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Sample records for prospective audit comparing

  1. How we do it: coblation tonsillectomy complication rates from a single ENT department compared with the National Prospective Tonsillectomy Audit.

    PubMed

    Clark, M P A; Smithard, A; Jervis, P

    2006-04-01

    Coblation tonsillectomy is a relatively new technique, the results of which need auditing within practising units, to justify its continued usage. * The National Prospective Tonsillectomy Audit provides an excellent source of data for individual units to compare their results to. * This retrospective audit of 391 coblation tonsillectomies shows that our units haemorrhage and return to theatre rates are similar to the National rates for cold steel & ties data. * Resolution of training issues and patient selection may lead to increased use of this technique.

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

    ERIC Educational Resources Information Center

    Gray, Dahli

    2008-01-01

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

  3. Prospective memory: A comparative perspective

    PubMed Central

    Crystal, Jonathon D.; Wilson, A. George

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

  5. Antimicrobial stewardship: a review of prospective audit and feedback systems and an objective evaluation of outcomes.

    PubMed

    Chung, Gladys W; Wu, Jia En; Yeo, Chay Leng; Chan, Douglas; Hsu, Li Yang

    2013-02-15

    Antimicrobial stewardship is an emerging field currently defined by a series of strategies and interventions aimed toward improving appropriate prescription of antibiotics in humans in all healthcare settings. The ultimate goal is the preservation of current and future antibiotics against the threat of antimicrobial resistance, although improving patient safety and reducing healthcare costs are important concurrent aims. Prospective audit and feedback interventions are probably the most widely practiced of all antimicrobial stewardship strategies. Although labor-intensive, they are more easily accepted by physicians compared with formulary restriction and preauthorization strategies and have a higher potential for educational opportunities. Objective evaluation of antimicrobial stewardship is critical for determining the success of such programs. Nonetheless, there is controversy over which outcomes to measure and there is a pressing need for novel study designs that can objectively assess antimicrobial stewardship interventions despite the limitations inherent in the structure of most such programs.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2008-12-01

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

  10. Surgical audit: A prospective study of the morbidity and mortality of acute appendicitis.

    PubMed

    Malatani, T S; Latif, A A; Al-Saigh, A; Cheema, M A; Abu-Eshy, S

    1991-03-01

    Between March and September 1989, acute apendicitis was clinically diagnosed in 317 patients who were studied as part of a prospective surgical audit. The study was designed to determine the accuracy of diagnosis, comparison of the macroscopic appearance of the appendix at operation, and subsequent histopathology and complications associated with the morbidity and mortality of emergency appendectomy. The clinical diagnosis was correct in 278 patients (88%). Thirty-nine (12%) of the patients had a negative laparotomy. There was no mortality, and wound infection was the source of increased morbidity in 37 (12%) patients. The highest incidence of wound infection was among those who had pus in the peritoneum (20%) or had a perforated or gangrenous appendix (25%). When the macroscopic appearance of the appendix was compared with the subsequent histopathological findings, a false positive error of 7% and a false negative error of 42% was found. During appendectomy the gross appearance of the appendix must be carefully noted so that a meticulous surgical technique can be complemented by appropriate antibiotic prophylaxis against wound infection, started at the time of surgery.

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

    PubMed Central

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

    2016-01-01

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

  12. Supracostal percutaneous nephrolithotomy: A prospective comparative study

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    Gonzalez, R; McGovern, M; Greener, A

    2015-01-01

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

  14. Physical and quality of life outcomes of patients with isolated hand burns--a prospective audit.

    PubMed

    Williams, Nicola; Stiller, Kathy; Greenwood, John; Calvert, Philip; Masters, Margot; Kavanagh, Sheila

    2012-01-01

    Hand burns can have major implications on function, appearance, and quality of life. Our clinical practice has changed over the last 10 years, with a steady increase in the proportion of hand burns receiving early and aggressive surgical management using Biobrane® sheets/gloves and a concomitant fall in the proportion requiring excision and split skin grafting. The aim of this study was to measure a comprehensive range of outcomes for patients admitted with isolated hand burns to review our outcomes and provide us with the "expected" patterns of recovery. A prospective audit was performed over a 14-month period, with outcomes measured during hospital admission and at 2 weeks, 1, 3, 6, and 12 months postinjury (depending on the method of management). Outcomes comprised pain, the Burns Specific Health Scale (abbreviated version B), return to work/leisure, total active range of motion, grip strength, the Michigan Hand Questionnaire, and scar appearance using Matching Assessment with Photographs of Scars. A total of 52 patients (35 male, mean age 39 years) with 57 burned hands participated. Patients whose burn injuries were such that they were able to be managed conservatively or with Biobrane® showed rapid recovery in all outcomes, with normal or near-normal values achieved within 2 weeks to 1 month postinjury. The patients whose burn injuries required excision and split skin grafting demonstrated more marked initial deterioration, a slower rate of improvement, but eventual good recovery. In conclusion, for this sample of patients with isolated hand burns, recovery was good and rapid for those whose burn injuries were such that they were managed conservatively or with Biobrane®.

  15. HSE auditing

    SciTech Connect

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

    1996-12-31

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

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

    PubMed

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

    2015-12-01

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

  17. Safety Auditing and Assessments

    NASA Technical Reports Server (NTRS)

    Goodin, James Ronald (Ronnie)

    2005-01-01

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

  18. A prospective audit of complications in 100 consecutive pediatric percutaneous renal biopsies done under real-time ultrasound guidance

    PubMed Central

    Sinha, R.; Maji, B.; Sarkar, B.; Meur, S.

    2016-01-01

    Despite being a common procedure, percutaneous renal biopsy (PRB) carries the potential for complications. The British Association of Paediatric Nephrologist (BAPN) has published standards for pediatric PRB. As Indian data are scarce, we conducted a prospective audit of 100 consecutive pediatric renal biopsies (60% males) under real-time ultrasound guidance. Nephrotic syndrome was the most common indication for PRB (68%) with minimal change disease (30%) and focal segmental glomerulosclerosis (25%) being the most common histopathological lesions. Gross hematuria was observed in six cases. Major complications was noted in one case, who needed longer hospital stay. The result of the audit demonstrated achievability of BAPN standards. In addition, we also show the usefulness of 16 gauge biopsy needle over 18 gauge biopsy needles (median number of glomeruli 25, range 3–90 vs 13, range 6–46, P = 0.001) without any increase in complications. Being a single center study, we do hope that our results will encourage a wider survey on the current state of pediatric PRB. PMID:27795625

  19. Sea lice monitoring on Atlantic salmon farms in New Brunswick, Canada: comparing audit and farm staff counts.

    PubMed

    Elmoslemany, A; Whyte, S K; Revie, C W; Hammell, K L

    2013-03-01

    Sea lice audits were performed by the Atlantic Veterinary College on commercial aquaculture sites in New Brunswick, Canada, in 2011. Although the primary objective was to verify that farms were reporting similar lice counts to third-party counts, more detailed comparisons were made to identify when lice counts were more likely to differ between the audit team and farm employees. A total of 28 sea lice audits were conducted on 16 sites between June and December 2011. During each audit, 10 cages were evaluated per site where possible, with ten fish per cage being evaluated by an audit technician and a further ten by a farm employee. Data analysis included descriptive statistics of lice counts by stage and limits of agreement plots. A random effects negative binomial model that accounted for clustering of cages within sites was applied to assess the effect of counter type and season on lice counts by stage. The results indicate that farms counts were generally in agreement with audit counts. However, when the average counts for chalimus and preadult (male and female) and adult male lice stages were high, farm counters were more likely to report a lower value. Higher lice counts were observed during autumn compared to summer especially for the adult female stage. Finally, there was a significant clustering effect for site and cage, with most of the variation attributable to site.

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Dozier, David M.; Hellweg, Susan A.

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

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

    PubMed

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

    2016-07-01

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

  3. An audit of paediatric audits.

    PubMed

    John, C M; Mathew, D E; Gnanalingham, M G

    2004-12-01

    An audit of audits at a children's hospital over a six year period showed that 27.8% fulfilled the criteria for a full audit and 22.2% were re-audited. It is recommended that newcomers to audit are given training on audit methodology and that all audit departments should audit their audits annually.

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

    PubMed

    Urbancic, F R; Hauser, R C

    1991-01-01

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

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

    PubMed Central

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

    2003-01-01

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

  6. National comparative audit of the use of platelet transfusions in the UK.

    PubMed

    Qureshi, H; Lowe, D; Dobson, P; Grant-Casey, J; Parris, E; Dalton, D; Hickling, K; Waller, F; Howell, C; Murphy, M F

    2007-12-01

    The objective of this national audit was to examine the use of platelet transfusions against audit standards developed from national guidelines. Hospitals were asked to provide data on 40 consecutive patients receiving platelet transfusions (15 haematology patients, 10 cardiac, 10 critical care and five in other clinical specialties). One hundred and eighty-seven UK hospitals participated, including 168/263 (64%) hospitals in England. A total of 4421 patients receiving platelet transfusions were audited. The reason for transfusion was documented in the medical records for 93% of transfusions and 57% were used for prophylaxis (in the absence of bleeding). Overall 3726/4421 (84%) of the transfusions were evaluable and 43% (1601/3726) were found to be non-compliant with the audit standards. A major non-compliance was failure to measure the platelet count before transfusion (29% of transfusions). Other non-compliances included the use of platelet transfusion in the absence of bleeding in 11% of cardiac surgery patients receiving platelet transfusions, the use of a threshold platelet count more than 10 x 10(9)/L for 60% of prophylactic platelet transfusions in haematology patients without risk factors indicating the need for a higher threshold, and a threshold platelet count more than 30 x 10(9)/L for 59% of prophylactic platelet transfusions in critical care. The reasons for the high rate of non-compliance were not explored in this audit, but this is a topic worthy of further study. The main recommendations were that hospitals should ensure there are written local guidelines for platelet transfusions, clinicians must be provided with training about their appropriate use, and hospitals should carry out regular audits of practice. More research should be carried out to develop the evidence base for the use of platelet transfusions, more detailed guidelines should be developed for platelet transfusions in critical care and cardiac surgery, and the audit should be repeated

  7. Offenders with Intellectual Disability: A Prospective Comparative Study

    ERIC Educational Resources Information Center

    Barron, P.; Hassiotis, A.; Banes, J.

    2004-01-01

    Intellectually disabled offenders (IDO) are a poorly served and under-recognized group, who are likely to require long-term specialist treatments and interventions. Method This prospective study investigated the characteristics and factors that influence outcome in this group, with particular reference to therapeutic interventions. Sixty-one…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Implementation of a pharmacist-led antimicrobial management team in a community teaching hospital: use of pharmacy residents and pharmacy students in a prospective audit and feedback approach.

    PubMed

    Laible, Brad R; Nazir, Jawad; Assimacopoulos, Aris P; Schut, Jennifer

    2010-12-01

    Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist. Due to limited resources, our institution chose to implement a pharmacist-led antimicrobial stewardship service on 1 medical/surgical ward, with the existing clinical pharmacist and 3 infectious disease physicians as core members. This clinical pharmacist was not trained in infectious disease specialty, and stewardship activities were only one part of his daily activities. Pharmacy residents and students were extensively utilized to assist in the stewardship process. Approximately two thirds of stewardship recommendations were accepted using primarily a prospective audit and feedback approach.

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

    PubMed Central

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

    2016-01-01

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

  11. Assessing Walking and Cycling Environments in the Streets of Madrid: Comparing On-Field and Virtual Audits.

    PubMed

    Gullón, Pedro; Badland, Hannah M; Alfayate, Silvia; Bilal, Usama; Escobar, Francisco; Cebrecos, Alba; Diez, Julia; Franco, Manuel

    2015-10-01

    Audit tools are useful for exploring the urban environment and its association with physical activity. Virtual auditing options are becoming increasingly available potentially reducing the resources needed to conduct these assessments. Only a few studies have explored the use of virtual audit tools. Our objective is to test if the Madrid Systematic Pedestrian and Cycling Environment Scan (M-SPACES) discriminates between areas with different urban forms and to validate virtual street auditing using M-SPACES. Three areas (N = 500 street segments) were selected for variation in population density. M-SPACES was used to audit street segments physically and virtually (Google Street View) by two researchers in 2013-2014. For both physical and virtual audits, all analyzed features score significantly different by area (p < 0.05). Most of the features showed substantial (ICC = 0.6-0.8) or almost perfect (ICC ≥ 0.8) agreement between virtual and physical audits, especially neighborhood permeability walking infrastructure, traffic safety, streetscape aesthetics, and destinations. Intra-rater agreement was generally acceptable (ICC > 0.6). Inter-rater agreement was generally poor (ICC < 0.4). Virtual auditing provides a valid and feasible way of measuring residential urban environments. Comprehensive auditor training may be needed to guarantee good inter-rater agreement. PMID:26349472

  12. The long-term effects of training interventions on transfusion practice: a follow-up audit of red cell concentrate utilisation at Kimberley Hospital, South Africa.

    PubMed

    Joubert, Jaco; Joubert, Sunette; Raubenheimer, Jacques; Louw, Vernon

    2014-12-01

    This audit in chronically anaemic adult patients assesses whether red cell concentrate is transfused according to guidelines, and evaluates the impact of training interventions, compared with a similar audit conducted in 2010. Retrospectively, 25 transfusion episodes were audited for appropriateness, the investigation of anaemia, threshold achievement, wastage, and informed consent. After training interventions, a further 25 episodes were prospectively analysed. The effects of current training interventions were not shown to have a statistically significant impact. Compared to a 2010 audit, however, a statistically significant improvement was demonstrated in transfusion practice, suggesting that training interventions may lead to sustainable long-term improvements.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2016-05-01

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

  16. 7 CFR 1739.20 - Audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... following paragraph, the recipient shall provide an independent audit report in accordance with 7 CFR part... Agency and all subsequent audits must be comparative audits as described in 7 CFR part 1773. (b) If the... AGRICULTURE BROADBAND GRANT PROGRAM Community Connect Grant Program § 1739.20 Audit requirements. A...

  17. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Audit standards. 571.12 Section 571.12 Indians NATIONAL... INVESTIGATIONS Audits § 571.12 Audit standards. (a) Each tribe shall prepare comparative financial statements... provide an annual audit of the financial statements of each class II and class III gaming operation on...

  18. Twenty-four hours or 10 days? A prospective randomised controlled trial in children comparing head bandages following pinnaplasty.

    PubMed

    Ramkumar, S; Narayanan, V; Laing, J H E

    2006-01-01

    The perceived benefits of bandaging for 10 days following pinnaplasty have been questioned by previous studies. The problems arising from these dressings are many [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bartley J. How long should ears be bandaged after otoplasty? J Laryngol Otol 1998;112:531-2. Wong MC, Sylaidis P. Head dressings for pinnaplasty: a tradition not supported by evidence. Br J Plast Surg 2001;54:81-2], including their slippage [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97-100. Jeffery SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588-90]. Eighty children were recruited into a prospective randomised controlled trial comparing the use of a head bandage for only 24 h with a standard practise of a 10-day head bandage. A preoperative measurement of the lateral ear projection (LEP) was made. The outcome measures recorded during the two planned postoperative visits at 10 days (visit 1) and 2 months (visit 2) were: patient satisfaction score, LEP, complications and any unscheduled hospital visits associated with the surgery. There was no significant difference in LEP and patient satisfaction between the two groups at both the scheduled postoperative visits. Differences between the groups in the number of unscheduled visits (p=0.21) did not reach statistical significance. The findings indicate that it is safe and effective to use head bandage for only 24 h following surgical correction of prominent ears. This study shows no benefit from the application of a formal head bandage for any longer than 1 day.

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

    ERIC Educational Resources Information Center

    O'Hare, Thomas

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  1. Internal auditing in hospitals.

    PubMed

    Edwards, Don; Kusel, Jim; Oxner, Tom

    2003-01-01

    The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.

  2. A Significant Reduction in Paediatric Post-Tonsillectomy Vomiting through Audit

    PubMed Central

    Bennett, AMD; Emery, PJ

    2008-01-01

    INTRODUCTION Postoperative vomiting occurs more frequently after tonsillectomy than any other commonly performed paediatric operation. Postoperative vomiting is also the commonest cause of morbidity and re-admission following tonsillectomy. We present a successful completed audit cycle and literature review on the subject. PATIENTS AND METHODS Data on the risk factors for postoperative vomiting, whether the patient vomited and details of the patient's vomitus were collected prospectively on consecutive patients and compared with a gold standard. Changes in practice were agreed and a second cycle performed. RESULTS Two cycles and a total of 107 patients were included in the audit. A significant reduction in vomiting from 27% to 11% was achieved following the introduction of routine use of intravenous dexamethasone during surgery. CONCLUSIONS This simple prospective audit of paediatric post-tonsillectomy vomiting has resulted in a statistically significant reduction in vomiting which would appear to be due to use of intra-operative steroids. PMID:18430338

  3. A Critical Evaluation of Academic Internal Audit

    ERIC Educational Resources Information Center

    Blackmore, Jacqueline Ann

    2004-01-01

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

  4. Does Postthyroidectomy Syndrome Really Exist Following Thyroidectomy? Prospective Comparative Analysis of Open vs. Endoscopic Thyroidectomy

    PubMed Central

    Park, Ki Nam; Mok, Ji Oh; Chung, Chan Hee

    2015-01-01

    Objectives This study prospectively evaluated postthyroidectomy syndrome (PTS) through objective and subjective voice changes following thyroidectomy of open vs. endoscopic thyroidectomy. Methods A prospective clinical trial (SCHBC IRB 09 26) was performed from Jan 2008 to Aug 2010 to compare the open thyroidectomy (OPEN group) and endoscopic thyroidectomy (ENDO group). Of the 110 patients, 75 completed the evaluation before and 1 and 6 months after surgery. Subjective parameters included perceptual analysis (GRBAS [grade, roughness, breathiness, asthenia, and strain] scale), stroboscopic or flexible fiberscopic analysis, voice handicap index, and 5-point visual analog scales for vocal fatigue, singing difficulty, difficulty with high-pitch phonation, and neck discomfort. Objective parameters included acoustic, aerodynamic analysis and the electroglottograph. Results For the ENDO group (n=36), the operation time was longer than in the OPEN group (n=39; P<0.01). For the OPEN group, two objective and five subjective parameters were worse 1 month postoperatively; of these, two subjective parameters persisted for 6 months (P<0.05). For the ENDO group, three objective and six subjective parameters were worse 1 month postoperatively, and three of the subjective parameters persisted 6 months postoperatively (P<0.05). Conclusion PTS really exists following simple thyroidectomy and are very common for both OPEN and ENDO groups. Most of the parameters improved gradually over time, but some subjective changes persisted 6 months postoperatively. PMID:25729500

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    SciTech Connect

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

    1984-06-01

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

  10. A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service.

    PubMed

    Madsen, A S; Laing, G L; Bruce, J L; Clarke, D L

    2016-09-01

    Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a 'significant cervical injury' was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed

  11. Scholastic Audits. Research Brief

    ERIC Educational Resources Information Center

    Walker, Karen

    2009-01-01

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

  12. Outpatient Myelography: A Prospective Trial Comparing Complications after Myelography between Outpatients and Inpatients in Japan

    PubMed Central

    Matsumoto, Tomohiro; Inoue, Hidenori; Aoki, Takaaki; Ishiguro, Naoki; Osawa, Yoshimitsu

    2015-01-01

    Study Design Prospective comparative study. Purpose To compare the incidence and severity of adverse reactions associated with myelography performed in outpatients vs. in inpatients and report the safety and usefulness of outpatient myelography in Japanese patients. Overview of Literature Myelography is normally performed as an inpatient procedure in most hospitals in Japan. No studies have reported the usefulness and adverse effects of outpatient myelography in Japanese patients. Methods We performed 221 myelography procedures. Eighty-five of the 221 patients underwent outpatient myelography using our new protocol. The incidence and severity of adverse reactions were compared with the other 136 patients, who underwent conventional inpatient myelography. We further compared the cost of outpatient and inpatient myelography. Results The overall rate of adverse effects was 9.4% in outpatients, as compared with 7.4% in inpatients. Overall, 1.2% of outpatients and 0.74% inpatients experienced "severe" adverse effects (requiring hospitalization). There were no significant differences between the 2 groups in either the overall rate of adverse effects or the rate of "severe" adverse effects. Moreover, the average outpatient procedure cost was only one-third to one-half that of the inpatient procedure. Conclusions This was the first study to address the safety and usefulness of outpatient myelography in Japanese patients. If selected according to proper inclusion criteria for outpatient procedure, no significant differences were observed in the adverse effects between inpatients and outpatients. The outpatient procedure is more economical and has the added benefit of being more convenient and time-efficient for the patient. PMID:26713127

  13. Glenoumeral dislocation: a prospective randomized study comparing spazo and kocher maneuvers

    PubMed Central

    Rezende, Bruno da Rocha Moreira; de Almeida, José Inácio; de Sousa, Uriel Jaime; Bomfim, Leônidas de Souza; Ferreira, Mário Soares

    2015-01-01

    OBJECTIVE: To evaluate and to compare the Spaso and Kocher reduction maneuvers in terms of efficiency, time of reduction, facileness, pain, discomfort to the patient, complications and risks, besides promoting the comparison between the two maneuvers, aiming to ground the emergency conduct. METHODS: A prospective study with 105 patients with acute shoulder dislocations were enrolled in the study between February 2011 and September 2012. The patients were randomized into two groups and they were submitted to the reduction of dislocation using the Spaso maneuver (group A) or the Kocher technique (group B) by first, second or third-year orthopedic surgery residents from our service. The results were evaluated and compared. RESULTS: There was no statistically significant difference between the two groups in terms of age, gender, timing of reduction, number of precedent episodes and complications after reduction. However, reduction was achieved in more cases using the Spaso method than it was among the Kocher group, as well as the mean duration of the reduction maneuver and discomfort were shorter in the group A patients. CONCLUSIONS: Both methods presented good results in terms of dislocation reduction and low complications rates. Nevertheless, the Spaso maneuver was more efficient, fast and easily applicable in comparison with Kocher's method. Level of Evidence I, Therapeutic. PMID:26327800

  14. DOUBLE-BLIND PROSPECTIVE RANDOMIZED STUDY COMPARING POLYETHYLENE GLYCOL TO LACTULOSE FOR BOWEL PREPARATION IN COLONOSCOPY

    PubMed Central

    MENACHO, Aline Moraes; REIMANN, Adriano; HIRATA, Lie Mara; GANZERELLA, Caroline; IVANO, Flavio Heuta; SUGISAWA, Ricardo

    2014-01-01

    Background Colonoscopy is the most frequent exam used to evaluate colonic mucosa, allowing the diagnosis and treatment of many diseases. The appropriate bowel preparation is indispensable for the realization of colonoscopy. Therefore, it is necessary the use of laxative medications, preferentially by oral administration. Aim To compare two medications used in bowel preparation in adult patients going to ambulatory colonoscopy and to analyze the patients' profile. Methods A double-blind prospective study with 200 patients, randomized in two groups: one that received polyethilene glycol and another that received lactulose. The patients answered to questionnaires to data compilation, as tolerance, symptoms and complications related to preparation. Besides, it was also evaluated the prepare efficacy related to the presence of fecal residue. Results Intestinal habit alterations and abdominal pain were the main reasons to realize the exams and hypertension was the most prevalent comorbidity. Ten percent of the ones who received lactulose didn't get to finish the preparation and 50% considered the taste "bad, but tolerable". The most common subjective symptom after the medication was nausea, especially after lactulose. During the exam, most of the patients who used lactulose had a "light discomfort" and the ones who used polyethilene glycol considered the discomfort as "tolerable". The quality of the preparation was good in 75%, undependable of the medication that was used. Conclusion Polyethilene glycol was more tolerable when compared to lactulose, without difference on the quality of the preparation. PMID:24676290

  15. Prospects of Comparing Van Allen Probes Data with Recent Nonlinear Radiation Belt Theory

    NASA Astrophysics Data System (ADS)

    Summers, D.; Omura, Y.; Tang, R.

    2013-12-01

    We consider the prospects of comparing recently developed theory and simulations of nonlinear wave processes with Van Allen Probes observational data. Electron gyro-resonant interaction with whistler-mode chorus waves is considered to be a prime mechanism for generating relativistic electrons in Earth's outer radiation belt. Resonant pitch angle scattering by chorus can also cause significant electron precipitation loss from the inner magnetosphere. Whistler-mode waves can as well act to suppress radiation belt electron fluxes below a theoretical (Kennel-Petschek) limit. Nonlinear cyclotron resonance theory is required to analyze the nonlinear characteristics of whistler-mode wave generation and the interaction of chorus with radiation belt electrons. We discuss recently developed nonlinear theory that involves wave trapping of resonant electrons near the equator and the formation of an electron hole in the phase space. The resulting formation of a resonant current causes nonlinear growth of a wave with rising frequency. Nonlinear wave trapping plays a significant role in both the generation of whistler-mode chorus emissions and the acceleration of radiation belt electrons to relativistic energies. A fraction of radiation belt electrons can be energized extremely efficiently by special wave trapping mechanisms called "relativistic turning acceleration" and "ultra-relativistic acceleration". In this presentation we summarize the salient features of whistler-mode wave generation and these associated acceleration processes,and discuss how they can be compared with particle and wave data from the Van Allen Probes mission.

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

    Ekanayaka, Ratna; Challenor, Rachel

    2016-08-01

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

  18. Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults

    PubMed Central

    Hong, Sung-Moon; Cho, Jae-Gu; Chae, Sung Won; Lee, Heung-Man

    2013-01-01

    Objectives Coblation is operated in low temperature, so it is proposed that tonsillectomy with coblation involves less postoperative pain and allows accelerated healing of the tonsillar fossae compared with other methods involving heat driven processes. However, the results of the previous studies showed that the effect of coblation tonsillectomy has been equivocal in terms of postoperative pain and hemorrhage. Though, most of the previous studies which evaluated coblation tonsillectomy were performed in children. Recently, electrocautery tonsillectomy has been used most widely because of the reduced intraoperative blood loss and shorter operative time compared to other techniques. This prospective study compared intraoperative records and postoperative clinical outcomes in adolescents and adults following coblation and electrocautery tonsillectomies. Methods Eighty patients over 16 years of age with histories of recurrent tonsillitis were enrolled. The patients were randomly allocated into coblation (n=40) and electrocautery tonsillectomy groups (n=40). All operations were performed by one surgeon who was skilled in both surgical techniques. Intraoperative parameters and postoperative outcomes were checked. Results Postoperative pain and otalgia were not significantly different between the two groups; however, there was a tendency towards reduced pain and otalgia in the coblation group. More cotton balls for swabbing the operative field were used introoperatively in the electrocautery group (P=0.00). There was no significant difference in postoperative hemorrhage, wound healing, commencement of a regular diet, and foreign body sensation between the groups. Conclusion Only cotton use, which represented the amount of blood loss, was less in the coblation tonsillectomy group. Coblation tonsillectomy warrants further study with respect to the decreased postoperative pain and otalgia. PMID:23799166

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  1. Comparative prospective study of two liver graft preservation solutions: University of Wisconsin and Celsior.

    PubMed

    Lopez-Andujar, Rafael; Deusa, Saulo; Montalvá, Eva; San Juan, Fernando; Moya, Angel; Pareja, Eugenia; DeJuan, Manuel; Berenguer, Marina; Prieto, Martín; Mir, Jose

    2009-12-01

    University of Wisconsin solution (UWS) is the gold standard for graft preservation. Celsior solution (CS) is a new solution not as yet widely used in liver grafts. The aim of this study was to compare the liver function of transplanted grafts stored in these 2 preservation solutions. The primary endpoints were the rates of primary nonfunction (PNF) and primary dysfunction (PDF). We performed a prospective and pseudorandomized study that included 196 patients (representing 104 and 92 livers preserved in UWS and CS, respectively) at La Fe University Hospital (Valencia, Spain) between March 2003 and May 2005. PNF and PDF rates, liver function laboratory parameters, postoperative bleeding, vascular and biliary complications, and patient and graft survival at 3 years were compared for the 2 groups. The 2 groups were similar in terms of donor variables, recipient variables, and surgical techniques. The PNF rates were 2.2% and 1.9% in the CS and UWS groups, respectively (P = not significant), and the PDF rates were 15.2% and 15.5% in the CS and UWS groups, respectively (P = not significant). There were no significant differences in the laboratory parameters for the 2 groups, except for alanine aminotransferase levels in month 3, which were lower in the CS group (P = 0.01). No significant differences were observed in terms of complications. Three-year patient and graft survival rates were as follows for years 1, 2, and 3: 83%, 80%, and 76% (patient) and 80%, 77%, and 73% (graft) for the UWS group and 83%, 77%, and 70% (patient) and 81%, 73%, and 67% (graft) for the CS group (P = not significant). In conclusion, this study shows that CS is as effective as UWS in liver preservation.

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

    ERIC Educational Resources Information Center

    Branine, Mohamed; Avramenko, Alex

    2015-01-01

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

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

    PubMed

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

    2010-12-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed

    Cummings, G; O'Keefe, G

    2000-04-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-05-01

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

  8. Health plan auditing: 100-percent-of-claims vs. random-sample audits.

    PubMed

    Sillup, George P; Klimberg, Ronald K

    2011-01-01

    The objective of this study was to examine the relative efficacy of two different methodologies for auditing self-funded medical claim expenses: 100-percent-of-claims auditing versus random-sampling auditing. Multiple data sets of claim errors or 'exceptions' from two Fortune-100 corporations were analysed and compared to 100 simulated audits of 300- and 400-claim random samples. Random-sample simulations failed to identify a significant number and amount of the errors that ranged from $200,000 to $750,000. These results suggest that health plan expenses of corporations could be significantly reduced if they audited 100% of claims and embraced a zero-defect approach.

  9. A Prospective Cohort Study Comparing Workload in Children with and without Developmental Coordination Disorder

    ERIC Educational Resources Information Center

    Rivilis, Irina; Liu, Jian; Cairney, John; Hay, John A.; Klentrou, Panagiota; Faught, Brent E.

    2012-01-01

    The purpose of this prospective cohort study was to assess how cardiorespiratory fitness (CRF) of children with probable developmental coordination disorder (DCD) changes over a period of 4.7 years relative to a group of typically developing controls. A school-based sample of children in a large region of Ontario, Canada with 75 out of a possible…

  10. A prospective randomised controlled trial comparing Merocel and Rapid Rhino nasal tampons in the treatment of epistaxis.

    PubMed

    Moumoulidis, Ioannis; Draper, Mark R; Patel, Hemi; Jani, Piyush; Price, Timothy

    2006-08-01

    A prospective study was performed to compare the efficacy and patient tolerance of Merocel and Rapid Rhino nasal tampons in the treatment of epistaxis. A total of 42 patients were studied. There was no significant difference between the two types of pack in efficacy or patient discomfort with pack in situ. Rapid Rhino produced significantly lower scores for subjective patient discomfort during insertion and removal of pack.

  11. AUDIT OF BLOOD REQUISITION.

    PubMed

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

    2001-01-01

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

  12. Financial audit

    SciTech Connect

    Not Available

    1992-01-01

    The Trans-Alaska Pipeline Liability Fund, a nonprofit corporate entity created in 1973, pays claims for damages, including cleanup costs, arising from oil discharges from vessel transporting Trans-Alaska Pipeline System oil loaded at Alaskan terminals to ports under U.S. jurisdiction. This paper presents the results of GAO's view of the independent certified public accountants' audit of the Fund's financial statements as of December 31, 1990. GAO also assesses progress toward disposing of the Fund's balances and terminating the Fund.

  13. Comparative Study for Efficacy and Safety of Adenoidectomy according to the Surgical Method: A Prospective Multicenter Study

    PubMed Central

    Lee, Woo Hyun; Kim, Dong-Kyu; Kim, Sung Wan; Kim, Young Hyo; Nam, Jung Gwon; Park, Seok-Won; Park, Chan-Soon; Bae, Woo Yong; Yeo, Nam-Kyung; Won, Tae-Bin; Lee, Seung Hoon; Lee, Tae-Hoon; Lee, Hyoung Joo; Kim, Sang-Wook; Jeong, Sung-Wook; Choi, Jeong-Seok; Han, Doo Hee; Choi, Ji Ho

    2015-01-01

    Background/Objective There have been several operative techniques for adenoidectomy and their efficacy and morbidity are different according to the technique. This prospective multicenter study was aimed to compare the efficacy and morbidity of coblation adenoidectomy (CA) with those of power-assisted adenoidectomy. Study Design Prospective multi-institutional study. Methods Children who underwent CA, power-assisted adenoidectomy with cauterization (PAA+C) or without cauterization (PAA-C) due to adenoid hypertrophy were enrolled from 13 hospitals between July 2013 and June 2014. Mean operation time, degree of intraoperative bleeding and postoperative bleeding rate were evaluated. Results A total of 388 children (mean age ± standard deviation = 6.6 ± 2.5 years; 245 males and 143 females) were included. According to the adenoidectomy technique, the children were classified into 3 groups: (1) CA (n = 116); (2) PAA+C (n = 153); and (3) PAA-C (n = 119). Significant differences were not found in age and sex among three groups. In the CA group, mean operation time was significantly shorter (P < 0.001) and degree of intraoperative bleeding was significantly less (P < 0.001) compared to PAA+C or PAA-C group. Delayed postoperative bleeding rate of PAA-C group was significantly higher than that of CA or PAA+C group (P = 0.016). Conclusions This prospective multicenter study showed that CA was superior to PAA in terms of mean operation time and degree of intraoperative bleeding. PMID:26267337

  14. Hassle-free audit trails: Automated audits

    SciTech Connect

    Manatt, D.R.

    1989-04-01

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

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

    PubMed Central

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

    2013-01-01

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

  16. Auditing medical records helps reduce liability.

    PubMed

    Ganguli, G; Winfrey, S

    1990-10-01

    An internal audit of a hospital's medical records department compares the department to standards developed by the hospital and to benchmarks set by accrediting organizations. An auditor can review the department's economy and effectiveness through employee surveys, direct observation, and interviews. By uncovering deficiencies and making recommendations for their correction, an internal audit can help limit a hospital's liability exposure.

  17. Mobile bearing UKA compared to fixed bearing TKA: a randomized prospective study.

    PubMed

    Sun, Peng-Fei; Jia, Yu-Hua

    2012-03-01

    We prospectively evaluated a consecutive series of 56 patients with unicompartmental knee arthritis who underwent unicompartmental knee replacement or total knee arthroplasty and received an average of 52months of follow-up. These patients were enrolled in a prospective randomized clinical trial. There were no significant differences in the pre-operative parameters of both groups. All the patients were followed up and evaluated preoperatively and yearly, the data was collected and statistical analysis was performed. At an average of 52months after surgery the mean Knee Society score was 80.5 (range: 70-100) and 78.9 (range: 70-87) for Unicompartmental knee replacement and total knee arthroplasty, mean range of postoperative motion for TKA is 115(0)±4(0) and 117(0)±7(0) for the group of UKA, with the numbers available, the difference between the two groups could not be shown to be significant. The average operation time of UKA and TKA is 68.8min and 81.5min(p<0.01). Blood drainage after operation had a significant difference between the two groups (p<0.01). Seven cases of UKA were converted to total knee arthroplasty - all of them within the first 2years of starting the procedure and all of them in relatively young patients. From the study we concluded that mobile bearing UKA can obtain similar clinical effect with TKA by surgeons who have the adequate training and experience. After the learning curve UKA should be considered the primary treatment option for unicompartmental knee arthritis.

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

    PubMed

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

    1998-01-01

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

  19. Do audition electives impact match success?

    PubMed Central

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

    2016-01-01

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

  20. Comparative evaluation of the immunogenicity of combined hepatitis A and B vaccine by a prospective and retrospective trial.

    PubMed

    Wolters, Bernd; Müller, Tobias; Ross, R Stefan; Clauberg, Ralf; Werfel, Uwe; Roggendorf, Hedwig; Siggelkow, Cornelius; Hausen, Thomas; Roggendorf, Michael

    2009-04-01

    In the past, immunogenicity of hepatitis A and B vaccines needed to be questioned in persons of advanced age, especially in those of 40 years and older. We performed a comparative multicenter prospective and retrospective study with the combined hepatitis A and B vaccine Twinrix to identify factors influencing the results of the vaccination in a population of all age groups. Out of 489 subjects enrolled, 241 were vaccinated in a prospective study (group 1) and 248 subjects in a retrospective study (group 2) in 17 German centers with median age of 40.1 (14-79) years. Following three applications of the combined hepatitis A/B vaccine we found 96.2% with protective antibodies against HAV and 88.7% were protected against HBV. With increasing age the subjects developed decreasing anti-HBs antibody levels whereas the seroprotection rate was significantly reduced by age (p < 0.05) in the retrospective study group only. Subjects with arterial hypertension and thyroid disease showed significantly decreased protection rates. The timing of the HBV antibody control seems to be important especially in low-responders because protective antibodies may drop below the detection limit within some month. The combined hepatitis A and B vaccine Twinrix proved to be highly effective against HBV, although antibody concentrations and seroprotection rates decreased with increasing age.

  1. Contracting for Audit Services.

    ERIC Educational Resources Information Center

    Heifetz, Harry S.

    1987-01-01

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

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

    ERIC Educational Resources Information Center

    Perris, Kirk

    2015-01-01

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

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

    PubMed

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

    1987-01-01

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

  4. A prospective randomized controlled trial comparing the use of merocel nasal tampons and BIPP in the control of acute epistaxis.

    PubMed

    Corbridge, R J; Djazaeri, B; Hellier, W P; Hadley, J

    1995-08-01

    A prospective study was undertaken to compare the efficacy of Merocel nasal tampons to BIPP (Bismuth Subnitrate and Iodoform Paste) impregnated ribbon gauze in the control of acute epistaxis requiring hospital admission. A total of 50 patients presenting with severe epistaxis was treated with either merocel nasal tampons, or BIPP. The groups did not differ significantly in terms of age, sex distribution, aetiology or severity of the bleed. There was no significant difference in efficacy or patient tolerance of either treatment. It was concluded that Merocel nasal tampons should be considered effective in the first line treatment of severe epistaxis uncontrolled by simple measures. Their ease of insertion makes them suitable for use in the accident and emergency department or in general practice.

  5. Necropsies in clinical audit.

    PubMed Central

    Anderson, N H; Shanks, J H; McCluggage, G W; Toner, P G

    1989-01-01

    The need for specialised forms of clinical audit was highlighted by the report of the Confidential Enquiry into Perioperative Deaths (CEPOD). Necropsy rates in a Northern Ireland teaching hospital were studied with particular reference to perioperative deaths. To provide an overall context for these observations, the pattern of the necropsy services in Northern Ireland as a whole was also determined. For 600 consecutive deaths in a major teaching hospital, the overall necropsy rate was 180 (30%). In the 74 perioperative deaths in this group (as defined by the CEPOD) the necropsy rate was 26 (35%), compared with 16 out of 72 (22%) for other surgical deaths and 89 out of 386 (23%) for medical cases. More coroners' necropsies were carried out in the perioperative group. These figures are within the range of the CEPOD experience. In 1987, in the whole of Northern Ireland, there were 8859 hospital deaths, 520 (5.9%) hospital necropsies, and 516 (5.8%) coroners' necropsies, giving an overall necropsy rate of 11.7%. Outside the two major Belfast teaching hospitals, however, there were 6799 hospital deaths, 76.6% of all hospital deaths for Northern Ireland. In this group there were 180 (2.6%) hospital necropsies and 383 (5.6%) coroners' cases, the overall necropsy rate being only 8.2%. These wide variations reflect the fact that the number of pathologists in post in the peripheral areas of the province falls substantially short of levels recommended by the Royal College of Pathologists. If clinical audit along CEPOD lines is to be effective nationally, more emphasis should be placed on the value of necropsy and local deficiencies in provision will have to be identified and remedied. It is suggested that this could be achieved by combining audit provisions with budgetary incentives. PMID:2794077

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  8. External dacryocystorhinostomy. A prospective study comparing the size of the operative and healed ostium.

    PubMed

    Bumsted, R M; Linberg, J V; Anderson, R L; Barreras, R

    1982-07-01

    This study compares the size of the operative anastomosis with the size of the healed intranasal ostium resulting from 22 external dacryocystorhinostomies. The area of the healed intranasal ostium was approximately 2% of the area of the surgical anastomosis. No correlation was found between the size of the surgical anastomosis and the size of the healed ostium. In all cases, excellent functional results were obtained, regardless of the size of the healed ostium. This study suggests the size of the surgical anastomosis is not directly related to the success of the procedure, although it must be large enough to technically perform the procedure.

  9. Audits Made Simple

    SciTech Connect

    Belangia, David Warren

    2015-04-09

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

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

    PubMed

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

    2014-09-01

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

  11. Analytical laboratory quality audits

    SciTech Connect

    Kelley, William D.

    2001-06-11

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

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

    PubMed Central

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

    2014-01-01

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

  13. A comparative study of continuous versus pulsed radiofrequency discectomy for management of low backache: Prospective randomized, double-blind study

    PubMed Central

    Jena, Bhagya Ranjan; Paswan, Anil; Singh, Yashpal; Loha, Sandeep; Singh, Anil Prasad; Rastogi, Virendra

    2016-01-01

    Background: Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others. Aim: The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin. Setting and Design: Prospective, randomized, double-blind trial. Materials and Methods: Forty patients with chronic discogenic low back pain were randomized to receive CRF plus intradiscal triamcinolone 40 mg (Group 1) or to receive PRF plus intradiscal triamcinolone 40 mg (Group 2). Outcome measured includes immediate as well as long-term pain relief using visual analog scale, the Oswestry Disability Index and straight leg raising test. Statistical Analysis: The continuous variables were compared by one-way analysis of variance test. Discrete variables were compared by Fisher's exact test/Chi-square test/Student's t-test, whichever appropriate. The value of P < 0.05 was considered statistically significant. Results: There was a significant decrease in pain score after CRF without any added side effect. Pain relief after PRF was insignificant. Conclusion: CRF with steroid seems to be better for treatment of chronic discogenic low back pain than PRF with steroid. PMID:27746559

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

    SciTech Connect

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

    2006-07-01

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

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

    PubMed Central

    Teixeira Alves, Marcelo de Pinho

    2015-01-01

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

  16. [Mini-laparoscopy vs. laparoscopy for the gallblader stone treatment. Prospective and comparative study].

    PubMed

    Lada, Paul Eduardo; Forez, Francisco; Janikov, Christian; Mariot, Daniela; Sanchez Tassone, Carlos; Massa, Martin

    2015-01-01

    Antecedentes: La colecistectomía por video-laparoscópica es considerada como el gold-standard del tratamiento de la colecistolitiasis. No obstante, en la literatura internacional sigue teniendo presencia las incisiones pequeñas adaptadas como procedimiento alternativo. Objetivos: El objetivo de este estudio es evaluar los resultados obtenidos con la video-laparoscopia (CVL) y las incisiones pequeñas adaptadas (IPA) en el tratamiento de la colecistolitiasis. Diseño: Prospectivo y comparativo protocolizado. Lugar de aplicación: Servicio de Cirugía General “Pablo Luis Mirizzi” del Hospital Nacional de Clínicas. Material y Métodos: Entre enero del 1994 y diciembre del 2011, hemos tratado quirúrgicamente 3822 pacientes con colélitiasis. En 1735 pacientes se práctico una CVL y en 2087 por IPA, configurando dos grupos, que en lo relacionado a la edad, sexo, operaciones previas y diagnóstico preoperatorio constituyen dos grupos comparables. Resultados: Ninguno de los procedimientos tuvo mortalidad. 115 casos (6,62%) fueron convertidos a cirugía abierta en la CVL. Las complicaciones postoperatorias quirúrgicas fueron del 2,40 % para la CVL y del 6,37 % para las IPA. Las causas de bilirragias fueron superiores y de mayor gravedad en la CVL, cuya incidencia fue del 0,55 % en contraposición del 0,23 % de los operados por IPA. Conclusiones: Sin duda en manos experimentadas la CVL constituye el procedimiento de elección o gold standard en el tratamiento de la colecistolitiasis. No obstante, sobretodo en ambientes o regiones con restricciones presupuestarias las IPA representa una excelente gold estándar alternativo, por ser un procedimiento seguro, muy económico y complejidad razonable con menor índice de lesiones quirúrgicas graves.

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

    PubMed Central

    Shashidhar, Nagam Reddy; Reddy, S.Rama Koteswara

    2016-01-01

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

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

    SciTech Connect

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

    2015-03-15

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

  19. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed Central

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

    2016-01-01

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

  1. A Prospective Randomized Study Comparing Mini-surgical Percutaneous Dilatational Tracheostomy With Surgical and Classical Percutaneous Tracheostomy

    PubMed Central

    Hashemian, Seyed Mohammad-Reza; Digaleh, Hadi

    2015-01-01

    Abstract Although percutaneous dilatational tracheostomy (PDT) is more accessible and less time-demanding compared with surgical tracheostomy (ST), it has its own limitations. We introduced a modified PDT technique and brought some surgical knowledge to the bedside to overcome some standard percutaneous dilatational tracheostomy relative contraindications. PDT uses a blind route of tracheal access that usually requires perioperational imaging guidance to protect accidental injuries. Moreover, there are contraindications in certain cases, limiting widespread PDT application. Different PDT modifications and devices have been represented to address the problem; however, these approaches are not generally popular among professionals due to limited accessibility and/or other reasons. We prospectively analyzed the double-blinded trial, patient and nurse head evaluating the complications, and collected data from 360 patients who underwent PDT, ST, or our modified mini-surgical PDT (msPDT, Hashemian method). These patients were divided into 2 groups—contraindicated to PDT—and randomization was done for msPDT or PDT in PDT-indicated group and msPDT or ST for PDT-contraindicated patients. The cases were compared in terms of pre and postoperational complications. Data analysis demonstrated that the mean value of procedural time was significantly lower in the msPDT group, either compared with the standard PDT or the ST group. Paratracheal insertion, intraprocedural hypoxemia, and bleeding were also significantly lower in the msPDT group compared with the standard PDT group. Other complications were not significantly different between msPDT and ST patients. The introduced msPDT represented a semiopen incision, other than blinded PDT route of tracheal access that allowed proceduralist to withdraw bronchoscopy and reduced the total time of procedure. Interestingly, the most important improvement was performing msPDT on PDT-contraindicated patients with the complication rate

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

    PubMed Central

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

    2016-01-01

    Introduction Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic procedure often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. Recently developed physics forceps is one of the instruments which is claimed to perform atraumatic extractions. Aim The aim of the present study was to compare the efficacy of physics forceps with conventional forceps in terms of operating time, prevention of marginal bone loss & soft tissue loss, postoperative pain and postoperative complications following bilateral premolar extractions for orthodontic purpose. Materials and Methods In this prospective split-mouth study, outcomes of the 2 groups (n = 42 premolars) requiring extraction of premolars for orthodontic treatment purpose using Physics forceps and Conventional forceps were compared. Clinical outcomes in form of time taken, loss of buccal soft tissue and buccal cortical plate based on extraction defect classification system, postoperative pain and other complication associated with extraction were recorded and compared. Results Statistically significant reduction in the operating time was noted in physics forceps group. Marginal bone loss and soft tissue loss was also significantly lesser in physics forceps group when compared to conventional forceps group. However, there was no statistically significant difference in severity of postoperative pain between both groups. Conclusion The results of the present study suggest that physics forceps was more efficient in reducing operating time and prevention of marginal bone loss & soft tissue loss when compared to conventional forceps in orthodontically indicated premolar extractions. PMID:27630951

  3. Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery--a prospective randomized study.

    PubMed

    Gopalraju, Prathibha; Lalitha, Ramanujapuram Manikarnike; Prasad, Kavitha; Ranganath, Krishnappa

    2014-07-01

    The aim of this comparative, prospective, randomized, controlled study was to evaluate two different regimens of analgesics: a preoperative intravenous dose of either Tramadol or Ketorolac given 10 min prior to surgery to assess their impact on clinical recovery after third molar surgery. Forty patients requiring surgical extraction of unilateral impacted mandibular third molars similar in position were enrolled in the study. Patients were randomly divided into two groups based on permuting the numbers. Patients in Group 1 and Group 2 were administered either Tramadol 50 mg or Ketorolac 30 mg, intravenously, 10 min prior to surgery. The difference in postoperative pain was assessed by four primary points: pain intensity as measured by a 10 mm visual analogue scale hourly for 12 h, median time to rescue analgesics, number of analgesics consumed and patient's overall 5-point global assessment scale. Throughout the 12 h investigation period, patients treated with Ketorolac reported significantly lower pain intensity scores, significantly longer time to rescue analgesics (Acetaminophen 500 mg) and less intake of postoperative analgesics. In Group 2, 40% of the patient had good overall assessment as compared to Group 1 where only 25% of patients had good overall assessment. The current study shows that pre-emptive use of Inj. Ketorolac 30 mg intravenously can reduce the severity of the postoperative sequelae of asymptomatic impacted mandibular third molar surgery.

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  7. Health plan auditing: 100-percent-of-claims vs. random-sample audits.

    PubMed

    Sillup, George P; Klimberg, Ronald K

    2011-01-01

    The objective of this study was to examine the relative efficacy of two different methodologies for auditing self-funded medical claim expenses: 100-percent-of-claims auditing versus random-sampling auditing. Multiple data sets of claim errors or 'exceptions' from two Fortune-100 corporations were analysed and compared to 100 simulated audits of 300- and 400-claim random samples. Random-sample simulations failed to identify a significant number and amount of the errors that ranged from $200,000 to $750,000. These results suggest that health plan expenses of corporations could be significantly reduced if they audited 100% of claims and embraced a zero-defect approach. PMID:21406351

  8. Auditing radiation sterilization facilities

    NASA Astrophysics Data System (ADS)

    Beck, Jeffrey A.

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

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

    PubMed Central

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

    2016-01-01

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

  10. Prospective randomized trial comparing Billroth I and Roux-en-Y procedures after distal gastrectomy for gastric carcinoma.

    PubMed

    Ishikawa, Makoto; Kitayama, Joji; Kaizaki, Shoichi; Nakayama, Hiroshi; Ishigami, Hironori; Fujii, Shin; Suzuki, Hiroyuki; Inoue, Tomomi; Sako, Akihiro; Asakage, Masahiro; Yamashita, Hiroharu; Hatono, Kenji; Nagawa, Hirokazu

    2005-11-01

    To determine the clinical efficacy of Roux-en-Y reconstruction (RY) after distal gastrectomy, we compared postoperative outcomes of patients who underwent RY or conventional Billroth I reconstruction (B-I). A total of 50 patients were prospectively randomized to either B-I or RY reconstruction, and complications, postoperative course, and nutritional status were compared. Bile reflux and inflammation in the remnant stomach and lower esophagus were evaluated by postoperative follow-up endoscopy at 6 months. Operative time and blood loss as well as postoperative nutrition did not show significant differences between the two groups. As anticipated, 5 of 24 patients with RY reconstruction developed gastrojejunal stasis in the early postoperative period, which led to a longer postoperative hospital stay as compared with the B-I group (mean +/- S.D; B-I; 19.0 +/- 6.2, RY; 31.8 +/- 21.7 days) (P < 0.05). Endoscopic examination revealed that the frequency of bile reflux (P < 0.01) and degree of inflammation in the remnant stomach (P < 0.05) were less in the RY group than in the B-I group. However, inflammatory findings in the lower esophagus were observed in 7 (27%) of B-I, and 8 (35%) of the RY group, suggesting that late phase esophagitis was not improved in the RY group. Roux-en-Y reconstruction was effective in preventing duodenogastric reflux and resulting gastritis, but it did not prevent esophagitis. Because RY reconstruction induces the frequent complication of Roux-en-Y stasis, causing longer postoperative hospital stay, this method has limited advantages over B-I anastomosis after distal gastrectomy.

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

    PubMed Central

    Jain, Nikil Kumar; John, Reena Rachel

    2016-01-01

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

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

    PubMed

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

    2016-08-01

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

  13. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    PubMed Central

    Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

    2014-01-01

    Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable. PMID:25383369

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    2016-01-01

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

  16. A Prospective Multi-Center Clinical Trial to Compare Efficiency, Accuracy and Safety Of the VisionScope Imaging System Compared to MRI and Diagnostic Arthroscopy

    PubMed Central

    Xerogeanes, John W.; Safran, Marc R.; Huber, Bryan; Mandelbaum, Bert R.; Robertson, William; Gambardella, Ralph A.

    2014-01-01

    Objectives: Until now, arthroscopic surgery has been the gold standard for the diagnosis of intra-articular pathology. When a patient presents with ongoing pain and/or disability despite non-operative care, MRI is commonly used as a diagnostic modality. To date, there is not a minimally-invasive option that can provide detailed information about the intra-articular pathology of a joint. VisionScope Imaging (VSI) is an office-based diagnostic modality that provides comprehensive real-time images and video of a joint with higher accuracy and reliability compared to static MR images. The purpose of this study was to compare the efficacy, accuracy and safety of VSI compared to MRI and surgical diagnostic arthroscopy. Methods: A prospective, blinded, multi-centered study was performed of all patients who had a routine surgical arthroscopy at one of the six participating clinical sites between July 2012 and May 2013. Patients were consented by the physician investigator at each site. Study inclusion criteria consisted of: suspected meniscal tears or articular cartilage damage. Patients were excluded from the study if they had (1) acute traumatic hemarthoses, (2) concomitant ligament injury, (3) active systemic infection, (4) allergy to silicone or any medication used during the procedure,. All patients had a MRI and a comprehensive physical exam prior to their surgical arthroscopy. Each patient underwent a MRI, VSI exam and surgical diagnostic arthroscopy. The attending physician completed standard forms comparing the VSI exam findings to the diagnostic arthroscopy findings on each patient. Two blinded experts unaffiliated with the study reviewed the VSI and MRI images. The arthroscopy served as the “control” comparison between the VSI and MRI findings. Results: There were 110 patients included in this study. The accuracy, sensitivity and specificity of VSI was equivalent to surgical diagnostic arthroscopy and more accurate than MRI (Table 1). When comparing VSI to

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

    PubMed Central

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

    2014-01-01

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

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

    SciTech Connect

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

    1983-08-01

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

  19. O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study.

    PubMed

    Belcaro, Gianni; Rosaria Cesarone, Maria; Ledda, Andrea; Cacchio, Marisa; Ruffini, Irma; Ricci, Andrea; Ippolito, Edmondo; Di Renzo, Andrea; Dugall, Mark; Corsi, Marcello; Marino Santarelli, Anna Rita; Grossi, Maria Giovanna

    2008-01-01

    O-(beta-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, > 56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1 g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.

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

    ERIC Educational Resources Information Center

    You, Byeong-keun; Liu, Na

    2011-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    Starling, Tina T.

    2011-01-01

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

  3. Dosimetric audit in brachytherapy

    PubMed Central

    Bradley, D A; Nisbet, A

    2014-01-01

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

  4. School Safety Audit Protocol.

    ERIC Educational Resources Information Center

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

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

  5. Auditing Schools for Safety.

    ERIC Educational Resources Information Center

    Butterfield, Eric,

    2000-01-01

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

  6. Comparative study on induction and effects of surgical menopause in a female rat model: a prospective case control study

    PubMed Central

    Moiety, Fady MS; Salem, Hesham A; Mehanna, Radwa A; Abdel-Ghany, Bedor S

    2015-01-01

    Objective: To compare induced surgical menopause in rat models following hysterectomy with ovarian preservation, unilateral or bilateral oophorectomy, versus control. Secondary objective was evaluation of certain physiological changes in the animal following the induced menopause. Design: A prospective case control study. Setting: University Research Centre. Methodology: 80 female rats were divided into four groups (n=20). HG: hysterectomy with ovarian preservation, UOG: unilateral oophorectomy, BOG: bilateral oophorectomy and CG: control rats. Blood tests were done at day 0, one week and one month post-procedure for hormonal profile including FSH and E2, and lipid profile including cholesterol, LDL and HDL. Behavioral tests (Learning and memory tests) were also done. Results: Menopause was successfully induced by the three used surgical methods. After one week, no significant difference in FSH level between CG and HG. But its level was significantly increased in BOG and UOG. E2 level was significantly decreased in HG, UOG and BOG in comparison to CG. Its level in BOG was significantly lower than that of UOG and HG. Cholesterol level was significantly higher in HG, UOG and BOG in comparison to CG, also its level was significantly increased in UOG and BOG in comparison to HG (P<0.001). Long term memory was affected in BOG and UOG, one week and one month post-menopausal induction in comparison to the control. Conclusion: surgical menopause, induced by hysterectomy alone, unilateral, or bilateral oophorectomy has a negative impact on reproductive hormonal function, as well as cognitive & cardiovascular integrity. We suggest a possibility of early ovarian failure after hysterectomy alone or with unilateral oophorectomy. PMID:26309602

  7. A prospective, randomized, single - blind study comparing intraplaque injection of thiocolchicine and verapamil in Peyronie's Disease: a pilot study

    PubMed Central

    Toscano, I. L.; Rezende, M.V.; Mello, L. F.; Pires, L.; Paulillo, D.; Glina, S.

    2016-01-01

    ABSTRACT Objectives: To compare the response to tiocolchicine and verapamil injection in the plaque of patients with Peyronie's disease. Materials and Methods: Prospective, single-blind, randomized study, selecting patients who have presented Peyronie's disease for less than 18 months. Thiocolchicine 4mg or verapamil 5mg were given in 7 injections (once a week). Patients who had received any treatment for Peyronie's disease in the past three months were excluded. The parameters used were the International Index of Erectile Function (IIEF-5) score, analysis of the curvature on pharmaco-induced erections and size of the plaque by ultrasonography. Results: Twenty-five patients were randomized, 13 received thiocolchicine and 12 were treated with verapamil. Both groups were statistically similar. The mean curvature was 46.7° and 36.2° before and after thiocolchicine, respectively (p=0.019) and 50.4° and 42.08° before and after verapamil, respectively (p=0.012). The curvature improved in 69% of patients treated with thiocolchicine and in 66% of those who received verapamil. Regarding sexual function, there was an increase in the IIEF-5 from 16.69 to 20.85 (p=0.23) in the thiocolchicine group. In the verapamil group the IIEF-5 score dropped from 17.50 to 16.25 (p=0.58). In the thiocolchicine group, the plaque was reduced in 61% of patients. In the verapamil group, 8% presented decreased plaque size. No adverse event was associated to thiocolchicine. Conclusion: The use of thiocolchicine in Peyronie's disease demonstrated improvement on penile curvature and reduction in plaque size. Thiocolchicine presented similar results to verapamil in curvature assessment. No significant side effects were observed with the use of tiocolchicine. PMID:24893912

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

    PubMed Central

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

    2014-01-01

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

  9. A prospective randomized control study comparing classic laryngeal mask airway with Guedel's airway for tracheal tube exchange and smooth extubation

    PubMed Central

    Jain, Shruti; Nazir, Nazia; Khan, Rashid M.; Ahmed, Syed M.

    2016-01-01

    Introduction: Extubation in deep plane of anesthesia followed by Guedel's oropharyngeal airway (OPA™) insertion is a routine method to avoid hemodynamic changes associated with tracheal extubation. Exchange of endotracheal tube (ETT) with Classic laryngeal mask airway (LMA™) prior to emergence from anesthesia also serves similar purpose. We had compared the hemodynamic changes involved during this ETT/LMA™ and ETT/OPA™ exchange technique. Material and Methods: This was a randomized prospective study on ASA I and 2 patients undergoing elective surgery under general anesthesia. These patients were randomly divided into two groups i.e. OPA group and LMA group of 50 patients each. Hemodynamic parameters i.e. systolic blood pressure (SBP) and heart rate (HR) were recorded during exchange of ETT with OPA™ or LMA™. Coughing / bucking during removal of OPA™ and LMA™, and presence of post operative sore throat for both the groups were also graded and recorded. Data within the groups have been analyzed using paired “t” test while those between the groups were analyzed using unpaired “t” test. Chi square test was used to analyze grades of coughing and post operative sore throat. Results: In both groups, hemodynamic parameters rose significantly as OPA™/LMA™ was placed (P < 0.05) and then started declining. Hemodynamic parameters continued to fall in LMA group after extubation. However in OPA group, hemodynamic parameters continued to rise even after extubation and declined only when OPA™ was removed. There was no statistical significant difference between the LMA and OPA group in respect to coughing and post operative sore throat. Conclusion: LMA™ is superior to OPA™ for exchange of ETT as it provides greater hemodynamic stability. PMID:27746550

  10. National stroke audit: a tool for change?

    PubMed Central

    Rudd, A; Lowe, D; Irwin, P; Rutledge, Z; Pearson, M

    2001-01-01

    Objectives—To describe the standards of care for stroke patients in England, Wales and Northern Ireland and to determine the power of national audit, coupled with an active dissemination strategy to effect change. Design—A national audit of organisational structure and retrospective case note audit, repeated within 18 months. Separate postal questionnaires were used to identify the types of change made between the first and second round and to compare the representativeness of the samples. Setting—157 trusts (64% of eligible trusts in England, Wales, and Northern Ireland) participated in both rounds. Participants—5589 consecutive patients admitted with stroke between 1 January 1998 and 31 March 1998 (up to 40 per trust) and 5375 patients admitted between 1 August 1999 and 31 October 1999 (up to 40 per trust). Audit tool—Royal College of Physicians Intercollegiate Working Party stroke audit. Results—The proportion of patients managed on stroke units rose between the two audits from 19% to 26% with the proportion managed on general wards falling from 60% to 55% and those managed on general rehabilitation wards falling from 14% to 11%. Standards of assessment, rehabilitation, and discharge planning improved equally on stroke units and general wards, but in many aspects remained poor (41% formal cognitive assessment, 46% weighed once during admission, 67% physiotherapy assessment within 72 hours, 24% plan documented for mood disturbance, 36% carers' needs assessed separately). Conclusions—Nationally conducted audit linked to a comprehensive dissemination programme was effective in stimulating improvements in the quality of care for patients with stroke. More patients are being managed on stroke units and multidisciplinary care is becoming more widespread. There remain, however, many areas where standards of care are low, indicating a need for investment of skills and resources to achieve acceptable levels. Key Words: stroke; clinical audit PMID:11533421

  11. Internal audit consider the implications.

    PubMed

    Baumgartner, Grant D; Hamilton, Angela

    2004-06-01

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

  12. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURAL RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently...

  13. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURAL RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently...

  14. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURAL RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently...

  15. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY PROCEDURAL RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently...

  16. Internal Auditing for School Districts.

    ERIC Educational Resources Information Center

    Cuzzetto, Charles

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

  17. Is benchmarking possible in audit of early outcomes after operations for head and neck cancer?

    PubMed

    Tighe, David; Sassoon, Isabel; Kwok, A; McGurk, Mark

    2014-12-01

    There is a need for a validated means of adjusting for case mix in morbidity audits of patients with cancer of the head and neck. To address this, we did a multicentre audit of 3 U.K. NHS cancer networks that treat patients with head and neck cancer, to compare the incidence of early adverse postoperative outcomes and to develop a means of adjusting for case mix. We did a retrospective and prospective audit of the case notes of 901 consecutive patients who had 1034 operations for squamous cell carcinoma (SCC) of the head and neck under general anaesthesia at 3 NHS hospitals. Analysis of raw data showed postoperative 30-day mortality (n=17) to be consistent between sites (1.7%-1.9%) but 30-day complication rates varied more (34%-49%). Logistic regression models predicting morbidity discriminated well (area under the curve 0.74-0.76). Adjusted morbidity rates for the 3 units were compared on a funnel plot with 95% and 99% confidence intervals to account for random variation. It is possible to benchmark surgical performance by focusing on early postoperative outcomes in head and neck surgery. Morbidity is common and usually has a considerable impact on recovery, bed occupancy, cost, and the patient's perception of the quality of care.

  18. Clinical efficacy of intra-articular injections in knee osteoarthritis: a prospective randomized study comparing hyaluronic acid and betamethasone

    PubMed Central

    Trueba Davalillo, Cesáreo Ángel; Trueba Vasavilbaso, Cesáreo; Navarrete Álvarez, José Mario; Coronel Granado, Pilar; García Jiménez, Ozcar Alejandro; Gimeno del Sol, Mercedes; Gil Orbezo, Félix

    2015-01-01

    Background Osteoarthritis (OA) is the most common joint disease and leading cause of disability. Intra-articular (IA) administration of hyaluronic acid (HA) or corticosteroids (CS) have been previously studied, though using insufficient number of patients or short follow-up periods. Objective We evaluate HA and CS in patients with knee OA in terms of clinical efficacy over 12 months. Methods We used a prospective, randomized study with parallel groups. Randomized patients received IA injections of HA or betamethasone (BM). The primary outcomes were improvement in pain using Visual Analog Scale and function in the Western Ontario and McMaster University Osteoarthritis Index (Likert scale). Follow-up visits were scheduled at 3 months, 6 months, 9 months, and 12 months. Results A total of 200 patients were included. Pain was significantly reduced in both groups at the first follow-ups. At 12 months, the mean pain reduction in the HA group was 33.6% (95% CI: 31.1–36.1) compared to 8.2% (95% CI: 5.2–11.1) in BM (P<0.0001). Function improvement was higher in HA through every visit, and mean improvement at 12 months was 47.5% (95% CI: 45.6–49.3) in HA patients vs 13.2% (95% CI: 11.4–14.9) in the BM group (P<0.0001). All patients from both groups achieved the Minimal Clinically Important Improvement (MCII) for both pain and function up to 6 months. At 9 months and 12 months, the MCII figures were higher in HA group with ≥80% compared to ≤10% in BM group (P<0.0001). Adverse reactions were rare and related to the administration procedure. Conclusion Both treatments effectively controlled OA symptoms. BM showed higher short-term effectiveness, while HA showed better long-term effectiveness, maintaining clinical efficacy in a large number of patients 1 year after administration. PMID:27790040

  19. RTOG 9804: A Prospective Randomized Trial for Good-Risk Ductal Carcinoma In Situ Comparing Radiotherapy With Observation

    PubMed Central

    McCormick, Beryl; Winter, Kathryn; Hudis, Clifford; Kuerer, Henry Mark; Rakovitch, Eileen; Smith, Barbara L.; Sneige, Nour; Moughan, Jennifer; Shah, Amit; Germain, Isabelle; Hartford, Alan C.; Rashtian, Afshin; Walker, Eleanor M.; Yuen, Albert; Strom, Eric A.; Wilcox, Jeannette L.; Vallow, Laura A.; Small, William; Pu, Anthony T.; Kerlin, Kevin; White, Julia

    2015-01-01

    Purpose The Radiation Therapy Oncology Group 9804 study identified good-risk patients with ductal carcinoma in situ (DCIS), a breast cancer diagnosis found frequently in mammographically detected cancers, to test the benefit of radiotherapy (RT) after breast-conserving surgery compared with observation. Patients and Methods This prospective randomized trial (1998 to 2006) in women with mammographically detected low- or intermediate-grade DCIS, measuring less than 2.5 cm with margins ≥ 3 mm, compared RT with observation after surgery. The study was designed for 1,790 patients but was closed early because of lower than projected accrual. Six hundred thirty-six patients from the United States and Canada were entered; tamoxifen use (62%) was optional. Ipsilateral local failure (LF) was the primary end point; LF and contralateral failure were estimated using cumulative incidence, and overall and disease-free survival were estimated using the Kaplan-Meier method. Results Median follow-up time was 7.17 years (range, 0.01 to 11.33 years). Two LFs occurred in the RT arm, and 19 occurred in the observation arm. At 7 years, the LF rate was 0.9% (95% CI, 0.0% to 2.2%) in the RT arm versus 6.7% (95% CI, 3.2% to 9.6%) in the observation arm (hazard ratio, 0.11; 95% CI, 0.03 to 0.47; P < .001). Grade 1 to 2 acute toxicities occurred in 30% and 76% of patients in the observation and RT arms, respectively; grade 3 or 4 toxicities occurred in 4.0% and 4.2% of patients, respectively. Late RT toxicity was grade 1 in 30%, grade 2 in 4.6%, and grade 3 in 0.7% of patients. Conclusion In this good-risk subset of patients with DCIS, with a median follow-up of 7 years, the LF rate was low with observation but was decreased significantly with the addition of RT. Longer follow-up is planned because the timeline for LF in this setting seems protracted. PMID:25605856

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

    PubMed Central

    2011-01-01

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

  1. Audits of radiopharmaceutical formulations

    SciTech Connect

    Castronovo, F.P. Jr. )

    1992-03-01

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

  2. Audit shock avoidance

    SciTech Connect

    Cooper, H.A.

    1994-10-01

    As the number of generating facilities constructed by independent power companies grows in the United States, one undesired by-product will likely be increased scrutiny of the federal income tax treatment of these projects by the Internal Revenue Service (IRS). The IRS has been quite active in recent years auditing electric generating facilities owned by electric utilities, and there is no reason to believe independent power plants will receive any different treatment. In auditing independent power plants, the IRS can be expected to use many of the same arguments and take many of the same positions that it has developed in utility audits.

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

    PubMed

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Sprau Coulter, Tabitha L.

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

  5. Measuring Data Quality Through a Source Data Verification Audit in a Clinical Research Setting.

    PubMed

    Houston, Lauren; Probst, Yasmine; Humphries, Allison

    2015-01-01

    Health data has long been scrutinised in relation to data quality and integrity problems. Currently, no internationally accepted or "gold standard" method exists measuring data quality and error rates within datasets. We conducted a source data verification (SDV) audit on a prospective clinical trial dataset. An audit plan was applied to conduct 100% manual verification checks on a 10% random sample of participant files. A quality assurance rule was developed, whereby if >5% of data variables were incorrect a second 10% random sample would be extracted from the trial data set. Error was coded: correct, incorrect (valid or invalid), not recorded or not entered. Audit-1 had a total error of 33% and audit-2 36%. The physiological section was the only audit section to have <5% error. Data not recorded to case report forms had the greatest impact on error calculations. A significant association (p=0.00) was found between audit-1 and audit-2 and whether or not data was deemed correct or incorrect. Our study developed a straightforward method to perform a SDV audit. An audit rule was identified and error coding was implemented. Findings demonstrate that monitoring data quality by a SDV audit can identify data quality and integrity issues within clinical research settings allowing quality improvement to be made. The authors suggest this approach be implemented for future research.

  6. Auditing the auditors.

    PubMed

    Pallarito, K

    1998-09-21

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

  7. Oneida Tribe Energy Audits

    SciTech Connect

    Olson, Ray; Schubert, Eugene

    2014-08-15

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

  8. Automated gaseous criteria pollutant audits

    SciTech Connect

    Watson, J.P.

    1998-12-31

    The Quality Assurance Section (QAS) of the California Air Resources Board (CARB) began performing automated gaseous audits of its ambient air monitoring sites in July 1996. The concept of automated audits evolved from the constant streamlining of the through-the-probe audit process. Continual audit van development and the desire to utilize advanced technology to save time and improve the accuracy of the overall audit process also contributed to the concept. The automated audit process is a computer program which controls an audit van`s ambient gas calibration system, isolated relay and analog to digital cards, and a monitoring station`s data logging system. The program instructs the audit van`s gas calibration system to deliver specified audit concentrations to a monitoring station`s instruments through their collection probe inlet. The monitoring station`s responses to the audit concentrations are obtained by the program polling the station`s datalogger through its RS-232 port. The program calculates relevant audit statistics and stores all data collected during an audit in a relational database. Planning for the development of an automated gaseous audit system began in earnest in 1993, when the CARB purchased computerized ambient air calibration systems which could be remotely controlled by computer through their serial ports. After receiving all the required components of the automated audit system, they were individually tested to confirm their correct operation. Subsequently, a prototype program was developed to perform through-the-probe automated ozone audits. Numerous simulated ozone audits documented the program`s ability to control audit equipment and extract data from a monitoring station`s data logging system. The program was later modified to incorporate the capability to perform audits for carbon monoxide, total hydrocarbons, methane, nitrogen dioxide, sulfur dioxide, and hydrogen sulfide.

  9. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

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

  10. Acid Rain Program CEM audit program

    SciTech Connect

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

    1997-12-31

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

  11. 10 CFR 603.1295 - Periodic audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  12. 29 CFR 96.42 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  13. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  14. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  15. 29 CFR 96.43 - Relation of organization-wide audits to other audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Relation of organization-wide audits to other audit..., CONTRACTS, AND OTHER AGREEMENTS Access to Records, Audit Standards and Relation of Organization-wide Audits to Other Audit Requirements § 96.43 Relation of organization-wide audits to other audit...

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

    PubMed Central

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

    2015-01-01

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

  17. Decentralization Calls for Internal Audits.

    ERIC Educational Resources Information Center

    DiCello, Jim

    1995-01-01

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

  18. Alveolar bone grafting: achieving the organisational standards determined by CSAG, a baseline audit at the Birmingham Children's Hospital.

    PubMed Central

    Clarkson, J.; Paterson, P.; Thorburn, G.; El-Ali, K.; Richard, B.; Hammond, M.; Wake, M.

    2005-01-01

    INTRODUCTION: Birmingham Children's Hospital (BCH) is the centre for a regional comprehensive cleft service attempting to implement the national guidelines for minimum standards of care. A national audit of cleft management (CSAG) found that 58% of alveolar bone grafts were successful; published series suggest that success rates can be of the order of 95%. We present the results of an audit of alveolar bone grafting over a 33-month period, after implementation. PATIENTS AND METHODS: A retrospective clinical process audit was taken from the hospital notes and an analysis of radiological outcome by Bergland score was obtained by two independent assessors. RESULTS: The audit highlighted the difficulties of integrating the increased clinical workload. Other difficulties included poorly standardised pre- and postoperative occlusal radiography, inconsistent orthodontic management and a lack of prospective data collection. An 81% success rate for alveolar bone grafting compares favourably to the CSAG study. Of 82 patients, 68 had sufficient data for a retrospective review; 21 were our own patients and 47 were referred into the centralised service. The success of bone grafting as defined by CSAG (including Bergland scores) is based on only two-thirds of the patients as many have their orthodontic treatment managed in more distant units and radiographs are much harder to obtain. Bone grafting later than age 11 years, was true for 28% (6/21) of our BCH patients and 46% (22/47) for those referred to our service. CONCLUSIONS: This audit demonstrates what has been achieved in a re-organised service in the context of Real Politik in the NHS and suggests the areas that require improvement. PMID:16263019

  19. Audits that Make a Difference

    SciTech Connect

    Malsbury, Judith

    1999-02-01

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

  20. Internal Audit in Higher Education.

    ERIC Educational Resources Information Center

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

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

  1. Developmental Audits with Challenging Youth

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2006-09-01

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

  4. National Energy Audit

    SciTech Connect

    Gettings, Michael B.

    2001-12-30

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

  5. National Energy Audit

    2001-12-30

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

  6. [Nurses' practice in health audit].

    PubMed

    Pinto, Karina Araújo; de Melo, Cristina Maria Meira

    2010-09-01

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

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

    SciTech Connect

    Lima, Luiz Henrique; Magrini, Alessandra

    2010-02-15

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

  8. COBRA compliance. Audit guidelines.

    PubMed

    Pranschke, S C

    1996-01-01

    An employer should evaluate the status of its records on COBRA compliance, paying particular attention to items the IRS will request. Prompt correction of any short-comings can help to decrease exposure during a COBRA audit. An added advantage will be a more systematic administration of this area of employee benefits.

  9. Passing the Audition

    ERIC Educational Resources Information Center

    Poliniak, Susan

    2012-01-01

    Auditioning is often uncomfortable but can lead to great rewards. Music educators can do much to help their students be at their best in front of a panel. In this article, four experts share their experiences as adjudicators and their advice on how best to prepare students for the process.

  10. Going beyond Audit

    ERIC Educational Resources Information Center

    Thomas, Mike; Liss, Anne; Milner, Alastair

    2011-01-01

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

  11. Energy Audit . . . Here's How.

    ERIC Educational Resources Information Center

    American School and University, 1983

    1983-01-01

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

  12. Conducting a Technology Audit

    ERIC Educational Resources Information Center

    Flaherty, William

    2011-01-01

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

  13. 12 CFR 704.15 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... summary of the audit report to the membership at the next annual meeting. (b) Internal audit. A corporate... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Audit requirements. 704.15 Section 704.15 Banks... UNIONS § 704.15 Audit requirements. (a) External audit. The corporate credit union supervisory...

  14. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a.... Guidance on determining Federal awards expended is provided in § 99.205. (b) Single audit....

  15. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  16. 38 CFR 41.200 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.200 Audit requirements. (a) Audit required. Non-Federal entities that expend $500,000 or more in a year in Federal awards shall have... part. Guidance on determining Federal awards expended is provided in § 41.205. (b) Single audit....

  17. 16 CFR 703.7 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Audits. 703.7 Section 703.7 Commercial... Audits. (a) The Mechanism shall have an audit conducted at least annually, to determine whether the... be kept under § 703.6 of this part shall be available for audit. (b) Each audit provided for...

  18. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Audit committees. 620.30 Section 620.30 Banks... Association Audit and Compensation Committees § 620.30 Audit committees. Each Farm Credit bank and association must establish and maintain an audit committee. An audit committee is established by adopting a...

  19. 13 CFR 120.490 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  20. 30 CFR 735.22 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  1. 32 CFR 37.1325 - Periodic audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  2. 20 CFR 655.1312 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  3. 32 CFR 37.1325 - Periodic audit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Periodic audit. 37.1325 Section 37.1325 National... TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1325 Periodic audit. An audit of... awards. Appendix C to this part describes what such an audit may cover. A periodic audit of a...

  4. 12 CFR 704.15 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Audit requirements. 704.15 Section 704.15 Banks... UNIONS § 704.15 Audit requirements. (a) External audit. The corporate credit union supervisory committee shall cause an annual opinion audit of the financial statements to be made. The audit must be...

  5. 7 CFR 3052.200 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit requirements. 3052.200 Section 3052.200..., DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.200 Audit requirements. (a) Audit required. Non-Federal entities that expend $500,000 or more in a year...

  6. 30 CFR 1217.250 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Audits. 1217.250 Section 1217.250 Mineral... Revenue AUDITS AND INSPECTIONS Other Solid Minerals § 1217.250 Audits. An audit of the lessee's accounts... duplicate copies of such annual or other audits to the mining supervisor, within 30 days after...

  7. 7 CFR 1290.10 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Audit requirements. 1290.10 Section 1290.10... PROGRAM § 1290.10 Audit requirements. The State is accountable for conducting a financial audit of the... audit, a copy of the audit results....

  8. 20 CFR 655.1312 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audits. 655.1312 Section 655.1312 Employees... United States (H-2A Workers) § 655.1312 Audits. (a) Discretion. The Department will conduct audits of... selected for audit will be chosen within the sole discretion of the Department. (b) Audit letter. Where...

  9. 7 CFR 1773.8 - Audit date.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Audit date. 1773.8 Section 1773.8 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.8 Audit date. (a) The annual audit must be performed as of the end of the same calendar month each year unless prior approval...

  10. 30 CFR 735.22 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Audit. 735.22 Section 735.22 Mineral Resources... ENFORCEMENT § 735.22 Audit. The agency shall arrange for an independent audit no less frequently than once..., Attachment P. The audits will be performed in accordance with the “Standards for Audit of...

  11. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  12. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  13. Reviewing audit: barriers and facilitating factors for effective clinical audit

    PubMed Central

    Johnston, G; Crombie, I; Alder, E; Davies, H; Millard, A

    2000-01-01

    I K Crombie, professor and E M Alder, senior lecturer H T O Davies, reader A Millard, research fellow Objective—To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. Design—A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. Results—Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. Conclusions—Clinical audit can be a valuable assistance to any programme which aims to improve the

  14. Auditing the Records of Student-Athletes.

    ERIC Educational Resources Information Center

    Riggs, Robert O.; Hedden, Carole R.

    1985-01-01

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

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

    ERIC Educational Resources Information Center

    Goldhaber, Gerald M.; Krivonos, Paul D.

    1977-01-01

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

  16. 38 CFR 41.220 - Frequency of audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.220 Frequency of audits... audit. (b) Any non-profit organization that had biennial audits for all biennial periods ending...

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

    ERIC Educational Resources Information Center

    Basbagi, R. Ragip

    2012-01-01

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

  18. Criteria for internal auditing.

    PubMed

    Holder, W W; Clay, R J

    1979-01-01

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

  19. The impact of management programs on physicians' work environment and health. A prospective, controlled study comparing different interventions.

    PubMed

    von Vultée, Pia Jansson; Arnetz, Bengt

    2004-01-01

    Female physicians have less influence over their daily work conditions and exhibit slower career advancement as compared to their male colleagues. The aim of this study is to assess the impact on individual and organizational well being from different kinds of management programs. Female physicians participating in management intervention programs were compared with a reference group of matched physicians and sickness absenteeism was significantly lower in the intervention group. No significant differences were found between the groups with regard to career advancement, individual, organizational and professional well being. Health care organizations spend a substantial amount of resources on management programs in order to improve leadership, autonomy and the work-environment of physicians in times of increasing discontent among this key group of health care employees. Our study indicates some beneficial health effects from structured management programs but there is a need to develop and assess the efficacy of these programs further.

  20. Inventory auditing: a manufacturing perspective.

    PubMed

    Swartley, J A; Hall, J D

    1990-08-01

    Despite the mystery that usually surrounds the annual audit program, its plan is easy to understand if you learn the basic concerns of the auditor. A five-step inventory audit plan usually consists of proving that the inventory exists, is completely represented, belongs to the firm, is properly valued, and is properly classified. To develop the inventory audit plan, an auditor must verify a firm's system of internal controls, in addition to verifying management's financial assertions by obtaining evidence about them. The time, cost, and frequency of the inventory audit with even the best plans may vary because of changing factors.

  1. Laparoscopic adjustable gastric banding. A prospective randomized study comparing the Swedish Adjustable Gastric Band and the MiniMizer Extra: one-year results

    PubMed Central

    Brimas, Gintautas; Strupas, Kęstutis

    2011-01-01

    Introduction A number of different adjustable gastric bands are available for laparoscopic adjustable gastric banding (LAGB). Few attempts have been made to compare the influence of band design differences for efficiency and complication rate and conflicting results have emerged from comparative studies. Aim To compare SAGB (Swedish Adjustable Gastric Band) and MiniMizer Extra adjustable gastric bands. Material and methods One hundred and three patients were included in the prospective randomized study. All patients underwent LAGB. The SAGB was used in 49 and MiniMizer Extra in 54 patients. The primary endpoint was weight loss, and secondary endpoints were complication rate, correction of co-morbidities and improvement of quality of life. Results There were no early complications. A significant difference in the proportion of patients who have reached good or excellent weight loss results (≥ 50% of initial excess body mass index loss) was found in favour of the MiniMizer Extra group (29.6% vs. 8.2%, p = 0.006). No difference was found in other weight loss parameters, resolution of co-morbidities and improvement of quality of life. One oesophageal dilatation and one leakage were diagnosed in the MiniMizer Extra group. Five band penetrations (9.3%) were diagnosed in the MiniMizer Extra group and no penetrations in the SAGB group (p = 0.069). Conclusions No major significant differences were found between the compared bands. Further results need to be confirmed by longer follow-up. PMID:23255982

  2. The “Laboratory” Effect: Comparing Radiologists' Performance and Variability during Prospective Clinical and Laboratory Mammography Interpretations1

    PubMed Central

    Gur, David; Bandos, Andriy I.; Cohen, Cathy S.; Hakim, Christiane M.; Hardesty, Lara A.; Ganott, Marie A.; Perrin, Ronald L.; Poller, William R.; Shah, Ratan; Sumkin, Jules H.; Wallace, Luisa P.; Rockette, Howard E.

    2008-01-01

    Purpose: To compare radiologists' performance during interpretation of screening mammograms in the clinic with their performance when reading the same mammograms in a retrospective laboratory study. Materials and Methods: This study was conducted under an institutional review board–approved, HIPAA-compliant protocol; the need for informed consent was waived. Nine experienced radiologists rated an enriched set of mammograms that they had personally read in the clinic (the “reader-specific” set) mixed with an enriched “common” set of mammograms that none of the participants had previously read in the clinic by using a screening Breast Imaging Reporting and Data System (BI-RADS) rating scale. The original clinical recommendations to recall the women for a diagnostic work-up, for both reader-specific and common sets, were compared with their recommendations during the retrospective experiment. The results are presented in terms of reader-specific and group-averaged sensitivity and specificity levels and the dispersion (spread) of reader-specific performance estimates. Results: On average, the radiologists' performance was significantly better in the clinic than in the laboratory (P = .035). Interreader dispersion of the computed performance levels was significantly lower during the clinical interpretations (P < .01). Conclusion: Retrospective laboratory experiments may not represent either expected performance levels or interreader variability during clinical interpretations of the same set of mammograms in the clinical environment well. © RSNA, 2008 PMID:18682584

  3. Randomised prospective study compares efficacy of five different stomach tubes for rumen fluid sampling in dairy cows.

    PubMed

    Steiner, S; Neidl, A; Linhart, N; Tichy, A; Gasteiner, J; Gallob, K; Baumgartner, W; Wittek, T

    2015-01-10

    The objective of the study was to compare the performance of five types of stomach tubes for rumen fluid sampling. Rumen fluid was sampled in rumen fistulated cows assigned to a 5×5 Latin square study design. The pH values of samples taken by stomach tubes and via fistulas were measured; the results were compared with indwelling sensor measurements. The practicability of the stomach tubes for regular use was tested in the field. Rumen fluid samples were obtained rapidly. Volumes for transfaunation could be obtained. The pH-values of samples taken with the four out of the five tubes (Dirksen, Geishauser, tube 4 and a simple water hose used with a gag) did not show significant differences to samples taken via rumen fistulas. Mean differences ranged between -0.02 and +0.09. Samples taken with tube 4 and the water hose showed also no significant differences to pH-sensor measurements. This study demonstrates that stomach tubes are suitable for rumen fluid sampling. Tube 4 seems to be the best probe for work in the field. It was well tolerated by the animals, saliva contamination is negligible. We, therefore, conclude that the evaluation of rumen acid base status in the field is possible.

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

    EPA Science Inventory

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

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

    PubMed

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

    2015-08-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-08-01

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

  8. Comparative host-parasite population structures: disentangling prospecting and dispersal in the black-legged kittiwake Rissa tridactyla.

    PubMed

    McCoy, Karen D; Boulinier, Thierry; Tirard, Claire

    2005-08-01

    Although much insight is to be gained through the comparison of the population genetic structures of parasites and hosts, there are, at present, few studies that take advantage of the information on vertebrate life histories available through the consideration of their parasites. Here, we examined the genetic structure of a colonial seabird, the black-legged kittiwake (Rissa tridactyla) using seven polymorphic microsatellite markers to make inferences about population functioning and intercolony dispersal. We sampled kittiwakes from 22 colonies across the species' range and, at the same time, collected individuals of one of its common ectoparasites, the tick Ixodes uriae. Parasites were genotyped at eight microsatellite markers and the population genetic structure of host and parasite were compared. Kittiwake populations are only genetically structured at large spatial scales and show weak patterns of isolation by distance. This may be due to long-distance dispersal events that erase local patterns of population subdivision. However, important additional information is gained by comparing results with those of the parasite. In particular, tick populations are strongly structured at regional scales and show a stepping-stone pattern of gene flow. Due to the parasite's life history, its population structure is directly linked to the frequency and spatial extent of within-breeding season movements of kittiwakes. The comparison of host and parasite gene flow therefore helps us to disentangle the intercolony movements of birds from that of true dispersal events (movement followed by reproduction). In addition, such data can provide essential elements for predicting the outcome of local co-evolutionary interactions.

  9. A Prospective, Comparative Study of the Occurrence and Severity of Constipation with Darifenacin and Trospium in Overactive Bladder

    PubMed Central

    Pundarikaksha, Hulikallu Purushotama; Hanumantharaju, Basavanahalli Krishnaiah; Anusha, Satenahalli Javaregowda

    2015-01-01

    Introduction: Darifenacin and trospium are the commonly used antimuscarinics in the management of overactive bladder (OAB). Constipation is the second most common treatment related side-effect. Though its incidence with the above two medications is known, data on their comparative severity and impact on patient’s well-being is lacking. Materials and Methods: Sixty subjects with OAB included in the study were randomized in 1:1 fashion to receive either darifenacin 7.5 mg OD or trospium extended release 60 mg OD. Treatment response was monitored using overactive bladder symptom score (OABSS). The severity of constipation was assessed using McMillan & Williams Constipation assessment scale (CAS), Bristol stool form scale and Knowles-Eccersley-Scott-Symptom (KESS) questionnaire score administered at baseline, 2 and 4 weeks of treatment. Results: OABSS improved significantly, -5.80 ± 3.99 (p = 0.0005) and -5.27 ± 2.98 (p = 0.0005) in darifenacin and trospium groups respectively. However, the difference between the two groups was not significant either at 2 weeks (p = 0.952) or 4 weeks (p = 0.654) of treatment. A significant decrease in stool consistency was noted with darifenacin treatment (p < 0.05), but the same was not seen with trospium (p = 0.076). There was no significant difference in scores of KESS questionnaire between baseline, 2 weeks and 4 weeks, both within the group and between the groups (p > 0.05). McMillan & Williams CAS scores increased at week 2 and week 4, in comparison with baseline scores in both darifenacin and trospium treated patients, however, the difference between the two groups was not statistically significant (p > 0.05). Conclusion: Darifenacin and trospium are equally efficacious and comparable in tolerability in terms of constipation severity and its impact on patient well-being. PMID:25954630

  10. Environmental auditing: Theory and applications

    NASA Astrophysics Data System (ADS)

    Thompson, Dixon; Wilson, Melvin J.

    1994-07-01

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

  11. Prevalence of tinea pedis in psoriasis, compared to atopic dermatitis and normal controls--a prospective study.

    PubMed

    Leibovici, Vera; Ramot, Yuval; Siam, Rula; Siam, Ihab; Hadayer, Noa; Strauss-Liviatan, Nurith; Hochberg, Malka

    2014-12-01

    There are discrepancies in the literature regarding the prevalence of tinea pedis in psoriasis. The aim of this investigation was to conduct a cross-sectional study of the prevalence of tinea pedis in psoriasis compared to atopic dermatitis patients and normal controls. We enrolled 232 psoriatic patients, 190 atopic dermatitis patients and 202 normal controls, between the years 2010 and 2013. The prevalence of tinea pedis was 13.8% in psoriasis patients, not significantly different from that in atopic dermatitis patients 8.4% (P = 0.092)), but significantly higher than in normal controls 7.4% (P = 0.043). Both gender and age affected the prevalence of tinea pedis in psoriasis and normal controls, while only age affected the prevalence of tinea pedis in atopic dermatitis. Regarding gender, there was higher prevalence of tinea pedis in men: 19.1% (P = 0.019) in psoriasis and 12.1% (P = 0.013) in normal controls. Age affected the prevalence of tinea pedis in normal controls (P < 0.001), psoriasis patients (P = 0.001) and atopic dermatitis patients (P = 0.001), with higher prevalence with increasing age. Trichophyton rubrum was the most common species in psoriasis (71.9%), atopic dermatitis (75.0%) and normal controls (73.3%). Our study found a relatively high prevalence of tinea pedis among psoriasis patients.

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

    PubMed

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

    2015-09-01

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

  13. Does Percutaneous Kyphoplasty Have Better Functional Outcome Than Vertebroplasty in Single Level Osteoporotic Compression Fractures? A Comparative Prospective Study

    PubMed Central

    Omidi-Kashani, F.; Samini, F.; Hasankhani, E. G.; Kachooei, A. R.; Toosi, K. Z.; Golhasani-Keshtan, F.

    2013-01-01

    Purpose. To evaluate the relative differences in surgical outcome of kyphoplasty (KP) versus vertebroplasty (VP) in the patients with single level refractory osteoporotic compression fractures (OCFs). Method. From August 2008 to May 2012, we intermittently treated 57 patients with single level OCF by PV and KP (Groups A and B, resp.). We used visual analogue scale (VAS) and short form 36 (SF36) questionnaire to measure functional recovery and followed them for six months. Independent samples t- and Kendall's tau-b tests were for statistics. Results. In terms of age, number, and bone mineral density of the patients, there were no significant differences between the two groups. In both groups, VAS and SF-36 scores improved significantly and remained relatively stable throughout the follow-up period. We had 9 and 6 asymptomatic cement extravasations and 5 and 8 new vertebral fractures in Group A and B, respectively. In comparing the two groups, the results indicated that KP almost failed to show any significant higher effect relative to VP during this period. Conclusions. In considering the high cost of KP relative to VP in the developing countries like Iran, there is no logical reason to use KP in a single level refractory OCF in these regions. PMID:23970997

  14. Topical bupivacaine compared to bupivacaine infiltration for post-tonsillectomy pain relief in children: a prospective randomized controlled clinical study.

    PubMed

    Haksever, Mehmet; Özmen, Süay; Akduman, Davut; Solmaz, Fevzi

    2014-09-01

    The objective of this study is to compare the topical administration of bupivacaine hydrochloride, saline and bupivacaine hydrochloride infiltration on post-tonsillectomy pain in children. Sixty children undergoing tonsillectomy were enrolled in the study. Patients were randomized into three groups using sealed envelopes. Group 1 (n = 20) received topical 0.5 % bupivacaine hydrochloride, group 2 (n = 20) received topical 0.9 % NaCl (saline), and group 3 (n = 20) received 0.5 % bupivacaine hydrochloride infiltrated around each tonsil. Pain was evaluated using McGrath's face scale. Pain scores in topical bupivacaine hydrochloride group was significantly lesser than the topical saline group at 5th, 13th, 17th and 21st hours, until the 6th day (p < 0.017). Moreover, pain scores of topical bupivacaine hydrochloride group was superior to bupivacaine hydrochloride infiltration group at 5th, 13th, 17th hours and 2nd, 3rd, 4th and 5th day (p < 0.017). There were significantly lesser morbidities in topical bupivacaine hydrochloride than saline group in 1st and 4th day (p < 0.017). Topical administration of bupivacaine hydrochloride proved to provide more efficient pain control than bupivacaine hydrochloride infiltration.

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

    PubMed

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

    2014-04-01

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

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

    PubMed Central

    Yu, Wei-hsin; Chiu, Chi-Tsun

    2015-01-01

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

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

    PubMed

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

    2010-04-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Earl-Slater, A; Wilcox, V

    1997-11-01

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

  20. Hamstring pain and muscle strains following anterior cruciate ligament reconstruction: a prospective, randomized trial comparing hamstring graft harvest techniques.

    PubMed

    D'Alessandro, Peter; Wake, Giulia; Annear, Peter

    2013-04-01

    There is limited information in the literature regarding hamstring pain and muscle strains in patients following anterior cruciate ligament (ACL) reconstruction using hamstring autograft. We sought to investigate whether dividing hamstring tendons distal to the musculotendinous junction rather than forcefully stripping tendons away from the muscle belly during graft harvest resulted in a lower incidence of hamstring pain, muscle strains, and leg flexion strength deficit following commencement of sport-specific training postoperatively. Patients were randomized to either the "Cut" or "Push" groups of hamstring tendon harvesting. All other operative techniques were uniform. A total of 34 (cut = 20, push = 14) patients had a mean follow-up of 30 months, and assessments were conducted by a blinded single practitioner. A customized hamstring strain questionnaire and visual analogue pain score provided information for the study's primary focus: evaluation of postoperative hamstring pain and muscle strains. Leg flexion strength was also measured and a full knee assessment was conducted. The Cincinnati sports activity rating scale (SARS) was used to account for varying degrees of sporting participation and intensity since reconstruction. The "Cut" group's mean visual analogue score was 10.05 mm, significantly lower than the "Push" group (24.66 mm, p = 0.0398). The Cut group also recorded a significant reduction in the incidence of hamstring strains following ACL reconstruction (5/20 patients 25%) compared with the Push group (7/14 patients 50%, p = 0.045). There was no difference in leg flexion strength between the groups. Of the patients who reported hamstring strains, there was no significant difference in the mean Cincinnati SARS between the groups, nor any difference in overall knee function. The incidence of hamstring pain and muscle strains was significantly reduced in patients receiving the "cut" technique of harvesting hamstring tendons in ACL reconstruction

  1. The Audit Committee. Board Basics

    ERIC Educational Resources Information Center

    Ostrom, John S.

    2004-01-01

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

  2. Getting Ready for an Audit.

    ERIC Educational Resources Information Center

    Jacobsen, Julia

    1979-01-01

    The increasing intrusion of the federal government in institutional affairs and accountability make audits of higher education institutions inevitable. Some suggestions on how to be prepared for an audit are provided. Suggestions include familiarization with regulations, current indirect cost rate, and current rate for benefits negotiated with…

  3. Safety Audit/Inspection Manual.

    ERIC Educational Resources Information Center

    American Chemical Society, Washington, DC.

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

  4. Women's Campus Safety Audit Guide.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

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

  5. Your Audit and Financial Controls.

    ERIC Educational Resources Information Center

    Hatch, Mary B.; And Others

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

  6. The National Diabetic Retinopathy Laser Treatment Audit. II. Proliferative retinopathy.

    PubMed

    Bailey, C C; Sparrow, J M; Grey, R H; Cheng, H

    1998-01-01

    The National Diabetic Retinopathy Laser Treatment Audit is a prospective survey of laser treatment for diabetic retinopathy throughout the United Kingdom. This paper presents data on 284 patients who were undergoing their first panretinal photocoagulation for proliferative retinopathy during a 2 month period in 1995, describing the demographic features, the level of systematic screening, the sources of referral, and the waiting times. For those cases where proliferative retinopathy was present at the first ophthalmology outpatient visit, the retinopathy was detected as a result of systematic screening in 46.8%, whilst 28.7% presented symptomatically. Of these patients 28.4% waited for more than 12 weeks from referral to the time of laser treatment, but once the patient had been listed for laser treatment this was performed within 8 weeks in 95.3%. The retinopathy features and the type of treatment given are also described. Compared with the DRS and ETDRS recommendations, at least 32.5-40.2% of eyes may be undertreated initially, and for those with high-risk characteristics these figures were at least 30.8-38.5%.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2003-02-01

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

  9. Prospective comparative study of single-layer versus double-layer closure of leg wounds after long saphenous vein harvest in coronary artery bypass graft operations

    PubMed Central

    Siddiqi, Mohammad Salman; Al Sabti, Hilal; Mukaddirov, Mirdavron; Sharma, Ashok Kumar

    2011-01-01

    Introduction Wound infection is one of the major complication post CABG that leads to prolonged length of stay and cost post surgery. Coronary artery bypass grafting is one of the most commonly performed operations in the world. The long saphenous vein harvested by traditional techniques is still widely used and caries a risk of wound infection. Objective The purpose of this study is to ascertain if a single-layer closure result in better wound healing and functional outcome as compared with the traditional two-layer closure after harvest of saphenous vein. Methods Sixty-seven consecutive patients undergoing CABG were prospectively randomized to have their leg wound closed by either a single-layer technique with a suction drain or double layers without suction drain. All wounds were assessed for the presence of serous discharge, inflammation, edema, purulent exudates, infection of the deep tissues, and pain postoperatively and two weeks after discharge. Results There were trends towards increased rates of wound related outcomes in patients in double layer group when compared with single layer group. Out of 77 patients in our study, 52 patients underwent single layer closure (males, n = 37; females, n= 15) and 25 patients underwent double layer closure (males, n = 21; females, n = 04). There was significant statistical difference between the treatment groups with single layer group having lower average scores (4.038) compared to double layer group (9.467), P- value 0.001. Patients whose legs were closed with the single layer technique had less post operative edema (23.07% vs 53.30) and pain (44.2 vs 73.33) compared with the double layer group. Conclusions Single-layer leg wound closure over a suction drain has shown a better wound outcome compared to traditional double-layer closure. A possible mechanism of better wound healing in the former technique might be through decreased tissue handling and a reduction in leg edema. PMID:22263084

  10. Introducing students to clinical audit.

    PubMed

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

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

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

    SciTech Connect

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

    2011-02-01

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

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

    ERIC Educational Resources Information Center

    Dill, David D.

    2000-01-01

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

  13. Psychophysiology of prospective memory.

    PubMed

    Rothen, Nicolas; Meier, Beat

    2014-01-01

    Prospective memory involves the self-initiated retrieval of an intention upon an appropriate retrieval cue. Cue identification can be considered as an orienting reaction and may thus trigger a psychophysiological response. Here we present two experiments in which skin conductance responses (SCRs) elicited by prospective memory cues were compared to SCRs elicited by aversive stimuli to test whether a single prospective memory cue triggers a similar SCR as an aversive stimulus. In Experiment 2 we also assessed whether cue specificity had a differential influence on prospective memory performance and on SCRs. We found that detecting a single prospective memory cue is as likely to elicit a SCR as an aversive stimulus. Missed prospective memory cues also elicited SCRs. On a behavioural level, specific intentions led to better prospective memory performance. However, on a psychophysiological level specificity had no influence. More generally, the results indicate reliable SCRs for prospective memory cues and point to psychophysiological measures as valuable approach, which offers a new way to study one-off prospective memory tasks. Moreover, the findings are consistent with a theory that posits multiple prospective memory retrieval stages.

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

    PubMed Central

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

    2016-01-01

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

  15. Internal Audits: A Must for Governing Boards.

    ERIC Educational Resources Information Center

    Allcorn, Seth

    1983-01-01

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

  16. 2 CFR 200.5 - Audit finding.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Audit finding. 200.5 Section 200.5 Grants... REQUIREMENTS FOR FEDERAL AWARDS Acronyms and Definitions Acronyms § 200.5 Audit finding. Audit finding means deficiencies which the auditor is required by § 200.516 Audit findings, paragraph (a) to report in the...

  17. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  18. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  19. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  20. 7 CFR 2500.055 - Audit.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Closeout § 2500.055 Audit. Awardees must comply with the audit requirements of 7 CFR part 3052. The audit... 7 Agriculture 15 2014-01-01 2014-01-01 false Audit. 2500.055 Section 2500.055 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT...

  1. 7 CFR 2500.055 - Audit.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Closeout § 2500.055 Audit. Awardees must comply with the audit requirements of 7 CFR part 3052. The audit... 7 Agriculture 15 2012-01-01 2012-01-01 false Audit. 2500.055 Section 2500.055 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT...

  2. 7 CFR 2500.055 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Closeout § 2500.055 Audit. Awardees must comply with the audit requirements of 7 CFR part 3052. The audit... 7 Agriculture 15 2013-01-01 2013-01-01 false Audit. 2500.055 Section 2500.055 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT...

  3. 20 CFR 627.481 - Audit resolution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  4. 21 CFR 820.22 - Quality audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  5. 21 CFR 820.22 - Quality audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  6. 7 CFR 1782.10 - Audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.10 Audit requirements. Audits for loans... experiencing problems, the servicing official will require an audit or other documentation deemed necessary to resolve the delinquency. The provisions of 7 CFR 3052 address audit requirements for recipients of...

  7. 7 CFR 1782.10 - Audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.10 Audit requirements. Audits for loans... experiencing problems, the servicing official will require an audit or other documentation deemed necessary to resolve the delinquency. The provisions of 7 CFR 3052 address audit requirements for recipients of...

  8. 7 CFR 1782.10 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.10 Audit requirements. Audits for loans... experiencing problems, the servicing official will require an audit or other documentation deemed necessary to resolve the delinquency. The provisions of 7 CFR 3052 address audit requirements for recipients of...

  9. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit...

  10. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit...

  11. 7 CFR 1291.11 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The...

  12. 7 CFR 3052.230 - Audit costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  13. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  14. 30 CFR 725.19 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. 20 CFR 655.24 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  16. 50 CFR 81.15 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  17. 20 CFR 601.9 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., Advances and Audits § 601.9 Audits. The Department of Labor's audit regulations at 29 CFR Part 96 and 29 CFR Part 99 shall apply with respect to employment service and unemployment compensation programs. ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 601.9 Section 601.9...

  18. 20 CFR 632.33 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND TRAINING PROGRAMS Administrative Standards and Procedures § 632.33 Audits. (a) General. The audit provisions of 41 CFR part 29-70 shall apply to Native American grantees. Until unified or single audit... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 632.33 Section 632.33...

  19. 30 CFR 217.200 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 217.200 Section 217.200 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT AUDITS AND INSPECTIONS Coal § 217.200 Audits. An audit of the accounts and books of operators/lessees for the purpose...

  20. 50 CFR 401.23 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Audits. 401.23 Section 401.23 Wildlife and... ENHANCEMENT § 401.23 Audits. The State is required to conduct an audit at least every two years in accordance with the provisions of Attachment P OMB Circular A-102. Failure to conduct audits as required...

  1. 29 CFR 96.32 - Audit requirement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  2. 24 CFR 236.901 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  3. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  4. 7 CFR 246.20 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 246.20 Section 246.20 Agriculture Regulations... Monitoring and Review § 246.20 Audits. (a) Federal audit responsibilities. (1) OIG reserves the right to perform audits of State and local agencies and other organizations involved in the Program as...

  5. 30 CFR 217.250 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  6. 30 CFR 208.15 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. 31 CFR 50.60 - Audit authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  8. 9 CFR 149.4 - Spot audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  9. 49 CFR 663.9 - Audit limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Audit limitations. 663.9 Section 663.9..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.9 Audit limitations. (a) An audit under this part is limited to verifying compliance with (1)...

  10. 28 CFR 33.51 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  11. 45 CFR 96.31 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Audits. 96.31 Section 96.31 Public Welfare... Audits. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits in accordance with the Single Audit Act Amendments of 1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133,...

  12. 7 CFR 285.4 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 285.4 Section 285.4 Agriculture Regulations of... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures in... such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in...

  13. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. 7 CFR 1291.11 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The...

  15. 20 CFR 655.24 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audits. 655.24 Section 655.24 Employees...) § 655.24 Audits. (a) Discretion. OFLC will conduct audits of H-2B temporary labor certification applications. The applications selected for audit will be chosen within the sole discretion of OFLC. (b)...

  16. 49 CFR 663.9 - Audit limitations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Audit limitations. 663.9 Section 663.9..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.9 Audit limitations. (a) An audit under this part is limited to verifying compliance with (1)...

  17. 7 CFR 4284.18 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Grant Programs § 4284.18 Audit requirements. Grantees must comply with the audit requirements of 7 CFR part 3052. The audit requirements apply to the years in which grant funds are received and years in... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit requirements. 4284.18 Section...

  18. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  19. 7 CFR 4284.657 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Audit requirements. Grantees must provide an annual audit in accordance with 7 CFR part 3052. The audit... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit requirements. 4284.657 Section 4284.657 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE...

  20. 28 CFR 33.51 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Audit. 33.51 Section 33.51 Judicial... Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits of State and Local Governments,” all grantees and subgrantees must provide for an independent audit...

  1. 45 CFR 158.402 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Audits. 158.402 Section 158.402 Public Welfare... REVENUE: REPORTING AND REBATE REQUIREMENTS HHS Enforcement § 158.402 Audits. (a) Notice of Audit. HHS will provide 30 days advance notice of its intent to conduct an audit of an issuer. (b) Conferences. All...

  2. 7 CFR 246.20 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Audits. 246.20 Section 246.20 Agriculture Regulations... Monitoring and Review § 246.20 Audits. (a) Federal audit responsibilities. (1) OIG reserves the right to perform audits of State and local agencies and other organizations involved in the Program as...

  3. 7 CFR 285.4 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Audits. 285.4 Section 285.4 Agriculture Regulations of... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures in... such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in...

  4. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Audits. 457.236 Section 457.236 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records...

  5. 30 CFR 1208.15 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Audits. 1208.15 Section 1208.15 Mineral... Revenue SALE OF FEDERAL ROYALTY OIL General Provisions § 1208.15 Audits. Audits of the accounts and books... at such other times as may be directed by ONRR. Such audits will be for the purpose of...

  6. 20 CFR 601.9 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., Advances and Audits § 601.9 Audits. The Department of Labor's audit regulations at 29 CFR Part 96 and 29 CFR Part 99 shall apply with respect to employment service and unemployment compensation programs. ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audits. 601.9 Section 601.9...

  7. 45 CFR 96.31 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Audits. 96.31 Section 96.31 Public Welfare... Audits. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits in accordance with the Single Audit Act Amendments of 1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133,...

  8. 50 CFR 401.23 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Audits. 401.23 Section 401.23 Wildlife and... ENHANCEMENT § 401.23 Audits. The State is required to conduct an audit at least every two years in accordance with the provisions of Attachment P OMB Circular A-102. Failure to conduct audits as required...

  9. 20 CFR 632.33 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND TRAINING PROGRAMS Administrative Standards and Procedures § 632.33 Audits. (a) General. The audit provisions of 41 CFR part 29-70 shall apply to Native American grantees. Until unified or single audit... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audits. 632.33 Section 632.33...

  10. 30 CFR 725.19 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Audit. 725.19 Section 725.19 Mineral Resources... REGULATIONS REIMBURSEMENTS TO STATES § 725.19 Audit. The agency shall arrange for an independent audit no less... Circular No. A-102, Attachment P. The audits will be performed in accordance with the “Standards for...

  11. Community College Internal Auditors: Internal Audit Guidebook.

    ERIC Educational Resources Information Center

    Jones, Ronna; And Others

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

  12. 7 CFR 277.17 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... agencies that receive FNS program funds. Audits shall be conducted on an organization-wide basis. Such... Audits of Federally Assisted Program,” and any compliance supplements approved by OMB, and generally...) Purpose of audit. Audits will include, at a minimum, an examination of the systems of internal...

  13. 24 CFR 236.901 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND INTEREST REDUCTION PAYMENT FOR RENTAL PROJECTS Audits § 236.901 Audit. Where a State or local... accordance with HUD audit requirements at 24 CFR part 44. ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Audit. 236.901 Section...

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2002-02-01

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

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

    PubMed

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

    2002-02-01

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

  19. Are we following an algorithm for managing chronic anal fissure? A completed audit cycle☆

    PubMed Central

    Farkas, Nicholas; Solanki, Kohmal; Frampton, Adam E.; Black, John; Gupta, Ashish; West, Nicholas J.

    2015-01-01

    Background Anal fissure is one of the commonest proctological diseases with considerable national variation in sequential treatment. We aimed to audit our compliance of chronic anal fissure (CAF) management with national guidance provided by the Association of Coloproctology of Great Britain and Ireland (ACPGBI). Methods We retrospectively audited patients presenting to outpatient clinics with CAF over a 6-month period. Using electronic patient records, notes and clinic letters, we compared their management with ACPGBI algorithm. A prospective re-audit was then performed. Results Forty-one patients were included in the analysis (59% male). Sixty-eight percent (n = 28/41) of patients were appropriately started on conservative dietary therapy, of whom only 7.1% (n = 2/28) had treatment success. Eighty-nine percent (n = 25/28) were then appropriately treated with either topical diltiazem 2% or GTN 0.4%. Overall, 43.9% (n = 18/41) of all patients' entire management strategy adhered to the ACPGBI guidelines. In total, 48.8% (n = 20/41) patients had surgical treatment (excluding Botox), of which only 15% (n = 3/20) had undergone ACPGBI-compliant management. After local dissemination of results and education, the re-audit of 20 patients showed significant improvement in adherence to the guidelines (43.9% vs. 95%; P = 0.0001). Conclusions Topical creams were the most successful treatments (50%; n = 9/18) in ACPGBI-compliant strategies. Importantly, these data suggests that compliance with the ACPGBI algorithm leads to healing without surgery in 83.3% (n = 15/18) of patients, compared to 26.1% (n = 6/23) with non-compliant methods (P = 0.0004). This highlights the benefit of early conservative and medical management of CAF, before attempting surgery. PMID:26858833

  20. Obstetric audit: the Bradford way.

    PubMed

    Lodge, Virginia; Lomas, Karen; Jaworskyj, Suzanne; Thomson, Heidi

    2014-08-01

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

  1. A Guide to Energy Audits

    SciTech Connect

    Baechler, Michael C.

    2011-09-01

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

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

    SciTech Connect

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

    2010-05-01

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

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Endoscopic diagnosis of invasion depth for early colorectal carcinomas: a prospective comparative study of narrow-band imaging, acetic acid, and crystal violet.

    PubMed

    Zhang, Jing-Jing; Gu, Li-Yang; Chen, Xiao-Yu; Gao, Yun-Jie; Ge, Zhi-Zheng; Li, Xiao-Bo

    2015-02-01

    Several studies have validated the effectiveness of narrow-band imaging (NBI) in estimating invasion depth of early colorectal cancers. However, comparative diagnostic accuracy between NBI and chromoendoscopy remains unclear. Other than crystal violet, use of acetic acid as a new staining method to diagnose deep submucosal invasive (SM-d) carcinomas has not been extensively evaluated. We aimed to assess the diagnostic accuracy and interobserver agreement of NBI, acetic acid enhancement, and crystal violet staining in predicting invasion depth of early colorectal cancers. A total of 112 early colorectal cancers were prospectively observed by NBI, acetic acid, and crystal violet staining in sequence by 1 expert colonoscopist. All endoscopic images of each technique were stored and reassessed. Finally, 294 images of 98 lesions were selected for evaluation by 3 less experienced endoscopists. The accuracy of NBI, acetic acid, and crystal violet for real-time diagnosis was 85.7%, 86.6%, and 92.9%, respectively. For image evaluation by novices, NBI achieved the highest accuracy of 80.6%, compared with that of 72.4% by acetic acid, and 75.8% by crystal violet. The kappa values of NBI, acetic acid, and crystal violet among the 3 trainees were 0.74 (95% CI 0.65-0.83), 0.68 (95% CI 0.59-0.77), and 0.70 (95% CI 0.61-0.79), respectively. For diagnosis of SM-d carcinoma, NBI was slightly inferior to crystal violet staining, when performed by the expert endoscopist. However, NBI yielded higher accuracy than crystal violet staining, in terms of less experienced endoscopists. Acetic acid enhancement with pit pattern analysis was capable of predicting SM-d carcinoma, comparable to the traditional crystal violet staining.

  6. A Prospective Comparative Study of High Resolution Ultrasound and MRI in the Diagnosis of Rotator Cuff Tears in a Tertiary Hospital of North India

    PubMed Central

    Chauhan, Narvir Singh; Ahluwalia, Ajay; Sharma, Yash Paul; Thakur, Lokesh

    2016-01-01

    Summary Background To evaluate the accuracy of high resolution ultrasound (USG) and MRI in the diagnosis of rotator cuff tears (RCT) and to determine if high resolution USG compares favorably in sensitivity and specificity to MRI in the diagnosis of rotator cuff injury. Material/Methods In this prospective comparative study, 40 patients with clinically suspected rotator cuff tears underwent both ultrasound and MRI of the shoulder. Out of these 40 patients, 31 patients who had positive findings for rotator cuff tears on ultrasound and/or MRI were finally included in the study while the remaining 9 patients with negative or unrelated findings were excluded. The USG and MRI were interpreted by two radiologists experienced in musculoskeletal radiology and blinded to findings of each other. Comparison was done using MRI as a standard reference. Results The agreement between USG and MRI for diagnosis of RCTs was statistically excellent; USG showed a sensitivity of 86.7% and a specificity of 100% for full-thickness tears, and a sensitivity of 89.7% and a specificity of 98.8% for partial-thickness tears; observed accuracy for full thickness tears was 98.4% and 95.9% for partial thickness tears. The Kappa coefficient of association was 0.91 for full thickness tears and 0.90 for partial thickness tears. Conclusions Considering the comparable diagnostic accuracy of USG and MRI, the former modality can be used as a first-line investigation for diagnosis of RCT. MRI should be used secondarily as a problem-solving tool either following an equivocal shoulder USG or for delineation of anatomy in cases where surgical correction is needed. PMID:27800039

  7. Palliative care of cancer patients: audit of current hospital procedures.

    PubMed

    Sessa, C; Pampallona, S; Carobbio, M; Neuenschwander, H; Cavalli, F

    1998-05-01

    The palliative care of cancer patients admitted for tumour-related symptoms to three different departments (medical oncology, radiotherapy, internal medicine) of a general hospital was prospectively audited. The physicians directly responsible for the patients provided prospective data by reporting both the diagnostic and therapeutic interventions performed and the degree of control achieved for each symptom. A patient form for evaluation of the control achieved in the case of each symptom by means of linear analogue scales was also provided. The appropriateness of all procedures was evaluated by two external auditors. Over 6 months, 125 such admissions were recorded: 24 patients entered the study and the management of 56 symptoms, the most common of which were pain and dyspnoea, was reviewed. A total of 72 diagnostic procedures were performed, deemed necessary for only 50% of symptoms, optional for 15%, and performed as part of a logical sequence for 38%. A total of 130 therapeutic interventions were undertaken, deemed necessary for 55% of symptoms, optional for 15% and carried out as part of a logical sequence for 44%. Re-evaluations of symptoms and physician and patient evaluations of the degree of control achieved could not be assessed because of lack of information. The audit could not be repeated owing to the low accrual of patients and incompleteness of the data collection. Reasons for failure of the study and proposals for feasible methods of auditing the management of symptoms in cancer patients are discussed.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Armitage, Jack; Poyzer, Jillian K.

    2010-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    SciTech Connect

    Szeluga, D.J.

    1985-01-01

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

  12. Segmental mobility, disc height and patient-reported outcomes after surgery for degenerative disc disease: a prospective randomised trial comparing disc replacement and multidisciplinary rehabilitation.

    PubMed

    Johnsen, L G; Brinckmann, P; Hellum, C; Rossvoll, I; Leivseth, G

    2013-01-01

    This prospective multicentre study was undertaken to determine segmental movement, disc height and sagittal alignment after total disc replacement (TDR) in the lumbosacral spine and to assess the correlation of biomechanical properties to clinical outcomes.A total of 173 patients with degenerative disc disease and low back pain for more than one year were randomised to receive either TDR or multidisciplinary rehabilitation (MDR). Segmental movement in the sagittal plane and disc height were measured using distortion compensated roentgen analysis (DCRA) comparing radiographs in active flexion and extension. Correlation analysis between the range of movement or disc height and patient-reported outcomes was performed in both groups. After two years, no significant change in movement in the sagittal plane was found in segments with TDR or between the two treatment groups. It remained the same or increased slightly in untreated segments in the TDR group and in this group there was a significant increase in disc height in the operated segments. There was no correlation between segmental movement or disc height and patient-reported outcomes in either group.In this study, insertion of an intervertebral disc prosthesis TDR did not increase movement in the sagittal plane and segmental movement did not correlate with patient-reported outcomes. This suggests that in the lumbar spine the movement preserving properties of TDR are not major determinants of clinical outcomes.

  13. Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized, double-blind study.

    PubMed

    Pouchain, E C; Costa, F W G; Bezerra, T P; Soares, E C S

    2015-07-01

    This study aimed to compare the effect of nimesulide and ketoprofen on inflammatory parameters related to the surgical removal of third molars. A split-mouth, prospective, randomized, double-blind study was conducted in patients undergoing removal of four third molars. Eighteen eligible patients were allocated to one of two groups to receive treatment two times a day with either ketoprofen 100 mg or nimesulide 100 mg for a period of 3 days. The rescue medication intake (number) and pain intensity were evaluated at 6, 12, 24, and 48 h, and at 7 days postoperatively. Swelling and maximum mouth opening were evaluated at 24 h, 72 h, and 7 days postoperatively. The peak pain score occurred at 6h after surgery in the nimesulide group and at 12h in the ketoprofen group. There was no statistically significant difference between the groups, although pain relief was observed after 48 h in the nimesulide group and after 7 days in the ketoprofen group. For each group, there was a statically significant difference in pain scores among the studied periods (P<0.0001). None of the patients required rescue medication. There was a statistically significant difference in maximum mouth opening between the preoperative and postoperative periods (P<0.0001). Ketoprofen and nimesulide were effective at controlling pain, swelling, and trismus after the surgical removal of third molars.

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

    NASA Astrophysics Data System (ADS)

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

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

  15. Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures: winner of the Dorr Award.

    PubMed

    Macaulay, William; Nellans, Kate W; Garvin, Kevin L; Iorio, Richard; Healy, William L; Rosenwasser, Melvin P

    2008-09-01

    The Displaced Femoral (neck fracture) Arthroplasty Consortium for Treatment and Outcomes study is a prospective, multicenter randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty (THA) in the treatment of displaced femoral neck fractures in previously independent patients. Primary outcomes were measured at 6, 12, and 24 months with the Short Form-36 (SF-36), Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Harris Hip Score and the Timed "Up & Go" Test. Forty subjects were enrolled. At 24 months, THA patients had significantly less pain on the SF-36 subscale than hemiarthroplasty patients (54.8 +/- 7.9 vs 44.7 +/- 10.5, P = .04) and scored significantly better on the SF-36 mental health subscale (54.9 +/- 9.4 vs 40.9 +/- 10.3, P = .006). Total hip arthroplasty patients also had superior WOMAC function scores (81.8 +/- 10.2 vs 65.1 +/- 18.1, P = .03). Significant differences in outcomes, without a significantly greater incidence of complications, suggest THA is a valuable treatment option for the active elderly hip fracture population.

  16. A prospective randomised study comparing a GnRH-antagonist versus a GnRH-agonist short protocol for ovarian stimulation in patients referred for IVF

    PubMed Central

    Gordts, S.; Van Turnhout, C.; Campo, R.; Puttemans, P.; Valkenburg, M.; Gordts, S.

    2012-01-01

    Objective: To compare two short protocols for ovarian stimulation in IVF cycles using an antagonist and an agonist short protocol. The outcomes studied were dosis rec FSH needed, days of stimulation, number of oocytes retrieved and pregnancy outcome. Methods: A prospective randomised study design. Inclusion criteria: first or second IVF attempt in women younger than 40 years. In the agonist protocol (Suprefact®) nasal spray was used. In the antagonist protocol (Orgalutran)® was started as soon as at least 1 follicle of 12 mm was visualized on ultrasound. Results: 160 cycles were included in the study: 80 in the antagonist group and 80 in the agonist group. A higher dosis of recombinant FSH (rec FSH) was used for stimulation in the antagonist group (1897 IU versus 1655 IU). Pregnancy rate per ET in the antagonist group was 37% with an ongoing pregnancy rate of 21%/ET and an implantation rate of 22%; versus respectively 39%, 20% and 22% in the agonist treated group. Live birth rate per started cylce was 19% in the antagonist group versus 20% in the agonist group. Conclusion: This study shows that implantation rates, ongoing pregnancy rates and live birth rates are equal in both groups. An identical number of oocytes was retrieved, with no difference in duration of the stimulation although a higher dosis of rec FSH was needed in the antagonist group. PMID:24753894

  17. The audit checklist: Your key to audit success

    SciTech Connect

    Maday, J.H. Jr.

    1992-02-01

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

  18. The audit checklist: Your key to audit success

    SciTech Connect

    Maday, J.H. Jr.

    1992-02-01

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

  19. Audit of the management of convulsive status epilepticus in children: the need for a uniform treatment strategy.

    PubMed

    Najam, Y; McDonald, D G; Keegan, M; Webb, D W; McMenamin, J B

    2004-09-01

    We conducted a two-year prospective audit to review the paediatric management of Convulsive Status Epilepticus (CSE) in Ireland. Our audit showed that there is considerable variability in the management of CSE in this country. In order to provide optimum care for this potentially life-threatening condition a uniform management strategy is required. We propose a protocol for the treatment of CSE, which should ensure uniform management and optimum care and also provide a template for further study and audit of this important disorder.

  20. Followup audit of the cask development program

    SciTech Connect

    Not Available

    1994-03-15

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

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

    PubMed Central

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

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Garrod, Simon; Pickering, Martin J.

    2016-03-01

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

  3. Comparing the hydrosurgery system to conventional debridement techniques for the treatment of delayed healing wounds: a prospective, randomised clinical trial to investigate clinical efficacy and cost-effectiveness.

    PubMed

    Liu, Jing; Ko, Jason H; Secretov, Erwin; Huang, Eric; Chukwu, Christiana; West, Julie; Piserchia, Katherine; Galiano, Robert D

    2015-08-01

    In these uncertain times of high health care costs, clinicians are looking for cost-effective devices to employ in their everyday practices. In an effort to promote cost-effective and proper wound repair, the hydrosurgical device allows accurate debridement of only unwanted tissue while precisely conserving viable structures for eventual repair. This prospective, randomised study compared procedures using the hydrosurgery system (VERSAJET™) with conventional debridement in order to assess clinical efficacy and cost-effectiveness when treating subjects with chronic wounds. A total of 40 subjects were recruited. There was no difference in time to achieve stable wound closure between the treatment groups (P = 0·77). There were no significant differences between the two groups in terms of cost of the first operative procedure (P = 0·28), cost of surgical procedures during the study (P = 0·51), cost of study treatment (P = 0·29) or cost to achieve stable wound closure (P = 0·85). There were no differences in quantitative bacterial counts after debridement with either methods (P = 0·376). However, the time taken for the first excision procedure was significantly faster using the hydrosurgery system (VERSAJET) when compared with conventional debridement (P < 0·001). The total excision time for all procedures was significantly less for the Hydrosurgery group than for the conventional group (P = 0·005). Also, the Hydrosurgery group demonstrated significantly less intraoperative blood loss than conventional group for all procedures (P = 0·003). In this study, although there were no differences in time to stable wound closure or bacterial reduction between the two groups, the hydrosurgery system (VERSAJET) did offer advantages in terms of operative times and intraoperative blood loss and was cost-neutral, despite the handpiece cost.

  4. Audit Today, Revocation Tomorrow?

    PubMed

    Miserez, Kevin R

    2015-01-01

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

  5. Audit of oxygen therapy.

    PubMed

    Gravil, J H; O'Neill, V J; Stevenson, R D

    1997-06-01

    We audited the use of oxygen in our hospital. Over three days we found 119 patients using oxygen, 21 wearing their mask incorrectly or not at all. The commonest indication was chronic obstructive pulmonary disease. Forty patients had no record of arterial gas analysis. Of those who had, 29 did not require oxygen and the average time from last arterial gas analysis was 5.7 days and only eight patients were being monitored with an oximeter. Taking into account the risk of exacerbating carbon dioxide retention and the problems that arise when discharging a patient who has been receiving oxygen therapy for the duration of their admission, we fee oxygen therapy should only be administered with the knowledge of the arterial gases and with frequent reassessment during therapy.

  6. Audit Today, Revocation Tomorrow?

    PubMed

    Miserez, Kevin R

    2015-01-01

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

  7. Preparing Your Students for Auditions.

    ERIC Educational Resources Information Center

    Knoedelseder, Kurt H.

    2000-01-01

    Argues that teachers and directors should teach their students how to audition. Offers tips, explanations, and observations regarding selection of material, preparation, appearance, making contact, and other advice. (SR)

  8. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  9. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

    Callac, Christopher; Matherne, Charlie

    2003-01-01

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

  10. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

    Callac, Christopher; Matherne, Charlie

    2002-01-01

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

  11. Using perinatal audit to promote change: a review.

    PubMed

    Mancey-Jones, M; Brugha, R F

    1997-09-01

    Close to half of all infant deaths world-wide now occur in the first week of life, almost all in developing countries, and the perinatal mortality rate (PNMR) is used as an indicator of the quality of health service delivery. Clinical audit aims to improve quality of care through the systematic assessment of practice against a defined standard, with a view to recommending and implementing measures to address specific deficiencies in care. Perinatal outcome audit evaluates crude or cause-specific PNMRs, reviewing secular trends over several years or comparing rates between similar institutions. However, the PNMR may not be a valid, reliable and sensitive indicator of quality of care at the institutional level in developing countries because of variations in the presenting case-mix, various confounding non-health service factors and the small number of deaths which occur. Process audit compares actual practice with standard (best) practice, based on the evidence of research or expert consensus. Databases reviewing the management of reproductive health problems in developing countries are currently being prepared so as to provide clinicians and health service managers with up-to-date information to support the provision of evidence-based care. Standard practice should be adapted and defined in explicit management guidelines, taking into account local resources and circumstances. Forms of process audit include the review of care procedures in cases which have resulted in a pre-defined adverse outcome, know as 'sentinel event audit'; and the review of all cases where a particular care activity was received or indicated, known as 'topic audit'. These are complementary and each depends on the quality of recorded data. The forum for comparing observed practice with the standard may be external, utilising an 'expert committee', or internal, in which care providers audit their own activities. Local internal audit is more likely to result in improvements in care if it is

  12. When and how to audit a diabetic foot service.

    PubMed

    Leese, Graham P; Stang, Duncan

    2016-01-01

    Quality improvement depends on data collection and audit of clinical services to inform clinical improvements. Various steps in the care of the diabetic foot can be used to audit a service but need defined audit standards. A diabetes foot service should have risk stratification system in place that should compare to the population-based figures of 76% having low-risk feet, 17% moderate risk and 7% being at high risk of ulceration. Resources can then be directed towards those with high-risk feet. Prevalence of foot ulceration needs to be audited. Community-based studies give an audit standard of around 2%, with 2 to 9% having had an ulcer at some stage in the past. Amputation rates should be easier to measure, and the best results are reported to be around 1.5-3 per 1000 people with diabetes. This is a useful benchmark figure, and the rate has been shown to decrease by approximately a third over the last 15 years in some centres. Ulceration rates and ulcer healing rates are the ultimate outcome audit measure as they are always undesirable, whilst occasionally for defined individuals, an amputation can be a good outcome. In addition to clinical outcomes, processes of care can be audited such as provision of clinical services, time from new ulcer to be seen by health care professional, inpatient foot care or use of antibiotics. Measurement of clinical services can be a challenge in the diabetic foot, but it is essential if clinical services and patient outcomes are to be improved.

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

    SciTech Connect

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

    2011-02-15

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

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

    PubMed Central

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

    2014-01-01

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

  15. 18 CFR 158.1 - Notice to audited person.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., records, accounts, books, communications or papers relevant to the audit of the audited person; matters... DISPOSITION OF CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES Disposition of Contested Audit Findings and Proposed Remedies § 158.1 Notice to audited person. An audit conducted by the Commission's staff...

  16. 18 CFR 41.1 - Notice to audited person.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... papers relevant to the audit of the audited person; matters under the Standards of Conduct or the Code of... CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES Disposition of Contested Audit Findings and Proposed Remedies § 41.1 Notice to audited person. (a) Applicability. This part applies to all audits conducted by...

  17. 18 CFR 286.103 - Notice to audited person.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AUTHORITIES ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES Disposition of Contested Audit Findings and Proposed Remedies § 286.103 Notice to audited person. An audit... deficiency or audit report or similar document containing a finding or findings that the audited person...

  18. 47 CFR 53.213 - Audit analysis and evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  19. 38 CFR 41.235 - Program-specific audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Program-specific audits... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.235 Program-specific audits. (a) Program-specific audit guide available. In many cases, a program-specific audit...

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

    PubMed

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

    2015-01-01

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

  1. Primary bacteraemia is associated with a higher mortality risk compared with pulmonary and intra-abdominal infections in patients with sepsis: a prospective observational cohort study

    PubMed Central

    Mansur, Ashham; Klee, Yvonne; Popov, Aron Frederik; Erlenwein, Joachim; Ghadimi, Michael; Beissbarth, Tim; Bauer, Martin; Hinz, José

    2015-01-01

    Objective To investigate whether common infection foci (pulmonary, intra-abdominal and primary bacteraemia) are associated with variations in mortality risk in patients with sepsis. Design Prospective, observational cohort study. Setting Three surgical intensive care units (ICUs) at a university medical centre. Participants A total of 327 adult Caucasian patients with sepsis originating from pulmonary, intra-abdominal and primary bacteraemia participated in this study. Primary and secondary outcome measures The patients were followed for 90 days and mortality risk was recorded as the primary outcome variable. To monitor organ failure, sepsis-related organ failure assessment (Sequential Organ Failure Assessment, SOFA) scores were evaluated at the onset of sepsis and throughout the observational period as secondary outcome variables. Results A total of 327 critically ill patients with sepsis were enrolled in this study. Kaplan-Meier survival analysis showed that the 90-day mortality risk was significantly higher among patients with primary bacteraemia than among those with pulmonary and intra-abdominal foci (58%, 35% and 32%, respectively; p=0.0208). To exclude the effects of several baseline variables, we performed multivariate Cox regression analysis. Primary bacteraemia remained a significant covariate for mortality in the multivariate analysis (HR 2.10; 95% CI 1.14 to 3.86; p=0.0166). During their stay in the ICU, the patients with primary bacteraemia presented significantly higher SOFA scores than those of the patients with pulmonary and intra-abdominal infection foci (8.5±4.7, 7.3±3.4 and 5.8±3.5, respectively). Patients with primary bacteraemia presented higher SOFA-renal score compared with the patients with other infection foci (1.6±1.4, 0.8±1.1 and 0.7±1.0, respectively); the patients with primary bacteraemia required significantly more renal replacement therapy than the patients in the other groups (29%, 11% and 12%, respectively). Conclusions

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

    SciTech Connect

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

    2013-04-12

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

  3. A prospective trial comparing FDG-PET/CT and CT to assess tumor response to cetuximab in patients with incurable squamous cell carcinoma of the head and neck

    PubMed Central

    Adkins, Douglas; Ley, Jessica; Dehdashti, Farrokh; Siegel, Marilyn J; Wildes, Tanya M; Michel, Loren; Trinkaus, Kathryn; Siegel, Barry A

    2014-01-01

    Computed tomography (CT), the standard method to assess tumor response to cetuximab in incurable squamous cell carcinoma of the head and neck (SCCHN), performs poorly as judged by the disparity between high disease control rate (46%) and short time to progression (TTP) (70 days). F-18 fluorodeoxyglucose positron emission tomography (FDG-PET)/CT is an alternative method to assess tumor response. The primary objective of this prospective trial was to evaluate the metabolic response of target lesions, assessed as the change in maximum standardized uptake value (SUVmax) on FDG-PET/CT before and after 8 weeks (cycle 1) of cetuximab. Secondary objectives were to compare tumor response by CT (RECIST 1.0) and FDG-PET/CT (EORTC criteria) following cycle 1, and determine TTP with continued cetuximab administration in patients with disease control by CT after cycle 1 but stratified for disease control or progression by FDG-PET/CT. Among 27 patients, the mean percent change of SUVmax of target lesions after cycle 1 was −21% (range: +72% to −81%); by FDG-PET/CT, partial response (PR)/stable disease (SD) occurred in 15 patients (56%) and progression in 12 (44%), whereas by CT, PR/SD occurred in 20 (74%) and progression in 7 (26%). FDG-PET/CT and CT assessments were discordant in 14 patients (P = 0.0029) and had low agreement (κ = 0.30; 95% confidence interval [CI]: 0.12, 0.48). With disease control by CT after cycle 1, median TTP was 166 days (CI: 86, 217) if the FDG-PET/CT showed disease control and 105 days (CI: 66, 159) if the FDG-PET/CT showed progression (P < 0.0001). Median TTP of the seven patients whose post cycle 1 CT showed progression compared to the 12 whose FDG-PET/CT showed progression were similar (53 [CI: 49, 56] vs. 61 [CI: 50, 105] days, respectively). FDG-PET/CT may be better than CT in assessing benefit of cetuximab in incurable SCCHN. PMID:25081631

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

    SciTech Connect

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

    2009-05-15

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

  5. 41 CFR 102-118.405 - Are my agency's prepayment audited transportation bills subject to periodic postpayment audit...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... prepayment audited transportation bills subject to periodic postpayment audit oversight from the GSA Audit... § 102-118.405 Are my agency's prepayment audited transportation bills subject to periodic postpayment... prepayment audited transportation bills to periodic postpayment audit oversight rather than...

  6. 41 CFR 102-118.405 - Are my agency's prepayment audited transportation bills subject to periodic postpayment audit...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... prepayment audited transportation bills subject to periodic postpayment audit oversight from the GSA Audit... § 102-118.405 Are my agency's prepayment audited transportation bills subject to periodic postpayment... prepayment audited transportation bills to periodic postpayment audit oversight rather than...

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

    ERIC Educational Resources Information Center

    Lightle, Susan S.; Timm, Teresa

    1997-01-01

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

  8. 12 CFR 715.7 - Supervisory Committee audit alternatives to a financial statement audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... it based its evaluation of internal control; or (c) Audit per Supervisory Committee Guide. An audit... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Supervisory Committee audit alternatives to a financial statement audit. 715.7 Section 715.7 Banks and Banking NATIONAL CREDIT UNION...

  9. 12 CFR 715.7 - Supervisory Committee audit alternatives to a financial statement audit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... it based its evaluation of internal control; or (c) Audit per Supervisory Committee Guide. An audit... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Supervisory Committee audit alternatives to a financial statement audit. 715.7 Section 715.7 Banks and Banking NATIONAL CREDIT UNION...

  10. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  11. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  12. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  13. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  14. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  15. School's Still out on Internal Auditing.

    ERIC Educational Resources Information Center

    Cuzzetto, Charles E.; Moran, Daniel D.

    1988-01-01

    Survey responses from 271 members of the Association of School Business Officials International were analyzed to determine the extent and use of internal auditing in school districts and the characteristics of districts with internal auditing positions. (MLF)

  16. Overview of Auditing for the Busy Rheumatologist.

    PubMed

    Huffstutter, Jessica G; Huffstutter, J Eugene

    2016-06-01

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

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

    ERIC Educational Resources Information Center

    Judd, Terry; Kennedy, Gregor

    2008-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2006-03-01

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

  20. 28 CFR 115.405 - Audit appeals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with...

  1. 28 CFR 115.405 - Audit appeals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with...

  2. 28 CFR 115.405 - Audit appeals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with...

  3. 24 CFR 92.506 - Audit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Audit. 92.506 Section 92.506... INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating jurisdiction, State recipients, and subrecipients must be conducted in accordance with 24 CFR 84.26 and 85.26....

  4. 24 CFR 92.506 - Audit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Audit. 92.506 Section 92.506... INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating jurisdiction, State recipients, and subrecipients must be conducted in accordance with 24 CFR 84.26 and 85.26....

  5. 24 CFR 92.506 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Audit. 92.506 Section 92.506... INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating jurisdiction, State recipients, and subrecipients must be conducted in accordance with 24 CFR 84.26 and 85.26....

  6. 24 CFR 92.506 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Audit. 92.506 Section 92.506... INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating jurisdiction, State recipients, and subrecipients must be conducted in accordance with 24 CFR 84.26 and 85.26....

  7. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS Bank and Association Audit and Compensation Committees § 620.30 Audit committees. Each Farm Credit bank and association... fiscal years. (a) Composition. Each member of an audit committee must be a member of the Farm...

  8. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS Bank and Association Audit and Compensation Committees § 620.30 Audit committees. Each Farm Credit bank and association... fiscal years. (a) Composition. Each member of an audit committee must be a member of the Farm...

  9. 17 CFR 37.205 - Audit trail.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... database. A swap execution facility's audit trail program shall include an electronic transaction history... respect to all audit trail data in the transaction history database. Such electronic analysis capability... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Audit trail. 37.205 Section...

  10. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the... findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule of findings and questioned costs: (1) Reportable conditions in internal control over...

  11. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the... findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule of findings and questioned costs: (1) Reportable conditions in internal control over...

  12. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the... findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule of findings and questioned costs: (1) Reportable conditions in internal control over...

  13. 28 CFR 33.51 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Audit. 33.51 Section 33.51 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits...

  14. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit findings. 41.510 Section 41.510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings....

  15. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit reporting. 99.505 Section 99.505 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.505 Audit reporting. The auditor's report(s) may be in the form of either combined or separate reports and may...

  16. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230 Audit... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable cost principles or regulations. (b) Unallowable costs. A non-Federal entity shall not charge...

  17. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit reporting. 41.505 Section 41.505 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.505 Audit reporting....

  18. Help Your Students Nail that College Audition!

    ERIC Educational Resources Information Center

    Keating, Andrea

    2003-01-01

    Focuses on how music teachers can assist high school students to prepare for a college audition and to select the right music program. Explains what audition committees look for in music students. Includes tips teachers can share with their students on program selection and the audition. (CMK)

  19. 13 CFR 120.490 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Audits. 120.490 Section 120.490 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Lenders Small Business Lending Companies (sblc) § 120.490 Audits. Every SBLC is subject to periodic audits by SBA's Office of...

  20. 7 CFR 1739.20 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accordance with 7 CFR part 1773, “Policy on Audits of the Agency's Borrowers.” (b) If the recipient is a... accordance with 7 CFR part 3052, “Audits of States, Local Governments, and Non-Profit Organizations.” ... AGRICULTURE BROADBAND GRANT PROGRAM Community Connect Grant Program § 1739.20 Audit requirements. A...

  1. 7 CFR 1739.20 - Audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with 7 CFR part 1773, “Policy on Audits of the Agency's Borrowers.” (b) If the recipient is a... accordance with 7 CFR part 3052, “Audits of States, Local Governments, and Non-Profit Organizations.” ... AGRICULTURE BROADBAND GRANT PROGRAM Community Connect Grant Program § 1739.20 Audit requirements. A...

  2. 7 CFR 1739.20 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accordance with 7 CFR part 1773, “Policy on Audits of the Agency's Borrowers.” (b) If the recipient is a... accordance with 7 CFR part 3052, “Audits of States, Local Governments, and Non-Profit Organizations.” ... AGRICULTURE BROADBAND GRANT PROGRAM Community Connect Grant Program § 1739.20 Audit requirements. A...

  3. 7 CFR 1739.20 - Audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... accordance with 7 CFR part 1773, “Policy on Audits of the Agency's Borrowers.” (b) If the recipient is a... accordance with 7 CFR part 3052, “Audits of States, Local Governments, and Non-Profit Organizations.” ... AGRICULTURE BROADBAND GRANT PROGRAM Community Connect Grant Program § 1739.20 Audit requirements. A...

  4. 38 CFR 41.230 - Audit costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable cost principles... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit costs. 41.230... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a)...

  5. 20 CFR 416.2220 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Payments for Vocational Rehabilitation Services Administrative Provisions § 416.2220 Audits. (a) General... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be...

  6. 20 CFR 404.2120 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Payments for Vocational Rehabilitation Services Administrative Provisions § 404.2120 Audits. (a) General... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be...

  7. 45 CFR 96.91 - Audit requirement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Audit requirement. 96.91 Section 96.91 Public... Block Grants § 96.91 Audit requirement. Pursuant to section 1745(b) of the Reconciliation Act (31 U.S.C. 1243 note) an audit is required with respect to the 2-year period beginning on October 1, 1981,...

  8. 42 CFR 430.33 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 430.33 Section 430.33 Public Health CENTERS... ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Grants; Reviews and Audits; Withholding... § 430.33 Audits. (a) Purpose. The Department's Office of Inspector General (OIG) periodically...

  9. 29 CFR 500.161 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Audits. 500.161 Section 500.161 Labor Regulations Relating... AGRICULTURAL WORKER PROTECTION Enforcement Agreements with Federal and State Agencies § 500.161 Audits. The Secretary shall conduct audits as he deems necessary of the State plans, but on not less than an...

  10. 29 CFR 515.6 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Audits. 515.6 Section 515.6 Labor Regulations Relating to... FOR INVESTIGATIONS AND INSPECTIONS § 515.6 Audits. The accounting records and the supporting data pertaining to expenditures for investigations and inspections under the Acts shall be subject to audit by...

  11. 24 CFR 883.313 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... developed by State agencies, these agencies shall follow audit requirements in 24 CFR part 44. (b) Where a..., the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 883.313 Section...

  12. 20 CFR 637.310 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 637.310 Section 637.310 Employees... TRAINING PARTNERSHIP ACT Additional Title V Administrative Standards and Procedures § 637.310 Audits. The Governor shall ensure that the State complies with the audit provisions at § 629.480 of this chapter....

  13. 20 CFR 404.2120 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be based... unless the State VR agency appeals that decision in writing in accordance with 45 CFR part 16 to the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 404.2120 Section 404.2120...

  14. 20 CFR 404.1627 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Board. The rules for hearings and appeals are provided in 45 CFR part 16. (b) Audits performed by the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 404.1627 Section 404.1627 Employees...- ) Determinations of Disability Administrative Responsibilities and Requirements § 404.1627 Audits. (a)...

  15. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart I... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 250.18 Section 250.18 Agriculture...

  16. 10 CFR 603.1115 - Single audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Single audits. 603.1115 Section 603.1115 Energy DEPARTMENT... Administration § 603.1115 Single audits. For audits of for-profit participant's systems, under §§ 603.640 through 603.660, the contracting officer is the focal point for ensuring that participants submit...

  17. 42 CFR 457.202 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 457.202 Section 457.202 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.202 Audits. (a) Purpose. The Department's Office of Inspector General...

  18. 28 CFR 31.201 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 31.201 Section 31.201 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Formula Grants General Requirements § 31.201 Audit. The State must assure that it adheres to the audit requirements enumerated in the “Financial...

  19. 49 CFR 237.151 - Audits; general.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Audits; general. 237.151 Section 237.151..., DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Documentation, Records, and Audits of Bridge Management Programs § 237.151 Audits; general. Each program adopted to comply with this part shall include...

  20. 7 CFR 735.403 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Audits. 735.403 Section 735.403 Agriculture... Audits. (a) No later than 120 calendar days following the end of the provider's fiscal year, the provider authorized under §§ 735.401 and 735.402 must submit to FSA an annual audit level financial statement and...

  1. 40 CFR 68.220 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Audits. 68.220 Section 68.220... ACCIDENT PREVENTION PROVISIONS Other Requirements § 68.220 Audits. (a) In addition to inspections for the... audit RMPs submitted under subpart G of this part to review the adequacy of such RMPs and...

  2. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  3. 24 CFR 882.124 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) SECTION 8 MODERATE REHABILITATION PROGRAMS Applicability, Scope and Basic Policies § 882.124 Audit. PHAs receiving financial assistance under this part are subject to audit requirements in 24 CFR part 44. ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 882.124 Section...

  4. 20 CFR 655.180 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  5. 11 CFR 9038.1 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  6. 24 CFR 941.209 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HOUSING DEVELOPMENT PHA Eligibility and Program Requirements § 941.209 Audit. All PHAs that receive funds under this part for the development of low-income housing shall comply with audit requirements in 24 CFR... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 941.209 Section...

  7. 42 CFR 38.9 - Federal audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Federal audits. 38.9 Section 38.9 Public Health... ASSISTANCE FOR CRISIS COUNSELING AND TRAINING § 38.9 Federal audits. The Secretary, the Administrator, and... supplies received under this part for the purpose of audit and examination....

  8. 49 CFR 663.11 - Audit financing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Audit financing. 663.11 Section 663.11..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.11 Audit financing. A recipient purchasing revenue rolling stock with FTA funds may charge the cost...

  9. 20 CFR 416.2220 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be based... unless the State VR agency appeals that decision in writing in accordance with 45 CFR part 16 to the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 416.2220 Section 416.2220...

  10. 48 CFR 225.872-6 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Audit. 225.872-6 Section...-6 Audit. (a) Memoranda of understanding with some qualifying countries contain annexes that provide for reciprocal “no-cost” audits of contracts and subcontracts (pre- and post-award). (b) To...

  11. 24 CFR 92.506 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating jurisdiction, State recipients, and subrecipients must be conducted in accordance with 24 CFR 84.26 and 85.26. ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Audit. 92.506 Section...

  12. 42 CFR 447.202 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 447.202 Section 447.202 Public Health... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment Methods: General Provisions § 447.202 Audits. The Medicaid agency must assure appropriate audit of records if payment is based on costs of services or on a fee...

  13. 20 CFR 416.1027 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Board. The rules for hearings and appeals are provided in 45 CFR part 16. (b) Audits performed by the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 416.1027 Section 416.1027 Employees... Determinations of Disability Administrative Responsibilities and Requirements § 416.1027 Audits. (a)...

  14. 28 CFR 100.18 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Audit. 100.18 Section 100.18 Judicial... ENFORCEMENT ACT OF 1994 § 100.18 Audit. (a) General. In order to evaluate the accuracy, completeness, and... examine and audit all of the carrier's supporting materials. (1) These materials include, but are...

  15. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 226.8 Section 226.8 Agriculture Regulations of... NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM State Agency Provisions § 226.8 Audits. (a) Unless otherwise exempt, audits at the State and institution levels must be conducted in accordance with Office...

  16. 48 CFR 1631.205-82 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Audits. 1631.205-82 Section... PROCEDURES Contracts With Commercial Organizations 1631.205-82 Audits. Carriers should ensure that the public accounting firms with which they contract for audits of FEHB accounts are registered with the Public...

  17. 24 CFR 880.211 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... administrator under § 880.505 receiving financial assistance under this part, the audit requirements in 24 CFR... financial assistance under this part, the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 880.211 Section...

  18. 10 CFR 72.176 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Audits. 72.176 Section 72.176 Energy NUCLEAR REGULATORY... RADIOACTIVE WASTE, AND REACTOR-RELATED GREATER THAN CLASS C WASTE Quality Assurance § 72.176 Audits. The... comprehensive system of planned and periodic audits to verify compliance with all aspects of the...

  19. 20 CFR 656.20 - Audit procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit procedures. 656.20 Section 656.20... FOR PERMANENT EMPLOYMENT OF ALIENS IN THE UNITED STATES Labor Certification Process § 656.20 Audit procedures. (a) Review of the labor certification application may lead to an audit of the...

  20. 10 CFR 71.137 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... planned and periodic audits to verify compliance with all aspects of the quality assurance program and...

  1. 24 CFR 884.124 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., receiving financial assistance under this part, the audit requirements in 24 CFR part 44 shall apply. (b... this part, the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 884.124 Section...

  2. 24 CFR 574.650 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  3. 30 CFR 220.033 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 220.033 Section 220.033 Mineral... Audits. (a) The accounts of an NPSL lessee or of a contractor of the lessee which are related to NPSL operations shall be subject to audit by DOI or its appointed agent. Where possible, the auditor for DOI...

  4. 24 CFR 954.503 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROGRAM Program Administration § 954.503 Audit. Audits of the grantee and subgrantees must be conducted in accordance with 24 CFR parts 44 and 45, as applicable. ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 954.503 Section...

  5. 7 CFR 249.18 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 249.18 Section 249.18 Agriculture Regulations... Agencies § 249.18 Audits. (a) Federal access to information. The Secretary of the U.S. Department of... State agency and their contractors, for the purpose of making surveys, audits, examinations,...

  6. 20 CFR 638.809 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 638.809 Section 638.809 Employees... THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.809 Audit. (a) The Secretary of Labor... purpose of making surveys, audits, examinations, excerpts, and transcripts. (b) The Secretary shall,...

  7. 24 CFR 214.500 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROGRAM Other Federal Requirements § 214.500 Audit. Housing counseling grant recipients and subrecipients shall be subject to the audit requirements contained in 24 CFR parts 84 and 85. HUD must be provided a... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audit. 214.500 Section...

  8. 7 CFR 3570.83 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... COMMUNITY PROGRAMS Community Facilities Grant Program § 3570.83 Audits. (a) Audits will be conducted in accordance with 7 CFR 1942.17(q)(4), except as provided in this section. (b) Grantees who are not required to... 7 Agriculture 15 2010-01-01 2010-01-01 false Audits. 3570.83 Section 3570.83...

  9. The RIACS Intelligent Auditing and Categorizing System

    NASA Technical Reports Server (NTRS)

    Bishop, Matt

    1988-01-01

    The organization of the RIACS auditing package is described along with how to installation instructions and how to interpret the output. How to set up both local and remote file system auditing is given. Logging is done on a time driven basis, and auditing in a passive mode.

  10. Validation of Organizational Communication Audit Instruments.

    ERIC Educational Resources Information Center

    DeWine, Sue; And Others

    Based on a review of the literature, this paper examines criticisms leveled against the communication audit developed by the International Communication Association (ICA) and then offers a modified version of the audit designed to meet those criticisms. Following a brief introduction, the first section of the paper reviews criticisms of the audit,…

  11. 44 CFR 151.22 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Audits. 151.22 Section 151.22..., Penalties § 151.22 Audits. At the discretion of the Administrator, all claims submitted under section 11 of the Act and all records of the claimant will be subject to audit by the Administrator or...

  12. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart I... 7 Agriculture 4 2011-01-01 2011-01-01 false Audits. 250.18 Section 250.18 Agriculture...

  13. 48 CFR 225.872-6 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Audit. 225.872-6 Section...-6 Audit. (a) Memoranda of understanding with some qualifying countries contain annexes that provide for reciprocal “no-cost” audits of contracts and subcontracts (pre- and post-award). (b) To...

  14. 48 CFR 1631.205-82 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Audits. 1631.205-82... AND PROCEDURES Contracts With Commercial Organizations 1631.205-82 Audits. Carriers should ensure that the public accounting firms with which they contract for audits of FEHB accounts are registered...

  15. 24 CFR 884.124 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., receiving financial assistance under this part, the audit requirements in 24 CFR part 44 shall apply. (b... this part, the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 884.124 Section...

  16. 20 CFR 638.809 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audit. 638.809 Section 638.809 Employees... THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.809 Audit. (a) The Secretary of Labor... purpose of making surveys, audits, examinations, excerpts, and transcripts. (b) The Secretary shall,...

  17. 20 CFR 416.1027 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Board. The rules for hearings and appeals are provided in 45 CFR part 16. (b) Audits performed by the... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Audits. 416.1027 Section 416.1027 Employees... Determinations of Disability Administrative Responsibilities and Requirements § 416.1027 Audits. (a)...

  18. 24 CFR 891.515 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Elderly and Persons with Disabilities § 891.515 Audit requirements. Nonprofits receiving assistance under this part are subject to the audit requirements in 24 CFR part 45. Section 202 Projects for the Elderly... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit requirements. 891.515...

  19. 7 CFR 249.18 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Audits. 249.18 Section 249.18 Agriculture Regulations... Agencies § 249.18 Audits. (a) Federal access to information. The Secretary of the U.S. Department of... State agency and their contractors, for the purpose of making surveys, audits, examinations,...

  20. 7 CFR 3570.83 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... COMMUNITY PROGRAMS Community Facilities Grant Program § 3570.83 Audits. (a) Audits will be conducted in accordance with 7 CFR 1942.17(q)(4), except as provided in this section. (b) Grantees who are not required to... 7 Agriculture 15 2011-01-01 2011-01-01 false Audits. 3570.83 Section 3570.83...

  1. 28 CFR 31.201 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Audit. 31.201 Section 31.201 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Formula Grants General Requirements § 31.201 Audit. The State must assure that it adheres to the audit requirements enumerated in the “Financial...

  2. 24 CFR 882.124 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) SECTION 8 MODERATE REHABILITATION PROGRAMS Applicability, Scope and Basic Policies § 882.124 Audit. PHAs receiving financial assistance under this part are subject to audit requirements in 24 CFR part 44. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 882.124 Section...

  3. 42 CFR 457.202 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Audits. 457.202 Section 457.202 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.202 Audits. (a) Purpose. The Department's Office of Inspector General...

  4. 45 CFR 96.91 - Audit requirement.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Audit requirement. 96.91 Section 96.91 Public... Block Grants § 96.91 Audit requirement. Pursuant to section 1745(b) of the Reconciliation Act (31 U.S.C. 1243 note) an audit is required with respect to the 2-year period beginning on October 1, 1981,...

  5. 10 CFR 71.137 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... planned and periodic audits to verify compliance with all aspects of the quality assurance program and...

  6. 20 CFR 404.1627 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Board. The rules for hearings and appeals are provided in 45 CFR part 16. (b) Audits performed by the... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Audits. 404.1627 Section 404.1627 Employees...- ) Determinations of Disability Administrative Responsibilities and Requirements § 404.1627 Audits. (a)...

  7. 24 CFR 941.209 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HOUSING DEVELOPMENT PHA Eligibility and Program Requirements § 941.209 Audit. All PHAs that receive funds under this part for the development of low-income housing shall comply with audit requirements in 24 CFR... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 941.209 Section...

  8. 24 CFR 954.503 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... PROGRAM Program Administration § 954.503 Audit. Audits of the grantee and subgrantees must be conducted in accordance with 24 CFR parts 44 and 45, as applicable. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 954.503 Section...

  9. 24 CFR 891.160 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... § 891.160 Audit requirements. Nonprofits receiving assistance under this part are subject to the audit requirements in 24 CFR part 45. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit requirements. 891.160...

  10. 43 CFR 3190.2-3 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Audit. 3190.2-3 Section 3190.2-3 Public... and Gas Inspections: General § 3190.2-3 Audit. In maintaining financial records relating to the funds... tribes and contractors shall comply with generally accepted accounting principles and audit...

  11. 42 CFR 447.202 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Audits. 447.202 Section 447.202 Public Health... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment Methods: General Provisions § 447.202 Audits. The Medicaid agency must assure appropriate audit of records if payment is based on costs of services or on a fee...

  12. 20 CFR 655.180 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audit. 655.180 Section 655.180 Employees... United States (H-2A Workers) Integrity Measures § 655.180 Audit. The CO may conduct audits of applications for which certifications have been granted. (a) Discretion. The applications selected for...

  13. 29 CFR 500.161 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Audits. 500.161 Section 500.161 Labor Regulations Relating... AGRICULTURAL WORKER PROTECTION Enforcement Agreements with Federal and State Agencies § 500.161 Audits. The Secretary shall conduct audits as he deems necessary of the State plans, but on not less than an...

  14. 24 CFR 880.211 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... administrator under § 880.505 receiving financial assistance under this part, the audit requirements in 24 CFR... financial assistance under this part, the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 880.211 Section...

  15. 29 CFR 515.6 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Audits. 515.6 Section 515.6 Labor Regulations Relating to... FOR INVESTIGATIONS AND INSPECTIONS § 515.6 Audits. The accounting records and the supporting data pertaining to expenditures for investigations and inspections under the Acts shall be subject to audit by...

  16. 24 CFR 883.313 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... developed by State agencies, these agencies shall follow audit requirements in 24 CFR part 44. (b) Where a..., the audit requirements in 24 CFR part 45 shall apply. ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Audit. 883.313 Section...

  17. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... internal control were disclosed by the audit of the financial statements and whether any such conditions... reportable conditions in internal control over major programs were disclosed by the audit and whether any... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit reporting....

  18. 12 CFR 1273.9 - Audit Committee.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... internal audit activities, including the selection, evaluation, compensation and, where appropriate, replacement of the internal auditor. The internal auditor shall report directly to the Audit Committee and... board of directors and the internal and external auditors. (12) The Audit Committee shall conduct...

  19. 12 CFR 917.7 - Audit committees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... internal auditor and that the internal auditor may be removed only with the approval of the audit committee; (ii) Provide that the internal auditor shall report directly to the audit committee on substantive matters and that the internal auditor is ultimately accountable to the audit committee and board...

  20. 32 CFR 34.16 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Program Management § 34.16 Audits. (a) Any recipient that expends $500,000 or more in a year under Federal... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... 32 National Defense 1 2011-07-01 2011-07-01 false Audits. 34.16 Section 34.16 National...

  1. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  2. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... that reportable conditions in internal control over major programs were disclosed by the audit and... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... 29 Labor 1 2011-07-01 2011-07-01 false Audit reporting. 99.505 Section 99.505 Labor Office of...

  3. 24 CFR 574.650 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  4. Anti-albuminuric effect of losartan versus amlodipine in hypertensive Japanese patients with type 2 diabetes mellitus: A prospective, open-label, randomized, comparative study

    PubMed Central

    Ohno, Yasuhiro; Nishimura, Akiyoshi; Iwai, Hiroshi; Hirota, Noriyuki; Yamauchi, Takaaki; Fujimoto, Mika; Miyatake, Toshiyuki; Arai, Hiroshi; Aoki, Norihiko

    2007-01-01

    Abstract Background The antiproteinuric effect of the angiotensin II receptor-antagonist losartan has been observed in patients with type 2 diabetes mellitus (T2DM). Proteinuria is considered to be a predictor of the progression of kidney disease. Objective The aims of the present study were to compare and examine the ability of losartan and amlodipine to ameliorate albuminuria in hypertensive Japanese patients (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) with T2DM and whether the change in albuminuria was associated with a change in glomerular filtration rate (GFR). Methods This prospective, open-label, randomized, comparative study was conducted over 3 months at the Kinki University School of Medicine, Osaka-Sayama, Japan. Hypertensive patients with T2DM were enrolled and randomly assigned to 1 of 2 study groups receiving either losartan (25–100 mg/d) or the calcium channel-blocker amlodipine (2.5–5 mg/d). Urinary albumin excretion (UAE), creatinine clearance, and GFR were recorded at study initiation (baseline) and study end (month 3). The GFR was measured from the fractional renal accumulation of 99mTc-diethylenetriaminepentaacetic acid. Adverse events (AEs) were monitored by a clinical research nurse during the examination. Results Fifty patients were asked to enroll and 38 returned the informed written consent. Thirty-five Japanese patients were included in the final study analysis. Seventeen patients were assigned to the losartan group (male sex, 10 [58.8%]; mean [SD] age, 58.1 [8.2] years) and 18 were assigned to the amlodipine group (male sex, 10 [55.6%]; mean [SD] age, 57.4 [8.9] years); no significant between-group difference in demographics was observed. A significant decrease from baseline to month 3 of mean (SD) UAE was observed in the losartan group (352.5 [556.6] mg/d vs 275.7 [466.1] mg/d; P = 0.048). No significant difference in mean (SD) UAE was observed in the amlodipine group for the same time period (298

  5. Nurses' participation in audit: a regional study

    PubMed Central

    Cheater, F. M.; Keane, M.

    1998-01-01

    OBJECTIVES: To find out to what extent nurses were perceived to be participating in audit, to identify factors thought to impede their involvement, and to assess progress towards multidisciplinary audit. RESEARCH DESIGN: Qualitative. METHODS: Focus groups and interviews. PARTICIPANTS: Chairs of audit groups and audit support staff in hospital, community and primary health care and audit leads in health authorities in the North West Region. RESULTS: In total 99 audit leads/support staff in the region participated representing 89% of the primary health care audit groups, 80% of acute hospitals, 73% of community health services, and 59% of purchasers. Many audit groups remain medically dominated despite recent changes to their structure and organisation. The quality of interprofessional relations, the leadership style of the audit chair, and nurses' level of seniority, audit knowledge, and experience influenced whether groups reflected a multidisciplinary, rather than a doctor centred approach. Nurses were perceived to be enthusiastic supporters of audit, although their active participation in the process was considered substantially less than for doctors in acute and community health services. Practice nurses were increasingly being seen as the local audit enthusiasts in primary health care. Reported obstacles to nurses' participation in audit included hierarchical nurse and doctor relationships, lack of commitment from senior doctors and managers, poor organisational links between departments of quality and audit, work load pressures and lack of protected time, availability of practical support, and lack of knowledge and skills. Progress towards multidisciplinary audit was highly variable. The undisciplinary approach to audit was still common, particularly in acute services. Multidisciplinary audit was more successfully established in areas already predisposed towards teamworking or where nurses had high involvement in decision making. Audit support staff were

  6. Audits for advanced treatment dosimetry

    NASA Astrophysics Data System (ADS)

    Ibbott, G. S.; Thwaites, D. I.

    2015-01-01

    Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

  7. Final Draft of RACER Audit

    SciTech Connect

    Paige, Karen Schultz; Gomez, Penelope E.

    2011-01-01

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

  8. Internal audits can safeguard hospital revenue.

    PubMed

    Allen, Barbara

    2013-09-01

    Hospitals should routinely perform internal audits of all functions affecting billing accuracy to mitigate the effects of payer audits and to protect revenue by improving billing processes. A primary focus for internal audits should be on coding accuracy, because coding errors leading to denials often reflect gaps in coders' knowledge or training. Effective communication between coding and denials management professionals is a critical success factor. Audits should support appeals processes, and audit findings should be used in educational initiatives aimed at improving coding accuracy.

  9. Evolution of an environmental audit program

    SciTech Connect

    Maday, J.H.; Kuusinen, T.L.

    1991-10-01

    Environmental audits are discussed. Within todays corporate culture, auditors and auditees alike, have been assigned stewardship over the environment. Audits provide a quality assurance check to contribute to the verification process, helping to ensure the management practices associated with the environmental management system are in place, functioning, and adequate. The objective of the audit is to help improve the effectiveness of that basic management system while at the same time determining compliance with the environmental requirements. Performing the audit in a well documented manner, using technique knowledgeable teams, will provide defendable benefits should the audit be challenged and will enhance the credibility of the existing environmental management system.

  10. Surgical audit in the developing countries.

    PubMed

    Bankole, J O; Lawal, O O; Adejuyigbe, O

    2003-01-01

    Audit assures provision of good quality health service at affordable cost. To be complete therefore, surgical practice in the young developing countries, as elsewhere, must incorporate auditing. Peculiarities of the developing countries and insufficient understanding of auditing may be, however, responsible for its been little practised. This article, therefore, reviews the objectives, the commonly evaluated aspects, and the method of audit, and includes a simple model of audit cycle. It is hoped that it will kindle the idea of regular practice of quality assurance by surgeons working in the young developing nations and engender a sustainable interest. PMID:12769314

  11. Health and safety management system audit reliability pilot project.

    PubMed

    Dyjack, D T; Redinger, C F; Ridge, R S

    2003-01-01

    This pilot study assessed occupational health and safety (OHS) management system audit finding reliability using a modified test-retest method. Two industrial hygienists with similar training and education conducted four, 1-day management system audits in four dissimilar organizational environments. The researchers examined four auditable sections (employee participation, training, controls, and communications) contained in a publicly available OHS management system assessment instrument. At each site, 102 auditable clauses were evaluated using a progressive 6-point scale. The team examined both the consistency of and agreement between the scores of the two auditors. Consistency was evaluated by calculating the Pearson r correlations for the two auditors' scores at each site and for each section within each site. Pearson correlations comparing overall scores for each site were all very low, ranging from 0.206 to 0.543. Training and communication system assessments correlated the highest, whereas employee participation and control system scores correlated the least. To measure agreement, t-tests were first calculated to determine whether the differences were statistically significant. Aggregate mean scores for two of the four sites were significantly different. Of the 16 total sections evaluated (i.e., 4 sections per site), seven scores were significantly different. Finally, the agreement of the scores between the two auditors for the four sites was evaluated by calculating two types of intraclass correlation coefficients, all of which failed to meet the minimum requirement for agreement. These findings suggest that opportunities for improving the reliability of the instrument and the audit process exist. Future research should include governmental and commercial OHS program assessments and related environmental management systems and their attendant audit protocols.

  12. [Blood transfusion audit methodology: the auditors, reference systems and audit guidelines].

    PubMed

    Chevrolle, F; Hadzlik, E; Arnold, J; Hergon, E

    2000-12-01

    The audit has become an essential aspect of the blood transfusion sector, and is a management tool that should be used judiciously. The main types of audit that can be envisaged in blood transfusion are the following: operational audit concerning a predetermined activity; systems quality audit; competence audit, combining the operational audit on a specific activity with quality management, e.g., laboratory accreditation; audit of the environmental management system; and social audit involving the organization of an activity and the management of human resources. However, the main type of audit considered in this article is the conformity audit, which in this context does not refer to internal control but to conformity with an internal guideline issued by the French National Blood Service. All audits are carried out on the basis of a predescribed method (contained in ISO 10 011). The audit is a system of investigation, evaluation and measurement, and also a means of continuous assessment and therefore improvement. The audit is based on set guidelines, but in fact consists of determining the difference between the directions given and what has actually been done. Auditing requires operational rigor and integrity, and has now become a profession in its own right.

  13. [Blood transfusion audit methodology: the auditors, reference systems and audit guidelines].

    PubMed

    Chevrolle, F; Hadzlik, E; Arnold, J; Hergon, E

    2000-12-01

    The audit has become an essential aspect of the blood transfusion sector, and is a management tool that should be used judiciously. The main types of audit that can be envisaged in blood transfusion are the following: operational audit concerning a predetermined activity; systems quality audit; competence audit, combining the operational audit on a specific activity with quality management, e.g., laboratory accreditation; audit of the environmental management system; and social audit involving the organization of an activity and the management of human resources. However, the main type of audit considered in this article is the conformity audit, which in this context does not refer to internal control but to conformity with an internal guideline issued by the French National Blood Service. All audits are carried out on the basis of a predescribed method (contained in ISO 10 011). The audit is a system of investigation, evaluation and measurement, and also a means of continuous assessment and therefore improvement. The audit is based on set guidelines, but in fact consists of determining the difference between the directions given and what has actually been done. Auditing requires operational rigor and integrity, and has now become a profession in its own right. PMID:11204842

  14. It's a Shame about Audit

    ERIC Educational Resources Information Center

    Tyler, Deborah; Wright, Russell Daine

    2004-01-01

    Academics are prone to mythologizing a lost golden age. As a result, it is often difficult to pinpoint what about new management methods that causes frustration and resentment. The authors look at the "audit culture" of contemporary universities, and suggest that such a culture promotes verbal dishonesty and an atmosphere of mistrust.

  15. Why Audit Communication in Organizations?

    ERIC Educational Resources Information Center

    White, Noel D.; Greenbaum, Howard H.

    The purpose of this paper is to present a common sense proposal, as opposed to a documented proposal, arguing for the adoption of a periodic communication audit procedure in organizations. The paper presents an approach and information the communication consultant can utilize in addressing management practitioners on the topic: "Why Audit…

  16. Energy Audits. Energy Technology Series.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This course in energy audits is one of 16 courses in the Energy Technology Series developed for an Energy Conservation-and-Use Technology curriculum. Intended for use in two-year postsecondary technical institutions to prepare technicians for employment, the courses are also useful in industry for updating employees in company-sponsored training…

  17. Strategic Audit and Marketing Plan

    ERIC Educational Resources Information Center

    Wright, Lianna S.

    2013-01-01

    The purpose of this audit was to revise the marketing plan for ADSum Professional Development School and give the owner a long-term vision of the school to operate competitively in the crowded field of for-profit schools. It is fairly simple to create a strategic plan but harder to implement and execute. Execution requires weeks and months of…

  18. Program Accountability: "The State Audit".

    ERIC Educational Resources Information Center

    Charles, Richard F.

    Guidelines, based on the California Education Code and the California Community College Student Attendance Accounting Manual, are presented as an aid to program-level administrators and staff preparing for a state audit of program attendance records. After introductory material examining the role of average daily attendance (ADA) and weekly…

  19. Antimicrobial stewardship auditing of patients reviewed by infectious diseases physicians in a tertiary university hospital

    PubMed Central

    2013-01-01

    Background The optimal way for antimicrobial stewardship programs (ASPs) to interact with existing infectious disease physician (IDP) services within the same institution is unknown. In our institution, IDPs and our prospective audit and feedback ASP operate independently, with occasionally differing recommendations offered for the same inpatient. We performed a retrospective audit on inpatients that had been reviewed by both IDPs and ASP within a 7-day period, focusing on cases where different therapy-modifying recommendations had been offered. We analyzed the outcomes in inpatients where the ASP recommendations were accepted and compared these with the inpatients where the IDP recommendations were accepted instead. Outcomes assessed were 30-day mortality post-ASP review, unplanned re-admission within 30 days post-discharge from hospital, and clinical deterioration at 7 days post-ASP review. Findings There were 143 (18.9%) patients where differing recommendations had been offered, with primary physicians accepting 69.9% of ASP recommendations. No significant differences in terms of demographics, clinical characteristics, 30-day mortality, and re-admission rates were observed, although clinical deterioration rates were lower in patients where the ASP recommendation was accepted (8.0% vs. 27.9%; p = 0.002). On multivariate analysis, hematology-oncology inpatients were associated with unplanned readmission. Increasing age and hematology-oncology inpatients were associated with clinical deterioration 7 days post-recommendation, whereas acceptance of ASP recommendations was protective. No characteristic was independently associated with 30-day mortality. Conclusion In conclusion, independent reviews by both IDPs and ASPs can be compatible within large tertiary hospitals, providing primary physicians even in situations of conflicting recommendations viable alternative antimicrobial prescribing advice. PMID:24176042

  20. "I Feel Pain"--Audit of Communication Skills and Understanding of Pain and Health Needs with People with Learning Disabilities

    ERIC Educational Resources Information Center

    Beacroft, Monica; Dodd, Karen

    2011-01-01

    An audit was conducted across Surrey to investigate pain recognition and management with people with learning disabilities. This section of the audit looked at what people with learning disabilities understood and experienced when they had pain compared to good practice from the literature. The results show that people with learning disabilities…

  1. Dealing confidently with IRS, Part I: Preparing for IRS audits.

    PubMed

    Holub, S F; Walker, S R

    1978-10-01

    With the IRS apparently making health care institutions the focus of a nationwide audit emphasis, hospital administrators will want to prepare themselves for confident handling of audits. Four types of audit procedures are explained, suggestions are made for getting a hospital ready for an audit, and strategies are suggested for maintaining control over the audit's progress.

  2. 48 CFR 237.270 - Acquisition of audit services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... services unless— (i) The cognizant DoD audit organization determines that expertise required to perform the audit is not available within the DoD audit organization; or (ii) Temporary audit assistance is required... that the cognizant DoD audit organization has approved the statement of work. The requiring...

  3. 29 CFR 99.220 - Frequency of audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Frequency of audits. 99.220 Section 99.220 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99... for the biennial period under audit. (b) Any non-profit organization that had biennial audits for...

  4. 29 CFR 99.235 - Program-specific audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Program-specific audits. 99.235 Section 99.235 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.235 Program-specific audits. (a) Program-specific audit guide available. In many cases, a...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Relation to other audit requirements. 99.215 Section 99.215 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other...

  6. 29 CFR 99.220 - Frequency of audits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Frequency of audits. 99.220 Section 99.220 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.220 Frequency of audits. Except for the provisions for biennial audits provided in paragraphs (a)...

  7. 29 CFR 99.220 - Frequency of audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Frequency of audits. 99.220 Section 99.220 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.220 Frequency of audits. Except for the provisions for biennial audits provided in paragraphs (a)...

  8. 29 CFR 99.220 - Frequency of audits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Frequency of audits. 99.220 Section 99.220 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.220 Frequency of audits. Except for the provisions for biennial audits provided in paragraphs (a)...

  9. 7 CFR 3052.500 - Scope of audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... understanding of internal control over Federal programs sufficient to plan the audit to support a low assessed... 7 Agriculture 15 2010-01-01 2010-01-01 false Scope of audit. 3052.500 Section 3052.500 Agriculture... audit. (a) General. The audit shall be conducted in accordance with GAGAS. The audit shall cover...

  10. 7 CFR 3052.235 - Program-specific audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Program-specific audits. (a) Program-specific audit guide available. In many cases, a program-specific audit guide will be available to provide specific guidance to the auditor with respect to internal control, compliance requirements, suggested audit procedures, and audit reporting requirements....

  11. The Communication Audit: A Framework for Teaching Management Communication.

    ERIC Educational Resources Information Center

    Shelby, Annette N.; Reinsch, N. Lamar, Jr.

    1996-01-01

    Describes a communication audit project used in a graduate-level management communication course. Reviews literature concerning communication audits, explains why and how an audit project is used in the author's classes, and describes specific audit-related assignments. Concludes that, although a challenging assignment, the audit is worthwhile.…

  12. The Benefit of Introducing Audit Software into Curricula for Computer Auditing Students: A Student Perspective from the University of Pretoria

    ERIC Educational Resources Information Center

    Coetzee, G. P.; du Bruyn, R.

    2003-01-01

    The use of computers in the learning process is a well-researched area. The introduction of computers and related audit software in the auditing field has had a major influence on the auditing process. Very little research has been done on the inclusion of computer audit software in the auditing syllabus. Even less research has been done on the…

  13. 25 CFR 39.410 - What qualifications must an audit firm meet to be considered for auditing ISEP administration?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... considered for auditing ISEP administration? 39.410 Section 39.410 Indians BUREAU OF INDIAN AFFAIRS... qualifications must an audit firm meet to be considered for auditing ISEP administration? To be considered for auditing ISEP administration under this subpart, an independent audit firm must: (a) Be a...

  14. Govt. Pubs.: Internal Auditing in Federal, State, and Local Governments.

    ERIC Educational Resources Information Center

    Knight, Susan; Wilson, Guy

    1980-01-01

    Lists reports, monographs, and journal articles of the last five years that deal with internal auditing at various governmental levels, including the growth of the internal audit, the development of guidelines, current practices, types of audit, and current issues. (FM)

  15. 15 CFR 295.10 - Special reporting and auditing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) mandate for program evaluation. The audit standards to be applied to ATP awards are the “Government... standards) and the ATP program-specified audit guidelines. The ATP program-specific audit guidelines...

  16. 30 CFR 1217.300 - Audit or review of records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... RESOURCES REVENUE AUDITS AND INSPECTIONS Geothermal Resources § 1217.300 Audit or review of records. The... rental, royalty, fees, and other payment requirements on a Federal geothermal lease. Audits or...

  17. 30 CFR 1217.300 - Audit or review of records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... RESOURCES REVENUE AUDITS AND INSPECTIONS Geothermal Resources § 1217.300 Audit or review of records. The... rental, royalty, fees, and other payment requirements on a Federal geothermal lease. Audits or...

  18. 30 CFR 217.300 - Audit or review of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT AUDITS AND INSPECTIONS Geothermal Resources § 217.300 Audit or review of records. The Secretary... rental, royalty, fees, and other payment requirements on a Federal geothermal lease. Audits or...

  19. 15 CFR 295.10 - Special reporting and auditing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) mandate for program evaluation. The audit standards to be applied to ATP awards are the “Government... standards) and the ATP program-specified audit guidelines. The ATP program-specific audit guidelines...

  20. Aggregate and event-level associations of substance use and sexual behavior among gay and bisexual men: Comparing retrospective and prospective data

    PubMed Central

    Rendina, H. Jonathon; Moody, Raymond L.; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T.

    2015-01-01

    Background Despite limited research, some evidence suggests that examining substance use at multiple levels may be of greater utility in predicting sexual behavior than utilizing one level of measurement, particularly when investigating different substances simultaneously. We aimed to examine aggregated and event-level associations between three forms of substance use—alcohol, marijuana, and club drugs—and two sexual behavior outcomes—sexual engagement and condomless anal sex (CAS). Method Analyses focused on both 6-week timeline follow-back (TLFB; retrospective) and 30-day daily diary (prospective) data among a demographically diverse sample of 371 highly sexually active HIV-positive and HIV-negative gay and bisexual men. Results Models from both TLFB and diary showed that event-level use of alcohol, marijuana, and club drugs was associated with increased sexual engagement, while higher aggregated frequency marijuana and any frequency club drug use were associated with decreased sexual engagement. Event-level use of club drugs was consistently associated with increased odds of CAS across both TLFB and diary models while higher frequency marijuana use was most consistently associated with a lower odds of CAS. Conclusions Findings indicated that results are largely consistent between retrospective and prospective data, but that retrospective results for substance use and sexual engagement were generally greater in magnitude. These results suggest that substance use primarily acts to increase sexual risk at the event-level and less so through individual-level frequency of use; moreover, it primarily does so by increasing the likelihood of sex on a given day with fewer significant associations with the odds of CAS on sex days. PMID:26190557