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Sample records for pathologist assessment compared

  1. A Comparative Study of the Perspectives of General and Oral and Maxillofacial Pathologists about the Rate and Value of Second Referral in Assessment of Oral and Maxillofacial Pathologic Lesions.

    PubMed

    Razavi, Sayed Mohammad; Liaghatdar, Alireza; Kargahi, Neda

    2017-02-16

    The main purpose in the practice of pathology is to provide an accurate diagnosis. Second referral and reassessment by a second pathologist significantly cause diagnostic errors, help to make an accurate diagnosis, and improve patient management. This study was aimed to assess the general perspectives of general and oral and maxillofacial pathologists in Iran on second referrals. In this cross-sectional, descriptive-analytical study, a 20-item questionnaire on second referrals was used to assess the general and oral and maxillofacial pathologists' perspective in Iran. The obtained data were analyzed by chi-square and Mann-Whitney tests (α = 0.05). A total of 64 questionnaires from general and 45 questionnaires from oral and maxillofacial pathologists were collected. The findings showed 70.9% of pathologists were in favor of seeking a second opinion when faced with diagnostic challenges. Significant differences were found between the oral and general pathologists in terms of the most challenging oral and maxillofacial lesions (p value < 0.001). In total, 74.8% of pathologists suggested second opinion to be useful and productive. Both groups of pathologists approved of the second referral. However, this pattern is still different, and it is possible to improve the referral rate among both groups and to enhance the knowledge of general pathologists about second referral to oral and maxillofacial pathologists.

  2. Classroom listening assessment: strategies for speech-language pathologists.

    PubMed

    Johnson, Cheryl DeConde

    2012-11-01

    Emphasis on classroom listening has gained importance for all children and especially for those with hearing loss and special listening needs. The rationale can be supported from trends in educational placements, the Response to Intervention initiative, student performance and accountability, the role of audition in reading, and improvement in hearing technologies. Speech-language pathologists have an instrumental role advocating for the accommodations that are necessary for effective listening for these children in school. To identify individual listening needs and make relevant recommendations for accommodations, a classroom listening assessment is suggested. Components of the classroom listening assessment include observation, behavioral assessment, self-assessment, and classroom acoustics measurements. Together, with a strong rationale, the results can be used to implement a plan that results in effective classroom listening for these children. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Assessing risks for gastric cancer: New tools for pathologists

    PubMed Central

    Genta, Robert M; Rugge, Massimo

    2006-01-01

    Although the Sydney Systems (original and updated) for the classification of gastritis have contributed substantially to the uniformity of the reporting of gastric conditions, they lack immediacy in conveying to the user information about gastric cancer risk. In this review, we summarize the current understanding of the gastric lesions associated with an increased risk for cancer, and present the rationale for a proposal for new ways of reporting gastritis. In addition to the traditional histopathological data gathered and evaluated according to the Sydney System rules, pathologists could add an assessment expressed as grading and staging of the gastric inflammatory and atrophic lesions and integrate these findings with pertinent laboratory information on pepsinogens and gastrin levels. Such an integrated report could facilitate clinicians’ approach to the management of patients with gastric conditions. PMID:17007013

  4. The Use of Interpreters by Speech-Language Pathologists Conducting Bilingual Speech-Language Assessments

    ERIC Educational Resources Information Center

    Palfrey, Carol Lynn

    2013-01-01

    The purpose of this non-experimental quantitative study was to explore the practices of speech-language pathologists in conducting bilingual assessments with interpreters. Data were obtained regarding the assessment tools and practices used by speech-language pathologists, the frequency with which they work with interpreters, and the procedures…

  5. Comparing accuracy of the Yale swallow protocol when administered by registered nurses and speech-language pathologists.

    PubMed

    Warner, Heather L; Suiter, Debra M; Nystrom, Karin V; Poskus, Kelly; Leder, Steven B

    2014-07-01

    (1) To describe the results of a web-based teaching module used by registered nurses to identify patients at risk of aspiration and (2) to determine accuracy of the registered nurse-administered 3-ounce water swallow challenge protocol, that is, drinking three ounces of water, a basic cognitive screen and oral mechanism evaluation, when compared with blinded ratings from speech-language pathology. Early identification of potential swallowing problems is important prior to ingestion of food, fluid and medications. Unfortunately, current nurse-administered screens use a variety of non-evidence-based assessments. It would be beneficial to use a valid, reliable and evidence-based screen, that is, the Yale swallow protocol. Prospective, blinded, referral-based. Fifty-two registered nurses and 101 inpatients participated. First, each participant was administered the 3-ounce water swallow challenge protocol by a speech-language pathologist. Second, a nurse administered the protocol to the same patient within one hour and independently recorded results and diet recommendations. The nurse was blinded to the study's purpose and results of the speech-language pathologist's initial screening. Out of view, but simultaneous with the nurse-administered protocol, a speech-language pathologist rerated the patient's challenge for comparison with initial results and determined the accuracy of the nurse-administered protocol. Intra- and inter-rater protocol agreements for the two speech-language pathologists were 100%. Inter-rater protocol agreement between registered nurses and speech-language pathologists was 98·01%. Results confirm the reliability and accuracy of a registered nurse-administered Yale swallow protocol. The consequence of 98% accuracy combined with previously reported 96·5% sensitivity, 97·9% negative predictive value and <2% false negative rate allowed for adoption of the protocol for the entire general hospital population. Avoidance of preventable prandial

  6. The bedside assessment practices of speech-language pathologists in adult dysphagia.

    PubMed

    Vogels, Brittany; Cartwright, Jade; Cocks, Naomi

    2015-01-01

    The current study aimed to investigate what Australian speech-language pathologists frequently include in their bedside assessments in adult dysphagia, what factors influence these bedside assessments and whether they are consistent with the current evidence base. These aims were achieved via an online questionnaire and a series of semi-structured interviews. In the questionnaire, respondents were asked to rate how frequently they utilized bedside assessment components on a scale of five ranging from never to always. One hundred and forty practicing speech-language pathologists completed the online questionnaire in full. Eight interviews were then conducted. Respondents reported utilizing predominantly motor elements of their oro-motor examination with very few sensory elements being frequently utilized. Five main themes arose from the interviews including the influence of the individual patient and participant, the current evidence base, the participants' clinical practice and the participants' workplace. The findings from this research have implications for current clinical and education practices, in particular the impact of education and training and caseload demands on current practice.

  7. TBI knowledge and pragmatic assessment among Connecticut school speech-language pathologists.

    PubMed

    McGrane, S A; Cascella, P W

    2000-11-01

    School-based speech-language pathologists from Connecticut responded to a random survey which had a twofold purpose, (1) to replicate a previous conclusion that clinicians' specific experience with traumatic brain injury (TBI) influences their knowledge of this subject, and (2) to explore the topic of pragmatic assessment and whether it is also influenced by specific TBI experience. Results indicate that Connecticut school clinicians favourably regard both their own knowledge of TBI and the contemporary issue of pragmatic assessment. Connecticut clinicians also report a relatively low degree of prior TBI training and clinical experience. Clinicians' degree of TBI training and clinical experience did not appear directly related to their reported competence in TBI knowledge and pragmatic assessment.

  8. Speech-Language Pathologists' Assessment Practices for Children with Suspected Speech Sound Disorders: Results of a National Survey

    ERIC Educational Resources Information Center

    Skahan, Sarah M.; Watson, Maggie; Lof, Gregory L.

    2007-01-01

    Purpose: This study examined assessment procedures used by speech-language pathologists (SLPs) when assessing children suspected of having speech sound disorders (SSD). This national survey also determined the information participants obtained from clients' speech samples, evaluation of non-native English speakers, and time spent on assessment.…

  9. An assessment of the information-seeking abilities and needs of practicing speech-language pathologists.

    PubMed

    Nail-Chiwetalu, Barbara; Bernstein Ratner, Nan

    2007-04-01

    This study assessed the information-seeking practices and needs of speech-language pathologists (SLPs). Improved understanding of these needs can inform librarians and educators to better prepare students in principles and methods of evidence-based practice (EBP) and, through continuing education (CE), promote the integration of EBP into clinical practice of SLPs. A 16-question survey was mailed to 1,000 certified speech-language pathologists in the United States. Two hundred and eight usable surveys were returned for a response rate of 21%. For clinical questions, SLPs most often consulted with a colleague, participated in CE activities, and searched the open Internet. Few respondents relied on scholarly journal articles for assistance with clinical cases. The most prominent barriers to finding appropriate information were time and knowledge of where and how to find relevant information. Few reported having information literacy instruction by a librarian. If EBP is to become a viable practice in clinical decision making, there appears to be a tremendous need for information literacy instruction in the university curriculum, as well as through CE activities for currently practicing SLPs. Given respondents' reported lack of time and limited access to full-text journals containing evidence relevant to clinical practice, the field of speech-language pathology will need to generate readily accessible clinical summaries of research evidence through meta-analyses, systematic reviews, and clinical practice guidelines.

  10. Speech-language pathologists' perspectives on cognitive communication assessment during post-traumatic amnesia.

    PubMed

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne

    2016-01-01

    There have been few reports of the approaches taken by speech-language pathologists (SLPs) when assessing cognitive communication (CC) during post-traumatic amnesia (PTA) after TBI. This study sought to understand SLPs' rationales for CC assessment during PTA and to examine their perspectives on assessment methods during the early recovery period. In this qualitative study, 10 SLPs participated in semi-structured face-to-face or telephone interviews about their rationales and methods for CC assessment during PTA and early recovery. Content analysis was conducted using NVivo software to identify key categories. SLPs reported their reasons for CC assessment as including: (1) Documenting changes and monitoring progress, (2) Feedback to team, family and patient, (3) Diagnosis of communication disorder, (4) Planning and (5) Prognosis. They described conducting ongoing, informal assessment and monitoring of CC, using a combination of standardized and non-standardized measures during PTA, and commenced formal testing after PTA resolution to formulate a baseline level of communication function. The current study highlighted the importance that SLPs placed on an individualized approach in CC assessment. Findings provided insight into the process of assessment of CC during PTA and the early stage of recovery after TBI.

  11. Assessment and Treatment of Working Memory Deficits in School-Age Children: The Role of the Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Boudreau, Donna; Costanza-Smith, Amy

    2011-01-01

    Purpose: To review research addressing the relationship of working memory (WM) to language development and academic functioning and to consider the role of the speech-language pathologist (SLP) in assessment and intervention of WM difficulties in school-age children. Method: Aspects of WM critical to language acquisition and academic success are…

  12. Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho*

    PubMed Central

    Guo, Ruiling; Bain, Barbara A.; Willer, Janene

    2008-01-01

    Objectives: The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources. Methods: A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically. Results: The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy. Discussions/Conclusion: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho. PMID:18379669

  13. Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho.

    PubMed

    Guo, Ruiling; Bain, Barbara A; Willer, Janene

    2008-04-01

    The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources. A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically. The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy. DISCUSSIONS/CONCLUSION: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho.

  14. Development and evaluation of the environment and communication assessment toolkit with speech-language pathologists.

    PubMed

    Bruce, Carrie; Brush, Jennifer A; Sanford, Jon A; Calkins, Margaret P

    2013-04-01

    Communication dysfunction that results from dementia can be exacerbated by environmental barriers such as inadequate lighting, noisy conditions, poor or absent environmental cues, and visual clutter. Speech-language pathologists (SLPs) should address these environmental barriers as part of a comprehensive treatment plan for clients with dementia. The Environment and Communication Assessment Toolkit for Dementia Care (ECAT) was evaluated by SLPs to determine: (1) changes in awareness of environmental factors prior to and after training; (2) impact of the ECAT on practice as measured by changes in the number of environmental modifications recommended and made prior to and after training; (3) utility of the information as measured by the helpfulness, amount of new information, and usefulness of the ECAT; and (4) usability of the ECAT materials based on ease of use. The SLPs used the ECAT with clients with dementia who had functional limitations and required substantial assistance with daily activities. Results indicate that the ECAT is an effective tool for SLPs, providing information about the impact of the environment on communication and supplying sufficient resources to make recommendations and implement effective interventions. The ECAT successfully increased awareness of environmental modifications, influenced the practice of recommending environmental modifications, and had utility in diverse aspects of clinical practice. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Speech-language pathologists' assessment and intervention practices with multilingual children.

    PubMed

    Williams, Corinne J; McLeod, Sharynne

    2012-06-01

    Within predominantly English-speaking countries such as the US, UK, Canada, New Zealand, and Australia, there are a significant number of people who speak languages other than English. This study aimed to examine Australian speech-language pathologists' (SLPs) perspectives and experiences of multilingualism, including their assessment and intervention practices, and service delivery methods when working with children who speak languages other than English. A questionnaire was completed by 128 SLPs who attended an SLP seminar about cultural and linguistic diversity. Approximately one half of the SLPs (48.4%) reported that they had at least minimal competence in a language(s) other than English; but only 12 (9.4%) reported that they were proficient in another language. The SLPs spoke a total of 28 languages other than English, the most common being French, Italian, German, Spanish, Mandarin, and Auslan (Australian sign language). Participants reported that they had, in the past 12 months, worked with a mean of 59.2 (range 1-100) children from multilingual backgrounds. These children were reported to speak between two and five languages each; the most common being: Vietnamese, Arabic, Cantonese, Mandarin, Australian Indigenous languages, Tagalog, Greek, and other Chinese languages. There was limited overlap between the languages spoken by the SLPs and the children on the SLPs' caseloads. Many of the SLPs assessed children's speech (50.5%) and/or language (34.2%) without assistance from others (including interpreters). English was the primary language used during assessments and intervention. The majority of SLPs always used informal speech (76.7%) and language (78.2%) assessments and, if standardized tests were used, typically they were in English. The SLPs sought additional information about the children's languages and cultural backgrounds, but indicated that they had limited resources to discriminate between speech and language difference vs disorder.

  16. Recognition and discrimination of tissue-marking dye color by surgical pathologists: recommendations to avoid errors in margin assessment.

    PubMed

    Williams, Andrew S; Hache, Kelly Dakin

    2014-09-01

    A variety of tissue-marking dye (TMD) colors can be used to indicate surgical pathology specimen margins; however, the ability of pathologists to differentiate between specific microscopic margin colors has not been assessed systematically. This study aimed to evaluate pathologists' accuracy in identifying TMD color and determine the least ambiguous combinations of colors for use in surgical pathology. Seven colors of TMD were obtained from three manufacturers and applied to excess formalin-fixed uterine tissue. Study blocks contained multiple tissue pieces, each marked with a different color from the same manufacturer. Slides were assessed by eight participants for color and color distinctness of each piece of tissue. Black, green, red, and blue TMDs were accurately identified by most participants, but participants had difficulty identifying violet, orange, and yellow TMDs. Black, green, and blue TMDs were most commonly rated as "confidently discernable." Pathologists have difficulty identifying and distinguishing certain colors of TMDs. The combined use of certain colors of TMDs (yellow/orange/red, blue/violet, and red/violet) within the same specimen should be avoided to decrease the risk of inaccurately reporting specimen margins. Copyright© by the American Society for Clinical Pathology.

  17. Accountability for Services for Young Children with Disabilities and the Assessment of Meaningful Outcomes: The Role of the Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Rooney, Robin

    2009-01-01

    Purpose: This article describes the federal accountability requirements related to young children with disabilities and the contribution of the speech-language pathologist (SLP) to provide these data through the use of authentic, functional assessments. Method: The article summarizes recent state and federal developments related to assessment for…

  18. Assessment and treatment of working memory deficits in school-age children: the role of the speech-language pathologist.

    PubMed

    Boudreau, Donna; Costanza-Smith, Amy

    2011-04-01

    To review research addressing the relationship of working memory (WM) to language development and academic functioning and to consider the role of the speech-language pathologist (SLP) in assessment and intervention of WM difficulties in school-age children. Aspects of WM critical to language acquisition and academic success are defined, and the importance of WM to language development and learning is discussed. Subsequently, strategies for assessing WM skills in children are presented. Following a discussion regarding the assessment of WM demands in the classroom, intervention strategies are provided. Children with poor WM skills are likely to experience significant difficulty in academic settings. Evidence-based strategies for both reducing WM demands and improving functional WM skills are reviewed. Research to date has documented that children with language impairments frequently have poor WM skills. SLPs can support poor WM skills by considering both modifications to the environment and child-enacted knowledge and skills, which may serve to reduce the impact of poor WM skills on learning and academic success.

  19. Speech-language pathologists' practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders.

    PubMed

    Mcleod, Sharynne; Baker, Elise

    2014-01-01

    A survey of 231 Australian speech-language pathologists (SLPs) was undertaken to describe practices regarding assessment, analysis, target selection, intervention, and service delivery for children with speech sound disorders (SSD). The participants typically worked in private practice, education, or community health settings and 67.6% had a waiting list for services. For each child, most of the SLPs spent 10-40 min in pre-assessment activities, 30-60 min undertaking face-to-face assessments, and 30-60 min completing paperwork after assessments. During an assessment SLPs typically conducted a parent interview, single-word speech sampling, collected a connected speech sample, and used informal tests. They also determined children's stimulability and estimated intelligibility. With multilingual children, informal assessment procedures and English-only tests were commonly used and SLPs relied on family members or interpreters to assist. Common analysis techniques included determination of phonological processes, substitutions-omissions-distortions-additions (SODA), and phonetic inventory. Participants placed high priority on selecting target sounds that were stimulable, early developing, and in error across all word positions and 60.3% felt very confident or confident selecting an appropriate intervention approach. Eight intervention approaches were frequently used: auditory discrimination, minimal pairs, cued articulation, phonological awareness, traditional articulation therapy, auditory bombardment, Nuffield Centre Dyspraxia Programme, and core vocabulary. Children typically received individual therapy with an SLP in a clinic setting. Parents often observed and participated in sessions and SLPs typically included siblings and grandparents in intervention sessions. Parent training and home programs were more frequently used than the group therapy. Two-thirds kept up-to-date by reading journal articles monthly or every 6 months. There were many similarities with

  20. Biospecimens and Biorepositories for the Community Pathologist

    PubMed Central

    Dash, Rajesh C.; Robb, James A.; Booker, David L.; Foo, Wen-Chi; Witte, David L.; Bry, Lynn

    2013-01-01

    Pathologists have long served as custodians of human biospecimens collected for diagnostic purposes. Rapid advancements in diagnostic technologies require that pathologists change their practices to optimize patient care. The proper handling of biospecimens creates opportunities for pathologists to improve their diagnoses while assessing prognosis and treatment. In addition, the growing need for high-quality biorepositories represents an opportunity for community pathologists to strengthen their role within the health care team, ensuring that clinical care is not compromised while facilitating research. This article provides a resource to community pathologists learning how to create high-quality biorepositories and participating in emerging opportunities in the biorepository field. While a variety of topics are covered to provide breadth of information, the intent is to facilitate a level of understanding that permits community pathologists to make more informed choices in identifying how best their skills and practice may be augmented to address developments in this field. PMID:22646276

  1. Implications of Variability in Clinical Bedside Swallowing Assessment Practices by Speech Language Pathologists.

    PubMed

    McAllister, Sue; Kruger, Samantha; Doeltgen, Sebastian; Tyler-Boltrek, Emma

    2016-10-01

    Speech language pathology (SLP) clinical bedside swallowing assessments (CBSA) are a cornerstone of quality care for patients in acute hospitals who have dysphagia. The CBSA informs clinical diagnosis and decisions regarding further instrumental assessment, and is used to develop a management plan and monitor progress. However, self-report and retrospective research shows that SLPs are highly variable in their use of assessment components considered by experts to be important for quality CBSA, casting doubt on the validity and reliability of CBSA. This prospective study describes the components included by SLPs when designing a standardised evidence based dysphagia assessment protocol for acute care patients and observed patterns of component use. The findings confirm that SLPs use the CBSA for multiple purposes beyond diagnosis of aspiration risk and dysphagia presence/severity. They are highly variable in their use of certain components, but also demonstrate consistent use of a core set. It is apparent that SLPs prioritise the application of clinical reasoning to tailor their CBSA to the patient over following a highly structured item-based protocol. The variability in component use likely reflects a complex clinical reasoning process that draws on a wide variety of information combined with expert knowledge as is also observed in many other medical specialties. Rather than promoting the standardisation of CBSA protocols that constrain SLP practice to strict item-based assessment protocols, consideration should be given to promoting the value and facilitating the clinical reasoning process that supports the utility of the CBSA for diagnosis, patient centred management and treatment planning.

  2. Speech-Language Pathologists

    MedlinePlus

    ... pathologists work with physicians and surgeons , social workers , psychologists , and other healthcare workers. In schools, they work ... ear problems. Doctoral or professional degree $74,890 Psychologists Psychologists study cognitive, emotional, and social processes and ...

  3. Accountability for services for young children with disabilities and the assessment of meaningful outcomes: the role of the speech-language pathologist.

    PubMed

    Hebbeler, Kathleen; Rooney, Robin

    2009-10-01

    This article describes the federal accountability requirements related to young children with disabilities and the contribution of the speech-language pathologist (SLP) to provide these data through the use of authentic, functional assessments. The article summarizes recent state and federal developments related to assessment for accountability and draws on the recommendations of national organizations, including the American Speech-Language-Hearing Association, to underscore the importance of high-quality assessment for guiding practice and for documenting child outcomes for accountability. The widespread use of recommended practices for assessment will provide children, families, and practitioners, including SLPs, with the highest quality assessment information, at the same time providing states and the federal government with much-needed valid data on child outcomes for accountability purposes.

  4. Improving Pathologists' Communication Skills.

    PubMed

    Dintzis, Suzanne

    2016-08-01

    The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

  5. Demographic and practice characteristics of pathologists who enjoy breast tissue interpretation.

    PubMed

    Oster, Natalia V; Geller, Berta M; Carney, Patricia A; Reisch, Lisa M; Onega, Tracy; Weaver, Donald L; Frederick, Paul; Elmore, Joann G

    2015-04-01

    Physician attributes, job satisfaction and confidence in clinical skills are associated with enhanced performance and better patient outcomes. We surveyed 252 pathologists to evaluate associations between enjoyment of breast pathology, demographic/clinical characteristics and diagnostic performance. Diagnostic performance was determined by comparing pathologist assessments of a set of 60 cases with consensus assessments of the same cases made by a panel of experienced pathologists. Eighty-three percent of study participants reported enjoying breast pathology. Pathologists who enjoy breast interpretation were more likely to review ≥10 cases/week (p = 0.003), report breast interpretation expertise (p = 0.013) and have high levels of confidence interpreting breast pathology (p < 0.001). These pathologists were less likely to report that the field was challenging (p < 0.001) and that breast cases make them more nervous than other types of pathology (p < 0.001). Enjoyment was not associated with diagnostic performance. Millions of women undergo breast biopsy annually, thus it is reassuring that although nearly a fifth of practicing pathologists who interpret breast tissue report not enjoying the field, precision is not impacted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. External Quality Assessment Programs in the US with an emphasis on urinary sediment testing: the College of American Pathologists experience.

    PubMed

    Glassy, Eric F; Blomberg, David J

    2015-08-11

    The College of American Pathologists (CAP) has maintained the highest standards for laboratory medicine through education, evaluation, and certification. One form of External Quality Assurance - proficiency testing (PT) - is the centerpiece of that mission. Over 500 medical and scientific experts oversee CAP PT programs which include more than 600 tests performed by 22,000 laboratories in over 100 countries. It is the most comprehensive laboratory peer-review comparison program in the world. The CAP offers four urine sediment PT products tailored to the needs of different laboratories. Each includes three or four digital images, shipped twice a year. The program is overseen by the Hematology and Clinical Microscopy Resource Committee. Images are graded if there is 80% or greater consensus of either referee or participant laboratories. Failing laboratories must analyze the reasons for the failure, report the results, and initiate corrective action. Over the years, there has been a progressive decline in the number of errors, demonstrating that education and regulatory oversight are major contributors to improved PT performance and, by extension, patient care. The PT urine sediment image databank is a unique resource, representing the consensus of many laboratories. Participant and referee responses identify which morphologic variants are unambiguous and which are more difficult to classify. The PT challenges include discussions of disease pathophysiology and key morphologic features. This teaching component is what helps to set the CAP's program apart. The discussions formed the basis for the Color Atlas of Urinary Sediment published by the CAP in 2010.

  7. Pathologists and liquid biopsies: to be or not to be?

    PubMed

    Hofman, Paul; Popper, Helmut H

    2016-12-01

    Recently, the advent of therapies targeting genomic alterations has improved the care of patients with certain types of cancer. While molecular targets were initially detected in nucleic acid samples extracted from tumor tissue, detection of nucleic acids in circulating blood has allowed the development of what has become known as liquid biopsies, which provide a complementary and alternative sample source allowing identification of genomic alterations that might be addressed by targeted therapy. Consequently, liquid biopsies might rapidly revolutionize oncology practice in allowing administration of more effective treatments. Liquid biopsies also provide an approach towards short-term monitoring of metastatic cancer patients to evaluate efficacy of treatment and/or early detection of secondary mutations responsible for resistance to treatment. In this context, pathologists, who have already been required in recent years to take interest in the domain of molecular pathology of cancer, now face new challenges. The attitude of pathologists to and level of involvement in the practice of liquid biopsies, including mastering the methods employed in molecular analysis of blood samples, need close attention. Regardless of the level of involvement of pathologists in this new field, it is mandatory that oncologists, biologists, geneticists, and pathologists work together to coordinate the pre-analytical, analytical, and post-analytical phases of molecular assessment of tissue and liquid samples of individual cancer patients. The challenges include (1) implementation of effective and efficient procedures for reception and analysis of liquid and tissue samples for histopathological and molecular evaluation and (2) assuring short turn-around times to facilitate rapid optimization of individual patient treatment. In this paper, we will review the following: (1) recent data concerning the concept of liquid biopsies in oncology and its development for patient care, (2) advantages

  8. The Pathologist Pipeline

    PubMed Central

    Timmons, Charles F.

    2016-01-01

    A shortage of physicians in the United States has been long projected. Because of predictions of retirement among the aging pathology workforce, there is an anticipated shortage of pathologist as well. To address the pathology workforce shortage among pathologists, the Association of Pathology Chairs assembled a subcommittee of the Association of Pathology Chairs Advocacy Committee to explore ways to identify the strengths, weaknesses, opportunities, and threats to the pathology workforce. One opportunity to encourage strong candidates to pursue pathology as a career is to explore possibility to revisit advanced credit for the post-sophomore fellowship. A survey that was designed to understand the post-sophomore fellowship training better was distributed on the listserv of the Program Directors Section of the Association of Pathology Chairs. A review of the literature on post-sophomore fellowship programs is presented in light of the findings from this survey. Many post-sophomore fellowship programs are run similar to a first-year resident experience, although programs show great diversity in curriculum, including some programs that focus on research. Post-sophomore fellowships attract medical students to the area of pathology and tend to end up in academic and research positions. A second survey of program directors served as an opinion poll of challenging issues that affect residency training. From the second opinion poll, most program directors feel that residents can use additional training to improve the outcome of our future pathologists. PMID:28725767

  9. "Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring.

    PubMed

    Engelberg, Jesse A; Retallack, Hanna; Balassanian, Ronald; Dowsett, Mitchell; Zabaglo, Lila; Ram, Arishneel A; Apple, Sophia K; Bishop, John W; Borowsky, Alexander D; Carpenter, Philip M; Chen, Yunn-Yi; Datnow, Brian; Elson, Sarah; Hasteh, Farnaz; Lin, Fritz; Moatamed, Neda A; Zhang, Yanhong; Cardiff, Robert D

    2015-11-01

    Hormone receptor status is an integral component of decision-making in breast cancer management. IHC4 score is an algorithm that combines hormone receptor, HER2, and Ki-67 status to provide a semiquantitative prognostic score for breast cancer. High accuracy and low interobserver variance are important to ensure the score is accurately calculated; however, few previous efforts have been made to measure or decrease interobserver variance. We developed a Web-based training tool, called "Score the Core" (STC) using tissue microarrays to train pathologists to visually score estrogen receptor (using the 300-point H score), progesterone receptor (percent positive), and Ki-67 (percent positive). STC used a reference score calculated from a reproducible manual counting method. Pathologists in the Athena Breast Health Network and pathology residents at associated institutions completed the exercise. By using STC, pathologists improved their estrogen receptor H score and progesterone receptor and Ki-67 proportion assessment and demonstrated a good correlation between pathologist and reference scores. In addition, we collected information about pathologist performance that allowed us to compare individual pathologists and measures of agreement. Pathologists' assessment of the proportion of positive cells was closer to the reference than their assessment of the relative intensity of positive cells. Careful training and assessment should be used to ensure the accuracy of breast biomarkers. This is particularly important as breast cancer diagnostics become increasingly quantitative and reproducible. Our training tool is a novel approach for pathologist training that can serve as an important component of ongoing quality assessment and can improve the accuracy of breast cancer prognostic biomarkers.

  10. Oral biopsy: oral pathologist's perspective.

    PubMed

    Kumaraswamy, K L; Vidhya, M; Rao, Prasanna Kumar; Mukunda, Archana

    2012-01-01

    Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  11. Comparative Judgement for Assessment

    ERIC Educational Resources Information Center

    Pollitt, Alastair

    2012-01-01

    Historically speaking, students were judged long before they were marked. The tradition of marking, or scoring, pieces of work students offer for assessment is little more than two centuries old, and was introduced mainly to cope with specific problems arising from the growth in the numbers graduating from universities as the industrial revolution…

  12. Comparative Judgement for Assessment

    ERIC Educational Resources Information Center

    Pollitt, Alastair

    2012-01-01

    Historically speaking, students were judged long before they were marked. The tradition of marking, or scoring, pieces of work students offer for assessment is little more than two centuries old, and was introduced mainly to cope with specific problems arising from the growth in the numbers graduating from universities as the industrial revolution…

  13. Cytokeratin immunohistochemistry improves interobserver variability between unskilled pathologists in the evaluation of tumor budding in T1 colorectal cancer.

    PubMed

    Kai, Keita; Aishima, Shinichi; Aoki, Shigehisa; Takase, Yukari; Uchihashi, Kazuyoshi; Masuda, Masanori; Nishijima-Matsunobu, Aki; Yamamoto, Mihoko; Ide, Kousuke; Nakayama, Atsushi; Yamasaki, Makiko; Toda, Shuji

    2016-02-01

    Tumor budding is a major risk factor for T1 colorectal cancer. Quality control of the pathological diagnosis of budding is crucial, irrespective of the pathologist's experience. This study examines the interobserver variability according to pathologists' experience and evaluates the influence of cytokeratin (CK) immunostaining in the assessment of budding. Hematoxylin-eosin (HE) and CK-immunostained slides of 40 cases with T1 primary colorectal cancer were examined. Budding grades were individually evaluated by 12 pathologists who we categorized into three groups by their experience (expert, with >10 years of experience (n = 4), senior, with 5-10 years (n = 4), and junior, < 5 years (n = 4)). The results revealed a tendency for the more experienced pathologists to assign higher budding grades compared to the less-experienced pathologists. In the junior group, the interobserver variability obtained with HE slides was poor, but it was markedly improved in the evaluation using CK-immunostained slides. The benefit of CK immunostaining was only slight in the expert group. CK immunostaining would be useful when a pathologist is not experienced enough or does not have enough confidence in the assessment of budding. © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  14. The role of the speech-language pathologist in home care.

    PubMed

    Giles, Melanie; Barker, Mary; Hayes, Amanda

    2014-06-01

    Speech language pathologists play an important role in the care of patients with speech, language, or swallowing difficulties that can result from a variety of medical conditions. This article describes how speech language pathologists assess and treat these conditions and the red flags that suggest a referral to a speech language pathologist is indicated.

  15. Factors Influencing School-Based Speech and Language Pathologists in the Selection of Communication Assessments for Students with Autism Spectrum Disorders: Why We Do What We Do

    ERIC Educational Resources Information Center

    Schwartz, Lorna T.

    2010-01-01

    Speech and language pathologists (SLPs) are collaborators in a diagnostic process that reflects an increasing number of referrals of children with autism spectrums disorders (ASD). Also, current practices leading to the remediation of speech and language disorders have come under scrutiny for limitations in effective carryover of targeted goals…

  16. Factors Influencing School-Based Speech and Language Pathologists in the Selection of Communication Assessments for Students with Autism Spectrum Disorders: Why We Do What We Do

    ERIC Educational Resources Information Center

    Schwartz, Lorna T.

    2010-01-01

    Speech and language pathologists (SLPs) are collaborators in a diagnostic process that reflects an increasing number of referrals of children with autism spectrums disorders (ASD). Also, current practices leading to the remediation of speech and language disorders have come under scrutiny for limitations in effective carryover of targeted goals…

  17. Breast imaging for interventional pathologists.

    PubMed

    Lieu, David

    2013-01-01

    Pathologist-performed, ultrasound-guided fine-needle aspiration biopsy is one of the frontiers of pathology. The College of American Pathologists, American Society for Clinical Pathology, and American Society of Cytopathology offer courses and certificate programs for pathologists in this area. The courses emphasize the biopsy of masses in the thyroid and head and neck. There is little training in ultrasound-guided biopsy of breast masses. To successfully perform an imaging-guided biopsy of the breast, pathologists should understand the basics of mammography and breast ultrasound. To review the basics of mammography and breast ultrasound to help interventional pathologists add ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast to their list of core competencies. Classic and recent literature and textbooks on mammography and breast ultrasound. The heart of early breast cancer detection is the screening mammogram. Abnormalities detected on screening, such as masses, densities, architectural distortions, nipple retraction, skin thickening, abnormal lymph nodes, and microcalcifications, will lead to a diagnostic mammogram and/or breast ultrasound. Lesions classified as Breast Imaging Reporting and Data System 4 or 5, and a few classified as 3 lesions, require biopsy. If the lesion is visible on ultrasound, ultrasound-guided fine-needle aspiration biopsy and/or core-needle biopsy is the procedure of choice. Suspicious lesions visible only on mammogram require stereotactic x-ray-guided biopsy. Interventional pathologists who understand the values and limitations of mammography and breast ultrasound are ready for the challenges of pathologist-performed, ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast.

  18. What impact has the introduction of a synoptic report for rectal cancer had on reporting outcomes for specialist gastrointestinal and nongastrointestinal pathologists?

    PubMed

    Messenger, David E; McLeod, Robin S; Kirsch, Richard

    2011-11-01

    Synoptic pathology reports increase the completeness of reporting for colorectal cancer. Despite the perceived superiority of specialist reporting, service demands dictate that general pathologists report colorectal cancer specimens in many centers. To determine differences in the completeness of rectal cancer reporting between specialist gastrointestinal and nongastrointestinal pathologists in both the narrative and synoptic formats. Pathology reports from rectal cancer resections performed between 1997 and 2008 were reviewed. A standardized, synoptic report was formally introduced in 2001. Reports were assessed for completeness according to 10 mandatory elements from the College of American Pathologists checklist. Overall, synoptic reports (n  =  315) were more complete than narrative reports (n  =  183) for TNM stage, distance to the circumferential radial margin, tumor grade, lymphovascular invasion, extramural venous invasion, perineural invasion, and regional deposits (all P < .01). Compared with those by nonspecialist pathologists, narrative reports by gastrointestinal pathologists were more complete for lymphovascular invasion (59.3% versus 35.9%, P  =  .02) and extramural venous invasion (70.4% versus 35.9%, P  =  .001), but there was no difference in completeness once a synoptic report was adopted. Gastrointestinal pathologists tended to report the presence of extramural venous invasion more frequently in both the narrative (18.5% versus 5.1%, P  =  .01) and synoptic formats (25.5% versus 14.6%, P  =  .02). Completeness of reporting, irrespective of subspecialist interest, was dramatically increased by the use of a synoptic report. Improvements in completeness were most pronounced among nongastrointestinal pathologists, enabling them to attain a level of report completeness comparable to that of gastrointestinal pathologists. Further studies are required to determine whether there are actual discrepancies in the detection of

  19. Diagnostic Reproducibility: What Happens When the Same Pathologist Interprets the Same Breast Biopsy Specimen at Two Points in Time?

    PubMed

    Jackson, Sara L; Frederick, Paul D; Pepe, Margaret S; Nelson, Heidi D; Weaver, Donald L; Allison, Kimberly H; Carney, Patricia A; Geller, Berta M; Tosteson, Anna N A; Onega, Tracy; Elmore, Joann G

    2017-05-01

    Surgeons may receive a different diagnosis when a breast biopsy is interpreted by a second pathologist. The extent to which diagnostic agreement by the same pathologist varies at two time points is unknown. Pathologists from eight U.S. states independently interpreted 60 breast specimens, one glass slide per case, on two occasions separated by ≥9 months. Reproducibility was assessed by comparing interpretations between the two time points; associations between reproducibility (intraobserver agreement rates); and characteristics of pathologists and cases were determined and also compared with interobserver agreement of baseline interpretations. Sixty-five percent of invited, responding pathologists were eligible and consented; 49 interpreted glass slides in both study phases, resulting in 2940 interpretations. Intraobserver agreement rates between the two phases were 92% [95% confidence interval (CI) 88-95] for invasive breast cancer, 84% (95% CI 81-87) for ductal carcinoma-in-situ, 53% (95% CI 47-59) for atypia, and 84% (95% CI 81-86) for benign without atypia. When comparing all study participants' case interpretations at baseline, interobserver agreement rates were 89% (95% CI 84-92) for invasive cancer, 79% (95% CI 76-81) for ductal carcinoma-in-situ, 43% (95% CI 41-45) for atypia, and 77% (95% CI 74-79) for benign without atypia. Interpretive agreement between two time points by the same individual pathologist was low for atypia and was similar to observed rates of agreement for atypia between different pathologists. Physicians and patients should be aware of the diagnostic challenges associated with a breast biopsy diagnosis of atypia when considering treatment and surveillance decisions.

  20. Poor agreement between endoscopists and gastrointestinal pathologists for the interpretation of probe-based confocal laser endomicroscopy findings

    PubMed Central

    Peter, Shajan; Council, Leona; Bang, Ji Young; Neumann, Helmut; Mönkemüller, Klaus; Varadarajulu, Shyam; Wilcox, Charles Melbern

    2014-01-01

    AIM: To compare the interpretation of probe-based confocal laser endomicroscopy (pCLE) findings between endoscopists and gastrointestinal (GI)-pathologists. METHODS: All pCLE procedures were undertaken and the endoscopist rendered assessment. The same pCLE videos were then viewed offline by an expert GI pathologist. Histopathology was considered the gold standard for definitive diagnosis. The sensitivity, specificity and accuracy for diagnosis of dysplastic/ neoplastic GI lesions and interobserver agreement between endoscopists and experienced gastrointestinal pathologist for pCLE findings were analyzed. RESULTS: Of the 66 included patients, 40 (60.6%) had lesions in the esophagus, 7 (10.6%) in the stomach, 15 (22.7%) in the biliary tract, 3 (4.5%) in the ampulla and 1 (1.5%) in the colon. The overall sensitivity, specificity and accuracy for diagnosing dysplastic/neoplastic lesions using pCLE were higher for endoscopists than pathologist at 87.0% vs 69.6%, 80.0% vs 40.0% and 84.8% vs 60.6% (P = 0.0003), respectively. Area under the ROC curve (AUC) was greater for endoscopists than the pathologist (0.83 vs 0.55, P = 0.0001). Overall agreement between endoscopists and pathologist was moderate for all GI lesions (K = 0.43; 95%CI: 0.26-0.61), luminal lesions (K = 0.40; 95%CI: 0.20-0.60) and those of dysplastic/neoplastic pathology (K = 0.55; 95%CI: 0.37-0.72), the agreement was poor for benign (K = 0.13; 95%CI: -0.097-0.36) and pancreaticobiliary lesions (K = 0.19; 95%CI: -0.26-0.63). CONCLUSION: There is a wide discrepancy in the interpretation of pCLE findings between endoscopists and pathologist, particularly for benign and malignant pancreaticobiliary lesions. Further studies are needed to identify the cause of this poor agreement. PMID:25548499

  1. Venous invasion in colorectal cancer: impact of an elastin stain on detection and interobserver agreement among gastrointestinal and nongastrointestinal pathologists.

    PubMed

    Kirsch, Richard; Messenger, David E; Riddell, Robert H; Pollett, Aaron; Cook, Megan; Al-Haddad, Sahar; Streutker, Catherine J; Divaris, Dimitrios X; Pandit, Rajani; Newell, Ken J; Liu, Jimin; Price, Russell G; Smith, Sharyn; Parfitt, Jeremy R; Driman, David K

    2013-02-01

    Venous invasion (VI) is an independent prognostic indicator in colorectal cancer and may prompt consideration for adjuvant chemotherapy in patients with stage II tumors. Recent evidence suggests that VI is underreported in colorectal cancer and that detection may be enhanced by an elastin stain. This study aimed (1) to determine the impact of an elastin stain on VI detection and on interobserver agreement between gastrointestinal (GI) and non-GI pathologists, and (2) to identify factors associated with increased VI detection. Forty hematoxylin and eosin (H&E)-stained slides were circulated to 6 GI and 6 non-GI pathologists who independently assessed the VI status as positive, negative, or equivocal. Six weeks later, 40 corresponding Movat-stained slides were recirculated together with the original H&E slides and reassessed for VI status. Detection of VI was >2-fold higher with a Movat stain compared with an H&E stain alone (46.4% vs. 19.6%, P=0.001). GI pathologists detected VI more frequently than non-GI pathologists on both H&E (30.0% vs. 9.2%, P=0.029) and Movat (58.3% vs. 34.6%, P=0.018) stains. There was higher interobserver agreement in the case of a Movat stain, particularly for extramural VI (H&E: κ=0.23 vs. Movat: κ=0.41). A poststudy survey indicated that GI pathologists and non-GI pathologists applied similar diagnostic criteria but that GI pathologists more frequently applied "orphan arteriole" and "protruding tongue" signs as diagnostic clues to VI. This study confirms that VI is underdetected on H&E and highlights the role of elastin staining in improving VI detection and interobserver agreement. Strategies to improve VI detection are warranted.

  2. Fluorescence confocal microscopy for pathologists.

    PubMed

    Ragazzi, Moira; Piana, Simonetta; Longo, Caterina; Castagnetti, Fabio; Foroni, Monica; Ferrari, Guglielmo; Gardini, Giorgio; Pellacani, Giovanni

    2014-03-01

    Confocal microscopy is a non-invasive method of optical imaging that may provide microscopic images of untreated tissue that correspond almost perfectly to hematoxylin- and eosin-stained slides. Nowadays, following two confocal imaging systems are available: (1) reflectance confocal microscopy, based on the natural differences in refractive indices of subcellular structures within the tissues; (2) fluorescence confocal microscopy, based on the use of fluorochromes, such as acridine orange, to increase the contrast epithelium-stroma. In clinical practice to date, confocal microscopy has been used with the goal of obviating the need for excision biopsies, thereby reducing the need for pathological examination. The aim of our study was to test fluorescence confocal microscopy on different types of surgical specimens, specifically breast, lymph node, thyroid, and colon. The confocal images were correlated to the corresponding histological sections in order to provide a morphologic parallel and to highlight current limitations and possible applications of this technology for surgical pathology practice. As a result, neoplastic tissues were easily distinguishable from normal structures and reactive processes such as fibrosis; the use of fluorescence enhanced contrast and image quality in confocal microscopy without compromising final histologic evaluation. Finally, the fluorescence confocal microscopy images of the adipose tissue were as accurate as those of conventional histology and were devoid of the frozen-section-related artefacts that can compromise intraoperative evaluation. Despite some limitations mainly related to black/white images, which require training in imaging interpretation, this study confirms that fluorescence confocal microscopy may represent an alternative to frozen sections in the assessment of margin status in selected settings or when the conservation of the specimen is crucial. This is the first study to employ fluorescent confocal microscopy on

  3. Design of a Genomics Curriculum: Competencies for Practicing Pathologists.

    PubMed

    Laudadio, Jennifer; McNeal, Jeffrey L; Boyd, Scott D; Le, Long Phi; Lockwood, Christina; McCloskey, Cindy B; Sharma, Gaurav; Voelkerding, Karl V; Haspel, Richard L

    2015-07-01

    The field of genomics is rapidly impacting medical care across specialties. To help guide test utilization and interpretation, pathologists must be knowledgeable about genomic techniques and their clinical utility. The technology allowing timely generation of genomic data is relatively new to patient care and the clinical laboratory, and therefore, many currently practicing pathologists have been trained without any molecular or genomics exposure. Furthermore, the exposure that current and recent trainees receive in this field remains inconsistent. To assess pathologists' learning needs in genomics and to develop a curriculum to address these educational needs. A working group formed by the College of American Pathologists developed an initial list of genomics competencies (knowledge and skills statements) that a practicing pathologist needs to be successful. Experts in genomics were then surveyed to rate the importance of each competency. These data were used to create a final list of prioritized competencies. A subset of the working group defined subtopics and tasks for each competency. Appropriate delivery methods for the educational material were also proposed. A final list of 32 genomics competency statements was developed. A prioritized curriculum was created with designated subtopics and tasks associated with each competency. We present a genomics curriculum designed as a first step toward providing practicing pathologists with the competencies needed to practice successfully.

  4. Occupational health risks of pathologists - results from a nationwide online questionnaire in Switzerland

    PubMed Central

    2012-01-01

    Background Pathologists are highly trained medical professionals who play an essential part in the diagnosis and therapy planning of malignancies and inflammatory diseases. Their work is associated with potential health hazards including injuries involving infectious human tissue, chemicals which are assumed to be carcinogenic or long periods of microscope and computer work. This study aimed to provide the first comprehensive assessment of the health situation of pathologists in Switzerland. Methods Pathologists in Switzerland were contacted via the Swiss Society of Pathologists and asked to answer an ethically approved, online anonymous questionnaire comprising 48 questions on occupational health problems, workplace characteristics and health behaviour. Results 163 pathologists participated in the study. Forty percent of pathologists reported musculoskeletal problems in the previous month. The overall prevalence was 76%. Almost 90% of pathologists had visual refraction errors, mainly myopia. 83% of pathologists had experienced occupational injuries, mostly cutting injuries, in their professional career; more than one fifth of participants reported cutting injuries in the last year. However, long lasting injuries and infectious diseases were rare. Depression and burnout affected every eighth pathologist. The prevalence of smoking was substantially below that of the general Swiss population. Conclusions The results of this study suggest that more care should be taken in technical and personal protective measures, ergonomic workplace optimisation and reduction of work overload and work inefficiencies. Despite the described health risks, Swiss pathologists were optimistic about their future and their working situation. The high rate of ametropia and psychological problems warrants further study. PMID:23216705

  5. The pathologist's guide to fixatives.

    PubMed

    Qidwai, Kiran; Afkhami, Michelle; Day, Christina E

    2014-01-01

    Proper tissue fixation is essential to ensure the highest level of specimen evaluation. Pathologists and laboratory staff are frequently consulted by clinical counterparts regarding what fixative should be used for different tissues or to enable a diagnosis of a specific condition. It is vital for the patient that the pathologist provides accurate information to ensure proper fixation. Frequently, once a tissue has been fixed inadequately or inappropriately, remedial changes may no longer be possible. Most often formalin is an adequate choice, if not the optimal one; however, there are certain situations when placing the tissue in formalin may limit the ability to reach a definitive diagnosis. It is imperative for pathologists to have the knowledge to communicate which fixative is optimal. Furthermore, as we move into a world of personalized medicine, where ancillary testing has both diagnostic and specific therapeutic implications, knowledge about how different fixatives affect immunohistochemistry, cytogenetics, and molecular studies becomes even more significant. This chapter provides practical information regarding common fixatives, their mechanism of action and optimal uses.

  6. A model for predicting pathologist's velocity profiles when navigating virtual slides.

    PubMed

    Gómez, Francisco; Romero, Eduardo

    2010-02-01

    Navigation through large microscopic images is a potential benefit for histology or pathology teaching, for improving the quality of diagnosis in pathology, or for communicating pathologists in some telemedicine applications. However, the size of this kind of images is prohibitive for navigation with conventional techniques. This article presents a soft computing model, which permits to anticipate the pathologist trajectories in diagnosis tasks when exploring virtual slides. The Bayesian strategy combines an offline model of a baseline pathologist knowledge (the prior) and a prediction online module (the likelihood) that captures a particular pathologist navigation pattern. While optimal parameters for the biologically inspired offline model are calculated using an Expectation-Maximization strategy, prediction is carried out by a particle filter. Parameters are estimated from several series of actual navigations performed by several pathologists in different virtual slides. The present approach is compared with other conventional prediction methods and decreases the calculated MSE in about a 50% for the entire group of pathologists.

  7. Medical malpractice charges in Germany--role of the forensic pathologist in the preliminary criminal proceeding.

    PubMed

    Dettmeyer, Reinhard; Egl, Monika; Madea, Burkhard

    2005-03-01

    Medical malpractice charges from 1989 to 2002 were evaluated. A rising number of cases during this period is evident. The charges of practice falling below the standard of care (n = 285) were surveyed to determine who informed the prosecution, which clinical subjects are involved, what kind of charges can be found and whether such allegations can be appropriately assessed by means of a forensic autopsy. Forensic pathologists were found to be useful for ascertainment and interpretation of autopsy findings. If special questions arise, an additional expert opinion should be suggested by the forensic pathologist. There was no relevant shift in the range of subjects involved compared to former studies. The investigated charges might represent only a small fraction of cases of medical practice falling below the standard of care.

  8. Resourcing speech-language pathologists to work with multilingual children.

    PubMed

    McLeod, Sharynne

    2014-06-01

    Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website ( http://www.csu.edu.au/research/multilingual-speech ) addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international

  9. The Changing Role of Speech-Language Pathologists.

    ERIC Educational Resources Information Center

    Karr, Susan T.; And Others

    1996-01-01

    Once limited to correcting articulation and lisps, speech-language pathologists now work with students with wide-ranging disabilities and educational needs. Principals should support their efforts to help teachers integrate speech and language goals with students' academic objectives, conduct screening and diagnostic assessments, develop…

  10. A pathologist׳s perspective on the perinatal autopsy.

    PubMed

    Ernst, Linda M

    2015-02-01

    The perinatal autopsy is an important tool in the investigation of fetal and neonatal death, and a complete understanding of its risks and benefits is necessary for providers of perinatal care. This review, from the perspective of a perinatal pathologist, reports the details of the autopsy procedure, its goals, its value to individual patients and the health care system in general, and its alternatives. Even with new emerging technologies, the conventional perinatal autopsy remains the gold standard for determining the cause of death and the final summary of all pathologic findings. Therefore, the information provided in this review can help providers properly convey information about perinatal autopsy to bereaved families. Copyright © 2014. Published by Elsevier Inc.

  11. Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey.

    PubMed

    Ducatman, Barbara S; Parslow, Tristram

    2016-01-01

    The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center(®) (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity

  12. Regulatory Forum Opinion Piece*: Veterinary Pathologists in Translational Pharmacology and Biomarker Integration in Drug Discovery and Development.

    PubMed

    Ramaiah, Shashi K; Walker, Dana B

    2016-02-01

    This article highlights emerging roles for veterinary pathologists outside of traditional functions and in line with the translational research (TR) approach. Veterinary pathologists offer unique and valuable expertise toward addressing particular TR and associated translational pharmacology questions, identifying gaps and risks in biomarker and pathology strategies, and advancing TR team decision making. Veterinary pathologists' attributes that are integral to the TR approach include (i) well-developed understanding of comparative physiology, pathology, and disease; (ii) extensive experience in interpretation and integration of complex data sets on whole-body responses and utilizing this for deciphering pathogenesis and translating events between laboratory species and man; (iii) proficiency in recognizing differences in disease end points among individuals, animal species and strains, and assessing correlations between these differences and other investigative (including biomarker) findings; and (iv) strong background in a wide spectrum of research technologies that can address pathomechanistic questions and biomarker needs. Some of the more evident roles in which veterinary pathologists can offer their greatest contributions to address questions and strategies of TR and biomarker integration will be emphasized. © The Author(s) 2016.

  13. Influence of pathologist experience on positive surgical margins following radical prostatectomy.

    PubMed

    Tallman, Jacob E; Packiam, Vignesh T; Wroblewski, Kristen E; Paner, Gladell P; Eggener, Scott E

    2017-07-01

    A positive surgical margin (PSM) following radical prostatectomy (RP) for prostate cancer is associated with increased risk of biochemical recurrence. We sought to examine whether the pathologist is an independent predictor of PSMs. We performed a retrospective review of 3,557 men who underwent RP for localized prostate cancer at our institution from 2003 to 2015. We evaluated 29 separate pathologists. Univariate and multivariable logistic regression were used to test variables previously shown to influence PSM rates. Overall rate of PSM was 18.9%. Compared with patients without PSM, patients with PSM had higher body mass index (mean: 28.8 vs. 28.3), Gleason score≥7 (84% vs. 66%), extracapsular extension (51% vs. 20%), and median prostate-specific antigen (5.9 vs. 5.1ng/ml) (all P<0.05). Univariate logistic regression showed that surgeon experience, pathologist experience, and pathologist genitourinary fellowship training were all predictors of PSMs (all P<0.05). Multivariable regression analysis confirmed that decreased surgeon experience, increased pathologist experience, higher pathologic Gleason score, higher pathologic stage, and higher prostate-specific antigen were significant predictors of PSMs. Increasing surgeon experience was associated with decreased odds of PSM (odds ratio = 0.79 per 1 standard deviation increase, 95% CI [0.70-0.89]). In contrast, increasing pathologist experience was associated with increased odds of PSM (odds ratio = 1.11 per 1 standard deviation increase, 95% CI [1.03-1.19]). The relationship between pathologist experience and PSM appeared to be nonlinear (Fig. 2). Greater pathologist experience appears to be associated with greater odds of PSMs following radical prostatectomy, even after controlling for case mix, pathologist fellowship training, and surgeon experience. Based on these findings, pathologists with less experience reviewing RP specimens may consider requesting rereview by a dedicated genitourinary pathologist

  14. Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors.

    PubMed

    Hendry, Shona; Salgado, Roberto; Gevaert, Thomas; Russell, Prudence A; John, Tom; Thapa, Bibhusal; Christie, Michael; van de Vijver, Koen; Estrada, M V; Gonzalez-Ericsson, Paula I; Sanders, Melinda; Solomon, Benjamin; Solinas, Cinzia; Van den Eynden, Gert G G M; Allory, Yves; Preusser, Matthias; Hainfellner, Johannes; Pruneri, Giancarlo; Vingiani, Andrea; Demaria, Sandra; Symmans, Fraser; Nuciforo, Paolo; Comerma, Laura; Thompson, E A; Lakhani, Sunil; Kim, Seong-Rim; Schnitt, Stuart; Colpaert, Cecile; Sotiriou, Christos; Scherer, Stefan J; Ignatiadis, Michail; Badve, Sunil; Pierce, Robert H; Viale, Giuseppe; Sirtaine, Nicolas; Penault-Llorca, Frederique; Sugie, Tomohagu; Fineberg, Susan; Paik, Soonmyung; Srinivasan, Ashok; Richardson, Andrea; Wang, Yihong; Chmielik, Ewa; Brock, Jane; Johnson, Douglas B; Balko, Justin; Wienert, Stephan; Bossuyt, Veerle; Michiels, Stefan; Ternes, Nils; Burchardi, Nicole; Luen, Stephen J; Savas, Peter; Klauschen, Frederick; Watson, Peter H; Nelson, Brad H; Criscitiello, Carmen; O'Toole, Sandra; Larsimont, Denis; de Wind, Roland; Curigliano, Giuseppe; André, Fabrice; Lacroix-Triki, Magali; van de Vijver, Mark; Rojo, Federico; Floris, Giuseppe; Bedri, Shahinaz; Sparano, Joseph; Rimm, David; Nielsen, Torsten; Kos, Zuzana; Hewitt, Stephen; Singh, Baljit; Farshid, Gelareh; Loibl, Sibylle; Allison, Kimberly H; Tung, Nadine; Adams, Sylvia; Willard-Gallo, Karen; Horlings, Hugo M; Gandhi, Leena; Moreira, Andre; Hirsch, Fred; Dieci, Maria V; Urbanowicz, Maria; Brcic, Iva; Korski, Konstanty; Gaire, Fabien; Koeppen, Hartmut; Lo, Amy; Giltnane, Jennifer; Rebelatto, Marlon C; Steele, Keith E; Zha, Jiping; Emancipator, Kenneth; Juco, Jonathan W; Denkert, Carsten; Reis-Filho, Jorge; Loi, Sherene; Fox, Stephen B

    2017-08-02

    Assessment of the immune response to tumors is growing in importance as the prognostic implications of this response are increasingly recognized, and as immunotherapies are evaluated and implemented in different tumor types. However, many different approaches can be used to assess and describe the immune response, which limits efforts at implementation as a routine clinical biomarker. In part 1 of this review, we have proposed a standardized methodology to assess tumor-infiltrating lymphocytes (TILs) in solid tumors, based on the International Immuno-Oncology Biomarkers Working Group guidelines for invasive breast carcinoma. In part 2 of this review, we discuss the available evidence for the prognostic and predictive value of TILs in common solid tumors, including carcinomas of the lung, gastrointestinal tract, genitourinary system, gynecologic system, and head and neck, as well as primary brain tumors, mesothelioma and melanoma. The particularities and different emphases in TIL assessment in different tumor types are discussed. The standardized methodology we propose can be adapted to different tumor types and may be used as a standard against which other approaches can be compared. Standardization of TIL assessment will help clinicians, researchers and pathologists to conclusively evaluate the utility of this simple biomarker in the current era of immunotherapy.

  15. Veterinary clinical pathologists in the biopharmaceutical industry.

    PubMed

    Schultze, A Eric; Bounous, Denise I; Bolliger, Anne Provencher

    2008-06-01

    There is an international shortage of veterinary clinical pathologists in the workplace. Current trainees in veterinary clinical pathology may choose to pursue careers in academe, diagnostic laboratories, government health services, biopharmaceutical companies, or private practice. Academic training programs attempt to provide trainees with an exposure to several career choices. However, due to the proprietary nature of much of the work in the biopharmaceutical industry, trainees may not be fully informed regarding the nature of work for veterinary clinical pathologists and the myriad opportunities that await employment in the biopharmaceutical industry. The goals of this report are to provide trainees in veterinary clinical pathology and other laboratory personnel with an overview of the work-life of veterinary clinical pathologists employed in the biopharmaceutical industry, and to raise the profile of this career choice for those seeking to enter the workforce. Biographical sketches, job descriptions, and motivation for 3 successful veterinary clinical pathologists employed in the biopharmaceutical industry are provided. Current and past statistics for veterinary clinical pathologists employed in the biopharmaceutical industry are reviewed. An overview of the drug development process and involvement of veterinary clinical pathologists in the areas of discovery, lead optimization, and candidate evaluation are discussed. Additional duties for veterinary clinical pathologists employed in the biopharmaceutical industry include development of biomarkers and new technologies, service as scientific resources, diagnostic support services, and laboratory management responsibilities. There are numerous opportunities available for trainees in veterinary clinical pathology to pursue employment in the biopharmaceutical industry and enjoy challenging and rewarding careers.

  16. Activity-based differentiation of pathologists' workload in surgical pathology.

    PubMed

    Meijer, G A; Oudejans, J J; Koevoets, J J M; Meijer, C J L M

    2009-06-01

    Adequate budget control in pathology practice requires accurate allocation of resources. Any changes in types and numbers of specimens handled or protocols used will directly affect the pathologists' workload and consequently the allocation of resources. The aim of the present study was to develop a model for measuring the pathologists' workload that can take into account the changes mentioned above. The diagnostic process was analyzed and broken up into separate activities. The time needed to perform these activities was measured. Based on linear regression analysis, for each activity, the time needed was calculated as a function of the number of slides or blocks involved. The total pathologists' time required for a range of specimens was calculated based on standard protocols and validated by comparing to actually measured workload. Cutting up, microscopic procedures and dictating turned out to be highly correlated to number of blocks and/or slides per specimen. Calculated workload per type of specimen was significantly correlated to the actually measured workload. Modeling pathologists' workload based on formulas that calculate workload per type of specimen as a function of the number of blocks and slides provides a basis for a comprehensive, yet flexible, activity-based costing system for pathology.

  17. Interobserver variability between expert urologic pathologists for extraprostatic extension and surgical margin status in radical prostatectomy specimens.

    PubMed

    Evans, Andrew J; Henry, Pauline C; Van der Kwast, Theodorus H; Tkachuk, Douglas C; Watson, Kemp; Lockwood, Gina A; Fleshner, Neil E; Cheung, Carol; Belanger, Eric C; Amin, Mahul B; Boccon-Gibod, Liliane; Bostwick, David G; Egevad, Lars; Epstein, Jonathan I; Grignon, David J; Jones, Edward C; Montironi, Rodolfo; Moussa, Madeleine; Sweet, Joan M; Trpkov, Kiril; Wheeler, Thomas M; Srigley, John R

    2008-10-01

    Accurate Gleason score, pathologic stage, and surgical margin (SM) information is critical for the planning of post-radical prostatectomy management in patients with prostate cancer. Although interobserver variability for Gleason score among urologic pathologists has been well documented, such data for pathologic stage and SM assessment are limited. We report the first study to address interobserver variability in a group of expert pathologists concerning extraprostatic soft tissue (EPE) and SM interpretation for radical prostatectomy specimens. A panel of 3 urologic pathologists selected 6 groups of 10 slides designated as being positive, negative, or equivocal for either EPE or SM based on unanimous agreement. Twelve expert urologic pathologists, who were blinded to the panel diagnoses, reviewed 40x whole-slide scans and provided diagnoses for EPE and SM on each slide. On the basis of panel diagnoses, as the gold standard, specificity, sensitivity, and accuracy values were high for both EPE (87.5%, 95.0%, and 91.2%) and SM (97.5%, 83.3%, and 90.4%). Overall kappa values for all 60 slides were 0.74 for SM and 0.63 for EPE. The kappa values were higher for slides with definitive gold standard EPE (kappa=0.81) and SM (kappa=0.73) diagnoses when compared with the EPE (kappa=0.29) and SM (kappa=0.62) equivocal slides. This difference was markedly pronounced for EPE. Urologic pathologists show good to excellent agreement when evaluating EPE and SM. Interobserver variability for EPE and SM interpretation was principally related to the lack of a clearly definable prostatic capsule and crush/thermal artifact along the edge of the gland, respectively.

  18. Comparative energy storage assessment item

    NASA Technical Reports Server (NTRS)

    Giudici, B.

    1984-01-01

    This analysis, a Space Station application study, rediscovered Integrated Power and Attitude Control (IPAC) and found the approach to have lower initial and resupply weight and lower initial and resupply cost than either battery/CMG or regenerative fuel cell/CMG systems. Preliminary trade studies were performed comparing (IPAC) with equivalent independent electrochemical power and control moment gyro (CMG) control approaches. Technologies considered to have adequate status for an initial Space Station were: (1) nickel cadmium batteries (NiCd batteries), (2) regenerative fuel cells (RFC), (3) Skylab class CMG's, and (4) state of the art IPAC using metal wheels and ball bearing suspension (SOA-IPAC). An advanced IPAC (ADV-IPAC) employing composite rotor material and magnetic suspension was included in the comparisons to illustrate a possible range of performance and cost of inertial systems. The candidates were compared on the basis of initial weight and cost and on the basis of resupply weight and cost for a 15 year mission. Thus, SOA-IPAC would appear to be an attractive approach for the initial Space Station and possible technology improvements would further the appeal for the initial and/or growth Space Station.

  19. A qualitative study comparing the assay performance characteristics between the 2007 and the 2013 American Society for Clinical Oncology and College of American Pathologists HER2 scoring methods in mucinous epithelial ovarian cancer.

    PubMed

    Chen, Chi-Kuan; Lee, Ming-Yung; Lin, Wea-Lung; Wang, Yu-Ting; Han, Chih-Ping; Yu, Cheng-Ping; Chao, Wan-Ru

    2014-12-01

    The remarkable success of trastuzumab and other newly developed anti-HER2 (human epidermal growth factor receptor 2) therapies in breast, gastric, or gastroesophageal junction cancer patients has supported us to investigate the HER2 status and its possible therapeutic implication in mucinous epithelial ovarian cancer (EOC). However, there is currently no standardization of HER2 scoring criteria in mucinous EOC. In this study, we aimed to compare both the assay performance characteristics of the 2007 and the 2013 American Society for Clinical Oncology and College of American Pathologists scoring methods. Forty-nine tissue microarray samples of mucinous EOC from Asian women were analyzed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) tests using the 2007 and the 2013 criteria, respectively. The overall concordance between IHC and FISH by the 2007 criteria was 97.92 % (kappa = 0.921), and that by the 2013 criteria was 100% (kappa = 1.000). The percentage of Her2 FISH-amplified cases showed an increasing trend significantly through their corresponding HER2 IHC ordinals by the 2007 and the 2013 criteria, respectively (P < 0.001, P < 0.001). After excluding equivocal cases, the specificity (100%) and positive predictive value (100%) were unchanged under either the 2007 or the 2013 criteria. The sensitivity (100%), negative predictive value (NPV) (100%), and accuracy (100%) of HER2 IHC were higher under the 2013 criteria than those (sensitivity 87.5%, NPV 97.6%, and accuracy 97.9%) under the 2007 criteria. Of the total 49 cases, the number (n = 4) of HER2 IHC equivocal results under the 2013 criteria was 4-fold higher than that (n = 1) under the 2007 criteria (8.16% vs 2.04%). Conclusively, if first tested by IHC, the 2013 criteria caused more equivocal HER2 IHC cases to be referred to Her2 FISH testing than the 2007 criteria. That decreased the false-negative rate of HER2 status and increased the detection rates of HER2 positivity in mucinous

  20. Twenty-First Century Pathologists' Advocacy.

    PubMed

    Allen, Timothy Craig

    2017-07-01

    Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are 2 of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.

  1. A web-based pilot study of inter-pathologist reproducibility using the ISHLT 2004 working formulation for biopsy diagnosis of cardiac allograft rejection: the European experience.

    PubMed

    Angelini, Annalisa; Andersen, Claus Boegelund; Bartoloni, Giovanni; Black, Fiona; Bishop, Paul; Doran, Helen; Fedrigo, Marny; Fries, Jochen W U; Goddard, Martin; Goebel, Heike; Neil, Desley; Leone, Ornella; Marzullo, Andrea; Ortmann, Monika; Paraf, Francois; Rotman, Samuel; Turhan, Nesrin; Bruneval, Patrick; Frigo, Anna Chiara; Grigoletto, Francesco; Gasparetto, Alessio; Mencarelli, Roberto; Thiene, Gaetano; Burke, Margaret

    2011-11-01

    The aim of this study was to assess, at the European level and using digital technology, the inter-pathologist reproducibility of the ISHLT 2004 system and to compare it with the 1990 system We also assessed the reproducibility of the morphologic criteria for diagnosis of antibody-mediated rejection detailed in the 2004 grading system. The hematoxylin-eosin-stained sections of 20 sets of endomyocardial biopsies were pre-selected and graded by two pathologists (A.A. and M.B.) and digitized using a telepathology digital pathology system (Aperio ImageScope System; for details refer to http://aperio.com/). Their diagnoses were considered the index diagnoses, which covered all grades of acute cellular rejection (ACR), early ischemic lesions, Quilty lesions, late ischemic lesions and (in the 2005 system) antibody-mediated rejection (AMR). Eighteen pathologists from 16 heart transplant centers in 7 European countries participated in the study. Inter-observer reproducibility was assessed using Fleiss's kappa and Krippendorff's alpha statistics. The combined kappa value of all grades diagnosed by all 18 pathologists was 0.31 for the 1990 grading system and 0.39 for the 2005 grading system, with alpha statistics at 0.57 and 0.55, respectively. Kappa values by grade for 1990/2005, respectively, were: 0 = 0.52/0.51; 1A/1R = 0.24/0.36; 1B = 0.15; 2 = 0.13; 3A/2R = 0.29/0.29; 3B/3R = 0.13/0.23; and 4 = 0.18. For the 2 cases of AMR, 6 of 18 pathologists correctly suspected AMR on the hematoxylin-eosin slides, whereas, in each of 17 of the 18 AMR-negative cases a small percentage of pathologists (range 5% to 33%) overinterpreted the findings as suggestive for AMR. Reproducibility studies of cardiac biopsies by pathologists in different centers at the international level were feasible using digitized slides rather than conventional histology glass slides. There was a small improvement in interobserver agreement between pathologists of different European centers when moving from the

  2. Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply.

    PubMed

    Robboy, Stanley J; Weintraub, Sally; Horvath, Andrew E; Jensen, Bradden W; Alexander, C Bruce; Fody, Edward P; Crawford, James M; Clark, Jimmy R; Cantor-Weinberg, Julie; Joshi, Megha G; Cohen, Michael B; Prystowsky, Michael B; Bean, Sarah M; Gupta, Saurabh; Powell, Suzanne Z; Speights, V O; Gross, David J; Black-Schaffer, W Stephen

    2013-12-01

    Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of changing market forces and emerging technologies on the supply of pathologists' services through 2030. Data came from various sources, including the literature, College of American Pathologists' internal data, and primary research through custom-developed surveys for the membership and for pathology practice managers Through 2010, there were approximately 18 000 actively practicing pathologists in the United States (5.7 per 100 000 population), approximately 93% of whom were board certified. Our model projects that the absolute and per capita numbers of practicing pathologists will decrease to approximately 14 000 full-time equivalent (FTE) pathologists or 3.7 per 100 000 in the coming 2 decades. This projection reflects that beginning in 2015, the numbers of pathologists retiring will increase precipitously, and is anticipated to peak by 2021. Including all types of separation, the net pathologist strength will begin falling by year 2015. Unless workforce entry or exit rates change, this trend will continue at least through 2030. These changes reflect the closure of many training programs 2 to 4 decades ago and the substantially decreased number of graduating residents. This comprehensive analysis predicts that pathologist numbers will decline steadily beginning in 2015. Anticipated population growth in general and increases in disease incidence owing to the aging population, to be presented in a companion article on demand, will lead to a net deficit in excess of more than 5700 FTE pathologists. To reach the projected need in pathologist numbers of nearly 20 000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions. We believe a pathologist shortage will negatively impact both

  3. Microwave processing: A boon for oral pathologists

    PubMed Central

    Kango, Prasad G; Deshmukh, RS

    2011-01-01

    Background: Research in oral and maxillofacial pathology has unlimited potential. We use every technology available to us for better and faster reliable diagnosis. But in most institutions, private laboratories and multispecialty hospitals, tissue processing takes considerable time, and therefore delays the diagnosis, which is required in urgent cases. We, in this institution, conducted a study to hasten the processing by using a simple kitchen microwave. Aim: To analyze tissue sections processed by microwave as compared to the gold standard of conventional processing. Settings and design: Studies published from 1970 till 2008, used body tissues such as brain, liver, kidney, heart, and lungs, for microwave processing. Oral tissues were not processed in microwave till now, except one study by Dr Shivaparthasundaram et al., in 2008. This is the second such study that used a sample size of 50 cases. Materials and Methods: A kitchen microwave was used for irradiation of the tissues. Conventional processing was carried out as per departmental protocol. A total of 50 microwave-coded slides were mixed with 50 conventional slides. All 100 slides were evaluated by four different pathologists. Statistical analysis: The result was subjected to statistical analysis using Chi-square test. Result and Conclusion: It was found that to make a diagnosis, microwave-processed tissue were at par with the conventional technique. Thus, it is time to move on from conventional processing to microwave processing to yield faster and reliable results. PMID:21731271

  4. Assessing the New American Society of Clinical Oncology/College of American Pathologists Guidelines for HER2 Testing by Fluorescence In Situ Hybridization: Experience of an Academic Consultation Practice.

    PubMed

    Press, Michael F; Villalobos, Ivonne; Santiago, Angela; Guzman, Roberta; Cervantes, Monica; Gasparyan, Armen; Campeau, Anaamika; Ma, Yanling; Tsao-Wei, Denice D; Groshen, Susan

    2016-04-15

    Context .- Evaluation of HER2 gene amplification by fluorescence in situ hybridization (FISH) was changed by recent American Society of Clinical Oncology/College of American Pathologists (ASCO-CAP) guidelines. Objective . -To determine frequencies and assess patterns of HER2 protein expression for each ASCO-CAP guideline FISH category among 7526 breast cancers accrued to our consultation practice. Design .- We retrospectively reevaluated the HER2 FISH status of breast cancers in our consultation practice according to ASCO-CAP FISH guidelines, and documented HER2 protein levels in each category. Results . -According to new guidelines, 17.7% of our consultation breast cancers were "ISH-positive" with HER2:CEP17 FISH ratios ≥2.0 and average HER2 gene copies per cell ≥4.0 (group 1); 0.4% were "ISH-positive" with ratios ≥2.0 and average copies <4.0 (group 2); 0.6% were "ISH-positive" with ratios <2.0 and average copies ≥6.0 (group 3); 4.6% were "ISH-equivocal" with ratios <2.0 and average copies ≥4.0 and <6.0 (group 4); and 76.7% were "ISH-negative" with ratios <2.0 and average copies <4.0 (group 5). However, only groups 1 (HER2 amplified) and 5 (HER2 not amplified) agreed with our previously reported status, and only these groups demonstrated the expected immunohistochemistry status, overexpression and low expression, respectively. Groups 2 and 4 breast cancers lacked overexpression, whereas group 3 was not significantly associated with either increased or decreased HER2 expression. Conclusions .- Although the status of approximately 95% of our cases (groups 1 and 5) is not affected by the new guidelines, those of the other 5% (groups 2-4) conflict with previous HER2 gene amplification status and with HER2 status by immunohistochemistry.

  5. PD-L1 immunohistochemistry in clinical diagnostics of lung cancer: inter-pathologist variability is higher than assay variability.

    PubMed

    Brunnström, Hans; Johansson, Anna; Westbom-Fremer, Sofia; Backman, Max; Djureinovic, Dijana; Patthey, Annika; Isaksson-Mettävainio, Martin; Gulyas, Miklos; Micke, Patrick

    2017-06-30

    Assessment of programmed cell death ligand 1 (PD-L1) immunohistochemical staining is used for decision on treatment with programmed cell death 1 and PD-L1 checkpoint inhibitors in lung adenocarcinomas and squamous cell carcinomas. This study aimed to compare the staining properties of tumor cells between the antibody clones 28-8, 22C3, SP142, and SP263 and investigate interrater variation between pathologists to see if these stainings can be safely evaluated in the clinical setting. Using consecutive sections from a tissue microarray with tumor tissue from 55 resected lung cancer cases, staining with five PD-L1 assays (28-8 from two different vendors, 22C3, SP142, and SP263) was performed. Seven pathologists individually evaluated the percentage of positive tumor cells, scoring each sample applying cutoff levels used in clinical studies: <1% positive tumor cells (score 0), 1-4% (score 1), 5-9% (score 2), 10-24% (score 3), 25-49% (score 4), and >50% positive tumor cells (score 5). Pairwise analysis of antibody clones showed weighted kappa values in the range of 0.45-0.91 with the highest values for comparisons with 22C3 and 28-8 and the lowest involving SP142. Excluding SP142 resulted in kappa 0.75-0.91. Weighted kappa for interobserver variation between pathologists was 0.71-0.96. Up to 20% of the cases were differently classified as positive or negative by any pathologist compared with consensus score using ≥1% positive tumor cells as cutoff. A significantly better agreement between pathologists was seen using ≥50% as cutoff (0-5% of cases). In conclusion, the concordance between the PD-L1 antibodies 22C3, 28-8 and SP263 is relatively good when evaluating lung cancers and suggests that any one of these assays may be sufficient as basis for decision on treatment with nivolumab, pembrolizumab, and durvalumab. The scoring of the pathologist presents an intrinsic source of error that should be considered especially at low PD-L1 scores.Modern Pathology advance

  6. Team acceptance of specific recommendations for the treatment of VPI as provided by speech pathologists.

    PubMed

    Dixon-Wood, V L; Williams, W N; Seagle, M B

    1991-07-01

    This retrospective study describes the frequency of one team's acceptance of speech pathologists' recommendations for specific secondary treatment procedures for the correction of VPI for 100 consecutive patients. In addition, assessment was made of the level of success in eliminating VPI relative to treatments utilized that were recommended by speech pathologists versus level of success when treatment other than that recommended by speech pathologists were used. For the 78 patients who received the treatment procedure recommended by speech pathologists, only 10 percent continued to demonstrate any clinically significant residual speech problem associated with VPI. However, for the 22 patients who received treatment other than that which had been recommended, 32 percent continued to demonstrate clinically significant speech problems associated with VPI. Data is presented on the success rate for correcting VPI relative to specific treatment recommendations including pharyngeal flap, palatal pushback, pharyngeal wall implant, tonsillectomy, prosthetic palatal lifts, and speech therapy.

  7. Hate crimes and the forensic pathologist.

    PubMed

    Prahlow, Joseph A

    2007-12-01

    Hate crimes represent crimes committed against an individual or group on the basis of their race, ethnicity, national origin, religion, sexual orientation, gender, gender identity, or disability. For the forensic pathologist, a death related to a hate crime should be considered a high-profile case, one in which the pathologist should expect abundant public interest and scrutiny. In this article, an overview of hate crimes is presented, stressing the different types of hate crimes and the motives of those who commit such crimes. For death investigators and forensic pathologists, an awareness of these details will help them to recognize and appropriately anticipate issues that may be important in deaths related to hate crimes.

  8. [Sarcomas, example of a pathologist network organization].

    PubMed

    Neuville, Agnes; Coindre, Jean-Michel

    2013-12-01

    Sarcomas are rare and heterogeneous with many subtypes explaining the high level of diagnostic difficulty with frequent important therapeutic consequences. In 2009, a national network of pathologists has been set up with the main objective to perform a systematic histological review of every new sarcoma, gastro-intestinal stromal tumor (GIST) and desmoid tumor. We describe the network organization and report the results of the first two years of activity. These results clearly show the interest of this organization for the patients as well as for all pathologists. Moreover, data and material collect allows a better knowledge of these tumors and an improvement of the rules for their diagnostic management.

  9. A Comparative Judgement Approach to Teacher Assessment

    ERIC Educational Resources Information Center

    McMahon, Suzanne; Jones, Ian

    2015-01-01

    We report one teacher's response to a top-down shift from external examinations to internal teacher assessment for summative purposes in the Republic of Ireland. The teacher adopted a comparative judgement approach to the assessment of secondary students' understanding of a chemistry experiment. The aims of the research were to investigate whether…

  10. A Comparative Judgement Approach to Teacher Assessment

    ERIC Educational Resources Information Center

    McMahon, Suzanne; Jones, Ian

    2015-01-01

    We report one teacher's response to a top-down shift from external examinations to internal teacher assessment for summative purposes in the Republic of Ireland. The teacher adopted a comparative judgement approach to the assessment of secondary students' understanding of a chemistry experiment. The aims of the research were to investigate whether…

  11. Commentary: Roles for Pathologists in a High-throughput Image Analysis Team.

    PubMed

    Aeffner, Famke; Wilson, Kristin; Bolon, Brad; Kanaly, Suzanne; Mahrt, Charles R; Rudmann, Dan; Charles, Elaine; Young, G David

    2016-08-01

    Historically, pathologists perform manual evaluation of H&E- or immunohistochemically-stained slides, which can be subjective, inconsistent, and, at best, semiquantitative. As the complexity of staining and demand for increased precision of manual evaluation increase, the pathologist's assessment will include automated analyses (i.e., "digital pathology") to increase the accuracy, efficiency, and speed of diagnosis and hypothesis testing and as an important biomedical research and diagnostic tool. This commentary introduces the many roles for pathologists in designing and conducting high-throughput digital image analysis. Pathology review is central to the entire course of a digital pathology study, including experimental design, sample quality verification, specimen annotation, analytical algorithm development, and report preparation. The pathologist performs these roles by reviewing work undertaken by technicians and scientists with training and expertise in image analysis instruments and software. These roles require regular, face-to-face interactions between team members and the lead pathologist. Traditional pathology training is suitable preparation for entry-level participation on image analysis teams. The future of pathology is very exciting, with the expanding utilization of digital image analysis set to expand pathology roles in research and drug development with increasing and new career opportunities for pathologists.

  12. Underrecognition of pathologist contributions to articles published in a major multidisciplinary medical journal.

    PubMed

    Franko, Angela D; Wright, James R; Trotter, Martin J

    2012-10-01

    The Canadian Medical Association Journal (CMAJ) is a high-impact multidisciplinary medical journal. We have observed instances in which a pathology diagnosis, documented with gross or microscopic images, forms an integral part of a CMAJ article, but a pathologist is neither an author nor acknowledged as a contributor. To examine the hypothesis that pathologist contributions are underrecognized and/or underdocumented, we reviewed all CMAJ articles over a 6-year period (September 2003-2009), and correlated the use of pathology images with pathologist authorship or contribution. For each article containing pathology images, department affiliations of authors were determined, and acknowledgments were assessed. Although only 1.7% of articles contained pathology images, 47% (26/55) of these articles did not include a pathologist as either an author or a contributor. We conclude that important intellectual contributions of pathologists are underrecognized and suggest that the scientific credibility of pathology data is in doubt when pathologists do not take on full responsibility of authorship or are not acknowledged as contributors.

  13. TOXICOGENOMICS DRUG DISCOVERY AND THE PATHOLOGIST

    EPA Science Inventory

    Toxicogenomics, drug discovery, and pathologist.

    The field of toxicogenomics, which currently focuses on the application of large-scale differential gene expression (DGE) data to toxicology, is starting to influence drug discovery and development in the pharmaceutical indu...

  14. Mobile Technologies for the Surgical Pathologist.

    PubMed

    Hartman, Douglas J

    2015-06-01

    Recent advances in hardware and computing power contained within mobile devices have made it possible to use these devices to improve and enhance pathologist workflow. This article discusses the possible uses ranging from basic functions to intermediate functions to advanced functions. Barriers to implementation are also discussed.

  15. Forensic Pathology: A Handbook for Pathologists.

    ERIC Educational Resources Information Center

    Fisher, Russell S., Ed.; Petty, Charles S., Ed.

    This document provides a guide containing basic information for community pathologists to perform medical legal autopsies. Thirty-two chapters consider procedures to use in general and specific situations. Each chapter was written by a specialist. The publication is designed to supplement existing publications. (SL)

  16. Improving Academic Teaching by Involving Community Pathologists.

    ERIC Educational Resources Information Center

    Batata, Al

    1979-01-01

    Wright State University School of Medicine uses community pathologists as unpaid volunteers to team teach pathology courses, making possible a small-group approach in the laboratory. The organization of the course and faculty teams, student evaluation, and results of this approach are discussed. (JMD)

  17. TOXICOGENOMICS DRUG DISCOVERY AND THE PATHOLOGIST

    EPA Science Inventory

    Toxicogenomics, drug discovery, and pathologist.

    The field of toxicogenomics, which currently focuses on the application of large-scale differential gene expression (DGE) data to toxicology, is starting to influence drug discovery and development in the pharmaceutical indu...

  18. Forensic Pathology: A Handbook for Pathologists.

    ERIC Educational Resources Information Center

    Fisher, Russell S., Ed.; Petty, Charles S., Ed.

    This document provides a guide containing basic information for community pathologists to perform medical legal autopsies. Thirty-two chapters consider procedures to use in general and specific situations. Each chapter was written by a specialist. The publication is designed to supplement existing publications. (SL)

  19. Breast volume assessment: comparing five different techniques.

    PubMed

    Bulstrode, N; Bellamy, E; Shrotria, S

    2001-04-01

    Breast volume assessment is not routinely performed pre-operatively because as yet there is no accepted technique. There have been a variety of methods published, but this is the first study to compare these techniques. We compared volume measurements obtained from mammograms (previously compared to mastectomy specimens) with estimates of volume obtained from four other techniques: thermoplastic moulding, magnetic resonance imaging, Archimedes principle and anatomical measurements. We also assessed the acceptability of each method to the patient. Measurements were performed on 10 women, which produced results for 20 breasts. We were able to calculate regression lines between volume measurements obtained from mammography to the other four methods: (1) magnetic resonance imaging (MRI), 379+(0.75 MRI) [r=0.48], (2) Thermoplastic moulding, 132+(1.46 Thermoplastic moulding) [r=0.82], (3) Anatomical measurements, 168+(1.55 Anatomical measurements) [r=0.83]. (4) Archimedes principle, 359+(0.6 Archimedes principle) [r=0.61] all units in cc. The regression curves for the different techniques are variable and it is difficult to reliably compare results. A standard method of volume measurement should be used when comparing volumes before and after intervention or between individual patients, and it is unreliable to compare volume measurements using different methods. Calculating the breast volume from mammography has previously been compared to mastectomy samples and shown to be reasonably accurate. However we feel thermoplastic moulding shows promise and should be further investigated as it gives not only a volume assessment but a three-dimensional impression of the breast shape, which may be valuable in assessing cosmesis following breast-conserving-surgery.

  20. Role of forensic pathologists in mass disasters.

    PubMed

    Schuliar, Yves; Knudsen, Peter Juel Thiis

    2012-06-01

    The forensic pathologist has always had a central role in the identification of the dead in every day practice, in accidents, and in disasters involving hundreds or thousands of victims. This role has changed in recent years, as advances in forensic odontology, genetics and anthropology have improved the chances of identifying victims beyond recognition. According to the Interpol DVI Guide, fingerprints, dental examination and DNA are the primary identifiers, and this has given new emphasis to the role of the forensic pathologist as the leader of a multidisciplinary team of experts in a disaster situation, based on his or her qualifications and the experience gained from doing the same work in the everyday situation of an institute of forensic medicine.

  1. Immunohistochemistry for Pathologists: Protocols, Pitfalls, and Tips

    PubMed Central

    Kim, So-Woon; Roh, Jin; Park, Chan-Sik

    2016-01-01

    Immunohistochemistry (IHC) is an important auxiliary method for pathologists in routine diagnostic work as well as in basic and clinical research including exploration of biomarkers, as IHC allows confirmation of target molecule expressions in the context of microenvironment. Although there has been a considerable progress in automation and standardization of IHC, there are still many things to be considered in proper optimization and appropriate interpretation. In this review, we aim to provide possible pitfalls and useful tips for practicing pathologists and residents in pathology training. First, general procedure of IHC is summarized, followed by pitfalls and tips in each step and a summary of troubleshooting. Second, ways to an accurate interpretation of IHC are discussed, with introduction to general quantification and analysis methods. This review is not intended to provide complete information on IHC, but to be used as a basic reference for practice and publication. PMID:27809448

  2. Inflammatory Dermatopathology for General Surgical Pathologists.

    PubMed

    Smith, Emily H; Chan, May P

    2017-09-01

    Owing to the wide variety and complexity of inflammatory skin diseases, inflammatory dermatopathology can be a challenging topic for dermatopathologists and general surgical pathologists alike. Following a basic tissue reaction pattern approach, this article reviews the most common and important entities of each pattern, with emphasis on differential diagnosis, diagnostic pitfalls, and appropriate workup when indicated. A few dermatologic emergencies are also discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Professor Witold Nowicki - a greatly spirited pathologist.

    PubMed

    Wincewicz, A; Szepietowska, A; Sulkowski, S

    2016-06-01

    This paper presents a complete overview of the scientific, professional and social activity of a great Polish pathologist, Witold Nowicki (1878-1941), from mainly Polish-written, original sources with a major impact on mostly his own publications. The biographical commemoration of this eminent professor is not only due to the fact that he provided a profound microscopic characterization of pneumatosis cystoides in 1909 and 1924. Nowicki greatly influenced the development of anatomical pathology in Poland, having authored over 82 publications, with special reference to tuberculosis, lung cancer, sarcomatous carcinomas, scleroma and others. However, the first of all his merits for the readership of Polish pathologists was his textbook titled Anatomical Pathology, which was a basic pathology manual in pre-war Poland. Witold Nowicki - as the head of the academic pathological anatomy department and former dean of the medical faculty - was shot with other professors by Nazi Germans in the Wuleckie hills in Lvov during World War Two. Professor Nowicki was described as being "small in size but great in spirit" by one of his associates, and remains an outstanding example of a meticulous pathologist, a patient tutor and a great social activist to follow.

  4. Fold assessment for comparative protein structure modeling.

    PubMed

    Melo, Francisco; Sali, Andrej

    2007-11-01

    Accurate and automated assessment of both geometrical errors and incompleteness of comparative protein structure models is necessary for an adequate use of the models. Here, we describe a composite score for discriminating between models with the correct and incorrect fold. To find an accurate composite score, we designed and applied a genetic algorithm method that searched for a most informative subset of 21 input model features as well as their optimized nonlinear transformation into the composite score. The 21 input features included various statistical potential scores, stereochemistry quality descriptors, sequence alignment scores, geometrical descriptors, and measures of protein packing. The optimized composite score was found to depend on (1) a statistical potential z-score for residue accessibilities and distances, (2) model compactness, and (3) percentage sequence identity of the alignment used to build the model. The accuracy of the composite score was compared with the accuracy of assessment by single and combined features as well as by other commonly used assessment methods. The testing set was representative of models produced by automated comparative modeling on a genomic scale. The composite score performed better than any other tested score in terms of the maximum correct classification rate (i.e., 3.3% false positives and 2.5% false negatives) as well as the sensitivity and specificity across the whole range of thresholds. The composite score was implemented in our program MODELLER-8 and was used to assess models in the MODBASE database that contains comparative models for domains in approximately 1.3 million protein sequences.

  5. Fold assessment for comparative protein structure modeling

    PubMed Central

    Melo, Francisco; Sali, Andrej

    2007-01-01

    Accurate and automated assessment of both geometrical errors and incompleteness of comparative protein structure models is necessary for an adequate use of the models. Here, we describe a composite score for discriminating between models with the correct and incorrect fold. To find an accurate composite score, we designed and applied a genetic algorithm method that searched for a most informative subset of 21 input model features as well as their optimized nonlinear transformation into the composite score. The 21 input features included various statistical potential scores, stereochemistry quality descriptors, sequence alignment scores, geometrical descriptors, and measures of protein packing. The optimized composite score was found to depend on (1) a statistical potential z-score for residue accessibilities and distances, (2) model compactness, and (3) percentage sequence identity of the alignment used to build the model. The accuracy of the composite score was compared with the accuracy of assessment by single and combined features as well as by other commonly used assessment methods. The testing set was representative of models produced by automated comparative modeling on a genomic scale. The composite score performed better than any other tested score in terms of the maximum correct classification rate (i.e., 3.3% false positives and 2.5% false negatives) as well as the sensitivity and specificity across the whole range of thresholds. The composite score was implemented in our program MODELLER-8 and was used to assess models in the MODBASE database that contains comparative models for domains in approximately 1.3 million protein sequences. PMID:17905832

  6. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

    PubMed Central

    Gomez-Macías, GS; Garza-Guajardo, R; Segura-Luna, J

    2009-01-01

    Background: Fine needle aspiration biopsy (FNAB) is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003–2005) were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2%) were adequate and 105 (7.7%) were inadequate. Of the 237 from Group 2, 178 were adequate (75.1%) and 59 inadequate (24.8%); in Group 3 there were 321 of which 283 (88.1%) were adequate and 38 (11.8%) inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001) and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis. PMID:19621092

  7. Colour perception in pathologists: the Farnsworth-Munsell 100-hue test.

    PubMed

    Rigby, H S; Warren, B F; Diamond, J; Carter, C; Bradfield, J W

    1991-09-01

    The value of many histological stains depends on the ability of the observer to differentiate colour. This ability was assessed in 30 histopathologists and cytopathologists of varying experience using the Farnsworth-Munsell 100-hue test. As a group, the pathologists performed better than a reference population. Twenty eight subjects showed a wide ranging ability to differentiate colour: none was colour blind. Three of the 30 pathologists, however, fell below the twentieth centile for normal subjects and only one was aware of this deficiency! They may unknowingly misinterpret subtle stains. Two of these three had specific and major defects which could affect their ability to interpret a wide range of less subtle stains. Those with the poorest colour discrimination were not those with the least experience of microscopy. Pathologists should be apprised of the importance of their ability to discriminate colour, and that formal colour vision testing of prospective histopathologists may be appropriate.

  8. Environmental considerations for the forensic pathologist

    SciTech Connect

    Greenberg, S.R.

    1982-12-01

    The total environment has frequently been appraised as something quite apart from anything of significance in human life or death. Accurate scientific observations have, within recent times, established that temperature, humidity, and barometric pressure may, indeed, exert profound affects upon man. Some climatic effects are beyond human control; other atmospheric effects are created by man himself through his efforts to become civilized. Mining, manufacturing, farming, even daily living are associated with diseases, accidents and death, either as causes or complications. The important role of the forensic pathologist in sorting out, and evaluating these factors in relation to altered morphology is emphasized.

  9. N staging: the role of the pathologist

    PubMed Central

    Biondi, Alberto; Ricci, Riccardo

    2017-01-01

    Gastric cancer is the second cause of cancer-related mortality worldwide. Metastases, including lymph nodes ones, heavily influence the prognosis of this disease. The pathological detection of positive lymph nodes is pivotal for an optimal prognostication and clinical management of affected individuals. Several factors influence the pathological investigation of surgical specimens, ultimately affecting the number of retrieved lymph nodes and, with it, the reliability of N staging. The pathologist plays a central role in optimizing this process. Factors influencing lymph node retrieval and analysis will be herein reviewed, together with the procedures adopted for an optimal pathological analysis of lymph nodes in gastric cancer. PMID:28275742

  10. Comparative assessment of differential network analysis methods.

    PubMed

    Lichtblau, Yvonne; Zimmermann, Karin; Haldemann, Berit; Lenze, Dido; Hummel, Michael; Leser, Ulf

    2017-09-01

    Differential network analysis (DiNA) denotes a recent class of network-based Bioinformatics algorithms which focus on the differences in network topologies between two states of a cell, such as healthy and disease, to identify key players in the discriminating biological processes. In contrast to conventional differential analysis, DiNA identifies changes in the interplay between molecules, rather than changes in single molecules. This ability is especially important in cases where effectors are changed, e.g. mutated, but their expression is not. A number of different DiNA approaches have been proposed, yet a comparative assessment of their performance in different settings is still lacking. In this paper, we evaluate 10 different DiNA algorithms regarding their ability to recover genetic key players from transcriptome data. We construct high-quality regulatory networks and enrich them with co-expression data from four different types of cancer. Next, we assess the results of applying DiNA algorithms on these data sets using a gold standard list (GSL). We find that local DiNA algorithms are generally superior to global algorithms, and that all DiNA algorithms outperform conventional differential expression analysis. We also assess the ability of DiNA methods to exploit additional knowledge in the underlying cellular networks. To this end, we enrich the cancer-type specific networks with known regulatory miRNAs and compare the algorithms performance in networks with and without miRNA. We find that including miRNAs consistently and considerably improves the performance of almost all tested algorithms. Our results underline the advantages of comprehensive cell models for the analysis of -omics data. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Continuing medical education for pathologists: an evaluation of the Royal College of Pathologists' Wessex pilot scheme.

    PubMed Central

    du Boulay, C

    1997-01-01

    AIM: To discover the attitudes to continuing medical education (CME) of the Wessex pathologists who participated in the Wessex CME pilot scheme and to identify their preferences and difficulties in pursuing CME activities. METHOD: The views of pathologists in the scheme were collected during a period of one year using workshops and discussions. A confidential, anonymous postal questionnaire based on these issues was sent to the 103 pathologists in Wessex who participated in the pilot scheme. RESULTS: A 64% response rate was obtained. The respondents identified lack of time and funded study leave as major barriers to CME and highlighted the gap between CME activity and its recognition and funding by employers. They wanted a wide variety of locally based CME activities to be recognised, and they valued local activities that linked theory with practice. They believed that the college scheme tended to favour academic activities over more practical and locally based ones. They found the paired peer review process time consuming but valuable for identifying their learning needs in some cases, but demonstrated that they have mixed preferences about the way they do their CME. CONCLUSIONS: The Wessex pathologists believe that CME is important and have positive attitudes to it. Their attitudes to CME echo the current literature about what makes CME effective. Unless individuals' preferences and difficulties are taken into account, CME programmes in which they participate are not likely to succeed. PMID:9516886

  12. Training of pathologists in countries belonging to the European Economic Community.

    PubMed Central

    Rinsler, M G

    1977-01-01

    The regulations and procedures for the training and assessment of pathologists engaged in morbid anatomy and histology, medical microbiology, haematology, and clinical chemistry in the countries of the European Economic Community are reviewed. Differences in the terminology used in the description of pathological disciplines are noted. Suggestions are made by which harmonisation of training, which is an EEC objective, could be achieved. PMID:334802

  13. Speech-Language Pathologists' Knowledge of Tongue/Palate Contact for Consonants

    ERIC Educational Resources Information Center

    McLeod, Sharynne

    2011-01-01

    Speech-language pathologists (SLPs) rely on knowledge of tongue placement to assess and provide intervention. A total of 175 SLPs who worked with children with speech sound disorders (SSDs) drew coronal diagrams of tongue/palate contact for 24 English consonants. Comparisons were made between their responses and typical English-speaking adults'…

  14. Health Literacy and the Role of the Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Hester, Eva Jackson; Stevens-Ratchford, Regena

    2009-01-01

    Purpose: This article reviews concepts of health literacy and discusses the role of speech-language pathologists in improving the health literacy of individuals with and without communication disorders. Method: A literature review was completed of health literacy definitions, concepts, and health literacy assessment and intervention studies with…

  15. Special Education Competencies for Teachers Project. Performance Competency Evaluation for Speech-Language Pathologists.

    ERIC Educational Resources Information Center

    Stulac, Joseph F., II; Olive, John

    Thirty-three speech-language pathologists (SLPs) were interviewed and observed by two teams of evaluators using a generic teacher performance assessment instrument. Interviews and therapy observations were recorded on videotape and all Ss were rated on their overall demonstration of competence by a panel of practitioners and teacher educators. As…

  16. Health Literacy and the Role of the Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Hester, Eva Jackson; Stevens-Ratchford, Regena

    2009-01-01

    Purpose: This article reviews concepts of health literacy and discusses the role of speech-language pathologists in improving the health literacy of individuals with and without communication disorders. Method: A literature review was completed of health literacy definitions, concepts, and health literacy assessment and intervention studies with…

  17. Speech-Language Pathologists' Knowledge of Tongue/Palate Contact for Consonants

    ERIC Educational Resources Information Center

    McLeod, Sharynne

    2011-01-01

    Speech-language pathologists (SLPs) rely on knowledge of tongue placement to assess and provide intervention. A total of 175 SLPs who worked with children with speech sound disorders (SSDs) drew coronal diagrams of tongue/palate contact for 24 English consonants. Comparisons were made between their responses and typical English-speaking adults'…

  18. Comparative performance assessment of switching options

    NASA Astrophysics Data System (ADS)

    Vukovic, Alex; Savoie, Michel J.

    2004-11-01

    Switching is one of the key functionalities in next generation optical networks. It might be performed by either an optical switch (optical-electrical-optical, or OEO) or a "purely" photonic switch (optical-optical-optical or OOO). Both switches are analyzed from two perspectives - as an individual network element, and as an integral part within the communication network. As an individual network element, the performance evaluation of the two switch types is based on the individual assessment of switch footprint and power dissipation, bandwidth utilization, scalability to high speed, transparency, interoperability, technology maturity and ability to manipulate data. Although both switch types have their own advantages as a network element, the full judgement of their role in next generation optical networks requires an overall network perspective. From that viewpoint, network functionalities such as grooming capabilities, scalability, traffic management, protection, line equalization and performance monitoring are those taken into account for comparative analyses to gain an understanding of the impacts of switch choice in the network. As a result of the comparative performance assessment, the merits and benefits of both switch types in actual network applications are analyzed and outlined. Although the paper evaluates some criteria for switch choice in a network, it points out potential technologies or techniques critical to next generation architectural solutions and protocols as well as the challenges to bridge the gap towards implementing flexible, cost-effective and dynamically provisioned networks of the future. Finally, the paper responds to one critical question - What is the expected role of each switch type in next generation applications and services?

  19. Legal decision-making by people with aphasia: critical incidents for speech pathologists.

    PubMed

    Ferguson, Alison; Duffield, Gemma; Worrall, Linda

    2010-01-01

    The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The

  20. Regulatory forum opinion piece: differences between protein-based biologic products (biotherapeutics) and chemical entities (small molecules) of relevance to the toxicologic pathologist.

    PubMed

    Leach, Michael W

    2013-01-01

    With the advances in cell culture methodologies and molecular biology that have occurred over the past several decades, biologics have become as common as small molecules within the portfolios of the pharmaceutical industry. Toxicologic pathologists should be aware of some of the fundamental differences between small molecules and biologics. Effects are not always observed in studies following administration of biologics. When findings are observed, the toxicologic pathologist should initially determine whether the effect(s) are mediated (directly or indirectly) via the intended pharmacology, exaggerated pharmacology, an immune response, and/or off target effects. Following this determination, the toxicologic pathologist should provide an assessment regarding the relevance of the findings to the intended clinical population, usually humans. The toxicologic pathologist may also be asked to assess unusual species and models. Given their broad background in physiology and immunology, toxicologic pathologists are uniquely positioned to provide this input to drug development teams.

  1. Comparing Two Approaches for Assessing Observation Impact

    NASA Technical Reports Server (NTRS)

    Todling, Ricardo

    2013-01-01

    Langland and Baker introduced an approach to assess the impact of observations on the forecasts. In that approach, a state-space aspect of the forecast is defined and a procedure is derived ultimately relating changes in the aspect with changes in the observing system. Some features of the state-space approach are to be noted: the typical choice of forecast aspect is rather subjective and leads to incomplete assessment of the observing system, it requires availability of a verification state that is in practice correlated with the forecast, and it involves the adjoint operator of the entire data assimilation system and is thus constrained by the validity of this operator. This article revisits the topic of observation impacts from the perspective of estimation theory. An observation-space metric is used to allow inferring observation impact on the forecasts without the limitations just mentioned. Using differences of observation-minus-forecast residuals obtained from consecutive forecasts leads to the following advantages: (i) it suggests a rather natural choice of forecast aspect that directly links to the data assimilation procedure, (ii) it avoids introducing undesirable correlations in the forecast aspect since verification is done against the observations, and (iii) it does not involve linearization and use of adjoints. The observation-space approach has the additional advantage of being nearly cost free and very simple to implement. In its simplest form it reduces to evaluating the statistics of observationminus- background and observation-minus-analysis residuals with traditional methods. Illustrations comparing the approaches are given using the NASA Goddard Earth Observing System.

  2. The Pathologist Workforce in the United States: II. An Interactive Modeling Tool for Analyzing Future Qualitative and Quantitative Staffing Demands for Services.

    PubMed

    Robboy, Stanley J; Gupta, Saurabh; Crawford, James M; Cohen, Michael B; Karcher, Donald S; Leonard, Debra G B; Magnani, Barbarajean; Novis, David A; Prystowsky, Michael B; Powell, Suzanne Z; Gross, David J; Black-Schaffer, W Stephen

    2015-11-01

    Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.

  3. Dysphagia Management: A Survey of School-Based Speech-Language Pathologists in Vermont

    ERIC Educational Resources Information Center

    Hutchins, Tiffany L.; Gerety, Katherine W.; Mulligan, Moira

    2011-01-01

    Purpose: This study (a) gathered information about the kinds of dysphagia management services school-based speech-language pathologists (SLPs) provide, (b) examined the attitudes of SLPs related to dysphagia management, (c) compared the responses of SLPs on the basis of their experience working in a medical setting, and (d) investigated the…

  4. Speech-Language Pathologists' Preparation, Practices, and Perspectives on Serving Culturally and Linguistically Diverse Children

    ERIC Educational Resources Information Center

    Guiberson, Mark; Atkins, Jenny

    2012-01-01

    This study describes the backgrounds, diversity training, and professional perspectives reported by 154 Colorado speech-language pathologists in serving children from culturally and linguistically diverse (CLD) backgrounds. The authors compare the results of the current survey to those of a similar survey collected in 1996. Respondents reported…

  5. Dysphagia Management: A Survey of School-Based Speech-Language Pathologists in Vermont

    ERIC Educational Resources Information Center

    Hutchins, Tiffany L.; Gerety, Katherine W.; Mulligan, Moira

    2011-01-01

    Purpose: This study (a) gathered information about the kinds of dysphagia management services school-based speech-language pathologists (SLPs) provide, (b) examined the attitudes of SLPs related to dysphagia management, (c) compared the responses of SLPs on the basis of their experience working in a medical setting, and (d) investigated the…

  6. Comparative proteomic assessment of matrisome enrichment methodologies

    PubMed Central

    Krasny, Lukas; Paul, Angela; Wai, Patty; Howard, Beatrice A.; Natrajan, Rachael C.; Huang, Paul H.

    2016-01-01

    The matrisome is a complex and heterogeneous collection of extracellular matrix (ECM) and ECM-associated proteins that play important roles in tissue development and homeostasis. While several strategies for matrisome enrichment have been developed, it is currently unknown how the performance of these different methodologies compares in the proteomic identification of matrisome components across multiple tissue types. In the present study, we perform a comparative proteomic assessment of two widely used decellularisation protocols and two extraction methods to characterise the matrisome in four murine organs (heart, mammary gland, lung and liver). We undertook a systematic evaluation of the performance of the individual methods on protein yield, matrisome enrichment capability and the ability to isolate core matrisome and matrisome-associated components. Our data find that sodium dodecyl sulphate (SDS) decellularisation leads to the highest matrisome enrichment efficiency, while the extraction protocol that comprises chemical and trypsin digestion of the ECM fraction consistently identifies the highest number of matrisomal proteins across all types of tissue examined. Matrisome enrichment had a clear benefit over non-enriched tissue for the comprehensive identification of matrisomal components in murine liver and heart. Strikingly, we find that all four matrisome enrichment methods led to significant losses in the soluble matrisome-associated proteins across all organs. Our findings highlight the multiple factors (including tissue type, matrisome class of interest and desired enrichment purity) that influence the choice of enrichment methodology, and we anticipate that these data will serve as a useful guide for the design of future proteomic studies of the matrisome. PMID:27589945

  7. Comparative assessment of amphibious hearing in pinnipeds.

    PubMed

    Reichmuth, Colleen; Holt, Marla M; Mulsow, Jason; Sills, Jillian M; Southall, Brandon L

    2013-06-01

    Auditory sensitivity in pinnipeds is influenced by the need to balance efficient sound detection in two vastly different physical environments. Previous comparisons between aerial and underwater hearing capabilities have considered media-dependent differences relative to auditory anatomy, acoustic communication, ecology, and amphibious life history. New data for several species, including recently published audiograms and previously unreported measurements obtained in quiet conditions, necessitate a re-evaluation of amphibious hearing in pinnipeds. Several findings related to underwater hearing are consistent with earlier assessments, including an expanded frequency range of best hearing in true seals that spans at least six octaves. The most notable new results indicate markedly better aerial sensitivity in two seals (Phoca vitulina and Mirounga angustirostris) and one sea lion (Zalophus californianus), likely attributable to improved ambient noise control in test enclosures. An updated comparative analysis alters conventional views and demonstrates that these amphibious pinnipeds have not necessarily sacrificed aerial hearing capabilities in favor of enhanced underwater sound reception. Despite possessing underwater hearing that is nearly as sensitive as fully aquatic cetaceans and sirenians, many seals and sea lions have retained acute aerial hearing capabilities rivaling those of terrestrial carnivores.

  8. Ultrasound physics and instrumentation for pathologists.

    PubMed

    Lieu, David

    2010-10-01

    Interest in pathologist-performed ultrasound-guided fine-needle aspiration is increasing. Educational courses discuss clinical ultrasound and biopsy techniques but not ultrasound physics and instrumentation. To review modern ultrasound physics and instrumentation to help pathologists understand the basis of modern ultrasound. A review of recent literature and textbooks was performed. Ultrasound physics and instrumentation are the foundations of clinical ultrasound. The key physical principle is the piezoelectric effect. When stimulated by an electric current, certain crystals vibrate and produce ultrasound. A hand-held transducer converts electricity into ultrasound, transmits it into tissue, and listens for reflected ultrasound to return. The returning echoes are converted into electrical signals and used to create a 2-dimensional gray-scale image. Scanning at a high frequency improves axial resolution but has low tissue penetration. Electronic focusing moves the long-axis focus to depth of the object of interest and improves lateral resolution. The short-axis focus in 1-dimensional transducers is fixed, which results in poor elevational resolution away from the focal zone. Using multiple foci improves lateral resolution but degrades temporal resolution. The sonographer can adjust the dynamic range to change contrast and bring out subtle masses. Contrast resolution is limited by processing speed, monitor resolution, and gray-scale perception of the human eye. Ultrasound is an evolving field. New technologies include miniaturization, spatial compound imaging, tissue harmonics, and multidimensional transducers. Clinical cytopathologists who understand ultrasound physics, instrumentation, and clinical ultrasound are ready for the challenges of cytopathologist-performed ultrasound-guided fine-needle aspiration and core-needle biopsy in the 21st century.

  9. Interobserver Variability in Histologic Evaluation of Radical Prostatectomy Between Central and Local Pathologists: Findings of TAX 3501 Multinational Clinical Trial

    PubMed Central

    Netto, George J.; Eisenberger, Mario; Epstein, Jonathan I.

    2012-01-01

    OBJECTIVES To determine the agreement between the local pathologist findings and central pathologist findings using data from the TAX 3501 trial. TAX 3501 was a randomized, multinational trial comparing the outcomes of patients with high-risk prostate cancer treated with androgen deprivation with or without docetaxel after radical prostatectomy (RP). Patient eligibility was determined by a minimal 5-year progression-free survival estimate of 60% using Kattan’s nomogram. METHODS The pathologic findings were reassessed in 257 consecutive RP specimens by 2 central pathologists and compared with the local pathologist data. RESULTS For the Gleason score, agreement was found in 181 (70%) of 257 cases, upgrading in 57 (75%), and downgrading in 25% of the RP specimens The most frequent upgrade was from Gleason score 7 to 8 or 9 and downgrading from Gleason score 8 to 7. Of the upgrades and downgrades, 37% and 21% were of 2 Gleason score points, respectively. For the tumor extent, agreement was found in 179 (70%) of 256 specimens, with upstaging in 70 (91%) and downstaging in 9%. The most frequent upstage was from focal to extensive extraprostatic extension (45%). For seminal vesicle invasion, agreement was found for 238 (93%) of 256 RP specimens Almost equal rates of underdiagnosing and overdiagnosing seminal vesicle invasion was observed. For margin status, agreement was present for 229 (89%) of 256 cases. The central pathologist review led to reclassification as a positive margin in 17 cases and a negative margin in 10. For lymph node status, 2 (1%) of 210 RP specimens had positive nodes identified only by the central pathologist. Agreement was observed in 154 negative and 54 positive cases. CONCLUSIONS Significant interobserver variations were found between the central and local pathologists. From the central pathologist review, the progression-free survival estimates were altered in 31 patients (13%), including 22 who were reassigned a greater risk estimate

  10. Job Stress of School-Based Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Harris, Stephanie Ferney; Prater, Mary Anne; Dyches, Tina Taylor; Heath, Melissa Allen

    2009-01-01

    Stress and burnout contribute significantly to the shortages of school-based speech-language pathologists (SLPs). At the request of the Utah State Office of Education, the researchers measured the stress levels of 97 school-based SLPs using the "Speech-Language Pathologist Stress Inventory." Results indicated that participants' emotional-fatigue…

  11. Statistical Literacy Among Academic Pathologists: A Survey Study to Gauge Knowledge of Frequently Used Statistical Tests Among Trainees and Faculty.

    PubMed

    Schmidt, Robert L; Chute, Deborah J; Colbert-Getz, Jorie M; Firpo-Betancourt, Adolfo; James, Daniel S; Karp, Julie K; Miller, Douglas C; Milner, Danny A; Smock, Kristi J; Sutton, Ann T; Walker, Brandon S; White, Kristie L; Wilson, Andrew R; Wojcik, Eva M; Yared, Marwan A; Factor, Rachel E

    2017-02-01

    -Statistical literacy can be defined as understanding the statistical tests and terminology needed for the design, analysis, and conclusions of original research or laboratory testing. Little is known about the statistical literacy of clinical or anatomic pathologists. -To determine the statistical methods most commonly used in pathology studies from the literature and to assess familiarity and knowledge level of these statistical tests by pathology residents and practicing pathologists. -The most frequently used statistical methods were determined by a review of 1100 research articles published in 11 pathology journals during 2015. Familiarity with statistical methods was determined by a survey of pathology trainees and practicing pathologists at 9 academic institutions in which pathologists were asked to rate their knowledge of the methods identified by the focused review of the literature. -We identified 18 statistical tests that appear frequently in published pathology studies. On average, pathologists reported a knowledge level between "no knowledge" and "basic knowledge" of most statistical tests. Knowledge of tests was higher for more frequently used tests. Greater statistical knowledge was associated with a focus on clinical pathology versus anatomic pathology, having had a statistics course, having an advanced degree other than an MD degree, and publishing research. Statistical knowledge was not associated with length of pathology practice. -An audit of pathology literature reveals that knowledge of about 12 statistical tests would be sufficient to provide statistical literacy for pathologists. On average, most pathologists report they can interpret commonly used tests but are unable to perform them. Most pathologists indicated that they would benefit from additional statistical training.

  12. Canadian Association of Pathologists-Association canadienne des pathologistes National Standards Committee/Immunohistochemistry: best practice recommendations for standardization of immunohistochemistry tests.

    PubMed

    Torlakovic, Emina Emilia; Riddell, Robert; Banerjee, Diponkar; El-Zimaity, Hala; Pilavdzic, Dragana; Dawe, Peter; Magliocco, Anthony; Barnes, Penny; Berendt, Richard; Cook, Donald; Gilks, Blake; Williams, Gaynor; Perez-Ordonez, Bayardo; Wehrli, Bret; Swanson, Paul E; Otis, Christopher N; Nielsen, Søren; Vyberg, Mogens; Butany, Jagdish

    2010-03-01

    Immunohistochemical and immunocytochemical assays are highly complex diagnostic analyses used to aid in the accurate identification and biologic characterization of tissue types in neoplastic and nonneoplastic diseases. Immunohistochemical tests are applied mainly to the diagnosis of neoplasms. Some immunohistochemical tests provide information of important prognostic and predictive value in selected human neoplasms and, as such, are often critical for the appropriate and effective treatment of patients. This document provides recommendations and opinions of the Canadian Association of Pathologists-Association canadienne des pathologistes National Standards Committee/Immunohistochemistry relevant to clinical immunohistochemical terminology, classification of immunohistochemical tests based on risk assessment, and quality control and quality assurance and summarizes matters to be considered for appropriate immunohistochemical/immunocytochemical test development, performance, and interpretation in diagnostic pathology and laboratory medicine.

  13. Risk Assessment and Alternatives Assessment: Comparing Two Methodologies

    PubMed Central

    2015-01-01

    The selection and use of chemicals and materials with less hazardous profiles reflects a paradigm shift from reliance on risk minimization through exposure controls to hazard avoidance. This article introduces risk assessment and alternatives assessment frameworks in order to clarify a misconception that alternatives assessment is a less effective tool to guide decision making, discusses factors promoting the use of each framework, and also identifies how and when application of each framework is most effective. As part of an assessor's decision process to select one framework over the other, it is critical to recognize that each framework is intended to perform different functions. Although the two frameworks share a number of similarities (such as identifying hazards and assessing exposure), an alternatives assessment provides a more realistic framework with which to select environmentally preferable chemicals because of its primary reliance on assessing hazards and secondary reliance on exposure assessment. Relevant to other life cycle impacts, the hazard of a chemical is inherent, and although it may be possible to minimize exposure (and subsequently reduce risk), it is challenging to assess such exposures through a chemical's life cycle. Through increased use of alternatives assessments at the initial stage of material or product design, there will be less reliance on post facto risk‐based assessment techniques because the potential for harm is significantly reduced, if not avoided, negating the need for assessing risk in the first place. PMID:26694655

  14. Comparability of Two Cognitive Performance Assessment Systems

    DTIC Science & Technology

    1992-02-01

    reauesters Qualified requesters may obtain copies from the Defense Technical Information Center (DTIC), Cameron Station , Alexandria, Virginia 22314...photometric expertise. Thanks also to Mr. Jim A. Chiaramonte, SPC4 Angelia Mattingly, 2LT Shawn Prickett , and PFC Hilda Pou for help in preparing the report...presentation and subject response characteristics of performance assessment batteries (PABs) which are implemented on the different computer systems

  15. Attracting and training more chemical pathologists in the United Kingdom.

    PubMed Central

    Calvert, G D

    1976-01-01

    I have attempted to define the function of the medical graduate in the clinical biochemistry laboratory and have examined data on recrutiment in the United Kingdom into clinical biochemistry. If trainee pathologists were encouraged to become proficient in both a branch of clinical medicine and in research techniques, the resulting chemical pathologists should be able to improve the consultative and investigative functions of the laboratory. To this end I have suggested some changes in the training regulations and in the role of the chemical pathologists. PMID:1010874

  16. Perceptions of pathology informatics by non-informaticist pathologists and trainees

    PubMed Central

    Walker, Addie; Garcia, Christopher; Baron, Jason M.; Gudewicz, Thomas M.; Gilbertson, John R.; Henricks, Walter H.; Lee, Roy E.

    2016-01-01

    Background: Although pathology informatics (PI) is essential to modern pathology practice, the field is often poorly understood. Pathologists who have received little to no exposure to informatics, either in training or in practice, may not recognize the roles that informatics serves in pathology. The purpose of this study was to characterize perceptions of PI by noninformatics-oriented pathologists and to do so at two large centers with differing informatics environments. Methods: Pathology trainees and staff at Cleveland Clinic (CC) and Massachusetts General Hospital (MGH) were surveyed. At MGH, pathology department leadership has promoted a pervasive informatics presence through practice, training, and research. At CC, PI efforts focus on production systems that serve a multi-site integrated health system and a reference laboratory, and on the development of applications oriented to department operations. The survey assessed perceived definition of PI, interest in PI, and perceived utility of PI. Results: The survey was completed by 107 noninformatics-oriented pathologists and trainees. A majority viewed informatics positively. Except among MGH trainees, confusion of PI with information technology (IT) and help desk services was prominent, even in those who indicated they understood informatics. Attendings and trainees indicated desire to learn more about PI. While most acknowledged that having some level of PI knowledge would be professionally useful and advantageous, only a minority plan to utilize it. Conclusions: Informatics is viewed positively by the majority of noninformatics pathologists at two large centers with differing informatics orientations. Differences in departmental informatics culture can be attributed to the varying perceptions of PI by different individuals. Incorrect perceptions exist, such as conflating PI with IT and help desk services, even among those who claim to understand PI. Further efforts by the PI community could address such

  17. Phonemic awareness skill of speech-language pathologists and other educators.

    PubMed

    Spencer, Elizabeth J; Schuele, C Melanie; Guillot, Kathryn M; Lee, Marvin W

    2008-10-01

    Educators rely on sufficient knowledge and skill to provide effective phonemic awareness instruction, an important component of early literacy instruction, particularly for children who experience difficulty learning to read. The purpose of this study was to evaluate and compare the phonemic awareness skill of several groups of educators, including speech-language pathologists (SLPs; n = 160), kindergarten teachers (n = 109), first-grade teachers (n = 112), reading teachers (n = 100), and special education teachers (n = 60). Participants completed a paper-pencil measure of phonemic awareness skill that included 3 tasks. The measure was designed to assess sophisticated explicit phonemic awareness skill within a print context, representing an advanced skill level that has been deemed critical to teaching. SLPs demonstrated superior performance on the measure of phonemic awareness skill when compared to other educators (d = 1.54). The performance of reading and special education teachers was comparable to that of kindergarten and first-grade teachers. Orthographic knowledge had an adverse impact on the performance of all groups. However, SLPs were far more proficient than other educators at segmenting words that had a complex relationship between speech and print (e.g., box, use). SLPs have relative expertise in phonemic awareness, yet their performance may not be proficient. Three recommendations are discussed: (a) Increase the phonemic awareness skill of all educators, (b) revise instructional materials to enhance educators' efforts to provide accurate and effective phonemic awareness instruction, and (c) include SLPs as members of the team responsible for phonemic awareness instruction and intervention.

  18. Factors affecting speech pathologists' implementation of stroke management guidelines: a thematic analysis.

    PubMed

    Miao, Melissa; Power, Emma; O'Halloran, Robyn

    2015-01-01

    Although clinical practice guidelines can facilitate evidence-based practice and improve the health outcomes of stroke patients, they continue to be underutilised. There is limited research into the reasons for this, especially in speech pathology. This study provides the first in-depth, qualitative examination of the barriers and facilitators that speech pathologists perceive and experience when implementing guidelines. A maximum variation sample of eight speech pathologists participated in a semi-structured interview concerning the implementation of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010. Interviews were transcribed, thematically analysed and member checked before overall themes were identified. Three main themes and ten subthemes were identified. The first main theme, making implementation explicit, reflected the necessity of accessing and understanding guideline recommendations, and focussing specifically on implementation in context. In the second theme, demand versus ability to change, the size of changes required was compared with available resources and collaboration. The final theme, Speech pathologist motivation to implement guidelines, demonstrated the influence of individual perception of the guidelines and personal commitment to improved practice. Factors affecting implementation are complex, and are not exclusively barriers or facilitators. Some potential implementation strategies are suggested. Further research is recommended. In most Western nations, stroke remains the single greatest cause of disability, including communication and swallowing disabilities. Although adherence to stroke clinical practice guidelines improves stroke patient outcomes, guidelines continue to be underutilised, and the reasons for this are not well understood. This is the first in-depth qualitative study identifying the complex barriers and facilitators to guideline implementation as experienced by speech pathologists in stroke care

  19. Communication-Based Services for Persons with Severe Disabilities in Schools: A Survey of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Siegel, Ellin B.; Maddox, Laura L.; Ogletree, Billy T.; Westling, David L.

    2010-01-01

    Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than…

  20. Paediatric concussion: Knowledge and practices of school speech-language pathologists.

    PubMed

    Duff, Melissa C; Stuck, Sarah

    2015-01-01

    To characterize paediatric concussion knowledge and the management practices of school-based speech-language pathologists (SLPs) in the US to establish a baseline upon which changes in SLP training, knowledge and best practices can be measured. A survey was developed to assess current knowledge and management of paediatric concussion allowing for comparison to previous and future surveys on SLP knowledge and practice in other areas of brain injury. One thousand surveys were distributed to school-based SLPs from 10 states. Two hundred and eighty SLPs from Minnesota, Wisconsin, New York, Massachusetts, Georgia, Florida, Texas, Tennessee, California and Arizona responded to the survey. Compared to previous survey results, SLPs from the current sample indicate an increase in general brain injury training, but confidence in providing clinical services to brain-injured students remains low. SLPs have a mix of accurate and inaccurate concussion knowledge and uncertainty about their role in concussion management. Findings suggest that increasing communication with other school personnel about concussion, increased training in paediatric TBI and concussion improved access to appropriate assessments tools and implementation of long-term concussion management will improve service delivery to school-aged children with concussion.

  1. Pathologists and the judicial process: how to avoid it.

    PubMed

    Epstein, J I

    2001-04-01

    This review article covers the full range of issues concerning malpractice as it relates to pathologists. Following a brief summary as to the incidence and general statistics on the outcome of lawsuits as well as common pathology misdiagnoses resulting in lawsuits, the definition of malpractice is discussed. These include duty, breech of standard of care, proximal cause, and damage. Details are provided as to what a pathologist should do from the initial threat of a lawsuit, to the initial lawsuit, and through the initial physician/lawyer meeting. An in-depth analysis as to how pathologists should handle themselves through the discovery process and, in particular, deposition is provided. Plaintiff attorneys' goals at deposition are covered in depth. These goals include: 1) education about the pathologist's case and strategies; 2) impeachment of the pathologist's credibility; and 3) judgment as to how effective a witness the pathologist will be at trial. Various types of plaintiff's attorney at deposition are summarized. Also discussed is the post-deposition meeting with the legal representative, whether to settle, and specific issues relating to trial. Finally, general tips on how to avoid a lawsuit in pathology are reviewed.

  2. Comparative assessment of semifragile watermarking techniques

    NASA Astrophysics Data System (ADS)

    Ekici, Oezguer; Coskun, Baris; Naci, Umut; Sankur, Bulent

    2001-11-01

    Semi-fragile watermarking techniques aim to prevent tampering and fraudulent use of modified images. A semi-fragile watermark monitors the integrity of the content of the image but not its exact representation. Thus the watermark is designed so that if the content of the image has not been tampered with, and so long as the correct key is known and the image ha sufficiently high quality, the integrity is proven. However if some parts of the image is replaced by someone who does not possess the key, the watermark information will not be reliably detected, which can be taken as evidence of forgery. In this paper we compare the performance of nine semi-fragile watermarking algorithms in terms of their miss probability under forgery attack, and in terms of false alarm probability under mild, hence non-malicious signal processing operations that preserve the content and quality of the image. We propose desiderata for semi-fragile watermarking algorithms and indicate the promising algorithms among existing ones.

  3. Nasometry, videofluoroscopy, and the speech pathologist's evaluation and treatment.

    PubMed

    de Stadler, Marie; Hersh, Cheryl

    2015-01-01

    The speech-language pathologist (SLP) plays an important role in the assessment and management of children with velopharyngeal insufficiency (VPI). The SLP assesses speech sound production and oral nasal resonance and identifies the characteristics of nasal air emission to guide the clinical and surgical management of VPI. Clinical resonance evaluations typically include an oral motor exam, identification of nasal air emission, and analysis of the speech sound repertoire. Additional elements include perceptual assessment of intra-oral air pressure, the degree of hypernasality, and vocal loudness/quality. Clinical speech and resonance evaluations are typically the gold-standard evaluation method until a child reaches 3-4 years of age, when sufficient compliance levels and speech-language abilities allow for participation in instrumental testing. At that time, objective assessment measures are introduced, including nasometry, videofluoroscopy, and/or nasopharyngoscopy. Nasometry is a computer-based tool that quantifies nasal air escape and allows comparison of the score against normative data. Videofluoroscopy is a radiographic tool used to assess the shaping of the velum and closure of the velopharyngeal mechanism during speech production. Evaluation findings guide decision making regarding surgical candidacy and/or the therapeutic management of VPI. Surgery should always be pursued first when an anatomic deficit prevents velopharyngeal closure. Therapy should always be pursued in children who present with velopharyngeal mislearning and/or motor planning issues resulting in VPI. It is not uncommon for children to receive a combination of surgical intervention and speech resonance therapy during their VPI management course. Collaborative decision making between the otorhinolaryngologist and the SLP provides optimal patient care. © 2015 S. Karger AG, Basel.

  4. Speech-language pathologists' roles in the delivery of positive behavior support for individuals with developmental disabilities.

    PubMed

    Bopp, Karen D; Brown, Kenneth E; Mirenda, Pat

    2004-02-01

    Positive behavior support interventions such as functional communication training (FCT) and visual schedules are increasingly being used with individuals with autism and other severe developmental disabilities who engage in problem behavior and use augmentative and alternative communication (AAC). The increasing use of these communication interventions has implications for speech-language pathologists who provide support to these individuals. The purpose of this tutorial is to summarize the research regarding the use of FCT/AAC interventions and visual schedules, and to provide suggestions for the roles that speech-language pathologists can play with regard to assessment, intervention design, and implementation in school and home settings.

  5. Society of Toxicologic Pathology position paper on best practices on recovery studies: the role of the anatomic pathologist.

    PubMed

    Perry, Rick; Farris, Georgia; Bienvenu, Jean-Guy; Dean, Charles; Foley, George; Mahrt, Chuck; Short, Brian

    2013-01-01

    This article reviews the regulatory guidelines that provide for the inclusion of recovery groups in toxicology studies, presents the challenges in the design and interpretation of nonclinical recovery studies, and summarizes the best practices for the role of an anatomic pathologist regarding toxicology studies with recovery groups. Evaluating the potential recovery of histopathologic findings induced by a biopharmaceutical requires the active participation of one or more anatomic pathologists. Their expertise is critical in risk assessment regarding the potential for recovery as well as providing scientific guidance in the design and evaluation of studies with recovery groups.

  6. Interobserver Variation Among Pathologists in Evaluating Perineural Invasion for Oral Squamous Cell Carcinoma.

    PubMed

    Chi, Angela C; Katabi, Nora; Chen, Huey-Shys; Cheng, Yi-Shing Lisa

    2016-12-01

    The aims of this study are as follows: (1) to assess variations among pathologists in evaluating perineural invasion (PNI) in oral squamous cell carcinoma (OSCC), (2) to survey PNI criteria used by pathologists and how they came to adopt those criteria. An electronic survey was sent to 363 oral and/or surgical pathologists. Eligibility criteria included pathology board certification. The survey participants were asked to rate whether PNI was present, absent, or uncertain for 15 provided photomicrographs, which depicted various types of tumor-nerve relationships without excessive desmoplasia or lymphocytic host response. The survey obtained information regarding demographics, whether PNI criteria were taught during residency, criteria used by participants to evaluate PNI, how the participants developed their criteria, and agreement with six proposed PNI definitions. 88 pathologists completed the survey. The participants included 47 males and 41 females, with average age = 49 years and average practice experience = 17 years. Practice settings included dental school (40 %), medical school (36 %), private pathology lab (13 %), and other (11 %). Agreement between participants in rating PNI status for the provided images was fair (κ = .38, 95 % CI .37-.39). 56 % of respondents indicated that they were taught PNI criteria during residency training. The basis for criteria currently used by participants included residency training (n = 42), published literature (n = 29), and own experience/views (n = 32). Agreement regarding six proposed PNI definitions was slight (κ = .10, 95 % CI .08-.11). In conclusion, interobserver agreement in assessing PNI status was fair. Our results suggest that more widely accepted, objective, and reproducible criteria are needed for evaluating PNI in OSCC.

  7. Forensic odontology in India, an oral pathologist's perspective

    PubMed Central

    Shetty, Pushparaja; Raviprakash, A

    2011-01-01

    Objectives: Oral pathologists have major responsibilities in the development of forensic science. We conducted a survey to evaluate the degree of involvement of oral pathologists in forensic investigations in India and the difficulties faced by them. Materials and Methods: Data was collected during 2007–2009 by means of a questionnaire survey among qualified oral pathologists related to confidence in handling forensic cases, knowledge and awareness, training in forensic odontology, practical exposure to forensic cases, and difficulties faced. Results: A total of 120 oral pathologists responded to the questionnaire. Of these, 28% expressed confidence in handling forensic cases, 7% had been exposed to formal training in forensic odontology, and 6% had handled forensic cases earlier. Only two participants said that they were part of the forensic team in their respective cities. Forty-eight percent of the participants said that they read forensic journals regularly. Conclusion: Oral pathologists are generally not very confident about handling forensic cases mainly because of inadequate formal training in the field of forensic dentistry, inadequate exposure to the subject, minimal importance given to the subject in the undergraduate and postgraduate curriculum, and no practical exposure to forensic cases. PMID:22022135

  8. Forensic odontology in India, an oral pathologist's perspective.

    PubMed

    Shetty, Pushparaja; Raviprakash, A

    2011-01-01

    Oral pathologists have major responsibilities in the development of forensic science. We conducted a survey to evaluate the degree of involvement of oral pathologists in forensic investigations in India and the difficulties faced by them. Data was collected during 2007-2009 by means of a questionnaire survey among qualified oral pathologists related to confidence in handling forensic cases, knowledge and awareness, training in forensic odontology, practical exposure to forensic cases, and difficulties faced. A total of 120 oral pathologists responded to the questionnaire. Of these, 28% expressed confidence in handling forensic cases, 7% had been exposed to formal training in forensic odontology, and 6% had handled forensic cases earlier. Only two participants said that they were part of the forensic team in their respective cities. Forty-eight percent of the participants said that they read forensic journals regularly. Oral pathologists are generally not very confident about handling forensic cases mainly because of inadequate formal training in the field of forensic dentistry, inadequate exposure to the subject, minimal importance given to the subject in the undergraduate and postgraduate curriculum, and no practical exposure to forensic cases.

  9. The virtuous pathologist. An ethical basis for laboratory medicine.

    PubMed

    Stempsey, W E

    1989-06-01

    The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.

  10. Inherent grading characteristics of individual pathologists contribute to clinically and prognostically relevant interobserver discordance concerning Broders' grading of penile squamous cell carcinomas.

    PubMed

    Gunia, Sven; Burger, Maximilian; Hakenberg, Oliver W; May, Dieter; Koch, Stefan; Jain, Anjun; Birnkammer, Kristina; Wieland, Wolf F; Otto, Wolfgang; Hofstädter, Ferdinand; Fritsche, Hans-Martin; Denzinger, Stefan; Gilfrich, Christian; Brookman-May, Sabine; May, Matthias

    2013-01-01

    We assessed the reproducibility and prognostic impact of the Broders' grading system (BGS) in a cohort of 147 patients with surgically treated penile squamous cell carcinomas. Conventionally stained histology slides were graded according to the BGS in two rounds by two study pathologists. Reproducibility was assessed using ĸ statistics. Multivariable analyses were calculated to predict cancer-specific survival (CSS). The 'mean grade' per pathologist per round was calculated by allocating grade points to each study case (G1-G4: 1-4 points) and dividing the sum of all grade points by the number of cases examined. The BGS showed substantial interobserver variation (59-87% with ĸ = 0.38-0.69) but almost perfect intraobserver reproducibility (91% with ĸ = 0.86 and 96% with ĸ = 0.94, respectively). The 'mean grade' per pathologist remained nearly constant in both rounds of examination (differences ≤0.05 grade points) but differed between the two pathologists (up to 0.4 grade points). In multivariable analyses, the prognostic impact of the BGS in terms of CSS was strongly pathologist-dependent. Clinically and prognostically relevant interobserver discordance concerning the BGS seems, at least in part, to be attributable to inherent 'aggressive' versus 'reserved' grading characteristics of individual pathologists. Copyright © 2012 S. Karger AG, Basel.

  11. Adhesion molecules in breast carcinoma: a challenge to the pathologist.

    PubMed

    Rossetti, Claudia; Reis, Beatriz da Costa Aguiar Alves; Delgado, Pamela de Oliveira; Azzalis, Ligia Ajaime; Junqueira, Virginia B C; Feder, David; Fonseca, Fernando

    2015-01-01

    The role of adhesion molecules is very important both in the activation of carcinogenesis and in the differentiation of subtypes of breast carcinoma, aiding in diagnosis, prognosis and therapeutic choice in these tumors. Therefore, understanding the functions and interrelationships among these molecules is crucial to the pathologist, who often uses these factors as a resource to differentiate tumors and further classify them according to a molecular point of view. Our goal is to describe the applicability and the difficulties encountered by the pathologist in the diagnosis of breast carcinoma, discussing the most commonly used markers of adhesion in routine analyses.

  12. Speech language pathologists' opinions of constraint-induced language therapy.

    PubMed

    Page, Stephen J; Wallace, Sarah E

    2014-01-01

    Constraint-induced language therapy (CILT) has received recent attention as a possible intervention to improve expressive language in people with nonfluent aphasia. Difficulties have been reported with the practical implementation of constraint-induced movement therapy due to its intensive treatment parameters. It remains unknown whether similar challenges may exist with CILT. To determine the opinions of speech-language pathologists (SLPs) about CILT for people with nonfluent aphasia. One hundred sixty-seven SLPs completed an electronic survey assessing their opinions of various aspects of CILT. Over 60% of participants felt that people with aphasia would be very unlikely or somewhat unlikely to adhere to CILT. The majority felt that people with aphasia would hold high or moderate concerns with the number of hours spent in therapy (high, 41.8%; moderate, 31.4%), the number of days spent in therapy (high, 44.4%; moderate, 24.8%), likelihood for managed care reimbursement (high, 74.8%; moderate, 15.2%), and other logistical issues (high, 39.2%; moderate, 30.7%). With respect to providing CILT, participants cited the number of hours of therapy (high, 37.3%; moderate, 21.6%) and the number of consecutive days of therapy (high, 29.4%; moderate, 20.3%) as concerns. There were 70.6% who indicated that their facilities lacked resources to provide CILT, and 90.9% felt that most facilitates do not have the resources to provide CILT. Some SLPs hold significant concerns with the administration of CILT, particularly related to its dosing and reimbursement parameters. Additional work is needed to investigate the issues that were identified in this survey using qualitative methods with SLPs and people with aphasia and to examine modified CILT protocols.

  13. Revolution in lung cancer: new challenges for the surgical pathologist.

    PubMed

    Cagle, Philip T; Allen, Timothy C; Dacic, Sanja; Beasley, Mary Beth; Borczuk, Alain C; Chirieac, Lucian R; Laucirica, Rodolfo; Ro, Jae Y; Kerr, Keith M

    2011-01-01

    Traditionally, lung cancer has been viewed as an aggressive, relentlessly progressive disease with few treatment options and poor survival. The traditional role of the pathologist has been primarily to differentiate small cell carcinoma from non-small cell carcinoma on biopsy and cytology specimens and to stage non-small cell carcinomas that underwent resection. In recent years, our concepts of lung cancer have undergone a revolution, including (1) the advent of successful, new, molecular-targeted therapies for lung cancer, many of which are associated with specific histologic cell types and subtypes; (2) new observations on the natural history of lung cancer derived from ongoing high-resolution computed tomography screening studies and recent histologic findings; and (3) proposals to revise the classification of lung cancers, particularly adenocarcinomas, in part because of the first 2 developments. To summarize the important, new developments in lung cancer, emphasizing the role of the surgical pathologist in personalized care for patients with lung cancer. Information about the new developments in lung cancer was obtained from the peer-review medical literature and the authors' experiences. For decades, we have perceived lung cancer as a relentlessly aggressive and mostly incurable disease for which the surgical pathologist had a limited role. Today, surgical pathologists have an important and expanding role in the diagnosis and treatment of lung cancer, and it is essential to keep informed of new advances.

  14. Impedance Screening by the School Speech-Language Pathologist.

    ERIC Educational Resources Information Center

    Lucker, Jay R.; Samsky, Jay G.

    1979-01-01

    Questions regarding the use of minimally trained speech-language pathologists in conducting an impedance screening program, obtaining the cooperation of the children during testing, and dealing with problems related to referral procedures are discussed, and an account of a pilot otoadmittance screening program is presented. (Author/DLS)

  15. Resource utilization and outcomes management: opportunities for the entrepreneurial pathologist.

    PubMed

    Vance, R P

    1997-01-01

    Pathologists and laboratory managers are facing an increasingly uncertain place in the emerging managed care marketplace. Among the various opportunities available is outcomes management. The role of benchmarking in outcomes management and the initial steps in developing outcomes management programs are presented.

  16. Bullying: What Speech-Language Pathologists Should Know

    ERIC Educational Resources Information Center

    Hughes, Stephanie

    2014-01-01

    Purpose: The purpose of this tutorial is to introduce speech-language pathologists (SLPs) to the broad issues surrounding the problem of school bullying in childhood and adolescence. Specifically, types of bullying and their causes are considered, as are the roles students take when bullying occurs and the effects of bullying on students with…

  17. Bullying: What Speech-Language Pathologists Should Know

    ERIC Educational Resources Information Center

    Hughes, Stephanie

    2014-01-01

    Purpose: The purpose of this tutorial is to introduce speech-language pathologists (SLPs) to the broad issues surrounding the problem of school bullying in childhood and adolescence. Specifically, types of bullying and their causes are considered, as are the roles students take when bullying occurs and the effects of bullying on students with…

  18. Impedance Screening by the School Speech-Language Pathologist.

    ERIC Educational Resources Information Center

    Lucker, Jay R.; Samsky, Jay G.

    1979-01-01

    Questions regarding the use of minimally trained speech-language pathologists in conducting an impedance screening program, obtaining the cooperation of the children during testing, and dealing with problems related to referral procedures are discussed, and an account of a pilot otoadmittance screening program is presented. (Author/DLS)

  19. Speech-Language Pathologists' Opinions on Response to Intervention

    ERIC Educational Resources Information Center

    Sanger, Dixie; Mohling, Sara; Stremlau, Aliza

    2012-01-01

    The purpose of this study was to survey the opinions of speech-language pathologists (SLPs) on response to intervention (RTI). Questionnaires were mailed to 2,000 randomly selected elementary and secondary SLPs throughout the United States. Mean results of 583 respondents (29.15%) indicated that SLPs agreed on 37 Likert-type items and responded…

  20. Thickened Liquids: Practice Patterns of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Garcia, Jane Mertz; Chambers, Edgar, IV; Molander, Michelle

    2005-01-01

    This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders…

  1. Thickened Liquids: Practice Patterns of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Garcia, Jane Mertz; Chambers, Edgar, IV; Molander, Michelle

    2005-01-01

    This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders…

  2. Computer Usage by Speech-Language Pathologists in Public Schools.

    ERIC Educational Resources Information Center

    Houle, Gail Ruppert

    1988-01-01

    Investigation of factors influencing public school speech-language pathologists' acceptance and/or resistance to computer technology found differences between frequent computer users and rare users which were attributed to differences in attitudes toward computers, available funding for computers, in-service training, and physical facilities.…

  3. Evidence-Based Practice among Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Zipoli, Richard P., Jr.; Kennedy, Marianne

    2005-01-01

    A total of 240 speech-language pathologists responded to a questionnaire examining attitudes toward and use of research and evidence-based practice (EBP). Perceived barriers to EBP were also explored. Positive attitudes toward research and EBP were reported. Attitudes were predicted by exposure to research and EBP practice during graduate training…

  4. Knowledge and Confidence of Speech-Language Pathologists Regarding Autism

    ERIC Educational Resources Information Center

    Ray, Julie M.

    2010-01-01

    The increased prevalence rate of autism has immense implications for speech language pathologists (SLPs) who are directly involved in the education and service delivery for students with autism. However, few studies have documented the effectiveness of the knowledge and confidence of SLPs regarding autism. The purpose of this study was to measure…

  5. Speech-Language Pathologists' Opinions on Response to Intervention

    ERIC Educational Resources Information Center

    Sanger, Dixie; Mohling, Sara; Stremlau, Aliza

    2012-01-01

    The purpose of this study was to survey the opinions of speech-language pathologists (SLPs) on response to intervention (RTI). Questionnaires were mailed to 2,000 randomly selected elementary and secondary SLPs throughout the United States. Mean results of 583 respondents (29.15%) indicated that SLPs agreed on 37 Likert-type items and responded…

  6. Predicting Adolescent Suicidality: Comparing Multiple Informants and Assessment Techniques

    ERIC Educational Resources Information Center

    Connor, Jennifer; Rueter, Martha

    2009-01-01

    Adolescent suicidality is a serious problem among American youth. Common risk factors for adolescent suicidality include depression and conduct problems but there is little agreement on the best means to assess these factors. We compared multiple informants (mothers, fathers, the adolescent and a sibling) and multiple assessment techniques using a…

  7. Comparative Validity of the Shedler and Westen Assessment Procedure-200

    ERIC Educational Resources Information Center

    Mullins-Sweatt, Stephanie N.; Widiger, Thomas A.

    2008-01-01

    A predominant dimensional model of general personality structure is the five-factor model (FFM). Quite a number of alternative instruments have been developed to assess the domains of the FFM. The current study compares the validity of 2 alternative versions of the Shedler and Westen Assessment Procedure (SWAP-200) FFM scales, 1 that was developed…

  8. Predicting Adolescent Suicidality: Comparing Multiple Informants and Assessment Techniques

    ERIC Educational Resources Information Center

    Connor, Jennifer; Rueter, Martha

    2009-01-01

    Adolescent suicidality is a serious problem among American youth. Common risk factors for adolescent suicidality include depression and conduct problems but there is little agreement on the best means to assess these factors. We compared multiple informants (mothers, fathers, the adolescent and a sibling) and multiple assessment techniques using a…

  9. The comparative risk assessment framework and tools (CRAFT)

    Treesearch

    Southern Research Station. USDA Forest Service

    2010-01-01

    To help address these challenges, the USDA Forest Service’s Eastern Forest Environmental Threat Assessment Center (EFETAC) and the University of North Carolina Asheville’s National Environmental Modeling and Analysis Center (NEMAC) designed a planning framework, called the Comparative Risk Assessment Framework and Tools (CRAFT). CRAFT is...

  10. Chemometrics applications in biotech processes: assessing process comparability.

    PubMed

    Bhushan, Nitish; Hadpe, Sandip; Rathore, Anurag S

    2012-01-01

    A typical biotech process starts with the vial of the cell bank, ends with the final product and has anywhere from 15 to 30 unit operations in series. The total number of process variables (input and output parameters) and other variables (raw materials) can add up to several hundred variables. As the manufacturing process is widely accepted to have significant impact on the quality of the product, the regulatory agencies require an assessment of process comparability across different phases of manufacturing (Phase I vs. Phase II vs. Phase III vs. Commercial) as well as other key activities during product commercialization (process scale-up, technology transfer, and process improvement). However, assessing comparability for a process with such a large number of variables is nontrivial and often companies resort to qualitative comparisons. In this article, we present a quantitative approach for assessing process comparability via use of chemometrics. To our knowledge this is the first time that such an approach has been published for biotech processing. The approach has been applied to an industrial case study involving evaluation of two processes that are being used for commercial manufacturing of a major biosimilar product. It has been demonstrated that the proposed approach is able to successfully identify the unit operations in the two processes that are operating differently. We expect this approach, which can also be applied toward assessing product comparability, to be of great use to both the regulators and the industry which otherwise struggle to assess comparability.

  11. Pharmacokinetic, pharmacodynamic and immunogenicity comparability assessment strategies for monoclonal antibodies.

    PubMed

    Putnam, Wendy S; Prabhu, Saileta; Zheng, Yanan; Subramanyam, Meena; Wang, Yow-Ming C

    2010-10-01

    Regulatory guidance stipulates that comparability assessment is required to support manufacturing process changes during the development of a biological product or post-approval. However, strategies for assessing the comparability of pre- and post-change materials are still evolving. A hierarchical risk-based approach is recommended, starting with analytical testing to ensure quality, followed by biological characterization and, if needed, in vivo pharmacokinetic (PK), PK-pharmacodynamic (PD), safety and/or efficacy studies. The need for an in vivo study and the type of study required depend on the magnitude and the potential impact of the changes and the timing in the development process. This review discusses factors affecting the PK, PD and immunogenicity of monoclonal antibodies, and provides guidance for determining non-clinical and clinical comparability assessment strategies. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Nonverbal learning disability: a tutorial for speech-language pathologists.

    PubMed

    Volden, Joanne

    2004-05-01

    Nonverbal learning disability (NLD) is a diagnostic category that is unfamiliar to most speech-language pathologists. This brief tutorial describes NLD's characteristics, a theoretical model proposed to explain its source, and areas of overlap between NLD and similar diagnostic categories. The communicative profile, made up of difficulties in pragmatic and semantic language in the presence of relatively preserved syntactic skill, is also discussed. Empirical evidence relevant to NLD is also evaluated. Many questions remain unresolved, but until systematic research provides definitive answers, speech-language pathologists are encouraged to rely on careful description of the individual child's communicative strengths and weaknesses to identify appropriate targets and to focus intervention on improving the child's ability to communicate effectively in everyday contexts.

  13. New Zealand pathologists: a case study in occupational control.

    PubMed

    France, N; Lawrence, S; Smith, J F

    2001-01-01

    This paper examines the progressive exertion of external managerial control over New Zealand pathologists as the country's New Public Management health reforms were implemented during the 1990s. Perspectives on professionalism, and its role in the effective use of resources, are discussed as part of the examination of this shift in decision-making power from pathologists to external management. Our analysis, based on a range of archived and interview data collected over the period 1997-2000, suggests that publicly unacceptable compromises in pathology service quality were risked by the pursuit of tight bureaucratic and free market controls over pathology practice. The paper concludes with suggestions for a health professional control model facilitative of maximal health gain.

  14. Proliferative Lesions of Parathyroid Glands: An Update for Practicing Pathologists.

    PubMed

    Shakeel, Shaheera; Mubarak, Muhammed

    2016-01-01

    Pathological lesions of parathyroid glands encompass a wide range of lesions ranging from developmental anomalies to inflammatory disorders to neoplastic processes. Proliferative lesions of parathyroid glands represent the commonest causes of hyperparathyroidism in clinical practice. However, the parathyroid specimens represent only a tiny fraction of the workload received in a non-specialist histopathology laboratory. As a result, the familiarity of the pathologists with the spectrum of parathyroid lesions is generally limited. An accurate diagnosis of the parathyroid lesions is challenging and a daunting task for both the clinicians and the pathologists. The traditional morphological approaches have limitations. Ancillary techniques of immunohistochemistry and molecular biology are being increasingly employed to resolve the diagnostic dilemmas. This review briefly describes the proliferative pathological lesions affecting the parathyroid glands and provides some useful tips on accurately diagnosing these lesions.

  15. Significant Individual Variation Between Pathologists in the Evaluation of Colon Cancer Specimens After Complete Mesocolic Excision.

    PubMed

    Munkedal, Ditte Louise E; Laurberg, Søren; Hagemann-Madsen, Rikke; Stribolt, Katrine J; Krag, Søren R P; Quirke, Philip; West, Nicholas P

    2016-10-01

    After the introduction of complete mesocolic excision, a new pathological evaluation of the resected colon cancer specimen was introduced. This concept has quickly gained acceptance and is often used to compare surgical quality. The grading of colon cancer specimens is likely to depend on both surgical quality and the training of the pathologist. The purpose of this study was to validate the principles of the pathological evaluation of colon cancer specimens. This was an exploratory study. The study was conducted in Aarhus, Denmark, and Leeds, United Kingdom. Colon cancers specimens were used. The agreement of gradings between participants was of interest. Four specialist GI pathologists and 2 abdominal surgeons evaluated 2 rounds of colon cancer specimens, each at 2 separate time points. Each round contained 50 specimens. After the first round, a protocol of detailed principles for the grading procedure was agreed on. Results from an experienced pathologist were considered as the reference results. In the first round, the distribution of gradings between participants showed substantial variation. In the second round, the variation was reduced. Intraobserver agreement was mostly fair to good, whereas interobserver agreement was frequently poor. This did not significantly change from round 1 to round 2. The small sample size of 100 specimens provided a very small number of specimens resected in the muscularis propria plane, which renders the evaluation of this group potentially unreliable. The evaluations were made on photos and not on fresh specimens. This study demonstrates significant variation in the pathological evaluation of colon cancer specimens. It demonstrates that it cannot be used in clinical studies, and care should be taken when comparing results between different hospitals.

  16. A Framework for Comparative Assessments of Energy Efficiency Policy Measures

    SciTech Connect

    Blum, Helcio; Atkinson, Barbara; Lekov, Alex

    2011-05-24

    When policy makers propose new policies, there is a need to assess the costs and benefits of the proposed policy measures, to compare them to existing and alternative policies, and to rank them according to their effectiveness. In the case of equipment energy efficiency regulations, comparing the effects of a range of alternative policy measures requires evaluating their effects on consumers’ budgets, on national energy consumption and economics, and on the environment. Such an approach should be able to represent in a single framework the particularities of each policy measure and provide comparable results. This report presents an integrated methodological framework to assess prospectively the energy, economic, and environmental impacts of energy efficiency policy measures. The framework builds on the premise that the comparative assessment of energy efficiency policy measures should (a) rely on a common set of primary data and parameters, (b) follow a single functional approach to estimate the energy, economic, and emissions savings resulting from each assessed measure, and (c) present results through a set of comparable indicators. This framework elaborates on models that the U.S. Department of Energy (DOE) has used in support of its rulemakings on mandatory energy efficiency standards. In addition to a rigorous analysis of the impacts of mandatory standards, DOE compares the projected results of alternative policy measures to those projected to be achieved by the standards. The framework extends such an approach to provide a broad, generic methodology, with no geographic or sectoral limitations, that is useful for evaluating any type of equipment energy efficiency market intervention. The report concludes with a demonstration of how to use the framework to compare the impacts estimated for twelve policy measures focusing on increasing the energy efficiency of gas furnaces in the United States.

  17. The changing role of the pathologist in the management of Barrett's oesophagus.

    PubMed

    Hopcroft, Suzanne A; Shepherd, Neil A

    2014-10-01

    Pathological specimens from columnar-lined oesophagus (CLO) comprise a considerable proportion of the workload of gastrointestinal pathologists in Western countries. There remain controversies concerning the diagnostic role of pathology. More recently, in the UK at least, the diagnosis has been regarded as primarily an endoscopic endeavour, with pathology being corroborative and only diagnostic when endoscopic features are equivocal or when there are additional features that make the endoscopic diagnosis unclear. There is also recognition that demonstration of intestinalisation or 'goblet cells' is not paramount, and should not be required for the diagnosis. There have been notable changes in the management of CLO neoplasia: pathologists are centrally involved in its management. Pathological assessment of endoscopic mucosal resection (EMR) specimens provides the most useful means of determining the management of early neoplasia and of determining indications for surgery. This represents an extraordinarily rapid change in management, in that, <10 years ago, laborious Seattle-type biopsy protocols were recommended, and high grade dysplasia was an indication for resectional surgery. Now, individual patient management is paramount: multi-professional meetings determine management after biopsy and EMR assessment. One significant change is that major resections are undertaken less often, in Western countries, for CLO neoplasia. © 2014 John Wiley & Sons Ltd.

  18. Oropharyngeal dysphagia: surveying practice patterns of the speech-language pathologist.

    PubMed

    Martino, Rosemary; Pron, Gaylene; Diamant, Nicholas E

    2004-01-01

    The present study was designed to obtain a comprehensive view of the dysphagia assessment practice patterns of speech-language pathologists and their opinion on the importance of these practices using survey methods and taking into consideration clinician, patient, and practice-setting variables. A self-administered mail questionnaire was developed following established methodology to maximize response rates. Eight dysphagia experts independently rated the new survey for content validity. Test-retest reliability was assessed with a random sample of 23 participants. The survey was sent to 50 speech-language pathologists randomly selected from the Canadian professional association database of members who practice in dysphagia. Surveys were mailed according to the Dillman Total Design Method and included an incentive offer. High survey (64%) and item response (95%) rates were achieved and clinicians were reliable reporters of their practice behaviors (ICC>0.60). Of all the clinical assessment items, 36% were reported with high (>80%) utilization and 24% with low (<20%) utilization, the former pertaining to tongue motion and vocal quality after food/fluid intake and the latter to testing of oral sensation without food. One-third (33%) of instrumental assessment items were highly utilized and included assessment of bolus movement and laryngeal response to bolus misdirection. Overall, clinician experience and teaching institutions influenced greater utilization. Opinions of importance were similar to utilization behaviors (r = 0.947, p = 0.01). Of all patients referred for dysphagia assessment, full clinical assessments were administered to 71% of patients but instrumental assessments to only 36%. A hierarchical model of practice behavior is proposed to explain this pattern of progressively decreasing item utilization.

  19. Comparing Two Forms of Dynamic Assessment and Traditional Assessment of Preschool Phonological Awareness

    ERIC Educational Resources Information Center

    Kantor, Patricia Thatcher; Wagner, Richard K.; Torgesen, Joseph K.; Rashotte, Carol A.

    2011-01-01

    The goal of the current study was to compare two forms of dynamic assessment and standard assessment of preschool children's phonological awareness. The first form of dynamic assessment was a form of scaffolding in which item formats were modified in response to an error so as to make the task easier or more explicit. The second form of dynamic…

  20. Comparing Two Forms of Dynamic Assessment and Traditional Assessment of Preschool Phonological Awareness

    ERIC Educational Resources Information Center

    Kantor, Patricia Thatcher; Wagner, Richard K.; Torgesen, Joseph K.; Rashotte, Carol A.

    2011-01-01

    The goal of the current study was to compare two forms of dynamic assessment and standard assessment of preschool children's phonological awareness. The first form of dynamic assessment was a form of scaffolding in which item formats were modified in response to an error so as to make the task easier or more explicit. The second form of dynamic…

  1. Assessing Tumor-infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method From the International Immunooncology Biomarkers Working Group: Part 1: Assessing the Host Immune Response, TILs in Invasive Breast Carcinoma and Ductal Carcinoma In Situ, Metastatic Tumor Deposits and Areas for Further Research.

    PubMed

    Hendry, Shona; Salgado, Roberto; Gevaert, Thomas; Russell, Prudence A; John, Tom; Thapa, Bibhusal; Christie, Michael; van de Vijver, Koen; Estrada, M V; Gonzalez-Ericsson, Paula I; Sanders, Melinda; Solomon, Benjamin; Solinas, Cinzia; Van den Eynden, Gert G G M; Allory, Yves; Preusser, Matthias; Hainfellner, Johannes; Pruneri, Giancarlo; Vingiani, Andrea; Demaria, Sandra; Symmans, Fraser; Nuciforo, Paolo; Comerma, Laura; Thompson, E A; Lakhani, Sunil; Kim, Seong-Rim; Schnitt, Stuart; Colpaert, Cecile; Sotiriou, Christos; Scherer, Stefan J; Ignatiadis, Michail; Badve, Sunil; Pierce, Robert H; Viale, Giuseppe; Sirtaine, Nicolas; Penault-Llorca, Frederique; Sugie, Tomohagu; Fineberg, Susan; Paik, Soonmyung; Srinivasan, Ashok; Richardson, Andrea; Wang, Yihong; Chmielik, Ewa; Brock, Jane; Johnson, Douglas B; Balko, Justin; Wienert, Stephan; Bossuyt, Veerle; Michiels, Stefan; Ternes, Nils; Burchardi, Nicole; Luen, Stephen J; Savas, Peter; Klauschen, Frederick; Watson, Peter H; Nelson, Brad H; Criscitiello, Carmen; O'Toole, Sandra; Larsimont, Denis; de Wind, Roland; Curigliano, Giuseppe; André, Fabrice; Lacroix-Triki, Magali; van de Vijver, Mark; Rojo, Federico; Floris, Giuseppe; Bedri, Shahinaz; Sparano, Joseph; Rimm, David; Nielsen, Torsten; Kos, Zuzana; Hewitt, Stephen; Singh, Baljit; Farshid, Gelareh; Loibl, Sibylle; Allison, Kimberly H; Tung, Nadine; Adams, Sylvia; Willard-Gallo, Karen; Horlings, Hugo M; Gandhi, Leena; Moreira, Andre; Hirsch, Fred; Dieci, Maria V; Urbanowicz, Maria; Brcic, Iva; Korski, Konstanty; Gaire, Fabien; Koeppen, Hartmut; Lo, Amy; Giltnane, Jennifer; Rebelatto, Marlon C; Steele, Keith E; Zha, Jiping; Emancipator, Kenneth; Juco, Jonathan W; Denkert, Carsten; Reis-Filho, Jorge; Loi, Sherene; Fox, Stephen B

    2017-09-01

    Assessment of tumor-infiltrating lymphocytes (TILs) in histopathologic specimens can provide important prognostic information in diverse solid tumor types, and may also be of value in predicting response to treatments. However, implementation as a routine clinical biomarker has not yet been achieved. As successful use of immune checkpoint inhibitors and other forms of immunotherapy become a clinical reality, the need for widely applicable, accessible, and reliable immunooncology biomarkers is clear. In part 1 of this review we briefly discuss the host immune response to tumors and different approaches to TIL assessment. We propose a standardized methodology to assess TILs in solid tumors on hematoxylin and eosin sections, in both primary and metastatic settings, based on the International Immuno-Oncology Biomarker Working Group guidelines for TIL assessment in invasive breast carcinoma. A review of the literature regarding the value of TIL assessment in different solid tumor types follows in part 2. The method we propose is reproducible, affordable, easily applied, and has demonstrated prognostic and predictive significance in invasive breast carcinoma. This standardized methodology may be used as a reference against which other methods are compared, and should be evaluated for clinical validity and utility. Standardization of TIL assessment will help to improve consistency and reproducibility in this field, enrich both the quality and quantity of comparable evidence, and help to thoroughly evaluate the utility of TILs assessment in this era of immunotherapy.

  2. Comparing two forms of dynamic assessment and traditional assessment of preschool phonological awareness.

    PubMed

    Thatcher Kantor, Patricia; Wagner, Richard K; Torgesen, Joseph K; Rashotte, Carol A

    2011-01-01

    The goal of the current study was to compare two forms of dynamic assessment and standard assessment of preschool children's phonological awareness. The first form of dynamic assessment was a form of scaffolding in which item formats were modified in response to an error so as to make the task easier or more explicit. The second form of dynamic assessment was direct instruction of the phonological awareness tasks. The results indicate that preschool children's phonological awareness can be assessed using standard assessment procedures, provided the items require processing units larger than the individual phoneme. No advantage was found in reliability or validity for either dynamic assessment condition relative to the standard assessment condition. Dynamic assessment does not appear to improve reliability or validity of phonological awareness assessments when preschool children are given tasks that they can perform using standard administration procedures.

  3. Comparing Two Forms of Dynamic Assessment and Traditional Assessment of Preschool Phonological Awareness

    PubMed Central

    Kantor, Patricia Thatcher; Wagner, Richard K.; Torgesen, Joseph K.; Rashotte, Carol A.

    2010-01-01

    The goal of the current study was to compare two forms of dynamic assessment and standard assessment of preschool children's phonological awareness. The first form of dynamic assessment was a form of scaffolding in which item formats were modified in response to an error so as to make the task easier or more explicit. The second form of dynamic assessment was direct instruction of the phonological awareness tasks. The results indicate that preschool children's phonological awareness can be assessed using standard assessment procedures, provided the items require processing units larger than the individual phoneme. No advantage was found in reliability or validity for either dynamic assessment condition relative to the standard assessment condition. Dynamic assessment does not appear to improve reliability or validity of phonological awareness assessments when preschool children are given tasks that they can perform using standard administration procedures. PMID:21685350

  4. Interobserver Reproducibility Among Gynecologic Pathologists in Diagnosing Heterologous Osteosarcomatous Component in Gynecologic Tract Carcinosarcomas.

    PubMed

    Sangoi, Ankur R; Kshirsagar, Malti; Roma, Andres A; Horvai, Andrew E; Chivukula, Mamatha; Ellenson, Lora H; Fadare, Oluwole; Folkins, Ann K; Garg, Karuna; Hanley, Krisztina; Longacre, Teri A; Haas, Jacqueline; McCluggage, W Glenn; McKenney, Jesse K; Nucci, Marisa R; Oliva, Esther; Park, Kay J; Parkash, Vinita; Quick, Charles M; Rabban, Joseph T; Rutgers, Joanne K L; Soslow, Robert; Vang, Russell; Yemelyanova, Anna; Zaloudek, Charles; Beck, Andrew H

    2017-02-17

    Distinguishing hyalinized stroma from osteoid production by a heterologous osteosarcomatous component can be challenging in gynecologic tract carcinosarcomas. As heterologous components in a carcinosarcoma may have prognostic and therapeutic implications, it is important that these are recognized. This study examines interobserver reproducibility among gynecologic pathologists in the diagnosis of osteosarcomatous components, and its correlation with expression of the novel antibody SATB2 (marker of osteoblastic differentiation) in these osteosarcomatous foci. Digital H&E images from 20 gynecologic tract carcinosarcomas were reviewed by 22 gynecologic pathologists with a request to determine the presence or absence of an osteosarcomatous component. The 20 preselected cases included areas of classic heterologous osteosarcoma (malignant cells producing osteoid; n=10) and osteosarcoma mimics (malignant cells with admixed nonosteoid matrix; n=10). Interobserver agreement was evaluated and SATB2 scored on all 20 cases and compared with the original diagnoses. Moderate agreement (Fleiss' κ=0.483) was identified for the 22 raters scoring the 20 cases with a median sensitivity of 7/10 and a median specificity of 9/10 for the diagnosis of osteosarcoma. SATB2 showed 100% sensitivity (10/10) and 60% (6/10) specificity in discriminating classic osteosarcoma from osteosarcoma mimics. Utilizing negative SATB2 as a surrogate marker to exclude osteosarcoma, 73% (16/22) of the reviewers would have downgraded at least 1 case to not contain an osteosarcomatous component (range, 1-6 cases, median 1 case). Gynecologic pathologists demonstrate only a moderate level of agreement in the diagnosis of heterologous osteosarcoma based on morphologic grounds. In such instances, a negative SATB2 staining may assist in increasing accuracy in the diagnosis of an osteosarcomatous component.

  5. Comparing Course Assessments: When Lower is Higher and Higher, Lower

    NASA Astrophysics Data System (ADS)

    Oliver, Dave; Dobele, Tony; Greber, Myles; Roberts, Tim

    2004-12-01

    This paper describes an exercise in determining the cognitive difficulty of the assessment tasks in six computing courses within an Information Technology (IT) degree, importing Bloom's taxonomy from the field of educational psychology as an analytical framework. Three of the six courses comprise a Programming stream and three a Data Communications and Networking stream. Bloom's taxonomy is described and we present other studies within computer science based on it. Next, we introduce the courses that were selected for the study and describe the process of analysis. The aggregated results are then presented and some inferences made. The results indicate that the programming courses required a relatively higher cognitive level in assessment tasks compared to the data communications and networking courses. This outcome suggests the need for alternative approaches to assessment.

  6. Assessing analytical comparability of biosimilars: GCSF as a case study.

    PubMed

    Nupur, Neh; Singh, Sumit Kumar; Narula, Gunjan; Rathore, Anurag S

    2016-10-01

    The biosimilar industry is witnessing an unprecedented growth with the newer therapeutics increasing in complexity over time. A key step towards development of a biosimilar is to establish analytical comparability with the innovator product, which would otherwise affect the safety/efficacy profile of the product. Choosing appropriate analytical tools that can fulfil this objective by qualitatively and/or quantitatively assessing the critical quality attributes (CQAs) of the product is highly critical for establishing equivalence. These CQAs cover the primary and higher order structures of the product, product related variants and impurities, as well as process related impurities, and host cell related impurities. In the present work, we use such an analytical platform for assessing comparability of five approved Granulocyte Colony Stimulating Factor (GCSF) biosimilars (Emgrast, Lupifil, Colstim, Neukine and Grafeel) to the innovator product, Neupogen(®). The comparability studies involve assessing structural homogeneity, identity, secondary structure, and product related modifications. Physicochemical analytical tools include peptide mapping with mass determination, circular dichroism (CD) spectroscopy, reverse phase chromatography (RPC) and size exclusion chromatography (SEC) have been used in this exercise. Bioactivity assessment include comparison of relative potency through in vitro cell proliferation assays. The results from extensive analytical examination offer robust evidence of structural and biological similarity of the products under consideration with the pertinent innovator product. For the most part, the biosimilar drugs were found to be comparable to the innovator drug anomaly that was identified was that three of the biosimilars had a typical variant which was reported as an oxidized species in the literature. But, upon further investigation using RPC-FLD and ESI-MS we found that this is likely a conformational variant of the biotherapeutic been

  7. Information Uncertainty to Compare Qualitative Reasoning Security Risk Assessment Results

    SciTech Connect

    Chavez, Gregory M; Key, Brian P; Zerkle, David K; Shevitz, Daniel W

    2009-01-01

    The security risk associated with malevolent acts such as those of terrorism are often void of the historical data required for a traditional PRA. Most information available to conduct security risk assessments for these malevolent acts is obtained from subject matter experts as subjective judgements. Qualitative reasoning approaches such as approximate reasoning and evidential reasoning are useful for modeling the predicted risk from information provided by subject matter experts. Absent from these approaches is a consistent means to compare the security risk assessment results. Associated with each predicted risk reasoning result is a quantifiable amount of information uncertainty which can be measured and used to compare the results. This paper explores using entropy measures to quantify the information uncertainty associated with conflict and non-specificity in the predicted reasoning results. The measured quantities of conflict and non-specificity can ultimately be used to compare qualitative reasoning results which are important in triage studies and ultimately resource allocation. Straight forward extensions of previous entropy measures are presented here to quantify the non-specificity and conflict associated with security risk assessment results obtained from qualitative reasoning models.

  8. Inter-observer variation between pathologists in diffuse parenchymal lung disease

    PubMed Central

    Nicholson, A; Addis, B; Bharucha, H; Clelland, C; Corrin, B; Gibbs, A; Hasleton, P; Kerr, K; Ibrahim, N; Stewart, S; Wallace, W; Wells, A

    2004-01-01

    Background: There have been few inter-observer studies of diffuse parenchymal lung disease (DPLD), but the recent ATS/ERS consensus classification provides a basis for such a study. Methods: A method for categorising numerically the percentage likelihood of these differential diagnoses was developed, and the diagnostic confidence of pathologists using this classification and the reproducibility of their diagnoses were assessed. Results: The overall kappa coefficient of agreement for the first choice diagnosis was 0.38 (n = 133 biopsies), increasing to 0.43 for patients (n = 83) with multiple biopsies. Weighted kappa coefficients of agreement, quantifying the level of probability of individual diagnoses, were moderate to good (mean 0.58, range 0.40–0.75). However, in 18% of biopsy specimens the diagnosis was given with low confidence. Over 50% of inter-observer variation related to the diagnosis of non-specific interstitial pneumonia and, in particular, its distinction from usual interstitial pneumonia. Conclusion: These results show that the ATS/ERS classification can be applied reproducibly by pathologists who evaluate DPLD routinely, and support the practice of taking multiple biopsy specimens. PMID:15170033

  9. Royal College of Pathologists' United Kingdom pilot study of laboratory accreditation. The College Accreditation Steering Committee.

    PubMed

    1990-02-01

    The Royal College of Pathologists recently commissioned a pilot study to assess the feasibility, desirability, and cost of establishing a national scheme for laboratory accreditation in the United Kingdom. Using a format similar to that designed by the College of American Pathologists, eight inspectors visited 24 laboratories comprising the major disciplines of two district hospitals, two teaching hospitals, a specialised (paediatric) hospital and a private hospital. Nine were considered accreditable without reservation, but 15 had deficiencies identified of differing importance which needed to be corrected before accreditation could be awarded. Problems identified were variable, but none related to technical performance and many did not require extra resources to correct. The exercise was conducted without organisational difficulty at an approximate direct cost of 300 pounds per laboratory. The study shows that the format used could form the basis of a cost effective nationwide strategy. The type of problems identified suggest that such a strategy is more likely to succeed if it is organised from within the pathology professions.

  10. The Pathologist 2.0: An Update on Digital Pathology in Veterinary Medicine.

    PubMed

    Bertram, Christof A; Klopfleisch, Robert

    2017-09-01

    Using light microscopy to describe the microarchitecture of normal and diseased tissues has changed very little since the middle of the 19th century. While the premise of histologic analysis remains intact, our relationship with the microscope is changing dramatically. Digital pathology offers new forms of visualization, and delivery of images is facilitated in unprecedented ways. This new technology can untether us entirely from our light microscopes, with many pathologists already performing their jobs using virtual microscopy. Several veterinary colleges have integrated virtual microscopy in their curriculum, and some diagnostic histopathology labs are switching to virtual microscopy as their main tool for the assessment of histologic specimens. Considering recent technical advancements of slide scanner and viewing software, digital pathology should now be considered a serious alternative to traditional light microscopy. This review therefore intends to give an overview of the current digital pathology technologies and their potential in all fields of veterinary pathology (ie, research, diagnostic service, and education). A future integration of digital pathology in the veterinary pathologist's workflow seems to be inevitable, and therefore it is proposed that trainees should be taught in digital pathology to keep up with the unavoidable digitization of the profession.

  11. Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey.

    PubMed

    Sanketh, D Sharathkumar; Srinivasan, Samuel Raj; Patil, Shankargouda; Ranganathan, Kannan

    2016-10-26

    In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion. © 2016 John Wiley & Sons Australia, Ltd.

  12. Comparative life cycle assessment of three biohydrogen pathways.

    PubMed

    Djomo, Sylvestre Njakou; Blumberga, Dagnija

    2011-02-01

    A life cycle assessment was performed to quantify and compare the energetic and environmental performances of hydrogen from wheat straw (WS-H(2)), sweet sorghum stalk (SSS-H(2)), and steam potato peels (SPP-H(2)). Inventory data were derived from a pilot plant. Impacts were assessed using the impact 2002+ method. When co-product was not considered, the greenhouse gas (GHG) emissions were 5.60 kg CO(2eq) kg(-1) H(2) for WS-H(2), 5.32 kg CO(2eq) kg(-1) H(2) for SSS-H(2), and 5.18 kg CO(2eq) kg(-1) H(2) for SPP-H(2). BioH(2) pathways reduced GHG emissions by 52-56% compared to diesel and by 54-57% compared to steam methane reforming production of H(2). The energy ratios (ER) were also comparable: 1.08 for WS-H(2), 1.14 for SSS-H(2) and 1.17 for SPP-H(2). A shift from SPP-H(2) to WS-H(2) would therefore not affect the ER and GHG emissions of these BioH(2) pathways. When co-product was considered, a shift from SPP-H(2) to WS-H(2) or SSS-H(2) decreased the ER, while increasing the GHG emissions significantly. Co-product yield should be considered when selecting BioH(2) feedstocks.

  13. Autopsy Practice in Ghana - Reflections of a Pathologist.

    PubMed

    Anim, J T

    2015-06-01

    Autopsy practice in Ghana can be said to be far from satisfactory. Most Ghanaians do not know that there are different categories of death, which categories of death require an autopsy and who is required to perform the autopsy. The problems have further been complicated by the fact that, unlike other countries where separate facilities are available for storage of the different categories of dead bodies, all dead bodies in Ghana are conveyed to the hospital mortuary, thus encouraging hospitals to expand body storage facilities in their mortuaries to meet the increasing demand. Public or community mortuaries used elsewhere for storage of bodies of deaths occurring in the community pending the Coroner's directions are non-existent in Ghana. Storage of all categories of dead bodies in hospital mortuaries has resulted in virtually all autopsies being done by the hospital pathologists, especially in the large centres, at the expense of other very important diagnostic functions of the pathologist. This paper explains relevant portions of the Coroner's Act of 1960 and emphasises the need to separate the few hospital autopsies that require the expertise of the pathologist from Coroner's autopsies that may be carried out by any registered medical officer, as specified in the Act, or better still, by specially trained Forensic Physicians/Medical Examiners, as pertains in other countries. The paper also clarifies the different categories of death, those that fall in the jurisdiction of the Coroner and the personnel required to assist the Coroner in his investigastions. Suggestions have also been made on how to approach manpower development to ensure that appropriate personnel are trained to assist the Coroner in the investgation of medico-legal cases.

  14. Comparing preference assessments: selection- versus duration-based preference assessment procedures.

    PubMed

    Kodak, Tiffany; Fisher, Wayne W; Kelley, Michael E; Kisamore, April

    2009-01-01

    In the current investigation, the results of a selection- and a duration-based preference assessment procedure were compared. A Multiple Stimulus With Replacement (MSW) preference assessment [Windsor, J., Piché, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439-455] and a variation of a Free-Operant (FO) preference assessment procedure [Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31, 605-620] were conducted with four participants. A reinforcer assessment was conducted to determine which preference assessment procedure identified the item that produced the highest rates of responding. The items identified as most highly preferred were different across preference assessment procedures for all participants. Results of the reinforcer assessment showed that the MSW identified the item that functioned as the most effective reinforcer for two participants.

  15. The role of the pathologist in human rights abuses

    PubMed Central

    Thomsen, J.

    2000-01-01

    The objective and unbiased statement is much valued in international work against human rights abuses. Pathologists play an increasingly important role. In this article, this role is illustrated by examples and the international set of rules is described. It is emphasised that under no circumstances should physicians assist in procedures, such as torture, which can weaken a human being. There is ongoing research into the sequelae of torture, both by gross and microscopic examination and in the living and dead victims. Key Words: torture • human rights • death in custody PMID:11002757

  16. Bilingual Language Assessment: Contemporary versus Recommended Practice in American Schools

    ERIC Educational Resources Information Center

    Arias, Graciela; Friberg, Jennifer

    2017-01-01

    Purpose: The purpose of this study was to identify current practices of school-based speech-language pathologists (SLPs) in the United States for bilingual language assessment and compare them to American Speech-Language-Hearing Association (ASHA) best practice guidelines and mandates of the Individuals with Disabilities Education Act (IDEA,…

  17. Comparative assessment of nanomaterial definitions and safety evaluation considerations.

    PubMed

    Boverhof, Darrell R; Bramante, Christina M; Butala, John H; Clancy, Shaun F; Lafranconi, Mark; West, Jay; Gordon, Steve C

    2015-10-01

    Nanomaterials continue to bring promising advances to science and technology. In concert have come calls for increased regulatory oversight to ensure their appropriate identification and evaluation, which has led to extensive discussions about nanomaterial definitions. Numerous nanomaterial definitions have been proposed by government, industry, and standards organizations. We conducted a comprehensive comparative assessment of existing nanomaterial definitions put forward by governments to highlight their similarities and differences. We found that the size limits used in different definitions were inconsistent, as were considerations of other elements, including agglomerates and aggregates, distributional thresholds, novel properties, and solubility. Other important differences included consideration of number size distributions versus weight distributions and natural versus intentionally-manufactured materials. Overall, the definitions we compared were not in alignment, which may lead to inconsistent identification and evaluation of nanomaterials and could have adverse impacts on commerce and public perceptions of nanotechnology. We recommend a set of considerations that future discussions of nanomaterial definitions should consider for describing materials and assessing their potential for health and environmental impacts using risk-based approaches within existing assessment frameworks. Our intent is to initiate a dialogue aimed at achieving greater clarity in identifying those nanomaterials that may require additional evaluation, not to propose a formal definition.

  18. Appropriateness of plantar pressure measurement devices: a comparative technical assessment.

    PubMed

    Giacomozzi, Claudia

    2010-05-01

    Accurate plantar pressure measurements are mandatory in both clinical and research contexts. Differences in accuracy, precision and reliability of the available devices have prevented so far the onset of standardization processes or the definition of reliable reference datasets. In order to comparatively assess the appropriateness of the most used pressure measurement devices (PMD) on-the-market, in 2006 the Institute the author is working for approved a two-year scientific project aimed to design, validate and implement dedicated testing methods for both in-factory and on-the field assessment. A first testing phase was also performed which finished in December 2008. Five commercial PMDs using different technologies-resistive, elastomer-based capacitive, air-based capacitive-were assessed and compared with respect to absolute pressure measurements, hysteresis, creep and COP estimation. The static and dynamic pressure tests showed very high accuracy of capacitive, elastomer-based technology (RMSE<0.5%), and quite a good performance of capacitive, air-based technology (RMSE<5%). High accuracy was also found for the resistive technology by TEKSCAN (RMSE<2.5%), even though a complex ad hoc calibration was necessary.

  19. Comparing Preference Assessments: Selection- versus Duration-Based Preference Assessment Procedures

    ERIC Educational Resources Information Center

    Kodak, Tiffany; Fisher, Wayne W.; Kelley, Michael E.; Kisamore, April

    2009-01-01

    In the current investigation, the results of a selection- and a duration-based preference assessment procedure were compared. A Multiple Stimulus With Replacement (MSW) preference assessment [Windsor, J., Piche, L. M., & Locke, P. A. (1994). "Preference testing: A comparison of two presentation methods." "Research in Developmental Disabilities,…

  20. A Comparative Analysis of Life-Cycle Assessment Tools for ...

    EPA Pesticide Factsheets

    We identified and evaluated five life-cycle assessment tools that community decision makers can use to assess the environmental and economic impacts of end-of-life (EOL) materials management options. The tools evaluated in this report are waste reduction mode (WARM), municipal solid waste-decision support tool (MSW-DST), solid waste optimization life-cycle framework (SWOLF), environmental assessment system for environmental technologies (EASETECH), and waste and resources assessment for the environment (WRATE). WARM, MSW-DST, and SWOLF were developed for US-specific materials management strategies, while WRATE and EASETECH were developed for European-specific conditions. All of the tools (with the exception of WARM) allow specification of a wide variety of parameters (e.g., materials composition and energy mix) to a varying degree, thus allowing users to model specific EOL materials management methods even outside the geographical domain they are originally intended for. The flexibility to accept user-specified input for a large number of parameters increases the level of complexity and the skill set needed for using these tools. The tools were evaluated and compared based on a series of criteria, including general tool features, the scope of the analysis (e.g., materials and processes included), and the impact categories analyzed (e.g., climate change, acidification). A series of scenarios representing materials management problems currently relevant to c

  1. A Comparative Analysis of Life-Cycle Assessment Tools for ...

    EPA Pesticide Factsheets

    We identified and evaluated five life-cycle assessment tools that community decision makers can use to assess the environmental and economic impacts of end-of-life (EOL) materials management options. The tools evaluated in this report are waste reduction mode (WARM), municipal solid waste-decision support tool (MSW-DST), solid waste optimization life-cycle framework (SWOLF), environmental assessment system for environmental technologies (EASETECH), and waste and resources assessment for the environment (WRATE). WARM, MSW-DST, and SWOLF were developed for US-specific materials management strategies, while WRATE and EASETECH were developed for European-specific conditions. All of the tools (with the exception of WARM) allow specification of a wide variety of parameters (e.g., materials composition and energy mix) to a varying degree, thus allowing users to model specific EOL materials management methods even outside the geographical domain they are originally intended for. The flexibility to accept user-specified input for a large number of parameters increases the level of complexity and the skill set needed for using these tools. The tools were evaluated and compared based on a series of criteria, including general tool features, the scope of the analysis (e.g., materials and processes included), and the impact categories analyzed (e.g., climate change, acidification). A series of scenarios representing materials management problems currently relevant to c

  2. Transcription factor motif quality assessment requires systematic comparative analysis

    PubMed Central

    Kibet, Caleb Kipkurui; Machanick, Philip

    2016-01-01

    Transcription factor (TF) binding site prediction remains a challenge in gene regulatory research due to degeneracy and potential variability in binding sites in the genome. Dozens of algorithms designed to learn binding models (motifs) have generated many motifs available in research papers with a subset making it to databases like JASPAR, UniPROBE and Transfac. The presence of many versions of motifs from the various databases for a single TF and the lack of a standardized assessment technique makes it difficult for biologists to make an appropriate choice of binding model and for algorithm developers to benchmark, test and improve on their models. In this study, we review and evaluate the approaches in use, highlight differences and demonstrate the difficulty of defining a standardized motif assessment approach. We review scoring functions, motif length, test data and the type of performance metrics used in prior studies as some of the factors that influence the outcome of a motif assessment. We show that the scoring functions and statistics used in motif assessment influence ranking of motifs in a TF-specific manner. We also show that TF binding specificity can vary by source of genomic binding data. We also demonstrate that information content of a motif is not in isolation a measure of motif quality but is influenced by TF binding behaviour. We conclude that there is a need for an easy-to-use tool that presents all available evidence for a comparative analysis. PMID:27092243

  3. A Comparative Assessment of Novel Mini-Laparoscopic Tools.

    PubMed

    Dorian, Emily D; DeAsis, Francis J; Lapin, Brittany; Amesbury, Robert; Tanaka, Ryota; Ujiki, Michael B

    2017-02-01

    Mini-laparoscopy, or needlescopy, is an emerging minimally invasive technique that aims to improve on standard laparoscopy in the areas of tissue trauma, pain, and cosmesis. The objective of this study was to determine if there was a difference in functionality between 2 novel mini-laparoscopic instruments when compared to standard laparoscopic tools. Differences were assessed in a simulated surgical environment. Twenty participants (5 novices, 10 intermediate, 5 expert) were recruited for this institutional review board-approved study in a surgical simulation training center. Group A tools were assembled intracorporeally, and Group B tools were assembled extracorporeally. Using standard laparoscopic graspers, mini-laparoscopic graspers, or a combination of both, each participant performed 3 basic laparoscopic training tasks: a Peg Transfer, Rubber Band Stretch, and Tootsie Roll Unwrapping. Following each round of tasks, participants completed a survey evaluating the mini-laparoscopic graspers with respect to standard laparoscopic graspers. Data were analyzed using Kruskal-Wallis test with Dunn's test for post hoc comparisons. When comparing task times, both mini tools performed at the level of standard laparoscopic graspers in all participant groups. Group A tools were quicker to assemble and disassemble versus Group B tools. According to posttask surveys, all participant groups indicated that both sets of mini-laparoscopic graspers were comparable to the standard graspers. In a nonclinical setting, mini-laparoscopic instruments perform at the level of standard laparoscopic tools. Based on these results, clinical trials would be a reasonable next step in assessing feasibility and safety.

  4. Alternative future scenarios for the SPS comparative assessment

    SciTech Connect

    Ayres, R.U.; Ridker, R.G.; Watson, W.D. Jr.; Arnold, J.; Tayi, G.

    1980-08-01

    The objective of the comparative assessment is to develop an initial understanding of the SPS with respect to a limited set of energy alternatives. A comparative methodology report describes the multi-step process in the comparative assessment. The first step is the selection and characterization of alternative energy systems. Terrestrial alternatives are selected, and their cost, performance, and environmental and social attributes are specified for use in the comparison with the SPS in the post-2000 era. Data on alternative technologies were sought from previous research and from other comparisons. The object of this study is to provide a futures framework for evaluating SPS (i.e., factor prices, primary energy prices, and energy demands for the US from 1980 to 2030). The economic/energy interactions are discussed, and a number of specific modelling schemes that have been used for long-range forecasting purposes are described. This discussion provides the rationale for the choice of a specific model and methodology, which is described. Long-range cost assumptions used in the forecast are detailed, and the basis for the selection of specific scenarios follows. Results of the analysis are detailed. (WHK)

  5. Biogrouting compared to jet grouting: environmental (LCA) and economical assessment.

    PubMed

    Suer, Pascal; Hallberg, Niklas; Carlsson, Christel; Bendz, David; Holm, Goran

    2009-03-01

    In order to predict consequences of replacing jet grouting with biogrouting, and identify major contributors to the cost of both technologies, a large road project in Stockholm, Sweden, was used as a case study. Jet grouting had been used to seal the contact between sheet piling and bedrock, biogrouting for the same function was computed. A comparative environmental and economical assessment was carried out using life cycle assessment (LCA). The results show that biogrouting was cheaper than jet grouting and would have had lower environmental impact. The major difference was the transport and use of heavier equipment for jet grouting. Biogrouting also used less water and produced less landfilled waste. However, the production of urea and CaCl(2) for biogrouting required much energy.

  6. Current knowledge and impressions of speech-language pathologists of the swallow of persons who are obese.

    PubMed

    Evitts, Paul M; Kopf, Michelle; Kauffman, Megan

    2014-01-01

    The overall goal of this study was to provide insight on the topic of dysphagia in the obese population. More specifically, the purpose of this study was to obtain preliminary descriptive data on the knowledge and impressions of speech-language pathologists (SLPs) working in the field of dysphagia on the swallow of persons who are obese. One hundred seventy-seven SLPs responded to a web-based survey that was posted on two popular listserves that serve the dysphagia community. Descriptive results showed that nearly all SLPs have assessed and treated patients who are obese for dysphagia, that there is little consensus as to how the obese swallow compares to the normal swallow, and that there is a consensus that dysphagia observed in the obese population is most likely related to other concomitant disorders. Results provide preliminary insight into the knowledge and impressions of SLPs working with dysphagia and highlight the need for future research to determine (1) if there is an increased incidence of dysphagia in the obese population, and (2) if obesity itself constitutes a risk factor for dysphagia or if any dysphagia observed in this population is related to other comorbidities.

  7. A comparative assessment of statistical methods for extreme weather analysis

    NASA Astrophysics Data System (ADS)

    Schlögl, Matthias; Laaha, Gregor

    2017-04-01

    Extreme weather exposure assessment is of major importance for scientists and practitioners alike. We compare different extreme value approaches and fitting methods with respect to their value for assessing extreme precipitation and temperature impacts. Based on an Austrian data set from 25 meteorological stations representing diverse meteorological conditions, we assess the added value of partial duration series over the standardly used annual maxima series in order to give recommendations for performing extreme value statistics of meteorological hazards. Results show the merits of the robust L-moment estimation, which yielded better results than maximum likelihood estimation in 62 % of all cases. At the same time, results question the general assumption of the threshold excess approach (employing partial duration series, PDS) being superior to the block maxima approach (employing annual maxima series, AMS) due to information gain. For low return periods (non-extreme events) the PDS approach tends to overestimate return levels as compared to the AMS approach, whereas an opposite behavior was found for high return levels (extreme events). In extreme cases, an inappropriate threshold was shown to lead to considerable biases that may outperform the possible gain of information from including additional extreme events by far. This effect was neither visible from the square-root criterion, nor from standardly used graphical diagnosis (mean residual life plot), but from a direct comparison of AMS and PDS in synoptic quantile plots. We therefore recommend performing AMS and PDS approaches simultaneously in order to select the best suited approach. This will make the analyses more robust, in cases where threshold selection and dependency introduces biases to the PDS approach, but also in cases where the AMS contains non-extreme events that may introduce similar biases. For assessing the performance of extreme events we recommend conditional performance measures that focus

  8. Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists regarding Children with Cleft Lip/Palate

    ERIC Educational Resources Information Center

    Bedwinek, Anne P.; Kummer, Ann W.; Rice, Gale B.; Grames, Lynn Marty

    2010-01-01

    Purpose: The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area. Method: A 16-item mixed-methods…

  9. Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists regarding Children with Cleft Lip/Palate

    ERIC Educational Resources Information Center

    Bedwinek, Anne P.; Kummer, Ann W.; Rice, Gale B.; Grames, Lynn Marty

    2010-01-01

    Purpose: The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area. Method: A 16-item mixed-methods…

  10. Framework for a comparative environmental assessment of drilling fluids

    SciTech Connect

    Meinhold, A.F.

    1998-11-01

    During the drilling of an oil or gas well, drilling fluid (or mud) is used to maintain well control and to remove drill cuttings from the hole. In response to effluent limitation guidelines promulgated by the US Environmental Protection Agency (EPA) for discharge of drilling wastes offshore, alternatives to water and oil-based muds have been developed. These synthetic-based muds (SBMs) are more efficient than water-based muds (WBMs) for drilling difficult and complex formation intervals and have lower toxicity and smaller environmental impacts than diesel or conventional mineral oil-based muds (OBMs). A third category of drilling fluids, derived from petroleum and called enhanced mineral oils (EMOs), also have these advantages over the traditionally used OBMs and WBMs. EPA recognizes that SBMs and EMOs are new classes of drilling fluids, but their regulatory status is unclear. To address this uncertainty, EPA is following an innovative presumptive rulemaking process that will develop final regulations for SBM discharges offshore in less than three years. This report develops a framework for a comparative risk assessment for the discharge of SBMs and EMOs, to help support a risk-based, integrated approach to regulatory decision making. The framework will help identify potential impacts and benefits associated with the use of SBMs, EMOs, WBMs, and OBMs; identify areas where additional data are needed; and support early decision-making in the absence of complete data. As additional data becomes available, the framework can support a full quantitative comparative assessment. Detailed data are provided to support a comparative assessment in the areas of occupational and public health impacts.

  11. Comparative endocrinology of leptin: Assessing function in a phylogenetic context

    PubMed Central

    Londraville, Richard L.; Macotela, Yazmin; Duff, Robert J.; Easterling, Marietta R.; Liu, Qin; Crespi, Erica J.

    2014-01-01

    As we approach the end of two decades of leptin research, the comparative biology of leptin is just beginning. We now have several leptin orthologs described from nearly every major clade among vertebrates, and are moving beyond gene descriptions to functional studies. Even at this early stage, it is clear that non-mammals display clear functional similarities and differences with their better-studied mammalian counterparts. This review assesses what we know about leptin function in mammals and non-mammals, and gives examples of how these data can inform leptin biology in humans. PMID:24525452

  12. Individual differences and subjective workload assessment - Comparing pilots to nonpilots

    NASA Technical Reports Server (NTRS)

    Vidulich, Michael A.; Pandit, Parimal

    1987-01-01

    Results by two groups of subjects, pilots and nonpilots, for two subjective workload assessment techniques (the SWAT and NASA-TLX tests) intended to evaluate individual differences in the perception and reporting of subjective workload are compared with results obtained for several traditional personality tests. The personality tests were found to discriminate between the groups while the workload tests did not. It is concluded that although the workload tests may provide useful information with respect to the interaction between tasks and personality, they are not effective as pure tests of individual differences.

  13. Quality improvement of patient care - forensic pathologists' perspective.

    PubMed

    Noguchi, Thomas T; Rogers, Christopher; Sathyavagiswaran, Lakshmanan

    2007-03-01

    In the U.S. today, the pathologists, both hospital-based and forensic, are regularly involved in quality assurance (QA) programs, the evaluation of patient safety at all levels of medical care, including treatments in walk-in clinics and medical offices. In the United States, official death investigations are conducted by the Medical Examiner's Office. The Medical Examiner's Office is aided in its work by a network of coordinating agencies to provide complete, comprehensive reporting and investigation of deaths placed under its jurisdiction. Those agencies are the Health Department, the Registrar of Vital Statistics on Births and Deaths, Division of Health Facilities, the Hospital Office of Decedent Affairs and the State medical licensing agencies, as well as the various law enforcement and regulatory agencies and the prosecuting attorney's office. Forensic pathologists are witnesses to the fatal results of often avoidable untoward events. They need to use their experiences to address and emphasize overall prevention programs to improve the quality of life in the community, to publicize the avoidable actions which can lead to untoward results. In the current growing atmosphere of threatening chemical, biological and radiation terrorist attacks, the health care system, especially hospitals, including emergency services, are mobilizing to develop plans to meet possible anticipated need for disaster preparedness.

  14. Skin condition assessment: a comparative study of techniques

    NASA Astrophysics Data System (ADS)

    Bindra, Ravindar M.; Wong, Joretta K.; Andrew, Jeremy J.; Xiao, Peng; Zhang, Bufa; Imhof, Robert E.

    1996-05-01

    We report the results of a study aimed at comparing Opto-Thermal Transient Emission Radiometry (OTTER) with established techniques of assessing skin condition, namely evaporimetry (TEWL), skin dielectric constant measurement, ATR-FTIR and clinical assessment. Comparisons were made during a week-long study of the effects of intensive washing on the volar forearms of 14 subjects. The study also provided a comparison of skin condition after washing with two different cleansers, a mild isethionate betaine cleansing bar and a soap bar. The subject-averaged results from OTTER and TEWL were found to correlate with the clinical assessments, namely that intensive washing with the soap bar produces greater skin damage than with the isethionate betaine bar. Skin dielectric constant measurements were found to be sensitive to changes of skin condition other than hydration, as evidenced by a daily oscillation that dominate the results. The ATR-FTIR measurements proved difficult to evaluate, because of interfering calcium deposits from the soap bar. On the practical side, OTTER and skin dielectric constant measurements were found to be quicker and more convenient to use than TEWL and ATR-FTIR.

  15. [Authorization of pathologists for the estimation of the tumor cell percentage on tissue sample for molecular analysis purpose].

    PubMed

    Luquain, Alexandra; Arbez-Gindre, Francine; Bedgedjian, Isabelle; Felix, Sophie; Harimenshi, Jean-Marie; Mihai, Ionela-Marcela; Monnien, Franck; Singeorzan, Cristina; Valmary-Degano, Séverine

    2016-08-01

    Before molecular analysis is performed, morphological control with an estimation of the tumour cell percentage (%TC) could have a major impact on mutation detection. Accreditation according to NF EN ISO 15189 commands an authorization through evaluation of skills. The objective of this work was to validate the empowerment of pathologists to estimate %TC in tissue sample prior to molecular analysis. The accreditation technical guidance methods in Medical biology and histopathology were taken as references. %TC was the ratio of tumour cell nuclei on all nuclei within the area selected for the DNA extraction. External evaluations quality scores were used for accuracy. In order to assess the intermediate precision, 35 %TC estimation were performed 15 days apart in 4 samples (biopsies, transparietal biopsies or surgical specimen, either fixed or frozen) by 7 pathologists. Three other cases with interference (inflammation, mucus, necrosis) were evaluated. A result was satisfactory if %TC were within ±20 % of expected percentage obtained by the average of 35 estimates. The performances were satisfactory since no estimate was made more than 20 % of the expected percentage. Low interpathologists reproducibility has been reported in the literature and can have a consequence on molecular analysis in samples with low %TC, where the value reach the analytical sensitivity thresholds of molecular techniques. The current report is an example of a step of the accreditation process, which is a challenge for pathologists' activity in the future.

  16. Comparing methods for assessing the effectiveness of subnational REDD+ initiatives

    NASA Astrophysics Data System (ADS)

    Bos, Astrid B.; Duchelle, Amy E.; Angelsen, Arild; Avitabile, Valerio; De Sy, Veronique; Herold, Martin; Joseph, Shijo; de Sassi, Claudio; Sills, Erin O.; Sunderlin, William D.; Wunder, Sven

    2017-07-01

    The central role of forests in climate change mitigation, as recognized in the Paris agreement, makes it increasingly important to develop and test methods for monitoring and evaluating the carbon effectiveness of REDD+. Over the last decade, hundreds of subnational REDD+ initiatives have emerged, presenting an opportunity to pilot and compare different approaches to quantifying impacts on carbon emissions. This study (1) develops a Before-After-Control-Intervention (BACI) method to assess the effectiveness of these REDD+ initiatives; (2) compares the results at the meso (initiative) and micro (village) scales; and (3) compares BACI with the simpler Before-After (BA) results. Our study covers 23 subnational REDD+ initiatives in Brazil, Peru, Cameroon, Tanzania, Indonesia and Vietnam. As a proxy for deforestation, we use annual tree cover loss. We aggregate data into two periods (before and after the start of each initiative). Analysis using control areas (‘control-intervention’) suggests better REDD+ performance, although the effect is more pronounced at the micro than at the meso level. Yet, BACI requires more data than BA, and is subject to possible bias in the before period. Selection of proper control areas is vital, but at either scale is not straightforward. Low absolute deforestation numbers and peak years influence both our BA and BACI results. In principle, BACI is superior, with its potential to effectively control for confounding factors. We conclude that the more local the scale of performance assessment, the more relevant is the use of the BACI approach. For various reasons, we find overall minimal impact of REDD+ in reducing deforestation on the ground thus far. Incorporating results from micro and meso level monitoring into national reporting systems is important, since overall REDD+ impact depends on land use decisions on the ground.

  17. Perspectives of Speech-Language Pathologists on the Use of Telepractice in Schools: Quantitative Survey Results

    PubMed Central

    Tucker, Janice K.

    2012-01-01

    This research surveyed 170 school-based speech-language pathologists (SLPs) in one northeastern state, with only 1.8% reporting telepractice use in school-settings. These results were consistent with two ASHA surveys (2002; 2011) that reported limited use of telepractice for school-based speech-language pathology. In the present study, willingness to use telepractice was inversely related to age, perhaps because younger members of the profession are more accustomed to using technology. Overall, respondents were concerned about the validity of assessments administered via telepractice; whether clinicians can adequately establish rapport with clients via telepractice; and if therapy conducted via telepractice can be as effective as in-person speech-language therapy. Most respondents indicated the need to establish procedures and guidelines for school-based telepractice programs. PMID:25945204

  18. Performance of Candida--fungal-induced atypia and proficiency testing: observations from the College of American Pathologists proficiency testing program.

    PubMed

    Moriarty, Ann T; Darragh, Teresa M; Fatheree, Lisa A; Souers, Rhona; Wilbur, David C

    2009-08-01

    Candida may elicit cellular changes on otherwise negative screening Papanicolaou tests that may be misinterpreted as atypical squamous cells of undetermined significance. Although these changes have been correctly interpreted in the educational program of the College of American Pathologists, the Interlaboratory Comparison Program in Gynecologic Cytology, the performance of negative slides with Candida faltered when the same field validated slides were included in proficiency testing (PT). To identify the performance differences of negative for intraepithelial lesion (NILM) Candida challenges before and after PT. We compare the performance of NILM College of American Pathologists slides with Candida as a single reference diagnosis, prior to PT (1991-2006) and after PT (2006-2007). There were 147,186 responses for slides with NILM Candida from the College of American Pathologists programs from 1991 through 2007. After PT, 79.7% of incorrect participant responses identified Candida as Category C (low-grade squamous intraepithelial lesion), whereas prior to PT only 59.5% of the incorrect diagnoses were low-grade squamous intraepithelial lesion (P < .001) in the field-validated component of the program. Validated Candida slides performed significantly more poorly in PT (97.2%) than prior to PT (98.3%) (P < .001). Candida challenges performed better in the educational component post-PT (98.3% versus 97.2%; P < .001). Cytotechnologists (97.9%) identified Candida more frequently than pathologists (97.3%) (P < .001) and ThinPrep preparations performed the best of all preparation types. Proficiency testing adversely affects the performance of participants in the identification of NILM Candida. Slides with Candida are more likely to be identified as low-grade squamous intraepithelial lesion in a PT exercise. Misidentification is not due to lack of recognition but most likely an attempt of test takers to optimize their likelihood of passing the examination.

  19. Comparing life cycle assessments of different biofuel options.

    PubMed

    Kendall, Alissa; Yuan, Juhong

    2013-06-01

    Life cycle assessment (LCA) has shown that first generation biofuels provide a little to no benefit for greenhouse gas (GHG) reductions compared to petroleum fuels, particularly when indirect effects are considered. Second generation fuels are intended to achieve greater GHG reductions and avoid other sustainability issues. LCAs of second generation biofuels exhibit great variability and uncertainty, leading to inconclusive results for the performance of particular pathways (combinations of feedstocks and fuels). Variability arises in part because of the prospective nature of LCAs for future fuels; however, a review of recent articles on biofuel LCA methodology indicates two additional sources of variability: real sources such as spatiotemporal heterogeneity, and methodological sources such as choices for co-product allocation methods and system boundary definition.

  20. Coaches' assessment of their coaching efficacy compared to athletes' perceptions.

    PubMed

    Short, Sandra E; Short, Martin W

    2004-10-01

    This study compared coaches' assessments of their own coaching efficacy with their athletes' perceptions of the coaches' efficacy. Coaching efficacy was measured with the Coaching Efficacy Scale. Participants were 9 football coaches and 76 football players from the same team. Analysis indicated coaches were confident in their coaching abilities (range 6.5 to 9.0 on a 9-point scale). For 7 of the 9 coaches the coaches' ratings of themselves were higher than the athletes' ratings. For the other 2 coaches, athletes' ratings of coaches' efficacy were higher than the coaches' ratings of themselves. All coaches' ratings fell within the 95% confidence interval based on the athletes' ratings of the coaches' efficacy. Results are discussed in terms of the interplay between athletes and coaches efficacy beliefs and its influence on behavior.

  1. Collaborative framework for PIV uncertainty quantification: comparative assessment of methods

    NASA Astrophysics Data System (ADS)

    Sciacchitano, Andrea; Neal, Douglas R.; Smith, Barton L.; Warner, Scott O.; Vlachos, Pavlos P.; Wieneke, Bernhard; Scarano, Fulvio

    2015-07-01

    A posteriori uncertainty quantification of particle image velocimetry (PIV) data is essential to obtain accurate estimates of the uncertainty associated with a given experiment. This is particularly relevant when measurements are used to validate computational models or in design and decision processes. In spite of the importance of the subject, the first PIV uncertainty quantification (PIV-UQ) methods have been developed only in the last three years. The present work is a comparative assessment of four approaches recently proposed in the literature: the uncertainty surface method (Timmins et al 2012), the particle disparity approach (Sciacchitano et al 2013), the peak ratio criterion (Charonko and Vlachos 2013) and the correlation statistics method (Wieneke 2015). The analysis is based upon experiments conducted for this specific purpose, where several measurement techniques are employed simultaneously. The performances of the above approaches are surveyed across different measurement conditions and flow regimes.

  2. Comparing students' performance on research-based conceptual assessments and traditional classroom assessments

    NASA Astrophysics Data System (ADS)

    Rebello, N. Sanjay

    2012-02-01

    The use of concept inventories to investigate students' learning gains is common in physics education research. However, comparatively little research has compared students' learning gains on concept inventories with other more traditional assessments in the classroom. We present a study comparing second semester calculus-based physics students' performance on traditional classroom assessments including exams and homework with learning gains on SEMCO (Survey of Electricity, Magnetism, Circuits and Optics), which was previously created by combining questions on other conceptual surveys such as CSEM and DIRECT. We report on students' performance on specific items on SEMCO and corresponding traditional classroom assessments that are based on the same topic. Our results indicate that while the overall performance on SEMCO might correlate with aggregate performance on class exams, the performance on clusters of SEMCO items that assess conceptual understanding in various topical areas does not correlate as strongly with performance on corresponding traditional exams. These results raise some potentially interesting issues on the validity and usefulness of traditional classroom assessments and conceptual assessments that are often used to measure student learning in introductory physics.

  3. Comparative assessment of three standardized robotic surgery training methods.

    PubMed

    Hung, Andrew J; Jayaratna, Isuru S; Teruya, Kara; Desai, Mihir M; Gill, Inderbir S; Goh, Alvin C

    2013-10-01

    To evaluate three standardized robotic surgery training methods, inanimate, virtual reality and in vivo, for their construct validity. To explore the concept of cross-method validity, where the relative performance of each method is compared. Robotic surgical skills were prospectively assessed in 49 participating surgeons who were classified as follows: 'novice/trainee': urology residents, previous experience <30 cases (n = 38) and 'experts': faculty surgeons, previous experience ≥30 cases (n = 11). Three standardized, validated training methods were used: (i) structured inanimate tasks; (ii) virtual reality exercises on the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, CA, USA); and (iii) a standardized robotic surgical task in a live porcine model with performance graded by the Global Evaluative Assessment of Robotic Skills (GEARS) tool. A Kruskal-Wallis test was used to evaluate performance differences between novices and experts (construct validity). Spearman's correlation coefficient (ρ) was used to measure the association of performance across inanimate, simulation and in vivo methods (cross-method validity). Novice and expert surgeons had previously performed a median (range) of 0 (0-20) and 300 (30-2000) robotic cases, respectively (P < 0.001). Construct validity: experts consistently outperformed residents with all three methods (P < 0.001). Cross-method validity: overall performance of inanimate tasks significantly correlated with virtual reality robotic performance (ρ = -0.7, P < 0.001) and in vivo robotic performance based on GEARS (ρ = -0.8, P < 0.0001). Virtual reality performance and in vivo tissue performance were also found to be strongly correlated (ρ = 0.6, P < 0.001). We propose the novel concept of cross-method validity, which may provide a method of evaluating the relative value of various forms of skills education and assessment. We externally confirmed the construct validity of each featured training tool. © 2013 BJU

  4. Comparative assessment of clinical rating scales in Wilson's disease.

    PubMed

    Volpert, Hanna M; Pfeiffenberger, Jan; Gröner, Jan B; Stremmel, Wolfgang; Gotthardt, Daniel N; Schäfer, Mark; Weiss, Karl Heinz; Weiler, Markus

    2017-07-21

    Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism resulting in multifaceted neurological, hepatic, and psychiatric symptoms. The objective of the study was to comparatively assess two clinical rating scales for WD, the Unified Wilson's Disease Rating Scale (UWDRS) and the Global Assessment Scale for Wilson's disease (GAS for WD), and to test the feasibility of the patient reported part of the UWDRS neurological subscale (termed the "minimal UWDRS"). In this prospective, monocentric, cross-sectional study, 65 patients (median age 35 [range: 15-62] years; 33 female, 32 male) with treated WD were scored according to the two rating scales. The UWDRS neurological subscore correlated with the GAS for WD Tier 2 score (r = 0.80; p < 0.001). Correlations of the UWDRS hepatic subscore and the GAS for WD Tier 1 score with both the Model for End Stage Liver Disease (MELD) score (r = 0.44/r = 0.28; p < 0.001/p = 0.027) and the Child-Pugh score (r = 0.32/r = 0.12; p = 0.015/p = 0.376) were weak. The "minimal UWDRS" score significantly correlated with the UWDRS total score (r = 0.86), the UWDRS neurological subscore (r = 0.89), and the GAS for WD Tier 2 score (r = 0.86). The UWDRS neurological and psychiatric subscales and the GAS for WD Tier 2 score are valuable tools for the clinical assessment of WD patients. The "minimal UWDRS" is a practical prescreening tool outside scientific trials.

  5. Comparative Assessment of Sagittal Skeletal Discrepancy: A Cephalometric Study

    PubMed Central

    N., Dilip Kumar; Prasad, Mandav; Shamnur, Naveen; G., Arun Kumar; K.R., Sridhar; B.R., Gopal Krishna; Gupta, Neeraj

    2015-01-01

    Background and Objectives Evaluating the sagittal apical base relationship during orthodontic diagnosis and treatment planning is an important step. This study was aimed at comparison of Beta angle, ANB angle and Wit’s appraisal for assessment of sagittal skeletal discrepancy. Materials and Methods Eighty six young adults (43 female and 43 male) were selected from the patient’s reporting to Department of Orthodontics, College of Dental Sciences, Davangere, India. Family lineage was studied to know the nativity of Davangere. The standardized pre-treatment lateral cephalogram of the chosen sample was traced. The sample was divided into three skeletal pattern groups: Class I, Class II and Class III, based on the ANB angle and profile, Beta angle was assessed in each group. Statistical Analysis The data was subjected to statistical analysis student’s t-test, ANOVA test and correlation and regression analysis, using the software namely SPSS Software version 13. Microsoft word and Excel were used to generate graphs and tables. Results In the local Davangere population, Class I skeletal pattern group exhibited Beta angle between 26°–34°, Beta angle less than 27° was found in Class II skeletal pattern, and Beta angle greater than 32° was seen Class III skeletal pattern. The coefficient of variation of Beta angle in all the three groups was significantly homogenous compared to ANB angle and Wits appraisal. The correlation and regression analysis of the total sample indicated a highly significant correlation between Beta angle and ANB angle (p<.001), and between Beta angle and Wits appraisal (p<.01). Conclusion Beta angle can be used to classify subjects into different skeletal patterns. The Correlation and regression analysis for the total sample suggests a highly significant relation between Beta angle and ANB angle and, between Beta angle and Wits appraisal. It can be more reliably used to assess sagittal jaw discrepancies than ANB angle and Wits appraisal

  6. Comparative assessment of sagittal skeletal discrepancy: a cephalometric study.

    PubMed

    Aparna, P; Kumar, Dilip N; Prasad, Mandav; Shamnur, Naveen; G, Arun Kumar; K R, Sridhar; B R, Gopal Krishna; Gupta, Neeraj

    2015-04-01

    Evaluating the sagittal apical base relationship during orthodontic diagnosis and treatment planning is an important step. This study was aimed at comparison of Beta angle, ANB angle and Wit's appraisal for assessment of sagittal skeletal discrepancy. Eighty six young adults (43 female and 43 male) were selected from the patient's reporting to Department of Orthodontics, College of Dental Sciences, Davangere, India. Family lineage was studied to know the nativity of Davangere. The standardized pre-treatment lateral cephalogram of the chosen sample was traced. The sample was divided into three skeletal pattern groups: Class I, Class II and Class III, based on the ANB angle and profile, Beta angle was assessed in each group. The data was subjected to statistical analysis student's t-test, ANOVA test and correlation and regression analysis, using the software namely SPSS Software version 13. Microsoft word and Excel were used to generate graphs and tables. In the local Davangere population, Class I skeletal pattern group exhibited Beta angle between 26°-34°, Beta angle less than 27° was found in Class II skeletal pattern, and Beta angle greater than 32° was seen Class III skeletal pattern. The coefficient of variation of Beta angle in all the three groups was significantly homogenous compared to ANB angle and Wits appraisal. The correlation and regression analysis of the total sample indicated a highly significant correlation between Beta angle and ANB angle (p<.001), and between Beta angle and Wits appraisal (p<.01). Beta angle can be used to classify subjects into different skeletal patterns. The Correlation and regression analysis for the total sample suggests a highly significant relation between Beta angle and ANB angle and, between Beta angle and Wits appraisal. It can be more reliably used to assess sagittal jaw discrepancies than ANB angle and Wits appraisal.

  7. A comparative assessment of the economics of plutonium disposition

    SciTech Connect

    Williams, K.A.; Miller, J.W.; Reid, R.L.

    1997-04-01

    The US Department of Energy office of Fissile Materials Disposition (DOE/MD) has been evaluating three technologies for the disposition of approximately 50 metric tons of surplus plutonium from defense-related programs: reactors, immobilization, and deep boreholes. As part of the process supporting an early CY 1997 Record of Decision (ROD), a comprehensive assessment of technical viability, cost, and schedule has been conducted by DOE/MD and its national laboratory contractors. Oak Ridge National Laboratory has managed and coordinated the life-cycle cost (LCC) assessment effort for this program. This paper discusses the economic analysis methodology and the results prior to ROD. A secondary intent of the paper is to discuss major technical and economic issues that impact cost and schedule. To evaluate the economics of these technologies on an equitable basis, a set of cost-estimating guidelines and a common cost-estimating format were utilized by all three technology teams. This paper also includes the major economic analysis assumptions and the comparative constant-dollar and discounted-dollar LCCs.

  8. Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists

    PubMed Central

    Remick, Amera K.; Catlin, Natasha R.; Quist, Erin M.; Steinbach, Thomas J.; Dixon, Darlene

    2015-01-01

    The Society of Toxicologic Pathology (STP) Education Committee and the STP Reproductive Special Interest Group held a North Carolina regional meeting entitled, “Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists” on March 13, 2015, at the National Institute of Environmental Health Sciences/National Toxicology Program in Research Triangle Park, North Carolina. The purpose of this regional meeting was to familiarize attendees with the topic of juvenile toxicity testing and discuss its relevance to clinical pediatric medicine, regulatory perspectives, challenges of appropriate study design confronted by toxicologists, and challenges of histopathologic examination and interpretation of juvenile tissues faced by pathologists. The 1-day meeting was a success with over 60 attendees representing industry, government, research organizations, and academia. PMID:26220944

  9. The College of American Pathologists Laboratory Accreditation Programme.

    PubMed

    Batjer, J D

    1990-01-01

    The Laboratory Accreditation Programme (LAP) offered by the College of American Pathologists (CAP) was begun in 1961. It is a voluntary peer review programme with the goal of laboratory improvement to excellence. It presently accredits more than 4300 laboratories throughout the world, although the majority are in the United States and Canada. Accreditation is contingent upon continuing successful performance in the CAP proficiency testing programmes, as well as passing biennial on-site laboratory inspections. These on-site inspections are done by practising laboratorians who use checklists appropriate for the various laboratory disciplines. Several governmental regulatory agencies (e.g. the Health Care Financing Agency) as well as private agencies (e.g. the Joint Commission on Accreditation of Healthcare Organizations) accept the LAP in place of their own programmes for laboratory accreditation.

  10. Pathologist and histotechnologist: a marriage in need of counseling.

    PubMed

    Enterline, H T

    1975-01-01

    The general level of histotechnology in this country is alarmingly low. Surgical pathology, a difficult field, is made doubly so by poorly prepared sections. The blame for this must rest in part on the pathologist because of his ignorance of histologic procedures, his acceptance of shoddy work, and his lack of interest in seeing that bright young people are enticed into the field and that adequate training facilities and career opportunities are available to them. Today we are asked to perform increasingly complex procedures, and if we are to meet this challenge, as well as perform our duties in pathologic anatomy to the best of our ability, it is essential that we rapidly change our attitude.

  11. Assessing and Comparing Global Health Competencies in Rehabilitation Students

    PubMed Central

    Ramsay, Tim

    2013-01-01

    Purpose. Globalization is contributing to changes in health outcomes and healthcare use in many ways, including health professionals' practices. The objective of this study was to assess and compare global health competencies in rehabilitation students. Method. Online cross-sectional survey of physiotherapy and occupational therapy students from five universities within Ontario. We used descriptive statistics to analyze students' perceived knowledge, skills, and learning needs in global health. We used Chi-square tests, with significance set at P < 0.05, to compare results across professions. Results. One hundred and sixty-six students completed the survey. In general, both physiotherapy and occupational therapy students scored higher on the “relationship between work and health,” “relationship between income and health,” and “socioeconomic position (SEP) and impact on health” and lower on “Access to healthcare for low income nations,” “mechanisms for why racial and ethnic disparities exist,” and “racial stereotyping and medical decision making.” Occupational therapy students placed greater importance on learning concerning social determinants of health (P = 0.03). Conclusion. This paper highlights several opportunities for improvement in global health education for rehabilitation students. Educators and professionals should consider developing strategies to address these needs and provide more global health opportunities in rehabilitation training programs. PMID:24381763

  12. Earth-to-orbit reusable launch vehicles: A comparative assessment

    NASA Technical Reports Server (NTRS)

    Chase, R. L.

    1978-01-01

    A representative set of space systems, functions, and missions for NASA and DoD from which launch vehicle requirements and characteristics was established as well as a set of air-breathing launch vehicles based on graduated technology capabilities corresponding to increasingly higher staging Mach numbers. The utility of the air-breathing launch vehicle candidates based on lift-off weight, performance, technology needs, and risk was assessed and costs were compared to alternative concepts. The results indicate that a fully reusable launch vehicle, whether two stage or one stage, could potentially reduce the cost per flight 60-80% compared to that for a partially reusable vehicle but would require advances in thermal protection system technology. A two-stage-to-orbit, parallel-lift vehicle with an air-breathing booster would cost approximately the same as a single-stage-to-orbit vehicle, but the former would have greater flexibility and a significantly reduced developmental risk. A twin-booster, subsonic-staged, parallel-lift vehicle represents the lowest system cost and developmental risk. However, if a large supersonic turbojet engine in the 350,000-N thrust class were available, supersonic staging would be preferred, and the investment in development would be returned in reduced program cost.

  13. Making environmental assessments of biomass production systems comparable worldwide

    NASA Astrophysics Data System (ADS)

    Meyer, Markus A.; Seppelt, Ralf; Witing, Felix; Priess, Joerg A.

    2016-03-01

    Global demand for agricultural and forestry products fundamentally affects regional land-use change associated with environmental impacts (EIs) such as erosion. In contrast to aggregated global metrics such as greenhouse gas (GHG) balances, local/regional EIs of different agricultural and forestry production regions need methods which enable worldwide EI comparisons. The key aspect is to control environmental heterogeneity to reveal man-made differences of EIs between production regions. Environmental heterogeneity is the variation in biotic and abiotic environmental conditions. In the present study, we used three approaches to control environmental heterogeneity: (i) environmental stratification, (ii) potential natural vegetation (PNV), and (iii) regional environmental thresholds to compare EIs of solid biomass production. We compared production regions of managed forests and plantation forests in subtropical (Satilla watershed, Southeastern US), tropical (Rufiji basin, Tanzania), and temperate (Mulde watershed, Central Germany) climates. All approaches supported the comparison of the EIs of different land-use classes between and within production regions. They also standardized the different EIs for a comparison between the EI categories. The EIs for different land-use classes within a production region decreased with increasing degree of naturalness (forest, plantation forestry, and cropland). PNV was the most reliable approach, but lacked feasibility and relevance. The PNV approach explicitly included most of the factors that drive environmental heterogeneity in contrast to the stratification and threshold approaches. The stratification approach allows consistent global application due to available data. Regional environmental thresholds only included arbitrarily selected aspects of environmental heterogeneity; they are only available for few EIs. Especially, the PNV and stratification approaches are options to compare regional EIs of biomass or crop production

  14. Comparative Assessment of Lixisenatide, Exenatide, and Liraglutide Pen Devices

    PubMed Central

    Enginee, Diplom; Elton, Hina; Penfornis, Alfred; Edelman, Steve

    2014-01-01

    Background: Glucagon-like peptide-1 (GLP-1) receptor agonists are a relatively recent addition to the treatment options for type 2 diabetes mellitus (T2DM) and are administered using prefilled pen devices. Method: In this open-label task and interview-based pilot study, 3 GLP-1 receptor agonist pen devices—exenatide (Byetta®, Bristol-Myers Squibb/AstraZeneca), liraglutide (Victoza®, Novo Nordisk), and lixisenatide (Lyxumia®, Sanofi-Aventis)—were comparatively assessed in a randomized order in 30 participants with T2DM for ease of use, using a series of key performance measures (time taken to complete a series of tasks, number of user errors [successful performance], and user satisfaction rating). Linear and logistic regression analysis was conducted for the lixisenatide and liraglutide pens versus the exenatide pen. Participants’ mean age was 60 years; 27% and 20% of the participants had visual impairments and reduced manual dexterity, respectively. Results: Tasks were completed faster (P < .001) and with higher successful performance (P = .001) with the lixisenatide pen than with the exenatide pen, whereas the liraglutide pen was not statistically significant versus the exenatide pen on these parameters. Overall, user satisfaction was statistically higher for the lixisenatide and liraglutide pens versus the exenatide pen (P < .001 for both). Conclusions: Lixisenatide and liraglutide pens are associated with higher user satisfaction compared with the exenatide pen. In addition, the lixisenatide pen is faster and results in fewer errors than its comparator (exenatide). The lixisenatide pen may therefore be a suitable choice for patients with T2DM, including older and pen device-naïve patients, and those with visual impairments and reduced manual dexterity. PMID:24876548

  15. Speech-Language Pathologist and General Educator Collaboration: A Model for Tier 2 Service Delivery

    ERIC Educational Resources Information Center

    Watson, Gina D.; Bellon-Harn, Monica L.

    2014-01-01

    Tier 2 supplemental instruction within a response to intervention framework provides a unique opportunity for developing partnerships between speech-language pathologists and classroom teachers. Speech-language pathologists may participate in Tier 2 instruction via a consultative or collaborative service delivery model depending on district needs.…

  16. Clinical pathologist in Korea--training program and its roles in laboratories.

    PubMed

    Cho, Han-Ik; Lee, Kap No; Park, Jong-Woo; Park, Hyosoon; Kwak, Yun Sik

    2002-01-01

    A rapid development of practice of laboratory medicine in Korea owes its success to the clinical pathologists (CP), who have played a role of a pathfinder for laboratories. The Korean CP postgraduate education (residency) program is unique in that it is exclusively for laboratory medicine. The training program for clinical pathologists includes diagnostic hematology, diagnostic immunology, clinical microbiology, clinical chemistry, blood bank, diagnostic genetics, informatics and laboratory management. The program has produced a strong group of about 600 laboratory physicians, officially clinical pathologists since 1963. Most of Korean clinical pathologists work as laboratory directors, directors of university hospital laboratories or teaching faculty members in medical schools. The roles of clinical pathologists are laboratory management, interpretation of laboratory test results, clinical consulting services to clinicians and patients, ordering secondary tests after reviews of requested test results and utilization management. The clinical pathologists have developed clinical laboratories to be a main contributor for improved medical practice. During the last 40 years under the turbulent healthcare system, clinical pathologists have significantly contributed to safeguard the laboratory interests. The education program and the role of clinical pathologists are described.

  17. Routine surgical telepathology in the Department of Veterans Affairs: experience-related improvements in pathologist performance in 2200 cases.

    PubMed

    Dunn, B E; Choi, H; Almagro, U A; Recla, D L; Krupinski, E A; Weinstein, R S

    1999-01-01

    To determine whether diagnostic concordance, case deferral rate, and/or time required to review slides changed significantly as telepathologists gained additional experience using a hybrid dynamic/store-and-forward (HDSF) telepathology (TP) system on the 2000 cases following an initial 200 consecutive surgical cases, previously reported. Gross surgical pathology specimens were prepared by specially trained personnel in Iron Mountain, Michigan. For TP, glass slides were placed on the stage of a robotic microscope at the Iron Mountain VAMC (remote site); control of the motorized microscope was then transferred to a pathologist located 220 miles away at the Milwaukee, Wisconsin, VAMC (host site). For each case, a telepathologist had the option of either rendering a diagnosis or deferring the case for later analysis by conventional light microscopy (LM). After the slides were read by TP and a surgical pathology report had been generated (for nondeferred cases), the slides were transported to Milwaukee, where they were reexamined by the same pathologist, now using LM. When there was disagreement between the TP and LM diagnosis, a supplemental or revised report was issued, and the referring physician was notified by telephone immediately. All supplemental and revised reports were reviewed by a third pathologist in the group. The slides were then reviewed by the pathology group practice or, when there was no consensus, by the Armed Forces Institute of Pathology to establish a "truth" diagnosis. To determine changes in telepathologist performance with experience after the initial start-up of the service, their performance in handling 10 consecutive sets of 200 surgical pathology cases was analyzed. Concordance rates for clinically significant TP and LM diagnoses were high for all 10 sets, ranging from 99% to 100%. Comparing the first set (Cases 201-400) with the last set (Cases 2001-2200), viewing times per case were reduced from 10.26 min to 3. 58 min. Viewing times per

  18. Comparative environmental assessment of natural and recycled aggregate concrete.

    PubMed

    Marinković, S; Radonjanin, V; Malešev, M; Ignjatović, I

    2010-11-01

    Constant and rapid increase in construction and demolition (C&D) waste generation and consumption of natural aggregate for concrete production became one of the biggest environmental problems in the construction industry. Recycling of C&D waste represents one way to convert a waste product into a resource but the environment benefits through energy consumption, emissions and fallouts reductions are not certain. The main purpose of this study is to determine the potentials of recycled aggregate concrete (concrete made with recycled concrete aggregate) for structural applications and to compare the environmental impact of the production of two types of ready-mixed concrete: natural aggregate concrete (NAC) made entirely with river aggregate and recycled aggregate concrete (RAC) made with natural fine and recycled coarse aggregate. Based on the analysis of up-to-date experimental evidence, including own tests results, it is concluded that utilization of RAC for low-to-middle strength structural concrete and non-aggressive exposure conditions is technically feasible. The Life Cycle Assessment (LCA) is performed for raw material extraction and material production part of the concrete life cycle including transport. Assessment is based on local LCI data and on typical conditions in Serbia. Results of this specific case study show that impacts of aggregate and cement production phases are slightly larger for RAC than for NAC but the total environmental impacts depend on the natural and recycled aggregates transport distances and on transport types. Limit natural aggregate transport distances above which the environmental impacts of RAC can be equal or even lower than the impacts of NAC are calculated for the specific case study. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Comparative Assessment of Very High Resolution Satellite and Aerial Orthoimagery

    NASA Astrophysics Data System (ADS)

    Agrafiotis, P.; Georgopoulos, A.

    2015-03-01

    This paper aims to assess the accuracy and radiometric quality of orthorectified high resolution satellite imagery from Pleiades-1B satellites through a comparative evaluation of their quantitative and qualitative properties. A Pleiades-B1 stereopair of high resolution images taken in 2013, two adjacent GeoEye-1 stereopairs from 2011 and aerial orthomosaic (LSO) provided by NCMA S.A (Hellenic Cadastre) from 2007 have been used for the comparison tests. As control dataset orthomosaic from aerial imagery provided also by NCMA S.A (0.25m GSD) from 2012 was selected. The process for DSM and orthoimage production was performed using commercial digital photogrammetric workstations. The two resulting orthoimages and the aerial orthomosaic (LSO) were relatively and absolutely evaluated for their quantitative and qualitative properties. Test measurements were performed using the same check points in order to establish their accuracy both as far as the single point coordinates as well as their distances are concerned. Check points were distributed according to JRC Guidelines for Best Practice and Quality Checking of Ortho Imagery and NSSDA standards while areas with different terrain relief and land cover were also included. The tests performed were based also on JRC and NSSDA accuracy standards. Finally, tests were carried out in order to assess the radiometric quality of the orthoimagery. The results are presented with a statistical analysis and they are evaluated in order to present the merits and demerits of the imaging sensors involved for orthoimage production. The results also serve for a critical approach for the usability and cost efficiency of satellite imagery for the production of Large Scale Orthophotos.

  20. Gleason grade 4 prostate adenocarcinoma patterns: an interobserver agreement study among genitourinary pathologists.

    PubMed

    Kweldam, Charlotte F; Nieboer, Daan; Algaba, Ferran; Amin, Mahul B; Berney, Dan M; Billis, Athanase; Bostwick, David G; Bubendorf, Lukas; Cheng, Liang; Compérat, Eva; Delahunt, Brett; Egevad, Lars; Evans, Andrew J; Hansel, Donna E; Humphrey, Peter A; Kristiansen, Glen; van der Kwast, Theodorus H; Magi-Galluzzi, Cristina; Montironi, Rodolfo; Netto, George J; Samaratunga, Hemamali; Srigley, John R; Tan, Puay H; Varma, Murali; Zhou, Ming; van Leenders, Geert J L H

    2016-09-01

    To assess the interobserver reproducibility of individual Gleason grade 4 growth patterns. Twenty-three genitourinary pathologists participated in the evaluation of 60 selected high-magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. 'Consensus' was defined as at least 80% agreement, and 'favoured' as 60-80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non-consensus cases, ill-formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill-formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern ('complex fused'). Consensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill-formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached. © 2016 John Wiley & Sons Ltd.

  1. Comparative flood damage model assessment: Towards a European approach

    NASA Astrophysics Data System (ADS)

    Jongman, B.; Kreibich, H.; Bates, P. D.; de Roo, A. P. J.; Barredo, J. I.; Gericke, A.; Apel, H.; Neal, J.; Aerts, J. C. J. H.; Ward, P. J.

    2012-04-01

    There is a wide variety of flood damage assessment models in use across countries and institutions, with large variations in their approaches and assumptions. In this study we compare seven established methodologies qualitatively and quantitatively, in order to identify key factors that should be taken into consideration in the development of a pan-European flood damage model. In the comparison, we included seven different flood damage models: FLEMO (Germany), Damage Scanner (The Netherlands), Rhine Atlas (Rhine basin), the Flemish method (Belgium), Multi-Coloured Manual (United Kingdom), HAZUS-MH (United States) and the aggregated EC-JRC approach (European Commission). The study is based on two case-studies of historical flood events, for which both hydrological and land-use data are available, as well as data on observed economic damages. One case-study is based on a 2002 flood event in Eilenburg, Germany. The second case-study covers the 2005 flooding in Carlisle, United Kingdom. We found that the models designed for the specific regions come very close to estimating the observed economic damage. A sensitivity analysis shows that the model results are most sensitive to variation in assumed maximum damage values, and almost as much to variation in the applied depth-damage functions. On the basis of these results, we propose the development of a Europe-wide flood damage model that is based on disaggregated land-use data, local asset values and a variable set of depth-damage functions.

  2. Comparative assessment of municipal wastewater disposal methods in southeast Florida.

    PubMed

    Bloetscher, Frederick; Englehardt, James D; Chin, David A; Rose, Joan B; Tchobanoglous, George; Amy, Vincent P; Gokgoz, Sinem

    2005-01-01

    A comparative assessment of the risks of three effluent disposal alternatives currently available to wastewater utilities in Southeast Florida is presented in this paper. The alternatives are: deep well injection and ocean outfalls following secondary treatment, and surface water (canal) discharges following secondary wastewater treatment, filtration and nutrient removal. Water quality data, relative to disposal of wastewater treatment plant effluent were gathered, along with water quality data on the receiving waters, from utilities. Comparisons and conclusions regarding potential health concerns associated with the three disposal alternatives are presented. The results indicated that health risks associated with deep wells were generally lower than those of the other two alternatives. The proximity of injection wells to aquifer storage and recovery wells was a determining factor relative to injection well risk. Urban ecological risks were also indicated to be lower, though impacts of urban water use/reuse to the Everglades were not studied. Additional data collection and analysis were recommended to understand the effects of wastewater management on the cycling of water, nutrients and other constituents on southeast Florida. In particular, it was recommended that monitoring of effluents for nitrosamines and pharmaceutically active substances be implemented on a broad scale.

  3. Comparative assessment of the methods for exchangeable acidity measuring

    NASA Astrophysics Data System (ADS)

    Vanchikova, E. V.; Shamrikova, E. V.; Bespyatykh, N. V.; Zaboeva, G. A.; Bobrova, Yu. I.; Kyz"yurova, E. V.; Grishchenko, N. V.

    2016-05-01

    A comparative assessment of the results of measuring the exchangeable acidity and its components by different methods was performed for the main mineral genetic horizons of texturally-differentiated gleyed and nongleyed soddy-podzolic and gley-podzolic soils of the Komi Republic. It was shown that the contents of all the components of exchangeable soil acidity determined by the Russian method (with potassium chloride solution as extractant, c(KCl) = 1 mol/dm3) were significantly higher than those obtained by the international method (with barium chloride solution as extractant, c(BaCl2) = 0.1 mol/dm3). The error of the estimate of the concentration of H+ ions extracted with barium chloride solution equaled 100%, and this allowed only qualitative description of this component of the soil acidity. In the case of the extraction with potassium chloride, the error of measurements was 50%. It was also shown that the use of potentiometric titration suggested by the Russian method overestimates the results of soil acidity measurement caused by the exchangeable metal ions (Al(III), Fe(III), and Mn(II)) in comparison with the atomic emission method.

  4. Comparative cytotoxicity assessments of some manufactured and anthropogenic nanoparticulate materials

    NASA Astrophysics Data System (ADS)

    Soto, Karla Fabiola

    Due to increasing diversity of newly engineered nanoparticles, it is important to consider the hazards of these materials. Very little is known regarding the potential toxicity of relatively new nanomaterials. However, beginning with several historical accounts of nanomaterials applications---chrysotile asbestos and silver---it was assumed that these examples would provide some awareness and guidelines for future nanomaterial and nanotechnology applications, especially health effects. In this study in vitro assays were performed on a murine alveolar macrophage cell line (RAW 264.7), human alveolar macrophage cell line (THB-1), and human epithelial lung cell line (A549) to assess the comparative cytotoxicity of a wide range of manufactured (Ag, TiO2, Fe2O3, Al2O3, ZrO2, black carbon, two different types of multiwall structures and chrysotile asbestos as the toxicity standard) and anthropogenic nanoparticulates. There are several parameters of nanoparticulates that are considered to trigger an inflammatory response (particularly respiratory) or cause toxicity. These parameters include: particle size, shape, specific surface area, transition metals in particulates, and organic compounds. Therefore, a wide variety of manufactured and anthropogenic nanoparticulates having different morphologies, sizes, specific surface area and chemistries as noted were tested. To determine the nanoparticulates' size and morphology, they were characterized by transmission electron microscopy, where it was observed that the commercial multiwall carbon nanotube aggregate had an identical morphology to chrysotile asbestos and combustion-formed carbon nanotubes, i.e.; those that form from natural gas combustion. Light optical microscopy was used to determine cell morphology upon exposure to nanoparticulates as an indication of cell death. Also, the polycyclic aromatic hydrocarbon (PAH) content of the collected nanoparticulates was analyzed and correlated with cytotoxic responses. For

  5. Comparative device assessments: Humalog KwikPen compared with vial and syringe and FlexPen.

    PubMed

    Ignaut, Debra A; Schwartz, Sherwyn L; Sarwat, Samiha; Murphy, Heather L

    2009-01-01

    The purpose of this study was to compare pen device-naïve patients' preferences for Humalog KwikPen (insulin lispro injection) (Eli Lilly and Company, Indianapolis, IN) to use of a vial and syringe and FlexPen(R) (insulin aspart injection) (Novo Nordisk A/S, Bagsvaerd, Denmark). This open-label, randomized, crossover 1-day study tested the hypotheses that KwikPen was preferred to vial and syringe, and if this was found to be a significant preference, that KwikPen was preferred to FlexPen. Accuracy of doses prepared, ease of use via insulin device assessment battery, and preference via insulin device preference battery were administered following each pen evaluation, and a final preference question administered following the evaluation of both pens. Clinical measures were not included as subjects injected into an appliance to simulate the injection experience. Primary outcome variables were evaluated by Question 13 of the insulin device preference battery and the final preference question. Among 232 enrolled patients randomized to 1 of 4 sequences (n = 58), Humalog KwikPen was significantly preferred over vial and syringe and over FlexPen. After patients were asked to assess Humalog KwikPen or FlexPen versus V&S by choosing "strongly agreed" or "agreed" to the following attributes: easy to use, easy to hold in their hands when injecting, and easy to press the injection button, the results exhibited significant differences in patient responses. Humalog KwikPen was significantly more accurate and was preferred to vial and syringe in appearance, quality, discretion, convenience, public use, easy to learn, easy to use, reliability, dose confidence, following insulin regimen, overall satisfaction, and recommendation to others. Humalog KwikPen was significantly preferred over vial and syringe and FlexPen. When compared with vial and syringe, Humalog KwikPen and FlexPen were easier to use and operate, demonstrated superior accuracy of doses prepared, and preferred by pen

  6. The imager replacing the pathologist in the diagnosis of hepatobiliary and pancreatic disease.

    PubMed

    van Leeuwen, D J

    2001-02-01

    Advances in imaging technology, specifically cross-sectional imaging techniques (ultrasonography, computer tomography, magnetic resonance imaging), are dynamic and rapid. They have dramatically changed the management of hepatobiliary and pancreatic diseases. Although imaging is not identical to the traditional gold standard of a tissue diagnosis, it often obviates its need and provides a much better insight into clinically relevant pathology compared with a biopsy. However, this requires a thorough insight into the clinical and pathologic aspects of the disease, knowledge of limitations of imaging techniques, and insight in management implications. The clear identification of characteristic disease findings on imaging, such as a cirrhotic configuration of the liver or gallstones that match clinical findings, are most helpful. Imaging and tissue investigation often have a complementary role in patient management. Their yield is highest if they are part of a critical integration of clinical findings by a multidisciplinary team. The latter should help as much in identifying specific opportunities for treatment as preventing futile and potential harmful interventions. The contribution of imagers and pathologists to the management of patients will continue to be redefined in the new century. Noninvasive and virtual imaging will develop further. A specific and challenging role for the pathologists and clinical imagers in close cooperation with many other disciplines will be to identify sensitive molecular targets that can be used to provide noninvasive images that not only accurately provide a diagnosis, but also resolution of disease and response to specific therapy. Ann Diagn Pathol 5:57-66, 2001. Copyright 2001 by W.B. Saunders Company

  7. A comparative assessment of endogenous water institutional change

    NASA Astrophysics Data System (ADS)

    Pande, Saket; Ersten, Maurits

    2013-04-01

    This paper builds the theory of endogenous institutional change, first proposed by Greif and Laitin (2004), for water scarce regions in context of water institutions. The current emphasis on environmental change, including hydrological change, largely ignores the adaptation of human societies to change. Humans have mostly been considered as boundary conditions or parameters of the dynamics of hydrological change and are not considered as conduits of feedbacks. Nonetheless, the dynamical representation of hydrological change with feedbacks between various components of a system is assuring since it is reminiscent of processual ecological anthropology(Orlove, 1980), except that individual decision making is absent. This paper proposes to consider selected dryland basins of the world, to conceptualize proxies of water relevant socio-economic organisation, such as spatial scales of upstream-downstream cooperation in water use, synthesized over time and then proposes a comparative assessment to test regularities predicted by an extension of river game theory (Ambec and Ehlers, 2008; van der Brink et al, 2012) to endogenous institutional change. References: Orlove, B. S. (1980). Ecological Anthropology. Annual Review of Anthropology, Vol. 9 (1980), pp. 235-273. Greif. A. and D. D. Laitin (2004). A Theory of Endogenous Institutional Change. American Political Science Review, Vol. 98, No. 4 November 2004. Ambec, S. and L. Ehlers (2008). Sharing a river amongst satiable agents. Games and Economic Behavior, 64, 35-50. Van der Brink, G. van der Laan and N. Moes (2012). Fair agreements for sharing international rivers with multiple springs and externalities. Journal of Environmental Economics and Management, 63, 388-403.

  8. Automatic cellularity assessment from post-treated breast surgical specimens.

    PubMed

    Peikari, Mohammad; Salama, Sherine; Nofech-Mozes, Sharon; Martel, Anne L

    2017-10-04

    Neoadjuvant treatment (NAT) of breast cancer (BCa) is an option for patients with the locally advanced disease. It has been compared with standard adjuvant therapy with the aim of improving prognosis and surgical outcome. Moreover, the response of the tumor to the therapy provides useful information for patient management. The pathological examination of the tissue sections after surgery is the gold-standard to estimate the residual tumor and the assessment of cellularity is an important component of tumor burden assessment. In the current clinical practice, tumor cellularity is manually estimated by pathologists on hematoxylin and eosin (H&E) stained slides, the quality, and reliability of which might be impaired by inter-observer variability which potentially affects prognostic power assessment in NAT trials. This procedure is also qualitative and time-consuming. In this paper, we describe a method of automatically assessing cellularity. A pipeline to automatically segment nuclei figures and estimate residual cancer cellularity from within patches and whole slide images (WSIs) of BCa was developed. We have compared the performance of our proposed pipeline in estimating residual cancer cellularity with that of two expert pathologists. We found an intra-class agreement coefficient (ICC) of 0.89 (95% CI of [0.70, 0.95]) between pathologists, 0.74 (95% CI of [0.70, 0.77]) between pathologist #1 and proposed method, and 0.75 (95% CI of [0.71, 0.79]) between pathologist #2 and proposed method. We have also successfully applied our proposed technique on a WSI to locate areas with high concentration of residual cancer. The main advantage of our approach is that it is fully automatic and can be used to find areas with high cellularity in WSIs. This provides a first step in developing an automatic technique for post-NAT tumor response assessment from pathology slides. © 2017 International Society for Advancement of Cytometry. © 2017 International Society for Advancement

  9. Raising future forensic pathologists (second report): results of a preliminary interview survey.

    PubMed

    Murakami, Manabu; Matoba, Kotaro; Hayakawa, Akira; Terazawa, Koichi

    2012-08-01

    Fostering the specialists of forensic pathology has become a worldwide problem. In Japan, factors such as government budget cuts, the introduction of initial postgraduate clinical training system, as well as national policy on increasing autopsy rates, may deter young graduates from entering this specialty. The aim of this study was to look for clues to promote the training of young forensic pathologists. We selected and interviewed five forensic pathologists, with each interview lasting approximately 60 minutes, and picked up common views among them. The interviews topic, based on a prior survey, was: "What do you believe forensic pathologists require to promote the training of their successors." We selected common views on the three themes listed below; 1) standardization of minimum requirements to be independent forensic pathologists, 2) balancing forensic pathologists' time among autopsy practice, research, and education, and 3) preparing positions for younger forensic pathologists. These opinions were the same as those of previous studies conducted overseas and must be discussed at academic conferences in the future, where both junior and senior forensic pathologists participate.

  10. Pathologists' roles in clinical utilization management. A financing model for managed care.

    PubMed

    Zhao, J J; Liberman, A

    2000-03-01

    In ancillary or laboratory utilization management, the roles of pathologists have not been explored fully in managed care systems. Two possible reasons may account for this: pathologists' potential contributions have not been defined clearly, and effective measurement of and reasonable compensation for the pathologist's contribution remains vague. The responsibilities of pathologists in clinical practice may include clinical pathology and laboratory services (which have long been well-defined and are compensated according to a resource-based relative value system-based coding system), laboratory administration, clinical utilization management, and clinical research. Although laboratory administration services have been compensated with mechanisms such as percentage of total service revenue or fixed salary, the involvement of pathologists seems less today than in the past, owing to increased clinical workload and time constraints in an expanding managed care environment, especially in community hospital settings. The lack of financial incentives or appropriate compensation mechanisms for the services likely accounts for the current situation. Furthermore, the importance of pathologist-driven utilization management in laboratory services lacks recognition among hospital administrators, managed care executives, and pathologists themselves, despite its potential benefits for reducing cost and enhancing quality of care. We propose a financial compensation model for such services and summarize its advantages.

  11. Group Assessment: Comparing Group and Individual Undergraduate Module Marks

    ERIC Educational Resources Information Center

    Almond, Richard J.

    2009-01-01

    This report describes a small study that analysed module marks of one cohort of science undergraduates from one academic year. It explored how group summative assessment marking affected the overall marks in comparison with individual assessment. A tutor allocated students to mixed ability project groups. Individual marks for the group work…

  12. Group Assessment: Comparing Group and Individual Undergraduate Module Marks

    ERIC Educational Resources Information Center

    Almond, Richard J.

    2009-01-01

    This report describes a small study that analysed module marks of one cohort of science undergraduates from one academic year. It explored how group summative assessment marking affected the overall marks in comparison with individual assessment. A tutor allocated students to mixed ability project groups. Individual marks for the group work…

  13. A Framework for Developing Comparable Multilingual Assessments for Minority Populations: Why Context Matters

    ERIC Educational Resources Information Center

    Oliveri, Maria Elena; Ercikan, Kadriye; Simon, Marielle

    2015-01-01

    The assessment of linguistic minorities often involves using multiple language versions of assessments. In these assessments, comparability of scores across language groups is central to valid comparative interpretations. Various frameworks and guidelines describe factors that need to be considered when developing comparable assessments. These…

  14. A comparison of Malaysian and Australian speech-language pathologists' practices with children with developmental disabilities who are pre-symbolic.

    PubMed

    Joginder Singh, Susheel; Iacono, Teresa; Gray, Kylie M

    2011-10-01

    The aim of this study was to explore the assessment, intervention, and family-centred practices of Malaysian and Australian speech-language pathologists (SLPs) when working with children with developmental disabilities who are pre-symbolic. A questionnaire was developed for the study, which was completed by 65 SLPs from Malaysia and 157 SLPs from Australia. Data reduction techniques were used prior to comparison of responses across questionnaire items. Results indicated that SLPs relied mostly on informal assessments. Malaysian and Australian SLPs differed significantly in terms of obtaining information from outside the clinic to inform assessment. When providing intervention, SLPs focused mostly on improving children's pre-verbal skills. A third of Australian SLPs listed the introduction of some form of symbolic communication as an early intervention goal, compared to only a small percentage of Malaysian SLPs. Regarding family involvement, SLPs most often involved mothers, with fathers and siblings being involved to a lesser extent. Overall, it appeared that practices of Malaysian SLPs had been influenced by developments in research, although there were some areas of service delivery that continued to rely on traditional models. Factors leading to similarities and differences in practice of SLPs from both countries as well as clinical and research implications of the study are discussed.

  15. Bullying: what speech-language pathologists should know.

    PubMed

    Hughes, Stephanie

    2014-01-01

    The purpose of this tutorial is to introduce speech-language pathologists (SLPs) to the broad issues surrounding the problem of school bullying in childhood and adolescence. Specifically, types of bullying and their causes are considered, as are the roles students take when bullying occurs and the effects of bullying on students with communication disorders. Strategies and suggestions to help SLPs more effectively prevent and manage bullying of students with communication disorders are discussed. A review of the scholarly literature in education, psychology, child and adolescent development, and speech-language pathology was conducted. Recommendations for how SLPs can prevent and intervene in bullying incidences were extrapolated from the reviewed literature. Students with communication disorders are at particularly high risk for being bullied by peers. Some students with communication disorders are "provocative victims" in that they demonstrate impairments in social skills that draw the attention of bullies. Both provocative victims and typical students may react aggressively when bullied and bully others in retaliation. SLPs can and should help to create an inclusive environment for all students while addressing bullying of students with communication disorders via therapeutic activities.

  16. Comparative risk assessment: an international comparison of methodologies and results.

    PubMed

    Morgenstern, R D; Shih, J; Sessions, S L

    2000-11-03

    Comparative risk assessment (CRA) is a systematic procedure for evaluating the environmental problems affecting a geographic area. This paper looks beyond the U.S. border and examines the experience with CRAs conducted in various developing countries and economies in transition, including Bangkok, Thailand, Cairo, Egypt and Quito, Ecuador, as well as other locations in Eastern Europe, Asia and Central and South America. A recent pilot CRA conducted in Taiwan is also considered. Comparisons are made of both the methodologies and the results across the relatively diverse international literature. The most robust finding is that conventional air pollutants (e.g., particulate matter and lead) consistently rank as high health risks across all of the CRAs examined. Given the varied nature of the settings studied in the CRAs, including level of economic development, urban-rural differences, and climate, this finding is particularly significant. Problems involving drinking water are also ranked as a high or medium health risk in almost all the countries studied. This is consistent with the results of analyses conducted by the World Bank suggesting contamination, limited coverage and erratic service by water supply systems. Beyond the major air pollutants and drinking water, the CRA results diverge significantly across countries. A number of problems involving toxic chemicals, e. g., hazardous air pollutants, rank as high health risks in the US but do not appear as consistent areas of concerns in the other countries studied. This likely reflects the so-called "risk transition" - the shift from sanitation and infection disease problems to those involving industry, vehicles and toxic substances - that often occurs with economic development. It may also reflect the greater information about sources of toxic pollutants in the U.S. For other problems, there are important differences across the developing countries and economies in transition. For example, hazardous and

  17. [Study of efficiancy of teleconsultation: the Telepathology Consultation Service of the Professional Assoziation of German Pathologists for the screening program of breast carcinoma].

    PubMed

    Schrader, T; Hufnagl, P; Schlake, W; Dietel, M

    2005-01-01

    In the autumn a German screening program was started for detecting breast cancer in the population of women fifty and above. For the first time in this program, quality assurance rules were established: All statements of the radiologists and pathologists have to be confirmed by a second opinion. This improvement in quality is combined with a delay in time and additional expence. A new Telepathology Consultation Service was developed based on the experiences of the Telepathology Consultation Center of the UICC to speed up the second opinion process. The complete web-based service is operated under MS Windows 2003 Server, as web server the Internet Information Server, and the SQL-Server (both Microsoft) as the database. The websites, forms and control mechanism have been coded in by ASP scripts and JavaScript. A study to evaluate the effectiveness of telepathological consultation in comparison to conventional consultation has been carried out. Pathologists of the Professional Association of German Pathologists took part as well as requesting pathologists and as consultants for other participants. The quality of telepathological diagnosis was comparable to the conventional diagnosis. Telepathology allows a faster respond of 1 to 2 day (conventional postal delay). The time to prepare a telepathology request is about twice as conventional. This ratio may be inverted by an interface between the Pathology Information System and the Telepathology Server and the use of virtual microscopy. The Telepathology Consultation Service of the Professional Association of German Pathologists is a fast and effective German-language, internet-based service for obtaining a second opinion.

  18. Speech-Language Pathologists and Primary Prevention: From Ideas to Action.

    ERIC Educational Resources Information Center

    Flynn, Pauline T.

    1983-01-01

    Speech-language pathologists can help prevent communication disorders by helping to promote disability awareness, focusing on good health, limiting noise pollution, and helping to prevent injuries due to vocal misuse. Suggested activities for each aspect are presented. (CL)

  19. Comparing Course Assessments: When Lower Is Higher and Higher, Lower

    ERIC Educational Resources Information Center

    Oliver, Dave; Dobele, Tony; Greber, Myles; Roberts, Tim

    2004-01-01

    This paper describes an exercise in determining the cognitive difficulty of the assessment tasks in six computing courses within an Information Technology (IT) degree, importing Bloom's taxonomy from the field of educational psychology as an analytical framework. Three of the six courses comprise a Programming stream and three a Data…

  20. Comparative assessment of selected PWR auxiliary feedwater system reliability analyses

    SciTech Connect

    Youngblood, R.; Fresco, A.; Papazoglou, I.A.; Tsao, J.

    1985-01-01

    This paper presents a sample of results obtained in reviewing utility submittals of Auxiliary Feedwater System reliability studies. These results are then used to illustrate a few general points regarding such studies. The submittals and reviews for operating license applications are quite significant in that they represent an application of probabilistic risk assessment techniques in the licensing process.

  1. Peer Review of Assessment Network: Supporting Comparability of Standards

    ERIC Educational Resources Information Center

    Booth, Sara; Beckett, Jeff; Saunders, Cassandra

    2016-01-01

    Purpose: This paper aims to test the need in the Australian higher education (HE) sector for a national network for the peer review of assessment in response to the proposed HE standards framework and propose a sector-wide framework for calibrating and assuring achievement standards, both within and across disciplines, through the establishment of…

  2. Skewness and Comparability of School Based Continuous Assessment Scores

    ERIC Educational Resources Information Center

    Gbore, Lawrence Olu; Olabode, Abe Thomas; Olufemi, Adodo Sunday

    2011-01-01

    This study examined skewness as means of determining the nature of distribution of school based continuous assessment (SBCA) scores in selected subjects among Secondary Schools in Ondo State, Nigeria, to determine whether or not there is need for moderation of the SBCA Scores. This is an ex-post-facto research design involving no treatment and…

  3. Peer Review of Assessment Network: Supporting Comparability of Standards

    ERIC Educational Resources Information Center

    Booth, Sara; Beckett, Jeff; Saunders, Cassandra

    2016-01-01

    Purpose: This paper aims to test the need in the Australian higher education (HE) sector for a national network for the peer review of assessment in response to the proposed HE standards framework and propose a sector-wide framework for calibrating and assuring achievement standards, both within and across disciplines, through the establishment of…

  4. The Problem of Assessing Problem Solving: Can Comparative Judgement Help?

    ERIC Educational Resources Information Center

    Jones, Ian; Inglis, Matthew

    2015-01-01

    School mathematics examination papers are typically dominated by short, structured items that fail to assess sustained reasoning or problem solving. A contributory factor to this situation is the need for student work to be marked reliably by a large number of markers of varied experience and competence. We report a study that tested an…

  5. Comparing Assessments within Junior Geography Textbooks Used in Mainland China

    ERIC Educational Resources Information Center

    Yang, Daihu

    2013-01-01

    The 2001 Geography Standards for Junior Secondary Schools are the first national standards for geographic education since the founding of Communist China. The standards heralded several new ideas for geographic education, and textbook assessments are one important way for understanding their impact. This study examines the changes in assessments…

  6. The Problem of Assessing Problem Solving: Can Comparative Judgement Help?

    ERIC Educational Resources Information Center

    Jones, Ian; Inglis, Matthew

    2015-01-01

    School mathematics examination papers are typically dominated by short, structured items that fail to assess sustained reasoning or problem solving. A contributory factor to this situation is the need for student work to be marked reliably by a large number of markers of varied experience and competence. We report a study that tested an…

  7. Comparing Course Assessments: When Lower Is Higher and Higher, Lower

    ERIC Educational Resources Information Center

    Oliver, Dave; Dobele, Tony; Greber, Myles; Roberts, Tim

    2004-01-01

    This paper describes an exercise in determining the cognitive difficulty of the assessment tasks in six computing courses within an Information Technology (IT) degree, importing Bloom's taxonomy from the field of educational psychology as an analytical framework. Three of the six courses comprise a Programming stream and three a Data…

  8. Comparing Assessments within Junior Geography Textbooks Used in Mainland China

    ERIC Educational Resources Information Center

    Yang, Daihu

    2013-01-01

    The 2001 Geography Standards for Junior Secondary Schools are the first national standards for geographic education since the founding of Communist China. The standards heralded several new ideas for geographic education, and textbook assessments are one important way for understanding their impact. This study examines the changes in assessments…

  9. Molecular genetic testing for cystic fibrosis: laboratory performance on the College of American Pathologists external proficiency surveys.

    PubMed

    Lyon, Elaine; Schrijver, Iris; Weck, Karen E; Ferreira-Gonzalez, Andrea; Richards, C Sue; Palomaki, Glenn E

    2015-03-01

    Molecular testing for cystic fibrosis mutations is widespread and routine in reproductive decision making and diagnosis. Our objective was to assess the level of performance of laboratories for this test. The College of American Pathologists administers external proficiency testing with multiple DNA samples distributed biannually. RESULTS are analyzed, reviewed, and graded by the joint College of American Pathologists/American College of Medical Genetics and Genomics Biochemical and Molecular Genetics Committee. Assessment is based on genotype and associated clinical interpretation. Overall, 357 clinical laboratories participated in the proficiency testing survey between 2003 and 2013 (322 in the United States and 35 international). In 2013, US participants reported performing nearly 120,000 tests monthly. Analytical sensitivity and specificity of US laboratories were 98.8% (95% confidence interval: 98.4-99.1%) and 99.6% (95% confidence interval: 99.4-99.7%), respectively. Analytical sensitivity improved between 2003 and 2008 (from 97.9 to 99.3%; P = 0.007) and remained steady thereafter. Clinical interpretation matched the intended response for 98.8, 86.0, and 91.0% of challenges with no, one, or two mutations, respectively. International laboratories performed similarly. Laboratory testing for cystic fibrosis in the United States has improved since 2003, and these data demonstrate a high level of quality. Neither the number of samples tested nor test methodology affected performance.

  10. Assessments of direct human exposure: the approach of EU risk assessments compared to scenario-based risk assessment.

    PubMed

    Wormuth, Matthias; Demou, Evangelia; Scheringer, Martin; Hungerbühler, Konrad

    2007-08-01

    The awareness of potential risks emerging from the use of chemicals in all parts of daily life has increased the need for risk assessments that are able to cover a high number of exposure situations and thereby ensure the safety of workers and consumers. In the European Union (EU), the practice of risk assessments for chemicals is laid down in a Technical Guidance Document; it is designed to consider environmental and human occupational and residential exposure. Almost 70 EU risk assessment reports (RARs) have been finalized for high-production-volume chemicals during the last decade. In the present study, we analyze the assessment of occupational and consumer exposure to trichloroethylene and phthalates presented in six EU RARs. Exposure scenarios in these six RARs were compared to scenarios used in applications of the scenario-based risk assessment approach to the same set of chemicals. We find that scenarios used in the selected EU RARs to represent typical exposure situations in occupational or private use of chemicals and products do not necessarily represent worst-case conditions. This can be due to the use of outdated information on technical equipment and conditions in workplaces or omission of pathways that can cause consumer exposure. Considering the need for exposure and risk assessments under the new chemicals legislation of the EU, we suggest that a transparent process of collecting data on exposure situations and of generating representative exposure scenarios is implemented to improve the accuracy of risk assessments. Also, the data sets used to assess human exposure should be harmonized, summarized in a transparent fashion, and made accessible for all risk assessors and the public.

  11. Entrustable Professional Activities for Pathology: Recommendations From the College of American Pathologists Graduate Medical Education Committee.

    PubMed

    McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin

    2017-01-01

    Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.

  12. Management of swallowing and communication difficulties in Down syndrome: A survey of speech-language pathologists.

    PubMed

    Meyer, Carly; Theodoros, Deborah; Hickson, Louise

    2017-02-01

    To explore speech pathology services for people with Down syndrome across the lifespan. Speech-language pathologists (SLPs) working in Australia were invited to complete an online survey, which enquired about the speech pathology services they had provided to client/s with Down syndrome in the past 12 months. The data were analysed using descriptive statistics. A total of 390 SLPs completed the survey; 62% reported seeing a client with Down syndrome in the past 12 months. Most commonly, SLPs provided assessment and individual intervention for communication with varying levels of family involvement. The areas of dysphagia and/or communication addressed by SLPs, or in need of more services differed according to the age of the person with Down syndrome. SLPs reported a number of reasons why services were restricted. There is a need to re-assess the way that SLPs currently provide services to people with Down syndrome. More research is needed to develop and evaluate treatment approaches that can be used to better address the needs of this population.

  13. Comparative environmental assessment of biocides used in antifouling paints.

    PubMed

    Voulvoulis, Nikolaos; Scrimshaw, Mark D; Lester, John N

    2002-05-01

    In response to increasing scientific evidence on the toxicity and persistence of organotin residues from antifouling paints in the aquatic environment, the use of triorganotin antifouling products was banned on boats of less than 25 m length in many countries during 1987. Alternatives to tributyltin (TBT) paint are mainly copper based coatings containing organic booster biocides to improve the efficacy of the formulation, and have been utilised on small boats for the last 10 years. With policies encouraging a total ban on TBT, it is expected that these biocides will be used to a greater extent in the future. Limited data and information are available on the environmental occurrence, fate, toxicity, and persistence of these biocides, and thus any decisions on policies regulating antifoulants cannot be fully informed. In this study, a multicriteria comparison of alternative biocides, based on a general assessment of available information in the literature, provided support for the use of the precautionary principle with respect to policies on antifouling products. This assessment was validated by a more detailed comparison of four selected biocides and TBT. Results indicate that TCMS pyridine and TCMTB demonstrate environmental characteristics similar to TBT and thus detail risk assessments are needed before their use is permitted. The widespread use of the other biocides should be allowed only after research to fill the gaps in knowledge with respect to their toxicity and persistence in aquatic environments.

  14. The value of biomedical research training for veterinary anatomic and clinical pathologists.

    PubMed

    Sharkey, L C; Simpson, R M; Wellman, M L; Craig, L E; Birkebak, T A; Kock, N D; Miller, M A; Harris, R K; Munson, L

    2012-07-01

    Veterinary pathologists traditionally have been actively engaged in research as principal investigators and as collaborators. Pathologists frequently obtain advanced training in research; however, it appears that in the last 10 years there has been a reversal of a previous trend toward increasing numbers of pathologists obtaining PhD degrees. This has arisen despite an established shortage of veterinarians engaged in research. This article evaluates the benefits of research training for individual pathologists, including a wide spectrum of professional opportunities and additional skill development beyond that usually provided by diagnostic pathology training alone. Various training models are discussed, including combined and sequential diagnostic residency and research degree training as well as the nondegree research fellowship programs more commonly pursued in human medicine. Best-practice recommendations for program infrastructure, mentorship, time management, and a team approach to research and research training are advocated to facilitate the development of successful programs and to encourage a continued emphasis on integrated training for pathologists as both clinical diagnosticians and experimentalists. This article is intended to help prospective and active pathology trainees, their mentors, and educational administrators optimize opportunities to ensure the future vitality of veterinary pathologists, and their contributions, in basic and applied research.

  15. "Apologies" from pathologists: why, when, and how to say "sorry" after committing a medical error.

    PubMed

    Dewar, Rajan; Parkash, Vinita; Forrow, Lachlan; Truog, Robert D

    2014-05-01

    How pathologists communicate an error is complicated by the absence of a direct physician-patient relationship. Using 2 examples, we elaborate on how other physician colleagues routinely play an intermediary role in our day-to-day transactions and in the communication of a pathologist error to the patient. The concept of a "dual-hybrid" mind-set in the intermediary physician and its role in representing the pathologists' viewpoint adequately is considered. In a dual-hybrid mind-set, the intermediary physician can align with the patients' philosophy and like the patient, consider the smallest deviation from norm to be an error. Alternatively, they might embrace the traditional physician philosophy and communicate only those errors that resulted in a clinically inappropriate outcome. Neither may effectively reflect the pathologists' interests. We propose that pathologists develop strategies to communicate errors that include considerations of meeting with the patients directly. Such interactions promote healing for the patient and are relieving to the well-intentioned pathologist.

  16. Sport, scales, or war? Metaphors speech-language pathologists use to describe caseload management.

    PubMed

    Kenny, Belinda; Lincoln, Michelle

    2012-06-01

    Professionals' experiences, perceptions, and attitudes may be reflected in the metaphors they use to describe and discuss important professional issues. This qualitative study explored speech-language pathologists' experiences of caseload management through metaphorical analysis. Metaphors provided a lens for reflecting participants' lived experiences and professional knowledge construction. Data was obtained from 16 practising speech-language pathologists during individual work place interviews. Participants included new graduate and experienced speech-language pathologists who were employed in hospital and community settings. Metaphors for caseload management were identified from participants' transcribed narratives, then coded and organized into themes. Participants produced a total of 297 metaphors during professional practice narratives. Thematic analysis indicated that participants used three salient metaphors of sport, measuring scales, and war when they addressed caseload issues. Metaphors of sport, scales, and war reflected speech-language pathologists' concerns about managing clients efficiently, perceived caseload burdens, and the conflict they experienced when resources were inadequate. These metaphors may also represent a continuum in speech-language pathologists' personal and professional responses to caseload demands. Shared metaphors may contribute to the professional socialization of individuals entering a profession and to changing or maintaining workplace culture. Hence, speech-language pathologists need to consider the impact of using metaphors of sport, measuring scales, and war during interactions with clients and colleagues.

  17. International aspirations for speech-language pathologists' practice with multilingual children with speech sound disorders: development of a position paper.

    PubMed

    McLeod, Sharynne; Verdon, Sarah; Bowen, Caroline

    2013-01-01

    A major challenge for the speech-language pathology profession in many cultures is to address the mismatch between the "linguistic homogeneity of the speech-language pathology profession and the linguistic diversity of its clientele" (Caesar & Kohler, 2007, p. 198). This paper outlines the development of the Multilingual Children with Speech Sound Disorders: Position Paper created to guide speech-language pathologists' (SLPs') facilitation of multilingual children's speech. An international expert panel was assembled comprising 57 researchers (SLPs, linguists, phoneticians, and speech scientists) with knowledge about multilingual children's speech, or children with speech sound disorders. Combined, they had worked in 33 countries and used 26 languages in professional practice. Fourteen panel members met for a one-day workshop to identify key points for inclusion in the position paper. Subsequently, 42 additional panel members participated online to contribute to drafts of the position paper. A thematic analysis was undertaken of the major areas of discussion using two data sources: (a) face-to-face workshop transcript (133 pages) and (b) online discussion artifacts (104 pages). Finally, a moderator with international expertise in working with children with speech sound disorders facilitated the incorporation of the panel's recommendations. The following themes were identified: definitions, scope, framework, evidence, challenges, practices, and consideration of a multilingual audience. The resulting position paper contains guidelines for providing services to multilingual children with speech sound disorders (http://www.csu.edu.au/research/multilingual-speech/position-paper). The paper is structured using the International Classification of Functioning, Disability and Health: Children and Youth Version (World Health Organization, 2007) and incorporates recommendations for (a) children and families, (b) SLPs' assessment and intervention, (c) SLPs' professional

  18. Device Comparability of Tablets and Computers for Assessment Purposes

    ERIC Educational Resources Information Center

    Davis, Laurie Laughlin; Kong, Xiaojing; McBride, Yuanyuan; Morrison, Kristin M.

    2017-01-01

    The definition of what it means to take a test online continues to evolve with the inclusion of a broader range of item types and a wide array of devices used by students to access test content. To assure the validity and reliability of test scores for all students, device comparability research should be conducted to evaluate the impact of…

  19. Device Comparability of Tablets and Computers for Assessment Purposes

    ERIC Educational Resources Information Center

    Davis, Laurie Laughlin; Kong, Xiaojing; McBride, Yuanyuan; Morrison, Kristin M.

    2017-01-01

    The definition of what it means to take a test online continues to evolve with the inclusion of a broader range of item types and a wide array of devices used by students to access test content. To assure the validity and reliability of test scores for all students, device comparability research should be conducted to evaluate the impact of…

  20. Challenges and opportunities in the adoption of College of American Pathologists checklists in electronic format: perspectives and experience of Reporting Pathology Protocols Project (RPP2) participant laboratories.

    PubMed

    Hassell, Lewis A; Parwani, Anil V; Weiss, Lawrence; Jones, Michael A; Ye, Jay

    2010-08-01

    The site-specific cancer checklists developed by the College of American Pathologists have the potential to improve the quality of data derived from pathology reports and incorporated into cancer registry databases and are now mandated report elements by various accrediting bodies. A pilot project, funded by the Centers for Disease Control National Project for Cancer Registries in 2004, brought 4 pathology services in 3 states, with differing baseline implementations of the checklists, the opportunity to partner with their state National Project for Cancer Registry and their laboratory information system vendors to evaluate the feasibility of using electronically encoded College of American Pathologists cancer checklists for melanoma and tumors of the breast and prostate. To identify existing and potential barriers to adoption of electronically encoded checklists and to also identify unique benefits not associated with text-only uses of the checklists. Participants mapped an implementation process from their current state to an electronic checklist-capable state. For a sample of cases of melanoma, prostate, and breast cancers, the checklist elements were captured and transmitted to the registry using Health Level 7 (version 2.3.1). Process assessments with adoption of electronic checklists were conducted to assess pathologist effect and other potential barriers. An evaluation of the utility and usefulness of electronic checklists was performed after the project. All 4 laboratories successfully performed the capture of individual data elements from the College of American Pathologists checklist into a discrete format suitable for electronic transmission. The effect on pathologist performance and laboratory workflow was neutral. Points of resistance were identified in the checklists and in individual users. Specific challenges in individual laboratories varied according to the personnel and the baseline system in use. Clinical responses to implemented changes were

  1. EMS Provider assessment of vehicle damage compared with assessment by a professional crash reconstructionist.

    PubMed

    Lerner, E Brooke; Cushman, Jeremy T; Blatt, Alan; Lawrence, Richard D; Shah, Manish N; Swor, Robert A; Brasel, Karen; Jurkovich, Gregory J

    2011-01-01

    To determine the accuracy of emergency medical services (EMS) provider assessments of motor vehicle damage when compared with measurements made by a professional crash reconstructionist. EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon emergency department arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle's owner was asked to consent to having a crash reconstructionist assess the vehicle. The assessment included measuring intrusion and external automobile deformity. Vehicle damage was used to calculate change in velocity. Paired t-test, correlation, and kappa were used to compare EMS estimates and investigator-derived values. Ninety-one vehicles were enrolled; of these, 58 were inspected and 33 were excluded because the vehicle was not accessible. Six vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared with the inspection findings. Patients were 46% male, 28% were admitted to hospital, and 1% died. The mean EMS-estimated deformity was 18 inches and the mean measured deformity was 14 inches. The mean EMS-estimated intrusion was 5 inches and the mean measured intrusion was 4 inches. The EMS providers and the reconstructionist had 68% agreement for determination of external automobile deformity (kappa 0.26) and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 American College of Surgeons Field Triage Decision Scheme criteria were applied. The mean (± standard deviation) EMS-estimated speed prior to the crash was 48 ± 13 mph and the mean reconstructionist-estimated change in velocity was 18 ± 12 mph (correlation -0.45). The EMS providers determined that 19 vehicles had rolled over, whereas the investigator identified 18 (kappa 0.96). In 55 cases, EMS and the investigator agreed on seat belt use; for

  2. Comparative assessment of health and safety impacts of coal use

    SciTech Connect

    Not Available

    1980-03-01

    Increasing the use of coal to replace oil and gas consumption is considered beneficial for economic and political reasons. The evaluation of this report, however, is that the shift to coal can involve significant health, safety, and environmental impacts compared to those from oil and natural gas systems, which are considerably less adverse than those of any coal energy system in use today. An evaluation and comparison of the potential impacts from the various alternative coal technologies would be useful to both governmental and industrial policy planners and would provide them with information relevant to a decision on assistance, incentives, and prioritization among the energy technologies. It is, therefore, the main objective of this report to review the key health, safety, and environmental impacts of some promising coal energy technologies and to compare them.

  3. Comparative Assessment of Advanced Gay Hydrate Production Methods

    SciTech Connect

    M. D. White; B. P. McGrail; S. K. Wurstner

    2009-06-30

    Displacing natural gas and petroleum with carbon dioxide is a proven technology for producing conventional geologic hydrocarbon reservoirs, and producing additional yields from abandoned or partially produced petroleum reservoirs. Extending this concept to natural gas hydrate production offers the potential to enhance gas hydrate recovery with concomitant permanent geologic sequestration. Numerical simulation was used to assess a suite of carbon dioxide injection techniques for producing gas hydrates from a variety of geologic deposit types. Secondary hydrate formation was found to inhibit contact of the injected CO{sub 2} regardless of injectate phase state, thus diminishing the exchange rate due to pore clogging and hydrate zone bypass of the injected fluids. Additional work is needed to develop methods of artificially introducing high-permeability pathways in gas hydrate zones if injection of CO{sub 2} in either gas, liquid, or micro-emulsion form is to be more effective in enhancing gas hydrate production rates.

  4. Graphologists' assessment of extraversion compared with assessment by means of a psychological test.

    PubMed

    van Rooij, J J; Hazelzet, A M

    1997-12-01

    The study investigated whether graphologists can infer extraversion from handwriting correctly. On the basis of three personality questionnaires, three persons (targets) were classified as extraverted and three as introverted. Ten graphologists independently analysed the handwriting of the targets and classified them as extraverted or introverted. Of the 60 (10 graphologists for 6 targets) classifications 58 were correct, which shows the graphologists assessed the classification of extraversion from handwriting. Graphologists agreed substantially on which characteristics of the handwriting were indicative for classification as extraversion or introversion. In each handwriting sample, however, both extraverted and introverted characteristics were present. Eventual classification may be based on the relative frequency of the two kinds of characteristics. Comparative studies like this one indicate that in research one should consider whether graphologists and psychologists share the same notion of extraversion.

  5. A Comparative Study on Emerging Electric Vehicle Technology Assessments

    SciTech Connect

    Ford, Jonathan; Khowailed, Gannate; Blackburn, Julia; Sikes, Karen

    2011-03-01

    Numerous organizations have published reports in recent years that investigate the ever changing world of electric vehicle (EV) technologies and their potential effects on society. Specifically, projections have been made on greenhouse gas (GHG) emissions associated with these vehicles and how they compare to conventional vehicles or hybrid electric vehicles (HEVs). Similar projections have been made on the volumes of oil that these vehicles can displace by consuming large amounts of grid electricity instead of petroleum-based fuels. Finally, the projected rate that these new vehicle fleets will enter the market varies significantly among organizations. New ideas, technologies, and possibilities are introduced often, and projected values are likely to be refined as industry announcements continue to be made. As a result, over time, a multitude of projections for GHG emissions, oil displacement, and market penetration associated with various EV technologies has resulted in a wide range of possible future outcomes. This leaves the reader with two key questions: (1) Why does such a collective range in projected values exist in these reports? (2) What assumptions have the greatest impact on the outcomes presented in these reports? Since it is impractical for an average reader to review and interpret all the various vehicle technology reports published to date, Sentech Inc. and the Oak Ridge National Laboratory have conducted a comparative study to make these interpretations. The primary objective of this comparative study is to present a snapshot of all major projections made on GHG emissions, oil displacement, or market penetration rates of EV technologies. From the extensive data found in relevant publications, the key assumptions that drive each report's analysis are identified and 'apples-to-apples' comparisons between all major report conclusions are attempted. The general approach that was taken in this comparative study is comprised of six primary steps: (1

  6. Comparative safety assessment of surface versus submarine plutonium shipments

    SciTech Connect

    Knepper, D.S.; Feltus, M.A. )

    1993-01-01

    The recent shipment of plutonium from France to Japan aboard the freighter Akatsuki Maru touched off protests from environmental and antinuclear organizations. These protests arose from the fear of an accidental sinking of the vessel that would release its cargo to the sea, as well as the threat of a terrorist nation highjacking the ship for its cargo to produce atomic weapons. The sinking of a merchant ship is not uncommon, as illustrated by the famous losses of the tankers Amoco Cadiz and Exxon Valdez. The highjacking of a lightly armed freighter such as the Akatsuki Maru is possible and would not be unduly difficult for a well-equipped terrorist nation. The combined threats of weapons proliferation and environmental damage arising from the diversion or destruction of a sea vessel carrying plutonium will continue to abound as the reprocessing of spent nuclear fuel increases. An alternate method for the transportation with reduced risks of both diversion and destruction needs to be developed. The shipment aboard the Akatsuki Maru was originally proposed to be flown from France to Japan over the continental United States. This proposal was rejected by the Reagan administration in 1988. A third alternative to the current ideas of air transport and surface transport is subsurface transport. This research project investigates the transportation of plutonium by submarine and compares it to the current method of transportation by freighter. This analysis involves a study of the military threat to a submarine by a terrorist nation and comparable threat to a surface vessel. To study the nonmilitary aspects of plutonium shipping, a fault-tree evaluation is performed for transportation by submarine and compared with the current risk analysis performed for surface vessels.

  7. A comparative assessment of waste incinerators in the UK

    SciTech Connect

    Nixon, J.D.; Wright, D.G.; Dey, P.K.; Ghosh, S.K.; Davies, P.A.

    2013-11-15

    Highlights: • We evaluate operational municipal solid waste incinerators in the UK. • The supply chain of four case study plants are examined and compared in detail. • Technical, financial and operational data has been gathered for the four plants. • We suggest the best business practices for waste incinerators. • Appropriate strategy choices are the major difficulties for waste to energy plants. - Abstract: The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supply chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87–92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste

  8. Speech-language pathologist-led fiberoptic endoscopic evaluation of swallowing: functional outcomes for patients after stroke.

    PubMed

    Bax, Louise; McFarlane, Mary; Green, Emma; Miles, Anna

    2014-03-01

    Dysphagia is a common complication after stroke and is associated with the development of pneumonia. Early detection of dysphagia and specifically aspiration is, therefore, critical in the prevention of pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) is a safe bedside instrumental tool for detecting dysphagia and aspiration and, therefore, has the potential to inform dysphagia management. This study investigated the clinical utility of a speech-language pathologist-led FEES service on functional outcomes for patients after acute stroke. A retrospective file audit was carried out on 220 patients before FEES was introduced and on 220 patients after the implementation of a speech-language pathologist-led FEES service. The primary outcome measure was incidence of pneumonia, and secondary outcome measures included mortality, diet on discharge, discharge destination, duration nil-by-mouth, incidence of nonoral feeding, and length of stay. There was a significant increase in instrumental assessment use in the group that had access to FEES (P < .001). There was a significant reduction of pneumonia rates in the group that had access to FEES (P = .037). Patients were also significantly more likely to leave hospital on standard diets (P = .004) but had longer periods of nonoral feeding (P = .013) and increased length of hospitalization (P < .001). When used selectively, FEES services have potential for improving functional outcomes for patients after stroke. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Twenty-five years of accomplishments of the College of American Pathologists Q-probes program for clinical pathology.

    PubMed

    Howanitz, Peter J; Perrotta, Peter L; Bashleben, Christine P; Meier, Frederick A; Ramsey, Glenn E; Massie, Larry W; Zimmerman, Roberta L; Karcher, Donald S

    2014-09-01

    During the past 25 years, the College of American Pathologists' (CAP) Q-Probes program has been available as a subscription program to teach laboratorians how to improve the quality of clinical laboratory services. To determine the accomplishments of the CAP Q-Probes program. We reviewed Q-Probes participant information, study data and conclusions, author information, and program accomplishments. During this time 117 Q-Probes clinical pathology studies were conducted by 54 authors and coauthors, 42,899 laboratories enrolled from 24 countries, 98 peer-reviewed publications occurred and were cited more than 1600 times, and the studies were featured 59 times in CAP Today. The most frequent studies (19) focused on turnaround times for results or products at specific locations (emergency department, operating room, inpatients, outpatients), specific diseases (acute myocardial infarction, urinary tract), availability for specific events such as morning rounds or surgery, a specific result (positive blood cultures), and a method on how to use data for improvement (stat test outliers). Percentile ranking of study participants with better performance provided benchmarks for each study with attributes statistically defined that influenced improved performance. Other programs, such as an ongoing quality improvement program (Q-Tracks), a laboratory competency assessment program, a pathologist certification program, and an ongoing physician practice evaluation program (Evalumetrics), have been developed from Q-Probes studies. The CAP's Q-Probes program has made significant contributions to the medical literature and has developed a worldwide reputation for improving the quality of clinical pathology services worldwide.

  10. Dysphagia management: a survey of school-based speech-language pathologists in Vermont.

    PubMed

    Hutchins, Tiffany L; Gerety, Katherine W; Mulligan, Moira

    2011-04-01

    This study (a) gathered information about the kinds of dysphagia management services school-based speech-language pathologists (SLPs) provide, (b) examined the attitudes of SLPs related to dysphagia management, (c) compared the responses of SLPs on the basis of their experience working in a medical setting, and (d) investigated the relationship between SLPs' training and their confidence to provide dysphagia services. Fifty-two school-based SLPs practicing in Vermont responded to a survey designed to gather information on the variables of interest. Respondents reported a low incidence of students requiring dysphagia services and SLPs providing a wide range of dysphagia services. Results indicated variability in attitudes related to dysphagia management, but trends were also evident. Chief among them were SLPs' low levels of confidence to provide dysphagia services and the need for additional training in dysphagia management. SLPs who had experience in a medical setting reported greater confidence to evaluate and treat students with dysphagia compared to those without experience in a medical setting. Relationships between a variety of previous training experiences and confidence to treat dysphagia were also revealed. This study expanded previous research in this area. Factors accounting for our results, limitations, directions for future research, and implications for practice are discussed.

  11. Activities in dementia care: A comparative assessment of activity types.

    PubMed

    Lokon, Elizabeth; Sauer, Philip E; Li, Yue

    2016-12-05

    This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all. We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N = 67 people with dementia as they participated in different activity types. People with dementia showed the highest well-being scores during Opening Minds through Art compared to all other activities. No significant well-being differences were found between creative activities led by licensed art/music therapist versus regular activity staff. Furthermore, no significant well-being differences were found between creative and non-creative activities that were both led by regular activity staff. Overall, people with dementia benefit from participating in activities, regardless of the type (creative or non-creative), or who conducts them (licensed therapists or activity staff). However, in order for people with dementia to reach significantly high levels of overall well-being, we recommend that activities are specifically designed for people with dementia and incorporate a 1:1 ratio between people with dementia and well-trained volunteers/staff members. © The Author(s) 2016.

  12. A comparative assessment of waste incinerators in the UK.

    PubMed

    Nixon, J D; Wright, D G; Dey, P K; Ghosh, S K; Davies, P A

    2013-11-01

    The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supply chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87-92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.

  13. Comparative toxicology of laboratory organisms for assessing hazardous waste sites

    SciTech Connect

    Miller, W.E.; Peterson, S.A.; Greene, J.C.; Callahan, C.A.

    1985-01-01

    Multi-media/multi-trophic level bioassays have been proposed to determine the extent and severity of environmental contamination at hazardous waste sites. Comparative toxicological profiles for algae (Selenastrum capricornutum), daphnia (Daphnia magna), earthworms (Eisenia foetida), microbes (Photobacterium fisherii, mixed sewage microorganisms) and plants; wheat Stephens, (Triticum aestivum), lettuce, butter crunch, (Lactuca sativa L.) radish, Cherry Belle, (Raphanus sativa L.), red clover, Kenland, (Trifolium pratense L.) and cucumber, Spartan Valor, (Cucumis sativa L.) are presented for selected heavy metals, herbicides and insecticides. Specific chemical EC/sub 50/ values are presented for each test organism. Differences in standard deviations were compared between each individual test organism, as well as for the chemical subgroup assayed. Algae and daphnia are the most sensitive test organisms to heavy metals and insecticides followed in order of decreasing sensitivity by Microtox (Photobacterium fisherii), DO depletion rate, seed germination and earthworms. Higher plants were most sensitive to 2,4-D, (2,4-Dichlorophenoxy acetic acid) followed by algae, Microtox, daphnia and earthworms. Differences in toxicity of 2,4-D chemical formulations and commercial sources of insecticides were observed with algae and daphia tests.

  14. Assessing and Comparing Information Security in Swiss Hospitals

    PubMed Central

    Hirschel, Jürg; Schlienger, Thomas; Businger, Walter; Zbinden, Alex M

    2012-01-01

    Background Availability of information in hospitals is an important prerequisite for good service. Significant resources have been invested to improve the availability of information, but it is also vital that the security of this information can be guaranteed. Objective The goal of this study was to assess information security in hospitals through a questionnaire based on the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) standard ISO/IEC 27002, evaluating Information technology – Security techniques – Code of practice for information-security management, with a special focus on the effect of the hospitals’ size and type. Methods The survey, set up as a cross-sectional study, was conducted in January 2011. The chief information officers (CIOs) of 112 hospitals in German-speaking Switzerland were invited to participate. The online questionnaire was designed to be fast and easy to complete to maximize participation. To group the analyzed controls of the ISO/IEC standard 27002 in a meaningful way, a factor analysis was performed. A linear score from 0 (not implemented) to 3 (fully implemented) was introduced. The scores of the hospitals were then analyzed for significant differences in any of the factors with respect to size and type of hospital. The participating hospitals were offered a benchmark report about their status. Results The 51 participating hospitals had an average score of 51.1% (range 30.6% - 81.9%) out of a possible 100% where all items in the questionnaire were fully implemented. Room for improvement could be identified, especially for the factors covering “process and quality management” (average score 1.3 ± 0.8 out of a maximum of 3) and “organization and risk management” (average score 1.3 ± 0.7 out of a maximum of 3). Private hospitals scored significantly higher than university hospitals in the implementation of “security zones” and “backup” (P = .008

  15. Assessing and comparing information security in swiss hospitals.

    PubMed

    Landolt, Sarah; Hirschel, Jürg; Schlienger, Thomas; Businger, Walter; Zbinden, Alex M

    2012-11-07

    Availability of information in hospitals is an important prerequisite for good service. Significant resources have been invested to improve the availability of information, but it is also vital that the security of this information can be guaranteed. The goal of this study was to assess information security in hospitals through a questionnaire based on the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) standard ISO/IEC 27002, evaluating Information technology - Security techniques - Code of practice for information-security management, with a special focus on the effect of the hospitals' size and type. The survey, set up as a cross-sectional study, was conducted in January 2011. The chief information officers (CIOs) of 112 hospitals in German-speaking Switzerland were invited to participate. The online questionnaire was designed to be fast and easy to complete to maximize participation. To group the analyzed controls of the ISO/IEC standard 27002 in a meaningful way, a factor analysis was performed. A linear score from 0 (not implemented) to 3 (fully implemented) was introduced. The scores of the hospitals were then analyzed for significant differences in any of the factors with respect to size and type of hospital. The participating hospitals were offered a benchmark report about their status. The 51 participating hospitals had an average score of 51.1% (range 30.6% - 81.9%) out of a possible 100% where all items in the questionnaire were fully implemented. Room for improvement could be identified, especially for the factors covering "process and quality management" (average score 1.3 ± 0.8 out of a maximum of 3) and "organization and risk management" (average score 1.3 ± 0.7 out of a maximum of 3). Private hospitals scored significantly higher than university hospitals in the implementation of "security zones" and "backup" (P = .008). Half (50.00%, 8588/17,177) of all assessed hospital beds

  16. Energy forest irrigated with wastewater: a comparative microbial risk assessment.

    PubMed

    Carlander, A; Schönning, C; Stenström, T A

    2009-09-01

    In this study, risks for human infection associated with irrigation of municipal wastewater on short rotation willow coppice (Salix) were evaluated in three countries. The aim was also to determine the reduction of indicator organisms and pathogens in the treatment plants. Two of the field sites were chosen for further evaluation by QMRA (quantitative microbial risk assessment) applied to three scenarios: accidental ingestions of wastewater, exposure to aerosols and ingestion of groundwater. The risks of infection for bacteria (Salmonella), virus (rotavirus) and protozoa (Giardia, Cryptosporidium) were characterised as probability of infections per exposure and number of infections per year.The highest risk for infection was associated with exposure to rotavirus in Culmore (Northern Ireland), by either accidental ingestion of wastewater or ingestion of groundwater (P(inf) 8 x 10(-1)). For Kvidinge (Sweden) the risk for virus infection by ingestion of wastewater were in the same range (P(inf) 7 x 10(-1)). The risk for Giardia infection differed between the two sites due to differences in concentration of this pathogen in the wastewater. The groundwater was found to have suffered faecal contamination due to the wastewater irrigation. Use of partially treated wastewater for irrigation of energy crops could be a sustainable option if site-specific recommendations are developed.

  17. Comparative assessment of different drought indices across the Mediterranean

    NASA Astrophysics Data System (ADS)

    Giglioni, Michele; Efstratiadis, Andreas; Lombardo, Federico; Napolitano, Francesco; Russo, Fabio

    2016-04-01

    Droughts have become one of the most challenging issues in hydrological sciences due to their major socio-economic impacts all over the world. In the context of the everyday water resources management practice, the identification and evaluation of droughts are mainly based on simplified indices, which are estimated through easily accessible information. In this work, we employ several meteorological indices, i.e. Standardized Precipitation Index (SPI), Standardized Precipitation and Evapotranspiration Index (SPEI), Reconnaissance Drought Index (RDI), Palmer Drought Z Index, and Palmer Drought Severity Index (PDSI), in order to evaluate the severity and duration of the observed drought events. The main purpose of this study is to underline the difference in the onset time of drought, the distance between events, and the discrepancies in the magnitude assessment for the same event. Various temporal aggregation scales, from one month to one year, have been considered in order to investigate the impacts of the adopted time scale on the drought characteristics. Our analysis focuses to the Mediterranean region, using data from Southern Italy and Greece.

  18. Comparative life cycle assessment of standard and green roofs.

    PubMed

    Saiz, Susana; Kennedy, Christopher; Bass, Brad; Pressnail, Kim

    2006-07-01

    Life cycle assessment (LCA) is used to evaluate the benefits, primarily from reduced energy consumption, resulting from the addition of a green roof to an eight story residential building in Madrid. Building energy use is simulated and a bottom-up LCA is conducted assuming a 50 year building life. The key property of a green roof is its low solar absorptance, which causes lower surface temperature, thereby reducing the heat flux through the roof. Savings in annual energy use are just over 1%, but summer cooling load is reduced by over 6% and reductions in peak hour cooling load in the upper floors reach 25%. By replacing the common flat roof with a green roof, environmental impacts are reduced by between 1.0 and 5.3%. Similar reductions might be achieved by using a white roof with additional insulation for winter, but more substantial reductions are achieved if common use of green roofs leads to reductions in the urban heat island.

  19. Australian speech-language pathologists' knowledge and practice of radiation protection while performing videofluoroscopic swallowing studies.

    PubMed

    Warren-Forward, Helen; Mathisen, Bernice; Best, Sofia; Boxsell, Philip; Finlay, James; Heasman, Anna; Hodis, David; Morgan, Cian; Nixon, Jayce

    2008-12-01

    During a videofluoroscopic swallowing study (VFSS), speech and language pathologists (SLPs) are potentially exposed to radiation. To effectively limit unnecessary exposure, SLPs performing VFSS are encouraged to actively shield themselves and to be monitored by radiation-monitoring badges. The aim of this research was to assess the level of current knowledge and practice of radiation protection among SLPs performing this procedure. A questionnaire was distributed via Speech Pathology Australia (SPA) and the Australasian Dysphagia Newsletter (ADN). Sixty-nine questionnaires were returned. The results revealed that participants had received some radiation protection training, which provided them with general knowledge on radiation protection. Participants indicated a lack of formal education and were unsure of the adequacy of the information provided. Ninety-seven percent of participants always wore lead aprons, 76% always wore thyroid shields, and 36% wore radiation-monitoring badges. The researchers recommend that education on radiation protection and safety be provided for SLPs at university level to educate them before they enter the workplace. It is also recommended that SLPs always wear lead aprons, thyroid shields, and radiation-monitoring badges.

  20. Speech-Language Pathologists' Knowledge and Attitudes Regarding Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Populations.

    PubMed

    Hancock, Adrienne; Haskin, Gregory

    2015-05-01

    The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. An online survey was completed by 279 SLPs from 4 countries. Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/feminization best practice and case examples had the highest mean priority scores. There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs.

  1. Educating globally conscious speech-language pathologists for collaborative professional practice.

    PubMed

    McNeilly, Lemmietta G

    2014-01-01

    Speech-language pathologists (SLPs) practicing in the US are facing significant changes in reimbursement, billing and practice in both health care and educational settings. Health care professionals need to convey and demonstrate the value of their services, measure functional patient outcomes and assess patient satisfaction. Documentation procedures for patient and student progress are changing, becoming more abbreviated and electronic. The content of curricula in accredited graduate programs and professional development programs for maintenance of certification for SLPs will need modifications to address the myriad of changes in clinical practice. University programs that design interprofessional education opportunities for students in speech-language pathology programs and educate students in other health professional programs, e.g. physical therapy, occupational therapy, nursing and pharmacy, will help practitioners who are prepared to engage in collaborative practice with other health care professionals in hospitals, schools and community-based environments. The American Speech-Language-Hearing Association (ASHA) is actively engaged in several initiatives to facilitate interprofessional education for graduate students, faculties and practicing professionals. Individuals and families with communication disorders in the US represent an array of cultures, and SLPs need to be prepared to work effectively with individuals from different cultural and linguistic backgrounds. © 2015 S. Karger AG, Basel.

  2. Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.

    PubMed

    Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

    2015-09-01

    Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement.

  3. Professional Practice Evaluation for Pathologists: The Development, Life, and Death of the Evalumetrics Program.

    PubMed

    Volmar, Keith E; McCall, Shannon J; Schifman, Ronald B; Talbert, Michael L; Tworek, Joseph A; Hulkower, Keren I; Guidi, Anthony J; Nakhleh, Raouf E; Souers, Rhona J; Bashleben, Christine P; Blond, Barbara J

    2017-04-01

    - In 2008, the Joint Commission (JC) implemented a standard mandating formal monitoring of physician professional performance as part of the process of granting and maintaining practice privileges. - To create a pathology-specific management tool to aid pathologists in constructing a professional practice-monitoring program, thereby meeting the JC mandate. - A total of 105 College of American Pathologists (CAP)-defined metrics were created. Metrics were based on the job descriptions of pathologists' duties in the laboratory, and metric development was aided by experience from the Q-Probes and Q-Tracks programs. The program was offered in a Web-based format, allowing secure data entry, customization of metrics, and central data collection for future benchmarking. - The program was live for 3 years, with 347 pathologists subscribed from 61 practices (median, 4 per institution; range, 1-35). Subscribers used 93 of the CAP-defined metrics and created 109 custom metrics. The median number of CAP-defined metrics used per pathologist was 5 (range, 1-43), and the median custom-defined metrics per pathologist was 2 (range, 1-5). Most frequently, 1 to 3 metrics were monitored (42.7%), with 20% each following 4 to 6 metrics, 5 to 9 metrics, or greater than 10 metrics. Anatomic pathology metrics were used more commonly than clinical pathology metrics. Owing to low registration, the program was discontinued in 2016. - Through careful vetting of metrics it was possible to develop a pathologist-specific management tool to address the JC mandate. While this initial product failed, valuable metrics were developed and implementation knowledge was gained that may be used to address new regulatory requirements for emerging value-based payment systems.

  4. Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials.

    PubMed

    Anglemyer, Andrew; Horvath, Hacsi T; Bero, Lisa

    2014-04-29

    Researchers and organizations often use evidence from randomized controlled trials (RCTs) to determine the efficacy of a treatment or intervention under ideal conditions. Studies of observational designs are often used to measure the effectiveness of an intervention in 'real world' scenarios. Numerous study designs and modifications of existing designs, including both randomized and observational, are used for comparative effectiveness research in an attempt to give an unbiased estimate of whether one treatment is more effective or safer than another for a particular population.A systematic analysis of study design features, risk of bias, parameter interpretation, and effect size for all types of randomized and non-experimental observational studies is needed to identify specific differences in design types and potential biases. This review summarizes the results of methodological reviews that compare the outcomes of observational studies with randomized trials addressing the same question, as well as methodological reviews that compare the outcomes of different types of observational studies. To assess the impact of study design (including RCTs versus observational study designs) on the effect measures estimated.To explore methodological variables that might explain any differences identified.To identify gaps in the existing research comparing study designs. We searched seven electronic databases, from January 1990 to December 2013.Along with MeSH terms and relevant keywords, we used the sensitivity-specificity balanced version of a validated strategy to identify reviews in PubMed, augmented with one term ("review" in article titles) so that it better targeted narrative reviews. No language restrictions were applied. We examined systematic reviews that were designed as methodological reviews to compare quantitative effect size estimates measuring efficacy or effectiveness of interventions tested in trials with those tested in observational studies

  5. Comparative assessment of three-phase oil relative permeability models

    NASA Astrophysics Data System (ADS)

    Ranaee, Ehsan; Riva, Monica; Porta, Giovanni M.; Guadagnini, Alberto

    2016-07-01

    We assess the ability of 11 models to reproduce three-phase oil relative permeability (kro) laboratory data obtained in a water-wet sandstone sample. We do so by considering model performance when (i) solely two-phase data are employed to render predictions of kro and (ii) two and three-phase data are jointly used for model calibration. In the latter case, a Maximum Likelihood (ML) approach is used to estimate model parameters. The tested models are selected among (i) classical models routinely employed in practical applications and implemented in commercial reservoir software and (ii) relatively recent models which are considered to allow overcoming some drawbacks of the classical formulations. Among others, the latter set of models includes the formulation recently proposed by Ranaee et al., which has been shown to embed the critical effects of hysteresis, including the reproduction of oil remobilization induced by gas injection in water-wet media. We employ formal model discrimination criteria to rank models according to their skill to reproduce the observed data and use ML Bayesian model averaging to provide model-averaged estimates (and associated uncertainty bounds) of kro by taking advantage of the diverse interpretive abilities of all models analyzed. The occurrence of elliptic regions is also analyzed for selected models in the framework of the classical fractional flow theory of displacement. Our study confirms that model outcomes based on channel flow theory and classical saturation-weighted interpolation models do not generally yield accurate reproduction of kro data, especially in the regime associated with low oil saturations, where water alternating gas injection (WAG) techniques are usually employed for enhanced oil recovery. This negative feature is not observed in the model of Ranaee et al. (2015) due to its ability to embed key effects of pore-scale phase distributions, such as hysteresis effects and cycle dependency, for modeling kro observed

  6. Assessment of cognition in mild cognitive impairment: A comparative study

    PubMed Central

    Snyder, Peter J.; Jackson, Colleen E.; Petersen, Ronald C.; Khachaturian, Ara S.; Kaye, Jeffrey; Albert, Marilyn S.; Weintraub, Sandra

    2014-01-01

    The demand for rapidly administered, sensitive, and reliable cognitive assessments that are specifically designed for identifying individuals in the earliest stages of cognitive decline (and to measure subtle change over time) has escalated as the emphasis in Alzheimer’s disease clinical research has shifted from clinical diagnosis and treatment toward the goal of developing presymptomatic neuroprotective therapies. To meet these changing clinical requirements, cognitive measures or tailored batteries of tests must be validated and determined to be fit-for-use for the discrimination between cognitively healthy individuals and persons who are experiencing very subtle cognitive changes that likely signal the emergence of early mild cognitive impairment. We sought to collect and review data systematically from a wide variety of (mostly computer-administered) cognitive measures, all of which are currently marketed or distributed with the claims that these instruments are sensitive and reliable for the early identification of disease or, if untested for this purpose, are promising tools based on other variables. The survey responses for 16 measures/batteries are presented in brief in this review; full survey responses and summary tables are archived and publicly available on the Campaign to Prevent Alzheimer’s Disease by 2020 Web site (http://pad2020.org). A decision tree diagram highlighting critical decision points for selecting measures to meet varying clinical trials requirements has also been provided. Ultimately, the survey questionnaire, framework, and decision guidelines provided in this review should remain as useful aids for the evaluation of any new or updated sets of instruments in the years to come. PMID:21575877

  7. How Effective Are Self- and Peer Assessment of Oral Presentation Skills Compared with Teachers' Assessments?

    ERIC Educational Resources Information Center

    De Grez, Luc; Valcke, Martin; Roozen, Irene

    2012-01-01

    Assessment of oral presentation skills is an underexplored area. The study described here focuses on the agreement between professional assessment and self- and peer assessment of oral presentation skills and explores student perceptions about peer assessment. The study has the merit of paying attention to the inter-rater reliability of the…

  8. Comparative assessment of Vibrio virulence in marine fish larvae.

    PubMed

    Rønneseth, A; Castillo, D; D'Alvise, P; Tønnesen, Ø; Haugland, G; Grotkjaer, T; Engell-Sørensen, K; Nørremark, L; Bergh, Ø; Wergeland, H I; Gram, L

    2017-10-01

    Vibrionaceae infections are a major obstacle for marine larviculture; however, little is known about virulence differences of Vibrio strains. The virulence of Vibrio strains, mostly isolated from vibriosis outbreaks in farmed fish, was tested in larval challenge trials with cod (Gadus morhua), turbot (Scophthalmus maximus) and halibut (Hippoglossus hippoglossus) using a multiwell dish assays with single-egg/larvae cultures. The strains differed significantly in virulence as some caused a high mortality of larva reaching 100% mortality after a few days, while others had no or only marginal effects on survival. Some Vibrio strains were pathogenic in all of the larva species, while some caused disease only in one of the species. Twenty-nine of the Vibrio anguillarum strains increased the mortality of larvae from at least one fish species; however, pathogenicity of the strains differed markedly. Other Vibrio species had no or less pronounced effects on larval mortalities. Iron uptake has been related to V. anguillarum virulence; however, the presence or absence of the plasmid pJM1 encoding anguibactin did not correlate with virulence. The genomes of V. anguillarum were compared (D. Castillo, P.W. D'Alvise, M. Middelboe & L. Gram, unpublished data) and most of the high-virulent strains had acquired virulence genes from other pathogenic Vibrio. © 2017 John Wiley & Sons Ltd.

  9. A comparative toxicity assessment of materials used in aquatic construction.

    PubMed

    Lalonde, Benoit A; Ernst, William; Julien, Gary; Jackman, Paula; Doe, Ken; Schaefer, Rebecca

    2011-10-01

    Comparative toxicity testing was performed on selected materials that may be used in aquatic construction projects. The tests were conducted on the following materials: (1) untreated wood species (hemlock [Tsuga ssp], Western red cedar (Thuja plicata), red oak [Quercus rubra], Douglas fir [Pseudotsuga menziesii], red pine [Pinus resinosa], and tamarack [Larix ssp]); (2) plastic wood; (3) Ecothermo wood hemlock stakes treated with preservatives (e.g., chromated copper arsenate [CCA], creosote, alkaline copper quaternary [ACQ], zinc naphthenate, copper naphthenate, and Lifetime Wood Treatment); (4) epoxy-coated steel; (5) hot-rolled steel; (6) zinc-coated steel; and (7) concrete. Those materials were used in acute lethality tests with rainbow trout, Daphnia magna, Vibrio fischeri and threespine stickleback. The results indicated the following general ranking of the materials (from the lowest to highest LC(50) values); ACQ > creosote > zinc naphthenate > copper naphthenate > CCA (treated at 22.4 kg/m(3)) > concrete > red pine > western red cedar > red oak > zinc-coated steel > epoxy-coated steel > CCA (6.4 kg/m(3)). Furthermore, the toxicity results indicated that plastic wood, certain untreated wood species (hemlock, tamarack, Douglas fir, and red oak), hot-rolled steel, Ecothermo wood, and wood treated with Lifetime Wood Treatment were generally nontoxic to the test species.

  10. COMPARATIVE ASSESSMENT OF TOTAL PHENOLIC CONTENT IN SELECTED MEDICINAL PLANTS

    PubMed Central

    Johnson, C.E.; Oladeinde, F. O.; Kinyua, A.M.; Michelin, R.; Makinde, J.M.; Jaiyesimi, A.A.; Mbiti, W.N.; Kamau, G.N.; Kofi-Tsekpo, W.M.; Pramanik, S.; Williams, A.; Kennedy, A.; Bronner, Y.; Clarke, K.; Fofonoff, P.; Nemerson, D.

    2009-01-01

    This study was to compare the total phenolic (TP) content in extracts from eleven plant materials collected at different geographical locations in Kenya, Nigeria, and USA. These plants have been selected because the majority of them are highly pigmented, from yellow to purple, and would therefore have economic value in industries for producing antioxidants and surfactants. Two of them were collected from the industrial and domestic waste outlets. Each analysis was achieved using the Folin-Ciocalteau technique. The order of decreasing phenolic acid content as gallic acid concentration (mg/g dry weight) was Prunus africana (55.14) > Acacia tortilis (42.11) > Khaya grandifoliola (17.54) > Curcuma longa (17.23) > Vernonia amygdalina (14.9)> Russelia equisetiformis (14.03) > Calendula officinalis (7.96) >Phragmites australis (control) (7.09) > Rauwolfia vomitoria (6.69) > Phragmites australis (industrial) (6.21) > Cnidoscolus aconitifolius (5.6). The TP contents of Spartina alterniflora species were below the detection limit. PMID:20119491

  11. Comparative mutagenicity assessment of aerosols in emissions from biofuel combustion

    NASA Astrophysics Data System (ADS)

    Mukherji, Suparna; Swain, Abhay Kumar; Venkataraman, Chandra

    This study was designed to determine the mutagenicity in extracts of aerosols generated from biofuel combustion in household cooking devices commonly used in India. Wood, dung cake and biofuel briquette were used as fuel in various stoves, including both traditional and improved stoves made of mud, fired clay and metal. The combustion aerosols of particle diameter less than 2.5 μm (PM2.5) were collected, and their organic extracts were tested for mutagenicity using the Ames Assay test with TA98 and TA100 strains of Salmonella typhimurium and studies were performed both with and without metabolic activation to account for direct and indirect acting mutagens. The measured mutagenicity emission factors, i.e., number of revertants per kg of fuel burnt, indicate that wood demonstrates significantly lower mutagenicity compared to dung cake and briquette. No significant stove effect was observed across all the fuels studied. The contribution of direct-acting mutagens was found to be greater than 70% in all cases. Such a high relative contribution of direct-acting mutagenicity has not been previously reported for biomass combustion aerosols.

  12. Climate change mitigation: comparative assessment of Malaysian and ASEAN scenarios.

    PubMed

    Rasiah, Rajah; Ahmed, Adeel; Al-Amin, Abul Quasem; Chenayah, Santha

    2017-01-01

    This paper analyses empirically the optimal climate change mitigation policy of Malaysia with the business as usual scenario of ASEAN to compare their environmental and economic consequences over the period 2010-2110. A downscaling empirical dynamic model is constructed using a dual multidisciplinary framework combining economic, earth science, and ecological variables to analyse the long-run consequences. The model takes account of climatic variables, including carbon cycle, carbon emission, climatic damage, carbon control, carbon concentration, and temperature. The results indicate that without optimal climate policy and action, the cumulative cost of climate damage for Malaysia and ASEAN as a whole over the period 2010-2110 would be MYR40.1 trillion and MYR151.0 trillion, respectively. Under the optimal policy, the cumulative cost of climatic damage for Malaysia would fall to MYR5.3 trillion over the 100 years. Also, the additional economic output of Malaysia will rise from MYR2.1 billion in 2010 to MYR3.6 billion in 2050 and MYR5.5 billion in 2110 under the optimal climate change mitigation scenario. The additional economic output for ASEAN would fall from MYR8.1 billion in 2010 to MYR3.2 billion in 2050 before rising again slightly to MYR4.7 billion in 2110 in the business as usual ASEAN scenario.

  13. Comparative Measurements of Cosmic Radiation Monitors for Aircrew Exposure Assessment

    NASA Astrophysics Data System (ADS)

    Getley, I. L.; Bennett, L. G. I.; Boudreau, M. L.; Lewis, B. J.; Green, A. R.; Butler, A.; Takada, M.; Nakamura, T.

    Various commercially available electronic personal dosimeters (EPDs) have recently been flown on numerous scheduled airline flights in order to determine their viability as small, convenient monitors to measure cosmic radiation at altitude. Often, frequent flyers or airline crew will acquire such dosimeters and report the readings from their flights, without due regard for the mixed radiation field at altitude, which is different from the intended fields on land. A sampling of EPDs has been compared to two types of spectrometers, which measure the total radiation spectrum. The “HAWK” tissue equivalent proportional counter is considered a reference instrument and measures the total dose equivalent H * (10). The Liulin-4N and 4SN linear energy transfer spectrometers each have a silicon semiconductor-based PIN diode detector which provides an absorbed dose, D, but have been further developed to provide H * (10). A Thermo Electron FH41B and B-10, and EPD-N2, and several personal dosimeters (Fuji NRY-21 and NRF-20, and RADOS DIS-100) were also flown.

  14. Comparative Measurements of Cosmic Radiation Monitors for Aircrew Exposure Assessment

    NASA Astrophysics Data System (ADS)

    Getley, I. L.; Bennett, L. G. I.; Boudreau, M. L.; Lewis, B. J.; Green, A. R.; Butler, A.; Takada, M.; Nakamura, T.

    Various commercially available electronic personal dosimeters (EPDs) have recently been flown on numerous scheduled airline flights in order to determine their viability as small, convenient monitors to measure cosmic radiation at altitude. Often, frequent flyers or airline crew will acquire such dosimeters and report the readings from their flights, without due regard for the mixed radiation field at altitude, which is different from the intended fields on land. A sampling of EPDs has been compared to two types of spectrometers, which measure the total radiation spectrum. The "HAWK" tissue equivalent proportional counter is considered a reference instrument and measures the total dose equivalent H*(10). The Liulin-4N and 4SN linear energy transfer spectrometers each have a silicon semiconductor-based PIN diode detector which provides an absorbed dose, D, but have been further developed to provide H*(10). A Thermo Electron FH41B and B-10, and EPD-N2, and several personal dosimeters (Fuji NRY-21 and NRF-20, and RADOS DIS-100) were also flown.

  15. COMPARATIVE ASSESSMENT OF TOTAL PHENOLIC CONTENT IN SELECTED MEDICINAL PLANTS.

    PubMed

    Johnson, C E; Oladeinde, F O; Kinyua, A M; Michelin, R; Makinde, J M; Jaiyesimi, A A; Mbiti, W N; Kamau, G N; Kofi-Tsekpo, W M; Pramanik, S; Williams, A; Kennedy, A; Bronner, Y; Clarke, K; Fofonoff, P; Nemerson, D

    2008-01-01

    This study was to compare the total phenolic (TP) content in extracts from eleven plant materials collected at different geographical locations in Kenya, Nigeria, and USA. These plants have been selected because the majority of them are highly pigmented, from yellow to purple, and would therefore have economic value in industries for producing antioxidants and surfactants. Two of them were collected from the industrial and domestic waste outlets. Each analysis was achieved using the Folin-Ciocalteau technique. The order of decreasing phenolic acid content as gallic acid concentration (mg/g dry weight) was Prunus africana (55.14) > Acacia tortilis (42.11) > Khaya grandifoliola (17.54) > Curcuma longa (17.23) > Vernonia amygdalina (14.9)> Russelia equisetiformis (14.03) > Calendula officinalis (7.96) >Phragmites australis (control) (7.09) > Rauwolfia vomitoria (6.69) > Phragmites australis (industrial) (6.21) > Cnidoscolus aconitifolius (5.6). The TP contents of Spartina alterniflora species were below the detection limit.

  16. Probabilistic risk assessment for comparative evaluation of security features

    NASA Astrophysics Data System (ADS)

    Saksena, Anshu; Lucarelli, Dennis

    2004-06-01

    A systematic approach for comparing the effectiveness of counterfeit deterrence features in banknotes, credit cards, digital media, etc. was previously presented. That approach built a probabilistic model around the expert identification of the most efficient process by which a counterfeiter can gain sufficient information to replicate a particular feature. We have extended the scope and functionality of that approach to encompass the entire counterfeiting process from the learning phase to the production of counterfeits. The extended approach makes determining the probabilities more straightforward by representing a more detailed model of the counterfeiting process, including many probable counterfeiting scenarios rather than just representing the least costly successful scenario. It uses the counterfeiter's probability of succeeding and level of effort as metrics to perform feature comparisons. As before, these metrics are evaluated for a security feature and presented in a way that facilitates comparison with other security features similarly evaluated. Based on this representation, the cost and laboratory procedures necessary for succeeding may be recovered by a dynamic programming technique. This information may be useful in forensic profiling of potential counterfeiters.

  17. Comparative Performance Assessment For Central Receiver CPV Systems

    NASA Astrophysics Data System (ADS)

    Lasich, John B.; Thomas, Ian; Verlinden, Pierre J.; Lewandowski, Allan; Heartag, Wolfgang; Wright, Mark

    2011-12-01

    A Central receiver Concentrating PV (C2PV) system has the potential to be the optimum solar energy generation system for utility scale because it combines the high efficiency of CPV with the low cost of a heliostat collector. Due to the off axis nature of a heliostat central receiver concentrator a cosine efficiency loss is incurred and, unlike `normal' tracking CPV lens and dish systems, the optical performance varies with time and site latitude. To investigate the optical performance of a C2PV system a ray trace model has been developed and the performance of a representative C2PV system is modelled throughout the year and at different site latitudes. The cosine loss and latitude dependence are put into perspective by calculating the annual average optical efficiency and testing its sensitivity to variations in site latitude. These values are then used to estimate a system performance by applying efficiencies for solar cell, balance of system and operational factors. This system efficiency is finally compared to published data for `normal' tracking CPV dish and lens systems. Modelled annual average AC system efficiency for the C2PV system was calculated to be 21% at 40° latitude and 19% at 15° latitude. These annual average AC system efficiencies are shown to be similar to those reported for typical dish and lens CPV systems when they are adjusted to use a total collector area baseline.

  18. Assessing The Anthropocene In The Context Of Comparative Planetology.

    NASA Astrophysics Data System (ADS)

    Grinspoon, D. H.

    2012-12-01

    of the fourth kind": intentional change. We are arguably approaching a branching point, where we will either become masters of our world or victims of our own success. Most likely this is a common experience of intelligent life developing technologically elsewhere in the universe, because regardless of specific evolutionary, cultural and technological paths, life will evolve by Darwinian evolution and therefore will inherit a biological imperative to multiply and maximize survival. Planets are finite and thus analogous developments will lead to a collision between technological survival strategies that are successful on limited temporal and spatial scales, and unforeseen long-term global consequences. The nature and prevalence of intelligent life in the universe will be shaped by how civilizations respond to this challenge, and future observations of exoplanets may reveal the global signatures of proto-intelligent or intelligent life. In addition to comparing the current rapid transformations of the Earth system to changes in our planet's past, some context for the Anthropocene can be gained by comparison with catastrophic changes on other planets. I will compare the rate, magnitude and duration of the Anthropocene with known and hypothesized catastrophic changes on other planets, including the loss of oceans and global resurfacing on Venus, global desiccation and quasi-periodic climate change on Mars, and the end-Cretaceous impact catastrophe on Earth.

  19. DNA extraction from benthic Cyanobacteria: comparative assessment and optimization.

    PubMed

    Gaget, V; Keulen, A; Lau, M; Monis, P; Brookes, J D

    2017-01-01

    Benthic Cyanobacteria produce toxic and odorous compounds similar to their planktonic counterparts, challenging the quality of drinking water supplies. The biofilm that benthic algae and other micro-organisms produce is a complex and protective matrix. Monitoring to determine the abundance and identification of Cyanobacteria, therefore, relies on molecular techniques, with the choice of DNA isolation technique critical. This study investigated which DNA extraction method is optimal for DNA recovery in order to guarantee the best DNA yield for PCR-based analysis of benthic Cyanobacteria. The conventional phenol-chloroform extraction method was compared with five commercial kits, with the addition of chemical and physical cell-lysis steps also trialled. The efficacy of the various methods was evaluated by measuring the quantity and quality of DNA by UV spectrophotometry and by quantitative PCR (qPCR) using Cyanobacteria-specific primers. The yield and quality of DNA retrieved with the commercial kits was significantly higher than that of DNA obtained with the phenol-chloroform protocol. Kits including a physical cell-lysis step, such as the MO BIO Power Soil and Biofilm kits, were the most efficient for DNA isolation from benthic Cyanobacteria. These commercial kits allow greater recovery and the elimination of dangerous chemicals for DNA extraction, making them the method of choice for the isolation of DNA from benthic mats. They also facilitate the extraction of DNA from benthic Cyanobacteria, which can help to improve the characterization of Cyanobacteria in environmental studies using qPCRs or population composition analysis using next-generation sequencing. © 2016 The Society for Applied Microbiology.

  20. Historical perspective and future directions in training of veterinary pathologists with an emphasis on zoo and wildlife species.

    PubMed

    Lowenstine, Linda J; Montali, Richard J

    2006-01-01

    This article discusses the history of the field of zoo and wildlife pathology, training opportunities for veterinary students and graduate veterinarians, and current and future job opportunities. The niches occupied by veterinarians in this field and their contributions to animal and human health are also highlighted. The field of zoo and wildlife, or "non-traditional" species, pathology has its roots in comparative anatomy, zoology, wildlife biology, and medical pathology in the mid- to late nineteenth century. The initial emphasis was on comparisons between animal and human diseases or on management of game animals. Veterinarians became increasingly involved during the twentieth century, gradually changing the emphasis to improvement of conservation strategies, captive care, and elucidation of diseases of concern for the animals themselves. Currently there are several zoos and wildlife agencies in the United States employing full-time veterinary pathologists. Private and government diagnostic laboratories, veterinary schools, and other academic institutions in the United States with pathology departments are other employers. The field requires post-DVM training by means of a residency program leading to board certification, graduate school (MS or PhD degrees), or both. Veterinary students can gain valuable experience in the field through externships and, at some schools, through elective courses in the curriculum. Current concerns about ecosystem health, bioterrorism, and the recognition that captive and free-ranging wildlife can serve as sentinel species will increase the demand for veterinary pathologists choosing this very rewarding career path specializing in non-traditional species.

  1. The ECVP/ESVP summer school in veterinary pathology: high-standard, structured training for young veterinary pathologists.

    PubMed

    Kipar, Anja; Aleksandersen, Mona; Benazzi, Cinzia; Hodge, Thomas; Sukura, Antti; Wyers, Monique

    2007-01-01

    This article describes the ECVP/ESVP Summer School in Veterinary Pathology, a new annual two-week European training facility established by the European College of Veterinary Pathologists (ECVP) in collaboration with the European Society of Veterinary Pathology (ESVP). The aim of the Summer Schools is to provide Europe-wide, harmonized, top-standard theoretical and practical post-graduate training for veterinarians specializing in veterinary pathology. In particular, it aims to support trainees in veterinary pathology in their individual preparation for the ECVP certifying examination. Ultimately, it aims to provide young pathologists with the skills and knowledge necessary to participate in international, high-quality research and the tools for applying international standards to their own research and for independent study for the ECVP certifying examination, even if they do not work in comparable academic environments and do not have the same level of local support and training. The ECVP/ESVP Summer Schools take place in European countries, with local organization from a university department of veterinary pathology. Each event comprises modules provided by internationally recognized specialists in their specific fields of expertise on different organ systems, diseases of specific species, specific techniques, and specific topics relevant to pathology, forming a cycle of four events to cover all major topics. Every two years a mock exam is organized as a tool to monitor individual progress in preparing for the ECVP certifying examination.

  2. Comparative assessment of water treatment using polymeric and inorganic coagulants

    NASA Astrophysics Data System (ADS)

    Manda, Innocent K. M.; Chidya, Russel C. G.; Saka, John D. K.; Biswick, Timothy T.

    2016-06-01

    Portable water plays a vital role in improving human life, particularly in controlling the spread of diseases. However, problems associated with lack of potable water are still common especially in developing countries including Malawi. Until now little information exists on the effectiveness of available commercial coagulants used by national water boards in Malawi. Therefore, this study was undertaken in Southern Region Water Board (SRWB) to investigate the efficiency of polymeric coagulants (sufdfloc 3850 and algaefloc 19s) in turbidity reduction comparative with inorganic coagulant (aluminium sulphate) at Zomba, Liwonde, Mangochi, Chikwawa and Mulanje Treatment plants. The jar test method was used to determine the effectiveness of the water coagulants. The results revealed that sudfloc 3850 was most effective in reducing turbidity at Mangochi (99.4 ± 0.06%) and Liwonde (97.2 ± 0.04%) using 0.4 mg L-1 flocculant dose. The Zomba, Mulanje and Chikwawa plants gave 19.56 ± 0.03%, 29.23 ± 0.02% and 9.43 ± 0.02% total reductions respectively. Algaefloc 19s afforded the highest turbidity reduction at Liwonde and Mangochi plants (98.66 ± 0.06 and 97.48 ± 0.05% at a dose of 0.4 and 0.6 mg L-1 respectively), while Chikwawa provided the lowest (9.52 ± 0.01%). At the Zomba and Mulanje plants 20.5 ± 0.03% and 28.4 ± 0.04% reductions were obtained respectively. The inorganic flocculant, alum provided a 99.0 ± 0.05% and 98.6 ± 0.04% reduction at a dose of 4.0 mg L-1 and 6.0 mg L-1 at Zomba and Liwonde plants respectively. The lowest reductions in turbidity were achieved at Chikwawa (7.50 ± 0.01%), Mangochi (12.97 ± 0.02%) and Mulanje (25.00 ± 0.02). The best and optimum pH ranges for polymeric and inorganic coagulants were 7.20-7.80 and 7.35 to 7.57 respectively. The results further revealed that sudfloc 3850 and algaefloc 19s achieved faster formation of heavy flocs than alum. At 0.4 mg L-1 flocculant dosage sudfloc 3850 and algaefloc 19s required ten times

  3. Comparative Study of Child Assessment Practices in English and Korean Preschools

    ERIC Educational Resources Information Center

    Nah, Kwi-Ok

    2014-01-01

    Child assessment practices in English and Korean preschools were compared by analysing data from interviews with educators, examples of child assessment, and official documents from each country. Child assessment in England was systematically implemented and characterised by several methodological and procedural strengths, whereas assessment in…

  4. Comparative Study of Child Assessment Practices in English and Korean Preschools

    ERIC Educational Resources Information Center

    Nah, Kwi-Ok

    2014-01-01

    Child assessment practices in English and Korean preschools were compared by analysing data from interviews with educators, examples of child assessment, and official documents from each country. Child assessment in England was systematically implemented and characterised by several methodological and procedural strengths, whereas assessment in…

  5. College of American Pathologists' laboratory standards for next-generation sequencing clinical tests.

    PubMed

    Aziz, Nazneen; Zhao, Qin; Bry, Lynn; Driscoll, Denise K; Funke, Birgit; Gibson, Jane S; Grody, Wayne W; Hegde, Madhuri R; Hoeltge, Gerald A; Leonard, Debra G B; Merker, Jason D; Nagarajan, Rakesh; Palicki, Linda A; Robetorye, Ryan S; Schrijver, Iris; Weck, Karen E; Voelkerding, Karl V

    2015-04-01

    The higher throughput and lower per-base cost of next-generation sequencing (NGS) as compared to Sanger sequencing has led to its rapid adoption in clinical testing. The number of laboratories offering NGS-based tests has also grown considerably in the past few years, despite the fact that specific Clinical Laboratory Improvement Amendments of 1988/College of American Pathologists (CAP) laboratory standards had not yet been developed to regulate this technology. To develop a checklist for clinical testing using NGS technology that sets standards for the analytic wet bench process and for bioinformatics or "dry bench" analyses. As NGS-based clinical tests are new to diagnostic testing and are of much greater complexity than traditional Sanger sequencing-based tests, there is an urgent need to develop new regulatory standards for laboratories offering these tests. To develop the necessary regulatory framework for NGS and to facilitate appropriate adoption of this technology for clinical testing, CAP formed a committee in 2011, the NGS Work Group, to deliberate upon the contents to be included in the checklist. Results . -A total of 18 laboratory accreditation checklist requirements for the analytic wet bench process and bioinformatics analysis processes have been included within CAP's molecular pathology checklist (MOL). This report describes the important issues considered by the CAP committee during the development of the new checklist requirements, which address documentation, validation, quality assurance, confirmatory testing, exception logs, monitoring of upgrades, variant interpretation and reporting, incidental findings, data storage, version traceability, and data transfer confidentiality.

  6. Speech-language pathologists' informal learning in healthcare settings: behaviours and motivations.

    PubMed

    Walden, Patrick R; Bryan, Valerie C

    2011-08-01

    The current research sought to identify the types of informal learning behaviours speech-language pathologists (SLPs) working in healthcare settings engage in as well as SLPs' motivations for engaging in informal learning. Twenty-four American Speech-Language-Hearing Association (ASHA)-certified SLPs participated in this qualitative study. Data collection consisted of computer-mediated interviews, online journaling, and a virtual focus group. These textual data were coded and collapsed into themes. All participant SLPs reported that they learned through collaboration (inter- and intra-disciplinary), worked with patients to learn through trial-and-error, and consulted non-peer-reviewed material on the internet as well as peer-reviewed research in order to learn informally in the workplace. Eighteen of the 24 participants reported being motivated to learn at work to meet a patient's need to meet therapy goals. Five of the 24 participants reported meeting their own personal learning needs was a motivating factor and 10 of the 24 participants reported learning informally to meet the needs of the healthcare organization/SLP profession. Results were compared to past research on SLPs' information retrieval behaviours. It was concluded that SLPs acknowledge their personal work-related gaps in knowledge and skills and actively seek to develop their knowledge and skill base through informal means.

  7. Speech-language pathologist job satisfaction in school versus medical settings.

    PubMed

    Kalkhoff, Nicole L; Collins, Dana R

    2012-04-01

    The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings. The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were computed from subscale category ratings and were compared between the 2 settings. Subscale category ratings for pay, promotion, supervision, benefits, contingent rewards, operating conditions, coworkers, nature of work, and communication were analyzed for differences between and within settings. Age, caseload size, and years-at-position were analyzed by linear regression to determine whether these factors might predict SLPs' job satisfaction. The survey had a response rate of 19.6% (N = 98 participants). Although SLPs in both settings were generally satisfied with their jobs, SLPs in medical settings had significantly higher total job satisfaction scores. Respondents from both settings had similar satisfaction ratings for subscale categories, with nature of work receiving the highest rating and operating conditions and promotion the lowest. Results of the linear regression analysis for age, caseload size, and years-at-position were not significant. Further research should evaluate important aspects of job satisfaction in both settings, especially nature of work operating conditions, and promotion.

  8. [Analysis of on-call consultations with clinical pathologists--identification of customer's satisfaction].

    PubMed

    Yanai, M

    2000-09-01

    One aspect whereby effectiveness of clinical pathologists can be measured is customer service and satisfaction. Clinical pathologist should identify their customers, their processes and procedures to meet these needs to the customer's satisfaction. To identify customer's satisfaction, the records of on-call consultations with clinical pathologists were analyzed. Between January 1996 and December 1998, 1327 consultations were recorded, 40% of which were consultations from physicians, 50% from medical technologists. Physicians requested interpretation of laboratory data obtained, and clinical knowledge mainly concerning the microbiology and hematology during office hours. On holidays, physicians needed help performing emergency tests such as Gram stain and Wright-Giemsa stain. During office hours, medical technologists requested clinical information concerning patients in whom unreasonable data would be reported and the contact to the clinical side. Furthermore, technologists inquired about the methodology of laboratory tests during day duty on holidays. These results indicated that the clinical pathologist in our hospital could satisfy the customer(physicians and medical technologists), by providing 1) a wide range of clinical knowledge concerning not only the laboratory medicine but clinical medicine including therapeutics, 2) capability of performing emergency tests such as Gram stain and Wright-Giemsa stain, and 3) capability of interpreting the results obtained. Although these would not be adopted in every hospital, every clinical pathologist should examine his role in the hospital.

  9. STP debate on the desirability of an international mechanism for recognizing qualified toxicologic pathologists.

    PubMed

    Bolon, Brad; Ochoa, Ricardo; Mann, Peter

    2009-12-01

    The June 2009 Town Hall meeting of the Society of Toxicologic Pathology (STP) and a subsequent survey considered whether or not STP should endorse a published proposal (Toxicol Pathol 37: 553-561, 2009) by the International Federation of Societies of Toxicologic Pathologists (IFSTP) to provide global recognition by credential review for toxicologic pathologists engaged in regulatory-type, nonclinical toxicology studies. One-third (374 of 1082) of STP members answered the survey. The majority of respondents rejected the IFSTP proposal (55% against) but favored the concept of global recognition (57% for), if available to both anatomic pathologists and clinical pathologists (67% for). Members preferred recognition by credential review (49% for) or via an internationally authored "best practices" document detailing the ideal educational and work experiences required for entry-level proficiency in toxicologic pathology (43% for). Therefore, the STP Executive Committee does not endorse the current IFSTP proposal but will continue discussions on global recognition of qualified toxicologic pathologists with other societies of toxicologic pathology.

  10. Demographic and Practice Characteristics of Pathologists Who Enjoy Breast Tissue Interpretation

    PubMed Central

    Oster, Natalia V.; Geller, Berta; Carney, Patricia A.; Reisch, Lisa M.; Onega, Tracy; Weaver, Donald L.; Frederick, Paul; Elmore, Joann G.

    2015-01-01

    Summary Physician attributes, job satisfaction and confidence in clinical skills are associated with enhanced performance and better patient outcomes. We surveyed 252 pathologists to evaluate associations between enjoyment of breast pathology, demographic/clinical characteristics and diagnostic performance. Diagnostic performance was determined by agreement with patient cases previously reviewed by a panel of experienced pathologists. Eighty-three percent of study participants reported enjoying breast pathology. Pathologists who enjoy breast interpretation were more likely to review ≥10 cases/week (p=0.003), report breast interpretation expertise (p=0.013), and high levels of confidence interpreting breast pathology (p<0.001). These pathologists were less likely to report that the field was challenging (p<0.001) and that breast cases make them more nervous than other types of pathology (p<0.001). Enjoyment was not associated with diagnostic performance. Millions of women undergo breast biopsy annually, thus it is reassuring that although nearly a fifth of practicing pathologists who interpret breast tissue report not enjoying the field, precision is not impacted. PMID:25554017

  11. Capacity to support young low-progress readers at school: experiences of speech-language pathologists.

    PubMed

    Serry, Tanya

    2013-12-01

    There is a complex interplay between expectations for speech-language pathologists based in primary schools to work with low-progress readers and various factors that may preclude this from actually occurring. This qualitative study investigated experiences and perspectives of nine Australian speech-language pathologists based in primary schools about their capacity to work with low-progress readers. Building on previous quantitative research, this study supported a relatively even split of those who do and do not work with such children. Moreover, thematic analysis revealed that speech-language pathologists face many more barriers than facilitators when attempting to become a member of written language support teams within schools. Facilitators included having a personal interest in reading difficulty as well as working in an environment supportive of speech-language pathology input for low-progress readers. Barriers to working with or participating in teams to support low-progress readers involved factors such as time constraints, resistance from educational colleagues, and a theoretical divide about reading difficulty between educators and speech-language pathologists. Suggested strategies to enhance school-based speech-language pathologists' capacity to operate as key supports for struggling readers are discussed. These include approaches such as aiming to create a more transparent role definition, professional advocacy, and increasing interdisciplinary collaborations at schools.

  12. [Technical considerations for KRAS testing in colorectal cancer. The pathologist's point of view].

    PubMed

    Bibeau, F; Frugier, H; Denouel, A; Sabourin, J-C; Boissiere-Michot, F

    2009-12-01

    The KRAS status is now a mandatory prerequisite in order to treat metastatic colorectal patients with anti-EGFR (epidermal growth factor receptor) antibodies, such as cetuximab (Erbitux) or panitumumab (Vectibix). KRAS mutations are unambiguously linked to a lack of response to these targeted therapies and to a poor outcome. The optimal determination of the KRAS status should be based on coordination between pathologists and biologists. The pathologist must morphologically check the tumor to be analyzed and be sure that the fixatives used are valuable for molecular biology. The pathologist's involvement may also concern the DNA extraction and the KRAS mutations analyses. This involvement has to be included in a multidisciplinary setting in order to get rapid and robust tests for the clinical use. The imperative knowledge of the KRAS status in the management of metastatic disease represents a good example of this multidisciplinary coordination. In the future, the pathologist's role should be extended, considering the emergence of a more and more personalized medicine, integrating efficiency and cost-effectiveness. Thus, the pathologist may contribute to validate new molecular tests and to offer his specific techniques for translational research.

  13. Liver steatosis assessment: correlations among pathology, radiology, clinical data and automated image analysis software.

    PubMed

    Lee, Michael J; Bagci, Pelin; Kong, Jun; Vos, Miriam B; Sharma, Puneet; Kalb, Bobby; Saltz, Joel H; Martin, Diego R; Adsay, N Volkan; Farris, Alton B

    2013-06-01

    Quantitating hepatic steatosis is important in many liver diseases and liver transplantation. Since steatosis estimation by pathologists has inherent intra- and inter-observer variability, we compared and contrasted computerized techniques with magnetic resonance imaging measurements, pathologist visual scoring, and clinical parameters. Computerized methods applied to whole slide images included a commercial positive pixel count algorithm and a custom algorithm programmed at our institution. For all liver samples (n=59), including pediatric, adult, frozen section, and permanent specimens, statistically significant correlations were observed between pathology, radiology, and each image analysis modality (r=0.75-0.97, p<0.0001), with the strongest correlations in the pediatric cohort. Statistically significant relationships were observed between each method and with body mass index (r=0.37-0.56, p from <0.0001 to <0.05) and with albumin (r=0.55-0.64, p<0.05) but not with alanine aminotransferase or aspartate aminotransferase. Although pathologist assessments correlated (r=0.64-0.86, 0.92-0.97, and 0.78-0.91 for microvesicular, macrovesicular, and overall steatosis, respectively), the absolute values of hepatic steatosis visual assessment were susceptible to intra- and inter-observer variability, particularly for microvesicular steatosis. Image analysis, pathologist assessments, radiology measurements, and several clinical parameters all showed correlations in this study, providing evidence for the utility of each method in different clinical and research settings. Copyright © 2013 Elsevier GmbH. All rights reserved.

  14. The use of oral and maxillofacial pathology services by general pathologists and their attitude towards it in Saudi Arabia.

    PubMed

    Binmadi, Nada O; Almazrooa, Soulafa A

    2017-08-01

    To investigate the awareness and usage of oral and maxillofacial pathology (OMFP)  subspecialty services among pathologists in Saudi Arabia. Methods: In this cross-sectional study, we conducted an electronic questionnaire survey of pathologists in all regions of Saudi Arabia. The study was conducted between July 2015 and August 2016.  The questionnaire comprised 19 questions to evaluate the knowledge of pathologists regarding microscopic OMFP and their perceptions towards this subspecialty. Results: Most of the pathologists surveyed (94.6%) were aware of the OMFP subspecialty and its scope of practice. Although most of the pathologists recognized the importance and need of this subspecialty, 70% of them never referred or consulted an oral pathologist as they either diagnosed the cases themselves or  did not know any oral pathologist (57.7%). The pathologists had the greatest difficulty in identifying and diagnosing odontogenic tumors, salivary gland tumors, and odontogenic cysts.  Conclusion: Pathologists are aware of the OMFP subspecialty, but their utilization of the services offered by OMFP specialists in Saudi Arabia is quite low despite the strong demand for OMFP services.

  15. Overview of the laboratory accreditation programme of the College of American Pathologists.

    PubMed

    Abu-Amero, K K

    2002-01-01

    Although Saudi medical laboratories have developed enormously over the past 25 years, the absence of a national body for medical laboratory accreditation has meant the number of accredited laboratories (seven) remains low. Of these, five are accredited by the College of American Pathologists' Laboratory Accreditation Program (LAP)--the 'gold standard' of laboratory accreditation. It requires successful performance in the College of American Pathologists' proficiency testing programme as well as passing on-site inspections carried out by practising laboratory technicians, after which the laboratory is accredited for a 2-year period. This article gives an insight into the current situation of laboratory accreditation in Saudi Arabia and an updated overview of the process involved in obtaining laboratory accreditation from the College of American Pathologists.

  16. [Web-ring of sites for pathologists in the internet: a computer-mediated communication environment].

    PubMed

    Khramtsov, A I; Isianov, N N; Khorzhevskiĭ, V A

    2009-01-01

    The recently developed Web-ring of pathology-related Web-sites has transformed computer-mediated communications for Russian-speaking pathologists. Though the pathologists may be geographically dispersed, the network provides a complex of asynchronous and synchronous conferences for the purposes of diagnosis, consultations, education, communication, and collaboration in the field of pathology. This paper describes approaches to be used by participants of the pathology-related Web-ring. The approaches are analogous to the tools employed in telepathology and digital microscopy. One of the novel methodologies is the use of Web-based conferencing systems, in which the whole slide digital images of tissue microarrays were jointly reviewed online by pathologists at distant locations. By using ImageScope (Aperio Technologies) and WebEx connect desktop management technology, they shared presentations and images and communicated in realtime. In this manner, the Web-based forums and conferences will be a powerful addition to a telepathology.

  17. Comparing Yes/No Angoff and Bookmark Standard Setting Methods in the Context of English Assessment

    ERIC Educational Resources Information Center

    Hsieh, Mingchuan

    2013-01-01

    The Yes/No Angoff and Bookmark method for setting standards on educational assessment are currently two of the most popular standard-setting methods. However, there is no research into the comparability of these two methods in the context of language assessment. This study compared results from the Yes/No Angoff and Bookmark methods as applied to…

  18. Comparing Sex Offender Risk Classification Using the Static-99 and LSI-R Assessment Instruments

    ERIC Educational Resources Information Center

    Gentry, Amanda L.; Dulmus, Catherine N.; Theriot, Matthew T.

    2005-01-01

    Objective: This study compares sex offender risk classification using two popular actuarial risk assessment instruments--the Static-99 and the Level of Service Inventory-Revised (LSI-R). Despite their extensive use, the two scales assess different types of risk factors and research has yet to compare them. Method: Static-99 and LSI-R risk…

  19. Comparing Yes/No Angoff and Bookmark Standard Setting Methods in the Context of English Assessment

    ERIC Educational Resources Information Center

    Hsieh, Mingchuan

    2013-01-01

    The Yes/No Angoff and Bookmark method for setting standards on educational assessment are currently two of the most popular standard-setting methods. However, there is no research into the comparability of these two methods in the context of language assessment. This study compared results from the Yes/No Angoff and Bookmark methods as applied to…

  20. On the Comparative Impact of Self-Assessment and Teacher-Assessment on Iranian EFL Learners' Academic Motivation

    ERIC Educational Resources Information Center

    Salimi, Asghar; Larsari, Vahid Nowrozi

    2015-01-01

    Nowadays, the function of language teaching and testing has been paid much attention by researchers. There is an overall notion in the literature that motivation, as driving force, is one of the likely learners' traits. The aim of this study was to examine the comparative impact of self-assessment and teacher-assessment on learners' academic…

  1. Diagnosis of Asbestos-Related Diseases: The Mineralogist and Pathologist's Role in Medicolegal Field.

    PubMed

    Capella, Silvana; Bellis, Donata; Belluso, Elena

    2016-03-01

    Because asbestos diseases represent a complex pattern of legal, social, and political issue, the involvement of the mineralogist and pathologist for a multidisciplinary assessment of its diagnosis helps investigate the relationship between mesothelioma or lung cancer and occupational or environmental asbestos exposure.In the present study, we consider the concentrations of asbestos bodies (ABs) detected by optical microscopy (OM) and scanning electron microscopy (SEM) and the burden of different kinds of mineral fibers (among which is asbestos) identified by SEM combined with an energy dispersive spectrometer (EDS), in 10 lung tissue samples of subjects with occupational and nonoccupational exposure to asbestos.In all subjects with occupational exposure to asbestos, more than 1000 ABs per gram of dry weight were detected both with OM and SEM; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.In 9 lung samples of the 10 investigated by SEM-EDS different inorganic fibers were found. Asbestos fibers have been identified too, and more than 100,000 fibers per gram of dry weight were detected in subjects with occupational exposure; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.Instead, when the ABs burden is low or moderate (such as in subjects with absent or probable asbestos exposure), the correlation between ABs concentration determined by OM and those determined by SEM is lost. Therefore, when the ABs value in OM is borderline, the SEM investigation became essential. Furthermore, the mineralogical analysis by SEM-EDS (identification and quantification of inorganic fibers in general and asbestos in particular) of the fibers detected in the lung tissues is very useful, if not necessary, to complete the pathological diagnosis of asbestos-related malignancies in medicolegal field.

  2. 77 FR 45379 - Increasing the Supply of Forensic Pathologists in the United States: A Report and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-31

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF JUSTICE Office of Justice Programs Increasing the Supply of Forensic Pathologists in the United States: A Report... Forensic Pathologists in the United States: A Report and Recommendations.'' The opportunity to provide...

  3. Ethical Perspective on Quality of Care: The Nature of Ethical Dilemmas Identified by New Graduate and Experienced Speech Pathologists

    ERIC Educational Resources Information Center

    Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan

    2009-01-01

    Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…

  4. Ethical Perspective on Quality of Care: The Nature of Ethical Dilemmas Identified by New Graduate and Experienced Speech Pathologists

    ERIC Educational Resources Information Center

    Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan

    2009-01-01

    Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…

  5. Interactive Rapid Dose Assessment Model (IRDAM): scenarios for comparing dose-assessment models. Vol. 3

    SciTech Connect

    Poeton, R.W.; Moeller, M.P.; Laughlin, G.J.; Desrosiers, A.E.

    1983-05-01

    The Interactive Rapid Dose Assessment Model (IRDAM) is a micro-computer based program designed to provide rapid assessments of the radiological impact of accidents at nuclear power plants. The main body of this document consists of 28 examples of IRDAM input and output, representing various types of accidents and releases. These examples are intended to provide a basis for comparison with other models or for testing IRDAM itself. Figures are included which show dose rates calculated by IRDAM for each scenario. Figures are also included which show calculations made using the computer codes WRAITH (Scherpelz, Borst and Hoenes, 1980) and RADPUR (Dabbert, et. al., 1982). Two other companion volumes to this one provide additional information on IRDAM. The User's Guide (NUREG/CR-3012, Volume 1) describes the setup and operation of equipment necessary to run IRDAM. Reactor Accident Assessment Methods (NUREG/CR-3012, Volume 2) describes the technical bases for IRDAM including methods, models and assumptions used in calculations.

  6. Comparative Human Health Impact Assessment of Engineered Nanomaterials in the Framework of Life Cycle Assessment.

    PubMed

    Fransman, Wouter; Buist, Harrie; Kuijpers, Eelco; Walser, Tobias; Meyer, David; Zondervan-van den Beuken, Esther; Westerhout, Joost; Klein Entink, Rinke H; Brouwer, Derk H

    2016-09-24

    For safe innovation, knowledge on potential human health impacts is essential. Ideally, these impacts are considered within a larger life-cycle-based context to support sustainable development of new applications and products. A methodological framework that accounts for human health impacts caused by inhalation of engineered nanomaterials (ENMs) in an indoor air environment has been previously developed. The objectives of this study are as follows: (i) evaluate the feasibility of applying the CF framework for NP exposure in the workplace based on currently available data; and (ii) supplement any resulting knowledge gaps with methods and data from the life cycle approach and human risk assessment (LICARA) project to develop a modified case-specific version of the framework that will enable near-term inclusion of NP human health impacts in life cycle assessment (LCA) using a case study involving nanoscale titanium dioxide (nanoTiO2 ). The intent is to enhance typical LCA with elements of regulatory risk assessment, including its more detailed measure of uncertainty. The proof-of-principle demonstration of the framework highlighted the lack of available data for both the workplace emissions and human health effects of ENMs that is needed to calculate generalizable characterization factors using common human health impact assessment practices in LCA. The alternative approach of using intake fractions derived from workplace air concentration measurements and effect factors based on best-available toxicity data supported the current case-by-case approach for assessing the human health life cycle impacts of ENMs. Ultimately, the proposed framework and calculations demonstrate the potential utility of integrating elements of risk assessment with LCA for ENMs once the data are available.

  7. School-Based Speech-Language Pathologists' Perspectives on Dysphagia Management in the Schools

    ERIC Educational Resources Information Center

    Bailey, Rita L.; Stoner, Julia B.; Angell, Maureen E.; Fetzer, Alycia

    2008-01-01

    Purpose: Although provision of dysphagia services is within the scope of practice of speech-language pathologists (SLPs), little is known about the perspectives of school-based SLPs in relation to these services. The purpose of this study was to examine SLPs' perspectives related to school-based management of students with dysphagia. Method: Focus…

  8. Voice Disorder Management Competencies: A Survey of School-Based Speech-Language Pathologists in Nebraska

    ERIC Educational Resources Information Center

    Teten, Amy F.; DeVeney, Shari L.; Friehe, Mary J.

    2016-01-01

    Purpose: The purpose of this survey was to determine the self-perceived competence levels in voice disorders of practicing school-based speech-language pathologists (SLPs) and identify correlated variables. Method: Participants were 153 master's level, school-based SLPs with a Nebraska teaching certificate and/or licensure who completed a survey,…

  9. A Study of Job Satisfaction Correlates among Urban School Speech Language Pathologists

    ERIC Educational Resources Information Center

    Maxie-Brown, Gwendolyn J.

    2011-01-01

    The purpose of this study was to examine relationships between the job satisfaction of speech language pathologists (SLPs) and self-efficacy, work relationships and two components of job performance: teacher judgments of student improvement and supervisor ratings of teacher efficiency. It was hypothesized that each of the variables would be…

  10. Expanding the Role of Speech-Language Pathologists in Instruction Transition Via Glasser's Choice Theory.

    ERIC Educational Resources Information Center

    Easterbrooks, Susan R.; Miller, Daniel L.

    1996-01-01

    Describes a blending of Glasser's Choice Theory/Reality Therapy with transition and pragmatic language theories to establish a process that speech/language pathologists may use in managing and implementing transition services. A rationale and blended model is provided, and sample Individualized Education Program objectives are given. (Author/CR)

  11. Speech-Language Pathologist Job Satisfaction in School versus Medical Settings

    ERIC Educational Resources Information Center

    Kalkhoff, Nicole L.; Collins, Dana R.

    2012-01-01

    Purpose: The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings. Method: The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were…

  12. Developing Educationally Relevant IEPs: A Technical Assistance Document for Speech-Language Pathologists.

    ERIC Educational Resources Information Center

    Brannen, Susan J.; Cooper, Eugene B.; Dellegrotto, John T.; Disney, Sarah T.; Eger, Diane L.; Ehren, Barbara J.; Ganley, Kimberly A.; Isakson, Carolyn W.; Montgomery, Judith K.; Ralabate, Patricia K.; Secord, Wayne A.; Whitmire, Kathleen A.

    This document provides information, based on the final Part B regulations implementing statutory changes made by the Individuals with Disabilities Education Act (IDEA) of 1997, which will assist speech-language pathologists in their role in developing Individualized Education Programs (IEPs) as IEP team members and in implementing those portions…

  13. Facilitating Emergent Literacy: Efficacy of a Model that Partners Speech-Language Pathologists and Educators

    ERIC Educational Resources Information Center

    Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice

    2012-01-01

    Purpose: This study examined the efficacy of a professional development program for early childhood educators that facilitated emergent literacy skills in preschoolers. The program, led by a speech-language pathologist, focused on teaching alphabet knowledge, print concepts, sound awareness, and decontextualized oral language within naturally…

  14. Addressing the Shortage of Speech-Language Pathologists in School Settings

    ERIC Educational Resources Information Center

    Squires, Katie

    2013-01-01

    There is a shortage of speech-language pathologists (SLPs) in this country. This shortage is due, in part, to the limited number of openings in graduate programs and the increased need for SLPs as their scope of practice widens, the autism rate grows, and the population ages. Schools are feeling this shortage the most. There are several reasons…

  15. Society of Toxicologic Pathologists (STP) Annual Symposium General Session II: Modem Pathology Methods for Neural Investigations

    EPA Science Inventory

    This half-day session at the 20I0 Joint Symposium of the Society of Toxicologic Pathology (STP) and the International Federation of Societies of Toxicologic Pathologists (IFSTP) explored many deceptively simple questions related to toxicologic neuropathology. What is the best met...

  16. Familiarity Breeds Support: Speech-Language Pathologists' Perceptions of Bullying of Students with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Blood, Gordon W.; Blood, Ingrid M.; Coniglio, Amy D.; Finke, Erinn H.; Boyle, Michael P.

    2013-01-01

    Children with autism spectrum disorders (ASD) are primary targets for bullies and victimization. Research shows school personnel may be uneducated about bullying and ways to intervene. Speech-language pathologists (SLPs) in schools often work with children with ASD and may have victims of bullying on their caseloads. These victims may feel most…

  17. Autism Spectrum Disorders: Experience, Training, and Confidence Levels of School-Based Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Plumb, Allison M.; Plexico, Laura W.

    2013-01-01

    Purpose: To investigate the graduate training experiences of school-based speech-language pathologists (SLPs) working with children with autism spectrum disorders (ASDs). Comparisons were made between recent graduates (post 2006) and pre-2006 graduates to determine if differences existed in their academic and clinical experiences or their…

  18. Providing Early Intervention Services to Diverse Populations: Are Speech-Language Pathologists Prepared?

    ERIC Educational Resources Information Center

    Caesar, Lena G.

    2013-01-01

    This study used a survey approach to investigate the current state of speech-language preservice academic and clinical preparation for providing early intervention (EI) services to culturally and linguistically diverse (CLD) populations. Information was obtained from speech-language pathologists (SLPs) employed in EI settings regarding their…

  19. Patient Fatigue during Aphasia Treatment: A Survey of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Riley, Ellyn A.

    2017-01-01

    The purpose of this study was to measure speech-language pathologists' (SLPs) perceptions of fatigue in clients with aphasia and identify strategies used to manage client fatigue during speech and language therapy. SLPs completed a short online survey containing a series of questions related to their perceptions of patient fatigue. Of 312…

  20. Speech-Language Pathologists' Comfort Levels in English Language Learner Service Delivery

    ERIC Educational Resources Information Center

    Kimble, Carlotta

    2013-01-01

    This study examined speech-language pathologists' (SLPs) comfort levels in providing service delivery to English language learners (ELLs) and limited English proficient (LEP) students. Participants included 192 SLPs from the United States and Guam. Participants completed a brief, six-item questionnaire that investigated their perceptions regarding…

  1. Korean Speech-Language Pathologists' Attitudes toward Stuttering According to Clinical Experiences

    ERIC Educational Resources Information Center

    Lee, Kyungjae

    2014-01-01

    Background: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there…

  2. Speech-Language Pathologist Job Satisfaction in School versus Medical Settings

    ERIC Educational Resources Information Center

    Kalkhoff, Nicole L.; Collins, Dana R.

    2012-01-01

    Purpose: The goal of this study was to determine if job satisfaction differs between speech-language pathologists (SLPs) working in school settings and SLPs working in medical settings. Method: The Job Satisfaction Survey (JSS) by Spector (1997) was sent via electronic mail to 250 SLPs in each of the 2 settings. Job satisfaction scores were…

  3. College of American Pathologists considerations for the delineation of pathology clinical privileges.

    PubMed

    Catalano, Edward W; Ruby, Stephen Gerard; Talbert, Michael L; Knapman, Douglas G

    2009-04-01

    The Joint Commission (JC) established new medical staff privileging requirements effective January 2008. The new requirements include the development of ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE) processes and incorporate the general competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice jointly developed by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). The College of American Pathologists makes resources available to assist members and their facilities in implementing the new requirements and improving patient care. To review the general requirements for privileging and identify how they may apply to pathologists, to identify currently available activities and metrics that may be useful in addressing these requirements, and to present identified concepts, activities, and metrics for consideration by pathologists and hospitals for their adaptation into the policies and procedures that address the new JC physician privileging requirements. Review available pathology privileging documentation that addressed the previous JC requirements, review the new requirements, and search for and review available and applicable resources, activities, and metrics. Common pathology activities and metrics can be incorporated into the privileging processes. Current and new activities and metrics can be incorporated or developed to address the 6 ACGME/ABMS "General Competencies." Each hospital has unique privileging and physician evaluation requirements. Providing concepts, activities, and metrics for pathologists and hospitals to consider in pathology privileging will help implement the OPPE and FPPE processes and meet medical staff privileging requirements.

  4. Dysphagic Independent Feeders' Justifications for Noncompliance with Recommendations by a Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Colodny, Nancy

    2005-01-01

    The purpose of this study was to examine the various ways in which independent-feeding patients with dysphagia justified their noncompliance with swallowing recommendations suggested by a speech-language pathologist (SLP). Sixty-three independent-feeding dysphagia patients between the ages of 65 and 100 years who had been identified by the SLP or…

  5. Lessons for Speech Pathologists. Using the Initial Teaching Alphabet to Improve Articulation.

    ERIC Educational Resources Information Center

    Goldman, Ronald

    Designed by speech pathologists for use with preschool children, 54 lessons utilize the Initial Teaching Alphabet (ITA). Beginning with the presentation of a single sound and its ITA symbol, lessons progress systematically through all the symbols; synthesis of the elements into syllables, words, sentences, stories, and general conversation is…

  6. Society of Toxicologic Pathologists (STP) Annual Symposium General Session II: Modem Pathology Methods for Neural Investigations

    EPA Science Inventory

    This half-day session at the 20I0 Joint Symposium of the Society of Toxicologic Pathology (STP) and the International Federation of Societies of Toxicologic Pathologists (IFSTP) explored many deceptively simple questions related to toxicologic neuropathology. What is the best met...

  7. Bullying in Children Who Stutter: Speech-Language Pathologists' Perceptions and Intervention Strategies

    ERIC Educational Resources Information Center

    Blood, Gordon W.; Boyle, Michael P.; Blood, Ingrid M.; Nalesnik, Gina R.

    2010-01-01

    Bullying in school-age children is a global epidemic. School personnel play a critical role in eliminating this problem. The goals of this study were to examine speech-language pathologists' (SLPs) perceptions of bullying, endorsement of potential strategies for dealing with bullying, and associations among SLPs' responses and specific demographic…

  8. Pharmacotherapy and Children with Autism Spectrum Disorder: A Tutorial for Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Self, Trisha L.; Hale, LaDonna S.; Crumrine, Daiquirie

    2010-01-01

    Purpose: The purpose of this tutorial is to provide speech-language pathologists (SLPs) with general information regarding the most commonly prescribed medications for children with autism spectrum disorder (ASD; e.g., central nervous system stimulants, noradrenergic reuptake inhibitors, alpha-2 adrenergic agonists, antipsychotics,…

  9. Identifying Culturally Competent Clinical Skills in Speech-Language Pathologists in the Central Valley of California

    ERIC Educational Resources Information Center

    Maul, Christine A.

    2010-01-01

    The purpose of this research was to identify specific clinical skills in speech-language pathologists (SLPs) that may constitute cultural competency, a term which currently lacks operational definition. Through qualitative interview methods, the following research questions were addressed: (1) What dominant themes, if any, can be found in SLPs'…

  10. Proceedings of the African Pathologists Summit; March 22-23, 2013; Dakar, Senegal: a summary.

    PubMed

    2015-01-01

    This report presents the proceedings of the African Pathologists Summit, held under the auspices of the African Organization for Research and Training in Cancer. To deliberate on the challenges and constraints of the practice of pathology in Sub-Saharan Africa and the avenues for addressing them. Collaborating organizations included the American Society for Clinical Pathology; Association of Pathologists of Nigeria; British Division of the International Academy of Pathology; College of Pathologists of East, Central and Southern Africa; East African Division of the International Academy of Pathology; Friends of Africa-United States and Canadian Academy of Pathology Initiative; International Academy of Pathology; International Network for Cancer Treatment and Research; National Cancer Institute; National Health and Laboratory Service of South Africa; Nigerian Postgraduate Medical College; Royal College of Pathologists; West African Division of the International Academy of Pathology; and Faculty of Laboratory Medicine of the West African College of Physicians. Information on the status of the practice of pathology was based on the experience of the participants, who are current or past practitioners of pathology or are involved in pathology education and research in Sub-Saharan Africa. The deliberations were carried out through presentations and working discussion groups. The significant lack of professional and technical personnel, inadequate infrastructure, limited training opportunities, poor funding of pathology services in Sub-Saharan Africa, and their significant impact on patient care were noted. The urgency of addressing these issues was recognized, and the recommendations that were made are contained in this report.

  11. Autism Spectrum Disorders: Experience, Training, and Confidence Levels of School-Based Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Plumb, Allison M.; Plexico, Laura W.

    2013-01-01

    Purpose: To investigate the graduate training experiences of school-based speech-language pathologists (SLPs) working with children with autism spectrum disorders (ASDs). Comparisons were made between recent graduates (post 2006) and pre-2006 graduates to determine if differences existed in their academic and clinical experiences or their…

  12. Preparation and Perceptions of Speech-Language Pathologists Working with Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Compton, Mary V.; Tucker, Denise A.; Flynn, Perry F.

    2009-01-01

    This study examined the level of preparedness of North Carolina speech-language pathologists (SLPs) who serve school-aged children with cochlear implants (CIs). A survey distributed to 190 school-based SLPs in North Carolina revealed that 79% of the participants felt they had little to no confidence in managing CI technology or in providing…

  13. Management of Vocal Nodules: A Regional Survey of Otolaryngologists and Speech-Language Pathologists.

    ERIC Educational Resources Information Center

    Allen, Marybeth S.; And Others

    1991-01-01

    Survey data from 21 otolaryngologists (70 percent return rate) and 32 speech-language pathologists (46 percent return rate) in Maine found differences in opinions between the 2 professional groups concerning referral patterns and treatment of vocal nodules in children and adults. Attitudinal problems were found to hamper a teamwork approach for…

  14. Familiarity Breeds Support: Speech-Language Pathologists' Perceptions of Bullying of Students with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Blood, Gordon W.; Blood, Ingrid M.; Coniglio, Amy D.; Finke, Erinn H.; Boyle, Michael P.

    2013-01-01

    Children with autism spectrum disorders (ASD) are primary targets for bullies and victimization. Research shows school personnel may be uneducated about bullying and ways to intervene. Speech-language pathologists (SLPs) in schools often work with children with ASD and may have victims of bullying on their caseloads. These victims may feel most…

  15. Bullying in Children Who Stutter: Speech-Language Pathologists' Perceptions and Intervention Strategies

    ERIC Educational Resources Information Center

    Blood, Gordon W.; Boyle, Michael P.; Blood, Ingrid M.; Nalesnik, Gina R.

    2010-01-01

    Bullying in school-age children is a global epidemic. School personnel play a critical role in eliminating this problem. The goals of this study were to examine speech-language pathologists' (SLPs) perceptions of bullying, endorsement of potential strategies for dealing with bullying, and associations among SLPs' responses and specific demographic…

  16. Preparing Bilingual Speech-Language Pathologists: The Development of an Innovative Master's Degree Program.

    ERIC Educational Resources Information Center

    Wright-Harp, Wilhelmina; Munoz, Emma

    2000-01-01

    This paper describes the two-year master's degree program for speech-language pathologists with a specialization in bilingualism (Spanish/English) developed at the University of the District of Columbia. First, the article describes the program's curriculum, clinical practicum, recruitment, and retention activities. It then discusses the student…

  17. Experienced Speech-Language Pathologists' Responses to Ethical Dilemmas: An Integrated Approach to Ethical Reasoning

    ERIC Educational Resources Information Center

    Kenny, Belinda; Lincoln, Michelle; Balandin, Susan

    2010-01-01

    Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual…

  18. Factors Impacting the Employment and Retention of Speech-Language Pathologists in Rural Public Schools.

    ERIC Educational Resources Information Center

    Neeley, Richard A.; And Others

    1994-01-01

    A survey of 169 speech-language pathologists (SLPs) employed in rural public schools examined reasons why SLPs opt to remain in rural settings. Three of the most important reasons for continued employment were related to salary, vacation, and support for continuing education. Includes the questionnaire and response rates. (KS)

  19. Korean Speech-Language Pathologists' Attitudes toward Stuttering According to Clinical Experiences

    ERIC Educational Resources Information Center

    Lee, Kyungjae

    2014-01-01

    Background: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there…

  20. Automated Detection of Heuristics and Biases among Pathologists in a Computer-Based System

    ERIC Educational Resources Information Center

    Crowley, Rebecca S.; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia

    2013-01-01

    The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to…

  1. Guidelines for the Roles and Responsibilities of the School-Based Speech-Language Pathologist.

    ERIC Educational Resources Information Center

    American Speech-Language-Hearing Association, Rockville, MD.

    These guidelines are an official statement of the American Speech-Language-Hearing Association (ASHA) that address the official roles and responsibilities of school-based speech-language pathologists. Chapter 1 outlines the guiding principles that underlie the development of the document, provides federal and global definitions of speech-language…

  2. Pharmacotherapy and Children with Autism Spectrum Disorder: A Tutorial for Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Self, Trisha L.; Hale, LaDonna S.; Crumrine, Daiquirie

    2010-01-01

    Purpose: The purpose of this tutorial is to provide speech-language pathologists (SLPs) with general information regarding the most commonly prescribed medications for children with autism spectrum disorder (ASD; e.g., central nervous system stimulants, noradrenergic reuptake inhibitors, alpha-2 adrenergic agonists, antipsychotics,…

  3. Dysphagic Independent Feeders' Justifications for Noncompliance with Recommendations by a Speech-Language Pathologist

    ERIC Educational Resources Information Center

    Colodny, Nancy

    2005-01-01

    The purpose of this study was to examine the various ways in which independent-feeding patients with dysphagia justified their noncompliance with swallowing recommendations suggested by a speech-language pathologist (SLP). Sixty-three independent-feeding dysphagia patients between the ages of 65 and 100 years who had been identified by the SLP or…

  4. School-Based Speech-Language Pathologists' Perspectives on Dysphagia Management in the Schools

    ERIC Educational Resources Information Center

    Bailey, Rita L.; Stoner, Julia B.; Angell, Maureen E.; Fetzer, Alycia

    2008-01-01

    Purpose: Although provision of dysphagia services is within the scope of practice of speech-language pathologists (SLPs), little is known about the perspectives of school-based SLPs in relation to these services. The purpose of this study was to examine SLPs' perspectives related to school-based management of students with dysphagia. Method: Focus…

  5. An Introduction to Item Response Theory and Rasch Models for Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Baylor, Carolyn; Hula, William; Donovan, Neila J.; Doyle, Patrick J.; Kendall, Diane; Yorkston, Kathryn

    2011-01-01

    Purpose: To present a primarily conceptual introduction to item response theory (IRT) and Rasch models for speech-language pathologists (SLPs). Method: This tutorial introduces SLPs to basic concepts and terminology related to IRT as well as the most common IRT models. The article then continues with an overview of how instruments are developed…

  6. School-Based Speech-Language Pathologists' Knowledge and Perceptions of Autism Spectrum Disorder and Bullying

    ERIC Educational Resources Information Center

    Ofe, Erin E.; Plumb, Allison M.; Plexico, Laura W.; Haak, Nancy J.

    2016-01-01

    Purpose: The purpose of the current investigation was to examine speech-language pathologists' (SLPs') knowledge and perceptions of bullying, with an emphasis on autism spectrum disorder (ASD). Method: A 46-item, web-based survey was used to address the purposes of this investigation. Participants were recruited through e-mail and electronic…

  7. Preparing Bilingual Speech-Language Pathologists: The Development of an Innovative Master's Degree Program.

    ERIC Educational Resources Information Center

    Wright-Harp, Wilhelmina; Munoz, Emma

    2000-01-01

    This paper describes the two-year master's degree program for speech-language pathologists with a specialization in bilingualism (Spanish/English) developed at the University of the District of Columbia. First, the article describes the program's curriculum, clinical practicum, recruitment, and retention activities. It then discusses the student…

  8. Expanding the Role of Speech-Language Pathologists in Instruction Transition Via Glasser's Choice Theory.

    ERIC Educational Resources Information Center

    Easterbrooks, Susan R.; Miller, Daniel L.

    1996-01-01

    Describes a blending of Glasser's Choice Theory/Reality Therapy with transition and pragmatic language theories to establish a process that speech/language pathologists may use in managing and implementing transition services. A rationale and blended model is provided, and sample Individualized Education Program objectives are given. (Author/CR)

  9. International Recommendations for Training Future Toxicologic Pathologists Participating in Regulatory-Type, Nonclinical Toxicity Studies*

    PubMed Central

    Bolon, Brad; Barale-Thomas, Erio; Bradley, Alys; Ettlin, Robert A.; Franchi, Carla A.S.; George, Catherine; Giusti, Anna Maria; Hall, Robert; Jacobsen, Matthew; Konishi, Yoichi; Ledieu, David; Morton, Daniel; Park, Jae-Hak; Scudamore, Cheryl L.; Tsuda, Hiroyuki; Vijayasarathi, S.K.; Wijnands, Marcel V.W.

    2010-01-01

    The International Federation of Societies of Toxicologic Pathologists (IFSTP) proposes a common global framework for training future toxicologic pathologists who will support regulatory-type nonclinical toxicology studies. Trainees optimally should undertake a scientific curriculum of at least 5 years at an accredited institution leading to a clinical degree (veterinary medicine or medicine). Trainees should then obtain 4 or more years of intensive pathology practice during a residency and/or on-the-job “apprenticeship,” at least 2 years of which must be focused on regulatory-type toxicologic pathology topics. Possession of a recognized pathology qualification (i.e., certification) is highly recommended. A non-clinical pathway (e.g., a graduate degree in medical biology or pathology) may be possible if medically trained pathologists are scarce, but this option is not optimal. Regular, lifelong continuing education (peer review of nonclinical studies, professional meetings, reading, short courses) will be necessary to maintain and enhance one’s understanding of current toxicologic pathology knowledge, skills, and tools. This framework should provide a rigorous yet flexible way to reliably train future toxicologic pathologists to generate, interpret, integrate, and communicate data in regulatory-type, nonclinical toxicology studies. PMID:22272030

  10. Speech-Language Pathologists and Autistic Children: What Is Our Role?

    ERIC Educational Resources Information Center

    Prizant, Barry M.

    1982-01-01

    The speech/language pathologist's role in planning and executing a program for autistic children that emphasizes the development of communication and interaction skills is addressed. Journal Availability: American Speech-Language-Hearing Association, 10801 Rockville Pike, Rockville, MD 20852. (SEW)

  11. Facilitating Emergent Literacy: Efficacy of a Model that Partners Speech-Language Pathologists and Educators

    ERIC Educational Resources Information Center

    Girolametto, Luigi; Weitzman, Elaine; Greenberg, Janice

    2012-01-01

    Purpose: This study examined the efficacy of a professional development program for early childhood educators that facilitated emergent literacy skills in preschoolers. The program, led by a speech-language pathologist, focused on teaching alphabet knowledge, print concepts, sound awareness, and decontextualized oral language within naturally…

  12. Training and Knowledge in Autism among Speech-Language Pathologists: A Survey

    ERIC Educational Resources Information Center

    Schwartz, Heatherann; Drager, Kathryn D. R.

    2008-01-01

    Purpose: The current study was designed to answer the following questions: (a) What knowledge do school-based speech-language pathologists (SLPs) have concerning autism? (b) What educational and clinical training do SLPs receive in autism? (c) Do SLPs have confidence in their ability to provide services to children with autism and their families?…

  13. Automated Detection of Heuristics and Biases among Pathologists in a Computer-Based System

    ERIC Educational Resources Information Center

    Crowley, Rebecca S.; Legowski, Elizabeth; Medvedeva, Olga; Reitmeyer, Kayse; Tseytlin, Eugene; Castine, Melissa; Jukic, Drazen; Mello-Thoms, Claudia

    2013-01-01

    The purpose of this study is threefold: (1) to develop an automated, computer-based method to detect heuristics and biases as pathologists examine virtual slide cases, (2) to measure the frequency and distribution of heuristics and errors across three levels of training, and (3) to examine relationships of heuristics to biases, and biases to…

  14. Voice Disorder Management Competencies: A Survey of School-Based Speech-Language Pathologists in Nebraska

    ERIC Educational Resources Information Center

    Teten, Amy F.; DeVeney, Shari L.; Friehe, Mary J.

    2016-01-01

    Purpose: The purpose of this survey was to determine the self-perceived competence levels in voice disorders of practicing school-based speech-language pathologists (SLPs) and identify correlated variables. Method: Participants were 153 master's level, school-based SLPs with a Nebraska teaching certificate and/or licensure who completed a survey,…

  15. An Introduction to Item Response Theory and Rasch Models for Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Baylor, Carolyn; Hula, William; Donovan, Neila J.; Doyle, Patrick J.; Kendall, Diane; Yorkston, Kathryn

    2011-01-01

    Purpose: To present a primarily conceptual introduction to item response theory (IRT) and Rasch models for speech-language pathologists (SLPs). Method: This tutorial introduces SLPs to basic concepts and terminology related to IRT as well as the most common IRT models. The article then continues with an overview of how instruments are developed…

  16. What Makes a Caseload (Un) Manageable? School-Based Speech-Language Pathologists Speak

    ERIC Educational Resources Information Center

    Katz, Lauren A.; Maag, Abby; Fallon, Karen A.; Blenkarn, Katie; Smith, Megan K.

    2010-01-01

    Purpose: Large caseload sizes and a shortage of speech-language pathologists (SLPs) are ongoing concerns in the field of speech and language. This study was conducted to identify current mean caseload size for school-based SLPs, a threshold at which caseload size begins to be perceived as unmanageable, and variables contributing to school-based…

  17. A Study of Job Satisfaction Correlates among Urban School Speech Language Pathologists

    ERIC Educational Resources Information Center

    Maxie-Brown, Gwendolyn J.

    2011-01-01

    The purpose of this study was to examine relationships between the job satisfaction of speech language pathologists (SLPs) and self-efficacy, work relationships and two components of job performance: teacher judgments of student improvement and supervisor ratings of teacher efficiency. It was hypothesized that each of the variables would be…

  18. Comparative assessment of transport risks--how it can contribute to health impact assessment of transport policies.

    PubMed Central

    Kjellstrom, Tord; van Kerkhoff, Lorrae; Bammer, Gabriele; McMichael, Tony

    2003-01-01

    Health impact assessment (HIA) and comparative risk assessment (CRA) are important tools with which governments and communities can compare and integrate different sources of information about various health impacts into a single framework for policy-makers and planners. Both tools have strengths that may be combined usefully when conducting comprehensive assessments of decisions that affect complex health issues, such as the health risks and impacts of transport policy and planning activities. As yet, however, HIA and CRA have not been applied widely to the area of transport. We draw on the limited experience of the application of these tools in the context of road transport to explore how comparative assessment of transport risks can contribute to HIA of transport policies. PMID:12894331

  19. Exploring speech-language pathologists' perspectives about living successfully with aphasia.

    PubMed

    Brown, Kyla; Worrall, Linda; Davidson, Bronwyn; Howe, Tami

    2011-01-01

    Exploring the concept of living successfully with aphasia challenges researchers and clinicians to identify positive rather than negative adaptive processes and factors that may inform clinical interventions and other community-based services for people with aphasia. Previous research on this topic has focused on the perspectives of individuals with aphasia, and identified a number of core components of living successfully with aphasia, including doing things, meaningful relationships, striving for a positive way of living, and communication. As service providers, speech-language pathologists may also contribute valuable insights regarding components of living successfully with aphasia and factors influencing individuals' abilities to achieve this goal. This research aimed to explore speech-language pathologists' perspectives about the meaning of living successfully with aphasia, and factors they perceive to influence individuals' abilities to live successfully with aphasia. Twenty-five speech-language pathologists from around Australia participated in semi-structured in-depth interviews on the topic of living successfully with aphasia. All interviews were transcribed verbatim and analysed using interpretative phenomenological analysis to identify themes of relevance. Through the analysis of speech-language pathologist participant transcripts, the following themes emerged as components of living successfully with aphasia: participation and community engagement; communication; meaningful relationships; autonomy or independence; acceptance and embracement of aphasia; self-esteem; happiness; and purpose or meaningfulness. A wide variety of factors were perceived to influence individuals' abilities to live successfully with aphasia. These included support, acceptance, and understanding; personal factors; and speech-language pathology services. Further research is required to extend findings by investigating how speech-language pathologists address identified themes in

  20. Evaluating Risk for Targeted Violence in Schools: Comparing Risk Assessment, Threat Assessment, and Other Approaches.

    ERIC Educational Resources Information Center

    Reddy, Marisa; Borum, Randy; Vossekuil, Bryan; Fein, Robert; Berglund, John; Modzeleski, William

    An increasing fear over violence in schools has prompted recent requests for psychologists, educators, and law enforcement professionals to assist in preventing future incidents of violence. This paper attempts to lay a foundation for developing effective assessment and prevention approaches by first distinguishing planned school-based attacks…

  1. Update on the College of American Pathologists Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology.

    PubMed

    Ghofrani, Mohiedean; Zhao, Chengquan; Davey, Diane D; Fan, Fang; Husain, Mujtaba; Laser, Alice; Ocal, Idris T; Shen, Rulong Z; Goodrich, Kelly; Souers, Rhona J; Crothers, Barbara A

    2016-12-01

    - Since 2008, the College of American Pathologists has provided the human papillomavirus for cytology laboratories (CHPV) proficiency testing program to help laboratories meet the requirements of the Clinical Laboratory Improvement Amendments of 1988. - To provide an update on trends in proficiency testing performance in the College of American Pathologists CHPV program during the 4-year period from 2011 through 2014 and to compare those trends with the preceding first 3 years of the program. - Responses of laboratories participating in the CHPV program from 2011 through 2014 were analyzed using a nonlinear mixed model to compare different combinations of testing medium and platform. - In total, 818 laboratories participated in the CHPV program at least once during the 4 years, with participation increasing during the study period. Concordance of participant responses with the target result was more than 98% (38 280 of 38 892). Overall performance with all 3 testing media-ThinPrep (Hologic, Bedford, Massachusetts), SurePath (Becton, Dickinson and Company, Franklin Lakes, New Jersey), or Digene (Qiagen, Valencia, California)-was equivalent (P = .51), and all 4 US Food and Drug Administration (FDA)-approved platforms-Hybrid Capture 2 (Qiagen), Cervista (Hologic), Aptima (Hologic), and cobas (Roche Molecular Systems, Pleasanton, California)-outperformed laboratory-developed tests, unspecified commercial kits, and other (noncommercial) methods in ThinPrep medium (P < .001). However, certain off-label combinations of platform and medium, most notably Cervista with SurePath, demonstrated suboptimal performance (P < .001). - Laboratories demonstrated proficiency in using various combinations of testing media and platforms offered in the CHPV program, with statistically significant performance differences in certain combinations. These observations may be relevant in the current discussions about FDA oversight of laboratory-developed tests.

  2. Human Papillomavirus Genotyping Testing Practice in 2014: Results of a College of American Pathologists National Survey.

    PubMed

    Zhao, Chengquan; Crothers, Barbara A; Ghofrani, Mohiedean; Li, Zaibo; Souers, Rhona J; Hussain, Mujtaba; Fan, Fang; Ocal, Idris Tolgay; Goodrich, Kelly; Shen, Rulong; Davey, Diane D

    2016-12-01

    - College of American Pathologists (CAP) surveys are used to establish national benchmarks for laboratories. - To investigate human papillomavirus (HPV) genotyping testing practice patterns in laboratories in 2014. - Data were analyzed from the CAP HPV Genotyping Practices Supplemental Questionnaire distributed to 749 laboratories participating in the CAP Human Papillomavirus (High Risk) for Cytology Program. - Six hundred four of 749 laboratories (80.6%) responded to the survey. More laboratories offered HPV genotyping testing and performed in-house HPV genotyping testing as compared to previous surveys. The Roche cobas HPV test was the most commonly used genotyping method (37.0%; 160 of 433), followed by Hologic Aptima HPV16 18/45 (26.1%; 113 of 433) and Hologic Cervista HPV16/18 (14.3%; 62 of 433). Most laboratories (287 of 399; 71.9%) offered HPV genotyping for high-risk HPV cases regardless of Papanicolaou (Pap) test results and patient age; this pattern was more common in laboratories using cobas. The remaining laboratories specifically offered testing to women with a negative Pap test result at age 30 years and older (65.2%, 73 of 112) or all ages (37.5%, 42 of 112). The median reporting rates of HPV16 and/or HPV18 positivity were 20.6%, 25.7%, 21.1%, and 57.4% for women with positive high-risk HPV adjunctive negative Pap results, atypical squamous cells of undermined significance, low-grade squamous intraepithelial lesion, and high-grade squamous lesion, respectively. - Human papillomavirus genotyping testing has increased. Roche cobas and Hologic Aptima genotype methods were the most common, and laboratories using cobas usually offered genotyping regardless of Pap test result and age. The data provide a baseline and trend of HPV genotyping test practices in 2014.

  3. The international criminal tribunal for the former Yugoslavia (ICTY) and the forensic pathologist: ethical considerations.

    PubMed

    Lorin de la Grandmaison, G; Durigon, M; Moutel, G; Herve, C

    2006-07-01

    Since 1991, war crimes in the former Yugoslavia have been the subject of several international medico-legal investigations of mass graves within the framework of inquiries led by the International Criminal Tribunal for the former Yugoslavia (ICTY). Forensic pathologists involved in the ICTY missions could be subjected to ethical tensions due to the difficulties of the missions, the emergent conflicts between forensic scientists of the investigating teams and the original nature of the ICTY proceedings. In order to study the nature of such ethical tensions, we sent a questionnaire to 65 forensic pathologists who have been involved in the ICTY missions. The rate of response was 38%. The majority of forensic pathologists questioned (n=18) did not know how the medico-legal data was exploited by the ICTY. Three of them have been subjected to pressures. Three of them were aware of mass grave sites knowingly not investigated by the ICTY. Fifteen considered that the ICTY respected the elementary rules of the law and four of them questioned the impartiality of the justice led by the ICTY. Two conflicting types of ethics can be drawn from these results: conviction ethics, which are shared by most of the forensic pathologists questioned, and responsibility ethics. In the former, the forensic pathologist completely agrees with the need for an international war crimes tribunal, even if such justice can be challenged regarding the respect of human rights and impartiality. In the latter, he or she needs to conduct him or herself in ways that do not infringe impartiality. As medical deontology duty requires impartiality ethics, discursive ethics are needed to ease ethical tensions and to suggest ethical guidelines. Alternatives to international justice, through a truth and reconciliation commission and by way of humanitarian missions combining victims' identification with forensic investigations for historical purposes, could be considered.

  4. The international criminal tribunal for the former Yugoslavia (ICTY) and the forensic pathologist: ethical considerations

    PubMed Central

    Lorin De La Grandmaison, Geoffroy; Durigon, Michel; Moutel, Grégoire; Hervé, Christian

    2006-01-01

    War crimes in the former Yugoslavia since 1991 have been subjected to several international medico-legal investigations of mass graves within the framework of inquiries led by the ICTY. Forensic pathologists involved in the ICTY missions could be subjected to ethical tensions due to the difficulties of the missions, the emergent conflicts between forensic scientists of the teams and the original nature of the ICTY proceedings. In order to study the nature of such ethical tensions, we sent a questionnaire to 65 forensic pathologists who have been involved in the ICTY missions. The rate of answer was 38%. The majority of the forensic pathologists questioned (n=18) did not know how the medico-legal data were exploited by the ICTY. Three of them have been subjected to pressures. Three of them were aware of mass grave sites wittingly not investigated by the ICTY. Fifteen considered that the ICTY respected the elementary rules of the law and four of them questioned the impartiality of the justice led by the ICTY. Two conflicting types of ethics can be drawn from these results: a conviction ethics which is shared by most of the forensic pathologists questioned and a responsibility ethics. In the first, the forensic pathologist completely agrees with the need for an international war crime tribunal even if such justice can be challenged regarding the respect of human rights and impartiality. In the second, he or she needs to conduct himself in ways that do not infringe impartiality. As medical deontology duty requires an impartiality ethics, discursive ethics are needed to ease ethical tensions and to suggest ethical guidelines. Alternatives to international justice through a truth and reconciliation commission and by the way of humanitarian mission of victims’ identification combined with forensic investigations for historical purposes could be considered. PMID:16909642

  5. Diagnostic Efficiency in Digital Pathology: A Comparison of Optical Versus Digital Assessment in 510 Surgical Pathology Cases.

    PubMed

    Mills, Anne M; Gradecki, Sarah E; Horton, Bethany J; Blackwell, Rebecca; Moskaluk, Christopher A; Mandell, James W; Mills, Stacey E; Cathro, Helen P

    2017-09-04

    Prior work has shown that digital images and microscopic slides can be interpreted with comparable diagnostic accuracy. Although accuracy has been well-validated, the interpretative time for digital images has scarcely been studied and concerns about efficiency remain a major barrier to adoption. We investigated the efficiency of digital pathology when compared with glass slide interpretation in the diagnosis of surgical pathology biopsy and resection specimens. Slides were pulled from 510 surgical pathology cases from 5 organ systems (gastrointestinal, gynecologic, liver, bladder, and brain). Original diagnoses were independently confirmed by 2 validating pathologists. Diagnostic slides were scanned using the Philips IntelliSite Pathology Solution. Each case was assessed independently on digital and optical by 3 reading pathologists, with a ≥6 week washout period between modalities. Reading pathologists recorded assessment times for each modality; digital times included time to load the case. Diagnostic accuracy was determined based on whether a rendered diagnosis differed significantly from the original diagnosis. Statistical analysis was performed to assess for differences in interpretative times across modalities. All 3 reading pathologists showed comparable diagnostic accuracy across optical and digital modalities (mean major discordance rates with original diagnosis: 4.8% vs. 4.4%, respectively). Mean assessment times ranged from 1.2 to 9.1 seconds slower on digital versus optical. The slowest reader showed a significant learning effect during the course of the study so that digital assessment times decreased over time and were comparable with optical times by the end of the series. Organ site and specimen type did not significantly influence differences in interpretative times. In summary, digital image reading times compare favorably relative to glass slides across a variety of organ systems and specimen types. Mean increase in assessment time is 4

  6. Health impact assessment of global climate change: expanding on comparative risk assessment approaches for policy making.

    PubMed

    Patz, Jonathan; Campbell-Lendrum, Diarmid; Gibbs, Holly; Woodruff, Rosalie

    2008-01-01

    Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.

  7. Reliability of peer and self-assessment scores compared with trainers' scores following third molar surgery.

    PubMed

    Evans, Ann W; Leeson, Rachel M A; Petrie, Aviva

    2007-09-01

    It is sometimes claimed that self-assessment is inaccurate and that clinicians over-rate their performance. There is a need to find out why this should be. Is poor self-assessment caused by some clinicians' inability to accurately judge performance? Or does over-scoring result from a desire to convey a more favourable impression? Peer assessment is widely advocated and is said to be of benefit to both assessor and assessee. In this study, we wanted to see if postgraduates were able to peer-assess and if this form of assessment was more reliable than self-assessment when compared with assessment by a trainer. We used checklist and global rating scales to evaluate surgical skills in removing a mandibular third molar tooth. There was no statistically significant difference between peer-assessed and trainer-assessed scores. We found that, on average, peer assessment (especially global rating scales) reflected trainer scores more accurately than self-assessment of surgical skills. Self-assessment scores were significantly higher on average than those given in peer assessment. Although peers and trainee surgeons came from the same group, the surgeons were more likely to over-score when measuring their own performances. The greatest variability (and over-scoring) between assessor and trainee surgeon appeared to occur in those with lower mean scores. Formative peer assessment may be a useful and less stressful mechanism for encouraging reflection.

  8. HER2 Testing and Clinical Decision Making in Gastroesophageal Adenocarcinoma: Guideline From the College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology.

    PubMed

    Bartley, Angela N; Washington, Mary Kay; Ventura, Christina B; Ismaila, Nofisat; Colasacco, Carol; Benson, Al B; Carrato, Alfredo; Gulley, Margaret L; Jain, Dhanpat; Kakar, Sanjay; Mackay, Helen J; Streutker, Catherine; Tang, Laura; Troxell, Megan; Ajani, Jaffer A

    2016-12-01

    ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA. To establish an evidence-based guideline for HER2 testing in patients with GEA, to formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making. The College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology convened an expert panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA. The panel is proposing 11 recommendations with strong agreement from the open-comment participants. The panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and a HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance. This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results. © 2016 College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Comparing Institution Nitrogen Footprints: Metrics for Assessing and Tracking Environmental Impact

    EPA Science Inventory

    When multiple institutions with strong sustainability initiatives use a new environmental impact assessment tool, there is an impulse to compare. The first seven institutions to calculate their nitrogen footprints using the nitrogen footprint tool have worked collaboratively to i...

  10. Delineation of HER2 Gene Status in Breast Carcinoma by Silver in Situ Hybridization is Reproducible among Laboratories and Pathologists

    PubMed Central

    Carbone, Antonino; Botti, Gerardo; Gloghini, Annunziata; Simone, Gianni; Truini, Mauro; Curcio, Maria Pia; Gasparini, Patrizia; Mangia, Anita; Perin, Tiziana; Salvi, Sandra; Testi, Adele; Verderio, Paolo

    2008-01-01

    An automated enzyme metallographic silver in situ hybridization method (SISH) has been reported to successfully determine human epidermal growth factor receptor 2 (HER2) gene amplification. We evaluated the staining and interpretative reproducibility of the HER2 SISH assay at five laboratories and compared SISH results with other in situ hybridization (ISH) methods. The HER2 gene status of 89 breast carcinomas was analyzed in parallel using manual dual-color fluorescence ISH, manual chromogenic ISH, and bright-field automated SISH. A total of 1098 SISH-stained slides were evaluated. For comparison, all specimens were stained by 4B5 immunohistochemistry for HER2 protein expression. Interpretation was performed by pathologists at five different laboratories using the algorithms provided by the manufacturers and the guidelines of American Society of Clinical Oncology/College of American Pathologists. Staining and interpretative reproducibility were measured through the computation of weighted kappa statistics. Following the optimization of SISH staining, 1077/1098 (98%) of slides were evaluable. Excellent reproducibility and efficacy of HER2 SISH staining, and interobserver interpretation (Kw = 0.91), were observed among five sites. For the 89 invasive breast cancer cases, the overall rate of concordance between consensus 4B5 and consensus SISH, fluorescence ISH, and chromogenic ISH was 96.6% (86/89), 97.8% (87/89), and 96.6% (86/89), respectively. Overall concordance between positive and negative SISH and fluorescence ISH results, as well as between individual and consensus positive and negative SISH results, was excellent (P < 0.001). PMID:18832456

  11. Comparative assessment of life cycle assessment methods used for personal computers.

    PubMed

    Yao, Marissa A; Higgs, Tim G; Cullen, Michael J; Stewart, Scott; Brady, Todd A

    2010-10-01

    This article begins with a summary of findings from commonly cited life cycle assessments (LCA) of Information and Communication Technology (ICT) products. While differing conclusions regarding environmental impact are expected across product segments (mobile phones, personal computers, servers, etc.) significant variation and conflicting conclusions are observed even within product segments such as the desktop Personal Computer (PC). This lack of consistent conclusions and accurate data limits the effectiveness of LCA to influence policy and product design decisions. From 1997 to 2010, the majority of published studies focused on the PC concluded that the use phase contributes most to the life cycle energy demand of PC products with a handful of studies suggesting that manufacturing phase of the PC has the largest impact. The purpose of this article is to critically review these studies in order to analyze sources of uncertainty, including factors that extend beyond data quality to the models and assumptions used. These findings suggest existing methods to combine process-based LCA data with product price data and remaining value adjustments are not reliable in conducting life cycle assessments for PC products. Recommendations are provided to assist future LCA work.

  12. Comparing Running Specific and Traditional Prostheses During Running: Assessing Performance and Risk

    DTIC Science & Technology

    2016-09-01

    AWARD NUMBER: W81XWH-15-1-0518 TITLE: Comparing Running-Specific and Traditional Prostheses during Running: Assessing Performance and Risk...2016 4. TITLE AND SUBTITLE Comparing Running-Specific and Traditional Prostheses During Running: Assessing Performance and Risk 5a. CONTRACT...bbaum@regis.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Regis

  13. What Makes the Finnish Different in Science? Assessing and Comparing Students' Science Learning in Three Countries

    ERIC Educational Resources Information Center

    Geller, Cornelia; Neumann, Knut; Boone, William J.; Fischer, Hans E.

    2014-01-01

    This manuscript details our efforts to assess and compare students' learning about electricity in three countries. As our world is increasingly driven by technological advancements, the education of future citizens in science becomes one important resource for economic productivity. Not surprisingly international large-scale assessments are viewed…

  14. Acceptance of Computerized Compared to Paper-and-Pencil Assessment in Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Weber, Bernhard; Schneider, Barbara; Fritze, Jurgen; Gille, Boris; Hornung, Stefan; Kuhner, Thorsten; Maurer, Konrad

    2003-01-01

    Investigated the acceptance of computerized assessment, particularly compared to conventional paper-and-pencil techniques, in seriously impaired psychiatric inpatients. Describes the development of a self-rating questionnaire (OPQ, Operation and Preference Questionnaire) and reports results that showed computerized assessment was convincingly…

  15. A Comparative Study of Adolescent Risk Assessment Instruments: Predictive and Incremental Validity

    ERIC Educational Resources Information Center

    Welsh, Jennifer L.; Schmidt, Fred; McKinnon, Lauren; Chattha, H. K.; Meyers, Joanna R.

    2008-01-01

    Promising new adolescent risk assessment tools are being incorporated into clinical practice but currently possess limited evidence of predictive validity regarding their individual and/or combined use in risk assessments. The current study compares three structured adolescent risk instruments, Youth Level of Service/Case Management Inventory…

  16. Balancing Autonomy and Comparability: State Approaches to Assessment Selection for Student Learning Objectives. Ask the Team

    ERIC Educational Resources Information Center

    Cushing, Ellen; Meyer, Cassandra

    2014-01-01

    States take a wide range of approaches to Student Learning Objectives (SLO) assessment selection. This "Ask the Team" brief helps states consider the trade-offs between approaches that offer more teacher choice and those that offer better comparability across SLOs. The brief identifies four common approaches to selecting SLO assessments:…

  17. What Makes the Finnish Different in Science? Assessing and Comparing Students' Science Learning in Three Countries

    ERIC Educational Resources Information Center

    Geller, Cornelia; Neumann, Knut; Boone, William J.; Fischer, Hans E.

    2014-01-01

    This manuscript details our efforts to assess and compare students' learning about electricity in three countries. As our world is increasingly driven by technological advancements, the education of future citizens in science becomes one important resource for economic productivity. Not surprisingly international large-scale assessments are viewed…

  18. Group Assessment at First Year and Final Degree Level: A Comparative Evaluation

    ERIC Educational Resources Information Center

    Plastow, N.; Spiliotopoulou, G.; Prior, S.

    2010-01-01

    Group projects are an established but debated pedagogical technique in higher education. The purpose of this study was to assess the appropriateness of combining individual and group marks in assessment. A mixed method design involving correlational and comparative elements was used. The sample included one cohort of students who completed a group…

  19. Composition Medium Comparability in a Direct Writing Assessment of Non-Native English Speakers

    ERIC Educational Resources Information Center

    Wolfe, Edward W.; Manalo, Jonathan R.

    2004-01-01

    The Test of English as a Foreign Language (TOEFL) contains a direct writing assessment, and examinees are given the option of composing their responses at a computer terminal using a keyboard or composing their responses in handwriting. This study sought to determine whether performance on a direct writing assessment is comparable for examinees…

  20. Peer Assessment in the Digital Age: A Meta-Analysis Comparing Peer and Teacher Ratings

    ERIC Educational Resources Information Center

    Li, Hongli; Xiong, Yao; Zang, Xiaojiao; Kornhaber, Mindy L.; Lyu, Youngsun; Chung, Kyung Sun; Suen, Hoi K.

    2016-01-01

    Given the wide use of peer assessment, especially in higher education, the relative accuracy of peer ratings compared to teacher ratings is a major concern for both educators and researchers. This concern has grown with the increase of peer assessment in digital platforms. In this meta-analysis, using a variance-known hierarchical linear modelling…

  1. A Comparative Study of Adolescent Risk Assessment Instruments: Predictive and Incremental Validity

    ERIC Educational Resources Information Center

    Welsh, Jennifer L.; Schmidt, Fred; McKinnon, Lauren; Chattha, H. K.; Meyers, Joanna R.

    2008-01-01

    Promising new adolescent risk assessment tools are being incorporated into clinical practice but currently possess limited evidence of predictive validity regarding their individual and/or combined use in risk assessments. The current study compares three structured adolescent risk instruments, Youth Level of Service/Case Management Inventory…

  2. Group Assessment at First Year and Final Degree Level: A Comparative Evaluation

    ERIC Educational Resources Information Center

    Plastow, N.; Spiliotopoulou, G.; Prior, S.

    2010-01-01

    Group projects are an established but debated pedagogical technique in higher education. The purpose of this study was to assess the appropriateness of combining individual and group marks in assessment. A mixed method design involving correlational and comparative elements was used. The sample included one cohort of students who completed a group…

  3. Life cycle assessment of a commercial rainwater harvesting system compared with a municipal water supply system

    EPA Science Inventory

    Building upon previously published life cycle assessment (LCA) methodologies, we conducted an LCA of a commercial rainwater harvesting (RWH) system and compared it to a municipal water supply (MWS) system adapted to Washington, D.C. Eleven life cycle impact assessment (LCIA) indi...

  4. Research Assessment as an Instrument for Steering Higher Education--A Comparative Study

    ERIC Educational Resources Information Center

    Orr, Dominic

    2004-01-01

    This paper argues that research assessment is of increasing importance as an instrument of New Public Management and within the context of efforts to establish a European Research Area. Specifically, it compares the procedures of research assessment in the Netherlands, the United Kingdom, Ireland and Germany in an attempt to distil basic design…

  5. Using the Reliability Theory for Assessing the Decision Confidence Probability for Comparative Life Cycle Assessments.

    PubMed

    Wei, Wei; Larrey-Lassalle, Pyrène; Faure, Thierry; Dumoulin, Nicolas; Roux, Philippe; Mathias, Jean-Denis

    2016-03-01

    Comparative decision making process is widely used to identify which option (system, product, service, etc.) has smaller environmental footprints and for providing recommendations that help stakeholders take future decisions. However, the uncertainty problem complicates the comparison and the decision making. Probability-based decision support in LCA is a way to help stakeholders in their decision-making process. It calculates the decision confidence probability which expresses the probability of a option to have a smaller environmental impact than the one of another option. Here we apply the reliability theory to approximate the decision confidence probability. We compare the traditional Monte Carlo method with a reliability method called FORM method. The Monte Carlo method needs high computational time to calculate the decision confidence probability. The FORM method enables us to approximate the decision confidence probability with fewer simulations than the Monte Carlo method by approximating the response surface. Moreover, the FORM method calculates the associated importance factors that correspond to a sensitivity analysis in relation to the probability. The importance factors allow stakeholders to determine which factors influence their decision. Our results clearly show that the reliability method provides additional useful information to stakeholders as well as it reduces the computational time.

  6. Accuracy is in the eyes of the pathologist: The visual interpretive process and diagnostic accuracy with digital whole slide images.

    PubMed

    Brunyé, Tad T; Mercan, Ezgi; Weaver, Donald L; Elmore, Joann G

    2017-02-01

    Digital whole slide imaging is an increasingly common medium in pathology, with application to education, telemedicine, and rendering second opinions. It has also made it possible to use eye tracking devices to explore the dynamic visual inspection and interpretation of histopathological features of tissue while pathologists review cases. Using whole slide images, the present study examined how a pathologist's diagnosis is influenced by fixed case-level factors, their prior clinical experience, and their patterns of visual inspection. Participating pathologists interpreted one of two test sets, each containing 12 digital whole slide images of breast biopsy specimens. Cases represented four diagnostic categories as determined via expert consensus: benign without atypia, atypia, ductal carcinoma in situ (DCIS), and invasive cancer. Each case included one or more regions of interest (ROIs) previously determined as of critical diagnostic importance. During pathologist interpretation we tracked eye movements, viewer tool behavior (zooming, panning), and interpretation time. Models were built using logistic and linear regression with generalized estimating equations, testing whether variables at the level of the pathologists, cases, and visual interpretive behavior would independently and/or interactively predict diagnostic accuracy and efficiency. Diagnostic accuracy varied as a function of case consensus diagnosis, replicating earlier research. As would be expected, benign cases tended to elicit false positives, and atypia, DCIS, and invasive cases tended to elicit false negatives. Pathologist experience levels, case consensus diagnosis, case difficulty, eye fixation durations, and the extent to which pathologists' eyes fixated within versus outside of diagnostic ROIs, all independently or interactively predicted diagnostic accuracy. Higher zooming behavior predicted a tendency to over-interpret benign and atypia cases, but not DCIS cases. Efficiency was not predicted

  7. Do Different Approaches to Examining Construct Comparability in Multilanguage Assessments Lead to Similar Conclusions?

    ERIC Educational Resources Information Center

    Oliveri, Maria E.; Ercikan, Kadriye

    2011-01-01

    In this study, we examine the degree of construct comparability and possible sources of incomparability of the English and French versions of the Programme for International Student Assessment (PISA) 2003 problem-solving measure administered in Canada. Several approaches were used to examine construct comparability at the test- (examination of…

  8. Do Different Approaches to Examining Construct Comparability in Multilanguage Assessments Lead to Similar Conclusions?

    ERIC Educational Resources Information Center

    Oliveri, Maria E.; Ercikan, Kadriye

    2011-01-01

    In this study, we examine the degree of construct comparability and possible sources of incomparability of the English and French versions of the Programme for International Student Assessment (PISA) 2003 problem-solving measure administered in Canada. Several approaches were used to examine construct comparability at the test- (examination of…

  9. Comparing functional analysis and paired-choice assessment results in classroom settings.

    PubMed

    Berg, Wendy K; Wacker, David P; Cigrand, Karla; Merkle, Steve; Wade, Jeanie; Henry, Kim; Wang, Yu-Chia

    2007-01-01

    The results of a functional analysis of problem behavior and a paired-choice assessment were compared to determine whether the same social reinforcers were identified for problem behavior and an appropriate response (time allocation). The two assessments were conducted in classroom settings with 4 adolescents with mental retardation who engaged in severe problem behavior. Each student's classroom teacher served as the therapist for all phases of assessment. The two assessment procedures identified the same social reinforcers for problem and appropriate behavior for 3 of 4 participants.

  10. Comparing the Costs and Acceptability of Three Fidelity Assessment Methods for Assertive Community Treatment.

    PubMed

    Rollins, Angela L; Kukla, Marina; Salyers, Michelle P; McGrew, John H; Flanagan, Mindy E; Leslie, Doug L; Hunt, Marcia G; McGuire, Alan B

    2017-01-04

    Successful implementation of evidence-based practices requires valid, yet practical fidelity monitoring. This study compared the costs and acceptability of three fidelity assessment methods: on-site, phone, and expert-scored self-report. Thirty-two randomly selected VA mental health intensive case management teams completed all fidelity assessments using a standardized scale and provided feedback on each. Personnel and travel costs across the three methods were compared for statistical differences. Both phone and expert-scored self-report methods demonstrated significantly lower costs than on-site assessments, even when excluding travel costs. However, participants preferred on-site assessments. Remote fidelity assessments hold promise in monitoring large scale program fidelity with limited resources.

  11. Protein comparability assessments and potential applicability of high throughput biophysical methods and data visualization tools to compare physical stability profiles

    PubMed Central

    Alsenaidy, Mohammad A.; Jain, Nishant K.; Kim, Jae H.; Middaugh, C. Russell; Volkin, David B.

    2014-01-01

    In this review, some of the challenges and opportunities encountered during protein comparability assessments are summarized with an emphasis on developing new analytical approaches to better monitor higher-order protein structures. Several case studies are presented using high throughput biophysical methods to collect protein physical stability data as function of temperature, agitation, ionic strength and/or solution pH. These large data sets were then used to construct empirical phase diagrams (EPDs), radar charts, and comparative signature diagrams (CSDs) for data visualization and structural comparisons between the different proteins. Protein samples with different sizes, post-translational modifications, and inherent stability are presented: acidic fibroblast growth factor (FGF-1) mutants, different glycoforms of an IgG1 mAb prepared by deglycosylation, as well as comparisons of different formulations of an IgG1 mAb and granulocyte colony stimulating factor (GCSF). Using this approach, differences in structural integrity and conformational stability profiles were detected under stress conditions that could not be resolved by using the same techniques under ambient conditions (i.e., no stress). Thus, an evaluation of conformational stability differences may serve as an effective surrogate to monitor differences in higher-order structure between protein samples. These case studies are discussed in the context of potential utility in protein comparability studies. PMID:24659968

  12. The role of the pathologist in environmental medicine and public health.

    PubMed Central

    Higginson, J.

    1977-01-01

    The present paper summarizes the role of the morbid anatomist and clinical pathologist in environmental carcinogenesis. It points out that in the past he has contributed considerably to the identification of rare tumors and their etiology. He has an important role to play in the future in providing more accurate data on which epidemiology studies can be developed. The view is also expressed that it is highly important that modern pathologists have an understanding of toxicologic and pharmacologic techniques and their potential application to biologic material in order that they may be in a position to correlate and develop multidisciplinary approaches to the identification of environmental hazards. Some of these approaches are illustrated and their potential developments outlined. PMID:836677

  13. Host response in tumor diagnosis and prognosis: importance of immunologists and pathologists alliance.

    PubMed

    Finn, Olivera J

    2012-12-01

    Pathologists and immunologists have collaborated over many years in their efforts to understand and properly diagnose cancer. The ability of pathologists to correctly diagnose this disease was facilitated by the development of immunohistology that utilized specificity of antibodies to distinguish between normal cells and cancer cells. Further boost was provided through the advent of monoclonal antibodies. The two disciplines are now together on the brink of a paradigm shift resulting from a better understanding of the importance for cancer diagnosis and prognosis to consider not only the characteristics of the cancer cells, but also the cancer microenvironment reflecting the host response to the disease. This new immunology and pathology alliance named "Immunoscore" will advance research in both disciplines as well as benefit patients.

  14. The role of the pathologist in tissue banking: European Consensus Expert Group Report.

    PubMed

    Bevilacqua, Generoso; Bosman, Fred; Dassesse, Thibaut; Höfler, Heinz; Janin, Anne; Langer, Rupert; Larsimont, Denis; Morente, Manuel M; Riegman, Peter; Schirmacher, Peter; Stanta, Giorgio; Zatloukal, Kurt; Caboux, Elodie; Hainaut, Pierre

    2010-04-01

    Human tissue biobanking encompasses a wide range of activities and study designs and is critical for application of a wide range of new technologies (-"omics") to the discovery of molecular patterns of disease and for implementation of novel biomarkers into clinical trials. Pathology is the cornerstone of hospital-based tissue biobanking. Pathologists not only provide essential information identifying the specimen but also make decisions on what should be biobanked, making sure that the timing of all operations is consistent with both the requirements of clinical diagnosis and the optimal preservation of biological products. This document summarizes the conclusions of a Pathology Expert Group Meeting within the European Biological and Biomolecular Research Infrastructure (BBMRI) Program. These recommendations are aimed at providing guidance for pathologists as well as for institutions hosting biobanks on how to better integrate and support pathological activities within the framework of biobanks that fulfill international standards.

  15. Development and validation of an instrument to measure occupational stress in speech-language pathologists.

    PubMed

    Fimian, M J; Lieberman, R J; Fastenau, P S

    1991-04-01

    The Speech-Language Pathologist Stress Inventory (SLPSI) is a 48-item questionnaire adapted from the Teacher Stress Inventory (Fimian, 1988). Factor analyses of the responses of 626 speech-language pathologists revealed four stress source factors (Bureaucratic Restrictions, Time and Workload Management, Lack of Professional Supports, and Instructional Limitations) and two stress manifestation factors (Emotional-Fatigue Manifestations and Biobehavioral Manifestations). The internal consistency reliability of scales based on these factors ranged from .71 to .87, with .93 for the entire scale. Evidence for construct validity was found in moderate positive correlations between the scales of the SLPSI and the scales of the Maslach Burnout Inventory (MBI) (Maslach & Jackson, 1986). Stress and burnout subscale intercorrelations ranged from .10 to .82 (p less than .01), and the correlation between stress strength and burnout frequency was .66 (p less than .001).

  16. Models of phonology in the education of speech-language pathologists.

    PubMed

    Nelson, Ryan; Ball, Martin J

    2003-01-01

    We discuss developments in theoretical phonology and, in particular, at the divide between theories aiming to be adequate accounts of the data, as opposed to those claiming psycholinguistic validity. It would seem that the latter might have greater utility for thye speech-language pathologist. However, we need to know the dominant models of clinical phonology, in both clinical education and practise, before we can promote other theoretical approaches. This article describes preliminary results from a questionnaire designed to discover what models of phonology are taught in institutions training speech-language pathologists in the United States. Results support anecdotal evidence that only a limited number of approaches (phonemic, distinctive features, and processes) are taught in many instances. They also demonstrate that some correspondents were unable to distinguish aspects of theoretical phonology from similar sounding (but radically different) models of intervention. This ties in with the results showing that some instructors of phonology courses have little or no background in the subject.

  17. [BRCA1 and BRCA2 - pathologists starting kit].

    PubMed

    Škapa, Petr

    2016-01-01

    Dysfunction of tumor suppressor genes BRCA1 and BRCA2 is involved in the pathogenesis of malignant tumors, especially breast and ovarian carcinoma. BRCA1/2 genes may be inactivated by germinal and somatic mutations or epigenetic changes. Germinal mutations are responsible for the hereditary breast and ovarian carcinoma syndrome. Defects of BRCA1/2 genes lead to the failure of homologous recombination, the basic mechanism for DNA double strand break repair. The resultant genomic instability is associated with a high risk of malignant transformation of the cell, but it also results in a higher sensitivity of tumors to platinum-based chemotherapeutic compounds which damage DNA structure directly. Inhibitors of poly(ADP-ribose) polymerase (PARP) are the next generation of antitumor agents aimed on the suppression of DNA single strand break repair. In homologous recombination deficient tumors, PARP inhibitors lead to accumulation of DNA damage and death of neoplastic cells through the mechanism of synthetic lethality. Platinum-based agents and PARP inhibitors are effective not only against tumors with germinal and somatic BRCA1/2 mutations but also against sporadic carcinomas with epigenetic BRCA1/2 inactivation or with defects of other independent genes involved in the control of homologous recombination. This phenomenon is represented by the term "BRCAness". Mutational analysis is used for the assessment of BRCA1/2 status, but it is complicated by the prominent length of BRCA1/2 genes and a wide spectrum of possible genetic alterations. Therefore, next generation sequencing seems to represent an optimal approach for BRCA1/2 evaluation nowadays. Development of reliable diagnostic tests for BRCAness in sporadic tumors and efforts to reverse platinum and PARP inhibitors resistance represent the key objectives of the forthcoming research.

  18. General pathologist-helper: The new medical app about general pathology

    PubMed Central

    Fernández-Vega, Iván

    2015-01-01

    Introduction: Smartphone applications (apps) have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. “General pathologist-helper (GP-HELPER)” is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. Materials and Methods: “GP-HELPER,” was created using Mobincube website platform. This tool also integrates “FORUM GP-HELPER,” an external website created using Miarroba website (http://forum-gp-helper.mboards.com) and “COMMUNITY GP-HELPER” a multichannel chat created using Chatango website platform. Results: The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data) about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose) and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as “FORUM GP-HELPER” and “COMMUNITY GP-HELPER” that let users to stay in touch everywhere and every time. Expert consult section is also available. Conclusions: “GP-HELPER” pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members. PMID:26730351

  19. Requirements for accreditation by the College of American Pathologists Laboratory Accreditation Program.

    PubMed

    Hamlin, W B

    1999-06-01

    The College of American Pathologists Laboratory Accreditation Program expects a participant laboratory or laboratory section to be able to demonstrate that it is in compliance with the Standards for Laboratory Accreditation. The program expects laboratories to demonstrate that they are continually taking steps to identify and correct deficient areas and improve performance, in compliance with the Clinical Laboratory Improvement Amendments of 1988 regulatory requirements, particularly those pertaining to proficiency testing performance, and participating as inspectors in the accreditation process.

  20. Applications of responsiveness to intervention and the speech-language pathologist in elementary school settings.

    PubMed

    Roth, Froma P; Troia, Gary A

    2009-05-01

    This article addresses ways in which speech-language pathologists can play a proactive and substantive part in school-wide language and reading disability prevention and intervention efforts within the responsiveness to intervention framework. Within a collaborative working paradigm, specific student-focused instructional targets are presented in the areas of oral language, metacognition, and reading comprehension. A discussion of professional development focuses on enhancing teacher-student communication interaction, a critical yet often undervalued component of teacher training.

  1. Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions.

    PubMed

    Volmar, Keith E; Idowu, Michael O; Hunt, Jennifer L; Souers, Rhona J; Meier, Frederick A; Nakhleh, Raouf E

    2014-05-01

    The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P < .001), while misidentifications were most often discovered by clinicians (44.6%, P < .001). Misidentification rates were lower when all malignancies were reviewed by a second pathologist before sign-out (0.0 versus 0.6 per 1000, P < .001), and specimen defect rates were lower when intradepartmental review of difficult cases was conducted after sign-out (0.0 versus 0.4 per 1000, P = .02). This study provides benchmarking data on report defects and defect fractions using standardized taxonomy.

  2. General pathologist-helper: The new medical app about general pathology.

    PubMed

    Fernández-Vega, Iván

    2015-01-01

    Smartphone applications (apps) have become increasingly prevalent in medicine. Due to most pathologists, pathology trainees, technicians, and medical students use smartphones; apps can be a different way for general pathology education. "General pathologist-helper (GP-HELPER)" is a novel app developed as a reference tool in general pathology and especially for general pathologists, developed for Android and iOS platforms. "GP-HELPER," was created using Mobincube website platform. This tool also integrates "FORUM GP-HELPER," an external website created using Miarroba website (http://forum-gp-helper.mboards.com) and "COMMUNITY GP-HELPER" a multichannel chat created using Chatango website platform. The application was released in July 2015, and it is been periodically updated since then. The app has permanent information (offline data) about different pathology protocols (TNM latest edition, protocols regarding management of tumors of unknown primary origin, and flowcharts for some of the most difficult tumors to diagnose) and a database with more than 5000 immunohistochemistry results from different tumors. Online data have links to more than 1100 reference pathology video lectures, 250 antibodies information, more than 70 pathology association websites, 46 pathology providers, and 78 outstanding pathology journal websites. Besides this information, the app has two interactive places such as "FORUM GP-HELPER" and "COMMUNITY GP-HELPER" that let users to stay in touch everywhere and every time. Expert consult section is also available. "GP-HELPER" pretends to integrate offline and online data about pathology with two interactive external places in order to represent a reference tool for general pathologists and associate members.

  3. Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists.

    PubMed

    Vitale, Caroline A; Berkman, Cathy S; Monteleoni, Carol; Ahronheim, Judith C

    2011-09-01

    Speech-language pathologists (SLP) are often called on to evaluate eating difficulties in patients with dementia. To assess factors associated with SLPs' knowledge and recommendations about feeding tubes in patients with advanced dementia. A mail survey was administered to a probability sample of 1500 SLPs from the American Speech-Language-Hearing Association mailing list; 731 usable surveys were received (response rate=53.7%). Self-perceived preparedness, knowledge, and care recommendations were measured. Knowledge items were scored as "evidence based" or not according to the best evidence in the literature. Only 42.1% of SLP respondents felt moderately/well prepared to manage dysphagia. Only 22.0% of respondents recognized that tube feeding is unlikely to reduce risk of aspiration pneumonia whereas a slight majority understood that tube feeding would not likely prevent an uncomfortable death (50.2%), improve functional status (54.5%), or enhance quality of life (QOL) (63.2%). A majority (70.0%) was willing to consider recommending oral feeding despite high risk of aspiration. Logistic regression analyses indicated that those willing to consider this recommendation gave the most evidence-based responses to knowledge questions about tube feeding outcomes: aspiration pneumonia (odds ratio [OR]=1.75, 95% confidence interval [CI]=1.07-2.87), functional status (OR=1.43, 95% CI=1.0-2.06), QOL (OR=2.19, 95% CI=1.52-3.17), and prevent uncomfortable death (OR=1.97, 95% CI=1.37-2.88). Logistic regression analyses also indicated that those with more experience evaluating patients with dementia gave the most evidence-based response to two knowledge questions: aspiration pneumonia (OR=2.64, 95% CI=1.48-4.72) and prevent uncomfortable death (OR=2.03, 95% CI=1.35-3.05) whereas those with higher self-perceived preparedness in managing dysphagia in dementia had less knowledge in two areas: aspiration pneumonia (OR=0.57, 95% CI=0.38-0.84) and QOL (OR=0.72, 95% CI=0

  4. Customer satisfaction in anatomic pathology. A College of American Pathologists Q-Probes study of 3065 physician surveys from 94 laboratories.

    PubMed

    Zarbo, Richard J; Nakhleh, Raouf E; Walsh, Molly

    2003-01-01

    Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of

  5. Molecular profiling--a tool for addressing emerging gaps in the comparative risk assessment of GMOs.

    PubMed

    Heinemann, Jack A; Kurenbach, Brigitta; Quist, David

    2011-10-01

    Assessing the risks of genetically modified organisms (GMOs) is required by both international agreement and domestic legislation. Many view the use of the "omics" tools for profiling classes of molecules as useful in risk assessment, but no consensus has formed on the need or value of these techniques for assessing the risks of all GMOs. In this and many other cases, experts support case-by-case use of molecular profiling techniques for risk assessment. We review the latest research on the applicability and usefulness of molecular profiling techniques for GMO risk assessment. As more and more kinds of GMOs and traits are developed, broader use of molecular profiling in a risk assessment may be required to supplement the comparative approach to risk assessment. The literature-based discussions on the use of profiling appear to have settled on two findings: 1. profiling techniques are reliable and relevant, at least no less so than other techniques used in risk assessment; and 2. although not required routinely, regulators should be aware of when they are needed. The dismissal of routine molecular profiling may be confusing to regulators who then lack guidance on when molecular profiling might be worthwhile. Molecular profiling is an important way to increase confidence in risk assessments if the profiles are properly designed to address relevant risks and are applied at the correct stage of the assessment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. A Survey of Attitudes of Board-Certified Veterinary Pathologists to Forensic Veterinary Pathology.

    PubMed

    McEwen, B J; McDonough, S P

    2016-09-01

    An electronic survey was conducted to determine the attitudes of veterinary pathologists toward forensic pathology and the adequacy of their training in the discipline. The survey was sent to 1933 diplomates of the American College of Veterinary Pathologists and 311 completed responses were analyzed. Of respondents, 80% report receiving at least 1 type of medicolegal case, with cases from law enforcement received most frequently. Most (74%) of the respondents indicated that their previous training did not prepare them adequately to handle forensic cases and almost half of the respondents (48%) indicated that they needed more training on serving as an expert witness. Relative risk ratios (RRR) and odds ratios (OR) were generated to determine the strength of a statistically significant association. Responses from a free-text entry question determining additional training needs could be grouped into 3 main categories: (1) veterinary forensic pathology science and procedures, (2) documentation, evidence collection and handling, and (3) knowledge of the medicolegal system. Last, a field for additional comments or suggestions regarding veterinary forensic pathology was completed by 107 respondents and many reinforced the need for training in the categories previously described. The survey highlights that a significant proportion of diplomates of the American College of Veterinary Pathologists are currently engaged in veterinary forensic pathology but feel their training has not adequately prepared them for these cases. Hopefully, the survey results will inform the college and residency training coordinators as they address the training requirements for an important emerging discipline.

  7. Preschool teachers' perceptions and reactions to challenging classroom behavior: implications for speech-language pathologists.

    PubMed

    Nungesser, Nicole R; Watkins, Ruth V

    2005-04-01

    Awareness of issues of social competence and challenging behavior related to childhood language an communication disorders has been increasing. The purpose of this clinical exchange is to provide speech-language pathologists with basic information on communication disorders and challenging behaviors, as well as with insights into ways to support both students and classroom teachers. To provide effective services to children with language impairments and optimally support classroom staff, speech-language pathologists need to recognize (a) the interdependence of language, communication, social competence, and challenging behaviors; (b) the significance that challenging behaviors can have on evaluations of academic competency; and (c) how teachers in early childhood classrooms perceive and react to challenging behaviors. This clinical exchange provides an overview of the relationship between language, communication, and social competence, and presents preliminary survey research data investigating teachers' perceptions and reactions to challenging behaviors. Clinical implications are discussed, including considerations for intervention with children who may exhibit challenging behaviors in combination with language disabilities, and the speech-language pathologist's instrumental role in educating and supporting classroom staff to use communication strategies when managing challenging classroom behaviors.

  8. Uncovering motivators and stumbling blocks: Exploring the clinical research experiences of speech-language pathologists.

    PubMed

    Finch, Emma; Cornwell, Petrea; Nalder, Emily; Ward, Elizabeth

    2015-04-01

    Healthcare providers increasingly expect that allied health staff will not only translate research evidence into their clinical practice, but also generate research. Little is known about how well prepared clinicians are to meet these expectations. Research suggests that allied health professionals, including speech-language pathologists, have moderate levels of interest in research, but only little-to-moderate experience participating in research activities. The present study aimed to explore the experiences and attitudes of speech-language pathologists in regards to undertaking research in their clinical settings. Focus groups were conducted with 21 practising speech-language pathologists (13 research engaged, eight not research engaged). The focus groups were transcribed and the data analysed qualitatively using content analysis. Two overarching themes mediated research engagement. Engagement in research was shaped by whether participants overcame any "fear" of research and the unique characteristics of their clinical context. Contextualizing and further shaping participants' experiences of these themes were personal factors, such as initiative and proactivity. The success of increasing the research engagement of the speech-language pathology workforce may be contingent on providing clinicians with more exposure to research opportunities and mentors as well as ensuring organizational structures are in place to encourage, support and facilitate research.

  9. Microarray-Based Gene Expression Analysis for Veterinary Pathologists: A Review.

    PubMed

    Raddatz, Barbara B; Spitzbarth, Ingo; Matheis, Katja A; Kalkuhl, Arno; Deschl, Ulrich; Baumgärtner, Wolfgang; Ulrich, Reiner

    2017-09-01

    High-throughput, genome-wide transcriptome analysis is now commonly used in all fields of life science research and is on the cusp of medical and veterinary diagnostic application. Transcriptomic methods such as microarrays and next-generation sequencing generate enormous amounts of data. The pathogenetic expertise acquired from understanding of general pathology provides veterinary pathologists with a profound background, which is essential in translating transcriptomic data into meaningful biological knowledge, thereby leading to a better understanding of underlying disease mechanisms. The scientific literature concerning high-throughput data-mining techniques usually addresses mathematicians or computer scientists as the target audience. In contrast, the present review provides the reader with a clear and systematic basis from a veterinary pathologist's perspective. Therefore, the aims are (1) to introduce the reader to the necessary methodological background; (2) to introduce the sequential steps commonly performed in a microarray analysis including quality control, annotation, normalization, selection of differentially expressed genes, clustering, gene ontology and pathway analysis, analysis of manually selected genes, and biomarker discovery; and (3) to provide references to publically available and user-friendly software suites. In summary, the data analysis methods presented within this review will enable veterinary pathologists to analyze high-throughput transcriptome data obtained from their own experiments, supplemental data that accompany scientific publications, or public repositories in order to obtain a more in-depth insight into underlying disease mechanisms.

  10. The Role of the Surgical Pathologist in the Diagnosis of Gastrointestinal Polyposis Syndromes.

    PubMed

    Rosty, Christophe

    2017-09-08

    Polyps of the gastrointestinal tract are very common lesions and most frequently sporadic in nature. Some polyp subtypes are associated with rare hereditary polyposis syndromes, including juvenile polyposis syndrome, Peutz-Jeghers syndrome, and Cowden syndrome. However, many sporadic benign lesions of the gastrointestinal tract can mimic some of these syndromic hamartomatous polyps. The role of the surgical pathologist is to raise the possibility of a hereditary condition in case of suggestive polyp histology and to look for clinical information to support the suspected diagnosis. In this review, the clinical presentation and the pathology associated with these rare hamartomatous polyposis syndromes are discussed in an attempt to provide pathologists clues in suggesting one such syndrome on the basis of histologic findings and clinical context. Identification of affected individuals is important because of the increased gastrointestinal and other malignancies. Recently, new adenomatous polyposis syndromes have been discovered, expanding the genetic causes of patient diagnosed with multiple colonic adenomas. By being aware of the clinical phenotype and the tumor spectrum associated with gastrointestinal polyposis syndromes, surgical pathologists can play a critical role in recommending genetic counseling when suspicious of such a diagnosis. This may lead to the identification of a genetic cause and appropriate surveillance of affected family members to screen for associated malignancies.

  11. Creating communicatively accessible healthcare environments: perceptions of speech-language pathologists.

    PubMed

    O'Halloran, Robyn; Lee, Yan Shan; Rose, Miranda; Liamputtong, Pranee

    2014-12-01

    There is a growing body of research that indicates that a person with a communication disability communicates and participates more effectively given a communicatively accessible environment. If this research is to be translated into practice then one needs to determine who will take on the role of creating communicatively accessible environments. This research adopted a qualitative methodology to explore the perceptions of speech-language pathologists about working to create communicatively accessible healthcare settings. Fifteen speech-language pathologists in three focus groups participated in this research. The focus group discussions were transcribed and analysed thematically. Thematic analysis indicated that speech-language pathologists believe there are four main benefits in creating communicatively accessible healthcare environments. These are Benefits for all people: Access for all, Benefits for healthcare administrators, Benefits for those wanting to improve communication with patients, and Benefits to the capacity to provide communicatively accessible environments. However, they believe these benefits can only be achieved if; The communication resources are available, Skilled, knowledgeable and supportive healthcare providers are available; and Systems are in place to support a whole-of-hospital approach. This research supports the development of a new role to improve the communicative accessibility of healthcare settings.

  12. Research issues in forensic pathology: a survey of academic institutions employing forensic pathologists.

    PubMed

    Nolte, Kurt B

    2004-05-01

    In an effort to characterize research efforts in forensic pathology, a questionnaire was sent to a representative of each of the 14 academic medical centers that employ full-time faculty forensic pathologists. Responses were received from all 14 (100%) of the institutions queried, representing a total of 39 forensic pathology faculty positions; 21 positions were tenure track and 18 positions were clinical or other tracks. Of the 39 positions, 25 positions (64%) at 10 institutions required some degree of research or scholarly output. Of the 25 forensic pathologists with a research imperative, only 3 (12%) were principal investigators or co-investigators on funded forensic pathology-based projects. The major limitation cited by respondents on the performance of forensic pathology research was the lack of protected time from service responsibilities. Fellowship training in forensic pathology was available at 6 of the 14 respondent institutions. Of these institutions, 4 (67%) had a research requirement for trainees, and 4 (67%) provided research training. In conclusion, very few US medical schools currently employ full-time faculty forensic pathologists. Of these, only a small number of institutions prioritize research by these faculty members. Scant federal funds are available to support research in forensic pathology. Few forensic pathology fellowship programs provide research training. To achieve a robust research agenda in forensic pathology that is sufficient to support the needs of the criminal justice and public health systems will require a paradigm shift in the medicolegal death investigative system and investment by federal agencies.

  13. Static digital telepathology: a model for diagnostic and educational support to pathologists in the developing world.

    PubMed

    Sohani, Aliyah R; Sohani, Moez A

    2012-01-01

    The practice of pathology in the developing world presents challenges in terms of limited resources, shortages of trained personnel, and lack of continuing education programs. Telepathology holds promise as a means of diagnostic and educational support. We donated multiheaded teaching microscopes equipped with digital cameras to four hospitals in Eastern Africa and trained local pathologists on their use. Static images of challenging cases were posted on a web-based telepathology platform. A U.S.-based pathologist reviewed images in consultation with subspecialist colleagues. Over a period of 40 months, 109 cases were submitted for second opinion consultation, including 29 dermatopathology cases (26.6%), 14 hematopathology cases (12.8%), and 13 cases each (11.9%) in cytopathology and bone and soft tissue pathology. Static images enabled a complete or partial diagnosis in 100/109 cases (91.7%). Factors precluding a definitive diagnosis included absence of confirmatory immunophenotyping, technical issues, or lack of clinical history. Case responses included a diagnosis and discussion, including differential diagnosis, references, and treatment recommendations. Static digital telepathology is a simple, cost-effective, reliable and efficient means to provide diagnostic and educational support to pathologists in the developing world. Additional training may help overcome technical factors precluding a definitive diagnosis in certain cases.

  14. Fault lines in forensic medical toxicology in Ireland exposed through replies of pathologists and coroners to anonymous questionnaires.

    PubMed

    Tormey, William P; Borovickova, Ingrid; Moore, Tara M

    2014-01-01

    The attitudes and experiences of pathologists and coroners to the provision of biochemical forensic toxicology in the Republic of Ireland were determined using separate questionnaires to each group anonymously. Replies were received from 36/88 (41%) of pathologists and 19/71 (27%) of coroners. 37% of coroners considered that histopathologists give an adequate opinion in forensic toxicology yet 58% of pathologists reported that they did not have adequate access to expert medical interpretative toxicological opinion. For drug-drug interactions and metabolic diseases, 69% of pathologists were unhappy with the processes and 68% of coroner replies did not know if vitreous samples were used appropriately. There is a clear requirement for retraining of coroners and for the appointment of medical toxicology expertise to improve the quality of service for coroners.

  15. How do swine practitioners and veterinary pathologists arrive at a diagnosis of Clostridium perfringens type A enteritis in neonatal piglets?

    PubMed

    Chan, Gloria; Farzan, Abdolvahab; Prescott, John F; Friendship, Robert

    2013-05-01

    A questionnaire was administered to 22 veterinary practitioners and 17 veterinary pathologists to investigate the methods used for diagnosis of Clostridium perfringens type A enteritis in neonatal pigs. Practitioners generally diagnosed C. perfringens type A associated enteritis by age of onset of diarrhea (between 1 to 7 days of age). Most practitioners (95%) were moderately to very confident in their diagnosis. Pathologists generally diagnosed C. perfringens type A associated enteritis by combinations of isolation of the organism, genotyping or detecting the toxins of the organism, and ruling out other pathogens through histopathology. Almost half (41%) of the pathologists were not confident of their diagnosis. This study reports that the current diagnostic method for C. perfringens type A enteritis is not specific, and although many pathologists expressed reservations about making a diagnosis of C. perfringens type A enteritis, most practitioners were confident in their diagnosis, even though reported clinical signs of clostridial diarrhea are similar to those of a number of other enteric diseases.

  16. Comparative assessment of the environmental impact of wastes from electricity generation systems

    SciTech Connect

    Torres, C. [Instituto de Medio Ambiente Smith, G.M.; Linsley, G.; Hossain, S.

    1994-12-31

    The paper describes an outline methodology for assessing and comparing the environmental impact arising from management of the wastes from nuclear and other electricity generation systems. The assessment framework is applicable to wastes from all generation systems, including nuclear, fossil and renewable fuel systems, and can also be applied to the management of mixed hazardous waste. The major energy technologies in terms of waste production can be classified according to three major categories of fuels: fossil, nuclear and renewable. The emphasis in this description is on nuclear utility low-level and mixed wastes and waste streams. The methodology may be used to support the project on Data Bases and Methodologies for Comparative Assessment of Different Energy Sources for Electricity Generation (DECADES project, (2)) which is being developed by the International Atomic Energy Agency in collaboration with other international agencies. The DECADES project has the overall objective to improve the abilities for comparative assessment of energy chains for electricity generation. The objective of a methodology such as that described here is to ensure that waste management aspects are included effectively in comparative assessments of energy systems. This paper discusses the waste strams arising from nuclear power plants.

  17. Speech pathologists and audiologists with Ph.D. in Brazil: profile from 1976 to 2008.

    PubMed

    Ferreira, Léslie Piccolotto; Russo, Iêda Chaves Pacheco; Adami, Fernando

    2010-01-01

    keeping data about Ph.D.s of speech pathologists and audiologists updated allows the retrieval of what has been developed in these fields of knowledge, besides giving a dimension of the development of the Speech, Language and Hearing Sciences in our country. to analyze the educational background of Brazilian speech pathologists and audiologists with Ph.D. within the period of 1976-2008. doctorate dissertations presented by Brazilian speech pathologists and audiologists during the period of 1976 (first presentation) to the end of 2008 were selected through information provided by postgraduation offices and also by consulting data published on Plataforma Lattes (online curriculum vitae for professors and scientists). For each finding the following variables were registered: author's gender, year of presentation, educational institution and post-graduate program where the dissertation was developed (according to the areas of knowledge determined by National Council of Scientific and Technological Development) and chosen theme (Language, Hearing and Balance, Motricity and orofacial functions, Voice e Public Health). The statistical analysis involved the description of the selected parameters, a regression analysis to verify increase of Ph.D. presentations, area of development and chosen theme, and application of the chi-square test to verify possible associations. a total of 504 dissertations were analyzed. The results were: 97.0% of the dissertations were presented by women; State Institutions were chosen by almost half (47.62%) of the speech pathologists and audiologists to obtain their Ph.D.; the Sciences of Life programs were the most prevalent (57.54%); concerning the chosen theme, most of the dissertations were developed in the field of Language (34.52%) and Hearing and Balance (32.34%). The regression analysis indicated an increase of all of the studied variables with significance mostly related to the year of presentation, choice of the area of Applied Human

  18. Communication-based services for persons with severe disabilities in schools: a survey of speech-language pathologists.

    PubMed

    Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L

    2010-01-01

    Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.

  19. Practise patterns of Malaysian speech-language pathologists in managing children with speech and language delay/disorder.

    PubMed

    Joginder Singh, Susheel; Chan, Min Yen; Ahmad Rusli, Yazmin

    2016-12-01

    Children with speech and language delay/disorder (SLD) in the developing language stage (DLS) are one of the largest populations served by speech-language pathologists (SLPs) working in paediatric settings. The aim of this study was to investigate the practise patterns adopted by Malaysian SLPs when managing these children. A web-based questionnaire was developed to obtain information about SLPs' practises during assessment, planning and treatment. A total of 53 SLPs completed the questionnaire. When assessing the children, participants either always or usually involved parents, suggesting that they understood the importance of family involvement in services provided. When planning goals, the SLPs relied mostly on their clinical experience and less on research evidence. Participants reported that, most often, they employed a one-to-one approach when providing treatment. There was, however, great variation in the frequency of treatment provided, reflecting the different workplaces of participants. Generally, findings from this study indicated that some practises employed by Malaysian SLPs when managing children with SLD in the DLS are on par with the best practise guidelines, but there is still room for improvement in certain areas such as team collaboration and evidence-based practise. Clinical and research implications are discussed.

  20. The ever-evolving role of pathologists in the management of breast cancer with neoadjuvant treatment: recommendations based on the Spanish clinical experience.

    PubMed

    Burgués, O; López-García, Mª Á; Pérez-Míes, B; Santiago, P; Vieites, B; García, J F; Peg, V

    2017-08-09

    To compare the current international standards for neoadjuvant systemic therapy (NAST) protocols, and establish consensus recommendations by Spanish breast pathologists; and to look into the Spanish reality of defining pathological complete response in daily practice. A modified Delphi technique was used to gain consensus among a panel of 46 experts with regard to important issues about NAST specimens, with the objective of standardize handling and analysis of these breast cancer specimens. In addition, a survey was conducted among 174 pathologists to explore the Spanish reality of post-NAST breast cancer specimens handling. Our survey shows that pathologists in Spain follow the same guidelines as their international colleagues and face the same problems and controversies. Among the experts, 94.1% agreed on the recommendation for a pre-treatment evaluation with a core needle biopsy, and 100% of experts agreed on the need of having properly indicated information for the post-NAST surgical specimens. However, only 82.7% of them receive properly labelled specimens and even less receive specimens where markers are identified and the degree of clinical/radiological response is mentioned. Among participants 59.9% were familiar with the residual cancer burden system for post-NAST response quantification, but only 16.1% used it regularly. Active participation on breast cancer multidisciplinary teams, optimal usage of core needle biopsy for timely and standardized procedures for the diagnostic analysis, and accurate diagnosis of pathological complete response and complete evaluation of the response to NAST need to become the standard practice when handling breast cancer specimens in Spain.

  1. Gender Differences in Structured Risk Assessment: Comparing the Accuracy of Five Instruments

    ERIC Educational Resources Information Center

    Coid, Jeremy; Yang, Min; Ullrich, Simone; Zhang, Tianqiang; Sizmur, Steve; Roberts, Colin; Farrington, David P.; Rogers, Robert D.

    2009-01-01

    Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management-20 (HCR-20; C. D. Webster, K. S.…

  2. Live versus Video Observations: Comparing the Reliability and Validity of Two Methods of Assessing Classroom Quality

    ERIC Educational Resources Information Center

    Curby, Timothy W.; Johnson, Price; Mashburn, Andrew J.; Carlis, Lydia

    2016-01-01

    When conducting classroom observations, researchers are often confronted with the decision of whether to conduct observations live or by using pre-recorded video. The present study focuses on comparing and contrasting observations of live and video administrations of the Classroom Assessment Scoring System-PreK (CLASS-PreK). Associations between…

  3. The Reading First Program and Statewide-Mandated Assessments: A Three-Year Comparative Study

    ERIC Educational Resources Information Center

    Ratcliff, Monica Wong; Powell, Sherlyn Ezell; Cage, Bob N.; Chen, Cheng C.

    2011-01-01

    This three-year comparative study investigated the impact of the Reading First (RF) Program on student performance as measured by statewide-mandated English Language Arts (ELA) assessment programs. A matching procedure was used where 3 RF schools and 3 non-RF schools from two rural school districts in north Louisiana were matched. The ELA test…

  4. Toward a Molecular Equivalent Dose: Use of the Medaka Model in Comparative Risk Assessment.

    EPA Science Inventory

    Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

  5. Assessing Observer Accuracy in Continuous Recording of Rate and Duration: Three Algorithms Compared

    ERIC Educational Resources Information Center

    Mudford, Oliver C.; Martin, Neil T.; Hui, Jasmine K. Y.; Taylor, Sarah Ann

    2009-01-01

    The three algorithms most frequently selected by behavior-analytic researchers to compute interobserver agreement with continuous recording were used to assess the accuracy of data recorded from video samples on handheld computers by 12 observers. Rate and duration of responding were recorded for three samples each. Data files were compared with…

  6. Comparing Two Theories of Grammatical Knowledge Assessment: A Bifactor-MIRT Analysis

    ERIC Educational Resources Information Center

    Cai, Yuyang

    2014-01-01

    This study compares two approaches to grammatical knowledge in language assessment: the structural view that regards grammatical knowledge as vocabulary and syntax (Bachman 1990), and the communicative view that perceives it as the binary combination of grammatical form and meaning (Purpura 2004). 1,491 second-year nursing students from eight…

  7. Comparing Results from the Clinical Assessment of Behavior and Child Behavior Checklist with Referred Preschoolers

    ERIC Educational Resources Information Center

    Myers, Carl L.

    2013-01-01

    Behavior rating scales are popular assessment tools but more research is needed on the preschool versions of the instruments, particularly with referred samples of preschoolers. This study examined the comparability of results from parent ratings on the preschool versions of the Child Behavior Checklist (CBCL/1.5-5, Achenbach & Rescorla, 2000)…

  8. Interactive Technologies for Teacher Training: Comparing Performance and Assessment in Second Life and simSchool

    ERIC Educational Resources Information Center

    Meritt, Julia; Gibson, David; Christensen, Rhonda; Knezek, Gerald

    2013-01-01

    Two alternative technologies forming the basis of computer-mediated teacher preparation systems are compared and contrasted regarding implementation, operation, and assessment considerations. The role-playing system in Second Life is shown to have the unique characteristic of developing a co-constructed pedagogical identity, while the flight…

  9. Toward a Molecular Equivalent Dose: Use of the Medaka Model in Comparative Risk Assessment.

    EPA Science Inventory

    Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

  10. Toward a molecular equivalent dose: use of the medaka model in comparative risk assessment

    EPA Science Inventory

    Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

  11. Education Students and Their Teachers: Comparing Views on Participative Assessment Practices

    ERIC Educational Resources Information Center

    Brew, Christine; Riley, Philip; Walta, Caroline

    2009-01-01

    Beliefs about the validity and merit of self-, peer- and group-assessment practices are presented from 213 pre-service primary teachers and 30 staff who teach them. Both groups were surveyed using comparable items. A subset of seven staff participated in semi-structured interviews. Staff were far more supportive of peer- and self-assessment…

  12. A Qualitative Assessment of the Learning Outcomes of Teaching Introductory American Politics in Comparative Perspective

    ERIC Educational Resources Information Center

    Gelbman, Shamira M.

    2011-01-01

    This article discusses the findings of an ethnographic content analysis of students' written reflections as a means for assessing the learning outcomes of teaching introductory American politics in comparative perspective. It focuses especially on determining whether and how this approach enhanced students' understanding and retention of knowledge…

  13. Gender Differences in Structured Risk Assessment: Comparing the Accuracy of Five Instruments

    ERIC Educational Resources Information Center

    Coid, Jeremy; Yang, Min; Ullrich, Simone; Zhang, Tianqiang; Sizmur, Steve; Roberts, Colin; Farrington, David P.; Rogers, Robert D.

    2009-01-01

    Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management-20 (HCR-20; C. D. Webster, K. S.…

  14. Comparing Students' Attitudes towards the Use of Traditional and Alternative Assessment Practices.

    ERIC Educational Resources Information Center

    DeMauro, Tom; Helphrey, Traci; Schram, Greg; Spiekermann, Carrie

    This paper describes a program designed to compare students' attitudes towards the use of traditional and alternative assessment practices. The targeted population consisted of a second and third grade general education class, a third grade physical education class, and an eighth grade applied technology class in three communities in northern…

  15. Comparing Results from the Clinical Assessment of Behavior and Child Behavior Checklist with Referred Preschoolers

    ERIC Educational Resources Information Center

    Myers, Carl L.

    2013-01-01

    Behavior rating scales are popular assessment tools but more research is needed on the preschool versions of the instruments, particularly with referred samples of preschoolers. This study examined the comparability of results from parent ratings on the preschool versions of the Child Behavior Checklist (CBCL/1.5-5, Achenbach & Rescorla, 2000)…

  16. Comparing Two Versions of Professional Development for Teachers Using Formative Assessment in Networked Mathematics Classrooms

    ERIC Educational Resources Information Center

    Yin, Yue; Olson, Judith; Olson, Melfried; Solvin, Hannah; Brandon, Paul R.

    2015-01-01

    This study compared two versions of professional development (PD) designed for teachers using formative assessment (FA) in mathematics classrooms that were networked with Texas Instruments Navigator (NAV) technology. Thirty-two middle school mathematics teachers were randomly assigned to one of the two groups: FA-then-NAV group and FA-and-NAV…

  17. On Applications of Rasch Models in International Comparative Large-Scale Assessments: A Historical Review

    ERIC Educational Resources Information Center

    Wendt, Heike; Bos, Wilfried; Goy, Martin

    2011-01-01

    Several current international comparative large-scale assessments of educational achievement (ICLSA) make use of "Rasch models", to address functions essential for valid cross-cultural comparisons. From a historical perspective, ICLSA and Georg Rasch's "models for measurement" emerged at about the same time, half a century ago. However, the…

  18. The Use of Illustrations in Large-Scale Science Assessment: A Comparative Study

    ERIC Educational Resources Information Center

    Wang, Chao

    2012-01-01

    This dissertation addresses the complexity of test illustrations design across cultures. More specifically, it examines how the characteristics of illustrations used in science test items vary across content areas, assessment programs, and cultural origins. It compares a total of 416 Grade 8 illustrated items from the areas of earth science, life…

  19. The Use of Illustrations in Large-Scale Science Assessment: A Comparative Study

    ERIC Educational Resources Information Center

    Wang, Chao

    2012-01-01

    This dissertation addresses the complexity of test illustrations design across cultures. More specifically, it examines how the characteristics of illustrations used in science test items vary across content areas, assessment programs, and cultural origins. It compares a total of 416 Grade 8 illustrated items from the areas of earth science, life…

  20. Live versus Video Observations: Comparing the Reliability and Validity of Two Methods of Assessing Classroom Quality

    ERIC Educational Resources Information Center

    Curby, Timothy W.; Johnson, Price; Mashburn, Andrew J.; Carlis, Lydia

    2016-01-01

    When conducting classroom observations, researchers are often confronted with the decision of whether to conduct observations live or by using pre-recorded video. The present study focuses on comparing and contrasting observations of live and video administrations of the Classroom Assessment Scoring System-PreK (CLASS-PreK). Associations between…

  1. Psychometric Adequacy and Comparability of the Short and Full forms of the Personality Assessment Inventory

    ERIC Educational Resources Information Center

    Frazier, Thomas W.; Naugle, Richard I.; Haggerty, Kathryn A.

    2006-01-01

    The 160-item short form of the Personality Assessment Inventory (PAI) was developed for situations in which respondents complete only the 1st half of the test. The present study evaluates the adequacy and comparability of the full and short forms of the PAI in terms of a wide range of psychometric characteristics. In all, 421 participants…

  2. Comparing Two Theories of Grammatical Knowledge Assessment: A Bifactor-MIRT Analysis

    ERIC Educational Resources Information Center

    Cai, Yuyang

    2014-01-01

    This study compares two approaches to grammatical knowledge in language assessment: the structural view that regards grammatical knowledge as vocabulary and syntax (Bachman 1990), and the communicative view that perceives it as the binary combination of grammatical form and meaning (Purpura 2004). 1,491 second-year nursing students from eight…

  3. Toward a molecular equivalent dose: use of the medaka model in comparative risk assessment

    EPA Science Inventory

    Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

  4. Comparing Two Versions of Professional Development for Teachers Using Formative Assessment in Networked Mathematics Classrooms

    ERIC Educational Resources Information Center

    Yin, Yue; Olson, Judith; Olson, Melfried; Solvin, Hannah; Brandon, Paul R.

    2015-01-01

    This study compared two versions of professional development (PD) designed for teachers using formative assessment (FA) in mathematics classrooms that were networked with Texas Instruments Navigator (NAV) technology. Thirty-two middle school mathematics teachers were randomly assigned to one of the two groups: FA-then-NAV group and FA-and-NAV…

  5. A Qualitative Assessment of the Learning Outcomes of Teaching Introductory American Politics in Comparative Perspective

    ERIC Educational Resources Information Center

    Gelbman, Shamira M.

    2011-01-01

    This article discusses the findings of an ethnographic content analysis of students' written reflections as a means for assessing the learning outcomes of teaching introductory American politics in comparative perspective. It focuses especially on determining whether and how this approach enhanced students' understanding and retention of knowledge…

  6. Comparative life cycle assessments: The case of paper and digital media

    SciTech Connect

    Bull, Justin G. Kozak, Robert A.

    2014-02-15

    The consumption of the written word is changing, as media transitions from paper products to digital alternatives. We reviewed the life cycle assessment (LCA) research literature that compared the environmental footprint of digital and paper media. To validate the role of context in influencing LCA results, we assessed LCAs that did not compare paper and print, but focused on a product or component that is part of the Information and Communication Technology (ICT) sector. Using a framework that identifies problems in LCA conduct, we assessed whether the comparative LCAs were accurate expressions of the environmental footprints of paper and print. We hypothesized that the differences between the product systems that produce paper and digital media weaken LCA's ability to compare environmental footprints. We also hypothesized that the characteristics of ICT as an industrial sector weaken LCA as an environmental assessment methodology. We found that existing comparative LCAs offered problematic comparisons of paper and digital media for two reasons — the stark material differences between ICT products and paper products, and the unique characteristics of the ICT sector. We suggested that the context of the ICT sector, best captured by the concept of “Moore's Law”, will continuously impede the ability of the LCA methodology to measure ICT products. -- Highlights: • We review the LCA research that compares paper and digital media. • We contrast the comparative LCAs with LCAs that examine only digital products. • Stark differences between paper and digital media weakens LCA findings. • Digital products in general challenge the LCA method's reliability. • Continuous innovation and global nature of digital products impedes LCA methodology.

  7. Whole tumor section quantitative image analysis maximizes between-pathologists' reproducibility for clinical immunohistochemistry-based biomarkers.

    PubMed

    Barnes, Michael; Srinivas, Chukka; Bai, Isaac; Frederick, Judith; Liu, Wendy; Sarkar, Anindya; Wang, Xiuzhong; Nie, Yao; Portier, Bryce; Kapadia, Monesh; Sertel, Olcay; Little, Elizabeth; Sabata, Bikash; Ranger-Moore, Jim

    2017-08-14

    Pathologists have had increasing responsibility for quantitating immunohistochemistry (IHC) biomarkers with the expectation of high between-reader reproducibility due to clinical decision-making especially for patient therapy. Digital imaging-based quantitation of IHC clinical slides offers a potential aid for improvement; however, its clinical adoption is limited potentially due to a conventional field-of-view annotation approach. In this study, we implemented a novel solely morphology-based whole tumor section annotation strategy to maximize image analysis quantitation results between readers. We first compare the field-of-view image analysis annotation approach to digital and manual-based modalities across multiple clinical studies (~120 cases per study) and biomarkers (ER, PR, HER2, Ki-67, and p53 IHC) and then compare a subset of the same cases (~40 cases each from the ER, PR, HER2, and Ki-67 studies) using whole tumor section annotation approach to understand incremental value of all modalities. Between-reader results for each biomarker in relation to conventional scoring modalities showed similar concordance as manual read: ER field-of-view image analysis: 95.3% (95% CI 92.0-98.2%) vs digital read: 92.0% (87.8-95.8%) vs manual read: 94.9% (91.4-97.8%); PR field-of-view image analysis: 94.1% (90.3-97.2%) vs digital read: 94.0% (90.2-97.1%) vs manual read: 94.4% (90.9-97.2%); Ki-67 field-of-view image analysis: 86.8% (82.1-91.4%) vs digital read: 76.6% (70.9-82.2%) vs manual read: 85.6% (80.4-90.4%); p53 field-of-view image analysis: 81.7% (76.4-86.8%) vs digital read: 80.6% (75.0-86.0%) vs manual read: 78.8% (72.2-83.3%); and HER2 field-of-view image analysis: 93.8% (90.0-97.2%) vs digital read: 91.0 (86.6-94.9%) vs manual read: 87.2% (82.1-91.9%). Subset implementation and analysis on the same cases using whole tumor section image analysis approach showed significant improvement between pathologists over field-of-view image analysis and manual read (HER2 100

  8. Comparability of developmental cognitive assessments between standard and computer testing methods

    PubMed Central

    Mandell, Dorothy J.; Sackett, Gene P.

    2008-01-01

    Substantial questions have been raised about the validity of using computer-based testing to assess cognitive development with young children. However, little work has been done to assess the comparability of performance elicited using computerized methods with performance garnered using standard testing methods. The purpose of this study was to establish whether computerized testing resulted in performance that was different than established performance norms for infant monkeys (Macaca nemestrina) tested on four highly used cognitive tasks. Infants performed comparably on simple discrimination, reversal learning, and delayed nonmatch-to-sample rule learning. However, the infants tested in a computer testing-environment appeared to have difficulty on a task that required them to form response strategies. The results of the study reveal some apparent limitations of computer-based testing with infants, but do show that performance on several common cognitive tasks is comparable between the environments. PMID:18688805

  9. Comparative assessment of 3D surface scanning systems in breast plastic and reconstructive surgery.

    PubMed

    Patete, Paolo; Eder, Maximilian; Raith, Stefan; Volf, Alexander; Kovacs, Laszlo; Baroni, Guido

    2013-10-01

    In this work, we compared accuracy, repeatability, and usability in breast surface imaging of 2 commercial surface scanning systems and a hand-held laser surface scanner prototype coupled with a patient's motion acquisition and compensation methodology. The accuracy of the scanners was assessed on an anthropomorphic phantom, and to evaluate the usability of the scanners on humans, thorax surface images of 3 volunteers were acquired. Both the intrascanner repeatability and the interscanner comparative accuracy were assessed. The results showed surface-to-surface distance errors inferior to 1 mm and to 2 mm, respectively, for the 2 commercial scanners and for the prototypical one. Moreover, comparable performances of the 3 scanners were found when used for acquiring the breast surface. On the whole, this study demonstrated that handheld laser surface scanners coupled with subject motion compensation methods lend themselves as competitive technologies for human body surface modeling.

  10. Targeted therapies and immune checkpoint inhibitors in the treatment of metastatic melanoma patients: a guide and update for pathologists.

    PubMed

    Kakavand, Hojabr; Wilmott, James S; Long, Georgina V; Scolyer, Richard A

    2016-02-01

    The previously dismal prospects for patients with advanced stage metastatic melanoma have greatly improved in recent years. Enhanced understanding of both the pathogenesis of melanoma and its molecular drivers, as well as the importance and regulation of anti-tumour immune responses, have provided new therapeutic opportunities for melanoma patients. There are two major distinct categories of systemic treatments with activity for patients with metastatic melanoma: (1) targeted therapies, which act to inhibit the oncogenes that drive the aberrant growth and dissemination of the tumour; and (2) immune checkpoint inhibitor therapies, which act to enhance anti-tumour immune responses by blocking negative regulators of immunity. Pathologists play a critical and expanding role in the selection of the most appropriate treatment for individual metastatic melanoma patients in the modern era of personalised/precision medicine. The molecular pathology testing of melanoma tumour tissue for the presence of targetable oncogenic mutations is already part of routine practice in many institutions. In addition, other potential oncogenic therapeutic targets continue to be identified and pathology testing techniques must readily adapt to this rapidly changing field. Recent research findings suggest that pathological assessment of tumour associated immune cells and immunosuppressive ligand expression of the tumour are likely to be important in identifying patients most likely to benefit from immune checkpoint inhibitors. Similarly, pathological and molecular observations of on-treatment tumour tissue biopsies taken from patients on targeted therapies have provided new insights into the mechanisms of action of targeted molecular therapies, have contributed to the identification of resistance mechanisms to these novel therapies and may be of higher value for selecting patients most likely to benefit from therapies. These data have already provided a rational biological basis for the

  11. Academic detailing can play a key role in assessing and implementing comparative effectiveness research findings.

    PubMed

    Fischer, Michael A; Avorn, Jerry

    2012-10-01

    Comparative effectiveness research evaluates the relative effectiveness, safety, and value of competing treatment options in clinically realistic settings. Such evaluations can be methodologically complex and difficult to interpret. There will be a growing need for critical evaluation of comparative effectiveness studies to assess the adequacy of their design and to put new information into a broader context. Equally important, this knowledge will have to be communicated to clinicians in a way that will actually change practice. We identify three challenges to effective dissemination of comparative effectiveness research findings: the difficulty of interpreting comparative effectiveness research data, the need for trusted sources of information, and the challenge of turning research results into clinical action. We suggest that academic detailing-direct outreach education that gives clinicians an accurate and unbiased synthesis of the best evidence for practice in a given clinical area-can translate comparative effectiveness research findings into actions that improve health care decision making and patient outcomes.

  12. In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement.

    PubMed

    Wright, C Y; Wilkes, M; du Plessis, J L; Reeder, A I; Albers, P N

    2016-08-01

    Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations. Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day. We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001). It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Assessment of dietary fish consumption in pregnancy: comparing one-, four- and thirty-six-item questionnaires.

    PubMed

    Oken, Emily; Guthrie, Lauren B; Bloomingdale, Arienne; Gillman, Matthew W; Olsen, Sjurdur F; Amarasiriwardena, Chitra J; Platek, Deborah N; Bellinger, David C; Wright, Robert O

    2014-09-01

    Fish consumption influences a number of health outcomes. Few studies have directly compared dietary assessment methods to determine the best approach to estimating intakes of fish and its component nutrients, including DHA, and toxicants, including methylmercury. Our objective was to compare three methods of assessing fish intake. We assessed 30 d fish intake using three approaches: (i) a single question on total fish consumption; (ii) a brief comprehensive FFQ that included four questions about fish; and (iii) a focused FFQ with thirty-six questions about different finfish and shellfish. Obstetrics practices in Boston, MA, USA. Fifty-nine pregnant women who consumed ≤2 monthly fish servings. Estimated intakes of fish, DHA and Hg were lowest with the one-question screener and highest with the thirty-six-item fish questionnaire. Estimated intake of DHA with the thirty-six-item questionnaire was 4·4-fold higher (97 v. 22 mg/d), and intake of Hg was 3·8-fold higher (1·6 v. 0·42 μg/d), compared with the one-question screener. Plasma DHA concentration was correlated with fish intake assessed with the one-question screener (Spearman r = 0·27, P = 0·04), but not with the four-item FFQ (r = 0·08, P = 0·54) or the thirty-six-item fish questionnaire (r = 0·01, P = 0·93). In contrast, blood and hair Hg concentrations were similarly correlated with fish and Hg intakes regardless of the assessment method (r = 0·35 to 0·52). A longer questionnaire provides no advantage over shorter questionnaires in ranking intakes of fish, DHA and Hg compared with biomarkers, but estimates of absolute intakes can vary by as much as fourfold across methods.

  14. Australian speech-language pathologists' perceptions and experiences of augmentative and alternative communication in early childhood intervention.

    PubMed

    Iacono, Teresa; Cameron, Marnie

    2009-12-01

    Speech-language pathologists (SLPs) working in early childhood intervention are expected to have knowledge and skills across a number of areas and to engage in evidence-based practice. We explored the knowledge and perceptions of SLPs working with young children within Australian early childhood settings about augmentative and alternative communication (AAC), evidence-based practice, and barriers to such practice. Fourteen clinicians participated in group or individual interviews. Thematic analysis of the transcripts of these discussions revealed that they had a broad view of AAC and its benefits. Their reported assessment and intervention approaches reflected best practice as documented in the literature. The exception was in the implementation of family-centred practice. Although the participants involved families in their children's intervention, many appeared to use a directive approach. There was also evidence of struggling with families' negative attitudes about the use of AAC. A major barrier for these clinicians in implementing AAC and best practice was limited time in light of the many demands and expectations. Despite some frustration, these participants were passionate about their work and belief in the benefits of AAC for young children with varied communication difficulties. The results suggest that many expectations placed on clinicians within early childhood intervention settings may fail to take into account the everyday demands on their time, in a context of varied resources and support.

  15. Distinguishing between casual talk and academic talk beginning in the preschool years: an important consideration for speech-language pathologists.

    PubMed

    van Kleeck, Anne

    2014-11-01

    The need for speech-language pathologists (SLPs) to consider an academic talk (AT) register in addition to an everyday casual talk (CT) register of oral language with children beginning in the preschool years is presented, the AT and CT registers are distinguished in a comprehensive manner, ideas regarding AT language assessment are proposed, and suggestions for fostering children's skills with the AT register are offered. Extant research and scholarship from a wide variety of disciplines are integrated and organized. The author discusses the role of the SLP in supporting AT skills beginning in the preschool years and the added risk of difficulties with the AT register for children with language impairment who are from diverse backgrounds. Two broad categories-social-interactive and cognitive-that give rise to linguistic features that differentiate between the CT and AT registers are deduced from extant scholarship. SLPs should consider children's competence with the AT register as they work to prepare preschoolers and older children for the language demands of school.

  16. Application of a logic model to an evidence-based practice training program for speech-language pathologists and audiologists.

    PubMed

    Guo, Ruiling; Bain, Barbara A; Willer, Janene

    2011-01-01

    The purpose of this study was to present the application of a logic model in planning, implementing, and evaluating an evidence-based practice (EBP) training program for speech-language pathologists (SLPs) and audiologists. A logic model was used as a guide in developing the EBP training program. The program investigators delineated the core components of the logic model based on the results of a needs assessment survey of SLPs and audiologists as well as literature reviews. The major components of the logic model were constructed as inputs, activities, outputs, and outcomes/impacts. Statistical analysis using repeated measures ANOVA for the pre-test and post-test indicated that the participants increased their EBP knowledge, information searching skills, and confidence in using EBP in their clinical practice (p < 0.001). Five of the eight program objectives were met by having at least 75% of the participants achieve the objectives. The logic model is a useful tool for grant application and program planning, implementation, and evaluation.

  17. Comparability of dietary patterns assessed by multiple dietary assessment methods: results from the 1946 British Birth Cohort.

    PubMed

    McNaughton, S A; Mishra, G D; Bramwell, G; Paul, A A; Wadsworth, M E J

    2005-03-01

    The aim of this study is to evaluate the consistency of dietary patterns assessed through the use of a dietary recall and a 5-day food diary. Participants (n = 2265) of a longitudinal study of health and development completed 48-h dietary recall at interview, followed by a 5-day food diary and with the 24 h immediately preceding the interview analysed separately as a 24-h recall. Mean intakes of foods and nutrients were calculated and dietary patterns were assessed using exploratory factor analysis, using the method of principal components. Paired t-tests and correlation coefficients were used to compare the three dietary assessment methods. Five distinct dietary patterns were identified using the food diary and the 48-h recall but were less consistent on the 24-h recall. Correlations between factor scores on the 48-h recall and the food diary (r = 0.13-0.67) were higher than those between the 24-h recall and food diary (r = -0.01-0.59). The recall methods were effective at ranking subjects according to food and nutrient intakes, with the 48-h recall and food diary showing higher correlations in both males and females. This study indicates that a 48-h recall effectively characterises dietary patterns in British adults when compared to a food diary and ranks participants appropriately with respect to most nutrients and foods and is superior to a single 24-h recall. These results have implications for longitudinal studies where maximising response rates to repeat dietary assessment tools is essential.

  18. The estimation of tumor cell percentage for molecular testing by pathologists is not accurate.

    PubMed

    Smits, Alexander J J; Kummer, J Alain; de Bruin, Peter C; Bol, Mijke; van den Tweel, Jan G; Seldenrijk, Kees A; Willems, Stefan M; Offerhaus, G Johan A; de Weger, Roel A; van Diest, Paul J; Vink, Aryan

    2014-02-01

    Molecular pathology is becoming more and more important in present day pathology. A major challenge for any molecular test is its ability to reliably detect mutations in samples consisting of mixtures of tumor cells and normal cells, especially when the tumor content is low. The minimum percentage of tumor cells required to detect genetic abnormalities is a major variable. Information on tumor cell percentage is essential for a correct interpretation of the result. In daily practice, the percentage of tumor cells is estimated by pathologists on hematoxylin and eosin (H&E)-stained slides, the reliability of which has been questioned. This study aimed to determine the reliability of estimated tumor cell percentages in tissue samples by pathologists. On 47 H&E-stained slides of lung tumors a tumor area was marked. The percentage of tumor cells within this area was estimated independently by nine pathologists, using categories of 0-5%, 6-10%, 11-20%, 21-30%, and so on, until 91-100%. As gold standard, the percentage of tumor cells was counted manually. On average, the range between the lowest and the highest estimate per sample was 6.3 categories. In 33% of estimates, the deviation from the gold standard was at least three categories. The mean absolute deviation was 2.0 categories (range between observers 1.5-3.1 categories). There was a significant difference between the observers (P<0.001). If 20% of tumor cells were considered the lower limit to detect a mutation, samples with an insufficient tumor cell percentage (<20%) would have been estimated to contain enough tumor cells in 27/72 (38%) observations, possibly causing false negative results. In conclusion, estimates of tumor cell percentages on H&E-stained slides are not accurate, which could result in misinterpretation of test results. Reliability could possibly be improved by using a training set with feedback.

  19. The expanding role of pathologists in the diagnosis and management of breast cancer: Worldwide Excellence in Breast Pathology Program.

    PubMed

    Masood, Shahla

    2003-01-01

    Pathology is the study of human illness and it involves the morphologic and biologic recognition of abnormalities that are associated with a disease. Breast pathology represents an excellent example of this discipline. By providing diagnostic information and by characterizing the biologic behavior of a breast lesion, a pathologist plays a critical role in a patient's life. Any mistake in this exercise is associated with serious consequences. In addition, there are many unresolved issues in breast pathology, which contribute to our limited understanding of the biology of breast cancer, variability in diagnostic criteria, and significant diversity in breast cancer management and therapy. Furthermore, breast pathology has remained an underrecognized discipline, and its importance in diagnosis and disease management is not fully realized. In order to better serve our patients, particularly medically underserved women and those living in countries with limited resources, we must place emphasis on effectively using the talent and expertise of pathologists around the globe. For example, to provide a cost-effective way to diagnose breast cancer, particularly at advanced stages, pathologists can sample lesions by fine-needle aspiration biopsy (FNAB), stain the resulting smears, and provide an immediate bedside diagnosis. This is a valid contribution; however, this exercise requires the availability of a pathologist with experience in breast cytopathology. Alternatively the pathologist may seek consultations from more experienced pathologists. Developing strategies to better recognize the importance of high-quality breast pathology services and to train qualified and innovative breast pathologists is an ambitious task. The proposed Worldwide Excellence in Breast Pathology Program may provide such an opportunity.

  20. [Close teamwork between pathologist and surgeon can improve results in colorectal cancer treatment].

    PubMed

    West, Nicholas P; Quirke, Philip; Hagemann-Madsen, Rikke Hjarnø

    2011-04-04

    Colorectal cancer is common in the Western world and is a leading cause of cancer related mortality. The introduction of multidisciplinary teams and focus on quality control has led to improved outcomes in which pathologists play a central role through feedback to surgeons, radiologists, and oncologists. This review focuses on the importance of pathological examination of the resection specimen and subsequent feedback to the surgical team regarding quality. Specific markers of oncological quality including grading the plane of surgery, tissue morphometry and lymph node yields are discussed.

  1. Analysis of prosthetic cardiac devices: a guide for the practising pathologist

    PubMed Central

    Butany, J; Collins, M J

    2005-01-01

    Pathologists all over the world increasingly encounter prosthetic cardiac devices. A good evaluation of these devices is a valuable source of information, which can contribute to patient care and the appreciation and understanding of the pathobiology involved in the changes occurring between the host and the implanted prosthetic device. This article summarises the considerations underlying the analysis of prosthetic devices (particularly prosthetic heart valves), including the identification of the devices, the major morphological features of the devices, their modes of failure, and some technical details about evaluation and pitfalls. PMID:15677529

  2. The forensic entomologist in the context of the forensic pathologist's role.

    PubMed

    Campobasso, C P; Introna, F

    2001-08-15

    An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts

  3. Medicolegal aspects of the Thai Airbus crash near Kathmandu, Nepal: findings of the investigating pathologists.

    PubMed

    Fernando, R; Vanezis, P

    1998-06-01

    A Thai Airbus, carrying 99 passengers and 14 crew members, traveling from Bangkok to Kathmandu, hit a mountain and crashed several minutes before landing. There were no survivors. Recovered human remains, none of which was easily identifiable, varied in size from a small piece of muscle to mutilated bodies. Of the 97 fragments, only 15 were sufficiently intact (albeit, only partially) to be designated as "bodies." Of the fragments and "bodies," only 11 were positively identified. Causes of death, although all traumatic, could not be stated accurately due to the degree of disintegration. Identification of human remains in these circumstances is a major problem for the pathologist.

  4. The speech-language pathologist's role in a writing lab approach.

    PubMed

    Nelson, N W; Van Meter, A M; Chamberlain, D; Bahr, C M

    2001-08-01

    In a writing lab approach, speech-language pathologists (SLPs) work on collaborative teams with general and special educators to foster language growth using inclusive, curriculum-based, computer-supported writing process instruction. By engaging students in authentic writing projects using recursive writing processes--planning, organizing, drafting, revising, editing, publishing, presenting--and supporting them with instructional scaffolding, peer feedback, and computers, SLPs can address individualized needs while achieving goals of the general education curriculum. Case examples illustrate how intervention can be designed to meet the needs of students with diverse disabilities to interact socially and progress academically within the general education curriculum.

  5. Accreditation of Individualized Quality Control Plans by the College of American Pathologists.

    PubMed

    Hoeltge, Gerald A

    2017-03-01

    The Laboratory Accreditation Program of the College of American Pathologists (CAP) began in 2015 to allow accredited laboratories to devise their own strategies for quality control of laboratory testing. Participants now have the option to implement individualized quality control plans (IQCPs). Only nonwaived testing that features an internal control (built-in, electronic, or procedural) is eligible for IQCP accreditation. The accreditation checklists that detail the requirements have been peer-reviewed by content experts on CAP's scientific resource committees and by a panel of accreditation participants. Training and communication have been key to the successful introduction of the new IQCP requirements.

  6. The responsibilities of speech-language pathologists toward children with ADHD.

    PubMed

    Heyer, J L

    1995-11-01

    The speech-language pathologist has the skills needed to be an active participant in both the diagnostic and intervention phases of the treatment of children with ADHD. Many of the behaviors that define ADHD are directly linked to communication. Westby and Cutler (1994) assert that "the strong association between language disorders and ADHD suggests the possibility of a common antecedent to both disorders, perhaps a temperamental or neurological characteristic linked to deficits in behavioral regulation" (p. 61). Although the speech-language pathologist may not have the security of standardized test scores to support his or her diagnosis, behaviors that cannot be tested (e.g., pragmatics and social interactions) may be keys to a child's classroom difficulties. As discussed, many of the criteria found in the DSM-IV diagnostic criteria for ADHD are characteristics of pragmatic skills. Supported by Barkley's (1993) new theory of ADHD which is based on poor response inhibition or inability to delay responses, the speech-language pathologist can be an important resource to both the teacher and parents by helping them understand the behaviors exhibited by an ADHD child. The impulsivity that is so disruptive in the classroom is directly linked to the inability to delay responses. It is agreed that continued research into the behavioral characteristics associated with ADHD as well as their long-term implications for learning is needed. ADHD is a multifaceted developmental disorder. There is no known cure for ADHD, and we are dependent on early diagnosis and ongoing intervention to reduce its lifelong effects. Effective treatment must be multi-modal and involve the coordination of a professional team as well as the child's family. It is vital that we help children with ADHD develop positive self-esteem, effective social skills, and good pragmatic language skills that will eventually have a positive impact on their functioning in all aspects of their interactions with their

  7. [IgG4-associated diseases : Essentials for pathologists and radiologists].

    PubMed

    Tannapfel, A

    2016-12-01

    Immunoglobulin G4-associated (IgG4) autoimmune diseases are systemic multiorgan diseases with variable clinical presentation. Principally, all organs can be affected. All IgG4-associated diseases have the same morphological correlate in common, which includes lymphoplasmacellular inflammation with abundant IgG4-positive plasma cells, obliterative phlebitis and storiform fibrosis, each with a variable manifestation. The exact pathogenesis is not yet completely understood; however, as in most cases glucocorticoids induce a prompt clinical response to therapy, this new multisystemic disease must be taken into consideration not only by pathologists but also by radiologists.

  8. The role of the toxicologic pathologist in the post-genomic era(#).

    PubMed

    Maronpot, Robert R

    2013-06-01

    An era can be defined as a period in time identified by distinctive character, events, or practices. We are now in the genomic era. The pre-genomic era: There was a pre-genomic era. It started many years ago with novel and seminal animal experiments, primarily directed at studying cancer. It is marked by the development of the two-year rodent cancer bioassay and the ultimate realization that alternative approaches and short-term animal models were needed to replace this resource-intensive and time-consuming method for predicting human health risk. Many alternatives approaches and short-term animal models were proposed and tried but, to date, none have completely replaced our dependence upon the two-year rodent bioassay. However, the alternative approaches and models themselves have made tangible contributions to basic research, clinical medicine and to our understanding of cancer and they remain useful tools to address hypothesis-driven research questions. The pre-genomic era was a time when toxicologic pathologists played a major role in drug development, evaluating the cancer bioassay and the associated dose-setting toxicity studies, and exploring the utility of proposed alternative animal models. It was a time when there was shortage of qualified toxicologic pathologists. The genomic era: We are in the genomic era. It is a time when the genetic underpinnings of normal biological and pathologic processes are being discovered and documented. It is a time for sequencing entire genomes and deliberately silencing relevant segments of the mouse genome to see what each segment controls and if that silencing leads to increased susceptibility to disease. What remains to be charted in this genomic era is the complex interaction of genes, gene segments, post-translational modifications of encoded proteins, and environmental factors that affect genomic expression. In this current genomic era, the toxicologic pathologist has had to make room for a growing population of

  9. Overall welfare assessment of laying hens: comparing science-based, environment-based and animal-based assessments.

    PubMed

    Shimmura, Tsuyoshi; Bracke, Marc B M; De Mol, Rudi M; Hirahara, Satoshi; Uetake, Katsuji; Tanaka, Toshio

    2011-02-01

    To increase the validity of evaluations and facilitate expansion and maintenance of assessment systems, we constructed a database of studies on the welfare of laying hens around the world. On the basis of this database, we devised a science-based welfare assessment model. Our model includes measurements, levels and weightings based on the scientific studies in the database, and can clarify the advantages and disadvantages of housing systems for laying hens from the viewpoint of the five freedoms. We also evaluated the usefulness of our model by comparing it with environment-based Animal Needs Index (ANI), another science-based model called FOWEL, and animal-based measurements. Our model showed that freedom from injury, pain and disease, and freedom from discomfort were more secure in the cage system, while non-cage systems scored better for natural behavior and freedom from fear and distress. A significant strong-positive correlation was found between the animal-based assessment and the total scores of ANI (rs = 0.94, P < 0.05), FOWEL (rs = 0.99, P < 0.05) or our model (rs = 0.99, P < 0.05), which indicate that these different approaches to welfare assessment may be used almost interchangeably to 'measure' a common property ('overall laying hen welfare'). However, assessments using our model and FOWEL were more sensitive than ANI and can be applied to cage systems, which suggest that our model and FOWEL may have added value. © 2011 The Authors. Journal compilation © 2011 Japanese Society of Animal Science.

  10. What Makes the Finnish Different in Science? Assessing and Comparing Students' Science Learning in Three Countries

    NASA Astrophysics Data System (ADS)

    Geller, Cornelia; Neumann, Knut; Boone, William J.; Fischer, Hans E.

    2014-12-01

    This manuscript details our efforts to assess and compare students' learning about electricity in three countries. As our world is increasingly driven by technological advancements, the education of future citizens in science becomes one important resource for economic productivity. Not surprisingly international large-scale assessments are viewed as significant sources of information about the effectiveness of science education. However, these assessments do not provide information about the reasons for particular effectiveness-or more importantly a lack thereof-as these assessments are based on one-time measurements of student achievement. In order to identify reasons for the effectiveness of science education, it is necessary to investigate students' learning as a result of science instruction. In this manuscript we report about the development of an instrument to assess students' learning in the field of electricity and the use of this instrument to collect data from N = 2,193 middle school students in Finland, Germany and Switzerland prior to and after instruction on the topic of electricity. Our findings indicate that the differences in students' science achievement as observed in large-scale assessments are a result of differences in students' science learning. And our findings suggest that these differences are more likely to stem from differences in science instruction than from systemic differences: a result that needs to be further explored by analyzing instruction in the three countries and its effect on students' learning.

  11. The empirical and methodological comparative value of the rapid assessment of drug use patterns.

    PubMed

    Power

    2000-03-01

    This paper examines the comparative value of rapid assessment in the field of illicit drug use. Three aims of rapid assessment are highlighted: one, to collect quality data to inform policy and practice; two, to encourage a multi-method research approach; and three, to promote and support greater local involvement and ownership of the project itself. A number of manuals and guidelines have been produced for rapid assessment. A key issue to address, therefore, is the extent to which a structured and standardised approach can provide sufficient flexibility to take into account the political, social and cultural differences in the respective countries in which assessment takes place. Using the empirical experience derived from four rapid assessment projects, a four-phase strategy is outlined: developing infrastructure and formative evaluation; research training and mapping exercises; data collection; and report writing and dissemination. In place of the current reactive approach, we need more strategic thinking at the macro-level. To enable comparison between projects we should move towards basic methodological standardisation, but this should be accomplished without stifling the sociological imagination, which is a crucial ingredient to successful rapid assessment.

  12. Early-stage comparative sustainability assessment of new bio-based processes.

    PubMed

    Patel, Akshay D; Meesters, Koen; den Uil, Herman; de Jong, Ed; Worrell, Ernst; Patel, Martin K

    2013-09-01

    Our increasing demand for materials and energy has put critical roadblocks on our path towards a sustainable society. To remove these roadblocks, it is important to engage in smart research and development (R&D). We present an early-stage sustainability assessment framework that is used to analyze eight new bio-based process alternatives developed within the CatchBio research consortium in the Netherlands. This assessment relies on a multi-criteria approach, integrating the performance of chemical conversions based on five indicators into an index value. These indicators encompass economics, environmental impact, hazards and risks thereby incorporating elements of green chemistry principles, and techno-economic and life cycle assessments. The analyzed bio-based options target the production of fuels and chemicals through chemical catalysis. For each bio-based process, two R&D stages (current laboratory and expected future) are assessed against a comparable conventional process. The multi-criteria assessment in combination with the uncertainty and scenario analysis shows that the chemical production processes using biomass as feedstock can provide potential sustainability benefits over conventional alternatives. However, further development is necessary to realize the potential benefits from biomass gasification and pyrolysis processes for fuel production. This early stage assessment is intended as an input for R&D decision making to support optimal allocation and utilization of resources to further develop promising bio-based processes. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

    PubMed

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  14. Life cycle assessment to compare the environmental impact of seven contemporary food waste management systems.

    PubMed

    Edwards, Joel; Othman, Maazuza; Crossin, Enda; Burn, Stewart

    2017-06-16

    Municipal food waste (FW) represents 35-45% of household residual waste in Australia, with the nation generating 1.6Tg annually. It is estimated that 91% of this FW ends up in landfill. This study used life cycle assessment to determine and compare the environmental impact of seven contemporary FW management systems for two real-life jurisdictions; incorporating the complete waste service and expanding the system to include inert and garden waste. Although, no system exhibited a best ranking across all impact categories, FW digestion based systems were all revealed to have a lower global warming potential than composting and landfilling systems. Mechanical biological treatment, anaerobic co-digestion, and home composting all demonstrated the lowest environmental impacts for two or more of the environmental impact categories assessed. The assessment included market and technological specific variables and uncertainties providing a framework for robust decision making at a municipality level. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Assessing the Goodness of Fit of Phylogenetic Comparative Methods: A Meta-Analysis and Simulation Study

    PubMed Central

    Jhwueng, Dwueng-Chwuan

    2013-01-01

    Background Phylogenetic comparative methods (PCMs) have been applied widely in analyzing data from related species but their fit to data is rarely assessed. Question Can one determine whether any particular comparative method is typically more appropriate than others by examining comparative data sets? Data I conducted a meta-analysis of 122 phylogenetic data sets found by searching all papers in JEB, Blackwell Synergy and JSTOR published in 2002–2005 for the purpose of assessing the fit of PCMs. The number of species in these data sets ranged from 9 to 117. Analysis Method I used the Akaike information criterion to compare PCMs, and then fit PCMs to bivariate data sets through REML analysis. Correlation estimates between two traits and bootstrapped confidence intervals of correlations from each model were also compared. Conclusions For phylogenies of less than one hundred taxa, the Independent Contrast method and the independent, non-phylogenetic models provide the best fit.For bivariate analysis, correlations from different PCMs are qualitatively similar so that actual correlations from real data seem to be robust to the PCM chosen for the analysis. Therefore, researchers might apply the PCM they believe best describes the evolutionary mechanisms underlying their data. PMID:23826183

  16. Assessing the Goodness of Fit of Phylogenetic Comparative Methods: A Meta-Analysis and Simulation Study.

    PubMed

    Jhwueng, Dwueng-Chwuan

    2013-01-01

    Phylogenetic comparative methods (PCMs) have been applied widely in analyzing data from related species but their fit to data is rarely assessed. Can one determine whether any particular comparative method is typically more appropriate than others by examining comparative data sets? I conducted a meta-analysis of 122 phylogenetic data sets found by searching all papers in JEB, Blackwell Synergy and JSTOR published in 2002-2005 for the purpose of assessing the fit of PCMs. The number of species in these data sets ranged from 9 to 117. I used the Akaike information criterion to compare PCMs, and then fit PCMs to bivariate data sets through REML analysis. Correlation estimates between two traits and bootstrapped confidence intervals of correlations from each model were also compared. For phylogenies of less than one hundred taxa, the Independent Contrast method and the independent, non-phylogenetic models provide the best fit.For bivariate analysis, correlations from different PCMs are qualitatively similar so that actual correlations from real data seem to be robust to the PCM chosen for the analysis. Therefore, researchers might apply the PCM they believe best describes the evolutionary mechanisms underlying their data.

  17. Selection of alternative central-station technologies for the Satellite Power System (SPS) comparative assessment

    NASA Technical Reports Server (NTRS)

    Samsa, M.

    1980-01-01

    An important effort is the Satellite Power System (SPS) comparative Assessment is the selection and characterization of alternative technologies to be compared with the SPS concept. The ground rules, criteria, and screening procedure applied in the selection of those alternative technologies are summarized. The final set of central station alternatives selected for comparison with the SPS concept includes: (1) light water reactor with improved fuel utilization, (2) conventional coal combustion with improved environmental controls, (3) open cycle gas turbine with integral low Btu gasifier, (4) terrestrial photovoltaic, (5) liquid metal fast breeder reactor, and (6) magnetic confinement fusion.

  18. Comparative Risk Assessment of Formulation Changes in Generic Drug Products: A Pharmacology/Toxicology Perspective.

    PubMed

    Rayavarapu, Sree; Braithwaite, Elena; Dorsam, Robert; Osterhout, James; Furlong, Lesley-Anne; Shetty, Daiva; Peters, John R

    2015-07-01

    This review highlights general toxicology concerns caused by formulation differences between generic and innovator drugs. It underscores the importance of a scientific, clinically oriented, evidence-based comparative safety evaluation procedure for generic drugs and discusses representative case studies from a pharmacology-toxicology perspective. For consideration by generic drug industry stakeholders, this article provides an overview of comparative risk assessments for generic drug products. Published by Oxford University Press on behalf of the Society of Toxicology 2015. This work is written by US Government employees and is in the public domain in the US.

  19. Red blood cell transfusion practices: a College of American Pathologists Q-Probes study of compliance with audit criteria in 128 hospitals.

    PubMed

    Ramsey, Glenn; Wagar, Elizabeth A; Grimm, Erin E; Friedberg, Richard C; Souers, Rhona J; Lehman, Christopher M

    2015-03-01

    Most information on compliance with audit criteria for red blood cell (RBC) transfusions comes from single institutions; few studies have compared practices among many hospitals. To survey a cross-section of hospitals in 2008 for criteria and compliance with RBC transfusion guidelines, using the College of American Pathologists Q-Probes format. One hundred twenty-eight hospitals, representing about 4.5% (724,332 of 16,212,000) of all annual RBC usage in the United States, provided information on their RBC audit practices and their recent rates of compliance. They also each examined 50 RBC transfusion episodes for compliance with their guidelines. The participants' median, pretransfusion hemoglobin thresholds for audit review were 8.0 to 8.9 g/dL for most clinical settings and 9.0 to 9.9 g/dL for patients with underlying cardiopulmonary disease. For the transfusion episodes examined, 60% (2063 of 6518) were for a single unit. The median of the institutional averages for pretransfusion hemoglobin was 8.1 g/dL, and the median rate of compliance was 69% (range, 0%-100%). Involvement by a pathologist or transfusion medicine expert in the audit system was associated with more-strict audit criteria and better compliance. Median hemoglobin thresholds for RBC transfusion audits were somewhat higher than currently evolving recommendations, but opportunities for improvement were provided by expert involvement and by the growing frequency of 1-unit transfusions.

  20. Comparative risk assessment of the burden of disease from climate change.

    PubMed

    Campbell-Lendrum, Diarmid; Woodruff, Rosalie

    2006-12-01

    The World Health Organization has developed standardized comparative risk assessment methods for estimating aggregate disease burdens attributable to different risk factors. These have been applied to existing and new models for a range of climate-sensitive diseases in order to estimate the effect of global climate change on current disease burdens and likely proportional changes in the future. The comparative risk assessment approach has been used to assess the health consequences of climate change worldwide, to inform decisions on mitigating greenhouse gas emissions, and in a regional assessment of the Oceania region in the Pacific Ocean to provide more location-specific information relevant to local mitigation and adaptation decisions. The approach places climate change within the same criteria for epidemiologic assessment as other health risks and accounts for the size of the burden of climate-sensitive diseases rather than just proportional change, which highlights the importance of small proportional changes in diseases such as diarrhea and malnutrition that cause a large burden. These exercises help clarify important knowledge gaps such as a relatively poor understanding of the role of nonclimatic factors (socioeconomic and other) that may modify future climatic influences and a lack of empiric evidence and methods for quantifying more complex climate-health relationships, which consequently are often excluded from consideration. These exercises highlight the need for risk assessment frameworks that make the best use of traditional epidemiologic methods and that also fully consider the specific characteristics of climate change. These include the longterm and uncertain nature of the exposure and the effects on multiple physical and biotic systems that have the potential for diverse and widespread effects, including high-impact events.