species. Phylogenetic character analyses of inferred genealogies of Pacific Bluefin and Yellowfin Tuna reveal similar reduced levels of mtDNA and microsatellite homoplasy. Thus, the discrepancy between inferred population sizes from mtDNA and microsatellite data in tuna is most likely not an artifact of the chosen mutation models used in the microsatellite analyses, but may reflect behavioral differences between the sexes such as female-biased philopatry and male-biased dispersal. This explanation now warrants critical testing with more local populations of tuna and with other animal and plant groups that have different life histories. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

    PubMed

    Jones, Philip M; Chow, Jeffrey T Y; Arango, Miguel F; Fridfinnson, Jason A; Gai, Nan; Lam, Kevin; Turkstra, Timothy P

    2017-10-01

    Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes. Following a prespecified protocol, an electronic database was used to systematically screen and extract data from RCTs published in the top 6 general anesthesiology journals by impact factor (Anaesthesia, Anesthesia & Analgesia, Anesthesiology, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and European Journal of Anaesthesiology) during the years 2007, 2010, 2013, and 2015. A manual search of each journal's Table of Contents was performed (in duplicate) to identify eligible RCTs. An adequately registered trial was defined as being registered in a publicly available trials registry before the first patient being enrolled with an unambiguously defined primary outcome. For adequately registered trials, the outcomes registered in the trial registry were compared with the outcomes reported in the article, with outcome discrepancies documented and analyzed by the type of discrepancy. During the 4 years studied, there were 860 RCTs identified, with 102 RCTs determined to be adequately registered (12%). The proportion of adequately registered trials increased over time, with 38% of RCTs being adequately registered in 2015. The most common reason in 2015 for inadequate registration was registering the RCT after the first patient had already been enrolled. Among adequately registered trials, 92% had at least 1 primary or secondary outcome discrepancy. In 2015, 42% of RCTs had at least 1 primary outcome discrepancy, while 90% of RCTs had at least 1 secondary outcome discrepancy. Despite trial registration being an accepted best practice, RCTs published in anesthesiology journals have a high rate of inadequate registration. While mandating trial registration has increased the proportion of adequately registered trials over time, there is still an unacceptably high proportion of inadequately registered RCTs. Among adequately registered trials, there are high rates of discrepancies between registered and reported outcomes, suggesting a need to compare a published RCT with its trial registry entry to be able to fully assess the quality of the study. If clinicians base their decisions on evidence distorted by primary outcome switching, patient care could be negatively affected.

  15. Explaining Discrepancies Between the Digit Triplet Speech-in-Noise Test Score and Self-Reported Hearing Problems in Older Adults.

    PubMed

    Pronk, Marieke; Deeg, Dorly J H; Kramer, Sophia E

    2018-04-17

    The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults' functional speech-in-noise test result and their self-reported hearing problems. Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is aware: those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is well: those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher self-efficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke R2 = .11 for the unaware model, and .10 for the false complaints model). The findings suggest that a small proportion of the discrepancies between older individuals' results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person's health (chronic diseases), demographics (gender), personality (self-efficacy to initiate behavior and to persist in adversity, self-esteem), mood (depressive symptoms), and social situation (social network size). Implications are discussed.

  16. 7 CFR 1773.39 - Utility plant and accumulated depreciation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... all services contracted for were in fact rendered; (iii) Reviewed time cards and pay rates for several... differences in the workpapers; and (3) Commented, in the management letter, on any discrepancies. (d...

  17. A qualitative evaluation of a comprehensive self-management programme for COPD patients: effectiveness from the patients' perspective.

    PubMed

    Monninkhof, Evelyn; van der Aa, Maaike; van der Valk, Paul; van der Palen, Job; Zielhuis, Gerhard; Koning, Karen; Pieterse, Marcel

    2004-11-01

    The COPE self-management programme, including a self-management education course, self-treatment of exacerbations and a fitness programme, appeared to have no significant effect on health related quality of life (HRQoL) as measured by the St. George's Respiratory Questionnaire (SGRQ). This is in contrast to our hypothesis and despite expressions of satisfaction of patients to healthcare workers. To understand this discrepancy, a qualitative study was performed. A purposive sample of 20 participants of the COPE self-management programme were interviewed at home using in-depth, semi-structured interviews. Interviews were audio taped and transcribed verbatim and analysed according grounded theory. The fitness programme was most positively evaluated by patients due to the perceived increase of exercise capacity and the social aspect of the group training. Major effects gained by the self-management education course reported by patients were the skills to evenly distribute their energy and to listen to their body signals. Most patients thought favourable about self-treatment of exacerbations. The possibility to start early, not having to call a doctor and autonomy were raised as important advantages. Furthermore, several patients reported increased self-confidence and coping behaviour as important effects of the COPE programme. Finally, many patients reported feeling safe due to the frequent follow-up visits and 24h access to the hospital, and this aspect elicited to be very important. In this study, the qualitative interviews suggest that the SGRQ and possibly other existing HRQoL instruments might fail to capture the full experience of patients in self-management studies. The need for more elaborate qualitative research on this subject is indicated.

  18. Work-family conflict and self-discrepant time allocation at work.

    PubMed

    Dahm, Patricia C; Glomb, Theresa M; Manchester, Colleen Flaherty; Leroy, Sophie

    2015-05-01

    We examine the relationships between work-to-family conflict, time allocation across work activities, and the outcomes of work satisfaction, well-being, and salary in the context of self-regulation and self-discrepancy theories. We posit work-to-family conflict is associated with self-discrepant time allocation such that employees with higher levels of work-to-family conflict are likely to allocate less time than preferred to work activities that require greater self-regulatory resources (e.g., tasks that are complex, or those with longer term goals that delay rewards and closure) and allocate more time than preferred to activities that demand fewer self-regulatory resources or are replenishing (e.g., those that provide closure or are prosocial). We suggest this self-discrepant time allocation (actual vs. preferred time allocation) is one mechanism by which work-to-family conflict leads to negative employee consequences (Allen, Herst, Bruck, & Sutton, 2000; Mesmer-Magnus & Viswesvaran, 2005). Using polynomial regression and response surface methodology, we find that discrepancies between actual and preferred time allocations to work activities negatively relate to work satisfaction, psychological well-being, and physical well-being. Self-discrepant time allocation mediates the relationship between work-to-family conflict and work satisfaction and well-being, while actual time allocation (rather than the discrepancy) mediates the relationship between work-to-family conflict and salary. We find that women are more likely than men to report self-discrepant time allocations as work-to-family conflict increases. (c) 2015 APA, all rights reserved.

  19. Clinical impact of second opinion in thyroid fine needle aspiration cytology (FNAC): A study of 922 interinstitutional consultations.

    PubMed

    Bajaj, Jaya; Morgenstern, Nora; Sugrue, Chiara; Wasserman, Jason; Wasserman, Patricia

    2012-05-01

    Interinstitutional consultation in pathology has shown to improve patient safety by detecting interpretive errors that may significantly impact clinical management. We conducted a study of 922 cases of thyroid FNAC slides, referred to our institution over a 2-year period, to assess the magnitude of discrepancies and determine the clinical impact of second opinion. Disagreements were categorized as none, minor or major, the latter two defined as one- or two-step deviations respectively on the NCI diagnostic categories scale. There were 122 disagreements (13%), including 44 major and 78 minor. Seventy-five patients underwent a change in management based on second opinion, in conjunction with clinical and radiologic findings (age, size of nodule, family history, ultrasonographic appearance, and solitary versus multiple nodules). The second opinion was supported on follow-up in 57% of major discrepancies, and the initial diagnosis was concurrent with the surgical diagnosis in 7% cases. The remainder (36%) of major discrepancy cases did not undergo surgery, precluding tissue confirmation. Critics have alleged increased costs due to interinstitutional consultations. However, cost avoidance from lost wages, potential surgical complications, and litigation is not easily quantified. Using a simplified calculation to objectively measure the costs associated with changed diagnoses, we estimate that second opinion of these 922 cases resulted in potential cost saving of $940,166 based on current Medicare reimbursement codes. Our study indicates the need for a quality-control program of outside thyroid FNA slides, especially in "high discrepancy categories" as discussed in the article. Copyright © 2011 Wiley-Liss, Inc.

  20. Cracked but Not Broken: The Continued Gender Gap in Senior Administrative Positions

    ERIC Educational Resources Information Center

    Gander, Michelle

    2010-01-01

    Much has been written about the glass ceiling and pay differentials in higher and further education (HE, FE) for women academics (McTavish and Miller 2009, Rees 2007) but very little about discrepancies for women "professional managers" within UK higher education. Professional managers as a term needs to be defined as universities call…

  1. CARA Status and Upcoming Enhancements

    NASA Technical Reports Server (NTRS)

    Johnson, Megan

    2017-01-01

    CAS 8.4.3 was deployed to operations on 13 June 2017. Discrepancies Between 3D Pc Estimates and advanced Monte Carlo Equinoctial-Sampling Pc Estimates discovered and discussed at 23 May 2017 Useras (Registered Trademark) Forum. The patch created the Reporting Pc, which is the greater value between the calculated 2D and 3D Pc values This changed the Pc reported in the CDMs to the Reporting Pc This changed the Pc reported on the Summary Report to the Reporting Pc This changed the Pc reported on Maneuver Screening Analysis (MSA) Report to the Reporting Pc. Both the 2D and 3D Pc added to the Summary Report details section The patch also updated the 3D Pc algorithm to eliminate velocity covariance from the Pc calculation This will bring 2D and 3D Pc into close alignment for vast majority of events, particularly for the events in which the 2D/3D discrepancy was found.

  2. [Histopathological diagnostic concordance in bone and soft tissue sarcomas between two comprehensive cancer centers from eastern and western Europe: a collaborative experience].

    PubMed

    Somcutian, Oana; Buiga, Rares; Galatir, Mihaela; Tudor Eniu, Dan; Rachieru, Claudiu; Coza, Daniela; Terrier, Philippe

    2015-01-01

    This study aims to assess the degree of concordance of histological diagnosis of bone and soft tissue sarcomas between a Comprehensive Cancer Center (CCC) of Eastern Europe - not specialized in this area of pathology - and an important CCC of Western Europe, which is one of the coordinators of a clinical reference network in sarcoma pathology. The goal is to have an overview of the sarcomatous pathology in a region of Eastern Europe and to discover diagnostic discrepancies between the two centers, while determining their cause. The initial diagnosis was compared with the revised diagnosis on 110 specimens from 88 patients with bone or soft tissue sarcomas from East-European CCC, in a one-year period of time. Complete diagnostic agreement was observed in 55 cases (62.5%), a partial agreement in 23 cases (26.1%) and a major disagreement in 10 cases (11.4%). Major discrepancies of the histological type was observed in only 3 cases (3.4%): one case of discordance benign/malignant and 2 cases of discordance mesenchymal/non mesenchymal. Minor histological discrepancies - not affecting the management of the patient - were observed in 18 cases (20.4%). A major discordance in grading - potentially changing the management of the patient - was noted in 7 cases (7.9%), and a minor discrepancy in 5 cases (5.7%). Some histological types were clearly overdiagnosed, like "adult fibrosarcomas" and "malignant peripheral nerve sheet tumors" (MPNST), mostly converted after the audit into "undifferentiated spindle cell sarcomas" or other types of sarcomas. Some "unclassified" sarcomas and "undifferentiated pleomorphic sarcomas" could be re-classified with the aid of an extensive panel of antibodies. Overall, immunohistochemistry was responsible, but not in exclusivity, for half of the minor discrepancies, and for 2 out of 3 cases of major histological discrepancies. Otherwise, the main cause of discrepancies was the difficulties in the interpretation of the morphology. Molecular biology was decisive in one case. Most grading discrepancies resulted from the appreciation of the mitotic index. The profile of the sarcomatous pathology in the northwest region of Romania does not appear to differ significantly from other parts of Europe or the world, but a prospective epidemiological study would be necessary to confirm this assessment. The expansion of immunohistochemical antibody panel, the over-specialization of pathologists and, in the future, the establishment of a national network of referral centers in sarcoma pathology, are required for a high level of histological diagnosis in Eastern Europe. A periodic external audit, continuing this trans-European collaboration between the two centers, would be beneficial for monitoring progress. Copyright © 2014. Published by Elsevier Masson SAS.

  3. Effects of perfectionism and exercise on disordered eating in college students.

    PubMed

    Paulson, Lauren R; Rutledge, Patricia C

    2014-01-01

    This study examined two dimensions of perfectionism (Standards and Discrepancy), two aspects of exercise (cardiovascular and strength), and the interaction of these variables as predictors of disordered eating in female and male college students. Recruited participants (N=314; n=204 women) completed self-report measures of disordered eating (Eating Attitudes Test), perfectionism (Almost Perfect Scale-Revised; Standards and Discrepancy subscales), and exercise (strength and cardiovascular). Among women, there was a significant three-way interaction between the two dimensions of perfectionism (Standards and Discrepancy) and cardiovascular exercise. Also among women, there was a significant two-way interaction between the Standards dimension and strength exercise and between the Discrepancy dimension and strength exercise. There were no significant main effects or interactions among men. We found some support for the hypotheses that adaptive perfectionism (higher Standards coupled with lower Discrepancy) is a protective factor for disordered eating and that maladaptive perfectionism (higher Standards coupled with higher Discrepancy) is a risk factor, although, only among women who engaged in lower, but not higher, levels of cardiovascular exercise. The findings also suggest that it may be beneficial to consider dimensions of perfectionism and exercise separately when studying disordered eating. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Integrating Safety in the Aviation System: Interdepartmental Training for Pilots and Maintenance Technicians

    NASA Technical Reports Server (NTRS)

    Mattson, Marifran; Petrin, Donald A.; Young, John P.

    2001-01-01

    The study of human factors has had a decisive impact on the aviation industry. However, the entire aviation system often is not considered in researching, training, and evaluating human factors issues especially with regard to safety. In both conceptual and practical terms, we argue for the proactive management of human error from both an individual and organizational systems perspective. The results of a multidisciplinary research project incorporating survey data from professional pilots and maintenance technicians and an exploratory study integrating students from relevant disciplines are reported. Survey findings suggest that latent safety errors may occur during the maintenance discrepancy reporting process because pilots and maintenance technicians do not effectively interact with one another. The importance of interdepartmental or cross-disciplinary training for decreasing these errors and increasing safety is discussed as a primary implication.

  5. Status of Neonatal Pain Assessment and Management in Jordan.

    PubMed

    Abdel Razeq, Nadin M; Akuma, Akuma O; Jordan, Sue

    2016-08-01

    Current pain assessment and management in neonates need to be fully described before neonatal pain care can be optimized. This study's purpose was to report neonatal nurses' knowledge, existing pain assessment practice, and pharmacological pain management of neonates in Jordan. A cross-sectional descriptive study was conducted. Eighteen neonatal intensive care units in Jordan were included in the study. One hundred eighty-four neonatal nurses participated. Questionnaires were distributed by and returned to the neonatal intensive care units' managers between June and August 2014. Descriptive and inferential statistics were used to present study results. Of 240 questionnaires distributed, 184 useable responses were returned. Nurses' knowledge regarding neonates' neurological development, nociception, and need for neonatal pain management was suboptimal. The analgesics most commonly used to treat neonatal pain were acetaminophen (52%) and lidocaine (45%). Benzodiazepines, phenobarbitone, and muscles relaxants were also used. Most nurses (54%-97%) reported that pain emanating from most painful procedures was never or rarely treated. Circumcision, lumbar punctures, and chest tube insertion were assigned the highest pain scores (≥9), but were rarely accompanied by analgesia. Pain assessment scales were more likely to be used, and procedural pain was more likely to be treated, in private hospitals than public hospitals. Neonates who require special care still suffer unnecessary pain that could be avoided and managed by following best practice recommendations. Disparities between developed and developing countries in quality of neonatal pain care appear to exist. Resources for education and routine care are needed to address these discrepancies. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Disagreement in Parental Reports of Father Involvement

    PubMed Central

    Charles, Pajarita; Spielfogel, Jill; Gorman-Smith, Deborah; Schoeny, Michael; Henry, David; Tolan, Patrick

    2016-01-01

    Despite agreement on the value of father involvement in children’s lives, research has been limited due to the exclusion of fathers in studies, questionable validity of mothers’ reports on father involvement, and simple measures of fathering behavior. Our study extends previous research by comparing reports of father involvement using robust, multidimensional father involvement measures. Data from 113 fathers and 126 mothers reporting on 221 children were used to assess father involvement. Results indicate that fathers reported significantly higher levels of involvement than mothers reported. Findings from hierarchical linear models suggest that race/ethnicity and mothers’ reports of positive relationship quality were associated with smaller discrepancies in reports of father involvement, whereas nonmarried partnerships, older children, father residence, and biological status predicted larger discrepancies. Our study demonstrates the importance of obtaining father involvement reports directly from fathers and why father involvement should be assessed as a multidimensional construct to examine fathering behavior. PMID:29515272

  7. Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report.

    PubMed

    Leyder, Patrick; Altounian, Gérard; Chardain, Jacques; Quilichini, Julien

    2015-09-01

    Surgically assisted rapid maxillary expansion (SARME) is usually considered the gold standard for maxillary transverse expansion in adults. However, a second surgical procedure is needed in cases of associated sagittal or vertical discrepancies. We describe the use of two new innovative devices for the correction of discrepancies in all dimensions during a single surgical procedure, thus reducing treatment duration. We report the case of a 21-year-old female patient, referred to our department for skeletal Class III malocclusion associated with right-side laterognathism and transverse maxillary deficiency. The patient underwent one-stage surgery, using sliding osteosynthesis plates and an adjustable bone-borne distractor. Pre-surgical orthodontics consisted in leveling and aligning the mandibular arch; maxillary leveling was initiated 3 months before surgery. Postoperative palatal distraction combined with orthodontic finishing enabled complete correction of dental and bony discrepancies after 3 months. In our experience, treatment of transverse, sagittal and vertical discrepancies has been possible in a single surgical procedure, using two innovative techniques: sliding osteosynthesis and an adjustable bone distractor. Two years post-surgery, the correction is stable in all dimensions. Copyright © 2015. Published by Elsevier Masson SAS.

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

    PubMed

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

    2017-12-27

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

  9. Sexual Closeness Discrepancies: What They Are and Why They Matter for Sexual Well-Being in Romantic Relationships.

    PubMed

    Frost, David M; McClelland, Sara I; Dettmann, Miranda

    2017-11-01

    This study examined the impact of sexual closeness on sexual well-being. We developed a nuanced and multifaceted conceptualization of sexual closeness in the form of a constellation of ideal sexual closeness with a partner, actual sexual closeness, and the discrepancy between the two. Data were obtained from a diverse sample of N = 619 participants who took part in the Lives and Relationships Study: A longitudinal survey of men and women in relationships living in the U.S. and Canada. Increases in sexual closeness discrepancies over a period of 1 year predicted concomitant decreases in two indicators of sexual well-being: sexual satisfaction and orgasm frequency evaluations. Decreases in sexual closeness discrepancies resulted in improvement in sexual well-being. Individuals who reported no sexual closeness discrepancies and experienced no changes in sexual closeness discrepancies tended to have the highest levels of sexual well-being. Importantly, sexual closeness discrepancies were robust predictors of sexual well-being, above and beyond individuals' actual sexual closeness, general relationship closeness, and other demographic and relationship characteristics known to be associated with sexual well-being. The present findings demonstrate that how close people feel sexually to their relationship partners is part of a general constellation of factors related to relationship closeness that, only when considered together, sufficiently explain the ways in which experiences of closeness impact sexual well-being in romantic relationships.

  10. Accelerometer thresholds: Accounting for body mass reduces discrepancies between measures of physical activity for individuals with overweight and obesity.

    PubMed

    Raiber, Lilian; Christensen, Rebecca A G; Jamnik, Veronica K; Kuk, Jennifer L

    2017-01-01

    The objective of this study was to explore whether accelerometer thresholds that are adjusted to account for differences in body mass influence discrepancies between self-report and accelerometer-measured physical activity (PA) volume for individuals with overweight and obesity. We analyzed 6164 adults from the National Health and Nutrition Examination Survey between 2003-2006. Established accelerometer thresholds were adjusted to account for differences in body mass to produce a similar energy expenditure (EE) rate as individuals with normal weight. Moderate-, vigorous-, and moderate- to vigorous-intensity PA (MVPA) durations were measured using established and adjusted accelerometer thresholds and compared with self-report. Durations of self-report were longer than accelerometer-measured MVPA using established thresholds (normal weight: 57.8 ± 2.4 vs 9.0 ± 0.5 min/day, overweight: 56.1 ± 2.7 vs 7.4 ± 0.5 min/day, and obesity: 46.5 ± 2.2 vs 3.7 ± 0.3 min/day). Durations of subjective and objective PA were negatively associated with body mass index (BMI) (P < 0.05). Using adjusted thresholds increased MVPA durations, and reduced discrepancies between accelerometer and self-report measures for overweight and obese groups by 6.0 ± 0.3 min/day and 17.7 ± 0.8 min/day, respectively (P < 0.05). Using accelerometer thresholds that represent equal EE rates across BMI categories reduced the discrepancies between durations of subjective and objective PA for overweight and obese groups. However, accelerometer-measured PA generally remained shorter than durations of self-report within all BMI categories. Further research may be necessary to improve analytical approaches when using objective measures of PA for individuals with overweight or obesity.

  11. Comparison between publicly accessible publications, registries, and protocols of phase III trials indicated persistence of selective outcome reporting.

    PubMed

    Zhang, Sheng; Liang, Fei; Li, Wenfeng

    2017-11-01

    The decision to make protocols of phase III randomized controlled trials (RCTs) publicly accessible by leading journals was a landmark event in clinical trial reporting. Here, we compared primary outcomes defined in protocols with those in publications describing the trials and in trial registration. We identified phase III RCTs published between January 1, 2012, and June 30, 2015, in The New England Journal of Medicine, The Lancet, The Journal of the American Medical Association, and The BMJ with available protocols. Consistency in primary outcomes between protocols and registries (articles) was evaluated. We identified 299 phase III RCTs with available protocols in this analysis. Out of them, 25 trials (8.4%) had some discrepancy for primary outcomes between publications and protocols. Types of discrepancies included protocol-defined primary outcome reported as nonprimary outcome in publication (11 trials, 3.7%), protocol-defined primary outcome omitted in publication (10 trials, 3.3%), new primary outcome introduced in publication (8 trials, 2.7%), protocol-defined nonprimary outcome reported as primary outcome in publication (4 trials, 1.3%), and different timing of assessment of primary outcome (4 trials, 1.3%). Out of trials with discrepancies in primary outcome, 15 trials (60.0%) had discrepancies that favored statistically significant results. Registration could be seen as a valid surrogate of protocol in 237 of 299 trials (79.3%) with regard to primary outcome. Despite unrestricted public access to protocols, selective outcome reporting persists in a small fraction of phase III RCTs. Only studies from four leading journals were included, which may cause selection bias and limit the generalizability of this finding. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Parent-Adolescent Informant Discrepancies of Social Skill Importance and Social Skill Engagement for Higher-Functioning Adolescents with Autism Spectrum Disorder

    PubMed Central

    McMahon, Camilla M.; Solomon, Marjorie

    2015-01-01

    Parent- and adolescent-report of social skill importance and social skill engagement on the Social Skills Rating System (Gresham & Elliott, 1990) were assessed in higher-functioning adolescents with Autism Spectrum Disorder (ASD). Compared to parents, adolescents reported that social skills were less important. Additionally, adolescents reported that they engaged in social skills more frequently than parents reported them to be engaging in social skills. Parents, but not adolescents, reported a discrepancy between importance and engagement, such that the importance of social skills was rated higher than the frequency of adolescent engagement in social skills. These results suggest that social skills interventions for individuals with ASD may need to target awareness of social skill importance and accurate monitoring of social skill engagement. PMID:26077952

  13. NASA University Program Management Information System

    NASA Technical Reports Server (NTRS)

    Gans, Gary

    1997-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA's objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well-being. NASA field codes and certain Headquarters program offices provide funds for those activities in universities which contribute to the mission needs of that particular NASA element. Although NASA has no predetermined amount of money to devote to university activities, the effort funded each year is substantial. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data. This report was prepared by the Education Division/FE, Office of Human Resources and Education, using a management information system which was modernized during FY 1993.

  14. NASA University Program Management Information System

    NASA Technical Reports Server (NTRS)

    2000-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA:s objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well-being. NASA field codes and certain Headquarters program offices provide funds for those activities in universities which contribute to the mission needs of that particular NASA element. Although NASA has no predetermined amount of money to devote to university activities, the effort funded each year is substantial. This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA:s Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data.* This report was prepared by the Education Division/FE, Office of Human Resources and Education, using a management information system which was modernized during FY 1993.

  15. Physical violence against children reported to the police: discrepancies between register-based data and child victim survey.

    PubMed

    Kuoppamäki, Sanna-Mari; Kääräinen, Juha; Ellonen, Noora

    2011-01-01

    This study examines the reporting and not reporting of child victimization to the police. The study focuses on comparing the police reports of child victimization to the Finnish Child Victim Survey (FCVS) to find out the kind of violence that is reported to the police and the kind that is not. A total number of 242 police reports of 12-year-old victims of physical violence were collected from the Finnish Police Information System. These reports were compared to the 12-year-old children's victimization experiences in the FCVS. Discrepancies between these two data can be found in the victim's gender, the relationship between the victim and the suspect, and the location of the assault. Physical violence against girls committed by mothers is not reported as often as physical violence against boys committed by men.

  16. Trends in Home Smoking Bans in the U.S., 1995–2007: Prevalence, Discrepancies, and Disparities

    PubMed Central

    Zhang, Xiao; Martinez-Donate, Ana P.; Kuo, Daphne; Jones, Nathan R.; Palmersheim, Karen A.

    2017-01-01

    Background Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in a) the adoption of home smoking bans; b) discrepancies in parental smoking ban reports; and c) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007. Methods We used data from the 1995/1996, 1998/1999, 2001/2002, 2003 and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period. Results Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education, or without infants were consistently less likely to report a home smoking ban over this period (p<0.05). Conclusion Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents, or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases. PMID:21813487

  17. Policy revision in health enterprise information security: P3WG final report

    NASA Astrophysics Data System (ADS)

    Sostrom, Kristen; Collmann, Jeff R.

    2003-05-01

    Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center (TATRC), TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG) examined military policies and regulations relating to computer-based information systems and medical records management. Using an interdisciplinary and interservice QA approach they compared existing military policies with the Health Insurance Portability and Accountability Act (HIPAA) Security Rule to identify gaps and discrepancies. The final report, including a plain English explanation of the individual standards and relevance to the Department of Defense (DoD), a comparative analysis and recommendations, will feed in to the security management process and HIPAA implementation efforts at multiple levels within the DoD. In light of High Reliability Theory, this process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains, building consensus on key policy reforms among military stakeholders across different disciplines, levels of command hierarchy and services.

  18. 41 CFR 128-50.103 - Investigation of any discrepancy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 50-SEIZED PERSONAL PROPERTY 50.1-Storage and... property, a board of survey shall conduct an investigation in accordance with 41 CFR 128-51.1. (b) If the...

  19. 41 CFR 128-50.103 - Investigation of any discrepancy.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 50-SEIZED PERSONAL PROPERTY 50.1-Storage and... property, a board of survey shall conduct an investigation in accordance with 41 CFR 128-51.1. (b) If the...

  20. Low numeracy predicts reduced accuracy of retrospective reports of frequency of sexual behavior.

    PubMed

    McAuliffe, Timothy L; DiFranceisco, Wayne; Reed, Barbara R

    2010-12-01

    Assessment of the frequency of sexual behavior relies on participants' ability to arithmetically aggregate information over time and across partners. This study examines the effect of numeracy (arithmetic skills) on the accuracy of retrospective reports of sexual behavior. For 91 days, the participants completed daily reports about their sexual activity. Participants then completed a survey on sexual behavior over the same period. The discrepancies between the survey-based and the diary-based measures of frequency of vaginal and anal intercourse were evaluated. Multiple regression analysis showed that the discrepancy between retrospective and diary measurements of sexual intercourse increased with lower numeracy (P = 0.026), lower education (P = 0.001), aggregate question format compared to partner-by-partner format (P = 0.031) and higher frequency of intercourse occasions (P < 0.001). Lower numeracy led to a 1.5-fold increase (adjusted mean = 14.1-20.9) in the discrepancy for those using the aggregate question format and a 2.0-fold increase (adjusted mean = 3.7-7.6) for those using the partner-by-partner format.

  1. Post-transcriptional Regulation of Tyrosine Hydroxylase Expression in Adrenal Medulla and Brain

    PubMed Central

    Tank, A. William; Xu, Lu; Chen, Xiqun; Radcliffe, Pheona; Sterling, Carol R.

    2009-01-01

    It is well-established that long-term stress leads to induction of tyrosine hydroxylase (TH) mRNA and TH protein in adrenal medulla and brain. This induction is usually associated with stimulation of TH gene transcription rate. However, a number of studies have reported major discrepancies between the stress-induced changes in TH gene transcription, TH mRNA and TH protein. These discrepancies suggest that post-transcriptional mechanisms also play an important role in regulating TH expression in response to stress and other stimuli. In this report we summarize some of our findings and literature reports that demonstrate these discrepancies in adrenal medulla, locus coeruleus and midbrain dopamine neurons. We then describe our recent work investigating the molecular mechanisms that mediate this post-transcriptional regulation in adrenal medulla and midbrain. Our results suggest that trans-acting factors binding to the polypyrimidine-rich region of the 3′UTR of TH mRNA play a role in these post-transcriptional mechanisms. A hypothetical cellular model describing this post-transcriptional regulation is proposed. PMID:19120116

  2. Interlaboratory discrepancy of antigenuria results in 2 patients with AIDS and histoplasmosis.

    PubMed

    McKinsey, David S; McKinsey, Joel P; Northcutt, Noelle; Sarria, Juan C

    2009-01-01

    Histoplasma polysaccharide antigen testing is used routinely to diagnose histoplasmosis. At least 3 antigen tests are commercially available. Controversy exists about the relative accuracy of these tests. We report 2 patients with AIDS and culture-confirmed Histoplasma capsulatum meningitis from whom discrepant Histoplasma polysaccharide antigen results were obtained from different laboratories and discuss the potential clinical implications of these results.

  3. Evaluation of discrepancies between thermoluminescent dosimeter and direct-reading dosimeter results

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shaw, K.R.

    1993-07-01

    Currently at Oak Ridge National Laboratory (ORNL), the responses of thermoluminescent dosimeters (TLDs) and direct-reading dosimeters (DRDs) are not officially compared or the discrepancies investigated. However, both may soon be required due to the new US Department of Energy (DOE) Radiological Control Manual. In the past, unofficial comparisons of the two dosimeters have led to discrepancies of up to 200%. This work was conducted to determine the reasons behind such discrepancies. For tests conducted with the TLDs, the reported dose was most often lower than the delivered dose, while DRDs most often responded higher than the delivered dose. Trends weremore » identified in personnel DRD readings, and ft was concluded that more training and more control of the DRDs could improve their response. TLD responses have already begun to be improved; a new background subtraction method was implemented in April 1993, and a new dose algorithm is being considered. It was concluded that the DOE Radiological Control Manual requirements are reasonable for identifying discrepancies between dosimeter types, and more stringent administrative limits might even be considered.« less

  4. Value of Supraregional Multidisciplinary Review for the Contemporary Management of Testicular Tumors.

    PubMed

    Purshouse, Karin; Watson, Robert A; Church, David N; Richardson, Charlotte; Crane, Gemma; Traill, Zoe; Sullivan, Mark; Roberts, Ian; Browning, Lisa; Turner, Gareth; Parameshwaran, Vishnu; Johnson, Joseph; Chitnis, Meenali; Protheroe, Andrew; Verrill, Clare

    2017-02-01

    Testicular cancers are an uncommon and highly curable group of tumors that are typically managed by specialist multidisciplinary teams (MDTs). Although recent guidelines have emphasized the importance of tumor prognostic factors in predicting recurrence and personalizing therapy in early-stage disease, the role of central pathology review in determining these factors is unclear. We compared the referral histopathology reports with those obtained after expert central review for all cases reviewed by the UK Thames Valley Cancer Network testicular tumor MDT from August 2004 to September 2012. For cases in which the findings differed, we recorded the effect of the alteration on the estimates of patient prognosis and predicted clinical management using international (European Society of Medical Oncology [ESMO]) and local guidelines. The histopathology reports were altered after central review in 129 of 465 cases (27.7%) referred to the testicular tumor MDT during the study period. These resulted in changes in the estimation of prognosis for 42 patients (9.0% total), with a predicted affect on management according to the ESMO guidelines in 30 cases (6.5%). These proportions were broadly similar for both seminoma and nonseminoma, although the reasons for the discrepancies differed between the 2 (principally errors in categorization of rete testis invasion in seminoma and of lymphovascular invasion in nonseminoma). Changes to the tumor type were uncommon (2 cases). Central MDT review results in frequent, clinically relevant alterations to testicular tumor histopathology reports for testicular tumors. The results of our study demonstrate the importance of specialist MDTs to inform patient-centered care and ensure best practice in the management of these uncommon cancers. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Prevalence of clinical trial status discrepancies: A cross-sectional study of 10,492 trials registered on both ClinicalTrials.gov and the European Union Clinical Trials Register.

    PubMed

    Fleminger, Jessica; Goldacre, Ben

    2018-01-01

    Trial registries are a key source of information for clinicians and researchers. While building OpenTrials, an open database of public trial information, we identified errors and omissions in registries, including discrepancies between descriptions of the same trial in different registries. We set out to ascertain the prevalence of discrepancies in trial completion status using a cohort of trials registered on both the European Union Clinical Trials Register (EUCTR) and ClinicalTrials.gov. We used matching titles and registry IDs provided by both registries to build a cohort of dual-registered trials. Completion statuses were compared; we calculated descriptive statistics on the prevalence of discrepancies. 11,988 dual-registered trials were identified. 1,496 did not provide a comparable completion status, leaving 10,492 trials. 16.2% were discrepant on completion status. The majority of discrepancies (90.5%) were a 'completed' trial on ClinicalTrials.gov inaccurately marked as 'ongoing' on EUCTR. Overall, 33.9% of dual-registered trials described as 'ongoing' on EUCTR were listed as 'completed' on ClinicalTrials.gov. Completion status on registries is commonly inaccurate. Previous work on publication bias may underestimate non-reporting. We describe simple steps registry owners and trialists could take to improve accuracy.

  6. Redefining the Practice of Peer Review Through Intelligent Automation-Part 3: Automated Report Analysis and Data Reconciliation.

    PubMed

    Reiner, Bruce I

    2018-02-01

    One method for addressing existing peer review limitations is the assignment of peer review cases on a completely blinded basis, in which the peer reviewer would create an independent report which can then be cross-referenced with the primary reader report of record. By leveraging existing computerized data mining techniques, one could in theory automate and objectify the process of report data extraction, classification, and analysis, while reducing time and resource requirements intrinsic to manual peer review report analysis. Once inter-report analysis has been performed, resulting inter-report discrepancies can be presented to the radiologist of record for review, along with the option to directly communicate with the peer reviewer through an electronic data reconciliation tool aimed at collaboratively resolving inter-report discrepancies and improving report accuracy. All associated report and reconciled data could in turn be recorded in a referenceable peer review database, which provides opportunity for context and user-specific education and decision support.

  7. Engineering Supply Management System: The Next Generation

    DTIC Science & Technology

    1991-09-01

    010 Partia! receipts 0018 Automatic inventory update 0 048 Discrepant material 0 004 Order processing requirements Transaction reversal capability 0 012...August 1991. 2-5 sys.em’s modules that support the DEH’s needs are the Sales Order Processing , Register Sales, Purchase Order Processing , Inventory...modular system developed by PIC Business Systems, Incorporated. This system possesses Order Processing , Inventory Management, Purchase Orders, and

  8. Telling tails explain the discrepancy in sexual partner reports.

    PubMed

    Morris, M

    1993-09-30

    An anomaly often noted in surveys of sexual behaviour is that the number of female sexual partners reported by men exceeds the number of male partners reported by women. This discrepancy is sometimes interpreted as evidence that surveys produce unreliable data due to sex-linked response and sampling bias. We report here that among the 90% of respondents reporting fewer than 20 lifetime partners, however, the ratio of male to female reports drops from 3.2:1 to 1.2:1. The anomaly thus appears to be driven by the upper tail of the contact distribution, an example of the general principle of outlier influence in data analysis. The implication is that sexual behaviour surveys provide reliable data in the main, and that simple improvements can increase precision in the upper tail to make these data more useful for modelling the spread of AIDS and other sexually transmitted diseases.

  9. Regression-Based Estimates of Observed Functional Status in Centenarians

    PubMed Central

    Mitchell, Meghan B.; Miller, L. Stephen; Woodard, John L.; Davey, Adam; Martin, Peter; Burgess, Molly; Poon, Leonard W.

    2011-01-01

    Purpose of the Study: There is lack of consensus on the best method of functional assessment, and there is a paucity of studies on daily functioning in centenarians. We sought to compare associations between performance-based, self-report, and proxy report of functional status in centenarians. We expected the strongest relationships between proxy reports and observed performance of basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). We hypothesized that the discrepancy between self-report and observed daily functioning would be modified by cognitive status. We additionally sought to provide clinicians with estimates of centenarians’ observed daily functioning based on their mental status in combination with subjective measures of activities of daily living (ADLs). Design and Methods: Two hundred and forty-four centenarians from the Georgia Centenarian Study were included in this cross-sectional population-based study. Measures included the Direct Assessment of Functional Status, self-report and proxy report of functional status, and the Mini-Mental State Examination (MMSE). Results: Associations between observed and proxy reports were stronger than between observed and self-report across BADL and IADL measures. A significant MMSE by type of report interaction was found, indicating that lower MMSE performance is associated with a greater discrepancy between subjective and objective ADL measures. Implications: Results demonstrate associations between 3 methods of assessing functional status and suggest proxy reports are generally more accurate than self-report measures. Cognitive status accounted for some of the discrepancy between observed and self-reports, and we provide clinicians with tables to estimate centenarians’ performance on observed functional measures based on MMSE and subjective report of functional status. PMID:20974657

  10. Management of fibular hemimelia using the Ilizarov method at Siriraj Hospital in Thailand.

    PubMed

    Unprasert, Prangthong; Kaewpornsawan, Kamolporn; Chotigavanichaya, Chatupon; Eamsobhana, Perajit

    2014-09-01

    Fibular hemimelia is one of the most common congenital longitudinal bone deficiencies. Previous treatment protocols called for amputation of the deficient limb; while others made attempts to save the limb. The objective of treatment is to restore function and achieve patient satisfaction. The authors evaluated the outcomes of the Ilizarov technique for the treatment of leg-length discrepancy and bone associated deformities in patients with fibular hemimelia. The present study also evaluated and assessed complications, knee and ankle function, and patient satisfaction with the treatment. Nine patients with fibular hemimelia who underwent tibial lengthening using the Ilizarov method were reviewed in the present study. Initial condition data, including age, gender type offibular hemimelia, initial limb-length discrepancy, predicted limb-length discrepancy, and the data were collected and analyzed. Activity level, patient satisfaction, complications, and residual leg-length discrepancy were assessed at the end of treatment. According to Achterman and Kalamchi classification, there were 4 patients with Type IA, 3 patients with Type IB, and 2 patients with Type II. In Type IA, the affected leg-length discrepancy and mean age at the initial treatment were 3.25 cm and 7.75 years, respectively. In type IB, the affected leg-length discrepancy and mean age at the initial treatment were 5.83 cm and 4.3 years, respectively. In Type II, the affected leg-length discrepancy and mean age at the initial treatment were 5.5 cm and 5 years, respectively. The mean follow-up was 5 years (range: 7-10). The mean lengthening was 7.52 cm (range: 4-13). The lengthening index was 1.28 mo/cm. The mean residual leg-length discrepancy was 0.94 cm. There was ankle joint stiffness and mild equinous foot in type II cases, but patients could walk well without gait aid. No patients were experiencing pain by the end of treatment. All patients expressed satisfaction with this technique. The Ilizarov technique for bone lengthening of the tibia has shown satisfactory results in the treatment of all types of congenital fibular hemimelia and should be considered an attractive alternative to amputation, as measureable functional improvement can be expected.

  11. Final Draft of RACER Audit

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Paige, Karen Schultz; Gomez, Penelope E.

    This document describes the approach Waste and Environmental Services - Environmental Data and Analysis plans to take to resolve the issues presented in a recent audit of the WES-EDA Environmental Database relative to the RACER database. A majority of the issues discovered in the audit will be resolved in May 2011 when the WES-EDA Environmental Database, along with other LANL databases, are integrated and moved to a new vendor providing an Environmental Information Management (EIM) system that allows reporting capabilities for all users directly from the database. The EIM system will reside in a publicly accessible LANL cloud-based software system.more » When this transition occurs, the data quality, completeness, and access will change significantly. In the remainder of this document, this new structure will be referred to as the LANL Cloud System In general, our plan is to address the issues brought up in this audit in three ways: (1) Data quality issues such as units and detection status, which impinge upon data usability, will be resolved as soon possible so that data quality is maintained. (2) Issues requiring data cleanup, such as look up tables, legacy data, locations, codes, and significant data discrepancies, will be addressed as resources permit. (3) Issues associated with data feed problems will be eliminated by the LANL Cloud System, because there will be no data feed. As discussed in the paragraph above, in the future the data will reside in a publicly accessible system. Note that report writers may choose to convert, adapt, or simplify the information they receive officially through our data base, thereby introducing data discrepancies between the data base and the public report. It is not always possible to incorporate and/or correct these errors when they occur. Issues in the audit will be discussed in the order in which they are presented in the audit report. Clarifications will also be noted as the audit report was a draft document, at the time of this response.« less

  12. Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures.

    PubMed

    Dimaro, Lian V; Roberts, Nicole A; Moghaddam, Nima G; Dawson, David L; Brown, Ian; Reuber, Markus

    2015-05-01

    Self-esteem (SE), or one's sense of competence and worth, is reduced in many mental and physical disorders. Low SE is associated with perceived stigma and disability and poor treatment outcomes. The present study examined implicit and explicit SE (automatic and deliberate views about the self) in people with epilepsy and people with psychogenic nonepileptic seizures (PNESs). Discrepancies between implicit SE and explicit SE have been found to correlate with psychological distress in disorders often associated with PNESs but are relatively unexplored in PNESs. We hypothesized that, compared with epilepsy, PNESs would be associated with lower self-reported SE and greater discrepancies between implicit SE and explicit SE. Thirty adults with PNESs, 25 adults with epilepsy, and 31 controls without a history of seizures were asked to complete the Rosenberg Self-esteem Scale as a measure of explicit SE and an Implicit Relational Assessment Procedure as a measure of implicit SE. The State-Trait Anxiety Inventory and Patient Health Questionnaire-15 (a somatic symptom inventory) were also administered. We found significant group differences in explicit (p<0.001) but not implicit SE. Patients with PNESs reported lower SE than the other groups. No group differences were found in implicit SE. Implicit-explicit SE discrepancies were larger in the group with PNESs than in the other groups (p<0.001). Higher frequency of PNESs (but not epileptic seizures) was associated with lower explicit SE (rs=-.83, p<0.01) and greater SE discrepancies (i.e., lower explicit relative to implicit SE; rs=.65, p<0.01). These relationships remained significant when controlling for anxiety and somatization. Patients with PNESs had lower explicit SE than those with epilepsy or healthy controls. In keeping with our expectations, there were greater discrepancies between implicit SE and explicit SE among patients with PNESs than in the other groups. Our results, including the strong relationship between PNES frequency, anxiety, and explicit-implicit SE discrepancies, support the interpretation that PNESs serve to reduce cognitive dissonance, perhaps protecting patients' implicit SE. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  13. 12 CFR 717.83 - Disposal of consumer information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records... consumer report or is derived from a consumer report and that is maintained or otherwise possessed by or on... information includes: (A) A consumer report that you obtain; (B) Information from a consumer report that you...

  14. Concordance between maternal recall of birth complications and data from obstetrical records.

    PubMed

    Keenan, Kate; Hipwell, Alison; McAloon, Rose; Hoffmann, Amy; Mohanty, Arpita; Magee, Kelsey

    2017-02-01

    Prenatal complications are associated with poor outcomes in the offspring. Access to medical records is limited in the United States and investigators often rely on maternal report of prenatal complications. We tested concordance between maternal recall and birth records in a community-based sample of mothers participating in a longitudinal study in order to determine the accuracy of maternal recall of perinatal complications. Participants were 151 biological mothers, who were interviewed about gestational age at birth, birthweight, and the most commonly occurring birth complications: nuchal cord and meconium aspiration when the female child was on average 6years old, and for whom birth records were obtained. Concordance between reports was assessed using one-way random intra-class coefficients for continuous measures and kappa coefficients for dichotomous outcomes. Associations between maternal demographic and psychological factors and discrepancies also were tested. Concordance was excellent for continuously measured birthweight (ICC=0.85, p<0.001) and good for gestational age (ICC=0.68, p<0.001). Agreement was good for low birthweight (<2500g) (kappa=0.67, p<0.001), fair for preterm delivery (<37weeks gestation) (kappa=0.44, p<0.001), and poor for nuchal cord or meconium aspiration. Most discrepancies were characterized by presence according to birth record and absence according to maternal recall. Receipt of public assistance was associated with a decrease in discrepancy in report of nuchal cord. Concordance between maternal retrospective report and medical birth records varies across different types of perinatal events. There was little evidence that demographic or psychological factors increased the risk of discrepancies. Maternal recall based on continuous measures of perinatal factors may yield more valid data than dichotomous outcomes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  15. Matching colonoscopy and pathology data in population-based registries: development of a novel algorithm and the initial experience of the New Hampshire Colonoscopy Registry.

    PubMed

    Greene, Mary Ann; Butterly, Lynn F; Goodrich, Martha; Onega, Tracy; Baron, John A; Lieberman, David A; Dietrich, Allen J; Srivastava, Amitabh

    2011-08-01

    The quality of polyp-level data in a population-based registry depends on the ability to match each polypectomy recorded by the endoscopist to a specific diagnosis on the pathology report. To review impediments encountered in matching colonoscopy and pathology data in a population-based registry. New Hampshire Colonoscopy Registry data from August 2006 to November 2008 were analyzed for prevalence of missing reports, discrepancies between colonoscopy and pathology reports, and the proportion of polyps that could not be matched because of multiple polyps submitted in the same container. New Hampshire Colonoscopy Registry. This study involved all consenting patients during the study period. Develop an algorithm for capturing number, size, location, and histology of polyps and for defining and flagging discrepancies to ensure data quality. The proportion of polyps with no assumption or discrepancy, the proportion of patient records eligible for determining the adenoma detection rate (ADR), and the number of patients with ≥3 adenomas. Only 50% of polyps removed during this period were perfectly matched, with no assumption or discrepancy. Records from only 69.9% and 29.7% of eligible patients could be used to determine the ADR and the number of patients with ≥3 adenomas, respectively. Rates of missing reports may have been higher in the early phase of establishment of the registry. This study highlights the impediments in collecting polyp-level data in a population-based registry and provides useful parameters for evaluating the quality and accuracy of data obtained from such registries. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  16. Urinary incontinence in working women: a comparison study.

    PubMed

    Palmer, Mary H; Fitzgerald, Sheila

    2002-12-01

    To compare the findings of two surveys concerning the nature of urinary incontinence and management strategies used by full-time employed working women. The first study was conducted in an urban academic setting with a survey distributed to 2000 women. The second study was conducted with 500 women in a rural pottery manufacturing facility. Twenty-one percent of the women working in an academic setting (group A) and 29% (p = 0.002) of the women working in a manufacturing setting (group B) reported being incontinent of urine at least monthly. More women in group B reported antecedents mixed incontinence (i.e., antecedent to both stress and urge incontinence). More women in group B also used panty liners to manage urine loss (p = 0.003), whereas more women in group A used voiding schedules (p = 0.008) and pelvic muscle exercises (p = 0.04). More women in group A reported that they did not know if their incontinence could improve (40% vs. 1%, p = 0.00). The majority in both groups said that getting treatment was of no or little importance, yet, overwhelmingly, most women (group A 81%; group B 86%) wanted more information about incontinence. Incontinence is a prevalent condition in working women. Discrepancies exist in the nature of the urine loss and strategies used to manage incontinence. Treatment also differs for those women who report urine loss to healthcare providers. Most women want to learn more about incontinence. Secondary prevention strategies need to be tailored and tested to meet symptoms and concerns for women in different work settings.

  17. Association Between Sexually Transmitted Diseases and Young Adults' Self-reported Abstinence

    PubMed Central

    DiClemente, Ralph J.; Danner, Fred; Crosby, Richard A.

    2011-01-01

    OBJECTIVE: Self-reported behavior has been the cornerstone of sexual health research and clinical practice, yet advances in sexually transmitted disease (STD) screening provide researchers with the opportunity to objectively quantify sexual risk behaviors. However, the extent to which young adults' laboratory-confirmed STD results and self-reported sexual behaviors are consistent has not been assessed in a nationally representative sample. PATIENTS AND METHODS: Data are derived from participants who completed wave 3 in the National Longitudinal Study of Adolescent Health. Young adults (N = 14 012) completed an audio computer-assisted self-interviewing survey and provided a urine specimen to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and a polymerase chain reaction assay to detect Trichomonas vaginalis. RESULTS: More than 10% of young adults with a laboratory-confirmed positive STD result reported abstaining from sexual intercourse in the 12 months before assessment and STD testing. After controlling for several sociodemographic factors, self-reported sex (versus those who reported abstinence) in the previous 12 months was significantly associated with testing positive, but the odds of testing positive were only slightly more than twofold (adjusted odds ratio: 2.11 [95% confidence interval: 2.097–2.122]). CONCLUSIONS: Findings indicate discrepancy between young adults' positive STD status and self-reported sexual behavior. No significant correlates of discrepant reporting were identified. From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior observed in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity among young adults. PMID:21199852

  18. Implicit and Explicit Self-Esteem Discrepancies, Victimization and the Development of Late Childhood Internalizing Problems.

    PubMed

    Leeuwis, Franca H; Koot, Hans M; Creemers, Daan H M; van Lier, Pol A C

    2015-07-01

    Discrepancies between implicit and explicit self-esteem have been linked with internalizing problems among mainly adolescents and adults. Longitudinal research on this association in children is lacking. This study examined the longitudinal link between self-esteem discrepancies and the development of internalizing problems in children. It furthermore examined the possible mediating role of self-esteem discrepancies in the longitudinal link between experiences of peer victimization and internalizing problems development. Children (N = 330, M(age) = 11.2 year; 52.5 % female) were followed over grades five (age 11 years) and six (age 12 years). Self-report measures were used annually to test for victimization and internalizing problems. Implicit self-esteem was assessed using an implicit association test, while explicit self-esteem was assessed via self-reports. Self-esteem discrepancies represented the difference between implicit and explicit self-esteem. Results showed that victimization was associated with increases in damaged self-esteem (higher levels of implicit than explicit self-esteem. Additionally, damaged self-esteem at age 11 years predicted an increase in internalizing problems in children over ages 11 to 12 years. Furthermore, damaged self-esteem mediated the relationship between age 11 years victimization and the development of internalizing problems. No impact of fragile self-esteem (lower levels of implicit than explicit self-esteem) on internalizing problems was found. The results thus underscore that, as found in adolescent and adult samples, damaged self-esteem is a predictor of increases in childhood internalizing problems. Moreover, damaged self-esteem might explain why children who are victimized develop internalizing problems. Implications are discussed.

  19. Multi-domain predictors of Oppositional Defiant Disorder symptoms in preschool children: Cross-informant differences

    PubMed Central

    Lavigne, John V.; Dahl, Katharine P.; Gouze, Karen R.; LeBailly, Susan A.; Hopkins, Joyce

    2014-01-01

    Existing research suggests that parent and teacher reports of children's behavior problems are often discrepant. The current study examined whether contextual (stress and family conflict), parent (depression), parenting (hostility, support, and scaffolding), and child factors (receptive vocabulary; negative affect, NA; effortful control, EC; inhibitory control, IC; attachment; and sensory regulation, SR) are related to parent-teacher reporting discrepancies. Participants included a community sample of 344 4-year-old children. A multi-informant approach was used to assess contextual, parent, parenting, and child factors. Parents and teachers completed the Oppositional Defiant Disorder (ODD) scale of the Child Symptom Inventory. Consistent with previous data, there was poor agreement between parents and teachers (r =.17). After correcting for multiple comparisons, child effortful control, parent hostility, and family conflict were significant predictors of parent-rated symptoms of ODD symptoms but not teacher-rated ODD symptoms. Only family conflict was a significant predictor of discrepancies in parent and teacher ratings. PMID:24997089

  20. Telepathology between Richmond and Beckley Veterans Affairs Hospitals: report on the first 1000 cases.

    PubMed

    Weisz-Carrington, P; Blount, M; Kipreos, B; Mohanty, L; Lippman, R; Todd, W M; Trent, B

    1999-01-01

    A telepathology connection between Richmond VAMC and Beckley VAMC using dynamic robotic telepathology to provide pathology services remotely was established. This study reports a 14-month experience using telepathology to diagnose surgical specimens obtained from patients at the Beckley VA Medical Center and viewed in Richmond 250 miles away. Over 14 months, 2325 slides representing 1000 cases were viewed. Discrepancies were observed in 20 of 2325 slides, or 0.86% of the total. None of the patients, where a discrepancy was found, were adversely affected by the preliminary report given. This study demonstrates that telepathology is a reliable and cost-effective alternative to on-site pathology services and reviews advantages and disadvantages of the system.

  1. Positron scattering from molecular hydrogen

    NASA Astrophysics Data System (ADS)

    Machacek, J. R.; Anderson, E. K.; Makochekanwa, C.; Buckman, S. J.; Sullivan, J. P.

    2013-10-01

    We present results for total and partial cross sections for positron scattering from H2. The total scattering and positronium formation cross sections are reported between 0.5 and 200 eV. Total quasielastic and inelastic scattering cross sections are reported for energies between the positronium formation threshold and 50 eV, with quasielastic differential scattering cross sections reported at 1, 3, 5, 7, and 10 eV. Our results are compared with previous work, both experimental and theoretical, with particular attention paid to the region below the positronium formation threshold, where there are apparent discrepancies in previous work. A discussion of possible reasons for discrepancies between this and previous work is presented, including a focus on known systematic effects in the experimental results.

  2. The importance of being "me": The relation between authentic identity expression and transgender employees' work-related attitudes and experiences.

    PubMed

    Martinez, Larry R; Sawyer, Katina B; Thoroughgood, Christian N; Ruggs, Enrica N; Smith, Nicholas A

    2017-02-01

    The present research examined the relation between authentic identity expression and transgender employees' work-related attitudes and experiences. Drawing on Kernis' (2003) theoretical conceptualization of authenticity and expanding on current workplace identity management research, we predicted that employees who had taken steps to reduce the discrepancy between their inner gender identities and their outward manifestations of gender would report more positive job attitudes and workplace experiences, in part because the reduction of this discrepancy is related to greater feelings of authenticity. In Study 1, we found that the extent to which one has transitioned was related to higher job satisfaction and perceived person-organization (P-O) fit and lower perceived discrimination. In Study 2, we replicate and extend these results by showing that the extent to which employees felt that others at work perceived them in a manner consistent with how they perceived themselves (relational authenticity) mediated the relations between extent of transition and all 3 of these outcomes. However, perceptions of alignment between one's felt and expressed identity (action authenticity) only mediated this link for job satisfaction. We discuss the theoretical and practical implications of our results, as well as avenues for future research on authenticity in the workplace. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Attitudes to teamwork and safety among Italian surgeons and operating room nurses.

    PubMed

    Prati, Gabriele; Pietrantoni, Luca

    2014-01-01

    Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.

  4. Electronic mail communication between physicians and patients: a review of challenges and opportunities.

    PubMed

    Antoun, Jumana

    2016-04-01

    Although promising benefits hold for email communication between physicians and patients in terms of lowering the costs of health care while maintaining or improving the quality of disease management and health promotion, physician use of email with patients is still low and lags behind the willingness of patients to communicate with their physicians through email. There is also a discrepancy between physicians' willingness and actual practice of email communication. Several factors may explain these discrepancies. They include physicians differ in their experience and attitude towards information technology; some may not be convinced that patients appreciate, need and can communicate by email with their doctors; others are still waiting for robust evidence on service performance and efficiency in addition to patient satisfaction and outcome that support such practice; and many are reluctant to do so because of perceived barriers. This report is a review of the literature on the readiness for and adoption of physician-patient email communication, and how can challenges be or have been addressed. The need for Governmental support and directives for email communication to move forward is iterated, and opportunities for future research are pointed out. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Challenges in estimating the health impact of Hurricane Sandy using macro-level flood data.

    NASA Astrophysics Data System (ADS)

    Lieberman-Cribbin, W.; Liu, B.; Schneider, S.; Schwartz, R.; Taioli, E.

    2016-12-01

    Background: Hurricane Sandy caused extensive physical and economic damage but the long-term health impacts are unknown. Flooding is a central component of hurricane exposure, influencing health through multiple pathways that unfold over months after flooding recedes. This study assesses concordance in Federal Emergency Management (FEMA) and self-reported flood exposure after Hurricane Sandy to elucidate discrepancies in flood exposure assessments. Methods: Three meter resolution New York State flood data was obtained from the FEMA Modeling Task Force Hurricane Sandy Impact Analysis. FEMA data was compared to self-reported flood data obtained through validated questionnaires from New York City and Long Island residents following Sandy. Flooding was defined as both dichotomous and continuous variables and analyses were performed in SAS v9.4 and ArcGIS 10.3.1. Results: There was a moderate agreement between FEMA and self-reported flooding (Kappa statistic 0.46) and continuous (Spearman's correlation coefficient 0.50) measures of flood exposure. Flooding was self-reported and recorded by FEMA in 23.6% of cases, while agreement between the two measures on no flooding was 51.1%. Flooding was self-reported but not recorded by FEMA in 8.5% of cases, while flooding was not self-reported but indicated by FEMA in 16.8% of cases. In this last instance, 84% of people (173/207; 83.6%) resided in an apartment (no flooding reported). Spatially, the most concordance resided in the interior of New York City / Long Island, while the greatest areas of discordance were concentrated in the Rockaway Peninsula and Long Beach, especially among those living in apartments. Conclusions: There were significant discrepancies between FEMA and self-reported flood data. While macro-level FEMA flood data is a relatively less expensive and faster way to provide exposure estimates spanning larger geographic areas affected by Hurricane Sandy than micro-level estimates from cohort studies, macro-level exposure estimates may underestimate the full flooding and health impacts of the hurricane. Future disaster preparedness efforts must integrate micro and macro-level flood exposures to produce the most accurate evaluation of health impacts in affected populations.

  6. Variability of age at onset in siblings with familial Alzheimer disease.

    PubMed

    Gómez-Tortosa, Estrella; Barquero, M Sagrario; Barón, Manuel; Sainz, M Jose; Manzano, Sagrario; Payno, Maria; Ros, Raquel; Almaraz, Carmen; Gómez-Garré, Pilar; Jiménez-Escrig, Adriano

    2007-12-01

    Variability of age at onset (AO) of Alzheimer disease (AD) among members of the same family is important as a biological clue and because of its clinical effects. To evaluate which clinical variables influence the discrepancy in AO among affected relatives with familial AD. Clinical genetic project of Spanish kindred with AD conducted by 4 academic hospitals in Madrid, Spain. Age at onset of AD in 162 families and discrepancy in AO in intragenerational and intergenerational affected pairs were analyzed in relation to age, sex, maternal or paternal transmission, pattern of inheritance, and apolipoprotein E genotype. Maternal transmission of AD was significantly more frequent than paternal transmission (P < .001). In 27% of the affected individuals, AO occurred before the patient was 65 years old. Discrepancy in AO among siblings was within 5 years in 44% of the families, 6 to 10 years in 29%, and more than 10 years in 27% (range, 0-22). This discrepancy was independent of the sex of the sibling pairs and was significantly lower with maternal transmission of AD (P = .02). Segregation analysis showed no differences in the inheritance pattern between families with low (< or =5 years) or high (>5 years) AO discrepancy. Age at onset in carriers of the apolipoprotein E epsilon4 allele was slightly younger. However, among siblings, an extra apolipoprotein E epsilon4 allele was not consistently associated with earlier onset of AD. Eighty percent of patients, independent of sex or mode of transmission, were already affected at their parents' reported AO. There is a wide discrepancy in AO in affected siblings that is not clearly explained by a single clinical variable or apolipoprotein E genotype. The interaction of many factors probably determines AO in each affected individual. However, maternal transmission of AD seems to result in a similar AO in offspring, and the risk of developing dementia after the parent's reported AO decreases significantly.

  7. Discrepancy Between ASTER- and MODIS- Derived Land Surface Temperatures: Terrain Effects

    PubMed Central

    Liu, Yuanbo; Noumi, Yousuke; Yamaguchi, Yasushi

    2009-01-01

    The MODerate resolution Imaging Spectroradiometer (MODIS) and the Advanced Spaceborne Thermal Emission Reflection Radiometer (ASTER) are onboard the same satellite platform NASA TERRA. Both MODIS and ASTER offer routine retrieval of land surface temperatures (LSTs), and the ASTER- and MODIS-retrieved LST products have been used worldwide. Because a large fraction of the earth surface consists of mountainous areas, variations in elevation, terrain slope and aspect angles can cause biases in the retrieved LSTs. However, terrain-induced effects are generally neglected in most satellite retrievals, which may generate discrepancy between ASTER and MODIS LSTs. In this paper, we reported the terrain effects on the LST discrepancy with a case examination over a relief area at the Loess Plateau of China. Results showed that the terrain-induced effects were not major, but nevertheless important for the total LST discrepancy. A large local slope did not necessarily lead to a large LST discrepancy. The angle of emitted radiance was more important than the angle of local slope in generating the LST discrepancy. Specifically, the conventional terrain correction may be unsuitable for densely vegetated areas. The distribution of ASTER-to-MODIS emissivity suggested that the terrain correction was included in the generalized split window (GSW) based approach used to rectify MODIS LSTs. Further study should include the classification-induced uncertainty in emissivity for reliable use of satellite-retrieved LSTs over relief areas. PMID:22399955

  8. Is It as Easy as Young People Claim for Them to Buy Cigarettes? Comparing the Results of Realistic Test Purchases with Those from Trading Standards Test Purchases

    ERIC Educational Resources Information Center

    Croghan, Emma; Aveyard, Paul; Johnson, Carol

    2005-01-01

    Purpose: There is a discrepancy between the ease of purchase of cigarettes reported by young people themselves and the results of ease of purchase obtained by tests done by official sources such as Trading Standards Units. This discrepancy suggests that either data from young people or from trading standards are unreliable. This research set out…

  9. Implications of Spatial Data Variations for Protected Areas Management: An Example from East Africa

    NASA Astrophysics Data System (ADS)

    Dowhaniuk, Nicholas; Hartter, Joel; Ryan, Sadie J.

    2014-09-01

    Geographic information systems and remote sensing technologies have become an important tool for visualizing conservation management and developing solutions to problems associated with conservation. When multiple organizations separately develop spatial data representations of protected areas, implicit error arises due to variation between data sets. We used boundary data produced by three conservation organizations (International Union for the Conservation of Nature, World Resource Institute, and Uganda Wildlife Authority), for seven Ugandan parks, to study variation in the size represented and the location of boundaries. We found variation in the extent of overlapping total area encompassed by the three data sources, ranging from miniscule (0.4 %) differences to quite large ones (9.0 %). To underscore how protected area boundary discrepancies may have implications to protected area management, we used a landcover classification, defining crop, shrub, forest, savanna, and grassland. The total area in the different landcover classes varied most in smaller protected areas (those less than 329 km2), with forest and cropland area estimates varying up to 65 %. The discrepancies introduced by boundary errors could, in this hypothetical case, generate erroneous findings and could have a significant impact on conservation, such as local-scale management for encroachment and larger-scale assessments of deforestation.

  10. Implications of spatial data variations for protected areas management: an example from East Africa.

    PubMed

    Dowhaniuk, Nicholas; Hartter, Joel; Ryan, Sadie J

    2014-09-01

    Geographic information systems and remote sensing technologies have become an important tool for visualizing conservation management and developing solutions to problems associated with conservation. When multiple organizations separately develop spatial data representations of protected areas, implicit error arises due to variation between data sets. We used boundary data produced by three conservation organizations (International Union for the Conservation of Nature, World Resource Institute, and Uganda Wildlife Authority), for seven Ugandan parks, to study variation in the size represented and the location of boundaries. We found variation in the extent of overlapping total area encompassed by the three data sources, ranging from miniscule (0.4 %) differences to quite large ones (9.0 %). To underscore how protected area boundary discrepancies may have implications to protected area management, we used a landcover classification, defining crop, shrub, forest, savanna, and grassland. The total area in the different landcover classes varied most in smaller protected areas (those less than 329 km(2)), with forest and cropland area estimates varying up to 65 %. The discrepancies introduced by boundary errors could, in this hypothetical case, generate erroneous findings and could have a significant impact on conservation, such as local-scale management for encroachment and larger-scale assessments of deforestation.

  11. Challenges in managing elderly people with diabetes in primary care settings in Norway

    PubMed Central

    2013-01-01

    Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

  12. Controversies in prostate cancer staging implementation at a tertiary cancer center.

    PubMed

    Sexton, Tracy; Rodrigues, George; Brecevic, Ed; Boyce, Laura; Parrack, Denise; Lock, Michael; D'Souza, David

    2006-12-01

    To assess accuracy of recorded prostate cancer stage after implementation of a quality assurance staging improvement plan. Genitourinary multidisciplinary TNM staging guidelines were prospectively implemented. Educational programs for health records technicians (HRT) and clinicians preceded implementation of the new guidelines. Patient stage information was entered into the Oncology Patient Information System (OPIS) as part of the usual operations of the cancer center by an HRT. Physician and HRT auditors performed a subsequent quality assurance audit on 97 prostate cancer patients seen over a 2-month period. Assessment of staging accuracy and reasons for discrepancies between the OPIS stage and auditor stage were analyzed and reported. Fifty-four (52%) charts showed discrepancies between auditors. Of the fifty-four, twelve (22%) had discrepancies between OPIS and auditor, thirty (56%) showed discrepancies between auditors, and twelve (22%) had discrepancies between OPIS, physician auditor, and HRT auditor. Forty-three (41%) cases had no discrepancies. Reasons for discrepancies included: misinterpretation of the digital rectal examination (16/54), inappropriate use of TRUS/MRI (9/54) in staging, stage not assigned at initial diagnosis (9/54), misinterpretation of pathology (7/54), TNM staging confusion (4/54), OPIS update not performed (3/54), inappropriate use of biopsy data (3/54), disagreement between consultants (2/54), and misinterpretation of TURP result (1/54). Overall staging accuracy was 76% for OPIS, 65% for the physician auditor and 62% for the HRT auditor. Despite guidelines and educational interventions, computer registry staging accuracy remains an issue. On-going audit procedures are proposed to identify and correct both published and institutional staging guidelines.

  13. Salary discrepancies between practicing male and female physician assistants.

    PubMed

    Coplan, Bettie; Essary, Alison C; Virden, Thomas B; Cawley, James; Stoehr, James D

    2012-01-01

    Salary discrepancies between male and female physicians are well documented; however, gender-based salary differences among clinically practicing physician assistants (PAs) have not been studied since 1992 (Willis, 1992). Therefore, the objectives of the current study are to evaluate the presence of salary discrepancies between clinically practicing male and female PAs and to analyze the effect of gender on income and practice characteristics. Using data from the 2009 American Academy of Physician Assistants' (AAPA) Annual Census Survey, we evaluated the salaries of PAs across multiple specialties. Differences between men and women were compared for practice characteristics (specialty, experience, etc) and salary (total pay, base pay, on-call pay, etc) in orthopedic surgery, emergency medicine, and family practice. Men reported working more years as a PA in their current specialty, working more hours per month on-call, providing more direct care to patients, and more funding available from their employers for professional development (p < .001, all comparisons). In addition, men reported a higher total income, base pay, overtime pay, administrative pay, on-call pay, and incentive pay based on productivity and performance (p < .001, all comparisons). Multivariate analysis of covariance and analysis of variance revealed that men reported higher total income (p < .0001) and base pay (p = .001) in orthopedic surgery, higher total income (p = .011) and base pay (p = .005) in emergency medicine, and higher base pay in family practice (p < .001), independent of clinical experience or workload. These results suggest that certain salary discrepancies remain between employed male and female PAs regardless of specialty, experience, or other practice characteristics. Copyright © 2012. Published by Elsevier Inc.

  14. Seeing the System through the End Users' Eyes: Shadow Expert Technique for Evaluating the Consistency of a Learning Management System

    NASA Astrophysics Data System (ADS)

    Holzinger, Andreas; Stickel, Christian; Fassold, Markus; Ebner, Martin

    Interface consistency is an important basic concept in web design and has an effect on performance and satisfaction of end users. Consistency also has significant effects on the learning performance of both expert and novice end users. Consequently, the evaluation of consistency within a e-learning system and the ensuing eradication of irritating discrepancies in the user interface redesign is a big issue. In this paper, we report of our experiences with the Shadow Expert Technique (SET) during the evaluation of the consistency of the user interface of a large university learning management system. The main objective of this new usability evaluation method is to understand the interaction processes of end users with a specific system interface. Two teams of usability experts worked independently from each other in order to maximize the objectivity of the results. The outcome of this SET method is a list of recommended changes to improve the user interaction processes, hence to facilitate high consistency.

  15. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: a cross-sectional study

    PubMed Central

    Hughes, Shannon; Cohen, David; Jaggi, Rachel

    2014-01-01

    Objective To examine the degree of concordance in reporting serious adverse events (SAEs) from antidepressant and antipsychotic drug trials among journal articles and clinical trial summaries, and to categorise types of discrepancies. Design Cross-sectional study of summaries of all antidepressant and antipsychotic trials included in an online trial registry and their first associated stand-alone journal articles. Setting Clinicalstudyresults.org, sponsored by Pharmaceutical Research and Manufacturers of America; clinicaltrials.gov, administered by the US National Institutes of Health. Main outcome measure 3 coders extracted data on the numbers and types of SAEs. Results 244 trial summaries for six antidepressant and antipsychotic drugs were retrieved, 142 (58.2%) listing an associated article. Of 1608 SAEs in drug-treated participants according to trial summaries, 694 (43.2%) did not appear in associated articles. Nearly 60% of SAEs counted in articles and 41% in trial summaries had no description. Most cases of death (62.3%) and suicide (53.3%) were not reported in articles. Half or more of the 142 pairs were discordant in reporting the number (49.3%) or description (67.6%) of SAEs. These discrepancies resulted from journal articles’ (1) omission of complete SAE data, (2) reporting acute phase study results only and (3) more restrictive reporting criteria. Trial summaries with zero SAE were 2.35 (95% CI, 1.58 to 3.49; p<0.001) times more likely to be published with no discrepancy in their associated journal article. Since clinicalstudyresults.org was removed from the Internet in 2011, only 7.8% of retrieved trial summaries appear with results on clinicaltrials.gov. Conclusions Substantial discrepancies exist in SAE data found in journal articles and registered summaries of antidepressant and antipsychotic drug trials. Two main scientific sources accessible to clinicians and researchers are limited by incomplete, ambiguous and inconsistent reporting. Access to complete and accurate data from clinical trials of drugs currently in use remains a pressing concern. PMID:25009136

  16. Parental autonomy support and discrepancies between implicit and explicit sexual identities: dynamics of self-acceptance and defense.

    PubMed

    Weinstein, Netta; Ryan, William S; Dehaan, Cody R; Przybylski, Andrew K; Legate, Nicole; Ryan, Richard M

    2012-04-01

    When individuals grow up with autonomy-thwarting parents, they may be prevented from exploring internally endorsed values and identities and as a result shut out aspects of the self perceived to be unacceptable. Given the stigmatization of homosexuality, individuals perceiving low autonomy support from parents may be especially motivated to conceal same-sex sexual attraction, leading to defensive processes such as reaction formation. Four studies tested a model wherein perceived parental autonomy support is associated with lower discrepancies between self-reported sexual orientation and implicit sexual orientation (assessed with a reaction time task). These indices interacted to predict anti-gay responding indicative of reaction formation. Studies 2-4 showed that an implicit/explicit discrepancy was particularly pronounced in participants who experienced their fathers as both low in autonomy support and homophobic, though results were inconsistent for mothers. Findings of Study 3 suggested contingent self-esteem as a link between parenting styles and discrepancies in sexual orientation measures. (c) 2012 APA, all rights reserved.

  17. Outcomes of disease prevention and management interventions in food pantries and food banks: protocol for a scoping review.

    PubMed

    Long, Christopher R; Rowland, Brett; Steelman, Susan C; McElfish, Pearl A

    2017-10-05

    Food insecurity is a difficulty faced in many households. During periods of food insecurity, households often seek food supplied by food pantries and food banks. Food insecurity has been associated with increased risk for several health conditions. For this reason, food pantries and food banks may have great promise as intervention sites, and health researchers have begun targeting food pantries and food banks as sites for disease prevention or management interventions. The aim of the scoping review is to examine disease prevention or management interventions implemented in food pantries and food banks. Relevant electronic databases (eg, MEDLINE, Cumulative Index to Nursing and Allied Health Literature-CINAHL Complete, Science Citation Index, Cochrane Database of Systematic Reviews) will be searched for articles with a publication date of 1997 or later using Medical Subject Headings and key terms, including food aid, food banks, food pantries, food shelves, hunger, food insecurity and related concepts. For each de-duplicated study record identified by the search strategy, two reviewers will independently assess whether the study meets eligibility criteria (eg, related to intervention type, context). The reviewers will examine studies' titles, abstracts and full text, comparing eligibility decisions to address any discrepancies. For each eligible study, data extraction will be executed by two reviewers independently, comparing extracted data to address any discrepancies. Extracted data will be synthesised and reported in a narrative review assessing the coverage and gaps in existing literature related to disease prevention and management interventions implemented in food pantries. The review's results will be useful to healthcare practitioners who work with food-insecure populations, healthcare researchers and food pantry or food bank personnel. The results of this scoping review will be submitted for publication to a peer-reviewed journal, and the authors will share the findings with food pantry and food bank stakeholder groups with whom they work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. 76 FR 2197 - Office of Thrift Supervision

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... consumer reports must employ when a user receives a notice of address discrepancy from a consumer reporting agency (CRA). The regulations describe reasonable policies and procedures for users of consumer reports... obtained a consumer report, and reconcile the address of the consumer with the CRA, if the user establishes...

  19. [Fine-needle aspiration (FNA) of the thyroid gland : Analysis of discrepancies between cytological and histological diagnoses].

    PubMed

    Dalquen, P; Rashed, B; Hinsch, A; Issa, R; Clauditz, T; Luebke, A; Lüttges, J; Saeger, W; Bohuslavizki, K H

    2016-09-01

    Diagnostic problems of thyroid cytology are frequently discussed, but relevance and causes of discrepant cytological and histological diagnoses are rarely studied in detail. Investigation of causes and relevance of discrepant diagnoses. The analysis includes 297 patients who had thyroid resection after prior fine needle aspiration (FNA) and is based on the cytological and histological reports. In special cases, cytological and histological specimens were re-examined. Malignant tumors were found in 45 patients (15.1 %). In 5 patients the cytological diagnosis was "false negative". Three of these 5 tumors were papillary carcinomas (PTC) of ≤10 mm, one an obviously nonmalignant papillary proliferation of the thyroidal epithelium and one a malignant lymphoma complicating autoimmune thyreoiditis (AIT). In 11 of the 35 patients with a FNA diagnosis "suspicious of malignancy" or "malignant," 1 AIT, 4 goiter nodules, and 6 adenomas were diagnosed histologically. However, since distinct nuclear atypia was found in three of five false positive diagnoses, there still remains doubt in their benignity. Carcinomas of ≤10 mm incidentally detected in the resected thyroid tissue may not be relevant to the patient and do not reduce the high negative predictive value of FNA. The final diagnosis on the resected tissue should include the cytological findings. Discrepant findings should be commented in the report to the clinician.

  20. Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium.

    PubMed

    Fanjul, María; Samuk, I; Bagolan, P; Leva, E; Sloots, C; Giné, C; Aminoff, D; Midrio, P

    2017-08-01

    The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers. A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium. Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%). Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.

  1. Discrepancies in Data Reporting for Rabies, Africa

    PubMed Central

    2013-01-01

    Human rabies is an ancient disease but in modern times has primarily been associated with dog rabies–endemic countries of Asia and Africa. From an African perspective, the inevitable and tragic consequences of rabies require serious reflection of the factors that continue to drive its neglect. Established as a major disease only after multiple introductions during the colonial era, rabies continues to spread into new reservoirs and territories in Africa. However, analysis of reported data identified major discrepancies that are indicators of poor surveillance, reporting, and cooperation among national, international, and global authorities. Ultimately, the absence of reliable and sustained data compromises the priority given to the control of rabies. Appropriate actions and changes, in accordance to the One Health philosophy and including aspects such as synchronized, shared, and unified global rabies data reporting, will not only be necessary, but also should be feasible. PMID:23628197

  2. Testing the accuracy of timing reports in visual timing tasks with a consumer-grade digital camera.

    PubMed

    Smyth, Rachael E; Oram Cardy, Janis; Purcell, David

    2017-06-01

    This study tested the accuracy of a visual timing task using a readily available and relatively inexpensive consumer grade digital camera. A visual inspection time task was recorded using short high-speed video clips and the timing as reported by the task's program was compared to the timing as recorded in the video clips. Discrepancies in these two timing reports were investigated further and based on display refresh rate, a decision was made whether the discrepancy was large enough to affect the results as reported by the task. In this particular study, the errors in timing were not large enough to impact the results of the study. The procedure presented in this article offers an alternative method for performing a timing test, which uses readily available hardware and can be used to test the timing in any software program on any operating system and display.

  3. Self-awareness of memory function in Parkinson's disease in relation to mood and symptom severity.

    PubMed

    Sitek, Emilia J; Sołtan, Witold; Wieczorek, Dariusz; Robowski, Piotr; Sławek, Jarosław

    2011-03-01

    In clinical practice, discrepancies are observed between self and proxy reports of various aspects of Parkinson's disease (PD). This study aimed at assessing self-awareness of memory function in PD both by comparing patients' and caregivers' questionnaire ratings of the patients' memory and by correlating subjective ratings with verbal learning results. Forty-five patient-proxy pairs participated in the study. Self-Rating Scale of Memory Functions was used as a questionnaire subjective measure. Auditory Verbal Learning Test (AVLT) was applied to assess verbal memory, Stroop test to assess cognitive control and Mini-Mental State Examination (MMSE) for global cognitive assessment. Patient self-reports did not diverge appreciably from proxy reports when global scores were considered, but patient-proxy consistency was low for individual items with the exception of those referring to verbal recall. Both patient and proxy ratings were moderately correlated with the objective measures. Patient-proxy discrepancies were associated with lower verbal learning, poor cognitive control and more severe PD symptomatology. Moreover, depression was associated with patients' overestimation of symptoms. Self-awareness of memory function is relatively well preserved in PD, but is negatively affected by depressive symptoms. Patient-proxy discrepancies increase also with disease severity, degree of memory problems and cognitive control deficits. Caregivers seem to be unaware of the specificity of memory problems in PD and report only some of them, mainly those related to verbal recall.

  4. Impression-Management in the Forced Compliance Paradigm.

    ERIC Educational Resources Information Center

    Saenz, Rogelio; Quigley-Fernandez, Barbara

    In its original formulation, dissonance reduction was postulated as a mode for resolving behavior-attitude discrepancies. One mode of resolution has been demonstrated in the forced compliance paradigm, whereby a subject rectifies a counterattitudinal behavior with an actual belief, resulting in moderating beliefs. A forced compliance situation was…

  5. Toward the Management of Heterosexual Jealousy

    ERIC Educational Resources Information Center

    Francis, Janice L.

    1977-01-01

    Despite the apparent universality of the jealousy phenomenon, communication in couples is inhibited by the social disapproval associated with its occurrance, and consequently discrepancies such as those evidenced in this study may pass entirely unobserved. As a result, jealousy problems remain unresolved and may serve to trigger further…

  6. Significant Discrepancy Between Estimated and Actual Longevity in St. Jude Medical Implantable Cardioverter-Defibrillators.

    PubMed

    Doppalapudi, Harish; Barrios, James; Cuellar, Jose; Gannon, Melanie; Yamada, Takumi; Kumar, Vineet; Maddox, William R; Plumb, Vance J; Brown, Todd M; McElderry, H Tom

    2017-05-01

    Real-time estimated longevity has been reported in pacemakers for several years, and was recently introduced in implantable cardioverter-defibrillators (ICDs). We sought to evaluate the accuracy of this longevity estimate in St. Jude Medical (SJM) ICDs, especially as the device battery approaches depletion. Among patients with SJM ICDs who underwent generator replacements due to reaching elective replacement indicator (ERI) at our institution, we identified those with devices that provided longevity estimates and reviewed their device interrogations in the 18 months prior to ERI. Significant discrepancy was defined as a difference of more than 12 months between estimated and actual longevity at any point during this period. Forty-six patients with Current/Promote devices formed the study group (40 cardiac resynchronization therapy [CRT] and 6 single/dual chamber). Of these, 34 (74%) had significant discrepancy between estimated and actual longevity (28 CRT and all single/dual). Longevity was significantly overestimated by the device algorithm (mean maximum discrepancy of 18.8 months), more in single/dual than CRT devices (30.5 vs. 17.1 months). Marked discrepancy was seen at voltages ≥2.57 volts, with maximum discrepancy at 2.57 volts (23 months). The overall longevity was higher in the discrepant group of CRT devices than in the nondiscrepant group (67 vs. 61 months, log-rank P = 0.03). There was significant overestimation of longevity in nearly three-fourths of Current/Promote SJM ICDs in the last 18 months prior to ERI. Longevity estimates of SJM ICDs may not be reliable for making clinical decisions on frequency of follow-up, as the battery approaches depletion. © 2017 Wiley Periodicals, Inc.

  7. Discrepancies between self and observer ratings of depression. The relationship to demographic, clinical and personality variables.

    PubMed

    Enns, M W; Larsen, D K; Cox, B J

    2000-10-01

    The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings. The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory. Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression. The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies. Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.

  8. Cray Research, Inc. Cray 1-s, Cray FORTRAN translator CFT) version 1. 11 Bugfix 1. Validation summary report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1983-09-09

    This Validation Summary Report (VSR) for the Cray Research, Inc., CRAY FORTRAN Translator (CFT) Version 1.11 Bugfix 1 running under the CRAY Operating System (COS) Version 1.12 provides a consolidated summary of the results obtained from the validation of the subject compiler against the 1978 FORTRAN Standard (X3.9-1978/FIPS PUB 69). The compiler was validated against the Full Level FORTRAN level of FIPS PUB 69. The VSR is made up of several sections showing all the discrepancies found -if any. These include an overview of the validation which lists all categories of discrepancies together with the tests which failed.

  9. Caregiver and Adolescent Discrepancies in Perceptions of Violence and Their Associations with Early Adolescent Aggression.

    PubMed

    Lindstrom Johnson, Sarah; Reichenberg, Raymond; Bradshaw, Catherine P; Haynie, Denise L; Cheng, Tina L

    2016-10-01

    This article examined the role of caregiver messages about violence and exposure to neighborhood violence on adolescent aggression in light of research regarding discrepancies between parents and their children. Drawing upon data from an urban African American sample of 144 caregiver/early adolescent dyads (M = 12.99; SD = 0.93; 58.7 % female) we examined covariates of discrepancies between caregiver and adolescent reports of perceptions of violence as well as their association with adolescent aggression. Analyses suggested that concordance in perceptions of violence was associated with children's attitudes about violence and caregivers' perceptions of family communication. Structural equation modeling indicated a unique role for individual perceptions and suggested that agreement in awareness of neighborhood violence could be protective for early adolescent involvement in aggression.

  10. Caregiver and Adolescent Discrepancies in Perceptions of Violence and their Associations with Early Adolescent Aggression

    PubMed Central

    Reichenberg, Raymond; Bradshaw, Catherine P.; Haynie, Denise L.; Cheng, Tina L.

    2016-01-01

    This article examined the role of caregiver messages about violence and exposure to neighborhood violence on adolescent aggression in light of research regarding discrepancies between parents and their children. Drawing upon data from an urban African American sample of 144 caregiver/early adolescent dyads (M = 12.99; SD = 0.93; 58.7% female) we examined covariates of discrepancies between caregiver and adolescent reports of perceptions of violence as well as their association with adolescent aggression. Analyses suggested that concordance in perceptions of violence was associated with children’s attitudes about violence and caregivers’ perceptions of family communication. Structural equation modeling indicated a unique role for individual perceptions and suggested that agreement in awareness of neighborhood violence could be protective for early adolescent involvement in aggression. PMID:27230117

  11. Discrepant Alcohol Use, Intimate Partner Violence, and Relationship Adjustment among Lesbian Women and their Relationship Partners

    PubMed Central

    Kelley, Michelle L.; Lewis, Robin J.; Mason, Tyler B.

    2015-01-01

    This study examined the association between relationship adjustment and discrepant alcohol use among lesbian women and their same-sex intimate partners after controlling for verbal and physical aggression. Lesbian women (N = 819) who were members of online marketing research panels completed an online survey in which they reported both their own and same-sex intimate partner’s alcohol use, their relationship adjustment, and their own and their partner’s physical aggression and psychological aggression (i.e., verbal aggression and dominance/isolation). Partners’ alcohol use was moderately correlated. Discrepancy in alcohol use was associated with poorer relationship adjustment after controlling for psychological aggression and physical aggression. Results are discussed in terms of the similarity and differences with previous literature primarily focused on heterosexual couples. PMID:26478657

  12. Discrepant Alcohol Use, Intimate Partner Violence, and Relationship Adjustment among Lesbian Women and their Relationship Partners.

    PubMed

    Kelley, Michelle L; Lewis, Robin J; Mason, Tyler B

    2015-11-01

    This study examined the association between relationship adjustment and discrepant alcohol use among lesbian women and their same-sex intimate partners after controlling for verbal and physical aggression. Lesbian women ( N = 819) who were members of online marketing research panels completed an online survey in which they reported both their own and same-sex intimate partner's alcohol use, their relationship adjustment, and their own and their partner's physical aggression and psychological aggression (i.e., verbal aggression and dominance/isolation). Partners' alcohol use was moderately correlated. Discrepancy in alcohol use was associated with poorer relationship adjustment after controlling for psychological aggression and physical aggression. Results are discussed in terms of the similarity and differences with previous literature primarily focused on heterosexual couples.

  13. Chargino contributions in light of recent ɛ‧/ɛ

    NASA Astrophysics Data System (ADS)

    Endo, Motoi; Mishima, Satoshi; Ueda, Daiki; Yamamoto, Kei

    2016-11-01

    Recently, the standard model prediction of ɛ‧ / ɛ was improved, and a discrepancy from the experimental results was reported at the 2.9σ level. We study the chargino contributions to Z penguin especially with the vacuum stability constraint. The vacuum decay rate is investigated, and it is shown that the discrepancy can be explained if superparticles are lighter than 4-6 TeV. Correlations with B (KL →π0 ν ν bar) and other experimental constraints are also discussed.

  14. Great expectations: points of congruencies and discrepancies between incoming accelerated second-degree nursing students and faculty.

    PubMed

    D'Antonio, Patricia; Beal, Margaret W; Underwood, Patricia W; Ward, Frances Rieth; McKelvey, Michele; Guthrie, Barbara; Lindell, Deborah

    2010-12-01

    This study analyzes the expectations that incoming students and faculty bring to accelerated pre-licensure education programs for second-degree students. Although research supports the congruence of expectations between students and faculty as essential to learning, anecdotal evidence and single case reports suggest there may be important discrepancies in expectations of second-degree students and their faculty. Data are intended to support curriculum review, refinement, and innovation in these programs. Copyright 2010, SLACK Incorporated.

  15. Toward a better understanding of psychological contract breach: a study of customer service employees.

    PubMed

    Deery, Stephen J; Iverson, Roderick D; Walsh, Janet T

    2006-01-01

    Experiences of psychological contract breach have been associated with a range of negative behavior. However, much of the research has focused on master of business administration alumni and managers and made use of self-reported outcomes. Studying a sample of customer service employees, the research found that psychological contract breach was related to lower organizational trust, which, in turn was associated with perceptions of less cooperative employment relations and higher levels of absenteeism. Furthermore, perceptions of external market pressures moderated the effect of psychological contract breach on absenteeism. The study indicated that psychological contract breach can arise when employees perceive discrepancies between an organization's espoused behavioral standards and its actual behavioral standards, and this can affect discretionary absence. (c) 2006 APA, all rights reserved.

  16. 41 CFR 109-1.5113 - Loss, damage, or destruction of personal property in possession of designated contractors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... designated contractors. (a) Designated contractors shall report any loss, damage, or destruction of personal... administrator; or loss, damage, or destruction of personal property not previously reported by the contractor... written reports. (c) Reports of physical inventory results and identified discrepancies shall be submitted...

  17. 41 CFR 109-1.5113 - Loss, damage, or destruction of personal property in possession of designated contractors.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... designated contractors. (a) Designated contractors shall report any loss, damage, or destruction of personal... administrator; or loss, damage, or destruction of personal property not previously reported by the contractor... written reports. (c) Reports of physical inventory results and identified discrepancies shall be submitted...

  18. Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

    PubMed

    Fried, Terri R; Niehoff, Kristina M; Street, Richard L; Charpentier, Peter A; Rajeevan, Nallakkandi; Miller, Perry L; Goldstein, Mary K; O'Leary, John R; Fenton, Brenda T

    2017-10-01

    To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. Randomized clinical trial. Primary care clinics at a Veterans Affairs Medical Center. Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Data management in clinical research: An overview

    PubMed Central

    Krishnankutty, Binny; Bellary, Shantala; Kumar, Naveen B.R.; Moodahadu, Latha S.

    2012-01-01

    Clinical Data Management (CDM) is a critical phase in clinical research, which leads to generation of high-quality, reliable, and statistically sound data from clinical trials. This helps to produce a drastic reduction in time from drug development to marketing. Team members of CDM are actively involved in all stages of clinical trial right from inception to completion. They should have adequate process knowledge that helps maintain the quality standards of CDM processes. Various procedures in CDM including Case Report Form (CRF) designing, CRF annotation, database designing, data-entry, data validation, discrepancy management, medical coding, data extraction, and database locking are assessed for quality at regular intervals during a trial. In the present scenario, there is an increased demand to improve the CDM standards to meet the regulatory requirements and stay ahead of the competition by means of faster commercialization of product. With the implementation of regulatory compliant data management tools, CDM team can meet these demands. Additionally, it is becoming mandatory for companies to submit the data electronically. CDM professionals should meet appropriate expectations and set standards for data quality and also have a drive to adapt to the rapidly changing technology. This article highlights the processes involved and provides the reader an overview of the tools and standards adopted as well as the roles and responsibilities in CDM. PMID:22529469

  20. Hyperthyroidism, hyperfunctioning thyroid nodule, and thyroid cancer in a young female: a rare and unusual coexistence.

    PubMed

    Hernán-Martínez, José; Uzcategui, María; Corder, Eric; Castillo, Manuel; Sostre, Samuel; Alicea, Luz

    2010-03-01

    The prevalence of concomitant thyroid carcinoma with Grave's disease has been reported to range from 0 to 10%. Many controversies exist in the literature regarding the diagnostic workup and management in these types of patients. We are reporting a case of a 31 year old woman who had Graves' disease, a palpable thyroid nodule, and results from a thyroid scan revealed a "hot" nodule. Interestingly, an ultrasound guided FNA of the "hot" nodule showed papillary thyroid microcarcinoma. Finally, a total thyroidectomy showed multilobar tumor involvement. The diagnostic tools employed to establish the proper management strategy for this patient were based on data in the literature that is full of discrepancies. The fact that Grave's disease occurs concomitantly with thyroid cancer, specifically the papillary type, is an indisputably rare combination. One rare feature on our clinical case was the reported malignancy of a papillary carcinoma within a "hot" nodule which usually is much less that 1%. Many studies describe an increasing incidence of Grave's disease patients with concomitant papillary thyroid carcinoma. One possible explanation for these findings could be improvements in medical technology of screening tools. We propose that, thyroid ultrasonography should be integrated in the diagnostic workup in patients presenting with Graves' disease, especially in those presenting with palpable nodules. Fine needle biopsy should not be restricted to cold nodules.

  1. Development of a computerized monitoring program to identify narcotic diversion in a pediatric anesthesia practice.

    PubMed

    Brenn, B Randall; Kim, Margaret A; Hilmas, Elora

    2015-08-15

    Development of an operational reporting dashboard designed to correlate data from multiple sources to help detect potential drug diversion by automated dispensing cabinet (ADC) users is described. A commercial business intelligence platform was used to create a dashboard tool for rapid detection of unusual patterns of ADC transactions by anesthesia service providers at a large pediatric hospital. By linking information from the hospital's pharmacy information management system (PIMS) and anesthesia information management system (AIMS) in an associative data model, the "narcotic reconciliation dashboard" can generate various reports to help spot outlier activity associated with ADC dispensing of controlled substances and documentation of medication waste processing. The dashboard's utility was evaluated by "back-testing" the program with historical data on an actual episode of diversion by an anesthesia provider that had not been detected through traditional methods of PIMS and AIMS data monitoring. Dashboard-generated reports on key metrics (e.g., ADC transaction counts, discrepancies in dispensed versus reconciled amounts of narcotics, PIMS-AIMS documentation mismatches) over various time frames during the period of known diversion clearly indicated the diverter's outlier status relative to other authorized ADC users. A dashboard program for correlating ADC transaction data with pharmacy and patient care data may be an effective tool for detecting patterns of ADC use that suggest drug diversion. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  2. Discrepancies between home medication and patient documentation in primary care.

    PubMed

    Rose, Olaf; Jaehde, Ulrich; Köberlein-Neu, Juliane

    2018-04-01

    Medication Reconciliation leads to quick detection of drug-related problems, studies in ambulatory care are scarce. The recently introduced Medication Plan in Germany serves as an ideal basis for Medication Reconciliation. The study aim was to provide accurate data on the magnitude of discrepancy between the prescription and the actually taken medicine. Clinical relevance of discrepancies was assessed to estimate the impact on medication safety. Patients were assessed at home, data was reconciled with the physician's documentation. Discrepancies were analyzed and stratified. Risk for hospitalization, risk for falls and the potential for drug-drug interactions was estimated based on literature. Drugs were tested for its origin and grouped to indication clusters. Detected DRPs at a Medication Review were linked to the results at Medication Reconciliation. Medication of 142 elderly patients from 12 practices was reconciled. 1498 drugs were found at the home assessment, 1099 (73.4%) of which were detected in the physician's documentation. 94.4% of the patients were affected by discrepancies. A total of 2.8 ± 2.4 drugs was undocumented per patient. 26.6% of missing drugs were prescribed by medical specialists, 42.5% of drugs of unknown origin were prescription drugs. 53.9% of the patients used a undocumented drug, which carried a high risk for hospitalization. 23.1% of the drugs not covered were used for treatment of cardiovascular diseases. 65.8% of the differing drugs caused at least one DRP. A high discrepancy between the drugs used by the patient and the medication documented by the primary care physician could be found. Relating drugs had a profound systemic effect and were particular relevant to medication safety. Many drugs were prescription drugs. The majority of differing drugs caused DRPs. A collaborative Medication Reconciliation as part of a Medication Management could compile the entire medication and increase patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Influences of Family Management and Spousal Perceptions on Stressor Pile-up.

    ERIC Educational Resources Information Center

    Imig, David R.; Imig, Gail L.

    1986-01-01

    Describes the contingent influence of family managerial efficacy and related spousal perceptions on the relationship between stressor pile-up and family cohesion. Perceived loss of managerial efficacy in conjunction with discrepant spousal perceptions of such change substantially increased the family's vulnerability to stressor pile-up. A…

  4. NASA University Program Management Information System

    NASA Technical Reports Server (NTRS)

    1999-01-01

    As basic policy, NASA believes that colleges and universities should be encouraged to participate in the nation's space and aeronautics program to the maximum extent practicable. Indeed, universities are considered as partners with government and industry in the nation's aerospace program. NASA's objective is to have them bring their scientific, engineering, and social research competence to bear on aerospace problems and on the broader social, economic, and international implications of NASA's technical and scientific programs. It is expected that, in so doing, universities will strengthen both their research and their educational capabilities to contribute more effectively to the national well-being. NASA field codes and certain Headquarters program offices provide funds for those activities in universities which contribute to the mission needs of that particular NASA element. Although NASA has no predetermined amount of money to devote to university activities, the effort funded each year is substantial. (See the bar chart on the next page). This annual report is one means of documenting the NASA-university relationship, frequently denoted, collectively, as NASA's University Program. This report is consistent with agency accounting records, as the data is obtained from NASA's Financial and Contractual Status (FACS) System, operated by the Financial Management Division and the Procurement Office. However, in accordance with interagency agreements, the orientation differs from that required for financial or procurement purposes. Any apparent discrepancies between this report and other NASA procurement or financial reports stem from the selection criteria for the data.

  5. Variations in the management of asymptomatic adolescent grade 2 or 3 left varicoceles: a survey of practitioners.

    PubMed

    Coutinho, Karl; McLeod, Daryl; Stensland, Kristian; Stock, Jeffrey A

    2014-06-01

    Our study aims to evaluate variations in management of asymptomatic adolescent grade 2 and 3 varicoceles by pediatric urologists. Electronic survey of all 267 current members of AAP Urology with 74 (28%) responding. When managing patients with positive examination findings, 49% of surveyed practitioners use scrotal sonography as initial screening, while 38% use only manual orchidometry and 11% observation with serial examinations. If significant testicular size discrepancy is identified, 32% immediately intervene surgically, while 59% repeat measurements in 6-12 months. When no discrepancy is identified, 36.6% of practitioners discharge their patients with no follow-up, 22.5% refer to an infertility specialist, and 31% evaluate with semen analysis. Fifty-seven percent of practitioners have never sent patients for semen analysis; only 4% send >50% of patients. Of these, 52% and 27% analyzed semen at 17-18 years and 19-20 years, respectively, and 10% send for semen analysis at <17 years. Our survey demonstrates that there does not appear to be a consensus among pediatric urologists managing asymptomatic grade 2 and 3 varicoceles. Better understanding of which adolescent patients with varicoceles will go on to develop male infertility is necessary to identify pediatric patients who could benefit from early intervention. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  6. A Modified Content Analysis of Existing School Psychology Reports

    ERIC Educational Resources Information Center

    Mallin, Barry; Schellenberg, Miriam E.; Smith, Christiane

    2012-01-01

    Discrepancies between our university's training program's report-writing guidelines and common practice in Manitoba could not be resolved by reference to the literature. To inform the discussion, we collected a sample of local real world school psychology reports and undertook a modified content analysis to operationally define and measure…

  7. Do Published Data in Trials Assessing Cancer Drugs Reflect the Real Picture of Efficacy and Safety?

    PubMed

    Lv, Jia-Wei; Chen, Yu-Pei; Zhou, Guan-Qun; Liu, Xu; Guo, Ying; Mao, Yan-Ping; Ma, Jun; Sun, Ying

    2017-11-01

    Background: The reporting quality of publications is of vital importance to ensure accurate evidence dissemination. This study aimed to compare the consistency of results reporting between the ClinicalTrials.gov results database and the respective matching publications. Methods: We identified 323 phase III/IV cancer drug trials with a randomized controlled design and searched PubMed for publications in a 50% random sample (n=160). Data were extracted independently from ClinicalTrials.gov and publications. A scoring system was applied to determine characteristics associated with reporting quality. Results: Of 117 reviewed trials with publications, result reporting was significantly more complete in ClinicalTrials.gov for efficacy measurement (92.3% vs 90.6%), serious adverse events (SAEs; 100% vs 43.6%), and other adverse events (OAEs; 100% vs 62.4%). For trials with both posted and published results for design information (n=117), efficacy measurements (n=98), SAEs (n=51), and OAEs (n=73), discrepancies were found in 16 (13.7%), 38 (38.8%), 26 (51.0%), and 54 (74.0%) trials, respectively. Overreporting of treatment effects (7 trials) and alteration of primary end points favoring statistically significant outcomes (11 trials) were the major discrepancies in efficacy reporting; incomplete (66 trials) and underreporting (20 trials) of SAEs were the predominant issues in benefit/risk reporting. Median quality score was 21 (range, 14-28). Trials that had parallel assignment, were phase IV, had primary funding by industry, were completed after 2009, and had earlier results posted possessed better reporting quality. Conclusions: Although most trials showed reasonable completeness and consistency, some discrepancies are prevalent and persistent, jeopardizing evidence-based decision-making. Our findings highlight the need to consult results systematically from both ClinicalTrials.gov and publications. Copyright © 2017 by the National Comprehensive Cancer Network.

  8. [OR-management and self-improvement - a discrepancy?].

    PubMed

    Casutt, Mattias; Konrad, Christoph; Schüpfer, Guido

    2014-10-01

    Today, operating room management is essential for a modern hospital. The strategic controls of this cost-intensive area and the ongoing cost pressure have necessitated management attention to this area. Economical, processual and quality data are well-known and established, although analysis of different health delivering organisations by benchmarking is still difficult. It remains still a severe task for the management of an OR and anaesthesia department. For these fields data is needed to identify and measure the performance of these departments in the dimensions of finances, development, processes and patient's needs. The key performance indicators are exemplified for an anaesthesia department and discussed. © Georg Thieme Verlag Stuttgart · New York.

  9. Investigating the Longer-Term Impact of the CREST Inquiry-Based Learning Programme on Student Self-regulated Processes and Related Motivations: Views of Students and Teachers

    NASA Astrophysics Data System (ADS)

    Moote, Julie

    2017-07-01

    This study investigates the impact of participation in the CREativity in Science and Technology (CREST) programme on student self-regulated processes and related motivations. The CREST scheme, a student-run science project managed by the British Science Association, is currently being implemented in schools across the UK to increase student engagement and motivation in science. Through implementing a rigorous quasi-experimental research design using two intervention conditions and one control group with immediate as well as 3-month delayed post-test data, the results documented both the immediate and longer-term positive impact of CREST participation on students' self-reported levels of self-regulation. The present study also investigates changes in teachers' perceptions of students' self-regulated learning through CREST programme participation. Group differences regarding changes in student self-reported self-regulation were not matched when looking at the teacher-reported self-regulated learning results at both immediate post-test and delayed post-test. These discrepancies are discussed in relation to analyses conducted on the other motivational constructs measured.

  10. Primary realignment vs suprapubic cystostomy for the management of pelvic fracture-associated urethral injuries: a systematic review and meta-analysis.

    PubMed

    Barrett, Keith; Braga, Luis H; Farrokhyar, Forough; Davies, Timothy O

    2014-04-01

    To compare primary urethral realignment (PR) with suprapubic cystostomy (SPC) for the management of pelvic fracture-associated posterior urethral injuries with regards to rates of stricture, erectile dysfunction, and urinary incontinence. Two electronic databases (MEDLINE and EMBASE) were searched with the assistance of a librarian. Title, abstract, and full text screening was carried out by 2 independent reviewers, with discrepancies resolved by consensus. Narrative reviews, surveys, and historical articles were excluded. Only studies reporting a direct comparison of PR vs SPC for the management of posterior urethral injuries associated with blunt trauma in adults were included. Quality assessment of the included articles was performed in duplicate. Stricture incidence was evaluated for all included studies, as were erectile dysfunction and incontinence rates when reported. All outcomes were treated as dichotomous data with calculation of odds ratio and were pooled using a random effects model with Review Manager 5.1. Our comprehensive search yielded 161 unique articles. Nine articles were included in the final meta-analysis. Stricture rate was significantly lower in the PR group (odds ratio [OR] = 0.12, 95% confidence interval [CI] 0.04-0.41, P <.001). There was no significant difference between the 2 interventions with regards to erectile dysfunction (OR = 1.19, 95% CI 0.73-1.92, P = .49) or incontinence (OR = 0.75, 95% CI 0.38-1.48, P = .41). PR appears to reduce the incidence of stricture formation after pelvic fracture-associated posterior urethral injuries as compared with SPC. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Health risk behaviors and depressive symptoms among Hispanic adolescents: Examining acculturation discrepancies and family functioning.

    PubMed

    Cano, Miguel Ángel; Schwartz, Seth J; Castillo, Linda G; Unger, Jennifer B; Huang, Shi; Zamboanga, Byron L; Romero, Andrea J; Lorenzo-Blanco, Elma I; Córdova, David; Des Rosiers, Sabrina E; Lizzi, Karina M; Baezconde-Garbanati, Lourdes; Soto, Daniel W; Villamar, Juan Andres; Pattarroyo, Monica; Szapocznik, José

    2016-03-01

    Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement 6 months postbaseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms 1 year postbaseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning; (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS; (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS. (c) 2016 APA, all rights reserved).

  12. Health Risk Behaviors and Depressive Symptoms among Hispanic Adolescents: Examining Acculturation Discrepancies and Family Functioning

    PubMed Central

    Cano, Miguel Ángel; Schwartz, Seth J.; Castillo, Linda G.; Unger, Jennifer B.; Huang, Shi; Zamboanga, Byron L.; Romero, Andrea J.; Lorenzo-Blanco, Elma I.; Córdova, David; Des Rosiers, Sabrina E.; Lizzi, Karina M.; Baezconde-Garbanati, Lourdes; Soto, Daniel W.; Villamar, Juan Andres; Pattarroyo, Monica; Szapocznik, José

    2015-01-01

    Drawing from a theory of bicultural family functioning two models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement six months post-baseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms one year post-baseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning, (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS, (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS. PMID:26301514

  13. Discrepancies between adolescents' attributed relevance and experiences regarding communication are associated with poorer client participation and learning processes in psychosocial care.

    PubMed

    Jager, Margot; Reijneveld, Sijmen A; Metselaar, Janneke; Knorth, Erik J; De Winter, Andrea F

    2014-12-01

    To examine adolescents' attributed relevance and experiences regarding communication, and whether discrepancies in these are associated with clients' participation and learning processes in psychosocial care. Adolescents receiving psychosocial care (n=211) completed measures of communication in three domains: affective communication, information provision, and shared decision-making. Participation involved clients' attendance and adherence (professional-reported). Learning processes involved clients' improved understanding and improved confidence (client and professional-reported). Important but less often experienced affective communication was associated with low adherence (odds ratio, 95% confidence interval: 2.8, 1.1-6.8), less improvement in understanding (3.7, 1.5-9.0), and less improvement in confidence (4.5, 1.8-11.6). If information provision or shared decision-making was important but less often experienced, adolescents were more likely to demonstrate less improvement in understanding (3.1, 1.1-8.5; 4.2, 1.7-10.8). The combination "less important but experienced" only had an effect regarding affective communication; these adolescents were more likely to demonstrate less improvement in confidence (6.0, 2.3-15.4). Discrepancies between attributed relevance and experiences frequently occur. These discrepancies negatively affect adolescents' participation and their learning processes, although the pattern differs across communication domains. Care professionals should pay considerable attention to their clients' communication preferences and adapt their communication style when necessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Discrepancies in assessing home care workers' working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels.

    PubMed

    Andersen, Gunn Robstad; Westgaard, Rolf H

    2015-07-25

    The present study is a follow-up study of factors contributing to an undesirable quality of work environment and sick leave rate in the home care services in a Norwegian municipality. The underlying assumption is that organizational discrepancies in the perceptions and appraisals of significant factors and processes in an organization have detrimental effects on the management of the organization and on work environment conditions. Thus, the study aim is to explore potential organizational discrepancies in the appraisals of factors relating to home care workers' working conditions. The study, using a mixed-methods design, comprised six home care units. It included survey responses of home care workers (80 respondents, response rate 54 %) and qualitative descriptions of stakeholders' appraisals of organizational issues gathered through semi-structured interviews (33 interviews with stakeholders at three organizational levels). Employees at different organizational levels in the home care services expressed divergent appraisals of factors related to the working conditions of home care workers, including impact of organizational measures (i.e. time pressure, work tasks, a new work program, organizational changes, budget model, budget allocation and coping strategies). Survey responses supported interview descriptions by home care workers. Results suggest that organizational discrepancy serve as an important barrier to a sustainable, well-functioning organization in general and to quality-enhancing changes to work procedures in particular. It is recommended to improve communication channels and facilitate the exchange of information across levels to ensure a common understanding of matters significant to the organization of the home care services and to the work environment of home care workers. The prevalence and impact of organizational discrepancy should be included in organization research, particularly when exploring explanatory factors of an unhealthy organization.

  15. Impact of Discordant Views in the Management of Descending Thoracic Aortic Aneurysm.

    PubMed

    Chiu, Peter; Sailer, Anna-Margaretha; Baiocchi, Michael; Goldstone, Andrew B; Schaffer, Justin M; Trojan, Jeff; Fleischmann, Dominik; Mitchell, R Scott; Miller, D Craig; Dake, Michael D; Woo, Y Joseph; Lee, Jason T; Fischbein, Michael P

    2017-01-01

    Thoracic endovascular aortic repair has a lower perceived risk than open surgical repair and has become an increasingly popular alternative. Whether general consensus exists regarding candidacy for either operation among open and endovascular specialists is unknown. A retrospective review of isolated descending thoracic aortic aneurysm at our institution between January 2005 and October 2015 was performed, excluding trauma and dissection. Two cardiac surgeons, 2 cardiovascular surgeons, 1 vascular surgeon, and 1 interventional radiologist gave their preference for open vs endovascular repair. Interobserver agreement was assessed with the kappa coefficient. k-means clustering agnostically grouped various patterns of agreement. The mean rating was predicted using least absolute shrinkage and selection operator regression. Negative binomial regression predicted the discrepancy between our panel of raters and the historical operation. Generalized estimating equation modeling was then used to evaluate the association between the extent of discrepancy and the adverse perioperative outcome. There were 77 patients with preoperative imaging studies. Pairwise interobserver agreement was only fair (median weighted kappa 0.270 [interquartile range 0.211-0.404]). Increasing age and proximal neck length predicted an increasing preference for thoracic endovascular aortic repair in our panel; larger proximal neck diameter predicted a general preference for open surgical repair. Increasing proximal neck diameter predicted a larger discrepancy between our panel and the historical operation. Greater discrepancy was associated with adverse outcome. Substantial disagreement existed among our panel, and an exploratory analysis of the effect of increasing discrepancy demonstrated an association with adverse perioperative outcome. An investigation of the effect of a thoracic aortic team with open and endovascular specialists is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

    PubMed

    Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

    2012-03-01

    An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  17. 78 FR 43239 - Agency Information Collection Activities: Submission to OMB for Reinstatement, With Change, of a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    .... As required by section 315 of the FACT Act, section 1022.82 requires users of consumer reports to... discrepancy from a credit reporting agency (CRA). Section 1022.82 requires each user of consumer reports to... belief that a consumer report relates to the consumer about whom it requested the report when it receives...

  18. 12 CFR Appendix J to Part 717 - Interagency Guidelines on Identity Theft Detection, Prevention, and Mitigation

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... consumer report. 2. A consumer reporting agency provides a notice of credit freeze in response to a request for a consumer report. 3. A consumer reporting agency provides a notice of address discrepancy, as defined in § 717.82(b) of this part. 4. A consumer report indicates a pattern of activity that is...

  19. Occupational Survey Report: Acquisition, Contracting/Manufacturing, AFSC 65XX

    DTIC Science & Technology

    1992-01-01

    solicitations or contract reviews 1.35 M739 Compare contractor invoices with QAE reports 1.34 P1354 Review contractors’ cost reports 1.33 111 z r. Cz W0 0...customers 89 M739 Compare contractor invoices with QAE reports 89 M731 Analyze adequacy of corrective actions to quality assurance (QA) discrepancies 89

  20. Discrepancies between the electronic medical record, the prescriptions in the Swedish national prescription repository and the current medication reported by patients.

    PubMed

    Ekedahl, Anders; Brosius, Helen; Jönsson, Julia; Karlsson, Hanna; Yngvesson, Maria

    2011-11-01

    To study discrepancies between (i) the prescribed current treatment stated by patients with congestive heart failure (CHF) compared with patients with other chronic diseases, (ii) the data in the medication list (ML) in the electronic medical record and (iii) the data in the prescription list (PL) on the prescriptions stored in the national prescription repository in Sweden, to determine current, noncurrent, duplicate and missing prescriptions. At one healthcare centre, a random sample of patients 18 years and older with a diagnosis of CHF, diabetes mellitus (DM) or osteoarthritis (OA) provided written informed consent to participate. Participants were interviewed by telephone on the prescribed current treatment. Of 161 invited patients (61 CHF, 50 DM and 50 OA), 66 patients were included. More than 80% of the patients had at least one discrepancy, a noncurrent, a duplicate or a missing prescription, in the ML and PL. The overall congruence for unique prescriptions on current treatment between the ML and the PL was only 55%. Patients with CHF had overall more discrepancies and patients with DM fewer discrepancies in the ML. Prescriptions for noncurrent treatment, duplicates and missing prescriptions are common in both the ML in the electronic medical record and the list on prescriptions stored in the Swedish National Prescription Repository. Patients with CHF had more discrepancies in the ML. The risk for medication errors in primary care due to incorrect information on prescribed treatment may be substantial. Copyright © 2011 John Wiley & Sons, Ltd.

  1. Accuracy of the medication history at admission to hospital in Saudi Arabia

    PubMed Central

    AbuYassin, Bishr H.; Aljadhey, Hisham; Al-Sultan, Mohammed; Al-Rashed, Sulaiman; Adam, Mansour; Bates, David W.

    2011-01-01

    Objective Inaccurate medication history at admission to hospitals leads to preventable adverse drug events, which in turn increase mortality, morbidity, and health care costs. The objective of this study was to investigate the role of pharmacists in identifying discrepancies in medication histories at admission to a tertiary referral hospital in Saudi Arabia. Methods We performed a prospective observational study in a 1200 bed tertiary hospital in Riyadh, Saudi Arabia. Patients were included if they were aged 16 years or older, were taking 5 or more medications, and were able to communicate or were accompanied by a caregiver who could communicate. Over 2 months in 2009, a pharmacist interviewed patients to ascertain all medications used prior to hospitalization, then all discrepancies were discussed with the admitting physician and unintended discrepancies were reported as errors. Results A pharmacist interviewed 60 patients who were taking 564 medications total. Of these patients, 65% were male, and their mean age was 62. Patients were taking an average of 9.4 medications. Twenty-two (37%) patients had at least one discrepancy, with the most common being omissions of medications (35%) and dosage errors (35%). The mean age for patients with discrepancies was 64.6 years, and without discrepancies, 60.8 years (P = 0.37). Conclusion Inaccurate medication history at admission to a hospital was common in Saudi Arabia. This has the potential to cause harm to patients if it remains undetected. Pharmacists could potentially play a major role in obtaining this medication history at the time of hospital admission. PMID:23960767

  2. Beyond 'Inop': Logbook Communication Between Airline Mechanics and Pilots

    NASA Technical Reports Server (NTRS)

    Munro, Pamela A.; Kanki, Barbara G.; Jordan, Kevin

    2008-01-01

    When mechanical discrepancies occur on aircraft, effective communication between pilots and mechanics can facilitate identification of the problem. A survey of pilots and mechanics was conducted to determine how often they were able to discuss discrepancies directly and to identify factors that influenced the detail they provided about discrepancies in the aircraft logbook. Logistical factors such as short turn times between flights and crew schedules appeared to present barriers to face-to-face meetings between pilots and mechanics. Guidelines for pilot logbook entries. Pilots reported receiving significantly less training on writing logbook entries and spent significantly less time making individual entries than mechanics. Mechanics indicated greater concern about the Federal Aviation Administration reading their entries than pilots. Mechanics indicated they had little opportunity to follow up with pilots to clarify a logbook entry once pilots departed the aircraft.

  3. How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa.

    PubMed

    Hodes, R; Price, I; Bungane, N; Toska, E; Cluver, L

    2017-08-25

    Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.

  4. Management of sexual side effects of antidepressant therapy.

    PubMed

    Hirschfeld, R M

    1999-01-01

    Sexual dysfunction occurs in over one third of the general population and has many causes, including psychosocial factors, general medical illness, nonpsychiatric medication, psychiatric disorders, and psychotropic medications. Psychosocial causes are the most prevalent, but many frequently used medications, such as diuretics, beta-blockers, and H2-blockers, can also cause sexual dysfunction. Sexual dysfunctions occur in many psychiatric disorders, including mood disorders, schizophrenia, substance abuse, and anxiety disorders. In addition, over half the patients with major depression will have some sexual dysfunction. Although much attention has been paid to sexual dysfunction associated with the selective serotonin reuptake inhibitors (SSRIs), many other commonly used psychotropics are associated with a variety of sexual dysfunction, including haloperidol, benzodiazepines, stimulants, and drugs of abuse. With regard to SSRIs, sexual dysfunction occurs in 50% or more of such patients, which is substantially higher than the rates reported in the Physicians' Desk Reference. The reason for this discrepancy is that patients will not spontaneously report sexual problems and must be questioned about such problems directly. A variety of strategies exist to manage antidepressant-induced sexual dysfunction, including waiting, reducing the antidepressant dose, use of drug holidays, use of adjunctive pharmacotherapy, and switching antidepressants. Use of an antidepressant with a low prevalence of sexual side effects, such as bupropion, nefazodone, and mirtazapine, may also be considered.

  5. Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People

    PubMed Central

    Curtis, Sophie; Thorn, Pinar; McRoberts, Alison; Hetrick, Sarah

    2018-01-01

    Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12–28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to feelings of shame and guilt. This highlights the need for accessible resources that seek to alleviate parents’ distress, influence the strategies implemented to manage the young person’s self-harm behaviour, reduce self-blame of family members, and increase the likelihood of parental help seeking. PMID:29747476

  6. Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People.

    PubMed

    Curtis, Sophie; Thorn, Pinar; McRoberts, Alison; Hetrick, Sarah; Rice, Simon; Robinson, Jo

    2018-05-10

    Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12⁻28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to feelings of shame and guilt. This highlights the need for accessible resources that seek to alleviate parents’ distress, influence the strategies implemented to manage the young person’s self-harm behaviour, reduce self-blame of family members, and increase the likelihood of parental help seeking.

  7. Report: Congressionally Requested Information on the Status and Length of Review for Appalachian Surface Mining Permit Applications

    EPA Pesticide Factsheets

    Report #12-P-0083, November 21, 2011. After reconciling discrepancies and vetting information, we identified 185 surface mining permit applications to review from the list of 237 that we received from the senator.

  8. Registration Priorities: A Report.

    ERIC Educational Resources Information Center

    Walters, Judy E.

    In May 1993, the California Community Colleges' Board of Governors adopted systemwide guidelines recommending student registration priorities to help address current discrepancies between available resources and courses and the colleges' open-door mission. This report describes the guidelines and results of a study conducted to determine their…

  9. Clinical Assessment of Affective Instability: Comparing EMA Indices, Questionnaire Reports, and Retrospective Recall

    ERIC Educational Resources Information Center

    Solhan, Marika B.; Trull, Timothy J.; Jahng, Seungmin; Wood, Phillip K.

    2009-01-01

    Traditional self-report measures of psychopathology may be influenced by a variety of recall biases. Ecological momentary assessment (EMA) reduces these biases by assessing individuals' experiences as they occur in their natural environments. This study examines the discrepancy between trait questionnaire, retrospective report, and EMA measures of…

  10. Values and Preferences of Individuals with Dementia: Perceptions of Family Caregivers over Time

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2013-01-01

    Purpose of the Study: Cross-sectional evidence indicates that family caregivers reporting on the importance of daily care values and preferences of individuals with mild-to-moderate dementia consistently report less importance than individuals with dementia (IWDs) self-report. Discrepancy is primarily associated with caregivers' beliefs about…

  11. The aviation safety reporting system

    NASA Technical Reports Server (NTRS)

    Reynard, W. D.

    1984-01-01

    The aviation safety reporting system, an accident reporting system, is presented. The system identifies deficiencies and discrepancies and the data it provides are used for long term identification of problems. Data for planning and policy making are provided. The system offers training in safety education to pilots. Data and information are drawn from the available data bases.

  12. Racial and Ethnic Disparities in Police-Reported Intimate Partner Violence Perpetration: A Mixed Methods Approach

    ERIC Educational Resources Information Center

    Lipsky, Sherry; Cristofalo, Meg; Reed, Sarah; Caetano, Raul; Roy-Byrne, Peter

    2012-01-01

    The objectives of this study were to examine racial and ethnic disparities in perpetrator and incident characteristics and discrepancies between police charges and reported perpetrator behaviors in police-reported intimate partner violence (IPV). This cross-sectional study used standardized police data and victim narratives of IPV incidents…

  13. Participative Decision Making in Schools: A Mediating-Moderating Analytical Framework for Understanding School and Teacher Outcomes

    ERIC Educational Resources Information Center

    Somech, Anit

    2010-01-01

    The increasing emergence of participation in decision making (PDM) in schools reflects the widely shared belief that flatter management and decentralized authority structures carry the potential for promoting school effectiveness. However, the literature indicates a discrepancy between the intuitive appeal of PDM and empirical evidence in respect…

  14. External Supply of Skill Groups: A Case of Industrial Management in Taiwan.

    ERIC Educational Resources Information Center

    Kao, Chiang; Chen, Liang-Hsuan; Wang, Tai-Yue; Lee, Hong-Tau

    1997-01-01

    Quantitative and qualitative analysis was conducted of the supply of skill groups and the output of junior colleges, colleges, and graduate schools in Taiwan. Discrepancies were identified between labor need of industry and numbers of graduates as well as between training expected by industry and supplied by schools. (SK)

  15. Discrepancy Analysis and Continuity Matrix: Tools for Measuring the Impact of Inservice Training.

    ERIC Educational Resources Information Center

    Kite, R. Hayman

    Within an inservice training program there is a functional interdependent relationship among problems, causes, and solutions. During a sequence of eight steps to ascertain program impact, a "continuity matrix", a management technique that assists in dealing with the problem/solution paradox is created. A successful training program must: (1) aim…

  16. The Effects of Truth Bias on Artifact-User Relationships: An Investigation of Factors for Improving Deception Detection in Artifact Produced Information

    DTIC Science & Technology

    1998-08-07

    Scenarios 124 APPENDIX B - Information Manipulation Descriptions 132 vi APPENDIX C - PC-III Screens 146 APPENDIX D - Discrepancy Reporting Sheet 162...in Figure 3-2. • A rtifact Truth Bias D e c e p tio n D ete ctio n A bility t Figure 3-2 - Artifact Truth Bias and Deception Detection...discrepancy recording sheet is provided in Appendix D . For each to the courses, a series of data manipulations was incorporated into the database

  17. Teaching reading comprehension to learners with autism spectrum disorder: Discrepancies between teacher and research-recommended practices.

    PubMed

    Accardo, Amy L; Finnegan, Elizabeth G

    2017-11-01

    Students with autism spectrum disorder have been found to experience difficulty with reading comprehension despite intact decoding and word recognition. This identified need for targeted reading comprehension remediation results in a need for teachers to utilize research-based practices and to individualize instruction for students with autism spectrum disorder; however, teachers report a lack of access to such practices. This study utilized survey methodology to gather perceptions and experiences of teachers and to compare teacher preparedness to use effective instructional practices emerging from the extant research to teacher-reported effective practices in the classroom. Study findings, based on 112 participants, reveal a discrepancy between teacher-reported effective practices, and the practices identified as effective through research, indicating a research to practice gap. Implications for practice include professional development recommendations, and the need for increased communication between researchers and teachers.

  18. Pre-trial inter-laboratory analytical validation of the FOCUS4 personalised therapy trial.

    PubMed

    Richman, Susan D; Adams, Richard; Quirke, Phil; Butler, Rachel; Hemmings, Gemma; Chambers, Phil; Roberts, Helen; James, Michelle D; Wozniak, Sue; Bathia, Riya; Pugh, Cheryl; Maughan, Timothy; Jasani, Bharat

    2016-01-01

    Molecular characterisation of tumours is increasing personalisation of cancer therapy, tailored to an individual and their cancer. FOCUS4 is a molecularly stratified clinical trial for patients with advanced colorectal cancer. During an initial 16-week period of standard first-line chemotherapy, tumour tissue will undergo several molecular assays, with the results used for cohort allocation, then randomisation. Laboratories in Leeds and Cardiff will perform the molecular testing. The results of a rigorous pre-trial inter-laboratory analytical validation are presented and discussed. Wales Cancer Bank supplied FFPE tumour blocks from 97 mCRC patients with consent for use in further research. Both laboratories processed each sample according to an agreed definitive FOCUS4 laboratory protocol, reporting results directly to the MRC Trial Management Group for independent cross-referencing. Pyrosequencing analysis of mutation status at KRAS codons12/13/61/146, NRAS codons12/13/61, BRAF codon600 and PIK3CA codons542/545/546/1047, generated highly concordant results. Two samples gave discrepant results; in one a PIK3CA mutation was detected only in Leeds, and in the other, a PIK3CA mutation was only detected in Cardiff. pTEN and mismatch repair (MMR) protein expression was assessed by immunohistochemistry (IHC) resulting in 6/97 discordant results for pTEN and 5/388 for MMR, resolved upon joint review. Tumour heterogeneity was likely responsible for pyrosequencing discrepancies. The presence of signet-ring cells, necrosis, mucin, edge-effects and over-counterstaining influenced IHC discrepancies. Pre-trial assay analytical validation is essential to ensure appropriate selection of patients for targeted therapies. This is feasible for both mutation testing and immunohistochemical assays and must be built into the workup of such trials. ISRCTN90061564. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. An exploratory pilot study of mechanisms of action within normative feedback for adult drinkers.

    PubMed

    Kuerbis, Alexis; Muench, Frederick J; Lee, Rufina; Pena, Juan; Hail, Lisa

    2016-01-01

    Background. Normative feedback (NF), or receiving information about one's drinking compared to peer drinking norms, is one of the most widely used brief interventions for prevention and intervention for hazardous alcohol use. NF has demonstrated predominantly small but significant effect sizes for intention to change and other drinking related outcomes. Identifying mechanisms of action may improve the effectiveness of NF; however, few studies have examined NF's mechanisms of action, particularly among adults. Objective. This study is an exploratory analysis of two theorized mechanisms of NF: discrepancy (specifically personal dissonance-the affective response to feedback) and belief in the accuracy of feedback. Method. Using Amazon's Mechanical Turk, 87 men (n = 56) and women (n = 31) completed an online survey during which they were asked about their perceptions about their drinking and actual drinking behaviors. Then participants were provided tailored NF and evaluated for their reactions. Severity of discrepancy was measured by the difference between one's estimated percentile ranking of drinking compared to peers and actual percentile ranking. Surprise and worry reported due to the discrepancy were proxies for personal dissonance. Participants were also asked if they believed the feedback and if they had any plans to change their drinking. Mediation analyses were implemented, exploring whether surprise, worry, or belief in the accuracy of feedback mediated severity of discrepancy's impact on plan for change. Results. Among this sample of adult drinkers, severity of discrepancy did not predict plan for change, and personal dissonance did not mediate severity of discrepancy. Severity of discrepancy was mediated by belief in the accuracy of feedback. In addition, viewing one's drinking as a problem prior to feedback and post-NF worry both predicted plan for change independently. Conclusions. Results revealed that NF may not work to create personal dissonance through discrepancy, but belief in the accuracy of feedback may be important. It appears the more one believes the feedback, the more one makes a plan for change, suggesting practitioners should be mindful of how information within feedback is presented. Findings also indicate NF may work by validating a preexisting perception that drinking is a problem instead of creating concern related to discrepancy where none existed. Limitations regarding generalizability are discussed.

  20. Validation of nursing management diagnoses.

    PubMed

    Morrison, R S

    1995-01-01

    Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

  1. One explanatory basis for the discrepancy of reported prevalences of sleep paralysis among healthy respondents.

    PubMed

    Fukuda, K

    1993-12-01

    In a previous study, the author and coworkers found 39.8% of healthy young adults had experienced sleep paralysis. Some other studies reported prevalence as about the same or higher (i.e., 40.7% to 62.0%) than that previous estimate, while yet other studies, including Goode's work cited by ASDC and ASDA classifications, suggested much lower prevalences (i.e., 4.7% to 26.2%). The author tested the hypothesis that this discrepancy among the reported prevalences is partly due to the expression used in each questionnaire. University students who answered the questionnaire using the term 'transient paralysis' reported the lower prevalence (26.4%), while the second group of respondents who answered the questionnaire using the term kanashibari, the Japanese folklore expression for sleep paralysis, gave the higher prevalence (39.3%). The third group who answered the questionnaire with the term 'condition,' probably a rather neutral expression, marked the middle (31.0%) of these.

  2. Knowledge vs. Action: Discrepancies in University Students' Knowledge about and Self-Reported Use of Self-Regulated Learning Strategies.

    PubMed

    Foerst, Nora M; Klug, Julia; Jöstl, Gregor; Spiel, Christiane; Schober, Barbara

    2017-01-01

    University students are supposed to be autonomous learners, able to adapt to an educational environment significantly less guided than school. Entering higher education poses a challenge of self-regulation, in which beginning students are often not prepared with self-regulation strategies needed. Since there are many studies assessing self-regulated learning (SRL) via classical self-reports, we know a lot about how students generally self-assess their SRL strategies. However, SRL and performance do not always correlate highly in these studies. The aim of the present study is to determine whether there are discrepancies between students' knowledge about SRL and their action in applying adequate SRL strategies in relevant learning situations. We also want to know whether such discrepancies generalize across domains and what the reasons for discrepancies are. The situation-specific Self-Regulated Learning Questionnaire for Action and Knowledge (SRL-QuAK) was used in a sample of 408 psychology and economic sciences students. Descriptive data analysis was conducted to determine potential discrepancies between SRL knowledge and action and differences between the study domains in an explorative way. The reasons for not using SRL-strategies were derived via qualitative content analysis. The results showed that although students had quite advanced knowledge of SRL strategies, they did not put this knowledge into action. This dissonance between SRL knowledge and action was found in both domains. In terms of reasons, students stated that they (a) lacked the time to use SRL strategies, (b) would not benefit from SRL strategies in the given situation, (c) would not be able to put the strategies to use effectively or (d) found it too arduous to use SRL strategies. The implications of these results will be discussed, e.g., the consequences for measures to overcome students' dissonance between knowledge and action and therefore to promote academic performance and well-being.

  3. Knowledge vs. Action: Discrepancies in University Students' Knowledge about and Self-Reported Use of Self-Regulated Learning Strategies

    PubMed Central

    Foerst, Nora M.; Klug, Julia; Jöstl, Gregor; Spiel, Christiane; Schober, Barbara

    2017-01-01

    University students are supposed to be autonomous learners, able to adapt to an educational environment significantly less guided than school. Entering higher education poses a challenge of self-regulation, in which beginning students are often not prepared with self-regulation strategies needed. Since there are many studies assessing self-regulated learning (SRL) via classical self-reports, we know a lot about how students generally self-assess their SRL strategies. However, SRL and performance do not always correlate highly in these studies. The aim of the present study is to determine whether there are discrepancies between students' knowledge about SRL and their action in applying adequate SRL strategies in relevant learning situations. We also want to know whether such discrepancies generalize across domains and what the reasons for discrepancies are. The situation-specific Self-Regulated Learning Questionnaire for Action and Knowledge (SRL-QuAK) was used in a sample of 408 psychology and economic sciences students. Descriptive data analysis was conducted to determine potential discrepancies between SRL knowledge and action and differences between the study domains in an explorative way. The reasons for not using SRL-strategies were derived via qualitative content analysis. The results showed that although students had quite advanced knowledge of SRL strategies, they did not put this knowledge into action. This dissonance between SRL knowledge and action was found in both domains. In terms of reasons, students stated that they (a) lacked the time to use SRL strategies, (b) would not benefit from SRL strategies in the given situation, (c) would not be able to put the strategies to use effectively or (d) found it too arduous to use SRL strategies. The implications of these results will be discussed, e.g., the consequences for measures to overcome students' dissonance between knowledge and action and therefore to promote academic performance and well-being. PMID:28798713

  4. Emergency CT brain: preliminary interpretation with a tablet device: image quality and diagnostic performance of the Apple iPad.

    PubMed

    Mc Laughlin, Patrick; Neill, Siobhan O; Fanning, Noel; Mc Garrigle, Anne Marie; Connor, Owen J O; Wyse, Gerry; Maher, Michael M

    2012-04-01

    Tablet devices have recently been used in radiological image interpretation because they have a display resolution comparable to desktop LCD monitors. We identified a need to examine tablet display performance prior to their use in preliminary interpretation of radiological images. We compared the spatial and contrast resolution of a commercially available tablet display with a diagnostic grade 2 megapixel monochrome LCD using a contrast detail phantom. We also recorded reporting discrepancies, using the ACR RADPEER system, between preliminary interpretation of 100 emergency CT brain examinations on the tablet display and formal review on a diagnostic LCD. The iPad display performed inferiorly to the diagnostic monochrome display without the ability to zoom. When the software zoom function was enabled on the tablet device, comparable contrast detail phantom scores of 163 vs 165 points were achieved. No reporting discrepancies were encountered during the interpretation of 43 normal examinations and five cases of acute intracranial hemorrhage. There were seven RADPEER2 (understandable) misses when using the iPad display and 12 with the diagnostic LCD. Use of software zoom in the tablet device improved its contrast detail phantom score. The tablet allowed satisfactory identification of acute CT brain findings, but additional research will be required to examine the cause of "understandable" reporting discrepancies that occur when using tablet devices.

  5. PARENTAL REPORTS OF EARLY SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS: DOES THE FATHER'S VIEW MAKE A DIFFERENCE?

    PubMed

    Alakortes, Jaana; Fyrstén, Jenni; Bloigu, Risto; Carter, Alice S; Moilanen, Irma K; Ebeling, Hanna E

    2017-05-01

    Although both mothers and fathers are essential sources of information to address early socioemotional/behavioral (SEB) problems, there continues to be a dearth of studies considering both parental views. A sample of 208 toddlers (M age = 19.3 months) was recruited through public child health centers. Both parents of 172 toddlers (76 boys, 96 girls) completed the Child Behavior Checklist (CBCL) 1-5 (T.M. Achenbach & L.A. Rescorla, 2000; Finnish translation by F. Almqvist, ). Correspondence (intraclass correlation coefficients; ICCs) between the maternal and paternal CBCL ratings was good (.64) for the Internalizing and excellent (.76) for the Externalizing and Total Problems scores whereas ICCs varied from .45 for the Withdrawn to .76 for the Sleep Problems and Aggressive Behavior syndrome scores. Regarding discrepancies, mothers consistently reported higher CBCL scale scores than did fathers. Most significant differences between the parental ratings were found on the Aggressive Behavior syndrome, Externalizing, and Total Problems scales. Interparental rating discrepancies increased with elevations in the corresponding CBCL scale scores. Positive correlations were found between maternal, but not paternal, parenting stress and interparental rating discrepancies on the CBCL. The observed differences between maternal and paternal ratings highlight the importance of gathering reports from both parents when assessing early SEB problems. The findings are more profoundly discussed in the article. © 2017 Michigan Association for Infant Mental Health.

  6. If substance use disorder treatment more than offsets its costs, why don't more medical centers want to provide it? A budget impact analysis in the Veterans Health Administration.

    PubMed

    Humphreys, Keith; Wagner, Todd H; Gage, Mistry

    2011-10-01

    Given that many studies have reported that the costs of substance use disorder (SUD) treatment are more than offset by other savings (e.g., in health care, in criminal justice, in foster care), why haven't health care system managers rushed to expand treatment? This article attempts to explain this puzzling discrepancy by analyzing 1998-2006 data from the national Veterans Affairs (VA) health care system. The main outcome measures were annual cost and utilization for VA SUD-diagnosed patients. The key independent variable was the medical centers' annual spending for SUD treatment. There was no evidence that SUD spending was associated with lower medical center costs over time within the medical center that paid for the treatment. Health care system managers may not be influenced by research suggesting that the costs of SUD treatment are more than fully offset because they bear the cost of providing treatment while the savings largely accrue to other systems. Published by Elsevier Inc.

  7. Vascular anomalies and the growth of limbs: a review.

    PubMed

    Enjolras, Odile; Chapot, René; Merland, Jean Jacques

    2004-11-01

    Growth of the limb in a child can be impaired, with the coexistence of a vascular malformation. In these vascular bone syndromes, altered growth is manifest as overgrowth or hypotrophy. The vascular malformation is usually complex and gets progressively worse with time. The two types of vascular anomalies in limbs, fast-flow and slow-flow, can be associated with limb length discrepancies. The fast-flow vascular malformations together with arteriovenous fistulae are part of Parkes Weber syndrome, characterized by congenital red cutaneous staining, hypertrophy in girth and increasing of limb length, lymphedema, increasing skin alterations due to a distal vascular steal, and pain, all of which develop during childhood. Treatment is generally conservative. An affected lower extremity can be complicated by pelvic tilting and scoliosis because leg length discrepancy may reach 10 cm. To avoid such a course, stapling epiphysiodesis of the knee cartilages is often performed, but this orthopedic procedure may augment the worsening of the arterial venous malformation in the limb. Therefore, less aggressive orthopedic management is preferable. Slow-flow vascular anomalies associated with limb growth alteration include (1) a diffuse capillary malformation (port-wine stain) with congenital hypertrophy of the involved extremity which is non-progressive; (2) purely venous malformations invading skin, muscles and joints, with pain, functional impairment, a chronic localized intravascular coagulopathy requiring distinctive management, and usually a slight undergrowth of the affected extremity and progressing amyotrophy; (3) the triad of a port-wine stain, anomalous veins and overgrowth of the limb, often known as Klippel-Trenaunay syndrome, which requires orthopedic management to decide the optimal timing for epiphysiodesis (i.e. when leg length discrepancy is >2.5 cm). Varicose veins are sometimes surgically removed after ultrasonographic and Doppler evaluation has confirmed a normal deep venous system. Capillary malformations can be effectively treated with pulsed dye laser, but results are usually poor in distal extremities.

  8. Mind your own business! Longitudinal relations between perceived privacy invasion and adolescent-parent conflict.

    PubMed

    Hawk, Skyler T; Keijsers, Loes; Hale, William W; Meeus, Wim

    2009-08-01

    Privacy coordination between adolescents and their parents is difficult, as adolescents' changing roles require adjustments to expectations about family boundaries. Adolescents' perceptions of privacy invasion likely provoke conflicts with parents, but higher levels of conflict may also foster invasion perceptions. This longitudinal study assessed relations between privacy invasion and conflict frequency among adolescents, mothers, and fathers (N = 309). Bidirectional relations were present; all reports showed that invasion provoked conflict in later adolescence, but the timing and direction of conflict-to-invasion relations differed between respondents and measurement waves. The findings suggest a functional role for conflict in adolescent-parent privacy negotiations, in that it both draws attention to discrepant expectations and provides youths with a means of directly managing perceived boundary violations. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  9. The association between global self-esteem, physical self-concept and actual vs ideal body size rating in Chinese primary school children.

    PubMed

    Lau, P W C; Lee, A; Ransdell, L; Yu, C W; Sung, R Y T

    2004-02-01

    To investigate whether the discrepancy between actual and ideal body size rating is related to Chinese children's global self-esteem and global physical self-concept. A cross-sectional study of school children who completed questionnaires related to global self-esteem, global physical self-concept, and actual vs ideal body size. A total of 386 Chinese children (44% girls and 56% boys) aged 7-13 y from a primary school in Hong Kong, China. Global self-esteem and physical self-concept were measured using the physical self-descriptive questionnaire. Actual vs ideal body size discrepancy was established using the silhouette matching task. No significant relationship was found between global self-esteem and actual-ideal body size discrepancy of children. Global physical self-concept had a moderate negative correlation (r=-0.12) with the body size discrepancy score and the discrepancy score explained very limited variance (R(2)=0.015; F(1, 296)=4.51; P<0.05) in global physical self-concept. Three body size discrepancy groups (none, positive, and negative) were examined to see if there were any significant differences in global self-esteem, global physical self-concept, and specific dimensions of physical self-concept. A significant overall difference was found between groups for global physical self-concept (F=3.73, P<0.05) and the physical self-concept subscales of physical activity (F=3.25, P<0.05), body fat (F=61.26, P<0.001), and strength (F=5.26, P<0.01). Boys scored significantly higher than girls on global physical self-concept-especially in the sport competence, strength, and endurance subscales. This study revealed that the actual-ideal body size discrepancy rating of Chinese children was not predictive of global physical self-concept and global self-esteem. These findings are contrary to those reported in Western children, which may mean that culture plays a role in the formation of body attitude.

  10. Is it About Me, You, or Us? Stress Reactivity Correlates of Discrepancies in We-Talk Among Parents and Preadolescent Children.

    PubMed

    Borelli, Jessica L; Smiley, Patricia A; Rasmussen, Hannah F; Gómez, Anthony

    2016-10-01

    An emerging literature suggests that not only do parent and child perceptions of parent-child relationship quality independently predict children's adjustment, but also that the discrepancy between parent and child perceptions of the relationship also carries predictive power. In the current study, we examine discrepancies in mother and children's we-talk, which is thought to reveal the degree to which members of a dyad conceive of problems affecting just one of the members as shared. We anticipate that discrepancies in which the mother expresses a greater sense of we-ness than the child would be particularly toxic during this developmental phase, when youth's strivings for independence ought to near their apex. Using an ethnically and socioeconomically diverse sample of school-aged children and their mothers (N = 106, 49.1 % female; 43 % Non-Hispanic White, 21 % African American, 21 % Hispanic, 10 % Asian, and 5 % of another ethnic category or mixed race; 48 % reported an annual income of <$60,000), we expose children to a standardized failure task that their mothers observe and then interview both members of the dyad regarding the task-we-talk is derived from these interviews. We examine the discrepancy between child and mother we-talk as a predictor of children's cortisol reactivity and mothers' behavioral overcontrol during the failure task. We also examine whether the discrepancy in mother-child we-talk predicts children's trait rumination. The interaction between child and mother we-talk was significantly associated with all three outcomes. Children's cortisol reactivity and rumination were highest when mothers used high and children used low levels of we-talk. A three-way interaction of children's we-talk, mothers' we-talk and child age emerged, suggesting that the association of discrepancies in we-talk with maternal overcontrol depended on child age, with significant effects emerging among older children. We discuss our results in terms of their implications for preadolescent development and emotion regulation.

  11. Comparison of MPEG digital video with super VHS tape for diagnostic echocardiographic readings

    NASA Technical Reports Server (NTRS)

    Soble, J. S.; Yurow, G.; Brar, R.; Stamos, T.; Neumann, A.; Garcia, M.; Stoddard, M. F.; Cherian, P. K.; Bhamb, B.; Thomas, J. D.

    1998-01-01

    BACKGROUND: Digital recording of echocardiographic studies is on the clinical horizon. However, full digital capture of complete echocardiographic studies in traditional video format is impractical, given current storage capacity and network bandwidth. To overcome these constraints, we evaluated the diagnostic image quality of digital video by using MPEG (Motion Picture Experts Group) compression. METHODS AND RESULTS: Fifty-eight complete, consecutive studies were recorded simultaneously with the use of MPEG-1 and sVHS videotape. Each matched MPEG and sVHS study pair was reviewed by two from a total of six readers, and findings were recorded with the use of a detailed, computerized reporting tool. Intrareader and interreader discrepancies were characterized as major or minor and analyzed in total and for specific subgroups of findings (left and right ventricular parameters, valvular insufficiency, and left ventricular regional wall motion). Intrareader discrepancies were reviewed by a consensus panel for agreement with either MPEG or sVHS findings. There was an exact concordance between MPEG and sVHS readings in 83% of findings. The majority of discrepancies were minor, with major discrepancies in only 2.7% of findings. There was no difference in the rate of consensus panel agreement with MPEG or sVHS for instances of intrareader discrepancy, either in total or for any subgroup of findings. Interreader discrepancy rates were nearly identical for both MPEG and sVHS. CONCLUSIONS: MPEG-1 digital video is equivalent to sVHS videotape for diagnostic echocardiography. MPEG increases the range of practical options for digital echocardiography and offers, for the first time, the advantages of digital recording in a familiar video format.

  12. Objectification in Virtual Romantic Contexts: Perceived Discrepancies between Self and Partner Ideals Differentially affect Body Consciousness in Women and Men

    PubMed Central

    Overstreet, Nicole M.; Quinn, Diane M.; Marsh, Kerry L.

    2015-01-01

    The current study examined whether exposure to sexually objectifying images in a potential romantic partner's virtual apartment affects discrepancies between people's perception of their own appearance (i.e., self-perceptions) and their perception of the body ideal that is considered desirable to a romantic partner (i.e., partner-ideals). Participants were 114 heterosexual undergraduate students (57 women and 57 men) from a northeastern U.S. university. The study used a 2 (Participant Gender) x 2 (Virtual Environment: Sexualized vs. Non-Sexualized) between-subjects design. We predicted that women exposed to sexually objectifying images in a virtual environment would report greater discrepancies between their self-perceptions and partner-ideals than men, which in turn would contribute to women's body consciousness. Findings support this hypothesis and show that perceived discrepancies account for the relationship between exposure to sexually objectifying images and body consciousness for women but not men. We also found gender asymmetries in objectification responses when each component of perceived discrepancies, i.e., self-perceptions versus perceptions of a romantic partner's body ideal, were examined separately. For men, exposure to muscular sexualized images was significantly associated with their self-perceptions but not their perceptions of the body size that is considered desirable to a romantic partner. For women, exposure to thin sexualized images was significantly associated with their perceptions that a romantic partner preferred a woman with a smaller body size. However, exposure to these images did not affect women's self-perceptions. Implications for gender asymmetries in objectification responses and perceived discrepancies that include a romantic partner's perceptions are discussed. PMID:26594085

  13. Magnetic Inflation and Stellar Mass. II. On the Radii of Single, Rapidly Rotating, Fully Convective M-Dwarf Stars

    NASA Astrophysics Data System (ADS)

    Kesseli, Aurora Y.; Muirhead, Philip S.; Mann, Andrew W.; Mace, Greg

    2018-06-01

    Main-sequence, fully convective M dwarfs in eclipsing binaries are observed to be larger than stellar evolutionary models predict by as much as 10%–15%. A proposed explanation for this discrepancy involves effects from strong magnetic fields, induced by rapid rotation via the dynamo process. Although, a handful of single, slowly rotating M dwarfs with radius measurements from interferometry also appear to be larger than models predict, suggesting that rotation or binarity specifically may not be the sole cause of the discrepancy. We test whether single, rapidly rotating, fully convective stars are also larger than expected by measuring their R\\sin i distribution. We combine photometric rotation periods from the literature with rotational broadening (v\\sin i) measurements reported in this work for a sample of 88 rapidly rotating M dwarf stars. Using a Bayesian framework, we find that stellar evolutionary models underestimate the radii by 10 % {--}15{ % }-2.5+3, but that at higher masses (0.18 < M < 0.4 M Sun), the discrepancy is only about 6% and comparable to results from interferometry and eclipsing binaries. At the lowest masses (0.08 < M < 0.18 M Sun), we find that the discrepancy between observations and theory is 13%–18%, and we argue that the discrepancy is unlikely to be due to effects from age. Furthermore, we find no statistically significant radius discrepancy between our sample and the handful of M dwarfs with interferometric radii. We conclude that neither rotation nor binarity are responsible for the inflated radii of fully convective M dwarfs, and that all fully convective M dwarfs are larger than models predict.

  14. Private patients in NHS hospitals: comparison of two sources of information.

    PubMed

    Williams, B T; Pearson, J

    1999-03-01

    The use of National Health Service (NHS) hospitals to treat private patients is debatable on the grounds of equity of access. Hospital Episodes Statistics (HES) annual reports are the only routine source of information on the scale of this activity. The accuracy of the information is doubted. This enquiry tested the completeness of HES data against information obtained directly from private patient unit managers. Managers of the 71 pay bed units in NHS hospitals in England were asked to supply from local registers and accounts the numbers of in-patients and day cases admitted in 1995-1996. Their reports were matched with the numbers of first consultant episodes for private in-patients and day cases shown for those hospitals in the HES data file for that year. Of the 71 units 62 responded; 53 of these gave usable data. The 53 included, and 18 excluded from the comparison, matched on median and range of bed numbers. Managers identified 16 per cent more total admissions than did HES, 62,572 against 54,131; 13 per cent more in-patient admissions, 39,776 against 35,319; and 21 per cent more day cases, 22,796 against 18,812. More total admissions were reported by managers of 38 pay bed units than were recorded in HES, fewer by 12, and equal numbers by three. Similar sized discrepancies were noted for in-patient admissions and day cases. Reasons for the under-reporting of private patients in HES included the use of separate patient administration systems for private patients with a failure to feed data to HES, and the omission of some provider units altogether by a minority of trusts from the returns made to the Department of Health. Overall, HES underestimates the amount of private patient activity reported directly by NHS hospitals. No method of validating private patient data is currently available. An amendment to an existing statistical return would provide a check on numbers. Central guidance on the inclusion of private patient activity in data transmitted by providers to the HES processing agency should be reinforced.

  15. Comparison of Western and Asian Guidelines Concerning the Management of Colon Cancer.

    PubMed

    Pellino, Gianluca; Warren, Oliver; Mills, Sarah; Rasheed, Shahnawaz; Tekkis, Paris P; Kontovounisios, Christos

    2018-02-01

    Guidelines are important to standardize treatments and optimize outcomes. Several societies have published authoritative guidelines for patients with colon cancer, and a certain degree of variation can be predicted. This study aims to compare Western and Asian guidelines for the management of colon cancer. A literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies published between 2010 and 2017 by the online resources from the official Web sites of the societies/panels. Sources included guidelines by European Society of Medical Oncology, the Japanese Society for Cancer of the Colon and Rectum, and the National Comprehensive Cancer Network. Only full-text studies and the latest guidelines dealing with colon cancer were included. Studies and guidelines were separately assessed by 2 authors, who independently identified discrepancies and areas for further research. These were discussed and agreed with by all the authors. The recommendations of the guidelines of each society were compared, seeking discrepancies and potential areas for improvement. Endoscopic techniques for the management of early colon cancer are discussed in detail in the Asian guidelines. Asian guidelines advocate extended (D3) lymphadenectomy on a routine basis in T3/T4 and in selected T2 patients, whereas such an approach is still under investigation in Western countries. Only US guidelines describe neoadjuvant chemotherapy and radiotherapy. All the guidelines recommend adjuvant treatment in selected stage II patients, but agreement exists that this is performed without solid evidence, because better outcomes are hypothesized based on studies including stage III or stage II/III patients. The role of cytoreductive surgery with intra-abdominal chemotherapy is dubious, and European guidelines only recommend it in the setting of trials. Asian guidelines endorse an aggressive surgical approach to peritoneal disease. Only US guidelines include a patient advocate in the drafting panel. Bias may have arisen from country-specific socioeconomic and cultural issues, and from the latest available updates. Surgical approaches to colon cancer differ significantly among Western and Asian guidelines, reflecting different concepts of treatment. The role of adjuvant treatment in node-negative disease and quality-of-life assessment need further research.

  16. He Said, She Said: Comparing Mother and Father Reports of Father Involvement

    ERIC Educational Resources Information Center

    Mikelson, Kelly S.

    2008-01-01

    This study compares mother and father reports of fathers' involvement, including frequency of involvement and emotional involvement, with their child and examines demographic and social factors that predict the discrepancy in father and mother reports. Using matched pairs of parents (n = 2,058) from the Fragile Families and Child Wellbeing data,…

  17. Can climate models be tuned to simulate the global mean absolute temperature correctly?

    NASA Astrophysics Data System (ADS)

    Duan, Q.; Shi, Y.; Gong, W.

    2016-12-01

    The Inter-government Panel on Climate Change (IPCC) has already issued five assessment reports (ARs), which include the simulation of the past climate and the projection of the future climate under various scenarios. The participating models can simulate reasonably well the trend in global mean temperature change, especially of the last 150 years. However, there is a large, constant discrepancy in terms of global mean absolute temperature simulations over this period. This discrepancy remained in the same range between IPCC-AR4 and IPCC-AR5, which amounts to about 3oC between the coldest model and the warmest model. This discrepancy has great implications to the land processes, particularly the processes related to the cryosphere, and casts doubts over if land-atmosphere-ocean interactions are correctly considered in those models. This presentation aims to explore if this discrepancy can be reduced through model tuning. We present an automatic model calibration strategy to tune the parameters of a climate model so the simulated global mean absolute temperature would match the observed data over the last 150 years. An intermediate complexity model known as LOVECLIM is used in the study. This presentation will show the preliminary results.

  18. Similarities and discrepancies in homozygous factor VII defects due to mutations in the region of residues Met298 to Cys310 (exon 8) in the catalytic domain of factor VII.

    PubMed

    Girolami, A; Berti de Marinis, G; Bonamigo, E; Vettore, S

    2011-06-01

    Patients with the Arg304Gln mutation in factor VII Padua (FVII Padua) show discrepant activity levels that depend on the thromboplastin used in the assay system. This report investigates the possibility that residues close to Arg304 (exon 8) show the same discrepant behavior. All available homozygous patients with a mutation in a 13-residue region (preceding and following Arg304) have been evaluated. Only the Arg304Trp mutation showed a discrepancy similar to that shown by the Arg304Gln mutation. Other homozygotes failed to show differences, despite their all being positive for cross-reacting material. Another FVII amino acid residue involved in tissue factor binding and activation is Arg79 (exon 4). No comparison could be carried out because no homozygotes for deficiency in this region have ever been described. The relationship between these 2 residues involved in tissue factor binding and activation has not yet been completely clarified; however, Arg residues 79 and 304 are the only 2 residues definitely shown thus far to be involved in this important function.

  19. Effects of gender role self-discrepancies and self-perceived attractiveness on social anxiety for women across social situations.

    PubMed

    Howell, Ashley N; Weeks, Justin W

    2017-01-01

    Psychosocial factors, such as gender role norms, may impact how social anxiety disorder (SAD) is experienced and expressed in different social contexts for women. However to date, these factors have not been examined via experimental methodology. This was a cross-sectional, quasi-experimental controlled study. The current study included 48 highly socially anxious (HSA) women (70.9% meeting criteria for SAD) and examined the relationships among psychosocial factors (i.e. gender role self-discrepancies and self-perceived physical attractiveness), self-perceived social performance, and state anxiety, across two in vivo social tasks (i.e. conversation and opinion speech). On average, participants reported belief that they ought to be less feminine for the speech task and more masculine for both the conversation and speech tasks. Also, for the conversation task, only lower self-rated attractiveness predicted poorer self-perceived performance and greater post-task state anxiety, above gender role self-discrepancies and confederate gender. For the speech task, only greater self-discrepancy in prototypical masculine traits predicted poorer performance ratings, and it was related to greater state anxiety in anticipation of the task. For HSA women, psychosocial factors may play different roles in social anxiety across social contexts.

  20. Accuracy of self-reported versus actual online gambling wins and losses.

    PubMed

    Braverman, Julia; Tom, Matthew A; Shaffer, Howard J

    2014-09-01

    This study is the first to compare the accuracy of self-reported with actual monetary outcomes of online fixed odds sports betting, live action sports betting, and online casino gambling at the individual level of analysis. Subscribers to bwin.party digital entertainment's online gambling service volunteered to respond to the Brief Bio-Social Gambling Screen and questions about their estimated gambling results on specific games for the last 3 or 12 months. We compared the estimated results of each subscriber with his or her actual betting results data. On average, between 34% and 40% of the participants expressed a favorable distortion of their gambling outcomes (i.e., they underestimated losses or overestimated gains) depending on the time period and game. The size of the discrepancy between actual and self-reported results was consistently associated with the self-reported presence of gambling-related problems. However, the specific direction of the reported discrepancy (i.e., favorable vs. unfavorable bias) was not associated with gambling-related problems. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  1. Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

    PubMed Central

    Manangan, Lilia Ponce; Tryon, Cheryl; Magee, Elvin; Miramontes, Roque

    2012-01-01

    Introduction. The Centers for Disease Control and Prevention (CDC)'s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009. Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit. Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions' QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012. Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality. PMID:22685648

  2. Insights, attitudes, and perceptions about asthma and its treatment: findings from a multinational survey of patients from Latin America.

    PubMed

    Maspero, Jorge F; Jardim, Jose R; Aranda, Alvaro; Tassinari C, Paolo; Gonzalez-Diaz, Sandra N; Sansores, Raul H; Moreno-Cantu, Jorge J; Fish, James E

    2013-11-04

    In 2011 the Latin America Asthma Insight and Management (LA AIM) survey explored the realities of living with asthma. We investigated perception, knowledge, and attitudes related to asthma among Latin American asthma patients. Asthma patients aged ≥12 years from four Latin American countries (Argentina, Brazil, Mexico, Venezuela) and the Commonwealth of Puerto Rico responded to questions during face-to-face interviews. A sample size of 2,169 patients (approximately 400 patients/location) provided an accurate representation of asthma patients' opinions. Questions probed respondents' views on topics such as levels of asthma control, frequency and duration of exacerbations, and current and recent use of asthma medications. A total of 2,169 adults or parents of children with asthma participated in the LA AIM survey. At least 20% of respondents experienced symptoms every day or night or most days or nights. Although 60% reported their disease as well or completely controlled, only 8% met guideline criteria for well-controlled asthma. 47% of respondents reported episodes when their asthma symptoms were more frequent or severe than normal, and 44% reported seeking acute care for asthma in the past year. Asthma patients in Latin America overestimated their degree of asthma control. The LA AIM survey demonstrated the discrepancy between patient perception of asthma control and guideline-mandated criteria. Additional education is required to teach patients that, by more closely following asthma management strategies outlined by current guidelines more patients can achieve adequate asthma control.

  3. Praise in Public, Criticize in Private? An Assessment of Performance Feedback Transparency in a Classroom Setting

    ERIC Educational Resources Information Center

    Seevers, Matthew T.; Rowe, William J.; Skinner, Steven J.

    2014-01-01

    Conventional wisdom in sales management encourages public delivery of positive feedback, and private delivery of negative feedback. In stark contrast, U.S. educators typically provide all performance feedback in relative (if not strict) privacy to comply with the Family Educational Rights and Privacy Act (FERPA). To investigate this discrepancy,…

  4. Strategies for Managing Massive Defects of the Foot in High-Energy Combat Injuries of the Lower Extremity

    DTIC Science & Technology

    2010-01-01

    infection, or avascular necrosis is extremely difficult. Tibiocalcaneal fusion typically leaves a patient with a leg length discrepancy unless large bone...fractures. J Orthop Trauma 2004;18(5):265–70. 37. Dennison MG, Pool RD, Simonis RB, et al. Tibiocalcaneal fusion for avascular necrosis of the talus

  5. Assessing the Universal Basic Education Primary and Koranic Schools' Synergy for "Almajiri" Street Boys in Nigeria

    ERIC Educational Resources Information Center

    Usman, Lantana M.

    2008-01-01

    Purpose: The purpose of this paper is to show how Nigeria's current Universal Basic Education on primary schooling targets Muslim "Almajiri" street boys for basic literacy acquisition. The paper examines the policy's management implementation practices and challenges, as well as provides policy options that may minimize discrepancies for…

  6. Self and Peer Assessment of Pediatricians, Psychiatrists and Medicine Specialists: Implications for Self-Directed Learning

    ERIC Educational Resources Information Center

    Violato, Claudio; Lockyer, Jocelyn

    2006-01-01

    Self-regulation in medicine depends on accurate self-assessment. The purpose of the present study was to examine the discrepancy between self and peer assessments for a group of specialist physicians from internal medicine (IM), pediatrics, and psychiatry clinical domains (i.e., patient management, clinical assessment, professional development,…

  7. A Visual Information Tool for User Participation during the Lifecycle of School Building Design: BIM

    ERIC Educational Resources Information Center

    Koutamanis, Alexander; Heuer, Jos; Könings, Karen D.

    2017-01-01

    User participation is a key element in decision processes concerning the accommodation of dynamic organisations such as schools. This article addresses the discrepancy between the perspectives of the architects and engineers, as the makers of school buildings, and school management, teachers and students, as the users of the buildings, and…

  8. Comparison of Maximal Wall Thickness in Hypertrophic Cardiomyopathy Differs Between Magnetic Resonance Imaging and Transthoracic Echocardiography.

    PubMed

    Bois, John P; Geske, Jeffrey B; Foley, Thomas A; Ommen, Steve R; Pellikka, Patricia A

    2017-02-15

    Left ventricular (LV) wall thickness is a prognostic marker in hypertrophic cardiomyopathy (HC). LV wall thickness ≥30 mm (massive hypertrophy) is independently associated with sudden cardiac death. Presence of massive hypertrophy is used to guide decision making for cardiac defibrillator implantation. We sought to determine whether measurements of maximal LV wall thickness differ between cardiac magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Consecutive patients were studied who had HC without previous septal ablation or myectomy and underwent both cardiac MRI and TTE at a single tertiary referral center. Reported maximal LV wall thickness was compared between the imaging techniques. Patients with ≥1 technique reporting massive hypertrophy received subset analysis. In total, 618 patients were evaluated from January 1, 2003, to December 21, 2012 (mean [SD] age, 53 [15] years; 381 men [62%]). In 75 patients (12%), reported maximal LV wall thickness was identical between MRI and TTE. Median difference in reported maximal LV wall thickness between the techniques was 3 mm (maximum difference, 17 mm). Of the 63 patients with ≥1 technique measuring maximal LV wall thickness ≥30 mm, 44 patients (70%) had discrepant classification regarding massive hypertrophy. MRI identified 52 patients (83%) with massive hypertrophy; TTE, 30 patients (48%). Although guidelines recommend MRI or TTE imaging to assess cardiac anatomy in HC, this study shows discrepancy between the techniques for maximal reported LV wall thickness assessment. In conclusion, because this measure clinically affects prognosis and therapeutic decision making, efforts to resolve these discrepancies are critical. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data.

    PubMed

    Kim, Yeon-Yong; Park, Jong Heon; Kang, Hee-Jin; Lee, Eun Joo; Ha, Seongjun; Shin, Soon-Ae

    2017-09-01

    The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

  10. Medication reconciliation by a pharmacy technician in a mental health assessment unit.

    PubMed

    Brownlie, Kay; Schneider, Carl; Culliford, Roger; Fox, Chris; Boukouvalas, Alexis; Willan, Cathy; Maidment, Ian D

    2014-04-01

    Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. In-patient mental health services. Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics;and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Mean number of discrepancies per admission corrected by the pharmacy technician. Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected.The most common discrepancy was omission(n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43(37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Medication discrepancies are common within mental health services with potentially significant consequences for patients.Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety.

  11. In view of standardization Part 2: Management of challenges in the initial treatment of burn patients in Burn Centers in Germany, Austria and Switzerland.

    PubMed

    Ziegler, Benjamin; Hirche, Christoph; Horter, Johannes; Kiefer, Jurij; Grützner, Paul Alfred; Kremer, Thomas; Kneser, Ulrich; Münzberg, Matthias

    2017-03-01

    Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland. The survey included standards of airway management and ventilation, fluid management and circulation, body temperature monitoring and management, topical burn wound treatment and a microbiological surveillance. Additionally, the distribution of standardized course systems was covered. 17 out of 22 questionnaires (77%) were returned completed. Regarding volume resuscitation, results showed a similar approach in estimating initial fluid while discrepancies persisted in the use of colloidal fluid and human albumin. Elective tracheostomy and the need for bronchoscopy with suspected inhalation injury were the most controversial issues revealed by the survey. Topical treatment of burned body surface also followed different principles regarding the use of synthetic epidermal skin substitutes or enzymatic wound debridement. Less discrepancy was found in basic diagnostic measures, body temperature management, estimation of the extent of burns and microbiological surveillance. While many burn-related issues are clearly not questionable and managed in a similar way in most participating facilities, we were able to show that the most contentious issues in burn trauma management involve initial volume resuscitation, management of inhalation trauma and topical burn wound treatment. Further research is required to address these topics and evaluate a potential superiority of a regime in order to increase the level of evidence. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. Outside CT imaging among emergency department transfer patients.

    PubMed

    Sung, Jeffrey C; Sodickson, Aaron; Ledbetter, Stephen

    2009-09-01

    The aim of this study was to characterize the quantity and types of outside computed tomographic (CT) examinations submitted for reinterpretation among emergency department (ED) transfers to a tertiary care, level I trauma, academic medical center and the frequency of and reasons for repeat imaging. Reinterpretation requests for outside CT studies accompanying ED transfer patients over a 4-month period were prospectively audited. Clinicians completed forms specifying type of CT study, outside report availability, interpretational discrepancies, repeat imaging requests, and reasons for repeat imaging. A total of 425 CT studies were reviewed among 255 transfer patients, with a mean of 2.8 examinations (range, 0-16) on 1.7 patients (range, 0-8) per day. The patients' mean age was 59 years, and 57% were male. The clinicians reported no outside verbal or written reports for 16% of patients. Interpretational discrepancies were noted in 12% of those with outside reports. Repeat scans might have been avoided in as many as 25% of rescanned patients (35% of repeat examinations) because they were performed solely for imaging or information technology reasons (inadequate imaging, compact disc inoperability, or unavailable images within the hospital's picture archiving and communication system). Rescanned trauma patients in particular had a high per patient rate (32%) of potentially avoidable reasons, with a lower rate (11%) in nontrauma patients. Outside CT imaging in ED transfers adds workload and resource requirements for receiving institutions. A communication gap exists between transferring and receiving institutions, and interpretational discrepancies are common. Process improvement measures are suggested that might reduce the substantial rates of potentially avoidable reimaging.

  13. The relationship between reciprocity and burnout in Dutch medical residents.

    PubMed

    Prins, Jelle T; Gazendam-Donofrio, Stacey M; Dillingh, Gea S; van de Wiel, Harry B M; van der Heijden, Frank M M A; Hoekstra-Weebers, Josette E H M

    2008-07-01

    This study examined reciprocity in medical residents' relationships with supervisors, fellow residents, nurses and patients, and associations between reciprocity and burnout. Furthermore, we considered if a discrepancy between the perceived and preferred levels of reciprocity influenced the level of burnout complaints. In 2003, self-report questionnaires were sent to the homes of all 292 medical residents at the University Medical Centre Groningen (UMCG), Groningen, the Netherlands. Reciprocity was measured with a single-item reciprocity scale based on the Hatfield Global Measure of Equity Scale. The Utrecht Burn-Out Scale (UBOS/MBI-HHS) was used to measure burnout. A total of 158 residents participated in the study. Those who reported under-benefiting in the relationship with supervisors perceived significantly more emotional exhaustion and depersonalisation than those who perceived a reciprocal relationship. Residents who indicated that they over-benefited in the relationship with nurses reported more emotional exhaustion than residents who perceived a reciprocal relationship and less personal accomplishment than residents who perceived a reciprocal relationship or under-benefit. No differences on the burnout subscales were found between residents who perceived their relationships with patients and fellow residents to be reciprocal and those who considered they under- or over-benefited. The greater the discrepancy between perceived and preferred reciprocity in the relationship with the supervisor, the more emotional exhaustion residents reported. Perceptions of reciprocity in relationships with supervisors and nurses had particular influence on the level of burnout complaints among residents. The discrepancy between the impacts of perceived and preferred reciprocity on burnout was negligible and the only significant relationship to emerge concerned that with emotional exhaustion.

  14. 77 FR 55681 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... prompted by reports of stress corrosion cracking in the chord segments made from 7079 aluminum in the... repairing discrepancies if necessary. We are issuing this AD to detect and correct stress corrosion and/or... America Code 55: Stabilizers. (e) Unsafe Condition This AD was prompted by reports of stress corrosion...

  15. 76 FR 72863 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... discrepancies if necessary. This proposed AD was prompted by reports of stress corrosion cracking in the chord... segments made from 7075 aluminum. We are proposing this AD to detect and correct stress corrosion and/or... proposed AD. Discussion We have received numerous reports of stress corrosion cracking in the chord...

  16. Children's Responses to Literature: Views of Children and Teachers.

    ERIC Educational Resources Information Center

    Pascoe, Elaine; Gilchrist, Margaret

    1987-01-01

    Presents a study comparing the elements children report enjoying in a book and the elements teachers believe children enjoy. Concludes that a great discrepancy exists between the two groups, as children reported they liked books offering excitement, suspense, and action, while teachers believed children pay more attention to characters. (JC)

  17. 12 CFR 334.80-334.81 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false [Reserved] 334.80-334.81 Section 334.80-334.81 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records...

  18. 12 CFR 41.80-81 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false [Reserved] 41.80-81 Section 41.80-81 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal § 41.80-81 [Reserved] ...

  19. 12 CFR 571.83 - Disposal of consumer information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal § 571.83 Disposal of consumer information. (a) Scope. This section applies to savings associations whose deposits... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Disposal of consumer information. 571.83...

  20. 12 CFR 334.83 - Disposal of consumer information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... GENERAL POLICY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal § 334.83 Disposal of consumer information. (a) In general. You must properly... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Disposal of consumer information. 334.83...

  1. 12 CFR 717.80-717.81 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false [Reserved] 717.80-717.81 Section 717.80-717.81 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal §§ 717.80...

  2. 12 CFR 334.83 - Disposal of consumer information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Disposal of consumer information. 334.83... GENERAL POLICY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal § 334.83 Disposal of consumer information. (a) In general. You must properly...

  3. 12 CFR 571.83 - Disposal of consumer information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Disposal of consumer information. 571.83... REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal § 571.83 Disposal of consumer information. (a) Scope. This section applies to savings associations whose deposits...

  4. Analysis of discrepancies observed between digital and analog images during a clinical trial of IRIS

    NASA Astrophysics Data System (ADS)

    Goldberg, Morris; Coristine, Marjorie; Currie, Shawn; Belanger, Garry; Ahuja, J.; Dillon, Richard F.; Robertson, John G.

    1990-08-01

    A clinical trial of an Integrated Radiological Information System (IRIS) was conducted at the Ottawa Civic Hospital with the Department of Emergency Medicine and the Department of Radiological Sciences between April 4, and May 12, 1989. During the trial, 319 active Emergency Department cases (905 films) were processed using IRIS. Radiologists examined the digital images on the image screen to formulate a diagnosis, then before dictating a report, they examined the analog films. In 30 cases there was a discrepancy between the information obtained while viewing the digital images on IRIS and the information obtained from the analog films. These anomalous cases were used in an independent study of the discrepancies. In the study, each case was reviewed in both digital and analog form by three physicians who provided a comparative rating of diagnostic quality. Any perceived differences between the digital and analog media were noted. Particular attention was paid to rating the relevance of the IRIS enhancement capabilities. Although ratings for digital images were high, the comparative ratings for the film are in general better. An analysis of the individual cases shows that: (i) most of the discrepancies probably resulted from physician inexperience in reading radiographs in digital form, (ii) the IRIS enhancement facilities significantly increase the ratings of satisfaction or perceived quality of digital images and (iii) an appropriate choice of enhancement may make visible the required diagnostic features for cases where some reviewers did not find the image/digital discrepant.

  5. Hepatic transporter drug-drug interactions: an evaluation of approaches and methodologies.

    PubMed

    Williamson, Beth; Riley, Robert J

    2017-12-01

    Drug-drug interactions (DDIs) continue to account for 5% of hospital admissions and therefore remain a major regulatory concern. Effective, quantitative prediction of DDIs will reduce unexpected clinical findings and encourage projects to frontload DDI investigations rather than concentrating on risk management ('manage the baggage') later in drug development. A key challenge in DDI prediction is the discrepancies between reported models. Areas covered: The current synopsis focuses on four recent influential publications on hepatic drug transporter DDIs using static models that tackle interactions with individual transporters and in combination with other drug transporters and metabolising enzymes. These models vary in their assumptions (including input parameters), transparency, reproducibility and complexity. In this review, these facets are compared and contrasted with recommendations made as to their application. Expert opinion: Over the past decade, static models have evolved from simple [I]/k i models to incorporate victim and perpetrator disposition mechanisms including the absorption rate constant, the fraction of the drug metabolised/eliminated and/or clearance concepts. Nonetheless, models that comprise additional parameters and complexity do not necessarily out-perform simpler models with fewer inputs. Further, consideration of the property space to exploit some drug target classes has also highlighted the fine balance required between frontloading and back-loading studies to design out or 'manage the baggage'.

  6. Discordant correlation of breast adenoid cystic carcinoma on imaging and pathology: A case report and literature review on surgical management.

    PubMed

    Yan, Zhiyan; Leong, May Ying; Lim, Geok Hoon

    2018-01-01

    Adenoid cystic carcinomas (ACC) of the breast are extremely rare tumours, accounting for <0.1% of newly diagnosed breast cancer cases. Little data exist regarding the correlation of radiological findings with histology of this rare subtype. To our knowledge, gross size discrepancy between the 2 modalities has not been reported. We describe a case of ACC with appreciable size discordance between imaging and pathology report. A 71 years old lady presented with a painless right breast lump of a few months duration. Clinical examination revealed a 1.5 cm right breast upper outer quadrant mass. Axillary and systemic examinations were unremarkable. Mammogram showed an asymmetric density in the right upper outer quadrant which corresponded to a suspicious nodule measuring about 2 cm on the ultrasound. Ultrasound of the axilla showed an indeterminate right lymph node. Core needle biopsy of the right breast nodule showed ACC while the lymph node biopsy was non- metastatic. Staging scans did not reveal any definite distant metastasis. Her naso-endoscopy and MRI of the neck were normal. She underwent a right mastectomy and sentinel lymph node biopsy. Final histology returned as a grade II 55 mm ACC. Lympho-vascular invasion was absent. The tumour was triple negative for Estrogen receptor (ER), Progesterone receptor (PR) and Human epidermal receptor 2 (HER 2). Sentinel lymph node biopsy was negative for metastasis. She recovered well but declined adjuvant chemotherapy and radiation therapy. She is currently well 6 months post operation. ACC is an extremely rare subtype, therefore there are limited reports in literature on its imaging and pathological characteristics. Of this sparse data, there was no mention that there might be a big size discrepancy between the 2 modalities. This appreciable discrepancy has implications for pre-operative planning and the choice of breast surgery. It will be useful if the pathological extent of ACC could be determined more accurately radiologically. However, there are no distinctive imaging characteristics for ACC. ACC can appear as a smooth round mass similar to that of a benign mass or as an irregular mass on mammogram. On ultrasound, ACC often manifested as a hypo- echoic heterogeneous mass with minimal vascularity on Doppler imaging and may have an indistinct margin. MRI has a higher sensitivity than mammogram and ultrasound in determining the true extent of the tumour, but there remains little data on its usefulness in ACC. ACC can be extensively infiltrative and present much larger than its radiological size, as reported in our case. Use of better imaging modalities judiciously, in these cases, are needed to more accurately predict the true pathological size of ACC to prevent inadequate surgery. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  7. Evidence for transcriptional interference in a dual-luciferase reporter system.

    PubMed

    Wu, Guo-Qing; Wang, Xiao; Zhou, Hong-Ying; Chai, Ke-Qun; Xue, Qian; Zheng, Ai-Hong; Zhu, Xiu-Ming; Xiao, Jian-Yong; Ying, Xu-Hua; Wang, Fu-Wei; Rui, Tao; Xu, Li-Yun; Zhang, Yong-Kui; Liao, Yi-Ji; Xie, Dan; Lu, Li-Qin; Huang, Dong-Sheng

    2015-12-01

    The dual-luciferase reporter assay is widely used for microRNA target identification and the functional validation of predicted targets. To determine whether curcumin regulates expression of the histone methyltransferase enhancer of zeste homolog 2 (EZH2) by targeting its 3'untranslated region (3'UTR), two luciferase reporter systems containing exactly the same sequence of the EZH2 3'UTR were used to perform dual-luciferase reporter assays. Surprisingly, there were certain discrepancies between the luciferase activities derived from these two reporter constructs. We normalized luciferase activity to an internal control to determine the amount of the reporter construct successfully transfected into cells, induced a transcriptional block with flavopiridol, quantified renilla luciferase mRNA levels, and compared the absolute luciferase activity among the different groups. The results suggested that curcumin promoted the transcription of the luciferase genes located downstream of the simian vacuolating virus 40 (SV40) early enhancer/promoter, but not those located downstream of the human cytomegalovirus (CMV) immediate-early or the herpes simplex virus thymidine kinase (HSV-TK) promoters. These results explain the discrepancies between the two luciferase reporter systems. The current study underscores the importance of taking caution when interpreting the results of dual-luciferase reporter assays and provides strategies to overcome the potential pitfall accompanying dual-luciferase reporter systems.

  8. Evidence for transcriptional interference in a dual-luciferase reporter system

    PubMed Central

    Wu, Guo-Qing; Wang, Xiao; Zhou, Hong-Ying; Chai, Ke-Qun; Xue, Qian; Zheng, Ai-Hong; Zhu, Xiu-Ming; Xiao, Jian-Yong; Ying, Xu-Hua; Wang, Fu-Wei; Rui, Tao; Xu, Li-Yun; Zhang, Yong-Kui; Liao, Yi-Ji; Xie, Dan; Lu, Li-Qin; Huang, Dong-Sheng

    2015-01-01

    The dual-luciferase reporter assay is widely used for microRNA target identification and the functional validation of predicted targets. To determine whether curcumin regulates expression of the histone methyltransferase enhancer of zeste homolog 2 (EZH2) by targeting its 3′untranslated region (3′UTR), two luciferase reporter systems containing exactly the same sequence of the EZH2 3′UTR were used to perform dual-luciferase reporter assays. Surprisingly, there were certain discrepancies between the luciferase activities derived from these two reporter constructs. We normalized luciferase activity to an internal control to determine the amount of the reporter construct successfully transfected into cells, induced a transcriptional block with flavopiridol, quantified renilla luciferase mRNA levels, and compared the absolute luciferase activity among the different groups. The results suggested that curcumin promoted the transcription of the luciferase genes located downstream of the simian vacuolating virus 40 (SV40) early enhancer/promoter, but not those located downstream of the human cytomegalovirus (CMV) immediate-early or the herpes simplex virus thymidine kinase (HSV-TK) promoters. These results explain the discrepancies between the two luciferase reporter systems. The current study underscores the importance of taking caution when interpreting the results of dual-luciferase reporter assays and provides strategies to overcome the potential pitfall accompanying dual-luciferase reporter systems. PMID:26620302

  9. A Lean Six Sigma journey in radiology.

    PubMed

    Bucci, Ronald V; Musitano, Anne

    2011-01-01

    The department of radiology at Akron Children's Hospital embarked on a Lean Six Sigma mission as part of a hospital wide initiative to show increased customer satisfaction, reduce employee dissatisfaction and frustration, and decrease costs. Three processes that were addressed were reducing the MRI scheduling back-log, reconciling discrepancies in billing radiology procedures, and implementing a daily management system. Keys to success is that managers provide opportunities to openly communicate between department sections to break down barriers. Executive leaders must be engaged in Lean Six Sigma for the company to be successful.

  10. Psychosocial health and quality of life among children with cardiac diagnoses: agreement and discrepancies between parent and child reports.

    PubMed

    Patel, Bhavika J; Lai, Lillian; Goldfield, Gary; Sananes, Renee; Longmuir, Patricia E

    2017-05-01

    Psychosocial health issues are common among children with cardiac diagnoses. Understanding parent and child perceptions is important because parents are the primary health information source. Significant discrepancies have been documented between parent/child quality-of-life data but have not been examined among psychosocial diagnostic instruments. This study examined agreement and discrepancies between parent and child reports of psychosocial health and quality of life in the paediatric cardiology population. Children (n=50, 6-14 years) with diagnoses of CHDs (n=38), arrhythmia (n=5), cardiomyopathy (n=4), or infectious disease affecting the heart (n=3) were enrolled, completing one or more outcome measures. Children and their parents completed self-reports and parent proxy reports of quality of life - Pediatric Quality of Life Inventory - and psychosocial health - Behavioral Assessment Scale for Children (Version 2). Patients also completed the Multidimensional Anxiety Scale for Children. Associations (Pearson's correlations, Intraclass Correlation Coefficients) and differences (Student's t-tests) between parent proxy reports and child self-reports were evaluated. Moderate parent-child correlations were found for physical (R=0.33, p=0.03), school (R=0.43, p<0.01), social (R=0.36, p=0.02), and overall psychosocial (R=0.43, p<0.01) quality of life. Parent-child reports of externalising behaviour problems, for example aggression, were strongly correlated (R=0.70, p<0.01). No significant parent-child associations were found for emotional quality of life (R=0.25, p=0.10), internalising problems (R=0.17, p=0.56), personal adjustment/adaptation skills (R=0.23, p=0.42), or anxiety (R=0.07, p=0.72). Our data suggest that clinicians caring for paediatric cardiac patients should assess both parent and child perspectives, particularly in relation to domains such as anxiety and emotional quality of life, which are more difficult to observe.

  11. 75 FR 67453 - Identity Theft Red Flags and Address Discrepancies Under the Fair and Accurate Credit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... reasonable policies and procedures that a user of consumer reports must employ when a user receives a notice... policies and procedures for users of consumer reports to enable a user to form a reasonable belief that it knows the identity of the person for whom it has obtained a consumer report, and reconcile the address...

  12. Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling

    PubMed Central

    2012-01-01

    Background High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS) as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. Methods In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. Results At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Conclusions Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care. PMID:22776745

  13. Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling.

    PubMed

    Hedt-Gauthier, Bethany L; Tenthani, Lyson; Mitchell, Shira; Chimbwandira, Frank M; Makombe, Simon; Chirwa, Zengani; Schouten, Erik J; Pagano, Marcello; Jahn, Andreas

    2012-07-09

    High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS) as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care.

  14. Prolonged partial epilepsy: a case report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wilson, M.A.

    1980-11-01

    The case study of a patient with prolonged partial epilepsy is presented. There was a discrepancy between the extent of the abnormality seen on the radionuclide angiogram and that seen on the static brain scan.

  15. Avascular Necrosis in the Contralateral Hip in Patients With Congenital Femoral Deficiency: A Report of 3 Cases.

    PubMed

    Brown, Timothy S; Wimberly, Robert L; Birch, John G

    2017-01-01

    Congenital femoral deficiency is an uncommon clinical entity. We report 3 patients who developed avascular necrosis of the hip in the long (normal) leg during longitudinal observation and/or treatment of congenital femoral deficiency. Patients were identified in limb length discrepancy clinic and their charts were retrospectively reviewed for clinical and radiographic data collection. We describe the occurrence of idiopathic avascular necrosis in the normal limb in patients being followed for limb length discrepancy. Although no conclusion could be drawn about the etiology of the avascular necrosis, we describe a previously undocumented relationship between congenital femoral deficiency and avascular necrosis in the contralateral hip. This occurred in our congenital femoral deficiency population at a rate higher than expected compared with published incidences of avascular necrosis of the hip in children. Level IV-case series.

  16. The Use of the Digital Smile Design Concept as an Auxiliary Tool in Aesthetic Rehabilitation: A Case Report.

    PubMed

    Zanardi, Piero Rocha; Laia Rocha Zanardi, Raquel; Chaib Stegun, Roberto; Sesma, Newton; Costa, Bru-No; Cruz Laganá, Dalva

    2016-01-01

    The digital smile design is a practical diagnosis method that can assist the clinician to visualize and measure dentogingival discrepancies. This clinical report aims to present the associated steps, from the diagnosis of the alterations diagnosis through to the final aesthetic result. A 37-years-old female patient presented as her main complaint the tooth form and colour discrepancies. Applying the digital smile design principle, the necessary measures for a harmonic smile correction could be accurately determined. The initial diagnosis led to a wax up of the master cast that was duplicated in acrylic resin directly in the mouth. This temporary restoration guided the periodontal surgery and the final pressed ceramic crown restoration. We conclude that the digital smile design concept seems to be a useful tool to achieve a satisfactory aesthetic result.

  17. A study of tantalum pentoxide Ta 2O 5 structures up to 28 GPa

    DOE PAGES

    Stavrou, Elissaios; Zaug, Joseph M.; Bastea, Sorin; ...

    2017-05-02

    In this study, tantalum pentoxide Ta 2O 5 with the orthorhombic L-Ta 2O 5 structure has been experimentally studied up to 28.3 GPa (at ambient temperature) using synchrotron angle-dispersive powder X-ray diffraction (XRD). The ambient pressure phase remains stable up to 25 GPa where with increased pressure a crystalline to amorphous phase transition occurs. A detailed equation of state (EOS), including pressure dependent lattice parameters, is reported. The results of this study were compared with a previous high-pressure XRD study by Li et al. A clear discrepancy between the ambient-pressure crystal structures and, consequently, the reported EOSs between the twomore » studies was revealed. Finally, he origin of this discrepancy is attributed to two different crystal structures used to index the XRD patterns.« less

  18. An audit of half-count myocardial perfusion imaging using resolution recovery software.

    PubMed

    Lawson, Richard S; White, Duncan; Nijran, Kuldip; Cade, Sarah C; Hall, David O; Kenny, Bob; Knight, Andy; Livieratos, Lefteris; Murray, Anthony; Towey, David

    2014-05-01

    The Nuclear Medicine Software Quality Group of the Institute of Physics and Engineering in Medicine has conducted a multicentre, multivendor audit to evaluate the use of resolution recovery software from several manufacturers when applied to myocardial perfusion data with half the normal counts acquired under a variety of clinical protocols in a range of departments. The objective was to determine whether centres could obtain clinical results with half-count data processed with resolution recovery software that were equivalent to those obtained using their normal protocols. Sixteen centres selected 50 routine myocardial perfusion studies each, from which the Nuclear Medicine Software Quality Group generated simulated half-count studies using Poisson resampling. These half-count studies were reconstructed using resolution recovery and the clinical reports compared with the original reports from the full-count data. A total of 769 patient studies were processed and compared. Eight centres found only a small number of clinically relevant discrepancies between the two reports, whereas eight had an unacceptably high number of discrepancies. There were no significant differences in acquisition parameters between the two groups, although centres finding a high number of discrepancies were more likely to perform both rest and stress scans on normal studies. Half of the participating centres could potentially make use of resolution recovery to reduce the administered activity for myocardial perfusion scans without changing their routine acquisition protocols. The other half could consider adjusting the reconstruction parameters used with their resolution recovery software if they wish to use reduced activity successfully.

  19. Trochanteric bursitis after total hip arthroplasty: incidence and evaluation of response to treatment.

    PubMed

    Farmer, Kevin W; Jones, Lynne C; Brownson, Kirstyn E; Khanuja, Harpal S; Hungerford, Marc W

    2010-02-01

    We examined the efficacy of corticosteroid injection as treatment for postarthroplasty trochanteric bursitis and the risk factors for failure of nonoperative treatment. There were 32 (4.6%) cases of postsurgical trochanteric bursitis in 689 primary total hip arthroplasties. Of the 25 hips with follow-up, 11 (45%) required multiple injections. Symptoms resolved in 20 (80%) but persisted in 5. We found no statistically significant differences between patients who did and did not develop trochanteric bursitis, or between those who did and did not respond to treatment. There was a trend toward younger age and greater limb-length discrepancy in nonresponders. In conclusion, (1) corticosteroid injection(s) for postoperative trochanteric bursitis is effective; and (2) nonoperative management may be more likely to fail in young patients and those with leg-length discrepancy. 2010 Elsevier Inc. All rights reserved.

  20. Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

    PubMed

    Byrne, Eamonn; Bury, Gerard

    2018-02-08

    Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

  1. Depressive symptoms in mothers and daughters: Attachment style moderates reporter agreement

    PubMed Central

    Milan, Stephanie; Wortel, Sanne; Ramirez, Jenna; Oshin, Linda

    2016-01-01

    Parents and adolescents show only modest agreement when reporting on depressive symptoms. Drawing from attachment theory and previous research on informant discrepancies, we tested hypotheses about how adolescent attachment style may impact reporting agreement in a sample of 184 low-income mother-adolescent daughter dyads (adolescent mean age = 15.4 (SD = 1.05), maternal mean age = 41.4 (SD = 7.60); 58% Latina, 26% African-American/Black, 16% as non-Hispanic, White). Mothers and adolescents reported on their own and each others’ depressive symptoms and adolescents reported on attachment style. Using a moderated Actor Partner Interdependence Model (APIM) to calculate reporter bias and accuracy estimates, we tested whether attachment style moderated maternal and adolescent accuracy in theoretically consistent ways. Mothers and adolescents showed similar levels of accuracy and bias when reporting on each other. Consistent with hypotheses, we found that adolescents who reported high levels of preoccupation were less accurate when reporting on their mothers because they tended to observe symptoms that their mothers did not endorse. Conversely, mothers were the most accurate in these dyads, potentially because preoccupied adolescents tend to elevate displays of emotional distress. Reporting accuracy was not affected by a dismissive style. These results add to literature indicating that parent-child reporting discrepancies often reflect meaningful information about relationships, and highlight the need to consider different sources of reporting bias and accuracy in assessment and treatment. PMID:27130142

  2. Evidence-based anatomical review areas derived from systematic analysis of cases from a radiological departmental discrepancy meeting.

    PubMed

    Chin, S C; Weir-McCall, J R; Yeap, P M; White, R D; Budak, M J; Duncan, G; Oliver, T B; Zealley, I A

    2017-10-01

    To produce short checklists of specific anatomical review sites for different regions of the body based on the frequency of radiological errors reviewed at radiology discrepancy meetings, thereby creating "evidence-based" review areas for radiology reporting. A single centre discrepancy database was retrospectively reviewed from a 5-year period. All errors were classified by type, modality, body system, and specific anatomical location. Errors were assigned to one of four body regions: chest, abdominopelvic, central nervous system (CNS), and musculoskeletal (MSK). Frequencies of errors in anatomical locations were then analysed. There were 561 errors in 477 examinations; 290 (46%) errors occurred in the abdomen/pelvis, 99 (15.7%) in the chest, 117 (18.5%) in the CNS, and 125 (19.9%) in the MSK system. In each body system, the five most common location were chest: lung bases on computed tomography (CT), apices on radiography, pulmonary vasculature, bones, and mediastinum; abdominopelvic: vasculature, colon, kidneys, liver, and pancreas; CNS: intracranial vasculature, peripheral cerebral grey matter, bone, parafalcine, and the frontotemporal lobes surrounding the Sylvian fissure; and MSK: calvarium, sacrum, pelvis, chest, and spine. The five listed locations accounted for >50% of all perceptual errors suggesting an avenue for focused review at the end of reporting. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Accuracy and usefulness of BMI measures based on self-reported weight and height: findings from the NHANES & NHIS 2001-2006.

    PubMed

    Stommel, Manfred; Schoenborn, Charlotte A

    2009-11-19

    The Body Mass Index (BMI) based on self-reported height and weight ("self-reported BMI") in epidemiologic studies is subject to measurement error. However, because of the ease and efficiency in gathering height and weight information through interviews, it remains important to assess the extent of error present in self-reported BMI measures and to explore possible adjustment factors as well as valid uses of such self-reported measures. Using the combined 2001-2006 data from the continuous National Health and Nutrition Examination Survey, discrepancies between BMI measures based on self-reported and physical height and weight measures are estimated and socio-demographic predictors of such discrepancies are identified. Employing adjustments derived from the socio-demographic predictors, the self-reported measures of height and weight in the 2001-2006 National Health Interview Survey are used for population estimates of overweight & obesity as well as the prediction of health risks associated with large BMI values. The analysis relies on two-way frequency tables as well as linear and logistic regression models. All point and variance estimates take into account the complex survey design of the studies involved. Self-reported BMI values tend to overestimate measured BMI values at the low end of the BMI scale (< 22) and underestimate BMI values at the high end, particularly at values > 28. The discrepancies also vary systematically with age (younger and older respondents underestimate their BMI more than respondents aged 42-55), gender and the ethnic/racial background of the respondents. BMI scores, adjusted for socio-demographic characteristics of the respondents, tend to narrow, but do not eliminate misclassification of obese people as merely overweight, but health risk estimates associated with variations in BMI values are virtually the same, whether based on self-report or measured BMI values. BMI values based on self-reported height and weight, if corrected for biases associated with socio-demographic characteristics of the survey respondents, can be used to estimate health risks associated with variations in BMI, particularly when using parametric prediction models.

  4. Dysautonomic responses during percutaneous carotid intervention: principles of physiology and management.

    PubMed

    Bujak, Marcin; Stilp, Erik; Meller, Stephanie M; Cal, Nicolas; Litsky, Jason; Setaro, John F; Mena, Carlos

    2015-02-01

    Percutaneous carotid artery stenting (CAS) has emerged as a less invasive alternative to carotid endarterectomy for the treatment of carotid atherosclerotic disease. The main risk of CAS is the occurrence of neuro-vascular complications; however, carotid artery stenting-related dysautonomia (CAS-D) (hypertension, hypotension, and bradycardia) is the most frequently reported problem occurring in the periprocedural period. Alterations in autonomic homeostasis result from baroreceptor stimulation, which occurs particularly at the time of balloon inflation in the region of the carotid sinus. The response can be profound enough to induce asystole or even complete cessation of postganglionic sympathetic nerve activity. Frequency and factors predisposing a patient to CAS-D have been investigated in several studies; however, there are significant discrepancies in results among reports. Lack of consistent findings may arise from using different methods and definitions, as well as other factors discussed in detail in this review. Furthermore, a correlation of CAS-D with short and long-term outcomes has been investigated only in small and mostly retrospective studies, explaining why its prognostic significance remains uncertain. In this manuscript, we have focused on risk factors, pathophysiology and management of periprocedural autonomic dysfunction. As there is no standardized approach to the treatment of CAS-D, we present an algorithm for the periprocedural management of patients undergoing CAS. The proposed algorithm was developed based on our procedural experience as well as data from the available literature. The Yale Algorithm was successfully implemented at our institution and we are currently collecting data for short- and long-term safety. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  5. Use of near-infrared spectroscopy (NIRS) in cerebral tissue oxygenation monitoring in neonates.

    PubMed

    Gumulak, Rene; Lucanova, Lucia Casnocha; Zibolen, Mirko

    2017-06-01

    Near-infrared spectroscopy (NIRS) is a technology capable of non-invasive, continuous measuring of regional tissue oxygen saturation (StO 2 ). StO 2 represents a state of hemodynamic stability, which is influenced by many factors. Extensive research has been done in the field of measuring StO 2 of various organs. The current clinical availability of several NIRS-based devices reflects an important development in prevention, detection and correction of discrepancy in oxygen delivery to the brain and vital organs. Managing cerebral ischemia remains a significant issue in the neonatal intensive care units (NICU). Cerebral tissue oxygenation (cStO 2 ) and cerebral fractional tissue extraction (cFTOE) are reported in a large number of clinical studies. This review provides a summary of the concept of function, current variability of NIRS-based devices used in neonatology, clinical applications in continuous cStO 2 monitoring, limitations, disadvantages, and the potential of current technology.

  6. The Coffee Berry Borer (Hypothenemus hampei) Invades Hawaii: Preliminary Investigations on Trap Response and Alternate Hosts

    PubMed Central

    Messing, Russell H.

    2012-01-01

    In August 2010 the coffee berry borer, Hypothenemus hampei, was first reported to have invaded the Kona coffee growing region of Hawaii, posing a severe economic challenge to the fourth largest agricultural commodity in the State. Despite its long and widespread occurrence throughout the tropics as the most serious pest of coffee, there are still discrepancies in the literature regarding several basic aspects of berry borer biology relevant to its control. In Kona coffee plantations, we investigated the beetles’ response to several trap and lure formulations, and examined the occurrence of beetles in seeds of alternate host plants occurring adjacent to coffee farms. While traps were shown to capture significant numbers of beetles per day, and the occurrence of beetles in alternate hosts was quite rare, the unique situation of coffee culture in Hawaii will make this pest extremely challenging to manage in the Islands. PMID:26466620

  7. Pearls and pitfalls of deformity correction and limb lengthening via monolateral external fixation.

    PubMed Central

    Noonan, K. J.; Price, C. T.

    1996-01-01

    In conclusion, monolateral external fixation can be effectively utilized in the management of limb length discrepancy and angular deformity. This manuscript outlines the pertinent theory, application and problems important in these cases. When faced with specific congenital conditions the surgeon is encouraged to reference relevant literature that is more focused than the current paper. PMID:9129275

  8. 76 FR 579 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... Payment Accuracy Through a ``Do Not Pay List'' (June 18, 2010); 3. Office of Management and Budget M-10-13... operating Public Housing programs may now offer tenants the option to pay a flat rent, or an income-based... all cases, program administrators will resolve income discrepancies in consultation with tenants...

  9. Pilot Study EURAMET.AUV.V-P1: Bilateral comparison on magnitude of the complex charge sensitivity of accelerometers from 10 Hz to 10 kHz

    NASA Astrophysics Data System (ADS)

    Bartoli, Claire; Hermawanto, Denny

    2017-01-01

    The results of a Pilot Study EURAMET.AUV.V-P1 between LNE (France) and RCM-LIPI (Indonesia) are reported. This bilateral comparison of sinusoidal vibration was organized after the implementation of various improvements at RCM-LIPI following a previous (unpublished) comparison that had revealed discrepancies in their results at frequencies above 5 kHz. The results of this Pilot Study, using the same accelerometers as the earlier comparison, demonstrate that the discrepancies at high frequencies have been resolved. For both the back-to-back and the single-ended accelerometers tested, the sensitivities of the RCM-LIPI and the LNE over the frequency range from 10 Hz to 10 kHz now agree within their declared uncertainties. Main text To reach the main text of this paper, click on Final Report. The final report has been peer-reviewed and approved for publication by the CCAUV.

  10. The impact of thin idealized media images on body satisfaction: does body appreciation protect women from negative effects?

    PubMed

    Halliwell, Emma

    2013-09-01

    This article examines whether positive body image can protect women from negative media exposure effects. University women (N=112) were randomly allocated to view advertisements featuring ultra-thin models or control images. Women who reported high levels of body appreciation did not report negative media exposure effects. Furthermore, the protective role of body appreciation was also evident among women known to be vulnerable to media exposure. Women high on thin-ideal internalization and low on body appreciation reported appearance-discrepancies that were more salient and larger when they viewed models compared to the control group. However, women high on thin-ideal internalization and also high on body appreciation rated appearance-discrepancies as less important and no difference in size than the control group. The results support the notion that positive body image protects women from negative environmental appearance messages and suggests that promoting positive body image may be an effective intervention strategy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Multicenter Assessment of Gram Stain Error Rates.

    PubMed

    Samuel, Linoj P; Balada-Llasat, Joan-Miquel; Harrington, Amanda; Cavagnolo, Robert

    2016-06-01

    Gram stains remain the cornerstone of diagnostic testing in the microbiology laboratory for the guidance of empirical treatment prior to availability of culture results. Incorrectly interpreted Gram stains may adversely impact patient care, and yet there are no comprehensive studies that have evaluated the reliability of the technique and there are no established standards for performance. In this study, clinical microbiology laboratories at four major tertiary medical care centers evaluated Gram stain error rates across all nonblood specimen types by using standardized criteria. The study focused on several factors that primarily contribute to errors in the process, including poor specimen quality, smear preparation, and interpretation of the smears. The number of specimens during the evaluation period ranged from 976 to 1,864 specimens per site, and there were a total of 6,115 specimens. Gram stain results were discrepant from culture for 5% of all specimens. Fifty-eight percent of discrepant results were specimens with no organisms reported on Gram stain but significant growth on culture, while 42% of discrepant results had reported organisms on Gram stain that were not recovered in culture. Upon review of available slides, 24% (63/263) of discrepant results were due to reader error, which varied significantly based on site (9% to 45%). The Gram stain error rate also varied between sites, ranging from 0.4% to 2.7%. The data demonstrate a significant variability between laboratories in Gram stain performance and affirm the need for ongoing quality assessment by laboratories. Standardized monitoring of Gram stains is an essential quality control tool for laboratories and is necessary for the establishment of a quality benchmark across laboratories. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  12. Multicenter Assessment of Gram Stain Error Rates

    PubMed Central

    Balada-Llasat, Joan-Miquel; Harrington, Amanda; Cavagnolo, Robert

    2016-01-01

    Gram stains remain the cornerstone of diagnostic testing in the microbiology laboratory for the guidance of empirical treatment prior to availability of culture results. Incorrectly interpreted Gram stains may adversely impact patient care, and yet there are no comprehensive studies that have evaluated the reliability of the technique and there are no established standards for performance. In this study, clinical microbiology laboratories at four major tertiary medical care centers evaluated Gram stain error rates across all nonblood specimen types by using standardized criteria. The study focused on several factors that primarily contribute to errors in the process, including poor specimen quality, smear preparation, and interpretation of the smears. The number of specimens during the evaluation period ranged from 976 to 1,864 specimens per site, and there were a total of 6,115 specimens. Gram stain results were discrepant from culture for 5% of all specimens. Fifty-eight percent of discrepant results were specimens with no organisms reported on Gram stain but significant growth on culture, while 42% of discrepant results had reported organisms on Gram stain that were not recovered in culture. Upon review of available slides, 24% (63/263) of discrepant results were due to reader error, which varied significantly based on site (9% to 45%). The Gram stain error rate also varied between sites, ranging from 0.4% to 2.7%. The data demonstrate a significant variability between laboratories in Gram stain performance and affirm the need for ongoing quality assessment by laboratories. Standardized monitoring of Gram stains is an essential quality control tool for laboratories and is necessary for the establishment of a quality benchmark across laboratories. PMID:26888900

  13. Rumination relates to reduced autobiographical memory specificity in formerly depressed patients following a self-discrepancy challenge: the case of autobiographical memory specificity reactivity.

    PubMed

    Raes, Filip; Schoofs, Hanne; Griffith, James W; Hermans, Dirk

    2012-12-01

    Reduced Autobiographical Memory Specificity (rAMS) is a hypothesized vulnerability factor for depression. Rumination is thought to be one of the processes underlying rAMS, but research has failed to show an association between trait rumination and rAMS in individuals who are not currently depressed (e.g., community samples, college samples, and formerly depressed samples). The present study tested whether a challenge procedure that induces a self-discrepancy focus can elicit an association between trait rumination and rAMS in formerly depressed participants. Trait rumination was assessed via self-report. Measures of psychopathology and cognitive function, including depression, were assessed via self-report and interview. Autobiographical Memory Specificity (AMS) was evaluated before and after the induction of a self-discrepancy focus in formerly depressed participants. Results showed that trait rumination was indeed negatively correlated with AMS after, but not before the induction. Moreover, high trait ruminating participants showed a decrease in AMS following the induction. In other words, memory specificity was reactive to the induction, but no such decrease was observed in low trait ruminating individuals. This study is mostly of women. These results may not generalize well to men. Our experimental control was within-subjects, which, although powerful and economical, cannot rule out certain confounding processes including natural changes in self-discrepancy, or non-specific or unintended effects of the induction. In order to detect rAMS in formerly depressed individuals or to observe associations between rAMS and trait measures of rumination, state ruminative processing needs to be activated. Results are discussed by framing rAMS as an example of cognitive reactivity, a general type of processing that is associated with depression. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Developing an international scoring system for a consensus-based social cognition measure: MSCEIT-managing emotions.

    PubMed

    Hellemann, G S; Green, M F; Kern, R S; Sitarenios, G; Nuechterlein, K H

    2017-10-01

    Measures of social cognition are increasingly being applied to psychopathology, including studies of schizophrenia and other psychotic disorders. Tests of social cognition present unique challenges for international adaptations. The Mayer-Salovey-Caruso Emotional Intelligence Test, Managing Emotions Branch (MSCEIT-ME) is a commonly-used social cognition test that involves the evaluation of social scenarios presented in vignettes. This paper presents evaluations of translations of this test in six different languages based on representative samples from the relevant countries. The goal was to identify items from the MSCEIT-ME that show different response patterns across countries using indices of discrepancy and content validity criteria. An international version of the MSCEIT-ME scoring was developed that excludes items that showed undesirable properties across countries. We then confirmed that this new version had better performance (i.e. less discrepancy across regions) in international samples than the version based on the original norms. Additionally, it provides scores that are comparable to ratings based on local norms. This paper shows that it is possible to adapt complex social cognitive tasks so they can provide valid data across different cultural contexts.

  15. Is there agreement between worker self and supervisor assessment of worker safety performance? An examination in the construction industry.

    PubMed

    Xia, Nini; Griffin, Mark A; Wang, Xueqing; Liu, Xing; Wang, Dan

    2018-06-01

    Individual safety performance (behavior) critically influences safety outcomes in high-risk workplaces. Compared to the study of generic work performance on different measurements, few studies have investigated different measurements of safety performance, typically relying on employees' self-reflection of their safety behavior. This research aims to address this limitation by including worker self-reflection and other (i.e., supervisor) assessment of two worker safety performance dimensions, safety compliance and safety participation. A sample of 105 workers and 17 supervisors in 17 groups in the Chinese construction industry participated in this study. Comparisons were made between worker compliance and participation in each measurement, and between workers' and supervisors' assessment of workers' compliance and participation. Multilevel modeling was adopted to test the moderating effects on the worker self-reflection and supervisor-assessment relationship by group safety climate and the work experience of supervisors. Higher levels of safety compliance than participation were found for self-reflection and supervisor assessment. The discrepancy between the two measurements in each safety performance dimension was significant. The work experience of supervisors attenuated the discrepancy between self- and supervisor-assessment of compliance. Contrary to our expectations, the moderating effect of group safety climate was not supported. The discrepancy between worker self- and supervisor-assessment of worker safety performance, thus, suggests the importance of including alternative measurements of safety performance in addition to self-reflection. Lower levels of participation behavior in both raters suggest more research on the motivators of participatory behavior. Practical applications The discrepancy between different raters can lead to negative reactions of ratees, suggesting that managers should be aware of that difference. Assigning experienced supervisors as raters can be effective at mitigating interrater discrepancy and conflicts in the assessment of compliance behavior. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

  16. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Duties of users of consumer reports... address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable...

  17. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of users of consumer reports... address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable...

  18. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Duties of users of consumer reports... address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable...

  19. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Duties of users of consumer reports... address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable...

  20. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duties of users of consumer reports... address(es) in the agency's file for the consumer. (c) Reasonable belief—(1) Requirement to form a reasonable belief. A user must develop and implement reasonable policies and procedures designed to enable...

  1. Self-Perceptions, Discrepancies between Self- and Other-Perceptions, and Children's Self-Reported Emotions

    ERIC Educational Resources Information Center

    Nuijens, Karen L.; Teglasi, Hedwig; Hancock, Gregory R.

    2009-01-01

    Self and others' perceptions of victimization, bullying, and academic competence were examined in relation to self-reported anxiety, depression, anger, and global self-worth in a non-clinical sample of second- and third-grade children. Previous studies document links between negative emotions and self-perceptions that are less favorable than…

  2. 76 FR 12733 - Shenzhen Tangreat Technology Co., Ltd., Grantee of Equipment Authorization FCC ID No. XRLTG-VIPJAMM

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... test units'' from a supplier located in China.\\16\\ Share indicated that it had offered only three units... certain apparent discrepancies between the application, test report, and equipment certification as to the... description of the product: ``computer peripheral for preprocessing data.'' \\25\\ Similarly, the test report...

  3. 12 CFR 571.80-570.81 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false [Reserved] 571.80-570.81 Section 571.80-570.81 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal §§ 571.80-570.81...

  4. Funding analysis of bilateral autologous free-flap breast reconstructions in Australia.

    PubMed

    Sinha, Shiba; Ruskin, Olivia; McCombe, David; Morrison, Wayne; Webb, Angela

    2015-08-01

    Bilateral breast reconstructions are being increasingly performed. Autologous free-flap reconstructions represent the gold standard for post-mastectomy breast reconstruction but are resource intensive. This study aims to investigate the difference between hospital reimbursement and true cost of bilateral autologous free-flap reconstructions. Retrospective analysis of patients who underwent bilateral autologous free-flap reconstructions at a single Australian tertiary referral centre was performed. Hospital reimbursement was determined from coding analysis. A true cost analysis was also performed. Comparisons were made considering the effect of timing, indication and complications of the procedure. Forty-six bilateral autologous free-flap procedures were performed (87 deep inferior epigastric perforators (DIEPs), four superficial inferior epigastric artery perforator flaps (SIEAs) and one muscle-sparing free transverse rectus abdominis myocutaneous flap (MS-TRAM)). The mean funding discrepancy between hospital reimbursement and actual cost was $12,137 ± $8539 (mean ± standard deviation (SD)) (n = 46). Twenty-four per cent (n = 11) of the cases had been coded inaccurately. If these cases were excluded from analysis, the mean funding discrepancy per case was $9168 ± $7453 (n = 35). Minor and major complications significantly increased the true cost and funding discrepancy (p = 0.02). Bilateral free-flap breast reconstructions performed in Australian public hospitals result in a funding discrepancy. Failure to be economically viable threatens the provision of this procedure in the public system. Plastic surgeons and hospital managers need to adopt measures in order to make these gold-standard procedures cost neutral. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Greenhouse gases accounting and reporting for waste management--a South African perspective.

    PubMed

    Friedrich, Elena; Trois, Cristina

    2010-11-01

    This paper investigates how greenhouse gases are accounted and reported in the waste sector in South Africa. Developing countries (including South Africa) do not have binding emission reduction targets, but many of them publish different greenhouse gas emissions data which have been accounted and reported in different ways. Results show that for South Africa, inventories at national and municipal level are the most important tools in the process of accounting and reporting greenhouse gases from waste. For the development of these inventories international initiatives were important catalysts at national and municipal levels, and assisted in developing local expertise, resulting in increased output quality. However, discrepancies in the methodology used to account greenhouse gases from waste between inventories still remain a concern. This is a challenging issue for developing countries, especially African ones, since higher accuracy methods are more data intensive. Analysis of the South African inventories shows that results from the recent inventories can not be compared with older ones due to the use of different accounting methodologies. More recently the use of Clean Development Mechanism (CDM) procedures in Africa, geared towards direct measurements of greenhouse gases from landfill sites, has increased and resulted in an improvement of the quality of greenhouse gas inventories at municipal level. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Intrahousehold discrepancy regarding food insecurity within intermarried couples of Vietnamese wives and Korean husbands in South Korea

    PubMed Central

    Choi, Ha Ney; Chung, Hye Won

    2011-01-01

    Our previous studies have demonstrated the inadequate nutritional status of Vietnamese female marriage immigrants in Korea. Major possible reasons include food insecurity due to economic problems as well as a lack of adjustment to unfamiliar Korean foods and limited access to Vietnamese foods; however, no study has investigated food insecurity among such intermarried couples. This study was performed to investigate the prevalence of food insecurity in Korean-husband-Vietnamese-wife couples and to determine whether they exhibit an intrahousehold discrepancy regarding food insecurity. A cross-sectional analysis of the Cohort of Intermarried Women in Korea study was performed with 84 intermarried couples. Among the 84 Vietnamese immigrants, 48.8% and 41.7% had food insecurity due to economic problems and a lack of foods appealing to their appetite, respectively. There was a marked discrepancy in reporting food insecurity between Vietnamese wives (22.6-38.1%) and their Korean husbands (6.0-15.5%). Vietnamese wives were five and two times more food-insecure due to economic problems and no foods appealing to their appetite, respectively, than their Korean spouses. A follow-up study is needed to investigate the causes of this discrepancy and ways of reducing food insecurity among female marriage immigrants living in low-income, rural communities. PMID:22125686

  7. Intrahousehold discrepancy regarding food insecurity within intermarried couples of Vietnamese wives and Korean husbands in South Korea.

    PubMed

    Choi, Ha Ney; Chung, Hye Won; Hwang, Ji-Yun; Chang, Namsoo

    2011-10-01

    Our previous studies have demonstrated the inadequate nutritional status of Vietnamese female marriage immigrants in Korea. Major possible reasons include food insecurity due to economic problems as well as a lack of adjustment to unfamiliar Korean foods and limited access to Vietnamese foods; however, no study has investigated food insecurity among such intermarried couples. This study was performed to investigate the prevalence of food insecurity in Korean-husband-Vietnamese-wife couples and to determine whether they exhibit an intrahousehold discrepancy regarding food insecurity. A cross-sectional analysis of the Cohort of Intermarried Women in Korea study was performed with 84 intermarried couples. Among the 84 Vietnamese immigrants, 48.8% and 41.7% had food insecurity due to economic problems and a lack of foods appealing to their appetite, respectively. There was a marked discrepancy in reporting food insecurity between Vietnamese wives (22.6-38.1%) and their Korean husbands (6.0-15.5%). Vietnamese wives were five and two times more food-insecure due to economic problems and no foods appealing to their appetite, respectively, than their Korean spouses. A follow-up study is needed to investigate the causes of this discrepancy and ways of reducing food insecurity among female marriage immigrants living in low-income, rural communities.

  8. Bias due to selective inclusion and reporting of outcomes and analyses in systematic reviews of randomised trials of healthcare interventions.

    PubMed

    Page, Matthew J; McKenzie, Joanne E; Kirkham, Jamie; Dwan, Kerry; Kramer, Sharon; Green, Sally; Forbes, Andrew

    2014-10-01

    Systematic reviews may be compromised by selective inclusion and reporting of outcomes and analyses. Selective inclusion occurs when there are multiple effect estimates in a trial report that could be included in a particular meta-analysis (e.g. from multiple measurement scales and time points) and the choice of effect estimate to include in the meta-analysis is based on the results (e.g. statistical significance, magnitude or direction of effect). Selective reporting occurs when the reporting of a subset of outcomes and analyses in the systematic review is based on the results (e.g. a protocol-defined outcome is omitted from the published systematic review). To summarise the characteristics and synthesise the results of empirical studies that have investigated the prevalence of selective inclusion or reporting in systematic reviews of randomised controlled trials (RCTs), investigated the factors (e.g. statistical significance or direction of effect) associated with the prevalence and quantified the bias. We searched the Cochrane Methodology Register (to July 2012), Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO and ISI Web of Science (each up to May 2013), and the US Agency for Healthcare Research and Quality (AHRQ) Effective Healthcare Program's Scientific Resource Center (SRC) Methods Library (to June 2013). We also searched the abstract books of the 2011 and 2012 Cochrane Colloquia and the article alerts for methodological work in research synthesis published from 2009 to 2011 and compiled in Research Synthesis Methods. We included both published and unpublished empirical studies that investigated the prevalence and factors associated with selective inclusion or reporting, or both, in systematic reviews of RCTs of healthcare interventions. We included empirical studies assessing any type of selective inclusion or reporting, such as investigations of how frequently RCT outcome data is selectively included in systematic reviews based on the results, outcomes and analyses are discrepant between protocol and published review or non-significant outcomes are partially reported in the full text or summary within systematic reviews. Two review authors independently selected empirical studies for inclusion, extracted the data and performed a risk of bias assessment. A third review author resolved any disagreements about inclusion or exclusion of empirical studies, data extraction and risk of bias. We contacted authors of included studies for additional unpublished data. Primary outcomes included overall prevalence of selective inclusion or reporting, association between selective inclusion or reporting and the statistical significance of the effect estimate, and association between selective inclusion or reporting and the direction of the effect estimate. We combined prevalence estimates and risk ratios (RRs) using a random-effects meta-analysis model. Seven studies met the inclusion criteria. No studies had investigated selective inclusion of results in systematic reviews, or discrepancies in outcomes and analyses between systematic review registry entries and published systematic reviews. Based on a meta-analysis of four studies (including 485 Cochrane Reviews), 38% (95% confidence interval (CI) 23% to 54%) of systematic reviews added, omitted, upgraded or downgraded at least one outcome between the protocol and published systematic review. The association between statistical significance and discrepant outcome reporting between protocol and published systematic review was uncertain. The meta-analytic estimate suggested an increased risk of adding or upgrading (i.e. changing a secondary outcome to primary) when the outcome was statistically significant, although the 95% CI included no association and a decreased risk as plausible estimates (RR 1.43, 95% CI 0.71 to 2.85; two studies, n = 552 meta-analyses). Also, the meta-analytic estimate suggested an increased risk of downgrading (i.e. changing a primary outcome to secondary) when the outcome was statistically significant, although the 95% CI included no association and a decreased risk as plausible estimates (RR 1.26, 95% CI 0.60 to 2.62; two studies, n = 484 meta-analyses). None of the included studies had investigated whether the association between statistical significance and adding, upgrading or downgrading of outcomes was modified by the type of comparison, direction of effect or type of outcome; or whether there is an association between direction of the effect estimate and discrepant outcome reporting.Several secondary outcomes were reported in the included studies. Two studies found that reasons for discrepant outcome reporting were infrequently reported in published systematic reviews (6% in one study and 22% in the other). One study (including 62 Cochrane Reviews) found that 32% (95% CI 21% to 45%) of systematic reviews did not report all primary outcomes in the abstract. Another study (including 64 Cochrane and 118 non-Cochrane reviews) found that statistically significant primary outcomes were more likely to be completely reported in the systematic review abstract than non-significant primary outcomes (RR 2.66, 95% CI 1.81 to 3.90). None of the studies included systematic reviews published after 2009 when reporting standards for systematic reviews (Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, and Methodological Expectations of Cochrane Intervention Reviews (MECIR)) were disseminated, so the results might not be generalisable to more recent systematic reviews. Discrepant outcome reporting between the protocol and published systematic review is fairly common, although the association between statistical significance and discrepant outcome reporting is uncertain. Complete reporting of outcomes in systematic review abstracts is associated with statistical significance of the results for those outcomes. Systematic review outcomes and analysis plans should be specified prior to seeing the results of included studies to minimise post-hoc decisions that may be based on the observed results. Modifications that occur once the review has commenced, along with their justification, should be clearly reported. Effect estimates and CIs should be reported for all systematic review outcomes regardless of the results. The lack of research on selective inclusion of results in systematic reviews needs to be addressed and studies that avoid the methodological weaknesses of existing research are also needed.

  9. Adolescent Loneliness and Social Skills: Agreement and Discrepancies Between Self-, Meta-, and Peer-Evaluations.

    PubMed

    Lodder, G M A; Goossens, L; Scholte, R H J; Engels, R C M E; Verhagen, M

    2016-12-01

    Lonely adolescents report that they have poor social skills, but it is unknown whether this is due to an accurate perception of a social skills deficit, or a biased negative perception. This is an important distinction, as actual social skills deficits require different treatments than biased negative perceptions. In this study, we compared self-reported social skills evaluations with peer-reported social skills and meta-evaluations of social skills (i.e., adolescents' perceptions of how they believe their classmates evaluate them). Based on the social skills view, we expected negative relations between loneliness and these three forms of social skills evaluations. Based on the bias view, we expected lonely adolescents to have more negative self- and meta-evaluations compared to peer-evaluations of social skills. Participants were 1342 adolescents (48.64 % male, M age  = 13.95, SD = .54). All classmates rated each other in a round-robin design to obtain peer-evaluations. Self- and meta-evaluations were obtained using self-reports. Data were analyzed using polynomial regression analyses and response surface modeling. The results indicated that, when self-, peer- and meta-evaluations were similar, a greater sense of loneliness was related to poorer social skills. Loneliness was also related to larger discrepancies between self- and peer-evaluations of loneliness, but not related to the direction of these discrepancies. Thus, for some lonely adolescents, loneliness may be related to an actual social skills deficit, whereas for others a biased negative perception of one's own social skills or a mismatch with the environment may be related to their loneliness. This implies that different mechanisms may underlie loneliness, which has implications for interventions.

  10. Parent-Child Discrepancy on Children's Body Weight Perception: The Role of Attachment Security.

    PubMed

    Uccula, Arcangelo; Nuvoli, Gianfranco

    2017-01-01

    The discrepancies between parents and their children on the description of the behavior and representations of their children have been shown in various studies. Other researchers have reported the parents' difficulty in correctly identifying the weight status of their children. The purpose of our study was to investigate the parent's attributional accuracy on their children's body weight perception in relation to the children attachment security. It was hypothesized that insecure children's parents have a greater discrepancy with their children compared to secure children with their parents. The research participants were 217 children, aged between 5 and 11 years of both genders, and their parents. The attachment pattern was measured by the SAT of Klagsbrun and Bowlby, with the Italian version of Attili. The children were also shown a set of figure body-drawings with which to measure the perception of their weight status. Parents answered a questionnaire to find out the parental attribution of their children's perception. The results show that the body weight perception of insecure children's parents have a greater discrepancy with their children's body weight perception compared with parentally secure children. In particular, parents of insecure children tend to underestimate the perception of their children. This result is most evident in disorganized children. In addition, the perception of insecure children's parents show a greater correlation with children's actual weight rather than with their children's perception. These results suggest that the discrepancies on the perception of children's body weight between parents and children may be influenced by the poor parental attunement to their children's internal states, which characterizes the insecure parent-child attachment relationship.

  11. Overnight shift work: factors contributing to diagnostic discrepancies.

    PubMed

    Hanna, Tarek N; Loehfelm, Thomas; Khosa, Faisal; Rohatgi, Saurabh; Johnson, Jamlik-Omari

    2016-02-01

    The aims of the study are to identify factors contributing to preliminary interpretive discrepancies on overnight radiology resident shifts and apply this data in the context of known literature to draw parallels to attending overnight shift work schedules. Residents in one university-based training program provided preliminary interpretations of 18,488 overnight (11 pm–8 am) studies at a level 1 trauma center between July 1, 2013 and December 31, 2014. As part of their normal workflow and feedback, attendings scored the reports as major discrepancy, minor discrepancy, agree, and agree--good job. We retrospectively obtained the preliminary interpretation scores for each study. Total relative value units (RVUs) per shift were calculated as an indicator of overnight workload. The dataset was supplemented with information on trainee level, number of consecutive nights on night float, hour, modality, and per-shift RVU. The data were analyzed with proportional logistic regression and Fisher's exact test. There were 233 major discrepancies (1.26 %). Trainee level (senior vs. junior residents; 1.08 vs. 1.38 %; p < 0.05) and modality were significantly associated with performance. Increased workload affected more junior residents' performance, with R3 residents performing significantly worse on busier nights. Hour of the night was not significantly associated with performance, but there was a trend toward best performance at 2 am, with subsequent decreased accuracy throughout the remaining shift hours. Improved performance occurred after the first six night float shifts, presumably as residents acclimated to a night schedule. As overnight shift work schedules increase in popularity for residents and attendings, focused attention to factors impacting interpretative accuracy is warranted.

  12. Affective Evaluations of Exercising: The Role of Automatic-Reflective Evaluation Discrepancy.

    PubMed

    Brand, Ralf; Antoniewicz, Franziska

    2016-12-01

    Sometimes our automatic evaluations do not correspond well with those we can reflect on and articulate. We present a novel approach to the assessment of automatic and reflective affective evaluations of exercising. Based on the assumptions of the associative-propositional processes in evaluation model, we measured participants' automatic evaluations of exercise and then shared this information with them, asked them to reflect on it and rate eventual discrepancy between their reflective evaluation and the assessment of their automatic evaluation. We found that mismatch between self-reported ideal exercise frequency and actual exercise frequency over the previous 14 weeks could be regressed on the discrepancy between a relatively negative automatic and a more positive reflective evaluation. This study illustrates the potential of a dual-process approach to the measurement of evaluative responses and suggests that mistrusting one's negative spontaneous reaction to exercise and asserting a very positive reflective evaluation instead leads to the adoption of inflated exercise goals.

  13. Study of weld offset in longitudinally welded SSME HPFTP inlet

    NASA Technical Reports Server (NTRS)

    Min, J. B.; Spanyer, K. S.; Brunair, R. M.

    1992-01-01

    Welded joints are an essential part of rocket engine structures such as the Space Shuttle Main Engine (SSME) turbopumps. Defects produced in the welding process can be detrimental to weld performance. Recently, review of the SSME high pressure fuel turbopump (HPFTP) titanium inlet X-rays revealed several weld discrepancies such as penetrameter density issues, film processing discrepancies, weld width discrepancies, porosity, lack of fusion, and weld offsets. Currently, the sensitivity of welded structures to defects is of concern. From a fatigue standpoint, weld offset may have a serious effect since local yielding, in general, aggravates cyclic stress effects. Therefore, the weld offset issue is considered in this report. Using the FEM and beamlike plate approximations, parametric studies were conducted to determine the influence of weld offsets and a variation of weld widths in longitudinally welded cylindrical structures with equal wall thicknesses on both sides of the joint. Following the study, some conclusions are derived for the weld offsets.

  14. Combined Orthodontic and Surgical Treatment in a 8-Years-Old Patient Affected By Severe Obstructive Sleep Apnea: A Case-Report.

    PubMed

    Gracco, Antonio; Bruno, Giovanni; de Stefani, Alberto; Ragona, Rosario Marchese; Mazzoleni, Sergio; Stellini, Edoardo

    An eight-years-old girl showed a restless sleep with snoring and severe apnea episodes, a mandibular retrognathia, mouth breathing, maxillary transverse discrepancy, mandibular transverse discrepancy, moderate crowding and anterior open-bite. The CBCT showed an anterior collapse of the epiglottis. The treatment consisted in a rapid palatal expansion, an epiglottoplasty and a reduction of the tongue base. Polysomnography revealed that apnea-hypopnea index improved from 21,8 episodes/hr at the baseline to 0,6 episodes/hr, average oxygen saturation from 96,5% to 98,1%, oxygen desaturation events from 23,4 episodes/hr to 1/hr.

  15. Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons.

    PubMed

    Kraemer, Mark R; Sandoval-Garcia, Carolina; Bragg, Taryn; Iskandar, Bermans J

    2017-09-01

    OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS). RESULTS Respondents agreed that shunt malfunction occurs most often as the result of ventricular catheter obstruction. Despite contrary evidence in the literature, most respondents (66%) also believed that choroid plexus is the tissue most often found in obstructed proximal catheters. However, free-text responses revealed that the respondents' understanding of the underlying pathophysiology of shunt obstruction was highly variable and included growth, migration, or adherence of choroid plexus, CSF debris, catheter position, inflammatory processes, and CSF overdrainage. Most respondents considered chronic CSF overdrainage to be a rare complication of shunting in their practice and reported wide variation in treatment protocols. Moreover, despite a lack of evidence in the literature, most respondents attributed chronic headaches in shunt patients to medical reasons (for example, migraines, tension). Accordingly, most respondents managed headaches with reassurance and/or referral to pain clinics. Lastly, there were variable opinions on the etiology of slit ventricle syndrome (SVS), which included early shunting, chronic overdrainage, and/or loss of brain compliance. Beyond shunt revision, respondents reported divergent SVS treatment preferences. CONCLUSIONS The survey shows that there is wide variability in the understanding and management of shunt-dependent hydrocephalus and its complications. Such discrepancies appear to be derived partly from inconsistent familiarity with existing literature but especially from a paucity of high-quality publications.

  16. Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis.

    PubMed

    Ramakrishna, Jayant; Strychowsky, Julie; Gupta, Michael; Sommer, Doron D

    2015-06-01

    To determine the effectiveness and safety of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). The study was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search strategy in MEDLINE, EMBASE, the Cochrane library, and Google Scholar was completed and limited to studies published in English. Relevant reference lists were reviewed. Two independent reviewers selected prospective or retrospective studies of pediatric patients treated with interventional sialendoscopy for the management of JRP. Outcome measures included rates of successful treatment (no further episodes of parotid swelling or need for further sialendoscopy) and complications, Two reviewers appraised the level of evidence using the Oxford Clinical Evidence-based Medicine (OCEBM) guidelines, extracted data, and resolved discrepancies by consensus. Weighted pooled proportion, 95% confidence interval (CI), and test results for heterogeneity and publication bias are reported. Seven studies were included. Levels of evidence varied from OCEBM level 3 to 4. The weighted pooled proportion of success rates for no further episodes by patient (n = 120) was 73% (95% CI: 64%-82%) and by gland (n = 165) 81% (95% CI: 75%-87%). The weighted pooled proportion of success rates for no further sialendoscopy by patient was 87% (95% CI: 81%-93%). Heterogeneity was low, and publication bias was not detected. There were no major complications reported. Surgical techniques and endoscopic findings are summarized. The results from this analysis suggest that sialendoscopy is effective and safe for the treatment of JRP and may be offered to appropriate patients. NA © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Do you see what I see? Effects of national culture on employees' safety-related perceptions and behavior.

    PubMed

    Casey, Tristan W; Riseborough, Karli M; Krauss, Autumn D

    2015-05-01

    Growing international trade and globalization are increasing the cultural diversity of the modern workforce, which often results in migrants working under the management of foreign leadership. This change in work arrangements has important implications for occupational health and safety, as migrant workers have been found to be at an increased risk of injuries compared to their domestic counterparts. While some explanations for this discrepancy have been proposed (e.g., job differences, safety knowledge, and communication difficulties), differences in injury involvement have been found to persist even when these contextual factors are controlled for. We argue that employees' national culture may explain further variance in their safety-related perceptions and safety compliance, and investigate this through comparing the survey responses of 562 Anglo and Southern Asian workers at a multinational oil and gas company. Using structural equation modeling, we firstly established partial measurement invariance of our measures across cultural groups. Estimation of the combined sample structural model revealed that supervisor production pressure was negatively related to willingness to report errors and supervisor support, but did not predict safety compliance behavior. Supervisor safety support was positively related to both willingness to report errors and safety compliance. Next, we uncovered evidence of cultural differences in the relationships between supervisor production pressure, supervisor safety support, and willingness to report errors; of note, among Southern Asian employees the negative relationship between supervisor production pressure and willingness to report errors was stronger, and for supervisor safety support, weaker as compared to the model estimated with Anglo employees. Implications of these findings for safety management in multicultural teams within the oil and gas industry are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Analytic computation of average energy of neutrons inducing fission

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Clark, Alexander Rich

    2016-08-12

    The objective of this report is to describe how I analytically computed the average energy of neutrons that induce fission in the bare BeRP ball. The motivation of this report is to resolve a discrepancy between the average energy computed via the FMULT and F4/FM cards in MCNP6 by comparison to the analytic results.

  19. Exploring Differences in Youth and Parent Reports of Antisociality among Adolescent Sexual and Nonsexual Offenders

    ERIC Educational Resources Information Center

    Skilling, Tracey A.; Doiron, James M.; Seto, Michael C.

    2011-01-01

    This study examined the extent of, and explored several possible explanations for, the discrepancies found between adolescent and parent reports of conduct problems in adolescent sexual and nonsexual offenders. We found that adolescent sexual offenders scored lower on measures of conduct problems than did nonsexual offenders, whether on the basis…

  20. Investigating uncertainty and emotions in conversations about family health history: a test of the theory of motivated information management.

    PubMed

    Rauscher, Emily A; Hesse, Colin

    2014-01-01

    Although the importance of being knowledgeable of one's family health history is widely known, very little research has investigated how families communicate about this important topic. This study investigated how young adults seek information from parents about family health history. The authors used the Theory of Motivated Information Management as a framework to understand the process of uncertainty discrepancy and emotion in seeking information about family health history. Results of this study show the Theory of Motivated Information Management to be a good model to explain the process young adults go through in deciding to seek information from parents about family health history. Results also show that emotions other than anxiety can be used with success in the Theory of Motivated Information Management framework.

  1. Challenges in Sex- and Gender-Centered Prevention and Management of Cardiovascular Disease: Implications of Genetic, Metabolic, and Environmental Paths.

    PubMed

    Kouvari, Matina; Yannakoulia, Mary; Souliotis, Kyriakos; Panagiotakos, Demosthenes B

    2018-01-01

    The recognition of cardiovascular disease (CVD) as a "male" privilege has been a commonly held concept. However, emerging data describe another reality. Heterogeneities have been convincingly demonstrated regarding CVD manifestations, risk factor burden, and prognosis between males and females. The aim of the present narrative review was to highlight sex- and gender-related discrepancies in primary and secondary CVD prevention, underscoring plausible underlying mechanisms. Manifestation of CVD in women is characterized by atypical symptoms/signs and inadequately studied pathophysiology features challenging accurate diagnosis and effective treatment. Regarding CVD risk assessment, the burden and effect size of conventional, novel, and female-specific risk factors needs better clarification. Hitherto outcomes are nonconsistent, while most importantly, the interpretation of the attendant metabolic paths remains a challenge; the interactions among genetic, metabolic, and environmental factors are of high complexity regulated by genomic and nongenomic sex hormones effects. To deal with these key points, the National Institutes of Health currently calls upon investigators to provide a sex- and gender-specific reporting in all health research hypotheses. The implementation of high-quality studies addressing these issues is an imperative need to maximize cost-effectiveness in prevention and management strategies.

  2. Covered Stent-Graft Treatment of Traumatic Internal Carotid Artery Pseudoaneurysms: A Review

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maras, Dimitrios; Lioupis, Christos; Magoufis, George

    Objective. To review the literature concerning the management with placement of covered stent-grafts of traumatic pseudoaneurysms of the extracranial internal carotid artery (ICA) resulting from penetrating craniocervical injuries or skull base fractures. Method. We have reviewed, from the Medline database, all the published cases in the English literature since 1990 and we have added a new case. Results. We identified 20 patients with traumatic extracranial ICA pseudoaneurysms due to penetrating craniocervical injuries or skull base fractures who had been treated with covered stent-graft implantation. Many discrepancies have been ascertained regarding the anticoagulation therapy. In 3 patients the ICA was totallymore » occluded in the follow-up period, giving an overall occlusion rate 15%. No serious complication was reported as a result of the endovascular procedure. Conclusion. Preliminary results suggest that placement of stent-grafts is a safe and effective method of treating ICA traumatic pseudoaneurysms resulting from penetrating craniocervical injuries or skull base fractures. The immediate results are satisfactory when the procedure takes place with appropriate anticoagulation therapy. The periprocedural morbidity and mortality and the early patency are also acceptable. A surveillance program with appropriate interventions to manage restenosis may improve the long-term patency.« less

  3. Computerized follow-up of discrepancies in image interpretation between emergency and radiology departments.

    PubMed

    Siegel, E; Groleau, G; Reiner, B; Stair, T

    1998-08-01

    Radiographs are ordered and interpreted for immediate clinical decisions 24 hours a day by emergency physicians (EP's). The Joint Commission for Accreditation of Health Care Organizations requires that all these images be reviewed by radiologists and that there be some mechanism for quality improvement (QI) for discrepant readings. There must be a log of discrepancies and documentation of follow up activities, but this alone does not guarantee effective Q.I. Radiologists reviewing images from the previous day and night often must guess at the preliminary interpretation of the EP and whether follow up action is necessary. EP's may remain ignorant of the final reading and falsely assume the initial diagnosis and treatment were correct. Some hospitals use a paper system in which the EP writes a preliminary interpretation on the requisition slip, which will be available when the radiologist dictates the final reading. Some hospitals use a classification of discrepancies based on clinical import and urgency, and communicated to the EP on duty at the time of the official reading, but may not communicate discrepancies to the EP's who initial read the images. Our computerized radiology department and picture archiving and communications system have increased technologist and radiologist productivity, and decreased retakes and lost films. There are fewer face-to-face consultants of radiologists and clinicians, but more communication by telephone and electronic annotation of PACS images. We have integrated the QI process for emergency department (ED) images into the PACS, and gained advantages over the traditional discrepancy log. Requisitions including clinical indications are entered into the Hospital Information System and then appear on the PACS along with images on readings. The initial impression, time of review, and the initials of the EP are available to the radiologist dictating the official report. The radiologist decides if there is a discrepancy, and whether it is category I (potentially serious, needs immediate follow-up), category II (moderate risk, follow-up in one day), or category III (low risk, follow-up in several days). During the working day, the radiologist calls immediately for category I discrepancies. Those noted from the evening, night, or weekend before are called to the EP the next morning. All discrepancies with the preliminary interpretation are communicated to the EP and are kept in a computerized log for review by a radiologist at a weekly ED teaching conference. This system has reduced the need for the radiologist to ask or guess what the impression was in the ED the night before. It has reduced the variability in recording of impressions by EP's, in communication back from radiologists, in the clinical] follow-up made, and in the documentation of the whole QI process. This system ensures that EP's receive notification of their discrepant readings, and provides continuing education to all the EP's on interpreting images on their patients.

  4. Does access to clinical study reports from the European Medicines Agency reduce reporting biases? A systematic review and meta-analysis of randomized controlled trials on the effect of erythropoiesis-stimulating agents in cancer patients

    PubMed Central

    Grabik, Michael; Tonia, Thomy; Jüni, Peter; Pétavy, Frank; Pignatti, Francesco

    2017-01-01

    Since 2010, the European Medicines Agency (EMA) has provided access to clinical study reports (CSRs). We requested CSRs for randomized controlled trials (RCTs) of erythropoiesis-stimulating agents (ESAs) in cancer patients from EMA and identified RCT publications with literature searches. We assessed CSR availability and completeness, the impact of unreported and unpublished data obtained from CSRs on the effects of ESAs on quality of life (QoL) of cancer patients, and discrepancies between data reported in the public domain and in CSRs. We used random-effects meta-analyses to evaluate the effect of ESAs on QoL measured with Functional Assessment of Cancer Therapy-Anemia (FACT-An), FACT-Fatigue (FACT-F) and FACT-Anemia Total (FACT-An Total) stratified by data source and the impact of discrepancies on QoL, mortality, adverse events, and clinical effectiveness outcomes. We identified 94 eligible RCTs; CSRs or other study documentation were available for 17 (18%) RCTs at EMA. Median report length was 1,825 pages (range 72–14,569). Of 180 outcomes of interest reported in the EMA documentation, 127 (71%) were publicly available. For 80 of those (63%) we noted discrepancies, but these had little impact on the pooled effect estimates. Of 27 QoL outcomes reported in the CSRs, 17 (63%) were unpublished. Including six unpublished comparisons (pooled mean difference [MD] 0.20; 95% confidence interval [CI] -1.93, 2.33) reduced the pooled effect of ESAs for FACT-An from MD 5.51 (95% CI 4.20, 6.82) in published data to MD 3.21 (95% CI 1.38, 5.03), which is below a clinically important difference (defined as MD ≥4). Effects were similar for FACT-F and FACT-An Total. Access to CSRs from EMA reduced reporting biases for QoL outcomes. However, EMA received documentation for a fraction of all RCTs on effects of ESAs in cancer patients. Additional efforts by other agencies and institutions are needed to make CSRs universally available for all RCTs. PMID:29228059

  5. Differences in flood hazard projections in Europe – their causes and consequences for decision making

    USGS Publications Warehouse

    Kundzewicz, Z. W.; Krysanova, V.; Dankers, R.; Hirabayashi, Y.; Kanae, S.; Hattermann, F. F.; Huang, S.; Milly, Paul C.D.; Stoffel, M.; Driessen, P.P.J.; Matczak, P.; Quevauviller, P.; Schellnhuber, H.-J.

    2017-01-01

    This paper interprets differences in flood hazard projections over Europe and identifies likely sources of discrepancy. Further, it discusses potential implications of these differences for flood risk reduction and adaptation to climate change. The discrepancy in flood hazard projections raises caution, especially among decision makers in charge of water resources management, flood risk reduction, and climate change adaptation at regional to local scales. Because it is naïve to expect availability of trustworthy quantitative projections of future flood hazard, in order to reduce flood risk one should focus attention on mapping of current and future risks and vulnerability hotspots and improve the situation there. Although an intercomparison of flood hazard projections is done in this paper and differences are identified and interpreted, it does not seems possible to recommend which large-scale studies may be considered most credible in particular areas of Europe.

  6. 19 CFR 19.6 - Deposits, withdrawals, blanket permits to withdraw and sealing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...), the value of the goods, import and export lading information, the duty rate and amount, and any..., reflecting the balance of merchandise covered by the warehouse entry. Any joint discrepancy report of the...

  7. Parental Perceptions of Children's Sibling Relationships.

    ERIC Educational Resources Information Center

    Kramer, Laurie; Baron, Lisa A.

    1995-01-01

    Parental appraisals of their children's sibling relationships, and their standards for sibling relationships, were assessed. Although parents reported most concern about their children's Agonism and Rivalry/Competition, the largest discrepancies between parental standards and observations involved behaviors reflecting Warmth. Results endorse…

  8. SOA Measurements vs. Models: a Status Report

    NASA Astrophysics Data System (ADS)

    Jimenez, J. L.; de Gouw, J. A.

    2009-12-01

    The advent of fast and more detailed organic aerosol (OA) and VOC measurements in the last decade has allowed clearer model-measurement comparisons for OA and secondary OA (SOA). Here we summarize the patterns emerging from studies to date.

  9. At least 8 studies have reported a large (x5-10) underestimation of SOA for polluted regions when using traditional models (those developed until ~2006) (Heald GRL05, Volkamer GRL06, Johnson ACP06, Kleinman ACP08, Matsui JGR09, Dzepina ACP09, Hodzic ACP09, Tsimpidi ACP09). This is especially obvious when models are evaluated with the ΔOA/ΔCO ratio.
  10. Close to pollution sources, discrepancies of an order-of-magnitude in SOA lead to smaller discrepancies (often x2-3) for total OA due to the presence of primary OA (de Gouw EST09). Such OA discrepancies have been repeatedly observed (e.g. Vutukuru JGR06, McKeen JGR07&09, Heald JGR07, Fast ACP09, Hodzic ACP09).
  11. The discrepancy is reduced when recently-updated yields for aromatics (Ng ACP07) and SOA from glyoxal (Volkamer GRL07) are used, and is eliminated when using SOA formation from S/IVOC (Robinson Sci07) although with an overprediction of SOA at long aging times (Dzepina ACP09; Hodzic ACP09b). It is not clear whether the urban discrepancy is removed for the right reasons.
  12. 4 evaluations of biogenic SOA formed in unpolluted regions find reasonable agreement between SOA from traditional models and field measurements (Tunved Sci06; Hodzic ACP09; Chen GRL09; Slowik ACPD09). One evaluation reports a significant underprediction (Capes ACP09), although the amount of precursor reacted was difficult to ascertain for that case. The difference with the systematic underprediction observed for anthropogenic SOA may be due to the lack of primary S/IVOC in biogenic emissions, or to other reasons (NOx, SO2, POA, etc.).
  13. Comparisons for biogenic SOA formed in polluted regions are more complex. Several studies have reported a lack of clear influence of biogenic VOCs in SOA formation in polluted regions (de Gouw JGR05, GRL09; Weber JGR07; Bahreini JGR09), but 14C studies suggest a large fraction of modern C (Weber JGR07). Synergistic effects of pollution and BVOCs appear likely (e.g. Goldstein PNAS09).
  14. SOA from biomass burning emissions appears variable in the field (Capes JGR09; Yokelson ACP09), likely due flaming vs. smoldering fraction and biomass identity, and perhaps also to prompt SOA formation triggered by HONO photolysis. Several studies report significant SOA formation, given enough photochemical processing. Models based on traditional precursors appear to underpredict SOA from BB sources (Grieshop ACP09; Hodzic ACP09).
  15. The very large SOA source in the free troposphere postulated by Heald (GRL05) has not been reported in later studies. Dunlea (ACP09) did not find evidence of this source across the Pacific near North America, though precipitation removal precludes any strong conclusions. However Carlton (EST09) reported better comparisons after implementing in-cloud SOA formation. Future model evaluations should compare POA, SOA precursors, OVOCs, oxidants, and boundary conditions. Multiple OA measurements (WSOC, OC, AMS, molecular tracers, 14C, etc.) are necessary to overcome the limitations of any one method. Measurements of semivolatile species are critically needed to constrain models.

  16. Speed and Deceleration Trials of U.S.S. Los Angeles

    NASA Technical Reports Server (NTRS)

    De France, S J; Burgess, C P

    1930-01-01

    The trials reported in this report were instigated by the Bureau of Aeronautics of the Navy Department for the purpose of determining accurately the speed and resistance of the U. S. S. "Los Angeles" with and without water recovery apparatus, and to clear up the apparent discrepancies between the speed attained in service and in the original trials in Germany. The trials proved very conclusively that the water recovery apparatus increases the resistance about 20 per cent, which is serious, and shows the importance of developing a type of recovery having less resistance. Between the American and the German speed trials without water recovery there remains an unexplained discrepancy of nearly 6 per cent in speed at a given rate of engine revolutions. Warping of the propeller blades and small cumulative errors of observation seem the most probable causes of the discrepancy. It was found that the customary resistance coefficients C, are 0.0242 and 0.0293 without and with the water recovery apparatus, respectively. The corresponding values of the propulsive coefficient K, are 56.7 and 44.6. If there is an error in these figures, it is probably in a slight overestimate of C, and an underestimate of K. The maximum errors are almost certainly less than 5 per cent. No scale effect was detected indicating variation of C with respect to velocity (author)

  17. Integrating content and structure aspects of the self: traits, values, and self-improvement.

    PubMed

    Roccas, Sonia; Sagiv, Lilach; Oppenheim, Shani; Elster, Andrey; Gal, Avigail

    2014-04-01

    Research on the structure of the self has mostly developed separately from research on its content. Taking an integrative approach, we studied two structural aspects of the self associated with self-improvement--self-discrepancies and perceived mutability--by focusing on two content areas, traits and values. In Studies 1A-C, 337 students (61% female) reported self-discrepancies in values and traits, with the finding that self-discrepancies in values are smaller than in traits. In Study 2 (80 students, 41% female), we experimentally induced either high or low mutability and measured perceived mutability of traits and values. We found that values are perceived as less mutable than traits. In Study 3, 99 high school students (60% female) reported their values, traits, and the extent to which they wish to change them. We found that values predict the wish to change traits, whereas traits do not predict the wish to change values. In Study 4, 172 students (47.7% female) were assigned to one of four experimental conditions in which they received feedback denoting either uniqueness or similarity to others, on either their values or their traits. The results indicated that feedback that one's values (but not traits) are unique affected self-esteem. Integrating between theories of content and structure of the self can contribute to the development of both. © 2013 Wiley Periodicals, Inc.

  18. Self-Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups.

    PubMed

    Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Strauman, Timothy J; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Klein, Marjorie H; Smith, Tracey L; Peterson, Carol B

    2016-11-01

    This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self-discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self-discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. The role of Thailand in the international trade in CITES-listed live reptiles and amphibians.

    PubMed

    Nijman, Vincent; Shepherd, Chris R

    2011-03-25

    International wildlife trade is one of the leading threats to biodiversity conservation. The Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) is the most important initiative to monitor and regulate the international trade of wildlife but its credibility is dependent on the quality of the trade data. We report on the performance of CITES reporting by focussing on the commercial trade in non-native reptiles and amphibians into Thailand as to illustrate trends, species composition and numbers of wild-caught vs. captive-bred specimens. Based on data in the WCMC-CITES trade database, we establish that a total of 75,594 individuals of 169 species of reptiles and amphibians (including 27 globally threatened species) were imported into Thailand in 1990-2007. The majority of individuals (59,895, 79%) were listed as captive-bred and a smaller number (15,699, 21%) as wild-caught. In the 1990s small numbers of individuals of a few species were imported into Thailand, but in 2003 both volumes and species diversity increased rapidly. The proportion of captive-bred animals differed greatly between years (from 0 to >80%). Wild-caught individuals were mainly sourced from African countries, and captive-bred individuals from Asian countries (including from non-CITES Parties). There were significant discrepancies between exports and imports. Thailand reports the import of >10,000 individuals (51 species) originating from Kazakhstan, but Kazakhstan reports no exports of these species. Similar discrepancies, involving smaller numbers (>100 individuals of 9 species), can be seen in the import of reptiles into Thailand via Macao. While there has been an increase in imports of amphibian and reptiles into Thailand, erratic patterns in proportions of captive-bred specimens and volumes suggests either capricious markets or errors in reporting. Large discrepancies with respect to origin point to misreporting or possible violations of the rules and intentions of CITES.

  20. The Role of Thailand in the International Trade in CITES-Listed Live Reptiles and Amphibians

    PubMed Central

    Nijman, Vincent; Shepherd, Chris R.

    2011-01-01

    Background International wildlife trade is one of the leading threats to biodiversity conservation. The Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) is the most important initiative to monitor and regulate the international trade of wildlife but its credibility is dependent on the quality of the trade data. We report on the performance of CITES reporting by focussing on the commercial trade in non-native reptiles and amphibians into Thailand as to illustrate trends, species composition and numbers of wild-caught vs. captive-bred specimens. Methodology/Principal Findings Based on data in the WCMC-CITES trade database, we establish that a total of 75,594 individuals of 169 species of reptiles and amphibians (including 27 globally threatened species) were imported into Thailand in 1990–2007. The majority of individuals (59,895, 79%) were listed as captive-bred and a smaller number (15,699, 21%) as wild-caught. In the 1990s small numbers of individuals of a few species were imported into Thailand, but in 2003 both volumes and species diversity increased rapidly. The proportion of captive-bred animals differed greatly between years (from 0 to >80%). Wild-caught individuals were mainly sourced from African countries, and captive-bred individuals from Asian countries (including from non-CITES Parties). There were significant discrepancies between exports and imports. Thailand reports the import of >10,000 individuals (51 species) originating from Kazakhstan, but Kazakhstan reports no exports of these species. Similar discrepancies, involving smaller numbers (>100 individuals of 9 species), can be seen in the import of reptiles into Thailand via Macao. Conclusion/Significance While there has been an increase in imports of amphibian and reptiles into Thailand, erratic patterns in proportions of captive-bred specimens and volumes suggests either capricious markets or errors in reporting. Large discrepancies with respect to origin point to misreporting or possible violations of the rules and intentions of CITES. PMID:21464976

  21. The influence of self-deception and impression management upon self-assessment in oral surgery.

    PubMed

    Evans, A W; Leeson, R M A; Newton John, T R O; Petrie, A

    2005-06-25

    To see if poor self-assessment of surgical performance during removal of mandibular third molars is influenced by self-deception (lack of insight) and impression management (trying to convey a favourable impression). A prospective study of 50 surgeons, surgically removing a lower third molar tooth. One UK dental school over a two year period. The surgeons' surgical skills were assessed (by two assessors) and self-assessed using check-list and global rating scales. Post-operatively, surgeons completed validated deception questionnaires which measured both self-deception enhancement (lack of insight), and impression management (the tendency to deliberately convey a favourable impression). Reliability between assessors, and between assessors' and surgeons' self-assessments were calculated. Discrepancies between assessors' and surgeons' scores were correlated with surgeons' deception scores. Reliability between assessors was excellent for checklist (0.96) and global rating scales (0.89) and better than the reliability between assessors and surgeons (0.51 and 0.49). There was a statistically significant correlation (r=0.45 p=0.001 checklist, r= 0.48 p<0.001 global) between over/ under-rating of their surgical performance by surgeons and their impression management scores. No statistically significant correlation was found between this inaccuracy in self-assessment and surgeons' individual self-deception scores. The majority of surgeons scored themselves higher than their assessors did for surgical skill in removing a single mandibular third molar tooth. Impression management (the tendency to deliberately convey a favourable impression) may contribute to a surgeon's inaccurate self-reporting of performance. Lack of insight appears to be much less important as a contributing factor. The authors speculate that pressure to provide evidence of good performance may be encouraging surgeons to manage their image and over-score themselves.

  22. A protocol for the Hamilton Rating Scale for Depression: Item scoring rules, Rater training, and outcome accuracy with data on its application in a clinical trial.

    PubMed

    Rohan, Kelly J; Rough, Jennifer N; Evans, Maggie; Ho, Sheau-Yan; Meyerhoff, Jonah; Roberts, Lorinda M; Vacek, Pamela M

    2016-08-01

    We present a fully articulated protocol for the Hamilton Rating Scale for Depression (HAM-D), including item scoring rules, rater training procedures, and a data management algorithm to increase accuracy of scores prior to outcome analyses. The latter involves identifying potentially inaccurate scores as interviews with discrepancies between two independent raters on the basis of either scores >=5-point difference) or meeting threshold for depression recurrence status, a long-term treatment outcome with public health significance. Discrepancies are resolved by assigning two new raters, identifying items with disagreement per an algorithm, and reaching consensus on the most accurate scores for those items. These methods were applied in a clinical trial where the primary outcome was the Structured Interview Guide for the Hamilton Rating Scale for Depression-Seasonal Affective Disorder version (SIGH-SAD), which includes the 21-item HAM-D and 8 items assessing atypical symptoms. 177 seasonally depressed adult patients were enrolled and interviewed at 10 time points across treatment and the 2-year followup interval for a total of 1589 completed interviews with 1535 (96.6%) archived. Inter-rater reliability ranged from ICCs of .923-.967. Only 86 (5.6%) interviews met criteria for a between-rater discrepancy. HAM-D items "Depressed Mood", "Work and Activities", "Middle Insomnia", and "Hypochondriasis" and Atypical items "Fatigability" and "Hypersomnia" contributed most to discrepancies. Generalizability beyond well-trained, experienced raters in a clinical trial is unknown. Researchers might want to consider adopting this protocol in part or full. Clinicians might want to tailor it to their needs. Copyright © 2016 Elsevier B.V. All rights reserved.

  23. Factors affecting the relationship between quantitative polymerase chain reaction (qPCR) and culture-based enumeration of Enterococcus in environmental waters.

    PubMed

    Raith, M R; Ebentier, D L; Cao, Y; Griffith, J F; Weisberg, S B

    2014-03-01

    To determine the extent to which discrepancies between qPCR and culture-based results in beach water quality monitoring can be attributed to: (i) within-method variability, (ii) between-method difference within each method class (qPCR or culture) and (iii) between-class difference. We analysed 306 samples using two culture-based (EPA1600 and Enterolert) and two qPCR (Taqman and Scorpion) methods, each in duplicate. Both qPCR methods correlated with EPA1600, but regression analyses indicated approximately 0·8 log10 unit overestimation by qPCR compared to culture methods. Differences between methods within a class were less than half of this and were minimal for between-replicate within a method. Using the 104 Enterococcus per 100 ml management decision threshold, Taqman qPCR indicated the same decisions as EPA1600 for 87% of the samples, but indicated beach posting for unhealthful water when EPA1600 did not for 12% of the samples. After accounting for within-method and within-class variability, 8% of the samples exhibited true between-class discrepancy where both qPCR methods indicated beach posting while both culture methods did not. Measurement target difference (DNA vs growth) accounted for the majority of the qPCR-vs-culture discrepancy, but its influence on monitoring application is outweighed by frequent incorrect posting with culture methods due to incubation time delay. This is the first study to quantify the frequency with which culture-vs-qPCR discrepancies can be attributed to target difference - vs - method variability. © 2013 The Society for Applied Microbiology.

  24. The Economics of Private Practice versus Academia in Surgery.

    PubMed

    Baimas-George, Maria; Fleischer, Brian; Korndorffer, James R; Slakey, Douglas; DuCoin, Christopher

    2018-04-16

    Residents often make career decisions regarding future practice without adequate knowledge to the realities of professional life. Currently there is a paucity of data regarding economic differences between practice models. This study seeks to illuminate the financial differences of surgical subspecialties between academic and private practice. Data were collected from the Association of American Medical College (AAMC) and the Medical Group Management Association's (MGMA) 2015 reports of average annual salaries. Salaries were analyzed for general surgery and 7 subspecialties. Fixed time of practice was set at 30 years. Assumptions included 5 years as assistant professor, 10 years as associate professor, and 15 years as full professor. Formula used: (average yearly salary) × [years of practice (30 yrs - fellowship/research yrs)] + ($50,000 × yrs of fellowship/research) = total adjusted lifetime revenue. As a full professor, academic surgeons in all subspecialties make significantly less than their private practice counterparts. The largest discrepancy is in vascular and cardiothoracic surgery, with full professors earning 16% and 14% less than private practitioners. Plastic surgery and general surgery are the only 2 disciplines that have similar lifetime revenues to private practitioners, earning 2% and 6% less than their counterparts' lifetime revenue. Academic surgeons in all surgical subspecialties examined earn less lifetime revenue compared to those in private practice. This difference in earnings decreases but remains substantial as an academic surgeon advances. With limited exposure to the diversity of professional arenas, residents must be aware of this discrepancy. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  25. Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses incorrect?

    PubMed

    Liu, Danyang; Gan, Rongchang; Zhang, Weidi; Wang, Wei; Saiyin, Hexige; Zeng, Wenjiao; Liu, Guoyuan

    2018-01-01

    Emergency medicine is a 'high risk' specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses. Clinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ 2 test. Of the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (p<0.001). Aortic dissection and myocardial infarction were the most common cause of death (15 cases for each disease) and the most common missed class I diagnoses (80% and 66.7% for each), higher than the average 49.6% of all class I errors of the study patients. High major disparities between clinical diagnoses and postmortem examinations exist in emergency medical disputes cases; acute aortic dissection and myocardial infarction are the most frequently major missed diagnoses that ED clinicians should pay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  26. Changing practice: red blood cell typing by molecular methods for patients with sickle cell disease.

    PubMed

    Casas, Jessica; Friedman, David F; Jackson, Tannoa; Vege, Sunitha; Westhoff, Connie M; Chou, Stella T

    2015-06-01

    Extended red blood cell (RBC) antigen matching is recommended to limit alloimmunization in patients with sickle cell disease (SCD). DNA-based testing to predict blood group phenotypes has enhanced availability of antigen-negative donor units and improved typing of transfused patients, but replacement of routine serologic typing for non-ABO antigens with molecular typing for patients has not been reported. This study compared the historical RBC antigen phenotypes obtained by hemagglutination methods with genotype predictions in 494 patients with SCD. For discrepant results, repeat serologic testing was performed and/or investigated by gene sequencing for silent or variant alleles. Seventy-one typing discrepancies were identified among 6360 antigen comparisons (1.1%). New specimens for repeat serologic testing were obtained for 66 discrepancies and retyping agreed with the genotype in 64 cases. One repeat Jk(b-) serologic phenotype, predicted Jk(b+) by genotype, was found by direct sequencing of JK to be a silenced allele, and one N typing discrepancy remains under investigation. Fifteen false-negative serologic results were associated with alleles encoding weak antigens or single-dose Fy(b) expression. DNA-based RBC typing provided improved accuracy and expanded information on RBC antigens compared to hemagglutination methods, leading to its implementation as the primary method for extended RBC typing for patients with SCD at our institution. © 2015 AABB.

  27. Physical activity, eating behaviour and body image perception among young adolescents in Kuantan, Pahang, Malaysia.

    PubMed

    Farah Wahida, Z; Mohd Nasir, M T; Hazizi, A S

    2011-12-01

    A cross-sectional study was conducted to determine physical activity, eating behaviour, body weight management knowledge, perception of body image and their association with body weight status of adolescents. Respondents were 360 adolescents, aged between 13 to 14 years, from six randomly selected secondary schools in Kuantan, Pahang. Physical activity, eating behaviour, body weight management knowledge and perception of body image were measured by the Physical Activity Questionnaire for Older Children (PAQ-C), Eating Attitude Test-26 (EAT-26), Weight Management Knowledge Inventory (WMKI) and Contour Drawing Rating Scale (CDRS), respectively. Almost half of the respondents were categorised as having a normal BMI, while 30.3% were severely thin and thin and 20.3% were overweight and obese. Mean physical activity score was 2.06 +/- 0.45 with more males (35.0%) being physically active than females (17.3%). Mean eating behaviour score was 15.41 +/- 10.37, with 27.8% of the respondents being at-risk for eating disorders. Mean weight management knowledge score was 5.35 +/- 1.80, with more females (77.7%) having higher mean scores than males (42.3%). Further, mean discrepancy score for body image perception was 1.24 +/- 0.99, with 78.1% of the respondents being dissatisfied with their current body size. Positive associations were found between eating behaviour (r = 0.28, p < 0.05) and body image (r = 0.35, p < 0.05) with BMI. Respondents with high eating behaviour scores and body image discrepancy scores were more likely to have greater BMI. This study shows the need for healthy eating and body image intervention programmes to prevent overweight and obesity problems among adolescents.

  1. Self-motion perception compresses time experienced in return travel.

    PubMed

    Seno, Takeharu; Ito, Hiroyuki; Shoji, Sunaga

    2011-01-01

    It is often anecdotally reported that time experienced in return travel (back to the start point) seems shorter than time spent in outward travel (travel to a new destination). Here, we report the first experimental results showing that return travel time is experienced as shorter than the actual time. This discrepancy is induced by the existence of self-motion perception.

  2. Teaching Scientific Methodology through Microcomputer Simulations in Genetics. Final Project Report.

    ERIC Educational Resources Information Center

    Kellogg, Ted; Latson, Jon

    There are two major concerns about the teaching of high school biology. One is the degree to which students memorize laws, facts, and principles, and the second involves the role of the classroom teacher. These aspects result in a discrepancy between the theory and practice of science education. The purpose of this report is to provide: (1) a…

  3. Discrepancy between Parental Reports of Infants' Receptive Vocabulary and Infants' Behaviour in a Preferential Looking Task

    ERIC Educational Resources Information Center

    Houston-Price, Carmel; Mather, Emily; Sakkalou, Elena

    2007-01-01

    Two experiments are described which explore the relationship between parental reports of infants' receptive vocabularies at 1 ; 6 () or 1 ; 3, 1 ; 6 and 1 ; 9 () and the comprehension infants demonstrated in a preferential looking task. The instrument used was the Oxford CDI, a British English adaptation of the MacArthur-Bates CDI (Words &…

  4. Brief Report: Parent-Adolescent Informant Discrepancies of Social Skill Importance and Social Skill Engagement for Higher-Functioning Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    McMahon, Camilla M.; Solomon, Marjorie

    2015-01-01

    Parent- and adolescent-report of social skill importance and social skill engagement on the Social Skills Rating System (Gresham and Elliott in The social skills rating system, American Guidance Service, Circle Pines, 1990) were assessed in higher-functioning adolescents with Autism Spectrum Disorder (ASD). Compared to parents, adolescents…

  5. "I'm Scared of the Disappointment": Young Adult Smokers' Relational Identity Gaps and Management Strategies as Sites of Communication Intervention.

    PubMed

    Stanley, Samantha J; Pitts, Margaret Jane

    2018-02-22

    While cigarette smoking is decreasing among young adults, rates of nicotine consumption through other devices, most notably electronic cigarettes, are on the rise. Framed by communication theory of identity, this study examines young adult smokers' experiences with relational others in regard to their smoking. Focus group discussions and individual interviews convened with 20 young adult cigarette and electronic cigarette smokers revealed identity gaps implicating the relational layer of identity, including personal-relational, enacted-relational, and personal-enacted-relational identity gaps. Participants used communicative and behavioral strategies to manage relational discrepancies. The documented identity gaps and management strategies present opportunities for targeted smoking cessation interventions that amplify dissonance created through identity gaps as a motivational tactic.

  6. Revisiting kaon physics in general Z scenario

    NASA Astrophysics Data System (ADS)

    Endo, Motoi; Kitahara, Teppei; Mishima, Satoshi; Yamamoto, Kei

    2017-08-01

    New physics contributions to the Z penguin are revisited in the light of the recently-reported discrepancy of the direct CP violation in K → ππ. Interference effects between the standard model and new physics contributions to ΔS = 2 observables are taken into account. Although the effects are overlooked in the literature, they make experimental bounds significantly severer. It is shown that the new physics contributions must be tuned to enhance B (KL →π0 ν ν bar), if the discrepancy of the direct CP violation is explained with satisfying the experimental constraints. The branching ratio can be as large as 6 ×10-10 when the contributions are tuned at the 10% level.

  7. Standardization for oxygen isotope ratio measurement - still an unsolved problem.

    PubMed

    Kornexl; Werner; Gehre

    1999-07-01

    Numerous organic and inorganic laboratory standards were gathered from nine European and North American laboratories and were analyzed for their delta(18)O values with a new on-line high temperature pyrolysis system that was calibrated using Vienna standard mean ocean water (VSMOW) and standard light Antartic precipitation (SLAP) internationally distributed reference water samples. Especially for organic materials, discrepancies between reported and measured values were high, ranging up to 2 per thousand. The reasons for these discrepancies are discussed and the need for an exact and reliable calibration of existing reference materials, as well as for the establishment of additional organic and inorganic reference materials is stressed. Copyright 1999 John Wiley & Sons, Ltd.

  8. Better Pay, More Jobs.

    ERIC Educational Resources Information Center

    Gregory, Vicki L.; Wohlmuth, Sonia Ramirez

    2000-01-01

    Reports the results of the 1999 survey of library schools that investigated salaries and job placement. Highlights include status of graduates; average starting salaries; discrepancies between salaries of men and women; and views of graduates regarding the placement process and their library school preparation. (LRW)

  9. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 264.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Manifest... waste acid, or toxic constituents not reported on the manifest or shipping paper. (c) Upon discovering a...

  10. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 265.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL... waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping...

  11. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 265.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL... waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping...

  12. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 264.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Manifest... waste acid, or toxic constituents not reported on the manifest or shipping paper. (c) Upon discovering a...

  13. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 264.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Manifest... waste acid, or toxic constituents not reported on the manifest or shipping paper. (c) Upon discovering a...

  14. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 264.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Manifest... waste acid, or toxic constituents not reported on the manifest or shipping paper. (c) Upon discovering a...

  15. 40 CFR 264.72 - Manifest discrepancies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 264.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Manifest... waste acid, or toxic constituents not reported on the manifest or shipping paper. (c) Upon discovering a...

  16. 40 CFR 265.72 - Manifest discrepancies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 265.72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) INTERIM STATUS STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL... waste solvent substituted for waste acid, or toxic constituents not reported on the manifest or shipping...

  17. Public Health Insurance in Oregon: Underenrollment of Eligible Children and Parental Confusion About Children's Enrollment Status

    PubMed Central

    Ray, Moira; Graham, Alan

    2011-01-01

    Objectives. We identified characteristics of Oregon children who were eligible for the Oregon Health Plan (OHP), the state's combined Medicaid–Children's Health Insurance Program (CHIP), but were not enrolled in January 2005. We also assessed whether parents’ confusion regarding their children's status affected nonenrollment. Methods. We conducted cross-sectional analyses of linked statewide Food Stamp Program and OHP administrative databases (n = 10 175) and primary data from a statewide survey (n = 2681). Results. More than 20% of parents with children not administratively enrolled in OHP reported that their children were enrolled. Parents of 11.3% of children who were administratively enrolled reported that they were not. Eligible but unenrolled children had higher odds of being older, having higher family incomes, and having employed and uninsured parents. Conclusions. These findings reveal an important discrepancy between administrative data and parent-reported access to public health insurance. This discrepancy may stem from transient coverage or confusion among parents and may result in underutilization of health insurance for eligible children. PMID:21421944

  18. Risky behaviors and educational attainment among young Mexican-origin mothers: The role of acculturative stress and the educational aspiration–expectation gap

    PubMed Central

    Bravo, Diamond Y.; Umaña-Taylor, Adriana J.; Toomey, Russell B.; Updegraff, Kimberly A.; Jahromi, Laudan B.

    2017-01-01

    The current longitudinal study examined how Mexican-origin adolescent mothers’ (N = 204) reports of acculturative stress during late adolescence were associated with their educational attainment and engagement in risky behaviors in young adulthood, 4 years post-partum; we also examined whether this association was mediated by discrepancies between adolescents’ educational aspirations and expectations. Findings revealed that mothers’ greater reports of stress regarding English competency pressures and pressures to assimilate were associated with a larger gap between their aspirations and expectations. Mothers’ reports of greater stress from pressures against assimilation, however, were associated with a smaller gap between aspirations and expectations. As expected, a larger gap between aspirations and expectations was associated with lower educational attainment and increased engagement in risky behaviors. Finally, significant mediation emerged, suggesting that the influence of stress from English competency pressures and pressures to assimilate on young mothers’ educational attainment and engagement in risky behaviors was mediated through the aspiration–expectation gap. Findings are discussed with respect to understanding discrepancies between young mothers’ aspirations and expectations in the context of acculturative stress. PMID:29263563

  19. Evaluation of a Social Norms Sexual Violence Prevention Marketing Campaign Targeted Toward College Men: Attitudes, Beliefs, and Behaviors Over 5 Years.

    PubMed

    Mennicke, Annelise; Kennedy, Stephanie C; Gromer, Jill; Klem-O'Connor, Mara

    2018-06-01

    The article evaluates the effectiveness of a 5-year social norms sexual violence prevention marketing campaign designed specifically for men on a large public university in the Southeastern United States. From 2010 through 2014, 4,158 men were asked about their self-reported attitudes, beliefs, and behavior related to sexual violence as well as their perception of their peers' attitudes, beliefs, and behaviors. Using social norms theory, a social norms marketing campaign was developed to target highly discrepant attitudes, beliefs, and behaviors. Results indicate that both self-reported and perception of peer attitudes and beliefs improved over time, and the discrepancy between the two reduced over time. In addition, the frequency of positive and prosocial self-reported behavior increased on five of the six indicators. This study represents a significant contribution to the literature, as it uses 5 years of data and includes behavioral indicators to add evidence for the efficacy of targeting misperceptions of social norms as a mechanism to engage men in gender-based violence prevention.

  20. “Chasing a Ghost”: Factors that Influence Primary Care Physicians to Follow Up on Incidental Imaging Findings

    PubMed Central

    Bugos, Eva K.; Langlotz, Curtis P.; Frasso, Rosemary

    2016-01-01

    Purpose To explore provider and patient characteristics that influence how primary care providers (PCPs) communicate and manage incidental imaging findings. Materials and Methods This HIPAA-compliant study was approved by the institutional review board. Through semistructured interviews, researchers explored concerns and perspectives of 30 PCPs on receiving and acting on incidental imaging findings. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Three research assistants independently coded all 30 deidentified transcripts and resolved discrepancies (κ = 0.85). Codes pertaining to PCP and patient characteristics were organized into an explanatory model. Results Some PCPs felt compelled but frustrated to pursue costly follow-up for incidental imaging findings of limited clinical importance. Other PCPs did not act on findings that were unfamiliar or occurred in an unusual clinical context when follow-up recommendations were not given; the challenges of researching the clinical importance of these findings or seeking specialist consultation led to inaction. Some PCPs reported using a uniform approach to communicate and manage incidental findings, while others adapted their approach to the patient and the finding. Sometimes PCP characteristics such as follow-up style superseded patient characteristics. At other times patient characteristics such as health literacy superseded PCP characteristics. Conclusion PCPs cited a variety of objective and subjective factors that influence how they communicate and manage incidental imaging findings. These results suggest that some patients may receive inappropriate follow-up of incidental imaging findings and present an opportunity for radiologists to help PCPs and patients to best use the information conveyed in imaging reports. © RSNA, 2016 Online supplemental material is available for this article. PMID:27192458

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