Factors Perceived to Influence the Decision for African Americans to Become Registered Organ Donors at the Department of Motorized Vehicles.

PubMed

DuBay, Derek A; Ivankova, Nataliya; Herby, Ivan; Schoenberger, Yu-Mei; Redden, David T; Holt, Cheryl; Siminoff, Laura; Fouad, Mona; Martin, Michelle Y

2017-01-01

African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors. The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV. Guided by the Social Cognitive Theory, 13 focus groups (n = 100 participants) were conducted with AAs within 3 months of visiting a DMV and making a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses. Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor. This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV. The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

Role strain among male RNs in the critical care setting: Perceptions of an unfriendly workplace.

PubMed

Carte, Nicholas S; Williams, Collette

2017-12-01

Traditionally, nursing has been a female-dominated profession. Men employed as registered nurses have been in the minority and little is known about the experiences of this demographic. The purpose of this descriptive, quantitative study was to understand the relationship between the variables of demographics and causes of role strain among male nurses in critical care settings. The Sherrod Role Strain Scale assesses role strain within the context of role conflict, role overload, role ambiguity and role incongruity. Data analysis of the results included descriptive and inferential statistics. Inferential statistics involved the use of repeated measures ANOVA testing for significant difference in the causes of role strain between male nurses employed in critical care settings and a post hoc comparison of specific demographic data using multivariate analyses of variance (MANOVAs). Data from 37 male nurses in critical care settings from the northeast of the United States were used to calculate descriptive statistics standard deviation, mean of the data analysis and results of the repeated ANOVA and the post hoc secondary MANOVA analysis. The descriptive data showed that all participants worked full-time. There was an even split from those participants who worked day shift (46%) vs. night shift (43%), most the participants indicated they had 15 years or more experience as an registered nurse (54%). Significant findings of this study include two causes of role strain in male nurses employed in critical care settings which are: role ambiguity and role overload based on ethnicity. Consistent with previous research findings, the results of this study suggest that male registered nurses employed in critical care settings do experience role strain. The two main causes of role strain in male nurses are role ambiguity and role overload. Copyright © 2017. Published by Elsevier Ltd.

In-memory interconnect protocol configuration registers

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

Cheng, Kevin Y.; Roberts, David A.

Systems, apparatuses, and methods for moving the interconnect protocol configuration registers into the main memory space of a node. The region of memory used for storing the interconnect protocol configuration registers may also be made cacheable to reduce the latency of accesses to the interconnect protocol configuration registers. Interconnect protocol configuration registers which are used during a startup routine may be prefetched into the host's cache to make the startup routine more efficient. The interconnect protocol configuration registers for various interconnect protocols may include one or more of device capability tables, memory-side statistics (e.g., to support two-level memory data mappingmore » decisions), advanced memory and interconnect features such as repair resources and routing tables, prefetching hints, error correcting code (ECC) bits, lists of device capabilities, set and store base address, capability, device ID, status, configuration, capabilities, and other settings.« less

Association between registered nurse staffing and management outcomes of patients with type 2 diabetes within primary care: a cross-sectional linkage study

PubMed Central

Lukewich, Julia; Edge, Dana S.; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan

2016-01-01

Background: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. Methods: Patient data from the Canadian Primary Care Sentinel Surveillance Network were matched with survey data from 15 Family Health Team practices in southeastern Ontario. Included patients were adults with type 2 diabetes mellitus who had at least 1 primary care encounter at a Family Health Team practice that completed the organizational survey between Apr. 1, 2013, and Mar. 31, 2014. The clinical outcomes explored included hemoglobin A1c, fasting plasma glucose, blood pressure, low-density lipoprotein cholesterol and urine albumin:creatinine ratio. Results: Of the 15 practices, 13 (86.7%) had at least 1 registered nurse. The presence of 1 or more registered nurses in the practice was associated with increased odds of patients' having their hemoglobin A1c, fasting plasma glucose, blood pressure and low-density lipoprotein cholesterol values meet recommended targets. Practices with the lowest ratios of patients with diabetes to registered nurse had a significantly greater proportion of patients with hemoglobin A1c and fasting plasma glucose values on target than did practices with the highest ratios of patients to registered nurse (p < 0.01 and p = 0.03, respectively). Interpretation: The findings suggest that registered nurse staffing within primary care practice teams contributes to better diabetic care, as measured by diabetes management indicators. This study sets the groundwork for further exploration of nursing and organizational contributions to patient care in the primary care setting. PMID:27398372

Apparatus and method for implementing power saving techniques when processing floating point values

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

Kim, Young Moon; Park, Sang Phill

An apparatus and method are described for reducing power when reading and writing graphics data. For example, one embodiment of an apparatus comprises: a graphics processor unit (GPU) to process graphics data including floating point data; a set of registers, at least one of the registers of the set partitioned to store the floating point data; and encode/decode logic to reduce a number of binary 1 values being read from the at least one register by causing a specified set of bit positions within the floating point data to be read out as 0s rather than 1s.

Floating point only SIMD instruction set architecture including compare, select, Boolean, and alignment operations

DOEpatents

Gschwind, Michael K [Chappaqua, NY

2011-03-01

Mechanisms for implementing a floating point only single instruction multiple data instruction set architecture are provided. A processor is provided that comprises an issue unit, an execution unit coupled to the issue unit, and a vector register file coupled to the execution unit. The execution unit has logic that implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA). The floating point vector registers of the vector register file store both scalar and floating point values as vectors having a plurality of vector elements. The processor may be part of a data processing system.

The capability set for work - correlates of sustainable employability in workers with multiple sclerosis.

PubMed

van Gorp, D A M; van der Klink, J J L; Abma, F I; Jongen, P J; van Lieshout, I; Arnoldus, E P J; Beenakker, E A C; Bos, H M; van Eijk, J J J; Fermont, J; Frequin, S T F M; de Gans, K; Hengstman, G J D; Hupperts, R M M; Mostert, J P; Pop, P H M; Verhagen, W I M; Zemel, D; Heerings, M A P; Reneman, M F; Middelkoop, H A M; Visser, L H; van der Hiele, K

2018-06-01

The aim of this study was to examine whether work capabilities differ between workers with Multiple Sclerosis (MS) and workers from the general population. The second aim was to investigate whether the capability set was related to work and health outcomes. A total of 163 workers with MS from the MS@Work study and 163 workers from the general population were matched for gender, age, educational level and working hours. All participants completed online questionnaires on demographics, health and work functioning. The Capability Set for Work Questionnaire was used to explore whether a set of seven work values is considered valuable (A), is enabled in the work context (B), and can be achieved by the individual (C). When all three criteria are met a work value can be considered part of the individual's 'capability set'. Group differences and relationships with work and health outcomes were examined. Despite lower physical work functioning (U = 4250, p = 0.001), lower work ability (U = 10591, p = 0.006) and worse self-reported health (U = 9091, p ≤ 0.001) workers with MS had a larger capability set (U = 9649, p ≤ 0.001) than the general population. In workers with MS, a larger capability set was associated with better flexible work functioning (r = 0.30), work ability (r = 0.25), self-rated health (r = 0.25); and with less absenteeism (r = - 0.26), presenteeism (r = - 0.31), cognitive/neuropsychiatric impairment (r = - 0.35), depression (r = - 0.43), anxiety (r = - 0.31) and fatigue (r = - 0.34). Workers with MS have a larger capability set than workers from the general population. In workers with MS a larger capability set was associated with better work and health outcomes. This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. The study is registered at the Dutch CCMO register ( https://www.toetsingonline.nl ). This study is approved by the METC Brabant, 12 February 2014. First participants are enrolled 1 st of March 2014.

Prognostic scoring systems for myelodysplastic syndromes (MDS) in a population-based setting: a report from the Swedish MDS register.

PubMed

Moreno Berggren, Daniel; Folkvaljon, Yasin; Engvall, Marie; Sundberg, Johan; Lambe, Mats; Antunovic, Petar; Garelius, Hege; Lorenz, Fryderyk; Nilsson, Lars; Rasmussen, Bengt; Lehmann, Sören; Hellström-Lindberg, Eva; Jädersten, Martin; Ejerblad, Elisabeth

2018-06-01

The myelodysplastic syndromes (MDS) have highly variable outcomes and prognostic scoring systems are important tools for risk assessment and to guide therapeutic decisions. However, few population-based studies have compared the value of the different scoring systems. With data from the nationwide Swedish population-based MDS register we validated the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R) and the World Health Organization (WHO) Classification-based Prognostic Scoring System (WPSS). We also present population-based data on incidence, clinical characteristics including detailed cytogenetics and outcome from the register. The study encompassed 1329 patients reported to the register between 2009 and 2013, 14% of these had therapy-related MDS (t-MDS). Based on the MDS register, the yearly crude incidence of MDS in Sweden was 2·9 per 100 000 inhabitants. IPSS-R had a significantly better prognostic power than IPSS (P < 0·001). There was a trend for better prognostic power of IPSS-R compared to WPSS (P = 0·05) and for WPSS compared to IPSS (P = 0·07). IPSS-R was superior to both IPSS and WPSS for patients aged ≤70 years. Patients with t-MDS had a worse outcome compared to de novo MDS (d-MDS), however, the validity of the prognostic scoring systems was comparable for d-MDS and t-MDS. In conclusion, population-based studies are important to validate prognostic scores in a 'real-world' setting. In our nationwide cohort, the IPSS-R showed the best predictive power. © 2018 John Wiley & Sons Ltd.

NOTE: Optimization of megavoltage CT scan registration settings for thoracic cases on helical tomotherapy

NASA Astrophysics Data System (ADS)

Woodford, Curtis; Yartsev, Slav; Van Dyk, Jake

2007-08-01

This study aims to investigate the settings that provide optimum registration accuracy when registering megavoltage CT (MVCT) studies acquired on tomotherapy with planning kilovoltage CT (kVCT) studies of patients with lung cancer. For each experiment, the systematic difference between the actual and planned positions of the thorax phantom was determined by setting the phantom up at the planning isocenter, generating and registering an MVCT study. The phantom was translated by 5 or 10 mm, MVCT scanned, and registration was performed again. A root-mean-square equation that calculated the residual error of the registration based on the known shift and systematic difference was used to assess the accuracy of the registration process. The phantom study results for 18 combinations of different MVCT/kVCT registration options are presented and compared to clinical registration data from 17 lung cancer patients. MVCT studies acquired with coarse (6 mm), normal (4 mm) and fine (2 mm) slice spacings could all be registered with similar residual errors. No specific combination of resolution and fusion selection technique resulted in a lower residual error. A scan length of 6 cm with any slice spacing registered with the full image fusion selection technique and fine resolution will result in a low residual error most of the time. On average, large corrections made manually by clinicians to the automatic registration values are infrequent. Small manual corrections within the residual error averages of the registration process occur, but their impact on the average patient position is small. Registrations using the full image fusion selection technique and fine resolution of 6 cm MVCT scans with coarse slices have a low residual error, and this strategy can be clinically used for lung cancer patients treated on tomotherapy. Automatic registration values are accurate on average, and a quick verification on a sagittal MVCT slice should be enough to detect registration outliers.

Use of antidepressants in Parkinson's disease: A Swedish register-based study of over 1.5 million older people.

PubMed

Haasum, Ylva; Fastbom, Johan; Johnell, Kristina

2016-06-01

It has been suggested that depression in Parkinson's Disease (PD) is often unrecognized and undertreated. However, few previous studies have studied the use of antidepressants in a large sample of both home-dwelling and institutionalized elderly persons with PD. We aimed to study the use of antidepressants in older persons using anti-parkinson drugs (APD, used as a proxy for PD), stratified by residential setting. We analyzed individual data on age, sex, residential setting and drug use in over 1.5 million older persons in the Swedish Prescribed Drug Register on 31th of December 2013. Twenty-two percent of the home-dwellers and 50% of the institutionalized elderly persons with APD used antidepressants. Persons with APD had a higher probability of use of any antidepressant compared to persons without APD. A selective serotonin reuptake inhibitor (SSRI) was the most commonly used antidepressants in both settings followed by mirtazapin. The high use of antidepressants among older persons with APD warrants further studies on the quality of treatment of depression in PD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting.

PubMed

Anderson, Joel G; Friesen, Mary Ann; Swengros, Diane; Herbst, Anna; Mangione, Lucrezia

2017-03-01

Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.

Using Registered Dental Hygienists to Promote a School-Based Approach to Dental Public Health

PubMed Central

Wellever, Anthony; Kelly, Patricia

2017-01-01

We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion. PMID:28661808

The Experiences of Registered Nurses Transitioning from Patient Care Settings to Academia

ERIC Educational Resources Information Center

Gwin, Teresa

2012-01-01

Registered nurses (RNs) who make the move from a patient-care service setting to an academic teaching environment often go through a transition phase in their first semesters of teaching that is difficult and traumatic. RNs that go on to higher academic degrees often do so in order to teach in schools of nursing. However, graduate work in nursing…

Nurses' meaning of caring with patients in acute psychiatric hospital settings: a grounded theory study.

PubMed

Chiovitti, Rosalina F

2008-02-01

The concept of caring is described as intangible, abstract, and invisible in nursing practice. This has translated into a view of caring as a personal choice or natural obligation rather than a deliberate process. While there has been movement to delineate caring within nursing in general, the psychiatric nurse's perspective on caring has been absent from theoretical works and measures constructed to describe nurse's work. To develop a substantive grounded theory of caring from the perspective of Registered Nurses working with patients in three Canadian acute psychiatric hospital settings. The qualitative research design of grounded theory methodology was used to develop a theory of caring. Three urban, acute psychiatric hospital settings in Canada. Two were general hospitals and one was a psychiatric hospital. Registered Nurses (N=17) licensed with the College of Nurses of Ontario. In-depth interviews with Registered Nurses were conducted using theoretical sampling. The data were analysed using constant comparative analysis. Protective empowering is the basic social psychological process that represents Registered Nurses' caring with patients in acute psychiatric hospital settings. Nurses accomplish protective empowering through six main categories of: (1) respecting the patient; (2) not taking the patient's behaviour personally; (3) keeping the patient safe; (4) encouraging the patient's health; (5) authentic relating; and (6) interactive teaching. The six main categories were accomplished through 27 subcategories. In the theory of protective empowering, the goal is to help patients participate in activities contributing to convalescence, health, and/or quality of life. The theory of protective empowering provides six main categories and 27 subcategories that can be transferred to funding formulas, patient health record documentation systems, nurse orientation and education programs, nurse role descriptions, and used in guiding discussions about organizational values of patient-centred care within a collaborative multidisciplinary context.

Reflections on Distributive Leadership for Work-Based Mobile Learning of Canadian Registered Nurses

ERIC Educational Resources Information Center

Fahlman, Dorothy

2017-01-01

The ubiquity, flexibility, and accessibility of mobile devices can transform how registered nurses in Canada learn beyond the confines of traditional education/training boundaries in their work settings. Many Canadian registered nurses have actively embraced mobile technologies for their work-based learning to meet their competency requirements…

Preliminary Study of Bioinformatics Patents and Their Classifications Registered in the KIPRIS Database.

PubMed

Park, Hyun-Seok

2012-12-01

Whereas a vast amount of new information on bioinformatics is made available to the public through patents, only a small set of patents are cited in academic papers. A detailed analysis of registered bioinformatics patents, using the existing patent search system, can provide valuable information links between science and technology. However, it is extremely difficult to select keywords to capture bioinformatics patents, reflecting the convergence of several underlying technologies. No single word or even several words are sufficient to identify such patents. The analysis of patent subclasses can provide valuable information. In this paper, I did a preliminary study of the current status of bioinformatics patents and their International Patent Classification (IPC) groups registered in the Korea Intellectual Property Rights Information Service (KIPRIS) database.

A Scandinavian experience of register collaboration: the Nordic Arthroplasty Register Association (NARA).

PubMed

Havelin, Leif I; Robertsson, Otto; Fenstad, Anne M; Overgaard, Søren; Garellick, Göran; Furnes, Ove

2011-12-21

The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research. A collaboration called NARA (Nordic Arthroplasty Register Association) was started in 2007, resulting in a common database for Denmark, Norway, and Sweden with regard to hip replacements in 2008 and primary knee replacements in 2009. Finland joined the project in 2010. A code set was defined for the parameters that all registers had in common, and data were re-coded, within each national register, according to the common definitions. After de-identification of the patients, the anonymous data were merged into a common database. The first study based on this common database included 280,201 hip arthroplasties and the second, 151,814 knee arthroplasties. Kaplan-Meier and Cox multiple regression analyses, with adjustment for age, sex, and diagnosis, were used to calculate prosthesis survival, with any revision as the end point. In later studies, specific reasons for revision were also used as end points. We found differences among the countries concerning patient demographics, preferred surgical approaches, fixation methods, and prosthesis brands. Prosthesis survival was best in Sweden, where cement implant fixation was used more commonly than it was in the other countries. As the comparison of national results was one of the main initial aims of this collaboration, only parameters and data that all three registers could deliver were included in the database. Compared with each separate register, this combined register resulted in reduced numbers of parameters and details. In future collaborations of registers with a focus on comparing the performances of prostheses and articulations, we should probably include only the data needed specifically for the predetermined purposes, from registers that can deliver these data, rather than compiling all data from all registers that are willing to participate.

Cohort Profile: the National Prostate Cancer Register of Sweden and Prostate Cancer data Base Sweden 2.0.

PubMed

Van Hemelrijck, Mieke; Wigertz, Annette; Sandin, Fredrik; Garmo, Hans; Hellström, Karin; Fransson, Per; Widmark, Anders; Lambe, Mats; Adolfsson, Jan; Varenhorst, Eberhard; Johansson, Jan-Erik; Stattin, Pär

2013-08-01

In 1987, the first Regional Prostate Cancer Register was set up in the South-East health-care region of Sweden. Other health-care regions joined and since 1998 virtually all prostate cancer (PCa) cases are registered in the National Prostate Cancer Register (NPCR) of Sweden to provide data for quality assurance, bench marking and clinical research. NPCR includes data on tumour stage, Gleason score, serum level of prostate-specific antigen (PSA) and primary treatment. In 2008, the NPCR was linked to a number of other population-based registers by use of the personal identity number. This database named Prostate Cancer data Base Sweden (PCBaSe) has now been extended with more cases, longer follow-up and a selection of two control series of men free of PCa at the time of sampling, as well as information on brothers of men diagnosed with PCa, resulting in PCBaSe 2.0. This extension allows for studies with case-control, cohort or longitudinal case-only design on aetiological factors, pharmaceutical prescriptions and assessment of long-term outcomes. The NPCR covers >96% of all incident PCa cases registered by the Swedish Cancer Register, which has an underreporting of <3.7%. The NPCR is used to assess trends in incidence, treatment and outcome of men with PCa. Since the national registers linked to PCBaSe are complete, studies from PCBaSe 2.0 are truly population based.

Mapping health outcome measures from a stroke registry to EQ-5D weights.

PubMed

Ghatnekar, Ola; Eriksson, Marie; Glader, Eva-Lotta

2013-03-07

To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n=272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for "dressing", "toileting", "mobility", "mood", "general health" and "proxy-responders" were applied to the validation set (n=272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥ 0.5 (P<0.01). This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility.

A national quality registers as a tool to audit items of the fundamentals of care to older patients with hip fractures.

PubMed

Hommel, Ami; Bååth, Carina

2016-06-01

The Swedish healthcare system has a unique resource in the national quality registers. A national quality registry contains individualised data concerning patient problems, medical interventions and outcomes after treatment, within all healthcare settings. Many healthcare settings face challenges related to the way they deliver the fundamentals of care, therefore, it is important to audit the outcome. It is estimated that the number of people aged 80 years or older will have almost quadrupled between 2000 and 2050. Hip fracture has been recognised as the most serious consequence of osteoporosis because of the risk of its complications, which include pain, acute confusional state, pressure ulcers, infections, disability, diminished quality of life and mortality. The aim of this study was therefore to explore if and how a national quality register can be used as an audit tool for the fundamentals of care when it concerns older patients suffering from a hip fracture. For this study we retrospectively selected and audited variables retrieved from the national quality hip fracture register. The audit included 1083 patients 80 years and older, consecutively admitted to a university hospital in the south of Sweden, in 2011-2013. Nearly half of the patients were admitted from their own homes and were living alone. Almost half of the patients could walk outdoors before the fracture occurred. After 4 months, 28.5% of the patients walked outdoors. Additionally, after 4 months about 30% of the patients were still suffering from pain after hip fracture surgery and still using analgesics. There was a reduction in length of stay between 2011 and 2013. As a part of the national quality register the questions from EQ5D were used before surgery and after 4 months. Before discharge from hospital there were less registered complications in 2012 and 2013 compared with 2011. The national hip fracture quality register allows healthcare staff to analyse nursing outcomes and to highlight some fundamental aspects of care. Greater awareness, among hospital staff, of risk factors for complications in hip fracture patients may lead to improved patient care. Through registration in a quality register and working with the results we as Registered Nurses can ensure quality health care for older adults. © 2015 John Wiley & Sons Ltd.

Registered nurses' use of research findings in the care of older people.

PubMed

Boström, Anne-Marie; Kajermo, Kerstin Nilsson; Nordström, Gun; Wallin, Lars

2009-05-01

To describe registered nurses' reported use of research in the care of older people and to examine associations between research use and factors related to the elements: the communication channels, the adopter and the social system. Research use among registered nurses working in hospital settings has been reported in many studies. Few studies, however, have explored the use of research among registered nurses working in the care of older people. A cross-sectional survey. In eight municipalities, all registered nurses (n = 210) working in older people care were invited to participate (response rate 67%). The Research Utilisation Questionnaire was adopted. Questions concerning the work organisation and research-related resources were sent to the Community Chief Nurse at each municipality. Descriptive statistics and logistic regression were applied. The registered nurses reported a relatively low use of research findings in daily practice, despite reporting a positive attitude to research. The registered nurses reported lack of access to research reports at the work place and that they had little support from unit managers and colleagues. Registered nurses working in municipalities with access to research-related resources reported more use of research than registered nurses without resources. The factors 'Access to research findings at work place', 'Positive attitudes to research' and 'Nursing programme at university level' were significantly associated with research use. There is a great potential to increase registered nurses' use of research findings in the care of older people. Factors which were linked to the communication channels and the adopter were associated with research use. Strategies to enhance research use should focus on access to and adequate training in using information sources, increased knowledge on research methodology and nursing science and a supportive organisation.

High agreement between the new Mongolian electronic immunization register and written immunization records: a health centre based audit

PubMed Central

Mungun, Tuya; Dorj, Narangerel; Volody, Baigal; Chuluundorj, Uranjargal; Munkhbat, Enkhtuya; Danzan, Gerelmaa; Nguyen, Cattram D; La Vincente, Sophie; Russell, Fiona

2017-01-01

Introduction Monitoring of vaccination coverage is vital for the prevention and control of vaccine-preventable diseases. Electronic immunization registers have been increasingly adopted to assist with the monitoring of vaccine coverage; however, there is limited literature about the use of electronic registers in low- and middle-income countries such as Mongolia. We aimed to determine the accuracy and completeness of the newly introduced electronic immunization register for calculating vaccination coverage and determining vaccine effectiveness within two districts in Mongolia in comparison to written health provider records. Methods We conducted a cross-sectional record review among children 2–23 months of age vaccinated at immunization clinics within the two districts. We linked data from written records with the electronic immunization register using the national identification number to determine the completeness and accuracy of the electronic register. Results Both completeness (90.9%; 95% CI: 88.4–93.4) and accuracy (93.3%; 95% CI: 84.1–97.4) of the electronic immunization register were high when compared to written records. The increase in completeness over time indicated a delay in data entry. Conclusion Through this audit, we have demonstrated concordance between a newly introduced electronic register and health provider records in a middle-income country setting. Based on this experience, we recommend that electronic registers be accompanied by routine quality assurance procedures for the monitoring of vaccination programmes in such settings. PMID:29051836

Speaking up, being heard: registered nurses' perceptions of workplace communication.

PubMed

Garon, Maryanne

2012-04-01

The aim of the present study was to explore nurses' perceptions of their own ability to speak up and be heard in the workplace. Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction, team work as well as patient safety. The present study utilized a qualitative approach, consisting of focus group interviews of 33 registered nurses (RNs), in staff or management positions from a variety of healthcare settings in California, USA. Data were analysed using thematic content analysis. Findings were organized into three categories: influences on speaking up, transmission and reception of a message and outcomes or results. The present study supported the importance of the manager in setting the culture of open communication. It is anticipated that findings from the present study may increase understandings of nurse views of communication within healthcare settings. The study highlights the importance of nurse managers in creating the communication culture that will allow nurses to speak up and be heard. These open communication cultures lead to better patient care, increased safety and better staff satisfaction. © 2011 Blackwell Publishing Ltd.

Learning needs assessment for registered nurses in two large acute care hospitals in Urban New Zealand.

PubMed

Dyson, Lyn; Hedgecock, Bronwyn; Tomkins, Sharon; Cooke, Gordon

2009-11-01

Ongoing education for the nursing workforce is necessary to ensure currency of knowledge in order to enable evidence based client care. The cost of education is high to the organisation and the individual, and must therefore be cost-effective, relevant and appropriate. According to research, education for nurses is not always systematically planned and developed and often relies on the interest area and assessment of the nurse educators. To survey the learning needs of clinically based registered nurses within an acute care setting. An anonymous questionnaire was used to collect the data. Two groups completed the questionnaire: all eligible registered nurses in two acute care hospitals located in urban New Zealand and their senior nurses such as clinical nurse managers, specialists and educators. The study found agreement on learning needs and also noted differing opinions between the Registered Nurses (RNs), and their senior RNs, RNs initially registered overseas and between levels of practice, on selection and ranking of learning needs. This survey identified a number of high learning needs for RNs working within acute care settings. Differences in perception of learning needs for RNs, between the nurses themselves and the Senior RNs exist, as well as among sub groups of RNs. As a result, educators and managers are encouraged to collaborate to realise the opportunity which exists for the provision of education across specialty areas and to work with the different groups and the individual to ensure unique learning needs are met.

"Theory Becoming Alive": The Learning Transition Process of Newly Graduated Nurses in Canada.

PubMed

Nour, Violet; Williams, Anne M

2018-01-01

Background Newly graduated nurses often encounter a gap between theory and practice in clinical settings. Although this has been the focus of considerable research, little is known about the learning transition process. Purpose The purpose of this study was to explore the experiences of newly graduated nurses in acute healthcare settings within Canada. This study was conducted to gain a greater understanding of the experiences and challenges faced by graduates. Methods Grounded theory method was utilized with a sample of 14 registered nurses who were employed in acute-care settings. Data were collected using in-depth interviews. Constant comparative analysis was used to analyze data. Results Findings revealed a core category, "Theory Becoming Alive," and four supporting categories: Entry into Practice, Immersion, Committing, and Evolving. Theory Becoming Alive described the process of new graduate nurses' clinical learning experiences as well as the challenges that they encountered in clinical settings after graduating. Conclusions This research provides a greater understanding of learning process of new graduate nurses in Canada. It highlights the importance of providing supportive environments to assist new graduate nurses to develop confidence as independent registered nurses in clinical areas. Future research directions as well as supportive educational strategies are described.

Supplement B: Research Networking Systems Characteristics Profiles. A Companion to the OCLC Research Report, Registering Researchers in Authority Files

ERIC Educational Resources Information Center

Smith-Yoshimura, Karen; Altman, Micah; Conlon, Michael; Cristán, Ana Lupe; Dawson, Laura; Dunham, Joanne; Hickey, Thom; Hill, Amanda; Hook, Daniel; Horstmann, Wolfram; MacEwan, Andrew; Schreur, Philip; Smart, Laura; Wacker, Melanie; Woutersen, Saskia

2014-01-01

The OCLC Research Report, "Registering Researchers in Authority Files", [Accessible in ERIC as ED564924] summarizes the results of the research conducted by the OCLC Research Registering Researchers in Authority Files Task Group in 2012-2014. Details of this research are in supplementary data sets: (1) "Supplement A: Use Cases. A…

A m-ary linear feedback shift register with binary logic

NASA Technical Reports Server (NTRS)

Perlman, M. (Inventor)

1973-01-01

A family of m-ary linear feedback shift registers with binary logic is disclosed. Each m-ary linear feedback shift register with binary logic generates a binary representation of a nonbinary recurring sequence, producible with a m-ary linear feedback shift register without binary logic in which m is greater than 2. The state table of a m-ary linear feedback shift register without binary logic, utilizing sum modulo m feedback, is first tubulated for a given initial state. The entries in the state table are coded in binary and the binary entries are used to set the initial states of the stages of a plurality of binary shift registers. A single feedback logic unit is employed which provides a separate feedback binary digit to each binary register as a function of the states of corresponding stages of the binary registers.

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

PubMed

Fleminger, Jessica; Goldacre, Ben

2018-01-01

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

Nurses who work in rural and remote communities in Canada: a national survey.

PubMed

MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela

2017-05-23

In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

Chasing the Mirage: a grounded theory of the clinical reasoning processes that Registered Nurses use to recognize delirium.

PubMed

El Hussein, Mohamed; Hirst, Sandra

2016-02-01

The aim of this study was to construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognize delirium in older adults in acute care hospitals. Delirium is under-recognized in acute hospital settings, this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' (RNs) clinical reasoning processes in complex situations such as delirium recognition. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of RNs in acute hospital settings. Seventeen RNs were recruited. Concurrent data collection and comparative analysis and theoretical sampling were conducted in 2013-2014. The core category to emerge from the data was 'chasing the mirage', which describes RNs' clinical reasoning processes to recognize delirium during their interaction with older adults. Understanding the reasoning that contributes to delirium under-recognition provides a strategy by which, this problem can be brought to the forefront of RNs' awareness and intervention. Delirium recognition will contribute to quality care for older adults. © 2015 John Wiley & Sons Ltd.

Highly parallel reconfigurable computer architecture for robotic computation having plural processor cells each having right and left ensembles of plural processors

NASA Technical Reports Server (NTRS)

Fijany, Amir (Inventor); Bejczy, Antal K. (Inventor)

1994-01-01

In a computer having a large number of single-instruction multiple data (SIMD) processors, each of the SIMD processors has two sets of three individual processor elements controlled by a master control unit and interconnected among a plurality of register file units where data is stored. The register files input and output data in synchronism with a minor cycle clock under control of two slave control units controlling the register file units connected to respective ones of the two sets of processor elements. Depending upon which ones of the register file units are enabled to store or transmit data during a particular minor clock cycle, the processor elements within an SIMD processor are connected in rings or in pipeline arrays, and may exchange data with the internal bus or with neighboring SIMD processors through interface units controlled by respective ones of the two slave control units.

Fire-setting performed in adolescence or early adulthood predicts schizophrenia: a register-based follow-up study of pre-trial offenders.

PubMed

Thomson, Annika; Tiihonen, Jari; Miettunen, Jouko; Virkkunen, Matti; Lindberg, Nina

2017-02-01

Aggressive and disruptive behaviours often precede the onset of serious mental illnesses. Fire-setting is a type of crime that is associated with psychotic disorders. The aim of this prospective follow-up study was to investigate if fire-setting performed in adolescence or early adulthood was associated with future diagnoses of schizophrenia or schizoaffective disorder. The consecutive sample consisted of 111 Finnish 15-25-year old males with fire-setting crimes, decreed to a pre-trial forensic psychiatric examination in 1973-1998, and showing no past nor current psychosis at the time of examination. For each firesetter, four age-, gender-, and place of birth-matched controls were randomly selected from the Central Population Register. The subjects were followed until the death of the individual, until they moved abroad, or until the end of 2012. Fourteen firesetters (12.6%) and five controls (1.1%) were diagnosed with either schizophrenia or schizoaffective disorder later in life, corresponding to a hazard ratio of 12.5. The delay between the fire-setting offense and the future diagnosis was on average nearly 10 years. Young male offenders undergoing a forensic psychiatric examination because of fire-setting crimes had a significant propensity for schizophrenia and schizoaffective disorder. Accurate assessments should be made both during imprisonment and later in life to detect possible psychotic signs in these individuals.

The care of patients assessed as not in need of emergency ambulance care - Registered nurses' lived experiences.

PubMed

Barrientos, Christian; Holmberg, Mats

2018-05-01

The aim of this study was to describe the care of patients assessed as not in need of emergency ambulance care, from Registered Nurse's lived experiences. Non-emergency patients in need of ambulance care are described as vulnerable and patients in ambulance care have earlier been found to be dependent on the Registered Nurse. However, little is known about the care of non-emergency patients in the ambulance setting, from the perspective of Registered Nurses. A reflective lifeworld research design was chosen. Five Registered Nurses with experience of ambulance care were individually interviewed. The result reveals the essence of the phenomenon as a desire to provide good care in an on-going struggle between one's own and others' expectations. Three meaning constituents emerged in the description; Being in a struggle between different expectations, Being in a questioned professional role, and Being in lack of support and formal directives. Registered Nurses' care for patients assessed as not in need of emergency ambulance care, is a complex struggle between different expectations. This may be related to the encounter between the nurse's and the patient's lifeworld. Copyright © 2018 Elsevier Ltd. All rights reserved.

First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

PubMed

de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

2016-01-01

There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

Mapping health outcome measures from a stroke registry to EQ-5D weights

PubMed Central

2013-01-01

Purpose To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. Methods We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n = 272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for “dressing“, “toileting“, “mobility”, “mood”, “general health” and “proxy-responders” were applied to the validation set (n = 272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). Results The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥0.5 (P < 0.01). Conclusion This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility. PMID:23496957

Health Professionals' Perceptions of Sexual Assault Management: A Delphi Study

ERIC Educational Resources Information Center

Jancey, Jonine; Meuleners, Lynn; Phillips, Maureen

2011-01-01

Objective: To explore health professionals' perceptions of sexual assault management practices and identify issues related to these practices across Western Australia (WA). Design: A two-round electronic Delphi study was undertaken with health professionals (medical doctors, registered nurses, social workers and managers). Setting: Healthcare…

Transformational leadership: effect on the job satisfaction of Registered Nurses in a hospital in China.

PubMed

Wang, Xiaohui; Chontawan, Ratanawadee; Nantsupawat, Raymoul

2012-02-01

The aim of this study was to describe the relationship between the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses at a tertiary care hospital in China. The healthcare system is changing rapidly. Research in Western countries has shown that transformational leadership affects job satisfaction. However, very little research related to this subject has been conducted in healthcare settings in China. The sample consisted of 238 nurses who work at a tertiary care hospital in China. Data were collected from April to August 2006. Research instruments included a demographic data form, a Leadership Practice Inventory and a Job Satisfaction Scale for clinical registered nurses. Both the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses were at a moderate level. There was a statistically significant positive correlation between the transformational leadership of nurse managers and job satisfaction (r = 0·556, P < 0·001). The findings indicate that the transformational leadership of nurse managers could have an effect on the job satisfaction of clinical Registered Nurses. © 2011 Blackwell Publishing Ltd.

Twin-Twin Transfusion Syndrome: study protocol for developing, disseminating, and implementing a core outcome set.

PubMed

Khalil, Asma; Perry, Helen; Duffy, James; Reed, Keith; Baschat, Ahmet; Deprest, Jan; Hecher, Kurt; Lewi, Liesbeth; Lopriore, Enrico; Oepkes, Dick

2017-07-14

Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice. With the advent and ongoing development of new therapeutic techniques, this is more important than ever. The development and use of a core outcome set has been proposed to address these issues, prioritising outcomes important to the key stakeholders, including patients. We aim to produce, disseminate, and implement a core outcome set for TTTS. An international steering group has been established to oversee the development of this core outcome set. This group includes healthcare professionals, researchers and patients. A systematic review is planned to identify previously reported outcomes following treatment for TTTS. Following completion, the identified outcomes will be evaluated by stakeholders using an international, multi-perspective online modified Delphi method to build consensus on core outcomes. This method encourages the participants towards consensus 'core' outcomes. All key stakeholders will be invited to participate. The steering group will then hold a consensus meeting to discuss results and form a core outcome set to be introduced and measured. Once core outcomes have been agreed, the next step will be to determine how they should be measured, disseminated, and implemented within an international context. The development, dissemination, and implementation of a core outcome set in TTTS will enable its use in future clinical trials, systematic reviews and clinical practice guidelines. This is likely to advance the quality of research studies and their effective use in order to guide clinical practice and improve patient care, maternal, short-term perinatal outcomes and long-term neurodevelopmental outcomes. Core Outcome Measures in Effectiveness Trials (COMET), 921 Registered on July 2016. International Prospective Register of Systematic Reviews (PROSPERO), CRD42016043999 . Registered on 2 August 2016.

Realising dignity in care home practice: an action research project.

PubMed

Gallagher, Ann; Curtis, Katherine; Dunn, Michael; Baillie, Lesley

2017-06-01

More than 400,000 older people reside in over 18,000 care homes in England. A recent social care survey found up to 50% of older people in care homes felt their dignity was undermined. Upholding the dignity of older people in care homes has implications for residents' experiences and the role of Registered Nurses. The study aimed to explore how best to translate the concept of dignity into care home practice, and how to support this translation process by enabling Registered Nurses to provide ethical leadership within the care home setting. Action research with groups of staff (Registered Nurses and non-registered caregivers) and groups of residents and relatives in four care homes in the south of England to contribute to the development of the dignity toolkit. Action research groups were facilitated by 4 researchers (2 in each care home) to discuss dignity principles and experiences within care homes. These groups reviewed and developed a dignity toolkit over six cycles of activity (once a month for 6 months). The Registered Nurses were individually interviewed before and after the activity. Hard copy and online versions of a dignity toolkit, with tailored versions for participating care homes, were developed. Registered Nurses and caregivers identified positive impact of making time for discussion about dignity-related issues. Registered Nurses identified ongoing opportunities for using their toolkit to support all staff. Nurses and caregivers expressed feelings of empowerment by the process of action research. The collaborative development of a dignity toolkit within each care home has the potential to enable ethical leadership by Registered Nurses that would support and sustain dignity in care homes. Action research methods empower staff to maintain dignity for older people within the care home setting through the development of practically useful toolkits to support everyday care practice. Providing opportunities for caregivers to be involved in such initiatives may promote their dignity and sense of being valued. The potential of bottom-up collaborative approaches to promote dignity in care therefore requires further research. © 2016 John Wiley & Sons Ltd.

Poor reporting of scientific leadership information in clinical trial registers.

PubMed

Sekeres, Melanie; Gold, Jennifer L; Chan, An-Wen; Lexchin, Joel; Moher, David; Van Laethem, Marleen L P; Maskalyk, James; Ferris, Lorraine; Taback, Nathan; Rochon, Paula A

2008-02-20

In September 2004, the International Committee of Medical Journal Editors (ICMJE) issued a Statement requiring that all clinical trials be registered at inception in a public register in order to be considered for publication. The World Health Organization (WHO) and ICMJE have identified 20 items that should be provided before a trial is considered registered, including contact information. Identifying those scientifically responsible for trial conduct increases accountability. The objective is to examine the proportion of registered clinical trials providing valid scientific leadership information. We reviewed clinical trial entries listing Canadian investigators in the two largest international and public trial registers, the International Standard Randomized Controlled Trial Number (ISRCTN) register, and ClinicalTrials.gov. The main outcome measures were the proportion of clinical trials reporting valid contact information for the trials' Principal Investigator (PI)/Co-ordinating Investigator/Study Chair/Site PI, and trial e-mail contact address, stratified by funding source, recruiting status, and register. A total of 1388 entries (142 from ISRCTN and 1246 from ClinicalTrials.gov) comprised our sample. We found non-compliance with mandatory registration requirements regarding scientific leadership and trial contact information. Non-industry and partial industry funded trials were significantly more likely to identify the individual responsible for scientific leadership (OR = 259, 95% CI: 95-701) and to provide a contact e-mail address (OR = 9.6, 95% CI: 6.6-14) than were solely industry funded trials. Despite the requirements set by WHO and ICMJE, data on scientific leadership and contact e-mail addresses are frequently omitted from clinical trials registered in the two leading public clinical trial registers. To promote accountability and transparency in clinical trials research, public clinical trials registers should ensure adequate monitoring of trial registration to ensure completion of mandatory contact information fields identifying scientific leadership.

NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE.

PubMed

Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus

2016-09-01

Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Predicting two-year survival versus non-survival after first myocardial infarction using machine learning and Swedish national register data.

PubMed

Wallert, John; Tomasoni, Mattia; Madison, Guy; Held, Claes

2017-07-05

Machine learning algorithms hold potential for improved prediction of all-cause mortality in cardiovascular patients, yet have not previously been developed with high-quality population data. This study compared four popular machine learning algorithms trained on unselected, nation-wide population data from Sweden to solve the binary classification problem of predicting survival versus non-survival 2 years after first myocardial infarction (MI). This prospective national registry study for prognostic accuracy validation of predictive models used data from 51,943 complete first MI cases as registered during 6 years (2006-2011) in the national quality register SWEDEHEART/RIKS-HIA (90% coverage of all MIs in Sweden) with follow-up in the Cause of Death register (> 99% coverage). Primary outcome was AUROC (C-statistic) performance of each model on the untouched test set (40% of cases) after model development on the training set (60% of cases) with the full (39) predictor set. Model AUROCs were bootstrapped and compared, correcting the P-values for multiple comparisons with the Bonferroni method. Secondary outcomes were derived when varying sample size (1-100% of total) and predictor sets (39, 10, and 5) for each model. Analyses were repeated on 79,869 completed cases after multivariable imputation of predictors. A Support Vector Machine with a radial basis kernel developed on 39 predictors had the highest complete cases performance on the test set (AUROC = 0.845, PPV = 0.280, NPV = 0.966) outperforming Boosted C5.0 (0.845 vs. 0.841, P = 0.028) but not significantly higher than Logistic Regression or Random Forest. Models converged to the point of algorithm indifference with increased sample size and predictors. Using the top five predictors also produced good classifiers. Imputed analyses had slightly higher performance. Improved mortality prediction at hospital discharge after first MI is important for identifying high-risk individuals eligible for intensified treatment and care. All models performed accurately and similarly and because of the superior national coverage, the best model can potentially be used to better differentiate new patients, allowing for improved targeting of limited resources. Future research should focus on further model development and investigate possibilities for implementation.

Assessing vaccination coverage in infants, survey studies versus the Flemish immunisation register: achieving the best of both worlds.

PubMed

Braeckman, Tessa; Lernout, Tinne; Top, Geert; Paeps, Annick; Roelants, Mathieu; Hoppenbrouwers, Karel; Van Damme, Pierre; Theeten, Heidi

2014-01-09

Infant immunisation coverage in Flanders, Belgium, is monitored through repeated coverage surveys. With the increased use of Vaccinnet, the web-based ordering system for vaccines in Flanders set up in 2004 and linked to an immunisation register, this database could become an alternative to quickly estimate vaccination coverage. To evaluate its current accuracy, coverage estimates generated from Vaccinnet alone were compared with estimates from the most recent survey (2012) that combined interview data with data from Vaccinnet and medical files. Coverage rates from registrations in Vaccinnet were systematically lower than the corresponding estimates obtained through the survey (mean difference 7.7%). This difference increased by dose number for vaccines that require multiple doses. Differences in administration date between the two sources were observed for 3.8-8.2% of registered doses. Underparticipation in Vaccinnet thus significantly impacts on the register-based immunisation coverage estimates, amplified by underregistration of administered doses among vaccinators using Vaccinnet. Therefore, survey studies, despite being labour-intensive and expensive, currently provide more complete and reliable results than register-based estimates alone in Flanders. However, further improvement of Vaccinnet's completeness will likely allow more accurate estimates in the nearby future. Copyright © 2013 Elsevier Ltd. All rights reserved.

Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants.

PubMed

Leahy-Warren, P; Varghese, V; Day, M R; Curtin, M

2018-02-09

To examine the perceptions of nurse managers, registered nurses and healthcare assistants of physical restraint use on older people in a long-term care setting in the Republic of Ireland. The use of physical restraint, although controversial, persists in long-term care settings, despite recommendations for restraint-free environments. Perception and attitude of staff can influence use of physical restraint. A descriptive cross-sectional design was used. A total of 250 nursing and healthcare assistant staff were recruited. A questionnaire incorporating demographics and the Perceptions of Restraint Use Questionnaire was used. Descriptive and inferential statistical analyses were conducted. Mean age of respondents (n = 156) was 41 years, and the majority were female. Overall, a low level of importance was attached to the use of restraint. Nurse managers and registered nurses compared favourably with healthcare assistants who attached a higher importance to use of restraint. Across all three staff groups, greatest importance was attached to the use of physical restraint for reducing falls, followed by prevention of treatment interference. Restraint was least favoured as a means of impairment management. Education was not an explanatory factor in perceived importance of physical restraint use. Nurse managers and registered nurses are unlikely to use physical restraint. However, there is concern regarding perception of healthcare assistants on use of restraint. Results from this study compare favourably with those in countries that have no policy on physical restraint use. Educational programmes alone are insufficient to address use of physical restraint. Attention to skill mix with adequate support for healthcare assistants in long-term care settings is recommended. © 2018 International Council of Nurses.

Patient safety: numerical skills and drug calculation abilities of nursing students and registered nurses.

PubMed

McMullan, Miriam; Jones, Ray; Lea, Susan

2010-04-01

This paper is a report of a correlational study of the relations of age, status, experience and drug calculation ability to numerical ability of nursing students and Registered Nurses. Competent numerical and drug calculation skills are essential for nurses as mistakes can put patients' lives at risk. A cross-sectional study was carried out in 2006 in one United Kingdom university. Validated numerical and drug calculation tests were given to 229 second year nursing students and 44 Registered Nurses attending a non-medical prescribing programme. The numeracy test was failed by 55% of students and 45% of Registered Nurses, while 92% of students and 89% of nurses failed the drug calculation test. Independent of status or experience, older participants (> or = 35 years) were statistically significantly more able to perform numerical calculations. There was no statistically significant difference between nursing students and Registered Nurses in their overall drug calculation ability, but nurses were statistically significantly more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections. Both nursing students and Registered Nurses were statistically significantly more able to perform calculations for solids, liquid oral and injections than calculations for drug percentages, drip and infusion rates. To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self)-testing of their ability. Time should be set aside in curricula for nursing students to learn how to perform basic numerical and drug calculations. This learning should be reinforced through regular practice and assessment.

40 CFR 53.2 - General requirements for a reference method determination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... part. Further, FRM samplers must be manufactured in an ISO 9001-registered facility, as defined in § 53... manufactured in an ISO 9001-registered facility, as defined in § 53.1 and as set forth in § 53.51. (b...

The Characteristics of TCM Clinical Trials: A Systematic Review of ClinicalTrials.gov.

PubMed

Chen, Junchao; Huang, Jihan; Li, Jordan V; Lv, Yinghua; He, Yingchun; Zheng, Qingshan

2017-01-01

The aim of this review is to characterize current status of global TCM clinical trials registered in ClinicalTrials.gov. We examined all the trials registered within ClinicalTrials.gov up to 25 September 2015, focusing on study interventions to identify TCM-related trials, and extracted 1,270 TCM trials from the data set. Overall, 691 (54.4%) trials were acupuncture, and 454 (35.8%) trials were herbal medicines. Differences in TCM trial intervention types were also evident among the specific therapeutic areas. Among all trials, 55.7% that were small studies enrolled <100 subjects, and only 8.7% of completed studies had reported results of trials. As for the location, the United States was second to China in conducting the most TCM trials. This review is the first snapshot of the landscape of TCM clinical trials registered in ClinicalTrials.gov, providing the basis for treatment and prevention of diseases within TCM and offering useful information that will guide future research on TCM.

The Characteristics of TCM Clinical Trials: A Systematic Review of ClinicalTrials.gov

PubMed Central

Huang, Jihan; Li, Jordan V.; Lv, Yinghua; He, Yingchun

2017-01-01

Objective The aim of this review is to characterize current status of global TCM clinical trials registered in ClinicalTrials.gov. Methods We examined all the trials registered within ClinicalTrials.gov up to 25 September 2015, focusing on study interventions to identify TCM-related trials, and extracted 1,270 TCM trials from the data set. Results Overall, 691 (54.4%) trials were acupuncture, and 454 (35.8%) trials were herbal medicines. Differences in TCM trial intervention types were also evident among the specific therapeutic areas. Among all trials, 55.7% that were small studies enrolled <100 subjects, and only 8.7% of completed studies had reported results of trials. As for the location, the United States was second to China in conducting the most TCM trials. Conclusion This review is the first snapshot of the landscape of TCM clinical trials registered in ClinicalTrials.gov, providing the basis for treatment and prevention of diseases within TCM and offering useful information that will guide future research on TCM. PMID:29138646

Registered nurses' perception of self-efficacy and competence in smoking cessation after participating in a web-based learning activity.

PubMed

Rosvall, Annica; Carlson, Elisabeth

2017-12-01

To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery. Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way. A convergent mixed-method design with data collection was done using questionnaires (n = 47) and semistructured interviews (n = 11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis. After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts. The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation. Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities. © 2017 John Wiley & Sons Ltd.

A note on chaotic unimodal maps and applications.

PubMed

Zhou, C T; He, X T; Yu, M Y; Chew, L Y; Wang, X G

2006-09-01

Based on the word-lift technique of symbolic dynamics of one-dimensional unimodal maps, we investigate the relation between chaotic kneading sequences and linear maximum-length shift-register sequences. Theoretical and numerical evidence that the set of the maximum-length shift-register sequences is a subset of the set of the universal sequence of one-dimensional chaotic unimodal maps is given. By stabilizing unstable periodic orbits on superstable periodic orbits, we also develop techniques to control the generation of long binary sequences.

A 32-bit NMOS microprocessor with a large register file

NASA Astrophysics Data System (ADS)

Sherburne, R. W., Jr.; Katevenis, M. G. H.; Patterson, D. A.; Sequin, C. H.

1984-10-01

Two scaled versions of a 32-bit NMOS reduced instruction set computer CPU, called RISC II, have been implemented on two different processing lines using the simple Mead and Conway layout rules with lambda values of 2 and 1.5 microns (corresponding to drawn gate lengths of 4 and 3 microns), respectively. The design utilizes a small set of simple instructions in conjunction with a large register file in order to provide high performance. This approach has resulted in two surprisingly powerful single-chip processors.

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings.

PubMed

McCabe, Marita P; Mellor, David; Davison, Tanya E; Karantzas, Gery; von Treuer, Kathryn; O'Connor, Daniel W

2013-09-19

The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy. A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention. Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care. The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost. Australia and New Zealand Clinical Trials Register (ANZCTR): The Universal Trial Number (UTN) is U1111-1141-0109.

Impact of improved recording of work-relatedness in primary care visits at occupational health services on sickness absences: study protocol for a randomised controlled trial.

PubMed

Atkins, Salla; Ojajärvi, Ulla; Talola, Nina; Viljamaa, Mervi; Nevalainen, Jaakko; Uitti, Jukka

2017-07-26

Employment protects and fosters health. Occupational health services, particularly in Finland, have a central role in protecting employee health and preventing work ability problems. However, primary care within occupational health services is currently underused in informing preventive activities. This study was designed to assess whether the recording of work ability problems and improvement of follow-up of work-related primary care visits can reduce sickness absences and work disability pensions after 1 year. A pragmatic trial will be conducted using patient electronic registers and registers of the central pensions agency in Finland. Twenty-two occupational health centres will be randomised to intervention and control groups. Intervention units will receive training to improve recording of work ability illnesses in the primary care setting and improved follow-up procedures. The intervention impact will be assessed through examining rates of sickness absence across intervention and control clinics as well as before and after the intervention. The trial will develop knowledge of the intervention potential of primary care for preventing work disability pensions and sickness absence. The use of routine patient registers and pensions registers to assess the outcomes of a randomised controlled trial will bring forward trial methodology, particularly when using register-based data. If successful, the intervention will improve the quality of occupational health care primary care and contribute to reducing work disability. ISRCTN Registry reference number ISRCTN45728263 . Registered on 18 April 2016.

A Multi-Factor Analysis of Job Satisfaction among School Nurses

ERIC Educational Resources Information Center

Foley, Marcia; Lee, Julie; Wilson, Lori; Cureton, Virginia Young; Canham, Daryl

2004-01-01

Although job satisfaction has been widely studied among registered nurses working in traditional health care settings, little is known about the job-related values and perceptions of nurses working in school systems. Job satisfaction is linked to lower levels of job-related stress, burnout, and career abandonment among nurses. This study evaluated…

Determined to Make a Difference: A Qualitative Study of College Women Student Leaders

ERIC Educational Resources Information Center

Wagoner, Heather Yattaw

2017-01-01

While research has grown related to the experiences of gender and leadership in the workplace, little research exists on the experiences of gender and leadership in collegiate student organization settings. This study explores the experiences of college women holding executive leadership roles in highly visible on-campus registered student…

Pilot study for supervised target detection applied to spatially registered multiparametric MRI in order to non-invasively score prostate cancer.

PubMed

Mayer, Rulon; Simone, Charles B; Skinner, William; Turkbey, Baris; Choykey, Peter

2018-03-01

Gleason Score (GS) is a validated predictor of prostate cancer (PCa) disease progression and outcomes. GS from invasive needle biopsies suffers from significant inter-observer variability and possible sampling error, leading to underestimating disease severity ("underscoring") and can result in possible complications. A robust non-invasive image-based approach is, therefore, needed. Use spatially registered multi-parametric MRI (MP-MRI), signatures, and supervised target detection algorithms (STDA) to non-invasively GS PCa at the voxel level. This study retrospectively analyzed 26 MP-MRI from The Cancer Imaging Archive. The MP-MRI (T2, Diffusion Weighted, Dynamic Contrast Enhanced) were spatially registered to each other, combined into stacks, and stitched together to form hypercubes. Multi-parametric (or multi-spectral) signatures derived from a training set of registered MP-MRI were transformed using statistics-based Whitening-Dewhitening (WD). Transformed signatures were inserted into STDA (having conical decision surfaces) applied to registered MP-MRI determined the tumor GS. The MRI-derived GS was quantitatively compared to the pathologist's assessment of the histology of sectioned whole mount prostates from patients who underwent radical prostatectomy. In addition, a meta-analysis of 17 studies of needle biopsy determined GS with confusion matrices and was compared to the MRI-determined GS. STDA and histology determined GS are highly correlated (R = 0.86, p < 0.02). STDA more accurately determined GS and reduced GS underscoring of PCa relative to needle biopsy as summarized by meta-analysis (p < 0.05). This pilot study found registered MP-MRI, STDA, and WD transforms of signatures shows promise in non-invasively GS PCa and reducing underscoring with high spatial resolution. Copyright © 2018 Elsevier Ltd. All rights reserved.

The experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings: a feminist poststructural approach: A qualitative study that explores negotiation of patient care between patients and chronically ill patients in hospital settings.

PubMed

Griscti, Odette; Aston, Megan; Martin-Misener, Ruth; Mcleod, Deborah; Warner, Grace

2016-07-01

The aim of this study was to understand the experiences of chronically ill patients and registered nurse in negotiating patient care in hospital. Specifically, we explored how social and institutional discourses shaped power relations and negotiation of patient care. Current literature indicates that although nurses embrace this notion, such partnerships are not easily implemented. Most existing studies focus on the role of the nurse as the leader of the partnership with little attention paid to how social and institutional values, beliefs and practices shape nurse/patient power relations; or how these relationships are negotiated between nurses and patients. The theoretical and methodological approaches used in this study are based on the precepts of Foucault and feminist poststructural theorists. In depth interviews were conducted with eight chronically ill patients and 10 registered nurses. Both nurses and patients commented about the relationships that develop between nurses and chronically ill patients and how these relationships facilitate negotiation of patient care. Both parties described challenging moments and how institutional discourses may hinder positive negotiations of care. In this paper we highlight three themes that emerged: getting to know each other, they are not the sickest patients and finding time to listen. This study offers an innovative way of unpacking negotiation of care between chronically ill patients and registered nurses. It exposes how social and institutional discourses play a pivotal role in shaping negotiations between nurses and chronically ill patients. Negotiating care with chronically ill patients is not as asymmetric as portrayed in some of the literature and tends to be based on mutual agreements between nurses and patients. Nurses make it a point to listen to patients' needs and resist institutional discourses that preclude them from spending time with patients. © 2016 John Wiley & Sons Ltd.

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda.

PubMed

Pedersen, Bastian; Ssemugabo, Charles; Nabankema, Victoria; Jørs, Erik

2017-01-01

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened.

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda

PubMed Central

Pedersen, Bastian; Ssemugabo, Charles; Nabankema, Victoria; Jørs, Erik

2017-01-01

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened. PMID:28615953

Barriers to Research Utilization by Certified Registered Nurse Anesthetists

ERIC Educational Resources Information Center

Palmer, Timothy J.

2013-01-01

At present, no documentation pertaining to the factors influencing utilization of research into clinical practice by Certified Registered Nurse Anesthetists (CRNAs) exists. An investigation was undertaken to determine perceptions of CRNAs regarding factors within the context of the work setting, which may serve to influence their utilization of…

Coming and staying: a qualitative exploration of Registered Nurses' experiences working in nursing homes.

PubMed

Prentice, Dawn; Black, Margaret

2007-09-01

Aim. This paper reports on a qualitative study that explored the reasons why Registered Nurses (RNs) chose to work in nursing homes in Southern Ontario, Canada and what factors attracted them to remain. Background.  There is a paucity of information about factors associated with the recruitment and retention of RNs within long-term care (LTC) in Canada. As the population of older people is growing in Canada and elsewhere, it is essential that we better understand what attracts RNs to work and remain in this setting. Design and method. A case study approach was used in this study of nine RNs working in three nursing homes. Data were collected through in-depth interviews. Findings. Six sub-themes were identified: 'Job of Choice', 'Job of Convenience', 'Caring for the Residents', 'A Supportive Environment', 'Heavy Workload' and 'Supervisory Role of the RN'. Conclusion. Nurses chose to work in the nursing home because it was a 'Job of Convenience'. However, characteristics of the organizational environment played a major role in their remaining. Also, the caring relationship with residents played a role in the nurses remaining in this setting. Relevance to clinical practice. Strategies are provided that nurse managers may consider when planning recruitment and retention activities for LTC settings.

Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study.

PubMed

Markkula, Niina; Lehti, Venla; Gissler, Mika; Suvisaari, Jaana

2017-12-01

Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study. A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use. The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05). The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.

EMPOWER-support of patient empowerment by an intelligent self-management pathway for patients: study protocol.

PubMed

Mantwill, Sarah; Fiordelli, Maddalena; Ludolph, Ramona; Schulz, Peter J

2015-03-20

Diabetes education together with patient empowerment has shown to be key to effective self-management behavior. When delivered through information and communication technologies (ICT), this solution has shown to lead to better health outcomes. However, the potential of ICT and their integration into the healthcare environment have not yet been fully exploited. ICT should be in particular used to facilitate communication and information exchange between patient and healthcare providers. In addition, systems should include components facilitating behavior change using empowerment approaches such as goal-setting. Funded by the European Commission (FP7-ICT-2011-288209) a web/mobile based platform (EMPOWER) has been developed, which aims at supporting self-management activities of diabetes patients and their treating physicians in Germany and Turkey. The platform semantically integrates multiple information sources, such as electronic and personal health records (EHR/PHR). Patients can register patterns of daily living, record blood glucose levels, design disease management plans and set long- and short-term goals. The project actively involves the treating physician, who has the possibility to set recommendations for the patient and to monitor his/her progress on the platform. In the test-phase of EMPOWER, patients will be assigned to an intervention group and a control group. Data will be collected at baseline and three months after the intervention started. In addition, qualitative interviews will be conducted to collect extra information on usability and usefulness. Outcome measures include amongst others the Problem Areas in Diabetes questionnaire (PAID), the Summary of Diabetes Self-Care Activities and scales evaluating doctor-patient interaction. Physiological parameters, such as physical activity or blood glucose levels will be collected via the platform. Further, log files and number of logins will serve as independent variables. The interplay between multiple sources, including EHR, patients' own registered information and physicians' recommendations on one platform can have important practice implications. It might not only improve self-management activities in diabetes patients but it will also facilitate physician's work, and ultimately the physician patient relationship. The trial has been registered with Deutsches Register Klinischer Studien (German register of clinical trials) under DRKS00007699 on January 30, 2015.

A systematic review of Registered Nurses; experiences of the influence of workplace culture and climatic factors on nursing workloads.

PubMed

Ross-Walker, Cheryl; Rogers-Clark, Cath; Pearce, Susanne

Nursing workload is an issue that effects both the recruitment and retention of nurses, and patient safety. Historically, measurement has focussed on the delivery of direct patient care and excluded workload of facilitating hands-on care and supporting the organisation via duties that reflect organisation cultural and climate needs. Qualitative research is appropriate to understand this complexity. To determine the best available evidence in relation to registered nurses experiences of workplace cultural and climatic factors that influence nursing workloads, in an acute health care setting. This review sought high quality studies which explored registered nurses' experiences of the influence of cultural and climatic factors on their workloads. Qualitative research studies and opinion-based text were considered. An extensive search of the literature was conducted to identify published and unpublished studies between January 1990 and June 2011 in English, and indexed in the following databases: CINAHL, Medline, Medline-In Process, PsychINFO, Emerald, Current Contents, TRIP, JSTOR Nursing Consult Psychology & Behavioural Sciences collections, Emerald Management Reviews, Emerald Full Text Journals, Embase, Dissertation Abstracts, ERIC, Proquest and MedNar, EBSCOhost, Science Direct, Wiley Interscience. Two independent reviewers (CRW and CRC), using appraisal tools from the Joanna Briggs Institute (JBI), assessed fifteen articles; one was excluded. Data were extracted from included papers using standardised tools developed by the JBI. Data from qualitative studies and textual/opinion papers were meta-synthesised separately using standardised instruments. Data synthesis involved the pooling of findings, then grouped into categories on the basis of similarity of meaning. The categories were further aggregated into synthesised findings. 14 papers were identified as high quality and meeting the inclusion criteria. 81 findings were identified from the 10 qualitative research papers and 39 conclusions from the 4 text/ opinion papers. While the research and non research evidence was analysed separately, both sets of evidence gave the same synthesised findings. The qualitative research findings were grouped into eight categories and textual data into six categories; all textual categories were also identified in the qualitative synthesis. These categories were aggregated into two synthesised findings. Nursing workloads are influenced by the largely immeasurable cultural factors within hospital environments. These factors signify 'how we do things around here'. Organisational climate influences nursing workloads because of inter-professional relationships, clinical governance, workplace support, non-nursing duties, organisational structure and organisation, work redesign, workflow and diversity within nursing roles. The component of registered nurses' workloads that are not patient-care should be recognised. Reviewing nursing roles to remove unnecessary work unrelated to patient care would positively influence nursing workloads, giving time for cognitive workload and clinical education and mentorship. Further qualitative research should explore the complexity of clinical nurses' roles in a diversity of settings, to address the responsibilities that registered nurses routinely assume, but which do not involve direct patient care. New workload models, which capture the non-measurable aspects of a registered nurse's role, should be developed and evaluated.

Nurses' workplace distress and ethical dilemmas in Tanzanian health care.

PubMed

Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro

2008-07-01

The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Earnings among Young and Mature Danish University Graduates

ERIC Educational Resources Information Center

Klausen, Trond Beldo

2016-01-01

This paper studies the association between graduation age and earnings among university graduates in Denmark, which is a country with one of the oldest student populations in the world. Exploiting a rich data-set from administrative registers, the current study is able to track labour market career for a longer period of time and to control for…

Factors contributing to registered nurse medication administration error: a narrative review.

PubMed

Parry, Angela M; Barriball, K Louise; While, Alison E

2015-01-01

To explore the factors contributing to Registered Nurse medication administration error behaviour. A narrative review. Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer. A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour. The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour. The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error. Copyright © 2014 Elsevier Ltd. All rights reserved.

District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena

2014-08-01

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.

Heap/stack guard pages using a wakeup unit

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

Gooding, Thomas M; Satterfield, David L; Steinmacher-Burow, Burkhard

A method and system for providing a memory access check on a processor including the steps of detecting accesses to a memory device including level-1 cache using a wakeup unit. The method includes invalidating level-1 cache ranges corresponding to a guard page, and configuring a plurality of wakeup address compare (WAC) registers to allow access to selected WAC registers. The method selects one of the plurality of WAC registers, and sets up a WAC register related to the guard page. The method configures the wakeup unit to interrupt on access of the selected WAC register. The method detects access ofmore » the memory device using the wakeup unit when a guard page is violated. The method generates an interrupt to the core using the wakeup unit, and determines the source of the interrupt. The method detects the activated WAC registers assigned to the violated guard page, and initiates a response.« less

Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study.

PubMed

Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann

2016-10-01

Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. The aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. A descriptive quantitative design was used. An online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

Managing a Scarce Natural Resource: The High Altitude Mountaineering Setting.

ERIC Educational Resources Information Center

Ewert, Alan

This study identifies some characteristics of mountaineering visitors, climbers' perceptions of the mountain environment, and certain preferred management options affecting both the mountain environment and the mountaineer on Mt. McKinley and adjacent Alaska Range peaks. Approximately 360 registered climbers were asked to complete a 26-item…

Challenges in Identifying Refugees in National Health Data Sets.

PubMed

Semere, Wagahta; Yun, Katherine; Ahalt, Cyrus; Williams, Brie; Wang, Emily A

2016-07-01

To evaluate publicly available data sets to determine their utility for studying refugee health. We searched for keywords describing refugees in data sets within the Society of General Internal Medicine Dataset Compendium and the Inter-University Consortium for Political and Social Research database. We included in our analysis US-based data sets with publicly available documentation and a self-defined, health-related focus that allowed for an examination of patient-level factors. Of the 68 data sets that met the study criteria, 37 (54%) registered keyword matches related to refugees, but only 2 uniquely identified refugees. Few health data sets identify refugee status among participants, presenting barriers to understanding refugees' health and health care needs. Information about refugee status in national health surveys should include expanded demographic questions and focus on mental health and chronic disease.

31 CFR 352.3 - Registration and issue.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Registration and issue. 352.3 Section....3 Registration and issue. (a) Registration. Series HH bonds may be registered as set forth in.... 3-80. (b) Validity of issue. A bond is validly issued when it is registered as provided 31 CFR part...

Co-registered photoacoustic, thermoacoustic, and ultrasound mouse imaging

NASA Astrophysics Data System (ADS)

Reinecke, Daniel R.; Kruger, Robert A.; Lam, Richard B.; DelRio, Stephen P.

2010-02-01

We have constructed and tested a prototype test bed that allows us to form 3D photoacoustic CT images using near-infrared (NIR) irradiation (700 - 900 nm), 3D thermoacoustic CT images using microwave irradiation (434 MHz), and 3D ultrasound images from a commercial ultrasound scanner. The device utilizes a vertically oriented, curved array to capture the photoacoustic and thermoacoustic data. In addition, an 8-MHz linear array fixed in a horizontal position provides the ultrasound data. The photoacoustic and thermoacoustic data sets are co-registered exactly because they use the same detector. The ultrasound data set requires only simple corrections to co-register its images. The photoacoustic, thermoacoustic, and ultrasound images of mouse anatomy reveal complementary anatomic information as they exploit different contrast mechanisms. The thermoacoustic images differentiate between muscle, fat and bone. The photoacoustic images reveal the hemoglobin distribution, which is localized predominantly in the vascular space. The ultrasound images provide detailed information about the bony structures. Superposition of all three images onto a co-registered hybrid image shows the potential of a trimodal photoacoustic-thermoacoustic-ultrasound small-animal imaging system.

MULTIPLE INPUT BINARY ADDER EMPLOYING MAGNETIC DRUM DIGITAL COMPUTING APPARATUS

DOEpatents

Cooke-Yarborough, E.H.

1960-12-01

A digital computing apparatus is described for adding a plurality of multi-digit binary numbers. The apparatus comprises a rotating magnetic drum, a recording head, first and second reading heads disposed adjacent to the first and second recording tracks, and a series of timing signals recorded on the first track. A series of N groups of digit-representing signals is delivered to the recording head at time intervals corresponding to the timing signals, each group consisting of digits of the same significance in the numbers, and the signal series is recorded on the second track of the drum in synchronism with the timing signals on the first track. The multistage registers are stepped cyclically through all positions, and each of the multistage registers is coupled to the control lead of a separate gate circuit to open the corresponding gate at only one selected position in each cycle. One of the gates has its input coupled to the bistable element to receive the sum digit, and the output lead of this gate is coupled to the recording device. The inputs of the other gates receive the digits to be added from the second reading head, and the outputs of these gates are coupled to the adding register. A phase-setting pulse source is connected to each of the multistage registers individually to step the multistage registers to different initial positions in the cycle, and the phase-setting pulse source is actuated each N time interval to shift a sum digit to the bistable element, where the multistage register coupled to bistable element is operated by the phase- setting pulse source to that position in its cycle N steps before opening the first gate, so that this gate opens in synchronism with each of the shifts to pass the sum digits to the recording head.

The effectiveness of delegation interventions by the registered nurse to the unlicensed assistive personnel and their impact on quality of care, patient satisfaction, and RN staff satisfaction: a systematic review.

PubMed

Hopkins, Una; Itty, Any Sajan; Nazario, Helen; Pinon, Miriam; Slyer, Jason; Singleton, Joanne

Delegation by the registered nurse is a decision making process that includes assessment, planning, implementation, and evaluation. Due to an ever-expanding global shortage of nurses, registered nurses are increasingly dependent on unlicensed assistive personnel to assist in the provision of safe patient care. Delegation is recognised as a fundamental nursing skill that can be utilised effectively to improve quality care. To examine and synthesize the best available evidence regarding the impact of delegation interventions used by the registered nurse with the unlicensed assistive personnel and their impact on quality of care, patient satisfaction, and registered nurse staff satisfaction. Registered nurses and unlicensed assistive personnel in patient care settings where delegation occurs.This review considered studies that evaluated the effectiveness of delegation interventions by registered nurses to unlicensed assistive personnel.The outcomes examined were quality of care, patient satisfaction, and/or registered nurse staff satisfaction as measured by validated and reliable tools.The review first considered randomised controlled trials; in their absence other research designs, such as non-randomised controlled trials, or other quasi-experimental studies, observational studies and descriptive studies were considered for inclusion in the systematic review. The search strategy aimed to find both published and unpublished studies in the English language from the inception of the included databases through December 2011. The databases searched included the Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL, Healthsource Nursing/Academic edition, and PsycINFO. A search of the grey literature and electronic hand searching of relevant journals was also performed. The studies selected for retrieval were critically evaluated by two independent reviewers for methodological quality using standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction instruments from the Joanna Briggs Institute. Studies were found to have significant heterogeneity between the populations and interventions of the included studies; therefore, pooled statistical meta-analysis could not be completed. The findings are presented in narrative form. Two quasi-experimental studies were identified. In one study, the women counselled by the lay nurse aides received 80% of recommended messages compared to 75% received by the women counselled by the nurse-midwives (β= 4.7, 95%CI: -1.7, 11.0; Non-inferiority). Non-inferiority was demonstrated between the lay nurse aides and the nurse-midwives with respect to communication techniques. The mean performance was high, 95% and 98% among nurse-midwives and lay nurse aides respectively (β =2.4, 95%CI: -0.2, 5.0; Non-inferiority). No difference was found between the nurse-midwives and the lay nurse aides in providing antenatal counselling, education, and maternal-newborn care when proper training and supervision was given. The other study examined six hypotheses that looked at quality of care outcomes in a care model where the registered nurse delegated tasks to unlicensed assistive personal. Five of these outcomes showed no significant improvement as a result of the intervention. Patient knowledge about intravenous therapy was the only quality of care outcome that showed improvement post-intervention with scores increasing from 27% at baseline to 78% at 12 months. There was no improvement in the one hypotheses evaluating registered nurses job satisfaction. There is a paucity of evidence on the effectiveness of delegation interventions and strategies by registered nurses to unlicensed assistive personnel. Delegation interventions require characteristics such as teamwork, training, support, supervision, communication, and evaluation to positively impact quality of care, patient satisfaction, and registered nurse staff satisfaction outcomes. Task shifting could have a positive impact on quality of care and staff satisfaction while providing the registered nurse with an opportunity to increase efficiency. The areas of feedback and evaluation in the registered nurse / unlicensed assistive personnel relationship needs further study.

A cross-sectional study of all clinicians' conflict of interest disclosures to NHS hospital employers in England 2015-2016.

PubMed

Feldman, Harriet Ruth; DeVito, Nicholas J; Mendel, Jonathan; Carroll, David E; Goldacre, Ben

2018-03-05

We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees. Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers. NHS Trusts (secondary/tertiary care organisations) in England. 236 Trusts were contacted, of which 217 responded. We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency. 185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria. Overall, recording of employees' conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees' conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US 'Sunshine Act'. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use and Distribution of Rehabilitation Services: A Register Linkage Study in One Hospital District Area in Finland

ERIC Educational Resources Information Center

Pulkki, Jutta Maarit; Rissanen, Pekka; Raitanen, Jani A.; Viitanen, Elina A.

2011-01-01

This study focuses on a large set of rehabilitation services used between 2004 and 2005 in one hospital district area in Finland. The rehabilitation system consists of several subsystems. This complex system is suggested to produce arbitrary rehabilitation services. Despite the criticisms against the system during decades, no attempts have been…

Staff perceptions of leadership during implementation of task-shifting in three surgical units.

PubMed

Henderson, Amanda; Paterson, Karyn; Burmeister, Liz; Thomson, Bernadette; Young, Louise

2013-03-01

Registered nurses are difficult to recruit and retain. Task shifting, which involves reallocation of delegation, can reduce demand for registered nurses. Effective leadership is needed for successful task shifting. This study explored leadership styles of three surgical nurse unit managers. Staff completed surveys before and after the implementation of task shifting. Task shifting involved the introduction of endorsed enrolled nurses (licensed nurses who must practise under registered nurse supervision) to better utilize registered nurses. Implementation of task shifting occurred over 4 months in a 700-bed tertiary hospital, in southeast Queensland, Australia. A facilitator assisted nurse unit managers during implementation. The impact was assessed by comparison of data before (n = 49) and after (n = 72) task shifting from registered nurses and endorsed enrolled nurses (n = 121) who completed the Ward Organization Features Survey. Significant differences in leadership and staff organization subscales across the settings suggest that how change involving task shifting is implemented influences nurses' opinions of leadership. Leadership behaviours of nurse unit managers is a key consideration in managing change such as task shifting. Consistent and clear messages from leaders about practice change are viewed positively by nursing staff. In the short term, incremental change possibly results in staff maintaining confidence in leadership. © 2012 Blackwell Publishing Ltd.

Quantized Detector Networks

NASA Astrophysics Data System (ADS)

Jaroszkiewicz, George

2017-12-01

Preface; Acronyms; 1. Introduction; 2. Questions and answers; 3. Classical bits; 4. Quantum bits; 5. Classical and quantum registers; 6. Classical register mechanics; 7. Quantum register dynamics; 8. Partial observations; 9. Mixed states and POVMs; 10. Double-slit experiments; 11. Modules; 12. Computerization and computer algebra; 13. Interferometers; 14. Quantum eraser experiments; 15. Particle decays; 16. Non-locality; 17. Bell inequalities; 18. Change and persistence; 19. Temporal correlations; 20. The Franson experiment; 21. Self-intervening networks; 22. Separability and entanglement; 23. Causal sets; 24. Oscillators; 25. Dynamical theory of observation; 26. Conclusions; Appendix; Index.

78 FR 28770 - Scope of the Register of Copyright's Exclusive Authority Over Statements of Account Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

...'s statements of account shall set forth each step of its calculations with sufficient information to... available by persons making digital phonorecord deliveries.'' Register's Division of Authority Decision... type of information in a notice of use (but not in the statement of account) to be served on the...

Preparing Payroll Register, Employee Earnings' Records, and Paychecks. Student's Manual and Instructor's Manual.

ERIC Educational Resources Information Center

McElveen, Peggy C.

Supporting performance objective 28 of the V-TECS (Vocational-Technical Education Consortium of States) Secretarial Catalog, both a set of student materials and an instructor's manual on preparing a payroll register, employee earnings' records, and paychecks are included in this packet, which is one in a series. The student materials include a…

76 FR 53530 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Control Number: 2120-0042. Title: Aircraft Registration. Form Numbers: FAA Forms 8050-1, 8050-2, 8050-4... states that all aircraft must be registered before they may be flown. It sets forth registration... of registration. The information collected is used by the FAA to register an aircraft or hold an...

New graduate registered nurse transition into primary health care roles: an integrative literature review.

PubMed

Murray-Parahi, Pauline; DiGiacomo, Michelle; Jackson, Debra; Davidson, Patricia M

2016-11-01

To summarise the literature describing new graduate nurse transition to professional practice within the primary health care (PHC) setting. There is a plethora of research literature spanning several decades about new graduate nurse transition in the acute care setting. Yet, the experiences of new graduate nurse in the PHC setting is unremarkable particularly considering the increasing demand for skilled health care workers and focus of health reform to provide care where people work and live. Electronic data bases, Academic Search Complete, EBSCO, Medline, PsycINFO, CINHAL, and ERIC were searched using a combination of terms and synonyms arising from three key concepts which identify the phenomenon; 'transition', 'new graduate registered nurse' and 'primary health care. An inclusive search strategy placed no limits on language or publication date. Of the 50 articles located and examined for relevance; 40 were sourced through databases and 10 from Google Scholar/Alerts and hand-searching references. None of the 19 articles retained for analysis addressed all key concepts. Some challenges of researching the professional transition of graduate nurses in PHC settings included, an absence of definitive transition models, a dearth of literature and deference to acute care research. Nursing in PHC settings, particularly the client's home is notably different to hospital settings because of higher levels of isolation and autonomy. Societal changes, health reform and subsequent demand for skilled workers in PHC settings has caused health care providers to question the logic that such roles are only for experienced nurses. Implications arise for education and health service providers who desire to close the theory practice gap and mitigate risk for all stakeholders when next generation nurses have limited opportunities to experience PHC roles as undergraduates and newly graduated registered nurses are already transitioning in this setting. © 2016 John Wiley & Sons Ltd.

Intended Use of a Building in Terms of Updating the Cadastral Database and Harmonizing the Data with other Public Records

NASA Astrophysics Data System (ADS)

Buśko, Małgorzata

2017-06-01

According to the original wording of the Regulation on the register of land and buildings of 2001, in the real estate cadastre there was one attribute associated with the use of a building structure - its intended use, which was applicable until the amendment to the Regulation was introduced in 2013. Then, additional attributes were added, i.e. the type of the building according to the Classification of Fixed Assets (KST), the class of the building according to the Polish Classification of Types of Constructions (PKOB) and, at the same time, the main functional use and other functions of the building remained in the Regulation as well. The record data on buildings are captured for the real estate cadastre from other data sets, for example those maintained by architectural and construction authorities. At the same time, the data contained in the cadastre, after they have been entered or changed in the database, are transferred to other registers, such as tax records, or land and mortgage court registers. This study is the result of the analysis of the laws applicable to the specific units and registers. A list of discrepancies in the attributes occurring in the different registers was prepared. The practical part of the study paid particular attention to the legal bases and procedures for entering the function of a building in the real estate cadastre, which is extremely significant, as it is the attribute determining the property tax basis.

Clinical Decision Making of Rural Novice Nurses

ERIC Educational Resources Information Center

Seright, Teresa J.

2010-01-01

The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent…

Perceptions and characteristics of registered nurses' involvement in decision making.

PubMed

Mangold, Kara L; Pearson, Kristina K; Schmitz, Julie R; Scherb, Cindy A; Specht, Janet P; Loes, Jean L

2006-01-01

This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.

A quasi-experimental investigation of message appeal variations on organ donor registration rates.

PubMed

Siegel, Jason T; Alvaro, Eusebio M; Crano, William D; Lac, Andrew; Ting, Sarah; Jones, Sara Pace

2008-03-01

Approximately 6,000 Americans die every year awaiting an organ transplant. Health promotion interventions may alleviate the shortage of viable organs by increasing the number of registered organ donors. This study is the first to evaluate the differential effectiveness of various organ donor messages in naturalistic settings. A 4 (Appeal)x4 (Exemplar)x4 (Location) counterbalanced quasi-experimental design was implemented. The behavioral outcome measure was the number of individuals who registered to be organ donors at computer kiosks. A number of significant main effects and interactions emerged. Most notably, of the 4 different appeals (counterargument, emotional, motivating action, dissonance), counterargument was by far the most efficacious, especially in academic-type settings (library, university, community college); the emotional appeal was most successful in hospitals. The findings from this study have implications for both organ donor investigations and health campaign research in general. Statistical interactions highlight the importance of evaluating multiple exemplars in multiple locations for each type of appeal when conducting health campaign research. Copyright (c) 2008 APA, all rights reserved.

76 FR 72643 - Western Pacific Pelagic Fisheries; Closure of the Hawaii Shallow-Set Pelagic Longline Fishery Due...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

.... 080225267-91393-03] RIN 0648-XA370 Western Pacific Pelagic Fisheries; Closure of the Hawaii Shallow- Set...: Temporary rule; fishery closure. SUMMARY: NMFS closes the shallow-set pelagic longline fishery north of the Equator for all vessels registered under the Hawaii longline limited access program. The shallow-set...

Evaluating beneficial drug effects in a non‐interventional setting: a review of effectiveness studies based on Swedish Prescribed Drug Register data

PubMed Central

Hoffmann, Mikael

2017-01-01

Aims To describe and assess current effectiveness studies published up to 2014 using Swedish Prescribed Drug Register (SPDR) data. Methods Study characteristics were extracted. Each study was assessed concerning the clinical relevance of the research question, the risk of bias according to a structured checklist, and as to whether its findings contributed to new knowledge. The biases encountered and ways of handling these were retrieved. Results A total of 24 effectiveness studies were included in the review, the majority on cardiovascular or psychiatric disease (n = 17; 71%). The articles linked data from four (interquartile range: three to four) registers, and were published in 21 different journals with an impact factor ranging from 1.58 to 51.66. All articles had a clinically relevant research question. According to the systematic quality assessments, the overall risk of bias was low in one (4%), moderate in eight (33%) and high in 15 (62%) studies. Overall, two (8%) studies were assessed as contributing to new knowledge. Frequently occurring problems were selection bias making the comparison groups incomparable, treatment bias with suboptimal handling of drug exposure and an intention‐to‐treat approach, and assessment bias including immortal time bias. Good examples of how to handle bias problems included propensity score matching and sensitivity analyses. Conclusion Although this review illustrates that effectiveness studies based on dispensed drug register data can contribute to new evidence of intended effects of drug treatment in clinical practice, the expectations of such data to provide valuable information need to be tempered due to methodological issues. PMID:27928842

Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age

PubMed Central

Höglund, Berit; Lindgren, Peter; Larsson, Margareta

2012-01-01

Objective. To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden. Design. Population-based register study. Setting. National registers; the National Patient Register linked to the Medical Birth Register. Sample. Children of first-time mothers with ID (n = 326; classified in the International Classification of Diseases 8–10) were identified and compared with 340 624 children of first-time mothers without ID or any other psychiatric diagnosis between 1999 and 2007. Methods. Population-based data were extracted from the National Patient Register and the Medical Birth Register. Main outcome measures. Mode of birth, preterm birth, small for gestational age, Apgar score, stillbirth and perinatal death. Results. Children born to mothers with ID were more often stillborn (1.2 vs. 0.3%) or died perinatally (1.8 vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5 vs. 17.7%) and preterm birth (12.2 vs. 6.1%), were small for gestational age (8.4 vs. 3.1%) and had lower Apgar scores (<7 points at five minutes; 3.7 vs 1.5%) compared with children born to mothers without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small for gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID. Conclusions. Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support. PMID:22924821

Leadership behaviours: effects on job satisfaction, productivity and organizational commitment.

PubMed

Chiok Foong Loke, J

2001-07-01

Research in the west has shown that job satisfaction, productivity and organizational commitment are affected by leadership behaviours. The purpose of this study is to determine the effect of leadership behaviours on employee outcomes in Singapore. Very little research related to this subject has been done in health care settings in this country. The comparison of the results of the different types of settings and samples will allow a better understanding of the relationship between leadership behaviours and employee outcomes and thus help to determine if leadership is worth the extra effort. The study explored the relationships between five leadership behaviours identified by Kouzes and Posner and the employee outcomes of registered nurses practising in the general wards, intensive care units and the coronary care unit in an acute hospital. Survey questionnaires were used to elicit responses from 100 registered nurses and 20 managers belonging to the organization. Data collected included demographic characteristics and the degree to which the five types of leadership behaviours were used as perceived by the nurse managers and the registered nurses. In addition, the level of nurse job satisfaction, the degree of productivity and the extent of organizational commitment are described. The findings show a similar trend to the original studies in the United States of America. Use of leadership behaviours and employee outcomes were significantly correlated. The regression results indicate that 29% of job satisfaction, 22% of organizational commitment and 9% of productivity were explained by the use of leadership behaviours. Recommendations are made in the light of these findings.

Do Modification and Interaction Work?--A Critical Review of Literature on the Role of Foreigner Talk in Second Language Acquisition

ERIC Educational Resources Information Center

Dela Rosa, John Paul O.; Arguelles, Diana C.

2016-01-01

This critical review of literature provides a detailed description of foreigner talk as a simplified register and critically discusses findings entrenched in studies done about this SLA issue. The studies cited are classified as researches concerning foreigner talk that occurs in both natural and classroom settings. Based on the critical review,…

Programmable DMA controller

NASA Technical Reports Server (NTRS)

Hendry, David F. (Inventor)

1993-01-01

In a data system having a memory, plural input/output (I/O) devices and a bus connecting each of the I/O devices to the memory, a direct memory access (DMA) controller regulating access of each of the I/O devices to the bus, including a priority register storing priorities of bus access requests from the I/O devices, an interrupt register storing bus access requests of the I/O devices, a resolver for selecting one of the I/O devices to have access to the bus, a pointer register storing addresses of locations in the memory for communication with the one I/O device via the bus, a sequence register storing an address of a location in the memory containing a channel program instruction which is to be executed next, an ALU for incrementing and decrementing addresses stored in the pointer register, computing the next address to be stored in the sequence register, computing an initial contents of each of the register. The memory contains a sequence of channel program instructions defining a set up operation wherein the contents of each of the registers in the channel register is initialized in accordance with the initial contents computed by the ALU and an access operation wherein data is transferred on the bus between a location in the memory whose address is currently stored in the pointer register and the one I/O device enabled by the resolver.

Canine Visitors: The Influence of Therapy Dogs on Young Children's Learning and Well-Being in Classrooms and Hospitals

ERIC Educational Resources Information Center

Jalongo, Mary Renck; Astorino, Terri; Bomboy, Nancy

2004-01-01

Trained therapy dogs are becoming an increasingly common sight in many educational and health care settings. This article, coauthored by a college professor, a Therapy Dogs International, Inc., Evaluator and local program director, and a registered nurse reviews the research on using registered therapy dogs as adjuncts in school programs and…

A machine learning approach for classification of anatomical coverage in CT

NASA Astrophysics Data System (ADS)

Wang, Xiaoyong; Lo, Pechin; Ramakrishna, Bharath; Goldin, Johnathan; Brown, Matthew

2016-03-01

Automatic classification of anatomical coverage of medical images is critical for big data mining and as a pre-processing step to automatically trigger specific computer aided diagnosis systems. The traditional way to identify scans through DICOM headers has various limitations due to manual entry of series descriptions and non-standardized naming conventions. In this study, we present a machine learning approach where multiple binary classifiers were used to classify different anatomical coverages of CT scans. A one-vs-rest strategy was applied. For a given training set, a template scan was selected from the positive samples and all other scans were registered to it. Each registered scan was then evenly split into k × k × k non-overlapping blocks and for each block the mean intensity was computed. This resulted in a 1 × k3 feature vector for each scan. The feature vectors were then used to train a SVM based classifier. In this feasibility study, four classifiers were built to identify anatomic coverages of brain, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans. Each classifier was trained and tested using a set of 300 scans from different subjects, composed of 150 positive samples and 150 negative samples. Area under the ROC curve (AUC) of the testing set was measured to evaluate the performance in a two-fold cross validation setting. Our results showed good classification performance with an average AUC of 0.96.

Educational needs and employment status of Scottish dental hygienists.

PubMed

Ross, M K; Ibbetson, R J; Rennie, J S

2005-01-22

To investigate the educational needs and employment status of registered dental hygienists in Scotland. Three hundred and eighty one registered dental hygienists with postal addresses in Scotland. Structured questionnaire. A 76% response rate was achieved following two mailings. Of the respondents, 43% were in full-time employment albeit in more than one setting, mostly in the 'central belt' of Scotland. It was reported that 41% were employed in general dental practice with both NHS and private lists and 39% worked in a purely private setting. The introduction of extended clinical duties had been well received and 59% of subjects were interested in additional training in dental therapy, should this become available. Absence of funding for CPD was raised repeatedly, with only 41% reporting a degree of financial assistance. Greater accessibility to continuing education via distance learning, particularly in remote and rural settings, was requested by 73% of hygienists. This study identifies a number of issues in relation to this increasingly important group of healthcare professionals, which will inform the providers of oral healthcare. Although hygienists' involvement in CPD was commendable, results indicated that despite commitment to their profession, respondents did not always feel respected in terms of their employment status or support for continuing professional development.

A contemporary examination of workplace learning culture: an ethnomethodology study.

PubMed

Newton, Jennifer M; Henderson, Amanda; Jolly, Brian; Greaves, Judith

2015-01-01

Creating and maintaining a sustainable workforce is currently an international concern. Extensive literature suggest that students and staff need to be 'engaged', that is they need to interact with the health team if they are to maximise learning opportunities. Despite many studies since the 1970s into what creates a 'good' learning environment, ongoing issues continue to challenge healthcare organisations and educators. A 'good' learning environment has been an intangible element for many professions as learning is hindered by the complexity of practice and by limitations on practitioners' time available to assist and guide novices. This study sought to explore the nature of the learning interactions and experiences in clinical nursing practice that enhance a 'good' workplace learning culture for both nursing students and qualified nurses. An ethnomethodology study. A range of clinical settings in Victoria and Queensland, Australia. Students and registered nurses (n=95). Fieldwork observations were carried out on student nurses and registered nurses, followed by an individual interview with each participant. An iterative approach to analysis was undertaken; field notes of observations were reviewed, interviews transcribed verbatim and entered into NVivo10. Major themes were then extracted. Three central themes: learning by doing, navigating through communication, and 'entrustability', emerged providing insights into common practices potentially enhancing or detracting from learning in the workplace. Students' and registered nurses' learning is constrained by a myriad of interactions and embedded workplace practices, which can either enhance the individual's opportunities for learning or detract from the richness of affordances that healthcare workplace settings have to offer. Until the culture/or routine practices of the healthcare workplace are challenged, the trust and meaningful communication essential to learning in practice, will be achievable only serendipitously. Copyright © 2014 Elsevier Ltd. All rights reserved.

Identification of Violence in Turkish Health Care Settings

ERIC Educational Resources Information Center

Ayranci, Unal; Yenilmez, Cinar; Balci, Yasemin; Kaptanoglu, Cem

2006-01-01

This study sought to investigate the contributing factors to and frequency of violence against health care workers (HCWs) working in western Turkey. The population is composed of a random sample of 1,209 HCWs from 34 health care workplaces. Written questionnaires were given to HCWs at all sites, where staff were instructed to register all types of…

Measurement and Analysis of Individualized Care Inventory Responses Comparing Long-Term Care Nurses and Care Aides

ERIC Educational Resources Information Center

O'Rourke, Norm; Chappell, Neena L.; Caspar, Sienna

2009-01-01

Purpose: Motivating and enabling formal caregivers to provide individualized resident care has become an increasingly important objective in long-term care (LTC) facilities. The current study set out to examine the structure of responses to the individualized care inventory (ICI). Design and Methods: Samples of 242 registered nurses (RNs)/licensed…

Nurses' Comfort Level with Emergency Interventions in the Rural Hospital Setting

ERIC Educational Resources Information Center

Ross, Erin L.; Bell, Sue E.

2009-01-01

Context: One quarter of the persons living in the United States receive their emergency care in a rural hospital. Nurses employed in these hospitals see few emergencies but must be prepared to provide expert and efficient care when they do occur. Purpose: The purpose of this study was to determine the influence of registered nurses' certifications…

Sputum smear examination and time to diagnosis in patients with smear-negative pulmonary tuberculosis in the Pacific

PubMed Central

Bissell, K.; Tabutoa, K.; Kienene, T.; Linh, N. N.; Briand, K.; Harries, A. D.

2012-01-01

Setting: National tuberculosis programmes (NTPs) in Kiribati and the Marshall Islands, 2006–2010. Objective: To determine the proportion of all tuberculosis (TB) cases that were pulmonary smear-negative, and for these patients to determine how many sputum smears were examined and the time from sputum smear examination to registration. Design: A retrospective cross-sectional study involving a record review of national TB and laboratory registers. Results: Of 2420 TB cases identified, 709 (29%) were registered as smear-negative pulmonary TB. Of the 695 (98%) with information on smear examination, 222 (32%) had no smear recorded, 61 (9%) had one smear, 86 (12%) two smears and 326 (47%) three smears. Among the 473 patients who had at least one smear, 238 (50%) were registered before sputum examination, 131 (28%) within 1 week, 72 (15%) between 1 and 4 weeks, and 34 (7%) >4 weeks after sputum examination. Conclusion: NTPs in Kiribati and the Marshall Islands are diagnosing 29% of all TB patients as smear-negative pulmonary TB. Many patients do not have smears done or are registered before undergoing smear examination. Corrective measures are needed. PMID:26392971

Hardware support for software controlled fast reconfiguration of performance counters

DOEpatents

Salapura, Valentina; Wisniewski, Robert W.

2013-06-18

Hardware support for software controlled reconfiguration of performance counters may include a plurality of performance counters collecting one or more counts of one or more selected activities. A storage element stores data value representing a time interval, and a timer element reads the data value and detects expiration of the time interval based on the data value and generates a signal. A plurality of configuration registers stores a set of performance counter configurations. A state machine receives the signal and selects a configuration register from the plurality of configuration registers for reconfiguring the one or more performance counters.

Hardware support for software controlled fast reconfiguration of performance counters

DOEpatents

Salapura, Valentina; Wisniewski, Robert W

2013-09-24

Hardware support for software controlled reconfiguration of performance counters may include a plurality of performance counters collecting one or more counts of one or more selected activities. A storage element stores data value representing a time interval, and a timer element reads the data value and detects expiration of the time interval based on the data value and generates a signal. A plurality of configuration registers stores a set of performance counter configurations. A state machine receives the signal and selects a configuration register from the plurality of configuration registers for reconfiguring the one or more performance counters.

Developing a policy for delegation of nursing care in the school setting.

PubMed

Spriggle, Melinda

2009-04-01

School nurses are in a unique position to provide care for students with special health care needs in the school setting. The incidence of chronic conditions and improved technology necessitate care of complex health care needs that had formerly been managed in inpatient settings. Delegation is a tool that may be used by registered nurses to allow unlicensed assistive personnel to perform appropriate nursing tasks and activities while keeping in mind that the registered nurse ultimately retains accountability for the delegation. The legal parameters for nursing delegation are defined by State Nurse Practice Acts, State Board of Nursing guidelines, and Nursing Administrative Rules/Regulations. Delegation becomes more challenging when carried out in a non-health care setting. School administrators may not be aware of legal issues related to delegation of nursing care in the school setting. It is crucial for school nurses to have a working knowledge of the delegation process. Development of a specific delegation policy will ensure that delegation is carried out in a manner providing for safe and appropriate care in the school setting.

Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark.

PubMed Central

Møller, L; Kristensen, T S; Hollnagel, H

1996-01-01

STUDY OBJECTIVE: To analyse the association between self rated health and the incidence of fatal and non-fatal coronary heart disease (CHD) in a Danish cohort followed up over 16 years. DESIGN: This was a prospective epidemiological follow up study. SETTING: A cohort from the County of Copenhagen, Denmark. PARTICIPANTS: The study included 1052 men and women born in 1936. During the 16 years' follow up 50 cases of CHD were registered in either the Danish register of deaths or the register of hospital admissions. MAIN RESULTS: Univariate analysis showed the following relative risks of CHD in the four self rated health groups: 'extremely good': 1.0, 'good': 4.0, 'poor': 5.8, 'miserable': 12.1 (p = 0.02). After control for the conventional CHD risk factors and a substantial number of other potential confounders the relative risks were: 1.0, 4.2, 6.5, and 18.6 (p = 0.02) respectively. CONCLUSIONS: Self rated health was an independent predictor of CHD in the present cohort. If confirmed, the association between self rated health and CHD may lead to new insight into psychosocial processes leading to this disease. Images PMID:8882226

Nurses' knowledge and educational needs regarding genetics.

PubMed

Seven, Memnun; Akyüz, Aygül; Elbüken, Burcu; Skirton, Heather; Öztürk, Hatice

2015-03-01

Nurses now require a basic knowledge of genetics to provide patient care in a range of settings. To determine Turkish registered nurses' current knowledge and educational needs in relation to genetics. A descriptive, cross-sectional study. Turkish registered nurses working in a university hospital in Turkey were recruited. All registered nurses were invited to participate and 175 completed the study. The survey instrument, basic knowledge of health genetics, confidence in knowledge and the nurses' need for genetics education were used to collect data. The majority (81.1%, n=142) of participants indicated that genetics was not taught during their degree program, although 53.1% to 96% of respondents felt confident in defining different genetic concepts. The average genetics knowledge score was 6.89±1.99 of a possible 11 (range 0-11). The majority (70.3%) expressed a strong wish to attend a continuing nursing education program in genetics. The study shows that although Turkish nurses are not sufficiently knowledgeable to apply genetics in practice, they are willing to have more education to support their care of patients. Nurses need to have more education related to genetics in accordance with advances in human genetics to optimize health care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study

PubMed Central

Hoben, Matthias; Knopp-Sihota, Jennifer A.; Nesari, Maryam; Chamberlain, Stephanie A.; Squires, Janet E.; Norton, Peter G.; Cummings, Greta G.; Stevens, Bonnie J.; Estabrooks, Carole A.

2017-01-01

Background: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population. Methods: Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers. In nursing homes, 169 registered nurses, 139 licensed practical nurses, 1506 care aides, 145 allied health care providers and 69 managers were surveyed. In pediatric hospitals, 63 physicians, 747 registered nurses, 155 allied health care providers, 49 nurse educators and 22 managers were surveyed. After standardization of the data for age and sex, we applied analyses of variance and general linear models, adjusted for multiple testing. Results: Nursing home workers and registered nurses in pediatric hospitals had poorer mental health than the Canadian population. Scores were lowest for registered nurses in nursing homes (mean difference -4.4 [95% confidence interval -6.6 to -2.6]). Physicians in pediatric hospitals and allied health care providers in nursing homes had better physical health than the general population. We also found important differences in physical/mental health for care provider groups within and between care settings. Interpretation: Mental health is especially poor among nursing home workers, who care for a highly vulnerable and medically complex population of older adults. Strategies including optimized work environments are needed to improve the physical and mental health of health care workers to ameliorate quality of patient care. PMID:29162609

Smear Conversion, Treatment Outcomes and the Time of Default in Registered Tuberculosis Patients on RNTCP DOTS in Puducherry, Southern India

PubMed Central

Jayakumar, Niranjana; Gnanasekaran, Dhivyalakshmi

2014-01-01

Background: Revised National Tuberculosis Control Programme (RNTCP) in India has achieved improved cure rates. Objectives: This study describes the achievements under RNTCP in terms of conversion rates, treatment outcomes and pattern of time of default in patients on directly observed short-course treatment for Tuberculosis in Puducherry, Southern India. Settings: Retrospective cohort study; Tuberculosis Unit in District Tuberculosis Centre, Puducherry, India. Materials and Methods: Cohort analysis of patients of registered at the Tuberculosis Unit during 1st and 2nd quarter of the year 2011. Details about sputum conversion, treatment outcome and time of default were obtained from the tuberculosis register. Statistical Analysis: Kaplan-Meier plots & log rank tests. Results: RNTCP targets with respect to success rate (85.7%), death rate (2.7%) and failure rate (2.1%) in new cases have been achieved but the sputum conversion rate (88%) and default rate (5.9%) targets have not been achieved. The overall default rate for all registered TB patients was 7.4%; significantly higher in category II. In retreatment cases registered as treatment after default, the default rate was high (9%). The cumulative default rate; though similar in the initial two months of treatment; was consistently higher in category II as compared to that in category I. Nearly 40% of all defaulters interrupted treatment between the second and fourth month after treatment initiation. Conclusion: Defaulting from treatment is more common among the retreatment cases and usually occurs during the transition phase from intensive phase to continuation phase. PMID:25478371

'Our Care through Our Eyes': a mixed-methods, evaluative study of a service-user, co-produced education programme to improve inpatient care of children and young people admitted following self-harm.

PubMed

Manning, Joseph C; Latif, Asam; Carter, Tim; Cooper, Joanne; Horsley, Angela; Armstrong, Marie; Wharrad, Heather

2015-12-29

Within Europe, the UK has one of the highest rates of self-harm, with a particularly high prevalence in children and young people (CYP). CYP who are admitted to paediatric hospital wards with self-harm are cared for by registered children's nurses who have been identified to lack specific training in caring for this patient group. This may impede the delivery of high quality care. Therefore, this study aims to co-produce, implement and evaluate an education programme for registered children's nurses to improve their knowledge, attitudes and confidence when caring for CYP admitted with self-harm. This mixed-methods evaluative study will involve a three-stage design. Stage 1: A priority-setting workshop will be conducted with 19 registered children's nurses. A Delphi technique will be used to establish consensus of information needs. Stage 2: An online educational intervention will be co-produced with 25 CYP and 19 registered children's nurses based on the priorities identified in Stage 1. Stage 3: The intervention will be implemented and evaluated with 250 registered children's nurses at a single hospital. Online Likert scale questionnaires will be administered at baseline and postintervention to assess levels of knowledge, attitudes and confidence in caring for CYP who self-harm. Descriptive and inferential statistics will be used to analyse the data. Statistical significance will be assessed at the 5% (two-sided) level. One-to-one qualitative interviews will also be undertaken with approximately 25 participants to explore any perceived impact on clinical practice. An interpretive descriptive approach will guide qualitative data collection and analysis. This study aims to develop, trial and evaluative a service-user, co-produced education programme for acute hospital registered children's nurses to improve the care of CYP admitted due to self-harm. The study has ethical approval from the National Health Services Research Ethics Committee and full governance clearance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Deformable anatomical templates for brachytherapy treatment planning in radiotherapy of cervical cancer

NASA Astrophysics Data System (ADS)

Christensen, Gary E.; Williamson, Jeffrey F.; Chao, K. S. C.; Miller, Michael I.; So, F. B.; Vannier, Michael W.

1997-10-01

This paper describes a new method to register serial, volumetric x-ray computed tomography (CT) data sets for tracking soft-tissue deformation caused by insertion of intracavity brachytherapy applicators to treat cervical cancer. 3D CT scans collected from the same patient with and without a brachytherapy applicator are registered to aid in computation of the radiation dose to tumor and normal tissue. The 3D CT image volume of pelvic anatomy with the applicator. Initial registration is accomplished by rigid alignment of the pelvic bones and non-rigid alignment of gray scale CT data and hand segmentations of the vagina, cervix, bladder, and rectum. A viscous fluid transformation model is used for non-rigid registration to allow for local, non-linear registration of the vagina, cervix, bladder, and rectum without disturbing the rigid registration of the bony pelvis and adjacent structures. Results are presented in which two 3D CT data sets of the same patient - imaged with and without a brachytherapy applicator - are registered.

Chapter 8: Web-based Tools - CARNIVORE

NASA Astrophysics Data System (ADS)

Graham, M. J.

Registries are an integral part of the VO infrastructure, yet the greatest exposure that most users will ever need to have to one is discovering resources through a registry portal. Some users, however, will have resources of their own that they need to register and will go to an existing registry to do so, but a small number will want to set up their own registry. They may have too many resources to register with an existing registry; they may want more control over their resource metadata than an existing registry will afford; or they may want to set up a specialized registry, e.g. a subjectspecific one. CARNIVORE is designed to offer those who want their own registry the functionality they require in an off-the-shelf implementation. This chapter describes how to set up your own registry using CARNIVORE.

Generating and executing programs for a floating point single instruction multiple data instruction set architecture

DOEpatents

Gschwind, Michael K

2013-04-16

Mechanisms for generating and executing programs for a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA) are provided. A computer program product comprising a computer recordable medium having a computer readable program recorded thereon is provided. The computer readable program, when executed on a computing device, causes the computing device to receive one or more instructions and execute the one or more instructions using logic in an execution unit of the computing device. The logic implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA), based on data stored in a vector register file of the computing device. The vector register file is configured to store both scalar and floating point values as vectors having a plurality of vector elements.

Experience with a Spanish-language laparoscopy website.

PubMed

Moreno-Sanz, Carlos; Seoane-González, Jose B

2006-02-01

Although there are no clearly defined electronic tools for continuing medical education (CME), new information technologies offer a basic platform for presenting training content on the internet. Due to the shortage of websites about minimally invasive surgery in the Spanish language, we set up a topical website in Spanish. This study considers the experience with the website between April 2001 and January 2005. To study the activity of the website, the registry information was analyzed descriptively using the log files of the server. To study the characteristics of the users, we searched the database of registered users. We found a total of 107,941 visits to our website and a total of 624,895 page downloads. Most visits to the site were made from Spanish-speaking countries. The most frequent professional profile of the registered users was that of general surgeon. The development, implementation, and evaluation of Spanish-language CME initiatives over the internet is promising but presents challenges.

40 CFR 164.22 - Contents of document setting forth objections.

Code of Federal Regulations, 2011 CFR

2011-07-01

... objections. 164.22 Section 164.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... registration, or change the classification of a pesticide, shall clearly and concisely set forth such...

40 CFR 164.22 - Contents of document setting forth objections.

Code of Federal Regulations, 2010 CFR

2010-07-01

... objections. 164.22 Section 164.22 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... RODENTICIDE ACT, ARISING FROM REFUSALS TO REGISTER, CANCELLATIONS OF REGISTRATIONS, CHANGES OF CLASSIFICATIONS... registration, or change the classification of a pesticide, shall clearly and concisely set forth such...

78 FR 645 - Federal Employee Pay Schedules and Rates That Are Set by Administrative Discretion

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

...--Federal Employee Pay Schedules and Rates That Are Set by Administrative Discretion Executive Order 13635--Adjustments of Certain Rates of Pay #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol... President [[Page 647

Turnover of registered nurses in Israel: characteristics and predictors.

PubMed

Toren, Orly; Zelker, Revital; Lipschuetz, Michal; Riba, Shoshana; Reicher, Sima; Nirel, Nurit

2012-05-01

In an era of global and local nursing shortages, nursing turnover has negative consequences in terms of diminished quality of care, increased costs and economic losses and decreased job satisfaction. To examine the turnover rate of registered nurses in Israel by assessing the varying degree of turnover between economic sectors, between hospital and community facilities, and/or between types of hospitals; and by examining potential predicting factors of turnover among registered nurses. A national phone survey was undertaken in Israel consisting of a random sampling of registered nurses of working age (up to age 60). The subjects comprised 10% of a national database of 32,000 registered nurses. The turnover rate among working nurses in Israel currently stands at 23%. In addition, 13% of employed nurses have taken a temporary leave of absence for a period greater than 6 months in the past 10 years, most up to 1 year. While job satisfaction rates were relatively high (72%), Professional satisfaction rates were 60% with no significant difference between hospital and community nurses. The turnover rate of registered nurses from a hospital setting to the community was significantly higher (p<.01) than that of community registered nurses to hospitals. Predicting factors of turnover were found to be: young age, part-time work, lack of advanced professional education, academic education and low satisfaction with the nursing profession. The shift of nursing workforce is mainly from hospitals to community health settings. There is a need to monitor and understand the characteristics of job and professional satisfaction among hospital nurses in order to implement crucial organizational interventions and retain hospital nursing staffs. Since young nurses, nurses working part time and nurses with no advanced professional and academic education, tend to move more than others, efforts should be targeted at these specific groups. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

High Job Demands and Low Job Control Increase Nurses' Professional Leaving Intentions: The Role of Care Setting and Profit Orientation.

PubMed

Wendsche, Johannes; Hacker, Winfried; Wegge, Jürgen; Rudolf, Matthias

2016-10-01

We investigated how two types of care setting (home care and nursing home) and type of ownership (for-profit vs. public/non-profit) of geriatric care services interacted in influencing registered nurses' intention to give up their profession. In prior research, employment in for-profit-organizations, high job demands, and low job control were important antecedents of nurses' intent to leave. However, the impact of care setting on these associations was inconclusive. Therefore, we tested a mediated moderation model predicting that adverse work characteristics would drive professional leaving intentions, particularly in for-profit services and in nursing homes. A representative German sample of 304 registered nurses working in 78 different teams participated in our cross-sectional study. As predicted, lower job control and higher job demands were associated with higher professional leaving intentions, and nurses reported higher job demands in public/non-profit care than in for-profit care, and in nursing homes compared to home care. Overall, RNs in nursing homes and home care reported similar intent to leave, but in for-profit settings only, nurses working in nursing homes reported higher professional leaving intentions than did nurses in home care, which was linked to lower job control in the for-profit nursing home setting, supporting mediated moderation. Taken together, our results indicate that the interplay of care setting and type of ownership is important when explaining nurses' intentions to give up their profession. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Impact of organizational policies and practices on workplace injuries in a hospital setting.

PubMed

Tveito, T H; Sembajwe, G; Boden, L I; Dennerlein, J T; Wagner, G R; Kenwood, C; Stoddard, A M; Reme, S E; Hopcia, K; Hashimoto, D; Shaw, W S; Sorensen, G

2014-08-01

This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units. A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases. Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes. Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.

Generational differences in work ethic among 3 generations of registered nurses.

PubMed

Jobe, Laura L

2014-05-01

The purpose of this study was to understand if differences in dimensions of work ethic exist among 3 generations of nurses working in an inpatient setting at an acute care facility. Generational differences are linked with increased turnover, with work ethic frequently cited as an important difference. The quantitative, quasi-experimental cross-sectional study recruited inpatient registered nurses from 2 teaching hospitals in a southern US metropolitan area to complete the Multidimensional Work Ethic Profile online. The 285 completed surveys indicated that similarities exist among the 3 generations, with statistically significant differences only in leisure, hard work, and delay of gratification dimensions. Understanding differences in work ethic dimensions could lead to strategies for improving the generational conflict. These results also lead to the conclusion that work ethic differences may not be the cause of the generational conflict among nurses.

76 FR 60781 - Toxics Release Inventory (TRI) Reporting for Facilities Located in Indian Country and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-30

... potential problems, set priorities, and take appropriate steps to reduce any potential risks to human health... not be disclosed except in accordance with procedures set forth in 40 CFR part 2. II. Introduction... Tribes, which is published periodically in the Federal Register. As also set forth at 40 CFR 372.3...

Providing Opportunities to Learn in Home-Based Child Care Settings: Observations of Learning Contexts and Behavior

ERIC Educational Resources Information Center

Rusby, Julie C.; Crowley, Ryann; Jones, Laura B.; Smolkowski, Keith

2017-01-01

Research Findings: This observation study investigated the prevalence and correlates of learning contexts provided to preschool-age children in 133 registered child care homes in below-average-income neighborhoods in the U.S. Pacific Northwest. On average, 30% of the observed proportion of time was spent in structured teacher-led activities, 51%…

THE MOTIVATION TO WORK. SPECIAL SUPPLEMENT TO "THE SELECTION OF TRAINEES UNDER MDTA".

ERIC Educational Resources Information Center

INDIK, BERNARD P.

THE PURPOSE OF THIS STUDY WAS TO BUILD A SET OF MEASURES WHICH WOULD PROVIDE INSIGHT INTO PEOPLE'S "MOTIVATION TO WORK." A SYSTEMATIC 10 PERCENT SAMPLE, 1,958 PERSONS, WAS DRAWN FROM THE REGISTERED POPULATION OF THE NEWARK EMPLOYMENT SERVICE IN LATE 1964. A SAMPLE OF 500 PERSONS, CLASSIFIED INTO EIGHT CATEGORIES ON THE BASIS OF A…

Real time, TV-based, point-image quantizer and sorter

DOEpatents

Case, Arthur L.; Davidson, Jackson B.

1976-01-01

A device is provided for improving the vertical resolution in a television-based, two-dimensional readout for radiation detection systems such as are used to determine the location of light or nuclear radiation impinging a target area viewed by a television camera, where it is desired to store the data indicative of the centroid location of such images. In the example embodiment, impinging nuclear radiation detected in the form of a scintillation occurring in a crystal is stored as a charge image on a television camera tube target. The target is scanned in a raster and the image position is stored according to a corresponding vertical scan number and horizontal position number along the scan. To determine the centroid location of an image that may overlap a number of horizontal scan lines along the vertical axis of the raster, digital logic circuits are provided with at least four series-connected shift registers, each having 512 bit positions according to a selected 512 horizontal increment of resolutions along a scan line. The registers are shifted by clock pulses at a rate of 512 pulses per scan line. When an image or portion thereof is detected along a scan, its horizontal center location is determined and the present front bit is set in the first shift register and shifted through the registers one at a time for each horizontal scan. Each register is compared bit-by-bit with the preceding register to detect coincident set bit positions until the last scan line detecting a portion of the image is determined. Depending on the number of shift registers through which the first detection of the image is shifted, circuitry is provided to store the vertical center position of the event according to the number of shift registers through which the first detection of the event is shifted. Interpolation circuitry is provided to determine if the event centroid is between adjacent scan lines and stored in a vertical address accordingly. The horizontal location of the event is stored in a separate address memory.

Analysis of a multisensor image data set of south San Rafael Swell, Utah

NASA Technical Reports Server (NTRS)

Evans, D. L.

1982-01-01

A Shuttle Imaging Radar (SIR-A) image of the southern portion of the San Rafael Swell in Utah has been digitized and registered to coregistered Landsat, Seasat, and HCMM thermal inertia images. The addition of the SIR-A image to the registered data set improves rock type discrimination in both qualitative and quantitative analyses. Sedimentary units can be separated in a combined SIR-A/Seasat image that cannot be seen in either image alone. Discriminant Analyses show that the classification accuracy is improved with addition of the SIR-A image to Landsat images. Classification accuracy is further improved when texture information from the Seasat and SIR-A images is included.

Ethnic/Racial, Religious, and Demographic Predictors of Organ Donor Registration Status Among Young Adults in the Southwestern United States.

PubMed

Ginossar, Tamar; Benavidez, Julian; Gillooly, Zachary D; Kanwal Attreya, Aarti; Nguyen, Hieu; Bentley, Joshua

2017-03-01

Context and Setting: New Mexico (NM) is a minority-majority state. Despite its unique cultural characteristics and documented ethnic/racial disparities in deceased organ donation (DOD), past studies did not explore predictors of organ donor registration status (ODRS) in this state. This study aimed at identifying demographic, cultural, and religious predictors of ODRS among a diverse sample of young adults in NM. This study focused on recruitment of American Indian, Hispanic, and Asian American participants through online social network sites and university listservs. Participants (N = 602) answered an online survey. The largest racial/ethnic group included American Indians (n = 200). Main outcome measures included ODRS, demographics, religious affiliation, and open-ended question on reasons for objections to DOD. Race/ethnicity, religion, and educational attainment were significant predictors of ODRS. Non-Hispanic whites (NHWs) were most likely to be registered as donors, with no significant difference between NHWs and Asians or Pacific Islanders. Non-Catholic Christians were most likely to be registered donors, followed by Catholics, practitioners of American Indian/Native American traditional religions, and Hindus, with Buddhists the least likely to register. This pattern was consistent with the propensity of individuals from these religious groups to cite religious objections to DOD. Finally, respondents who had graduated from high schools in NM were 2.3 times less likely to be registered as organ donors compared to those who had graduated in other states. This study provides evidence for the need for culturally tailored interventions targeting diverse communities in NM.

A concept of a MIABIS based register of biosample collections at the Medical University of Innsbruck.

PubMed

Hofer, Philipp; Fiegl, Heidi; Angerer, Justina; Mueller-Holzner, Elisabeth; Chamson, Martina; Klocker, Helmut; Steiner, Eberhardt; Hauffe, Helga; Zschocke, Johannes; Goebel, Georg

2014-01-01

The knowledge about the quality of samples and associated clinical data in biospecimen collections is a premise of clinical research. An electronic biosample register aims to facilitate the discovery of information about biosample collections in a hospital. Moreover, it might improve scientific collaboration and research quality through a shared access to harmonized sample collection description data. The aim of this paper is to present a concept of a web-based biosample register of the existing biosample collections at the Medical University of Innsbruck. A uniform description model is built based on an analysis of the sample collection data of independent sample management systems from two departments within the hospital. An extended set of attributes of the minimum dataset used by the Swedish sample collection register (MIABIS) has been applied to all biosample collections as a common description model. The results of the analysis and the data model are presented together with a first concept of a sample collection search register.

Simplified microprocessor design for VLSI control applications

NASA Technical Reports Server (NTRS)

Cameron, K.

1991-01-01

A design technique for microprocessors combining the simplicity of reduced instruction set computers (RISC's) with the richer instruction sets of complex instruction set computers (CISC's) is presented. They utilize the pipelined instruction decode and datapaths common to RISC's. Instruction invariant data processing sequences which transparently support complex addressing modes permit the formulation of simple control circuitry. Compact implementations are possible since neither complicated controllers nor large register sets are required.

Development of a core outcome set for studies involving patients undergoing major lower limb amputation for peripheral arterial disease: study protocol for a systematic review and identification of a core outcome set using a Delphi survey.

PubMed

Ambler, Graeme K; Bosanquet, David C; Brookes-Howell, Lucy; Thomas-Jones, Emma; Waldron, Cherry-Ann; Edwards, Adrian G K; Twine, Christopher P

2017-12-28

The development of a standardised reporting set is important to ensure that research is directed towards the most important outcomes and that data is comparable. To ensure validity, the set must be agreed by a consensus of stakeholders including patients, healthcare professionals and lay representatives. There is currently no agreed core outcome set for patients undergoing major lower limb amputation for peripheral arterial disease (PAD) for either short- or medium-term research outcomes. By developing these sets we aim to rationalise future trial outcomes, facilitate meta-analysis and improve the quality and applicability of amputation research. We will undertake a comprehensive systematic review of studies of patients undergoing major lower limb amputation for PAD. Data regarding all primary and secondary outcomes reported in relevant studies will be extracted and summarised as outcome domains. We will then undertake focus groups with key stakeholders (patients, carers, health and social care workers) to collect qualitative data to identify the main short- and medium-term research outcomes for patients undergoing major lower limb amputation. Results of the systematic review and focus groups will be combined to create a comprehensive list of potential key outcomes. Stakeholders (patients, researchers and health and social care workers) will then be polled to determine which of the outcomes are considered to be important in a general context using a three-phase Delphi process. After preliminary analysis, results will be presented at a face-to-face meeting of key stakeholders for discussion and voting on the final set of core outcomes. This project is being run in parallel with a feasibility trial assessing perineural catheters in patients undergoing lower limb amputation (the PLACEMENT trial). Full ethical approval has been granted for the study (Wales REC 3 reference number 16/WA/0353). Core outcome sets will be developed for short- and medium-term outcomes of research involving patients undergoing major lower limb amputation for PAD. This will help with the design of future trials and facilitate meta-analyses of trial data. PROSPERO: CRD42017059329 . Registered on 30 March 2017. 975 . Registered on 5 April 2017.

An open-access, mobile compatible, electronic patient register for rheumatic heart disease ('eRegister') based on the World Heart Federation's framework for patient registers.

PubMed

van Dam, Joris; Musuku, John; Zühlke, Liesl J; Engel, Mark E; Nestle, Nick; Tadmor, Brigitta; Spector, Jonathan; Mayosi, Bongani M

2015-01-01

Rheumatic heart disease (RHD) remains a major disease burden in low-resource settings globally. Patient registers have long been recognised to be an essential instrument in RHD control and elimination programmes, yet to date rely heavily on paper-based data collection and non-networked data-management systems, which limit their functionality. To assess the feasibility and potential benefits of producing an electronic RHD patient register. We developed an eRegister based on the World Heart Federation's framework for RHD patient registers using CommCare, an open-source, cloud-based software for health programmes that supports the development of customised data capture using mobile devices. The resulting eRegistry application allows for simultaneous data collection and entry by field workers using mobile devices, and by providers using computer terminals in clinics and hospitals. Data are extracted from CommCare and are securely uploaded into a cloud-based database that matches the criteria established by the WHF framework. The application can easily be tailored to local needs by modifying existing variables or adding new ones. Compared with traditional paper-based data-collection systems, the eRegister reduces the risk of data error, synchronises in real-time, improves clinical operations and supports management of field team operations. The user-friendly eRegister is a low-cost, mobile, compatible platform for RHD treatment and prevention programmes based on materials sanctioned by the World Heart Federation. Readily adaptable to local needs, this paperless RHD patient register program presents many practical benefits.

EDUCATIONAL INEQUALITIES IN REPEAT ABORTION: A LONGITUDINAL REGISTER STUDY IN FINLAND 1975-2010.

PubMed

Väisänen, Heini

2016-11-01

The proportion of repeat abortions among all abortions has increased over the last decades in Finland. This study examined the association of education with the likelihood of repeat abortion, and the change in this association over time using reliable longitudinal data. A unique set of register data from three birth cohorts were followed from age 20 to 45, including about 22,000 cases of repeat abortion, and analysed using discrete-time event-history models. Low education was found to be associated with a higher likelihood of repeat abortion. Women with low education had abortions sooner after the preceding abortion, and were more often single, younger and had larger families at the time of abortion than more highly educated women. The educational differences were more significant for later than earlier cohorts. The results show a lack of appropriate contraceptive use, possibly due to lack of knowledge of, or access to, services. There is a need to improve access to family planning services, and contraceptives should be provided free of charge. Register data overcome the common problems of under-reporting of abortion and attrition ensuring the results are reliable, unique and of interest internationally.

75 FR 77642 - Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program--Notice of Correction On pages 75469 and 75470, Volume 75, Number 232, Federal Register...

Developing a Policy for Delegation of Nursing Care in the School Setting

ERIC Educational Resources Information Center

Spriggle, Melinda

2009-01-01

School nurses are in a unique position to provide care for students with special health care needs in the school setting. The incidence of chronic conditions and improved technology necessitate care of complex health care needs that had formerly been managed in inpatient settings. Delegation is a tool that may be used by registered nurses to allow…

Retainment incentives in three rural practice settings: variations in job satisfaction among staff registered nurses.

PubMed

Stratton, T D; Dunkin, J W; Juhl, N; Geller, J M

1995-05-01

Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.

Poor uptake of primary healthcare registration among recent entrants to the UK: a retrospective cohort study

PubMed Central

Stagg, Helen R; Jones, Jane; Bickler, Graham

2012-01-01

Objectives Uptake of healthcare among migrants is a complex and controversial topic; there are multiple recognised barriers to accessing primary care. Delays in presentation to healthcare services may result in a greater burden on costly emergency care, as well as increased public health risks. This study aimed to explore some of the factors influencing registration of new entrants with general practitioners (GPs). Design Retrospective cohort study. Setting Port health screening at Heathrow and Gatwick airports, primary care. Participants 252 559 new entrants to the UK, whose entry was documented by the port health tuberculosis screening processes at Heathrow and Gatwick. 191 had insufficient information for record linkage. Primary outcome measure Registration with a GP practice within the UK, as measured through record linkage with the Personal Demographics Service (PDS) database. Results Only 32.5% of 252 368 individuals were linked to the PDS, suggesting low levels of registration in the study population. Women were more likely to register than men, with a RR ratio of 1.44 (95% CI 1.41 to 1.46). Compared with those from Europe, individuals of nationalities from the Americas (0.43 (0.39 to 0.47)) and Africa (0.74 (0.69 to 0.79)) were less likely to register. Similarly, students (0.83 (0.81 to 0.85)), long-stay visitors (0.82 (0.77 to 0.87)) and asylum seekers (0.46 (0.42 to 0.51)) were less likely to register with a GP than other migrant groups. Conclusions Levels of registration with GPs within this selected group of new entrants, as measured through record linkage, are low. Migrant groups with the lowest proportion registered are likely to be those with the highest health needs. The UK would benefit from a targeted approach to identify the migrants least likely to register for healthcare and to promote access among both users and service providers. PMID:22869094

Quantum Physics Principles and Communication in the Acute Healthcare Setting: A Pilot Study.

PubMed

Helgeson, Heidi L; Peyerl, Colleen Kraft; Solheim-Witt, Marit

This pilot study explores whether clinician awareness of quantum physics principles could facilitate open communication between patients and providers. In the spirit of action research, this study was conceptualized with a holistic view of human health, using a mixed method design of grounded theory as an emergent method. Instrumentation includes surveys and a focus group discussion with twelve registered nurses working in an acute care hospital setting. Findings document that the preliminary core phenomenon, energy as information, influences communication in the healthcare environment. Key emergent themes include awareness, language, validation, open communication, strategies, coherence, incoherence and power. Research participants indicate that quantum physics principles provide a language and conceptual framework for improving their awareness of communication and interactions in the healthcare environment. Implications of this pilot study support the feasibility of future research and education on awareness of quantum physics principles in other clinical settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

PubMed

James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

2011-02-01

To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

Characteristics of clinical trials registered in ClinicalTrials.gov, 2007-2010.

PubMed

Califf, Robert M; Zarin, Deborah A; Kramer, Judith M; Sherman, Rachel E; Aberle, Laura H; Tasneem, Asba

2012-05-02

Recent reports highlight gaps between guidelines-based treatment recommendations and evidence from clinical trials that supports those recommendations. Strengthened reporting requirements for studies registered with ClinicalTrials.gov enable a comprehensive evaluation of the national trials portfolio. To examine fundamental characteristics of interventional clinical trials registered in the ClinicalTrials.gov database. A data set comprising 96,346 clinical studies from ClinicalTrials.gov was downloaded on September 27, 2010, and entered into a relational database to analyze aggregate data. Interventional trials were identified and analyses were focused on 3 clinical specialties-cardiovascular, mental health, and oncology-that together encompass the largest number of disability-adjusted life-years lost in the United States. Characteristics of registered clinical trials as reported data elements in the trial registry; how those characteristics have changed over time; differences in characteristics as a function of clinical specialty; and factors associated with use of randomization, blinding, and data monitoring committees (DMCs). The number of registered interventional clinical trials increased from 28,881 (October 2004-September 2007) to 40,970 (October 2007-September 2010), and the number of missing data elements has generally declined. Most interventional trials registered between 2007 and 2010 were small, with 62% enrolling 100 or fewer participants. Many clinical trials were single-center (66%; 24,788/37,520) and funded by organizations other than industry or the National Institutes of Health (NIH) (47%; 17,592/37,520). Heterogeneity in the reported methods by clinical specialty; sponsor type; and the reported use of DMCs, randomization, and blinding was evident. For example, reported use of DMCs was less common in industry-sponsored vs NIH-sponsored trials (adjusted odds ratio [OR], 0.11; 95% CI, 0.09-0.14), earlier-phase vs phase 3 trials (adjusted OR, 0.83; 95% CI, 0.76-0.91), and mental health trials vs those in the other 2 specialties. In similar comparisons, randomization and blinding were less frequently reported in earlier-phase, oncology, and device trials. Clinical trials registered in ClinicalTrials.gov are dominated by small trials and contain significant heterogeneity in methodological approaches, including reported use of randomization, blinding, and DMCs.

WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial.

PubMed

Hamdani, S U; Akhtar, P; Zill-E-Huma; Nazir, H; Minhas, F A; Sikander, S; Wang, D; Servilli, C; Rahman, A

2017-01-01

Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan. The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by 'family volunteers' to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule - child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894). This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings. Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

78 FR 43220 - Advisory Committee on Commercial Operations of Customs and Border Protection (COAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

...) Working Group, and review and discuss a case study regarding the Partner Government Agency--Message Set... to the public. DATES: COAC will meet on Wednesday, August 7, from 1:00 p.m. to 5:00 p.m. e.s.t...-registering using a method indicated below: --For members of the public who plan to attend the meeting in...

Gender and Publishing in Nursing: a secondary analysis of h-index ranking tables.

PubMed

Porter, Sam

2018-05-24

To analyse published ranking tables on academics' h-index scores to establish whether male nursing academics are disproportionately represented in these tables compared with their representation across the whole profession. Previous studies have identified a disproportionate representation of UK male nursing academics in publishing in comparison to their US counterparts. Secondary statistical analysis, which involved comparative correlation of proportions. Four papers from the UK, Canada and Australia containing h-index ranking tables and published between 2010-2017, were re-analysed in June 2017 to identify authors' sex. Pearson's chi-squared test was applied to ascertain whether the number of men included in the tables was statistically proportionate to the number of men on the pertinent national professional register. There was a disproportionate number of men with high h-index scores in the UK and Canadian data sets, compared with the proportion of men on the pertinent national registers. The number of men in the Australian data set was proportionate with the number of men on the nursing register. There was a disproportionate number of male professors in UK universities. The influence of men over nursing publishing in the UK and Canada outweighs their representation across the whole profession. Similarly, in the UK, men's representation in the professoriate is disproportionately great. However, the Australian results suggest that gender inequality is not inevitable and that it is possible to create more egalitarian nursing cultures. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

27 CFR 29.55 - Registry of stills and distilling apparatus.

Code of Federal Regulations, 2010 CFR

2010-04-01

... distilling apparatus. 29.55 Section 29.55 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Registry of stills and distilling apparatus. (a) General. Every person having possession, custody, or control of any still or distilling apparatus set up shall, immediately on its being set up, register the...

27 CFR 29.55 - Registry of stills and distilling apparatus.

Code of Federal Regulations, 2011 CFR

2011-04-01

... distilling apparatus. 29.55 Section 29.55 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Registry of stills and distilling apparatus. (a) General. Every person having possession, custody, or control of any still or distilling apparatus set up shall, immediately on its being set up, register the...

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

PubMed

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services. This study is registered with Clinicaltrials.gov ( NCT03380078 ). Registered 20 December 2017, retrospectively registered.

Swedish nurses' experiences of caring for dying people: a holistic approach.

PubMed

Iranmanesh, Sedigheh; Häggström, Terttu; Axelsson, Karin; Sävenstedt, Stefan

2009-01-01

Most people need to be cared for at the end of their lives by professionals. This study aimed to elucidate the meaning of nurses' experiences of caring for dying persons at home and in a special unit in a hospital. Four registered nurses working in private homes and 4 registered nurses working in a specific unit in a hospital setting were interviewed. The study was planned and carried out with a phenomenological hermeneutic approach. A naive reading guided a structural analysis, which resulted in 3 main themes: meeting patients and family members as unique persons, learning in a challenging environment, and gaining personal strength. The interpreted comprehensive understanding conveyed a meaning that caring for families with a member awaiting the end of life created a situation where the presence of an inevitable death demanded nurses to create close relationships with each unique person involved.

Trends and changes in paediatric tonsil surgery in Sweden 1987–2013: a population-based cohort study

PubMed Central

Borgström, Anna; Nerfeldt, Pia; Friberg, Danielle; Sunnergren, Ola; Stalfors, Joacim

2017-01-01

Objectives The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents regarding incidence, indications for surgery, surgical methods and the age and gender distributions. Setting A retrospective longitudinal population-based cohort study based on register data from the Swedish National Patient Register (NPR) and population data from Statistics Sweden. Participants All Swedish children 1–<18 years registered in the NPR with a tonsil surgery procedure 1987–2013. Results 167 894 tonsil surgeries were registered in the NPR 1987–2013. An increase in the total incidence rate was observed, from 22/10 000 person years in 1987 to 47/10 000 in 2013. The most marked increase was noted in children 1–3 years of age, increasing from 17 to 73/10 000 person years over the period. The proportion children with obstructive/sleep disordered breathing (SDB) indications increased from 42.4% in 1987 to 73.6% in 2013. Partial tonsillectomy, tonsillotomy (TT), increased since 1996 and in 2013 55.1% of all tonsil procedures were TTs. Conclusions There have been considerable changes in clinical practice for tonsil surgery in Swedish children over the past few decades. Overall, a doubling in the total incidence rate was observed. This increase consisted mainly of an increase in surgical procedures due to obstructive/SDB indications, particularly among the youngest age group (1–3 years old). TT has gradually replaced tonsillectomy as the predominant method for tonsil surgery. PMID:28087550

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Variations in Care Quality Outcomes of Dying People: Latent Class Analysis of an Adult National Register Population.

PubMed

Öhlén, Joakim; Russell, Lara; Håkanson, Cecilia; Alvariza, Anette; Fürst, Carl Johan; Årestedt, Kristofer; Sawatzky, Richard

2017-01-01

Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people to understand and evaluate symptom relief as an indicator of quality of care at end of life. The aims of this study were to distinguish classes of patients who have different symptom relief patterns during the last week of life and to identify predictors of these classes in an adult register population. In a cross-sectional retrospective design, data were used from 87,026 decedents with expected deaths registered in the Swedish Register of Palliative Care in 2011 and 2012. Study variables were structured into patient characteristics, and processes and outcomes of quality of care. A latent class analysis was used to identify symptom relief patterns. Multivariate multinomial regression analyses were used to identify predictors of class membership. Five latent classes were generated: "relieved pain," "relieved pain and rattles," "relieved pain and anxiety," "partly relieved shortness of breath, rattles and anxiety," and "partly relieved pain, anxiety and confusion." Important predictors of class membership were age, sex, cause of death, and having someone present at death, individual prescriptions as needed (PRN) and expert consultations. Interindividual variability and complexity in symptom relief patterns may inform quality of care and its evaluation for dying people across care settings. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Empowering aged care nurses to deliver person-centred care: Enabling nurses to shine.

PubMed

Marriott-Statham, Kelly; Mackay, Maria; Brennan, Ngaire; Mackay, Jacinta

2018-05-23

In this paper, the authors will describe the journey of registered nurses across a series of workshops as part of a research project that was undertaken in a regional aged care service in New South Wales, Australia. The aim of the project was to empower the participant registered nurses to positively influence the health care workplace culture within the residential care home by raising consciousness about their own practice. Registered nurses were actively involved in this reconnaissance phase of a participatory action research project through practice development principles and methods. Registered nurses determined the content and the outcomes of the overall program. The researchers evaluated the impact of a series of workshops, designed to develop skills and knowledge using nominal group technique. Results revealed registered nurses perceived they were empowered to flourish, and developed an understanding of the uniqueness of their role. A shared understanding of the role of the registered nurse in the aged care setting was fundamental in enabling them to feel empowered to lead their team and contribute positively to the workplace culture. Overall, the outcomes of this project have positively impacted workplace culture. Copyright © 2018. Published by Elsevier Ltd.

Nurses' Knowledge and Attitudes about Pain: Personal and Professional Characteristics and Patient Reported Pain Satisfaction.

PubMed

Brant, Jeannine M; Mohr, Carla; Coombs, Nicholas C; Finn, Susan; Wilmarth, Estella

2017-08-01

Pain is a nursing sensitive indicator and yet pain is often not well managed in both hospital and ambulatory settings. Improving nurse knowledge and attitudes about pain may translate to improved patient outcomes. The objective of this study was to investigate knowledge and attitudes about pain (KAP) in nurses who work in diverse settings, professional and personal characteristics that predict KAP, and whether KAP correlated with patient satisfaction according to Hospital Consumer Assessment of Healthcare Providers (HCAHPS). Descriptive, cross-sectional, correlational study. A large integrated health care facility in the northwest. A total of 217 registered nurses working in acute, ambulatory, and long-term care. A Pain Knowledge and Attitudes Survey was administered to registered nurses in diverse settings. Scores were examined for personal and professional predictors of KAP and correlated with HCAHPS patient satisfaction surveys. Nurses scored an average of 72%; nurses in long-term care scored the highest. Having more than 5 years of nursing experience, being a certified nurse, and receiving pain education in the last year were predictive of a higher score on the KAP survey, which explained only 9.8% of the variance. Unit mean KAP scores were highly correlated with unit-based HCAHPS scores (r = 0.917, p = .01). Certified nurses scored higher on the KAP survey, consistent with other studies. This study suggests that having more knowledge and better attitudes about pain may improve patient satisfaction of pain. Further studies are needed that link knowledge and attitudes about pain to patient outcomes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Hardware support for software controlled fast multiplexing of performance counters

DOEpatents

Salapura, Valentina; Wisniewski, Robert W

2013-10-01

Performance counters may be operable to collect one or more counts of one or more selected activities, and registers may be operable to store a set of performance counter configurations. A state machine may be operable to automatically select a register from the registers for reconfiguring the one or more performance counters in response to receiving a first signal. The state machine may be further operable to reconfigure the one or more performance counters based on a configuration specified in the selected register. The state machine yet further may be operable to copy data in selected one or more of the performance counters to a memory location, or to copy data from the memory location to the counters, in response to receiving a second signal. The state machine may be operable to store or restore the counter values and state machine configuration in response to a context switch event.

Hardware support for software controlled fast multiplexing of performance counters

DOEpatents

Salapura, Valentina; Wisniewski, Robert W.

2013-01-01

Performance counters may be operable to collect one or more counts of one or more selected activities, and registers may be operable to store a set of performance counter configurations. A state machine may be operable to automatically select a register from the registers for reconfiguring the one or more performance counters in response to receiving a first signal. The state machine may be further operable to reconfigure the one or more performance counters based on a configuration specified in the selected register. The state machine yet further may be operable to copy data in selected one or more of the performance counters to a memory location, or to copy data from the memory location to the counters, in response to receiving a second signal. The state machine may be operable to store or restore the counter values and state machine configuration in response to a context switch event.

Application of SEU imaging for analysis of device architecture using a 25 MeV/u 86Kr ion microbeam at HIRFL

NASA Astrophysics Data System (ADS)

Liu, Tianqi; Yang, Zhenlei; Guo, Jinlong; Du, Guanghua; Tong, Teng; Wang, Xiaohui; Su, Hong; Liu, Wenjing; Liu, Jiande; Wang, Bin; Ye, Bing; Liu, Jie

2017-08-01

The heavy-ion imaging of single event upset (SEU) in a flash-based field programmable gate array (FPGA) device was carried out for the first time at Heavy Ion Research Facility in Lanzhou (HIRFL). The three shift register chains with separated input and output configurations in device under test (DUT) were used to identify the corresponding logical area rapidly once an upset occurred. The logic units in DUT were partly configured in order to distinguish the registers in SEU images. Based on the above settings, the partial architecture of shift register chains in DUT was imaged by employing the microbeam of 86Kr ion with energy of 25 MeV/u in air. The results showed that the physical distribution of registers in DUT had a high consistency with its logical arrangement by comparing SEU image with logic configuration in scanned area.

Design of a modular digital computer system, CDRL no. D001, final design plan

NASA Technical Reports Server (NTRS)

Easton, R. A.

1975-01-01

The engineering breadboard implementation for the CDRL no. D001 modular digital computer system developed during design of the logic system was documented. This effort followed the architecture study completed and documented previously, and was intended to verify the concepts of a fault tolerant, automatically reconfigurable, modular version of the computer system conceived during the architecture study. The system has a microprogrammed 32 bit word length, general register architecture and an instruction set consisting of a subset of the IBM System 360 instruction set plus additional fault tolerance firmware. The following areas were covered: breadboard packaging, central control element, central processing element, memory, input/output processor, and maintenance/status panel and electronics.

The influence of regional geological settings on the seismic hazard level in copper mines in the Legnica-Głogów Copper Belt Area (Poland)

NASA Astrophysics Data System (ADS)

Burtan, Zbigniew

2017-11-01

The current level of rockburst hazard in copper mines of the (LGOM) Legnica- Głogów Copper Belt Area is mostly the consequence of mining-induced seismicity, whilst the majority of rockbursting events registered to date were caused by high-energy tremors. The analysis of seismic readings in recent years reveals that the highest seismic activity among the copper mines in the LGOM is registered in the mine Rudna. This study investigates the seismic activity in the rock strata in the Rudna mine fields over the years 2006-2015. Of particular interest are the key seismicity parameters: the number of registered seismic events, the total energy emissions, the energy index. It appears that varied seismic activity in the area may be the function of several variables: effective mining thickness, the thickness of burst-prone strata and tectonic intensity. The results support and corroborate the view that principal factors influencing the actual seismic hazard level are regional geological conditions in the copper mines within the Legnica-Głogów Copper Belt Area.

Selection strategies for newly registered blood donors in European countries

PubMed Central

Lieshout-Krikke, Ryanne W.; Domanovic, Dragoslav; de Kort, Wim; Mayr, Wolfgang; Liumbruno, Giancarlo M.; Pupella, Simonetta; Kurz, Johann; Knutson, Folke; MacLennan, Sheila; Folléa, Gilles

2017-01-01

Background Two selection strategies for newly-registered blood donors are available: a single-visit selection called the standard selection procedure (SSP), and a two-stage selection named predonation and donation screening (PDS). This study reviews the selection strategies for newly-registered donors currently applied in European countries. Material and methods We collected data on donor selection procedures, blood donation, laboratory screening and HIV, HCV and HBV positive donors/donations from 2010 to 2013 in 30 European countries by using questionnaires. We grouped the countries according to the applied selection strategy, and for each country, we calculated the 4-year prevalence of confirmed positive results indicating the presence of overall and recent HIV, HCV and HBV infections among first-time and repeat donations and among newly-registered donors. Results Most of the 24 countries (80%) apply the SSP strategy for selection of newly-registered donors. Twenty-two countries (73.3%) employ a nucleic acid amplification testing in addition to the mandatory serological screening. The survey confirms a higher overall prevalence of HIV, HCV and HBV infections among first-time donations and newly-registered donors than among repeat donations. In contrast, the prevalence of recently acquired HIV and HCV infections was lower among first-time donations and newly-registered donors than among repeat donations, but higher for recent HBV infections (6.7/105 vs 2.6/105 in the SSP setting and 4.3/105 vs 0.5/105 in one country using PDS). The relatively low numbers of infected donors selected by PDS impeded accurate assessment of the prevalence of recent infections in first-time donations. Discussion The data from European countries provide inconclusive evidence that applying PDS reduces the risk of donations being made in the diagnostic window of first-time donors. The impact of PDS on the risk of window-period donations and blood donor management needs further investigation. PMID:27723449

The relationships among social capital, organisational commitment and customer-oriented prosocial behaviour of hospital nurses.

PubMed

Hsu, Chiu-Ping; Chang, Chia-Wen; Huang, Heng-Chiang; Chiang, Chi-Yun

2011-05-01

This study examines the perceptions of registered nurses of social capital, organisational commitment and customer-oriented prosocial behaviour. Additionally, this study also addresses a conceptual model for testing how registered nurses' perceptions of three types of social capital influence their organisational commitment, in turn intensifying customer-oriented prosocial behaviour, including role-prescribed customer service and extra-role customer service. Customer-oriented prosocial behaviour explains differences in job satisfaction and job performance. However, the critical role of customer orientation in the hospital setting has yet to be explored. Survey. The survey was conducted to obtain data from registered nurses working for a large Taiwanese medical centre, yielding 797 usable responses and a satisfactory response rate of 86.7%. The partial least squares method was adopted to obtain parameter estimates and test proposed hypotheses. The study measurements display satisfactory reliability, as well as both convergent and discriminant validities. All hypotheses were supported. Empirical results indicate that registered nurses' perceptions of social capital were significantly impacted the extent of organisational commitment, which in turn significantly influenced customer-oriented prosocial behaviour. By stimulating nursing staff commitment, health care providers can urge them to pursue organisational goals and provide high quality customer service. To enhance organisational commitment, health care managers should endeavour to create interpersonal interaction platforms in addition to simply offering material rewards. Nurses act as contact employees for their patient customers in the hospital, and they are required to provide patient safety and service quality. This study shows that nurses with high organisational commitment are willing to provide customer-oriented prosocial activities, which in turn enhances patient satisfaction. © 2011 Blackwell Publishing Ltd.

The primacy of vital signs--acute care nurses' and midwives' use of physical assessment skills: a cross sectional study.

PubMed

Osborne, Sonya; Douglas, Clint; Reid, Carol; Jones, Lee; Gardner, Glenn

2015-05-01

Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. The study used a single-centre, cross-sectional survey design. The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses' Use of Physical Assessment Scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value <.05 was considered significant for all analyses. Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F=35.77, p<.001), lack of confidence (F=5.52, p=.02), work area (F=3.79, p=.002), and clinical role (F=44.24, p<.001) were significant predictors of the extent of physical assessment skill use. The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses' physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Preliminary analysis on faint luminous lightning events recorded by multiple high speed cameras

NASA Astrophysics Data System (ADS)

Alves, J.; Saraiva, A. V.; Pinto, O.; Campos, L. Z.; Antunes, L.; Luz, E. S.; Medeiros, C.; Buzato, T. S.

2013-12-01

The objective of this work is the study of some faint luminous events produced by lightning flashes that were recorded simultaneously by multiple high-speed cameras during the previous RAMMER (Automated Multi-camera Network for Monitoring and Study of Lightning) campaigns. The RAMMER network is composed by three fixed cameras and one mobile color camera separated by, in average, distances of 13 kilometers. They were located in the Paraiba Valley (in the cities of São José dos Campos and Caçapava), SP, Brazil, arranged in a quadrilateral shape, centered in São José dos Campos region. This configuration allowed RAMMER to see a thunderstorm from different angles, registering the same lightning flashes simultaneously by multiple cameras. Each RAMMER sensor is composed by a triggering system and a Phantom high-speed camera version 9.1, which is set to operate at a frame rate of 2,500 frames per second with a lens Nikkor (model AF-S DX 18-55 mm 1:3.5 - 5.6 G in the stationary sensors, and a lens model AF-S ED 24 mm - 1:1.4 in the mobile sensor). All videos were GPS (Global Positioning System) time stamped. For this work we used a data set collected in four RAMMER manual operation days in the campaign of 2012 and 2013. On Feb. 18th the data set is composed by 15 flashes recorded by two cameras and 4 flashes recorded by three cameras. On Feb. 19th a total of 5 flashes was registered by two cameras and 1 flash registered by three cameras. On Feb. 22th we obtained 4 flashes registered by two cameras. Finally, in March 6th two cameras recorded 2 flashes. The analysis in this study proposes an evaluation methodology for faint luminous lightning events, such as continuing current. Problems in the temporal measurement of the continuing current can generate some imprecisions during the optical analysis, therefore this work aim to evaluate the effects of distance in this parameter with this preliminary data set. In the cases that include the color camera we analyzed the RGB mode (red, green, blue) and compared them with the data provided by the black and white cameras for the same event and the influence of these parameters with the luminosity intensity of the flashes. Two peculiar cases presented, from the data obtained at one site, a stroke, some continuing current during the interval between the strokes and, then, a subsequent stroke; however, the other site showed that the subsequent stroke was in fact an M-component, since the continuing current had not vanished after its parent stroke. These events generated a dubious classification for the same event that was based only in a visual analysis with high-speed cameras and they were analyzed in this work.

Cohort profile: the Scottish Research register SHARE. A register of people interested in research participation linked to NHS data sets.

PubMed

McKinstry, Brian; Sullivan, Frank M; Vasishta, Shobna; Armstrong, Roma; Hanley, Janet; Haughney, John; Philip, Sam; Smith, Blair H; Wood, Amanda; Palmer, Colin N A

2017-02-01

Recruitment to trials is often difficult. Many trials fail to meet recruitment targets resulting in underpowered studies which waste resources and the time of those who participated. While there is evidence that many people are willing to take part in research, particularly if it involves a condition from which they suffer, researchers are unable to easily contact such people often relying on busy clinicians to identify them. Many clinicians perceive themselves as too busy to take part in research activities. The Scottish Health Research Register SHARE adopts an approach which asks the public to consent to their data held in National Health Service databases to be used to determine their suitability for research projects. Additionally, participants can consent for spare blood, left after routine venepuncture to be automatically identified in the laboratory and stored for future research studies. Anyone over the age of 16 years in Scotland can participate. Participants are approached through a range of methods including directly at outpatient clinics and general practitioners practices, leaflets with hospital letters and personal email from employers. SHARE has recruited around 130 000 people. SHARE has demonstrated that it can quickly and efficiently recruit to studies, over 20 until now. In addition, it can be used to administer questionnaire studies by email and recruit to patient and public involvement groups. SHARE continues to steadily recruit with the ambition of eventually achieving 1 000 000 people in Scotland. We are steadily increasing the number of data sets we use for identifying participants. We are adding a mobile app which will facilitate dissemination about research and allow the collection of physiological and activity data if desired. We anticipate that SHARE will soon become the main source of health research recruitment in Scotland. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cohort profile: the Scottish Research register SHARE. A register of people interested in research participation linked to NHS data sets

PubMed Central

McKinstry, Brian; Sullivan, Frank M; Vasishta, Shobna; Armstrong, Roma; Hanley, Janet; Haughney, John; Philip, Sam; Smith, Blair H; Wood, Amanda; Palmer, Colin N A

2017-01-01

Purpose Recruitment to trials is often difficult. Many trials fail to meet recruitment targets resulting in underpowered studies which waste resources and the time of those who participated. While there is evidence that many people are willing to take part in research, particularly if it involves a condition from which they suffer, researchers are unable to easily contact such people often relying on busy clinicians to identify them. Many clinicians perceive themselves as too busy to take part in research activities. The Scottish Health Research Register SHARE adopts an approach which asks the public to consent to their data held in National Health Service databases to be used to determine their suitability for research projects. Additionally, participants can consent for spare blood, left after routine venepuncture to be automatically identified in the laboratory and stored for future research studies. Participants Anyone over the age of 16 years in Scotland can participate. Participants are approached through a range of methods including directly at outpatient clinics and general practitioners practices, leaflets with hospital letters and personal email from employers. Findings to date SHARE has recruited around 130 000 people. SHARE has demonstrated that it can quickly and efficiently recruit to studies, over 20 until now. In addition, it can be used to administer questionnaire studies by email and recruit to patient and public involvement groups. Future plans SHARE continues to steadily recruit with the ambition of eventually achieving 1 000 000 people in Scotland. We are steadily increasing the number of data sets we use for identifying participants. We are adding a mobile app which will facilitate dissemination about research and allow the collection of physiological and activity data if desired. We anticipate that SHARE will soon become the main source of health research recruitment in Scotland. PMID:28148535

Enhancing the quality of supportive supervisory behavior in long-term care facilities.

PubMed

McGillis Hall, Linda; McGilton, Katherine S; Krejci, Janet; Pringle, Dorothy; Johnston, Erin; Fairley, Laura; Brown, Maryanne

2005-04-01

The practices of managers and registered nurses (RNs) in long-term care facilities are frequently ineffective in assisting the licensed practical nurses (LPNs) and healthcare aides (HCAs) whom they supervise. Little research exists that examines the area of supportive relationships between nursing staff and supervisors in these settings. The purpose of this study was to gather data that could improve management practices in long-term care residential facilities and enhance the quality of the supervisory relationships between supervisors (nurse managers and RNs) and care providers (HCAs and LPNs) in these settings. The study also identified factors that influence the supervisors' ability to establish supportive relationships with care providers. The challenges and barriers to nurse managers and leaders related to enacting supportive behaviors are discussed as well as their implications for long-term care settings.

Imaging system for cardiac planar imaging using a dedicated dual-head gamma camera

DOEpatents

Majewski, Stanislaw [Morgantown, VA; Umeno, Marc M [Woodinville, WA

2011-09-13

A cardiac imaging system employing dual gamma imaging heads co-registered with one another to provide two dynamic simultaneous views of the heart sector of a patient torso. A first gamma imaging head is positioned in a first orientation with respect to the heart sector and a second gamma imaging head is positioned in a second orientation with respect to the heart sector. An adjustment arrangement is capable of adjusting the distance between the separate imaging heads and the angle between the heads. With the angle between the imaging heads set to 180 degrees and operating in a range of 140-159 keV and at a rate of up to 500kHz, the imaging heads are co-registered to produce simultaneous dynamic recording of two stereotactic views of the heart. The use of co-registered imaging heads maximizes the uniformity of detection sensitivity of blood flow in and around the heart over the whole heart volume and minimizes radiation absorption effects. A normalization/image fusion technique is implemented pixel-by-corresponding pixel to increase signal for any cardiac region viewed in two images obtained from the two opposed detector heads for the same time bin. The imaging system is capable of producing enhanced first pass studies, bloodpool studies including planar, gated and non-gated EKG studies, planar EKG perfusion studies, and planar hot spot imaging.

Reportable Quantities Federal Register Notices

EPA Pesticide Factsheets

Comprehensive Environmental Response, Compensation and Liability Act regulation designates specific substances as hazardous; identifies the quantity of substances which, when released, requires notification; and sets forth the notification requirements.

77 FR 18307 - Update to the January 6, 2012, Federal Register

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... to announce that a Presidential $1 Four-Coin Set, priced at $9.95, will be offered instead of the $1... follows: Retail Product price Presidential $1 Four-Coin Set $9.95 Presidential $1 Coin & First Spouse... FURTHER INFORMATION CONTACT: B. B. Craig, Associate Director for Sales and Marketing, United States Mint...

Diabetes Management in the School Setting. Position Statement. Revised

ERIC Educational Resources Information Center

Wright, Janet B.; Easterling, Traci; Hardy, Alicen

2017-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is the school staff member who has the knowledge, skills, and statutory authority to fully meet the healthcare needs of students with diabetes in the school setting. Diabetes management in…

Diabetes Management in the School Setting. Position Statement

ERIC Educational Resources Information Center

Butler, Sarah; Fekaris, Nina; Pontius, Deborah; Zacharski, Susan

2012-01-01

It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as school nurse) is the only school staff member who has the skills, knowledge base, and statutory authority to fully meet the healthcare needs of students with diabetes in the school setting. Diabetes management…

Merge of Five Previous Catalogues Into the Ground Truth Catalogue and Registration Based on MOLA Data with THEMIS-DIR, MDIM and MOC Data-Sets

NASA Astrophysics Data System (ADS)

Salamuniccar, G.; Loncaric, S.

2008-03-01

The Catalogue from our previous work was merged with the date of Barlow, Rodionova, Boyce, and Kuzmin. The resulting ground truth catalogue with 57,633 craters was registered, using MOLA data, with THEMIS-DIR, MDIM, and MOC data-sets.

The Role of Certified Registered Nurse Anesthetists in Patient Education

DTIC Science & Technology

2000-10-01

settings. AORN Journal, 64, 941-952. Burns, N., & Grove, S. (1997). The practice of nursing research conduct, critique, & utilization (3rd ed...nursing theory to perioperative nursing practice. AORN Journal, 64, 261-264 & 267-268. Patient Education 27 Haddock, J., & Burrows, C. (1997). The...Study on effects of methods of preoperative education in women. AORN Journal, 67, 203-213. Miller, B., & Capps, E. (1997). Meeting JCAHO patient

Development of a Continuum Damage Mechanics Material Model of a Graphite-Kevlar(Registered Trademark) Hybrid Fabric for Simulating the Impact Response of Energy Absorbing Kevlar(Registered Trademark) Hybrid Fabric for Simulating the Impact Response of Energy Absorbing

NASA Technical Reports Server (NTRS)

Jackson, Karen E.; Fasanella, Edwin L.; Littell, Justin D.

2017-01-01

This paper describes the development of input properties for a continuum damage mechanics based material model, Mat 58, within LS-DYNA(Registered Trademark) to simulate the response of a graphite-Kevlar(Registered Trademark) hybrid plain weave fabric. A limited set of material characterization tests were performed on the hybrid graphite-Kevlar(Registered Trademark) fabric. Simple finite element models were executed in LS-DYNA(Registered Trademark) to simulate the material characterization tests and to verify the Mat 58 material model. Once verified, the Mat 58 model was used in finite element models of two composite energy absorbers: a conical-shaped design, designated the "conusoid," fabricated of four layers of hybrid graphite-Kevlar(Registered Trademark) fabric; and, a sinusoidal-shaped foam sandwich design, designated the "sinusoid," fabricated of the same hybrid fabric face sheets with a foam core. Dynamic crush tests were performed on components of the two energy absorbers, which were designed to limit average vertical accelerations to 25- to 40-g, to minimize peak crush loads, and to generate relatively long crush stroke values under dynamic loading conditions. Finite element models of the two energy absorbers utilized the Mat 58 model that had been verified through material characterization testing. Excellent predictions of the dynamic crushing response were obtained.

Australia's first transition to professional practice in primary care program for graduate registered nurses: a pilot study.

PubMed

Aggar, Christina; Bloomfield, Jacqueline; Thomas, Tamsin H; Gordon, Christopher J

2017-01-01

Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction. This study aimed to determine whether a transition to professional practice program implemented in the general practice setting led to competent practice nurses in their first year post-graduation. A longitudinal, exploratory mixed-methods design was used to assess the pilot study. Data were collected at three times points (3, 6, 12 months) with complete data sets from graduate nurses ( n =  4) and preceptors ( n =  7). We assessed perceptions of the graduates' nursing competency and confidence, satisfaction with the preceptor/graduate relationship, and experiences and satisfaction with the program. Graduate nurse competency was assessed using the National Competency Standards for Nurses in General Practice. Semi-structured interviews with participants at Time 3 sought information about barriers, enablers, and the perceived impact of the program. Graduate nurses were found to be competent within their first year of clinical practice. Program perceptions from graduate nurses and preceptors were positive and the relationship between the graduate nurse and preceptor was key to this development. With appropriate support registered nurses can transition directly into primary care and are competent in their first year post-graduation. While wider implementation and research is needed, findings from this study demonstrate the potential value of transition to professional practice programs within primary care as a nursing workforce development strategy.

Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: results from a prospective cohort study in the Sicilian general practice setting.

PubMed

Ferrara, Rosarita; Ientile, Valentina; Piccinni, Carlo; Pasqua, Alessandro; Pecchioli, Serena; Fontana, Andrea; Alecci, Umberto; Scoglio, Riccardo; Magliozzo, Francesco; Torrisi, Sebastiano Emanuele; Vancheri, Carlo; Vitulo, Patrizio; Fantaci, Giovanna; Ferrajolo, Carmen; Cazzola, Mario; Cricelli, Claudio; Caputi, Achille Patrizio; Trifirò, Gianluca

2018-03-23

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lungs associated with progressive disability. Although general practitioners (GPs) should play an important role in the COPD management, critical issues have been documented in the primary care setting. The aim of this study was to evaluate the effectiveness of an educational program for the improvement of the COPD management in a Sicilian general practice setting. The effectiveness of the program, was evaluated by comparing 15 quality-of-care indicators developed from data extracted by 33 GPs, at baseline vs. 12 and 24 months, and compared with data from a national primary care database (HSD). Moreover, data on COPD-related and all-cause hospitalizations over time of COPD patients, was measured. Overall, 1,465 patients (3.2%) had a registered diagnosis of COPD at baseline vs. 1,395 (3.0%) and 1,388 (3.0%) over time (vs. 3.0% in HSD). COPD patients with one spirometry registered increased from 59.7% at baseline to 73.0% after 2 years (vs. 64.8% in HSD). Instead, some quality of care indicators where not modified such as proportion of COPD patients treated with ICS in monotherapy that was almost stable during the study period: 9.6% (baseline) vs. 9.9% (after 2 years), vs. 7.7% in HSD. COPD-related and all-cause hospitalizations of patients affected by COPD decreased during the two observation years (from 6.9% vs. 4.0%; from 23.0% vs. 18.9%, respectively). Our study showed that educational program involving specialists, clinical pharmacologists and GPs based on training events and clinical audit may contribute to partly improve both diagnostic and therapeutic management of COPD in primary care setting, despite this effect may vary across GPs and indicators of COPD quality of care.

Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

PubMed

Newton, Louise; Pront, Leeanne; Giles, Tracey M

2016-06-01

To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing students, along with adequate recognition of the additional time required to effectively supervise these students. © 2016 John Wiley & Sons Ltd.

36 CFR 60.1 - Authorization and expansion of the National Register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... districts, sites, buildings, structures, and objects significant in American history, architecture, archeology, engineering and culture. The regulations herein set forth the procedural requirements for listing...

Shifting hospital care to primary care: An evaluation of cardiology care in a primary care setting in the Netherlands.

PubMed

Quanjel, Tessa C C; Struijs, Jeroen N; Spreeuwenberg, Marieke D; Baan, Caroline A; Ruwaard, Dirk

2018-05-09

In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital. This is a retrospective observational study based on quantitative data. Data collected between January 1 and December 31, 2015 were extracted from the electronic medical record system. Logistic regression analyses were used to select patient groups that should be excluded from referral to Primary Care Plus. In total, 1525 patients were included in the analyses. Results showed that male patients, older patients, those with the referral indication 'Stable Angina Pectoris' or 'Dyspnoea' and patients whose reason for referral was 'To confirm disease' or 'Screening of unclear pathology' had a significantly higher probability of being referred to hospital care after Primary Care Plus. To achieve efficiency one should exclude patient groups with a significantly higher probability of being referred to hospital care after Primary Care Plus. NTR6629 (Data registered: 25-08-2017) (registered retrospectively).

"But my doctor recommended pot": medical marijuana and the patient-physician relationship.

PubMed

Nussbaum, Abraham M; Boyer, Jonathan A; Kondrad, Elin C

2011-11-01

As the use of medical marijuana expands, it is important to consider its implications for the patient-physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a setting rife with conflicts of interest despite insufficient scientific knowledge about marijuana. This system diminishes the patient-physician relationship to the recommendation of a single substance while unburdening physicians of their usual responsibilities to the welfare of their patients.

Evaluation of a community transition to professional practice program for graduate registered nurses in Australia.

PubMed

Aggar, Christina; Gordon, Christopher J; Thomas, Tamsin H T; Wadsworth, Linda; Bloomfield, Jacqueline

2018-03-26

Australia has an increasing demand for a sustainable primary health care registered nursing workforce. Targeting graduate registered nurses who typically begin their nursing career in acute-care hospital settings is a potential workforce development strategy. We evaluated a graduate registered nurse Community Transition to Professional Practice Program which was designed specifically to develop and foster skills required for primary health care. The aims of this study were to evaluate graduates' intention to remain in the primary health care nursing workforce, and graduate competency, confidence and experiences of program support; these were compared with graduates undertaking the conventional acute-care transition program. Preceptor ratings of graduate competence were also measured. All of the 25 graduates (n = 12 community, n = 13 acute-care) who completed the questionnaire at 6 and 12 months intended to remain in nursing, and 55% (n = 6) of graduates in the Community Transition Program intended to remain in the primary health care nursing workforce. There were no differences in graduate experiences, including level of competence, or preceptors' perceptions of graduate competence, between acute-care and Community Transition Programs. The Community Transition to Professional Practice program represents a substantial step towards developing the primary health care health workforce by facilitating graduate nurse employment in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

Loss to follow-up among children in pre-ART care under the National AIDS Programme, Tamil Nadu, South India

PubMed Central

Kumar, A. M. V.; Chinnakali, P.; Rajendran, M.; Valan, A. S.; Rewari, B. B.; Swaminathan, S.

2017-01-01

Setting: Children aged <15 years constitute 7% of all people living with the human immunodeficiency virus (HIV) in India. A previous study from an antiretroviral therapy (ART) centre in south India reported 82% loss to follow-up (LTFU) among children in pre-ART care (2006–2011). Objective: To assess the proportion of LTFU within 1 year of registration among HIV-infected children (aged < 15 years) registered in all 43 ART centres in the state of Tamil Nadu, India, during the year 2012. Design: This was a retrospective cohort study involving a review of programme records. Results: Of 656 children registered for HIV care, 20 (3%) were not assessed for ART eligibility. Of those remaining, 226 (36%) were not ART eligible and entered pre-ART care. Among these, at 1 year of registration, 50 (22%) were LTFU, 40 (18%) were transferred out and 136 (60%) were retained in care at the same centre. The child's age, sex, World Health Organization stage or occurrence of opportunistic infection were not associated with LTFU. Conclusion: One in five children registered under pre-ART care were lost to follow-up. Stronger measures to prevent LTFU and reinforce retrieval actions are necessary in the existing National HIV Programme. PMID:28695080

Loss to follow-up among children in pre-ART care under the National AIDS Programme, Tamil Nadu, South India.

PubMed

Devi, N P; Kumar, A M V; Chinnakali, P; Rajendran, M; Valan, A S; Rewari, B B; Swaminathan, S

2017-06-21

Setting: Children aged <15 years constitute 7% of all people living with the human immunodeficiency virus (HIV) in India. A previous study from an antiretroviral therapy (ART) centre in south India reported 82% loss to follow-up (LTFU) among children in pre-ART care (2006-2011). Objective: To assess the proportion of LTFU within 1 year of registration among HIV-infected children (aged < 15 years) registered in all 43 ART centres in the state of Tamil Nadu, India, during the year 2012. Design: This was a retrospective cohort study involving a review of programme records. Results: Of 656 children registered for HIV care, 20 (3%) were not assessed for ART eligibility. Of those remaining, 226 (36%) were not ART eligible and entered pre-ART care. Among these, at 1 year of registration, 50 (22%) were LTFU, 40 (18%) were transferred out and 136 (60%) were retained in care at the same centre. The child's age, sex, World Health Organization stage or occurrence of opportunistic infection were not associated with LTFU. Conclusion: One in five children registered under pre-ART care were lost to follow-up. Stronger measures to prevent LTFU and reinforce retrieval actions are necessary in the existing National HIV Programme.

Recognition and assessment of resident' deterioration in the nursing home setting: A critical ethnography.

PubMed

Laging, Bridget; Kenny, Amanda; Bauer, Michael; Nay, Rhonda

2018-04-01

To explore the recognition and assessment of resident deterioration in the nursing home setting. There is a dearth of research exploring how nurses and personal-care-assistants manage a deteriorating nursing home resident. Critical ethnography. Observation and semi-structured interviews with 66 participants (general medical practitioners, nurses, personal-care-assistants, residents and family members) in two Australian nursing homes. The study has been reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. The value of nursing assessment is poorly recognised in the nursing home setting. A lack of clarity regarding the importance of nursing assessments associated with resident care has contributed to a decreasing presence of registered nurses and an increasing reliance on personal-care-assistants who had inadequate skills and knowledge to recognise signs of deterioration. Registered nurses experienced limited organisational support for autonomous decision-making and were often expected to undertake protocol-driven decisions that contributed to potentially avoidable hospital transfers. Nurses need to demonstrate the importance of assessment, in association with day-to-day resident care and demand standardised, regulated, educational preparation of an appropriate workforce who are competent in undertaking this role. Workforce structures that enhance familiarity between nursing home staff and residents could result in improved resident outcomes. The value of nursing assessment, in guiding decisions at the point of resident deterioration, warrants further consideration. © 2018 John Wiley & Sons Ltd.

Establishing and maintaining the National Vaccination Register in Finland.

PubMed

Baum, Ulrike; Sundman, Jonas; Jääskeläinen, Susanna; Nohynek, Hanna; Puumalainen, Taneli; Jokinen, Jukka

2017-04-27

Computerised, population-based vaccination registers are valuable tools for assessing the vaccine uptake and impact in populations. However, reliable impact assessment is only possible if the data quality can be reviewed and monitored continuously. This report describes the establishment and maintenance of the National Vaccination Register (NVR) in Finland. Currently, the NVR covers nationwide records of vaccinations given within the frame of the National Vaccination Programme since 2009. All vaccinations registered in the NVR contain a record of the personal identity code, the administered vaccine, and the date of vaccination. The vaccine lot number is the key component for recording and identifying vaccinations, because of its broad availability across patient information systems and its importance in vaccine safety monitoring. Vaccination records are accumulated and updated daily into the NVR, and their completeness is monitored monthly to assess deficiencies in data entry and data collection. Additionally, an alert system reports unexpected changes in data accumulation prompting the validation of observed changes in vaccination coverage. The presented process documentation may serve as basis to improve the design and quality of other vaccination or healthcare registers and aims to inspire the set-up of vaccination registers in those countries which still do not have one. This article is copyright of The Authors, 2017.

Full-custom design of split-set data weighted averaging with output register for jitter suppression

NASA Astrophysics Data System (ADS)

Jubay, M. C.; Gerasta, O. J.

2015-06-01

A full-custom design of an element selection algorithm, named as Split-set Data Weighted Averaging (SDWA) is implemented in 90nm CMOS Technology Synopsys Library. SDWA is applied in seven unit elements (3-bit) using a thermometer-coded input. Split-set DWA is an improved DWA algorithm which caters the requirement for randomization along with long-term equal element usage. Randomization and equal element-usage improve the spectral response of the unit elements due to higher Spurious-free dynamic range (SFDR) and without significantly degrading signal-to-noise ratio (SNR). Since a full-custom, the design is brought to transistor-level and the chip custom layout is also provided, having a total area of 0.3mm2, a power consumption of 0.566 mW, and simulated at 50MHz clock frequency. On this implementation, SDWA is successfully derived and improved by introducing a register at the output that suppresses the jitter introduced at the final stage due to switching loops and successive delays.

LSI arrays for space stations

NASA Technical Reports Server (NTRS)

Gassaway, J. D.

1976-01-01

Two approaches have been taken to study CCD's and some of their fundamental limitations. First a numerical analysis approach has been developed to solve the coupled transport and Poisson's equation for a thorough analysis of charge transfer in a CCD structure. The approach is formulated by treating the minority carriers as a surface distribution at the Si-SiO2 interface and setting up coupled difference equations for the charge and the potential. The SOR method is proposed for solving the two dimensional Poisson's equation for the potential. Methods are suggested for handling the discontinuities to improve convergence. Second, CCD shift registers were fabricated with parameters which should allow complete charge transfer independent of the transfer electrode gap width. A test instrument was designed and constructed which can be used to test this, or any similar, three phase CCD shift register.

Analysis of multiple incidence angle SIR-B data for determining forest stand characteristics

NASA Technical Reports Server (NTRS)

Hoffer, R. M.; Lozano-Garcia, D. F.; Gillespie, D. D.; Mueller, P. W.; Ruzek, M. J.

1986-01-01

For the first time in the U.S. space program, digital synthetic aperture radar (SR) data were obtained from different incidence angles during Space Shuttle Mission 41-G. Shuttle Imaging Radar-B (SIR-B) data were obtained at incidence angles of 58 deg., 45 deg., and 28 deg., on October 9, 10, and 11, 1984, respectively, for a predominantly forested study area in northern Florida. Cloud-free LANDSAT Thematic Mapper (T.M.) data were obtained over the same area on October 12. The SIR-B data were processed and then digitally registered to the LANDSAT T.M. data by scientists at the Jet Propulsion Laboratory. This is the only known digitally registered SIR-B and T.M. data set for which the data were obtained nearly simultaneously. The data analysis of this information is discussed.

An open-access mobile compatible electronic patient register for rheumatic heart disease (‘eRegister’) based on the World Heart Federation’s framework for patient registers

PubMed Central

van Dam, Joris; Tadmor, Brigitta; Spector, Jonathan; Musuku, John; Zühlke, Liesl J; Zühlke, Liesl J; Engel, Mark E; Mayosi, Bongani M; Nestle, Nick

2015-01-01

Summary Background Rheumatic heart disease (RHD) remains a major disease burden in low-resource settings globally. Patient registers have long been recognised to be an essential instrument in RHD control and elimination programmes, yet to date rely heavily on paper-based data collection and non-networked data-management systems, which limit their functionality. Objectives To assess the feasibility and potential benefits of producing an electronic RHD patient register. Methods We developed an eRegister based on the World Heart Federation’s framework for RHD patient registers using CommCare, an open-source, cloud-based software for health programmes that supports the development of customised data capture using mobile devices. Results The resulting eRegistry application allows for simultaneous data collection and entry by field workers using mobile devices, and by providers using computer terminals in clinics and hospitals. Data are extracted from CommCare and are securely uploaded into a cloud-based database that matches the criteria established by the WHF framework. The application can easily be tailored to local needs by modifying existing variables or adding new ones. Compared with traditional paper-based data-collection systems, the eRegister reduces the risk of data error, synchronises in real-time, improves clinical operations and supports management of field team operations. Conclusions The user-friendly eRegister is a low-cost, mobile, compatible platform for RHD treatment and prevention programmes based on materials sanctioned by the World Heart Federation. Readily adaptable to local needs, this paperless RHD patient register program presents many practical benefits. PMID:26444995

Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings.

PubMed

Sving, Eva; Gunningberg, Lena; Högman, Marieann; Mamhidir, Anna-Greta

2012-05-01

To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. A descriptive design with a multimethods approach. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare managers. © 2012 Blackwell Publishing Ltd.

29 CFR 30.1 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... This part sets forth policies and procedures to promote equality of opportunity in apprenticeship... registering of apprenticeship programs for Federal purposes. The purpose of this part is to promote equality...

48 CFR 19.501 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... officer shall perform market research and document why a small business set-aside is inappropriate when an... market price. [48 FR 42240, Sept. 19, 1983] Editorial Note: For Federal Register citations affecting...

Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey.

PubMed

Bloomfield, Jacqueline G; Aggar, Christina; Thomas, Tamsin H T; Gordon, Christopher J

2018-02-01

Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. This study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. A cross-sectional survey design comprising a quantitative online survey. 14 Australian universities from all states/territories, both rural and urban. 530 final-year nursing students. Binary logistic regression identifying factors contributing to desire to work in primary health care. The desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. Collaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Nest size is predicted by female identity and the local environment in the blue tit (Cyanistes caeruleus), but is not related to the nest size of the genetic or foster mother

PubMed Central

Parker, Timothy H.; Griffith, Simon C.

2018-01-01

The potential for animals to respond to changing climates has sparked interest in intraspecific variation in avian nest structure since this may influence nest microclimate and protect eggs and offspring from inclement weather. However, there have been relatively few large-scale attempts to examine variation in nests or the determinates of individual variation in nest structure within populations. Using a set of mostly pre-registered analyses, we studied potential predictors of variation in the size of a large sample (803) of blue tit (Cyanistes caeruleus) nests across three breeding seasons at Wytham Woods, UK. While our pre-registered analyses found that individual females built very similar nests across years, there was no evidence in follow-up (post hoc) analyses that their nest size correlated to that of their genetic mother or, in a cross-fostering experiment, to the nest where they were reared. In further pre-registered analyses, spatial environmental variability explained nest size variability at relatively broad spatial scales, and especially strongly at the scale of individual nest boxes. Our study indicates that nest structure is a characteristic of individuals, but is not strongly heritable, indicating that it will not respond rapidly to selection. Explaining the within-individual and within-location repeatability we observed requires further study. PMID:29765658

Moving on? Predictors of Intent to Leave among Rural and Remote RNs in Canada

ERIC Educational Resources Information Center

Stewart, Norma J.; D'Arcy, Carl; Kosteniuk, Julie; Andrews, Mary Ellen; Morgan, Debra; Forbes, Dorothy; MacLeod, Martha L. P.; Kulig, Judith C.; Pitblado, J. Roger

2011-01-01

Context: Examination of factors related to the retention or voluntary turnover of Registered Nurses (RNs) has mainly focused on urban, acute care settings. Purpose: This paper explored predictors of intent to leave (ITL) a nursing position in all rural and remote practice settings in Canada. Based on the conceptual framework developed for this…

Nursing Delegation to Unlicensed Assistive Personnel in the School Setting. Position Statement. Revised

ERIC Educational Resources Information Center

Cagginello, Joan; Blackborow, Mary; Porter, Jessica; Disney, Jody; Andresen, Kathleen; Tuck, Christine

2014-01-01

It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the registered professional school nurse (hereinafter referred to as school nurse), when based on the nursing definition of delegation (American Nurses Association [ANA], 2012) and in…

Gender-based wage differentials among registered dietitians.

PubMed

Pollard, Prudence; Taylor, Maxine; Daher, Noha

2007-01-01

The debate on compensation equity is broad-based, addressing many organizational, personal, and outcome factors. Central to compensation philosophy is the issue of gender equity. Health care, like many other industries, remains fraught with gender inequity in compensation. This inequity is partially explained by choice of practice area. However, much remains unexplained. Health care is a female-dominated industry with most of the women working in the allied health professions (eg, nurses, dietitians, etc). Registered dietitians (RD) may experience wage discrimination, similar to registered nurses, but prior to the present study, the assumption was not tested. Using data from the first comprehensive study of RD compensation, we examined gender equity in total cash compensation to RDs. Data were collected on total cash compensation, and questions focused on career progression and work outcomes. For purposes of our study, we analyzed data on 5,477 full-time RDs. Ninety-six percent were women, the median age was 43, and median total cash compensation for RDs employed in the position for at least 1 year was $45,500.00. Women earned $45,285.00 and men earned $50,250.00. A median wage gap of $4,965.00 between women and men was observed. Variability in total cash compensation to women was best explained by size of budget, years of experience, work setting, and educational level. Variability for men was explained by size of budget, years of experience, educational level, and employer status. Conclusions suggest that given the wage discrimination that female RDs experience, work organizations should evaluate their pay plans to monitor pay equity. Factors that women can manage to receive compensation that is equal to that of the men include size of budgets they manage, years of experience in the field, employer status, work setting, and educational level attained. Findings are useful for career advisers, human resource specialists, compensation specialists, supervisors, RDs, and compensation researchers.

Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings.

PubMed

Skosireva, Anna; O'Campo, Patricia; Zerger, Suzanne; Chambers, Catharine; Gapka, Susan; Stergiopoulos, Vicky

2014-09-07

Research on discrimination in healthcare settings has primarily focused on health implications of race-based discrimination among ethno-racial minority groups. Little is known about discrimination experiences of other marginalized populations, particularly groups facing multiple disadvantages who may be subjected to other/multiple forms of discrimination. (1) To examine the prevalence of perceived discrimination due to homelessness/poverty, mental illness/alcohol/drug related problems, and race/ethnicity/skin color while seeking healthcare in the past year among racially diverse homeless adults with mental illness; (2) To identify whether perceiving certain types of discrimination is associated with increased likelihood of perceiving other kinds of discrimination; and (3) To examine association of these perceived discrimination experiences with socio-demographic characteristics, self-reported measures of psychiatric symptomatology and substance use, and Emergency Department utilization. We used baseline data from the Toronto site of the At Home/Chez Soi randomized controlled trial of Housing First for homeless adults with mental illness (n = 550). Bivariate statistics and multivariable logistic regression models were used for the analysis. Perceived discrimination related to homelessness/poverty (30.4%) and mental illness/alcohol/substance use (32.5%) is prevalent among ethnically diverse homeless adults with mental illness in healthcare settings. Only 15% of the total participants reported discrimination due to race/ethnicity/skin color. After controlling for relevant confounders and presence of psychosis, all types of discrimination in healthcare settings were associated with more frequent ED use, a greater - 3 - severity of lifetime substance abuse, and mental health problems. Perceiving discrimination of one type was associated with increased likelihood of perceiving other kinds of discrimination. Understanding the experience of discrimination in healthcare settings and associated healthcare utilization is the first step towards designing policies and interventions to address health disparities among vulnerable populations. This study contributes to the knowledge base in this important area. This study has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

Factors associated with personal protection equipment use and hand hygiene among hemodialysis staff.

PubMed

Shimokura, Gayle; Weber, David J; Miller, William C; Wurtzel, Heather; Alter, Miriam J

2006-04-01

Because exposure to blood by health care workers is frequent during hemodialysis, gloves are required for all contact with patients and their equipment, followed by hand hygiene. In this study, we investigated factors associated with performing these practices as recommended. Staff members from a sample of 45 US hemodialysis facilities were surveyed using an anonymous self-administered questionnaire. Factors independently associated with reporting increased compliance with recommended hand hygiene and glove use practices during patient care were identified with multivariate modeling. Of 605 eligible staff members, 420 (69%) responded: registered nurses, 41%; dialysis technicians, 51%; and licensed practical nurses, 8%. Only 35% reported that dialysis patients were at risk for bloodborne virus infections, and only 36% reported always following recommended hand hygiene and glove use practices. Independent factors associated with more frequent compliance were being a technician (versus a registered nurse) and reporting always doing what was needed to protect themselves from infection. Compliance with recommended hand hygiene and glove use practices by hemodialysis staff was low. The rationale for infection control practices specific to the hemodialysis setting was poorly understood by all staff. Infection control training should be tailored to this setting and should address misconceptions.

A Fault-tolerant RISC Microprocessor for Spacecraft Applications

NASA Technical Reports Server (NTRS)

Timoc, Constantin; Benz, Harry

1990-01-01

Viewgraphs on a fault-tolerant RISC microprocessor for spacecraft applications are presented. Topics covered include: reduced instruction set computer; fault tolerant registers; fault tolerant ALU; and double rail CMOS logic.

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations.

PubMed Central

Webster, Lucy; Groskreutz, Derek; Grinbergs-Saull, Anna; Howard, Rob; O'Brien, John T; Mountain, Gail; Banerjee, Sube; Woods, Bob; Perneczky, Robert; Lafortune, Louise; Roberts, Charlotte; McCleery, Jenny; Pickett, James; Bunn, Frances; Challis, David; Charlesworth, Georgina; Featherstone, Katie; Fox, Chris; Goodman, Claire; Jones, Roy; Lamb, Sallie; Moniz-Cook, Esme; Schneider, Justine; Shepperd, Sasha; Surr, Claire; Thompson-Coon, Jo; Ballard, Clive; Brayne, Carol; Burke, Orlaith; Burns, Alistair; Clare, Linda; Garrard, Peter; Kehoe, Patrick; Passmore, Peter; Holmes, Clive; Maidment, Ian; Murtagh, Fliss; Robinson, Louise; Livingston, Gill

2017-01-01

BACKGROUND There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. OBJECTIVES To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI). DATA SOURCES We included disease modification trials with quantitative outcomes of efficacy from (1) references from related systematic reviews in workstream 1; (2) searches of the Cochrane Dementia and Cognitive Improvement Group study register, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015, and clinical trial registries [International Standard Randomised Controlled Trial Number (ISRCTN) and clinicaltrials.gov] on 22 and 29 January 2016; and (3) hand-searches of reference lists of relevant systematic reviews from database searches. REVIEW METHODS The project consisted of four workstreams. (1) We obtained related core outcome sets and work from co-applicants. (2) We systematically reviewed published and ongoing disease modification trials to identify the outcomes used in different domains. We extracted outcomes used in each trial, recording how many used each outcome and with how many participants. We divided outcomes into the domains measured and searched for validation data. (3) We consulted with PPI participants about recommended outcomes. (4) We presented all the synthesised information at a conference attended by the wider body of National Institute for Health Research (NIHR) dementia researchers to reach consensus on a core set of outcomes. RESULTS We included 149 papers from the 22,918 papers screened, referring to 125 individual trials. Eighty-one outcomes were used across trials, including 72 scales [31 cognitive, 12 activities of daily living (ADLs), 10 global, 16 neuropsychiatric and three quality of life] and nine biological techniques. We consulted with 18 people for PPI. The conference decided that only cognition and biological markers are core measures of disease modification. Cognition should be measured by the Mini Mental State Examination (MMSE) or the Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog), and brain changes through structural magnetic resonance imaging (MRI) in a subset of participants. All other domains are important but not core. We recommend using the Neuropsychiatric Inventory for neuropsychiatric symptoms: the Disability Assessment for Dementia for ADLs, the Dementia Quality of Life Measure for quality of life and the Clinical Dementia Rating scale to measure dementia globally. LIMITATIONS Most of the trials included participants with Alzheimer's disease, so recommendations may not apply to other types of dementia. We did not conduct economic analyses. The PPI consultation was limited to members of the Alzheimer's Society Research Network. CONCLUSIONS Cognitive outcomes and biological markers form the core outcome set for future disease modification trials, measured by the MMSE or ADAS-Cog, and structural MRI in a subset of participants. FUTURE WORK We envisage that the core set may be superseded in the future, particularly for other types of dementia. There is a need to develop an algorithm to compare scores on the MMSE and ADAS-Cog. STUDY REGISTRATION The project was registered with Core Outcome Measures in Effectiveness Trials [ www.comet-initiative.org/studies/details/819?result=true (accessed 7 April 2016)]. The systematic review protocol is registered as PROSPERO CRD42015027346. FUNDING The National Institute for Health Research Health Technology Assessment programme. PMID:28625273

Preparing nurses for practice: a phenomenological study of the new graduate in Australia.

PubMed

Kelly, Jennifer; Ahern, Kathy

2009-03-01

To explore the expectations of final year nursing students before they start employment and to describe the experiences of newly graduated nurses during their first six months of employment as registered nurses. Nursing shortages are at crisis point world wide with registered nurses leaving the profession at a high rate and changing occupations. Thus, there is a need to reflect on new graduate nurses experiences in relation to retention and support. Husserl's phenomenological approach was used to gain insight and understanding into the lived experiences of new graduate nurses. Students enrolled in a Bachelor of Nursing programme at an Australian University were interviewed in their final semester and during employment in the hospital setting. Semi-structured interviews were used to gather data from 13 participants. Data were collected at three intervals: prior to commencing employment, one month and six months postemployment and the results were analysed thematically. As students, the participants held positive perceptions surrounding their impending role as a registered nurse and what it would encompass. However, after one month of employment, it became apparent that nursing comprised of a culture that embraced cliques which excluded them. The graduates were unprepared for 'bitchiness' and the limited amount of assistance with unfamiliar tasks they received from registered nurses. Participants also found rotating to different wards recreated the feelings they experienced on commencing employment. Nursing curricula should prepare new graduates for foreseeable stressors and oppressive practices so that graduates can become proactive in preventing and responding to factors such as silence and aggression. Moreover, nursing courses need to ensure that socialisation issues are addressed to assist in the eradication of oppressive practices. Finally, organisations need to address socialisation issues such as hostility within the workplace to address the attrition of new graduates from the profession. Individuals in clinical practice settings need to be cognisant of the significant role that experienced registered nurses and nurse unit managers occupy in the socialisation of new graduate nurses. Additionally, there needs to be increased awareness that nursing culture can influence recruitment and retention of new graduates. Further, health care organisations need to evaluate the benefits of new graduates rotating through clinical areas in the first 12 months of employment.

36 CFR 67.5 - Standards for evaluating significance within registered historic districts.

Code of Federal Regulations, 2014 CFR

2014-07-01

... a district is one which by location, design, setting, materials, workmanship, feeling and..., workmanship, feeling and association have been so altered or have so deteriorated that the overall integrity...

36 CFR 67.5 - Standards for evaluating significance within registered historic districts.

Code of Federal Regulations, 2012 CFR

2012-07-01

... a district is one which by location, design, setting, materials, workmanship, feeling and..., workmanship, feeling and association have been so altered or have so deteriorated that the overall integrity...

36 CFR 67.5 - Standards for evaluating significance within registered historic districts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... a district is one which by location, design, setting, materials, workmanship, feeling and..., workmanship, feeling and association have been so altered or have so deteriorated that the overall integrity...

36 CFR 67.5 - Standards for evaluating significance within registered historic districts.

Code of Federal Regulations, 2013 CFR

2013-07-01

... a district is one which by location, design, setting, materials, workmanship, feeling and..., workmanship, feeling and association have been so altered or have so deteriorated that the overall integrity...

Ancilla-driven quantum computation for qudits and continuous variables

NASA Astrophysics Data System (ADS)

Proctor, Timothy; Giulian, Melissa; Korolkova, Natalia; Andersson, Erika; Kendon, Viv

2017-05-01

Although qubits are the leading candidate for the basic elements in a quantum computer, there are also a range of reasons to consider using higher-dimensional qudits or quantum continuous variables (QCVs). In this paper, we use a general "quantum variable" formalism to propose a method of quantum computation in which ancillas are used to mediate gates on a well-isolated "quantum memory" register and which may be applied to the setting of qubits, qudits (for d >2 ), or QCVs. More specifically, we present a model in which universal quantum computation may be implemented on a register using only repeated applications of a single fixed two-body ancilla-register interaction gate, ancillas prepared in a single state, and local measurements of these ancillas. In order to maintain determinism in the computation, adaptive measurements via a classical feed forward of measurement outcomes are used, with the method similar to that in measurement-based quantum computation (MBQC). We show that our model has the same hybrid quantum-classical processing advantages as MBQC, including the power to implement any Clifford circuit in essentially one layer of quantum computation. In some physical settings, high-quality measurements of the ancillas may be highly challenging or not possible, and hence we also present a globally unitary model which replaces the need for measurements of the ancillas with the requirement for ancillas to be prepared in states from a fixed orthonormal basis. Finally, we discuss settings in which these models may be of practical interest.

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

Proctor, Timothy; Giulian, Melissa; Korolkova, Natalia

Although qubits are the leading candidate for the basic elements in a quantum computer, there are also a range of reasons to consider using higher-dimensional qudits or quantum continuous variables (QCVs). In this paper, we use a general “quantum variable” formalism to propose a method of quantum computation in which ancillas are used to mediate gates on a well-isolated “quantum memory” register and which may be applied to the setting of qubits, qudits (for d>2), or QCVs. More specifically, we present a model in which universal quantum computation may be implemented on a register using only repeated applications of amore » single fixed two-body ancilla-register interaction gate, ancillas prepared in a single state, and local measurements of these ancillas. In order to maintain determinism in the computation, adaptive measurements via a classical feed forward of measurement outcomes are used, with the method similar to that in measurement-based quantum computation (MBQC). We show that our model has the same hybrid quantum-classical processing advantages as MBQC, including the power to implement any Clifford circuit in essentially one layer of quantum computation. In some physical settings, high-quality measurements of the ancillas may be highly challenging or not possible, and hence we also present a globally unitary model which replaces the need for measurements of the ancillas with the requirement for ancillas to be prepared in states from a fixed orthonormal basis. In conclusion, we discuss settings in which these models may be of practical interest.« less

Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation.

PubMed

Fiset, Valerie; Luciani, Tracy; Hurtubise, Alyssa; Grant, Theresa L

2017-04-01

The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting. [Journal of Gerontological Nursing, 43(4), 49-56.]. Copyright 2017, SLACK Incorporated.

Life expectancies for individuals with psychiatric diagnoses.

PubMed

Hannerz, H; Borgå, P; Borritz, M

2001-09-01

The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.

Monitoring the injured brain: registered, patient specific atlas models to improve accuracy of recovered brain saturation values

NASA Astrophysics Data System (ADS)

Clancy, Michael; Belli, Antonio; Davies, David; Lucas, Samuel J. E.; Su, Zhangjie; Dehghani, Hamid

2015-07-01

The subject of superficial contamination and signal origins remains a widely debated topic in the field of Near Infrared Spectroscopy (NIRS), yet the concept of using the technology to monitor an injured brain, in a clinical setting, poses additional challenges concerning the quantitative accuracy of recovered parameters. Using high density diffuse optical tomography probes, quantitatively accurate parameters from different layers (skin, bone and brain) can be recovered from subject specific reconstruction models. This study assesses the use of registered atlas models for situations where subject specific models are not available. Data simulated from subject specific models were reconstructed using the 8 registered atlas models implementing a regional (layered) parameter recovery in NIRFAST. A 3-region recovery based on the atlas model yielded recovered brain saturation values which were accurate to within 4.6% (percentage error) of the simulated values, validating the technique. The recovered saturations in the superficial regions were not quantitatively accurate. These findings highlight differences in superficial (skin and bone) layer thickness between the subject and atlas models. This layer thickness mismatch was propagated through the reconstruction process decreasing the parameter accuracy.

Principles of health information systems in developing countries.

PubMed

Krickeberg, Klaus

The setting of this article is an all-embracing Health Information System (HIS)* of the type that exists mainly in developing and transition countries. It was inspired by work in Vietnam and other places. The article discusses the basic principles on which a well-functioning HIS needs to rest regardless of the technical means employed (paper, electronic devices). Eleven principles for designing or reforming a HIS are identified, including: explicit description of the underlying units (target population) and variables; no list of indicators to be fixed in advance; only one register per target population; technical coordination between registers and reports; correction algorithms; local use of data and indicators; autonomy of health institutions regarding the information that concerns them; and novel use of registers for various studies. Apart from their technical role, these principles give shape to the philosophy that underlies this article, and make clear that a HIS is not only a tool for collecting indicators; it is intimately tied to clinical and preventive practice, as well as to health management and health economy. In fact, it permeates the entire health system. It can potentially play a much more extended, varied, and useful role than simply that of providing health services to a community.

Facilitating mental health research for patients, clinicians and researchers: a mixed-method study.

PubMed

Robotham, D; Waterman, S; Oduola, S; Papoulias, C; Craig, T; Wykes, T

2016-08-08

Research registers using Consent for Contact (C4C) can facilitate recruitment into mental health research studies, allowing investigators to contact patients based on clinical records information. We investigated whether such a register was useful for mental health research, seeking the perspectives of patients and research investigators. In 2012, a C4C register was developed in a large secondary mental health provider within the UK; almost 9000 patients have joined. This mixed-method study audited the effectiveness of the register. A 'mystery shopper' exercise was conducted, and patients (n=21) were recruited to ask clinicians about the availability of research opportunities. Structured interviews were conducted with patients (n=52) about their experiences of being on the register. Similar interviews were conducted with 18 investigators from 19 studies, who had attempted to use the register to recruit participants. The impact of C4C on study recruitment, and whether it helped patients learn about research. So far, the register has provided 928 individuals with 1085 research opportunities (in 60% of cases, the individual agreed to participate in the study). Clinicians were willing to link patients to research opportunities, but often lacked information about studies. For patients, the register provided opportunities which they may not otherwise have; 27 of 52 had participated in studies since joining the register (18 participating for the first time). Most investigators used the register to supplement recruitment to their studies, but described problems in prescreening potential participants from a clinical record for complex studies. Although the register helped investigators recruit for studies, and provided patients with research opportunities, clinicians' input is still useful for identifying suitable participants. C4C registers should be adapted to provide clinicians with automatically updated information on local studies allowing them to match patients on their caseload with active studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Exploring end-of-life interaction in dyads of parents and adult children: a protocol for a mixed-methods study.

PubMed

Stiel, Stephanie; Stelzer, Eva-Maria; Schneider, Nils; Herbst, Franziska A

2018-04-27

A considerable number of terminally-ill adult children are outlived by at least one parent and receive palliative care prior to their death. At the same time, adult children continue to be confronted with their parents' terminal illnesses and end-of-life situations. The current study explores the specifics of dyadic interaction at the end of life between a) adult children suffering from a life-threatening disease and their parents, and b) terminally ill parents and their adult children. This prospective observational study aims at filling the existing gap on adult child-parent interaction specifics at the end of life using an exploratory mixed-methods framework. The mixed-methods framework combines a qualitative face-to face interview and quantitative self-report questionnaires to study the topic at hand. The qualitative interview will focus on experiences, expectations, and wishes with regard to dyadic communication, information about illness and prognosis, expressed and perceived burden and support as well as caregiving role at the end of life. The questionnaires will cover socio-demographics, loneliness, attachment style, social support, and emotional closeness. The research group is currently adjusting a semi-structured interview guide and questionnaire instructions based on the results of a multiprofessional scientific advisory board meeting (Jan. 2018). In a next step, and prior to qualitative and quantitative data collection, the questionnaires will be piloted on patients and their family members in a palliative care setting. The main expected results are i) a description of the specifics of the interaction within and between both dyads, ii) the development of hypotheses and a theoretical framework on the specifics, similarities, and differences for both study groups, and iii) clinical conclusions on specific psychosocial care needs of both groups. The study was registered prospectively in the Health Services Research Germany register (Versorgungsforschung Deutschland - Datenbank) (Registration N° VfD_Dy@EoL_17_003897; date of registration: November 22, 2017) and in the German Clinical Trials Register (Deutsches Register Klinischer Studien) (Registration N° DRKS00013206 ; date of registration: October 27, 2017). The study is visible in the International Clinical Trials Registry Platform Search Portal of the World Health Organization under the German Clinical Trials Register number.

24 CFR 1715.50 - Advertising disclaimers; subdivisions registered and effective with HUD.

Code of Federal Regulations, 2010 CFR

2010-04-01

... statement may be set in type of at least six point font. (c) This disclaimer statement need not appear on... at the bottom of the front page. The disclaimer statement shall be set in type of at least ten point font. Obtain the Property Report required by Federal law and read it before signing anything. No...

Development of a Comprehensive Seismic Yield Estimation System for Underground Nuclear Explosions

DTIC Science & Technology

1993-05-01

Inc. SPOT data are copyrighted by CNES (1986,1987). UNIX is a registered trademark of AT&T Bell Laboratories. FrameMaker is a registered trademark of...interface to the desktop publishing package FrameMaker , version 3.0 X, which allows the user to generate, edit and print a report of the analysis. Startup...if you’re sure. 3. Logout of UNIX at the console. FrameMaker Instructions FrameMaker version 3.0 X or later must be set up on the Sun work- station as

California's minimum-nurse-staffing legislation and nurses' wages.

PubMed

Mark, Barbara; Harless, David W; Spetz, Joanne

2009-01-01

In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.

The TRICLOBS Dynamic Multi-Band Image Data Set for the Development and Evaluation of Image Fusion Methods

PubMed Central

Hogervorst, Maarten A.; Pinkus, Alan R.

2016-01-01

The fusion and enhancement of multiband nighttime imagery for surveillance and navigation has been the subject of extensive research for over two decades. Despite the ongoing efforts in this area there is still only a small number of static multiband test images available for the development and evaluation of new image fusion and enhancement methods. Moreover, dynamic multiband imagery is also currently lacking. To fill this gap we present the TRICLOBS dynamic multi-band image data set containing sixteen registered visual (0.4–0.7μm), near-infrared (NIR, 0.7–1.0μm) and long-wave infrared (LWIR, 8–14μm) motion sequences. They represent different military and civilian surveillance scenarios registered in three different scenes. Scenes include (military and civilian) people that are stationary, walking or running, or carrying various objects. Vehicles, foliage, and buildings or other man-made structures are also included in the scenes. This data set is primarily intended for the development and evaluation of image fusion, enhancement and color mapping algorithms for short-range surveillance applications. The imagery was collected during several field trials with our newly developed TRICLOBS (TRI-band Color Low-light OBServation) all-day all-weather surveillance system. This system registers a scene in the Visual, NIR and LWIR part of the electromagnetic spectrum using three optically aligned sensors (two digital image intensifiers and an uncooled long-wave infrared microbolometer). The three sensor signals are mapped to three individual RGB color channels, digitized, and stored as uncompressed RGB (false) color frames. The TRICLOBS data set enables the development and evaluation of (both static and dynamic) image fusion, enhancement and color mapping algorithms. To allow the development of realistic color remapping procedures, the data set also contains color photographs of each of the three scenes. The color statistics derived from these photographs can be used to define color mappings that give the multi-band imagery a realistic color appearance. PMID:28036328

The TRICLOBS Dynamic Multi-Band Image Data Set for the Development and Evaluation of Image Fusion Methods.

PubMed

Toet, Alexander; Hogervorst, Maarten A; Pinkus, Alan R

2016-01-01

The fusion and enhancement of multiband nighttime imagery for surveillance and navigation has been the subject of extensive research for over two decades. Despite the ongoing efforts in this area there is still only a small number of static multiband test images available for the development and evaluation of new image fusion and enhancement methods. Moreover, dynamic multiband imagery is also currently lacking. To fill this gap we present the TRICLOBS dynamic multi-band image data set containing sixteen registered visual (0.4-0.7μm), near-infrared (NIR, 0.7-1.0μm) and long-wave infrared (LWIR, 8-14μm) motion sequences. They represent different military and civilian surveillance scenarios registered in three different scenes. Scenes include (military and civilian) people that are stationary, walking or running, or carrying various objects. Vehicles, foliage, and buildings or other man-made structures are also included in the scenes. This data set is primarily intended for the development and evaluation of image fusion, enhancement and color mapping algorithms for short-range surveillance applications. The imagery was collected during several field trials with our newly developed TRICLOBS (TRI-band Color Low-light OBServation) all-day all-weather surveillance system. This system registers a scene in the Visual, NIR and LWIR part of the electromagnetic spectrum using three optically aligned sensors (two digital image intensifiers and an uncooled long-wave infrared microbolometer). The three sensor signals are mapped to three individual RGB color channels, digitized, and stored as uncompressed RGB (false) color frames. The TRICLOBS data set enables the development and evaluation of (both static and dynamic) image fusion, enhancement and color mapping algorithms. To allow the development of realistic color remapping procedures, the data set also contains color photographs of each of the three scenes. The color statistics derived from these photographs can be used to define color mappings that give the multi-band imagery a realistic color appearance.

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

Gruen, R L; Weeramanthri, T S; Knight, S E; Bailie, R S

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients' styles of specialist outreach were shown to improve access, but there was no evidence of impact on health outcomes. Specialist outreach as part of more complex multifaceted interventions involving collaboration with primary care, education or other services was associated with improved health outcomes, more efficient and guideline-consistent care, and less use of inpatient services. The additional costs of outreach may be balanced by improved health outcomes. This review supports the hypothesis that specialist outreach can improve access, outcomes and service use, especially when delivered as part of a multifaceted intervention. The benefits of simple outreach models in urban non-disadvantaged settings seem small. There is a need for good comparative studies of outreach in rural and disadvantaged settings where outreach may confer most benefit to access and health outcomes.

One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour.

PubMed

Harris, Rebecca; Gamboa, Ana; Dailey, Yvonne; Ashcroft, Angela

2012-03-14

The dental care setting is an appropriate place to deliver dietary assessment and advice as part of patient management. However, we do not know whether this is effective in changing dietary behaviour. To assess the effectiveness of one-to-one dietary interventions for all ages carried out in a dental care setting in changing dietary behaviour. The effectiveness of these interventions in the subsequent changing of oral and general health is also assessed. The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 24 January 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1950 to 24 January 2012), EMBASE via OVID (1980 to 24 January 2012), CINAHL via EBSCO (1982 to 24 January 2012), PsycINFO via OVID (1967 to 24 January 2012), and Web of Science (1945 to 12 April 2011). We also undertook an electronic search of key conference proceedings (IADR and ORCA between 2000 and 13 July 2011). Reference lists of relevant articles, thesis publications (Dissertations Abstracts Online 1861 to 2011) were searched. The authors of eligible trials were contacted to identify any unpublished work. Randomised controlled trials assessing the effectiveness of one-to-one dietary interventions delivered in a dental care setting. Abstract screening, eligibility screening and data extraction decisions were all carried out independently and in duplicate by two review authors. Consensus between the two opinions was achieved by discussion, or involvement of a third review author. Five studies met the criteria for inclusion in the review. Two of these were multi-intervention studies where the dietary intervention was one component of a wider programme of prevention, but where data on dietary behaviour change were reported. One of the single intervention studies was concerned with dental caries prevention. The other two concerned general health outcomes. There were no studies concerned with dietary change aimed at preventing tooth erosion. In four out of the five included studies a significant change in dietary behaviour was found for at least one of the primary outcome variables. There is some evidence that one-to-one dietary interventions in the dental setting can change behaviour, although the evidence is greater for interventions aiming to change fruit/vegetable and alcohol consumption than for those aiming to change dietary sugar consumption. There is a need for more studies, particularly in the dental practice setting, as well as greater methodological rigour in the design, statistical analysis and reporting of such studies.

DAM - detection and mapping

NASA Technical Reports Server (NTRS)

1977-01-01

Integrated set of manual procedures, computer programs, and graphic devices processes multispectral scanner data from orbiting Landsat into precisely registered and formatted maps of surface water and other resources at variety of scales, sheet formats, and tick intervals.

Environmental Impact Statement Filing Guidance

EPA Pesticide Factsheets

Describes how to submit an environmental impact statement through the e-NEPA electronic submission system. Describes how EPA submits a notice of availability in to the Federal Register and how the comment time period if set forth.

47 CFR 52.21 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NANC. (p) The term Registered Internet-based TRS User has the meaning set forth in 47 CFR 64.601. (q... part of the public switched network that, among other things: (1) Interconnects to an SCP and sends to...

Prospective register-based study of the impact of immigration on educational inequalities in mortality in Norway.

PubMed

Elstad, Jon Ivar; Øverbye, Einar; Dahl, Espen

2015-04-11

Differences in mortality with regard to socioeconomic status have widened in recent decades in many European countries, including Norway. A rapid upsurge of immigration to Norway has occurred since the 1990s. The article investigates the impact of immigration on educational mortality differences among adults in Norway. Two linked register-based data sets are analyzed; the first consists of all registered inhabitants aged 20-69 in Norway January 1, 1993 (2.6 millions), and the second of all registered inhabitants aged 20-69 as of January 1, 2008 (2.8 millions). Deaths 1993-1996 and 2008-2011, respectively, immigrant status, and other background information are available in the data. Mortality is examined by Cox regression analyses and by estimations of age-adjusted deaths per 100,000 personyears. Both relative and absolute educational inequality in mortality increased from the 1993-1996 period to 2008-2011, but overall mortality levels went down during these years. Immigrants in general, and almost all the analyzed immigrant subcategories, had lower mortality than the native majority. This was due to comparatively low mortality among lower educated immigrants, while mortality among higher educated immigrants was similar to the mortality level of highly educated natives. The widening of educational inequality in mortality during the 1990s and 2000s in Norway was not due to immigration. Immigration rather contributed to slightly lower overall mortality in the population and a less steep educational gradient in mortality.

Safety and effectiveness of eribulin in Japanese patients with locally advanced or metastatic breast cancer: a post-marketing observational study.

PubMed

Watanabe, Junichiro; Ito, Yoshinori; Ohsumi, Shozo; Mizutani, Mitsuhiro; Tashiro, Hideya; Sakurai, Kenichi; Takahashi, Masato; Saito, Tsuyoshi; Tsurutani, Junji; Mukai, Hirofumi; Yoshinami, Tetsuhiro; Takao, Shintaro; Yamamoto, Yasuhisa; Matsuoka, Toshiyuki; Iwase, Hirotaka; Iwata, Hiroji; Nakamura, Seigo; Saeki, Toshiaki

2017-12-01

Background This large-scale study was conducted to evaluate the safety and effectiveness of eribulin for the treatment of inoperable or recurrent breast cancer in real-world settings in Japan. Methods Between July and December 2011, eligible patients with inoperable or recurrent breast cancer receiving eribulin for the first time were centrally registered and observed for 1 year. Eribulin was administered intravenously (1.4 mg/m 2 ) on days 1 and 8 of every 3-week cycle. The primary endpoint was the frequency and intensity of adverse drug reactions (ADRs). Secondary endpoints included overall response rate (ORR) and time to treatment failure (TTF). Results Of 968 patients registered at 325 institutions, 951 and 671 were included in the safety and effectiveness analyses, respectively. In the safety population, ADRs were observed in 841 patients (88.4%). The most common (≥15% incidence) were neutropenia (66.6%), leukopenia (62.4%), lymphopenia (18.4%), and peripheral neuropathy (16.8%). The most common grade ≥ 3 ADRs (>5% incidence) were neutropenia (59.8%), leukopenia (50.5%), lymphopenia (16.1%), and febrile neutropenia (7.7%). In the effectiveness population, ORR was 16.5% (95% confidence interval: 13.7, 19.4). The median TTF was 127 days (95% confidence interval: 120, 134). Conclusions The safety and effectiveness profile of eribulin was consistent with prior studies. Eribulin had a favorable risk-benefit balance when used in real-world clinical settings.

The relationship between emotional intelligence competencies and preferred conflict-handling styles.

PubMed

Morrison, Jeanne

2008-11-01

The purpose of this study was to determine if a relationship exists between emotional intelligence (EI) and preferred conflict-handling styles of registered nurses. Conflict cannot be eliminated from the workplace therefore learning appropriate conflict-handling skills is important. Ninety-four registered nurses working in three south Mississippi healthcare facilities participated in this quantitative study. Ninety-two valid sets of data instruments were collected for this study. Higher levels of EI positively correlated with collaborating and negatively with accommodating. The issue of occupational stress and conflict among nurses is a major concern. It is imperative nurses learn how to effectively handle conflict in the work environment. Developing the competencies of EI and understanding how to effectively handle conflict is necessary for nurses working in a highly stressful occupation. Effective leadership management includes conflict management and collaboration. The art of relationship management is necessary when handling other people's emotions. When conflict is approached with high levels of EI, it creates an opportunity for learning effective interpersonal skills. Understanding how EI levels and conflict skills correlate can be used to improve interpersonal relationships in a healthcare facility.

[Usefulness of electronic drug registers: Spanish register of patients treated with fingolimod (Gilenya ®)].

PubMed

Fernández, Óscar; Rodríguez-Antigüedad, Alfredo; Oreja-Guevara, Celia; Garcia-Garcia, Margarida; Montalban, Xavier

2014-01-16

This study outlines the design of an electronic register of patients with multiple sclerosis who began treatment with fingolimod in Spain. The system is intended to serve as a tool to monitor its utilisation in daily clinical practice and thus allow optimisation of the way it is used. To establish the profile of patients with multiple sclerosis undergoing treatment with fingolimod and to determine the effectiveness and safety of this treatment in daily clinical practice. An observation-based, retrospective and prospective, multi-centre registry is set up, which will be active for five years. Forty neurologists working in Spain will participate in the project. Patients treated with fingolimod who fulfil the selection criteria will be included in the study. The effectiveness variables that will be evaluated are: disability measured by means of the Expanded Disability Status Scale, the rate of attacks, T1 gadolinium-enhancing lesions and new lesions in T2, and the percentage of patients who were free of activity and those who require concomitant treatments. The tolerability variables that will be evaluated are: the rate of patients who present events and adverse reactions, respectively, with a separate analysis of those presenting after the first dose or that are related to the fingolimod risk management plan and the treatment dropout rate. New pharmaceuticals that have only recently been commercialised require more information about their effectiveness and safety, beyond the controlled environment of a clinical trial. Initiatives involving electronic registries such as the Gilenya register are a solution that can respond to such needs by providing information in the shortest possible time about the most suitable management in order to be able to make the best and most efficient use of it.

Trauma registry record linkage: methodological approach to benefit from complementary data using the example of the German Pelvic Injury Register and the TraumaRegister DGU®

PubMed Central

2013-01-01

Background In Germany, hospitals can deliver data from patients with pelvic fractures selectively or twofold to two different trauma registries, i.e. the German Pelvic Injury Register (PIR) and the TraumaRegister DGU® (TR). Both registers are anonymous and differ in composition and content. We describe the methodological approach of linking these registries and reidentifying twofold documented patients. The aim of the approach is to create an intersection set that benefit from complementary data of each registry, respectively. Furthermore, the concordance of data entry of some clinical variables entered in both registries was evaluated. Methods PIR (4,323 patients) and TR (34,134 patients) data from 2004-2009 were linked together by using a specific match code including code of the trauma department, dates of admission and discharge, patient’s age, and sex. Data entry concordance was evaluated using haemoglobin and blood pressure levels at emergency department arrival, Injury Severity Score (ISS), and mortality. Results Altogether, 420 patients were identified as documented in both data sets. Linkage rates for the intersection set were 15.7% for PIR and 44.4% for TR. Initial fluid management for different Tile/OTA types of pelvic ring fractures and the patient’s posttraumatic course, including intensive care unit data, were now available for the PIR population. TR is benefiting from clinical use of the Tile/OTA classification and from correlation with the distinct entity “complex pelvic injury.” Data entry verification showed high concordance for the ISS and mortality, whereas initial haemoglobin and blood pressure data showed significant differences, reflecting inconsistency at the data entry level. Conclusions Individually, the PIR and the TR reflect a valid source for documenting injured patients, although the data reflect the emphasis of the particular registry. Linking the two registries enabled new insights into care of multiple-trauma patients with pelvic fractures even when linkage rates were poor. Future considerations and development of the registries should be done in close bilateral consultation with the aim of benefiting from complementary data and improving data concordance. It is also conceivable to integrate individual modules, e.g. a pelvic fracture module, into the TR likewise a modular system in the future. PMID:23496832

Structure of the Saint Francois Mountains and surrounding lead belt, south east Missouri: Inferences from thermal IR and other data sets

NASA Technical Reports Server (NTRS)

Arvidson, R. E. (Principal Investigator); Guinness, E. A.; Bindschadler, D. L.

1983-01-01

Several digital data sets were registered to a common base map for southern Missouri. These registered data sets were examined in an attempt to improve our understanding of the crustal structure and the relationships between structure and Pb-Zn-Cu, Fe, Mn, and Ba ores in the area. Data included land station reading of gravity, geologic data, and Heat Capacity Mapping Mission (HCMM) images. The HCMM day infrared (IR) images of Missouri displayed linear features, which parallel a newly discovered NW-SE trending Bouguer gravity low. The structural pattern over the gravity low suggests vertical uplift of the low density crust via isostatic readjustment and consequent fracturing of the Paleozoic sedimentary cover. The presence of a gravity low is interesting because rifts are often sites of extensive mineralization. The HCMM thermal data were also examined in conjunction with digital topography, land use, and LANDSAT MSS data to understand the phenomena that produce linears on the HCMM day IR images. Finally, the kinds of information that can be extracted from day-night IR pairs are discussed.

What If? Conditionals in Educational Registers

ERIC Educational Resources Information Center

Louwerse, Max M.; Crossley, Scott A.; Jeuniaux, Patrick

2008-01-01

Many corpus linguistic studies have investigated classification of texts into genres and registers, but relatively few of these studies have looked at linguistic features in educational registers. From a pedagogical perspective it is important to determine whether certain linguistic features behave differently across registers within particular…

SU-E-J-76: CBCT Reconstruction of a Full Couch Using Rigid Registration and Pre-Scanned Couch Image and Its Clinical Application

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

Hu, E; Lasio, G; Lee, M

Purpose: Only a part of a treatment couch is reconstructed in CBCT due to the limited field of view (FOV). This often generates inaccurate results in the delivered dose evaluation with CBCT and more noise in the CBCT reconstruction. Full reconstruction of the couch at treatment setup can be used for more accurate exit beam dosimetry. The goal of this study is to develop a method to reconstruct a full treatment couch using a pre-scanned couch image and rigid registration. Methods: A full couch (Exact Couch, Varian) model image was reconstructed by rigidly registering and combining two sets of partialmore » CBCT images. The full couch model includes three parts: two side rails and a couch top. A patient CBCT was reconstructed with reconstruction grid size larger than the physical field of view to include the full couch. The image quality of the couch is not good due to data truncation, but good enough to allow rigid registration of the couch. A composite CBCT image of the patient plus couch has been generated from the original reconstruction by replacing couch portion with the pre-acquired model couch, rigidly registered to the original scan. We evaluated the clinical usefulness of this method by comparing treatment plans generated on the original and on the modified scans. Results: The full couch model could be attached to a patient CBCT image set via rigid image registration. Plan DVHs showed 1∼2% difference between plans with and without full couch modeling. Conclusion: The proposed method generated a full treatment couch CBCT model, which can be successfully registered to the original patient image. This method was also shown to be useful in generating more accurate dose distributions, by lowering 1∼2% dose in PTV and a few other critical organs. Part of this study is supported by NIH R01CA133539.« less

Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.

PubMed

Anderson, Natalie Elizabeth; Kent, Bridie; Owens, R Glynn

2015-03-01

Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses. A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants' experiences. Thematic analysis was undertaken to identify emerging themes, with participants' own words used as theme headings, where their phrases provided succinct or powerful descriptors. A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings - some only a few months prior, others - more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants' experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pesticide poisoning in Zhejiang, China: a retrospective analysis of adult cases registration by occupational disease surveillance and reporting systems from 2006 to 2010

PubMed Central

Zhang, Meibian; Fang, Xinglin; Zhou, Lifang; Su, Liling; Zheng, Jiajia; Jin, Minjuan; Zou, Hua; Chen, Guangdi

2013-01-01

Objective Despite the rapid industrialisation and urbanisation over the past 30 years, agriculture is one of the largest economic sectors in China and the unregulated use of pesticides result in extensive pesticide poisoning. The objective of this study was to analyse pesticide poisoning cases registration received by Zhejiang Provincial Center for Disease Control and Prevention, China. Design Register-based study. Setting Cases registered regarding pesticide poisoning. Data were obtained from the Occupational Disease Surveillance and Reporting Systems in Zhejiang province from 2006 to 2010, which contains anonymous records representing general population of Zhejiang province, China. Participants All cases registered as pesticide poisoning were identified. Primary outcome Monthly and age-group pesticide poisoning death rates were calculated. Results A total of 20 097 pesticide poisoning cases with 1413 deaths were recorded during the study period. There were 10 513 male pesticide poisoning cases with 782 deaths, and 9584 females with 631 deaths. Pesticide poisoning occurred mostly in non-occupational exposure (79.86%), in which the majority (85.77%) of the cases was of intentional pesticide poisoning. The occupational exposure was most common in men during the farming season. The death rate increased stepwise with age, and the pesticide suicide rate was higher in the older age group. Conclusions Pesticide poisoning remains a major health problem in China, and further recommendations to reduce the pesticide poisoning are required. PMID:24270833

77 FR 65939 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... Technology Architecture (VistA) Records-VA'' (79VA19) as set forth in the Federal Register 75 FR 4454. VA is... Health Information Systems and Technology Architecture (VistA) Records-VA ROUTINE USES OF RECORDS...

EPA Regulation of Bed Bug Pesticides

EPA Pesticide Factsheets

All pesticides must be registered by EPA before being sold and used in the U.S., other than those that rely on a limited set of active ingredients (so-called minimum risk pesticides). EPA reviews for safety and effectiveness.

Where is the breathing mode? High voltage Hall effect thruster studies with EMD method

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

Kurzyna, J.; Makowski, K.; Mazouffre, S.

2008-03-19

Discharge current and local plasma oscillations are studied in a high voltage Hall effect thruster PPS registered -X000. Characteristic time scales that appear in different operating conditions are resolved with the use of Hilbert-Huang spectra (HHS) which display time dependenc of instantaneous frequency and power. Sets of intrinsic mode functions (imfs) that are used for HHS calculation result due to application of empirical mode decomposition method (EMD) to nonstationary multicomponent signals. In the experiment the signals are captured in the electric circuit of the thruster as well locally, in the vicinity of the thruster exhaust region. Classical electric probes spacedmore » along the azimuth and/or thruster axis let us study correlations of signals which were captured in different locations. In this way azimuthal and axial propagation of disturbances is inspected. The discharge voltage is varied in the range of 200 divide 900 V while xenon mas flow rate of 5 divide 9 mg/s. LF, MF, and HF characteristic bands that are known from previous studies of PPS registered -100 thruster have been also detected here. However, expanding discharge current onto a set of intrinsic modes we can resolve MF mode more reliably than before. Moreover, for higher discharge voltages, this irregular mode turns into more regular waveform and tends to dominate in the discharge current masking almost completely the breathing mode (LF oscillations of the discharge current). In such a case triggering of HF oscillations is correlated with the phase of MF mode while in the case of PPS registered -100 thruster it was correlated with the appropriate phase of the breathing mode (LF band). Regular HF emission that can be unambiguously interpreted as azimuthal electrostatic wave now is observed only in the specific operating conditions of the thruster. However, even if irregular HF emission is observed the time delay of cross-correlated signals which are captured in different azimuthal locations corresponds to the velocity of azimuthal electron drift in the field of magnetic barrier.« less

Identification of registered nursing care of residents in English nursing homes using the Minimum Data Set Resident Assessment Instrument (MDS/RAI) and Resource Utilisation Groups version III (RUG-III).

PubMed

Carpenter, Iain; Perry, Michelle; Challis, David; Hope, Kevin

2003-05-01

to determine if a combination of Minimum Data Set/Resident Assessment Instrument (MDS/RAI) assessment variables and the Resource Utilisation Groups version III (RUG-III) case-mix system could be used as a method of identifying and reimbursing registered nursing care needs in long-term care. the sample included 193 nursing home residents from four nursing homes from three different locations and care providers in England. The study included assessments of residents' care needs using either the MDS/RAI assessments or RUG stand-alone questionnaires and a time study that recorded the amount of nursing time received by residents over a 24-h period. Validity of RUG-III for explaining the distribution of care time between residents in different RUG-III groups was tested. The difference in direct and indirect care provided by registered general nurses (RGN) and care assistants (CA) to residents in RUG-III clinical groups was compared. the RUG-III system explained 56% of the variance in care time (Eta2, P=0.0001). Residents in RUG-III groups associated with particular medical and nursing needs (enhanced RGN care) received more than twice as much indirect RGN care time (t-test, P<0.001) and 1.4 times as much direct RGN and direct CA time (t-test, P<0.01) than residents with primarily cognitive impairment or physical problems only (standard RGN care). Residents with enhanced RGN care received an average of 48.1 min of RGN care in 24 h (95% CI 4.1-55.2) compared with an average of 31.1 min (95% CI 26.8-35.5) for residents in the standard RGN care group. A third low RGN care group was created following publication of the Department of Health guidance on NHS Funded Nursing Care. With three levels, the enhanced care group receives about 38% more than the standard group, and the low group receives about 50% of the standard group. the RUG-III system effectively differentiated between nursing home residents who are receiving 'low', 'standard' and 'enhanced' RGN care time. The findings could provide the basis of a reimbursement system for registered nursing time in long-term care facilities in the UK.

Administrator Leadership Styles and Their Impact on School Nursing.

PubMed

Davis, Charles R

2018-01-01

In comparison to other professional staff in an educational based setting, the registered professional school nurse has unique roles, responsibilities, education, training, and scope of practice. In carrying out this unique and specialized role, school nurses operate under a building administrator, the leader of the building and often the immediate supervisor of the school nurse. In addition, many school nurses in small districts are the only registered professional nurse employed by the school. The building administrator's leadership style not only sets the tone for the day-to-day operations in the school but also impacts the school nurse functioning and program implementation. This article reviews the three most common types of leadership styles as defined by Kurt Lewin-laissez-faire, democratic, and coercive/authoritarian-and their potential impact on school nursing practice. In addition, the article provides recommendations for school nurses for successful practice with regard to supervisor leadership styles.

Work force policy perspectives: registered nurses.

PubMed

Friss, L O

1981-01-01

If the decline in full-time labor force participation by registered nurses in hospitals is to be reversed, the issue of equal pay for comparable work must be addressed. Under pressure for cost containment, policies tend to focus on labor force economics rather than on limitations of services. While the two are interrelated, wage policies must be considered independently. This article describes the network which determines how nurse salaries are set: the relationship between the private sector, the general schedule and the Veteran's Administration. The effects of this system are documented, using testimony from a case in the tenth circuit, as well as comparisons with other reference groups: policemen, teachers, laborers, and VA career fields. The evidence suggests that there is a need for policy intervention. Prime areas for action are the comparability practices by governments, particularly in the areas of classification standards and pay setting. Hospital personnel practices which continue past effects of occupational segregation also should be changed.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

PubMed

Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

2008-04-01

The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

Electroencephalography leads placed by nontechnologists using a template system produce signals equal in quality to technologist-applied, collodion disk leads.

PubMed

Kolls, Brad J; Olson, Daiwai M; Gallentine, William B; Skeen, Mark B; Skidmore, Christopher T; Sinha, Saurabh R

2012-02-01

The purpose of this study was to compare the quality of the electroencephalographic (EEG) data obtained with a BraiNet template in a practical use setting, to that obtained with standard 10/20 spaced, technologist-applied, collodion-based disk leads. Pairs of 8-hour blocks of EEG data were prospectively collected from 32 patients with a Glasgow coma score of ≤9 and clinical concern for underlying nonconvulsive status epilepticus over a 6-month period in the Neurocritical Care Unit at the Duke University Medical Center. The studies were initiated with the BraiNet template system applied by critical care nurse practitioners or physicians, followed by standard, collodion leads applied by registered technologists using the 10/20 system of placement. Impedances were measured at the beginning and end of each block recorded and variance in impedance, mean impedance, and the largest differences in impedances found within a given lead set were compared. Physicians experienced in reading EEG performed a masked review of the EEG segments obtained to assess the subjective quality of the recordings obtained with the templates. We found no clinically significant differences in the impedance measures. There was a 3-hour reduction in the time required to initiate EEG recording using the templates (P < 0.001). There was no difference in the overall subjective quality distributions for template-applied versus technologist-applied EEG leads. The templates were also found to be well accepted by the primary users in the intensive care unit. The findings suggest that the EEG data obtained with this approach are comparable with that obtained by registered technologist-applied leads and represents a possible solution to the growing clinical need for continuous EEG recording availability in the critical care setting.

Predictors of situation awareness in student registered nurse anesthetists.

PubMed

Wright, Suzanne M; Fallacaro, Michael D

2011-12-01

Situation awareness (SA) is defined as one's perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. The concept of SA is well known in the aviation industry, which is characterized by complexity and dynamism. The discipline of anesthesia shares these same environmental characteristics, yet the study of SA in this setting is in its infancy. Guided by Endsley's theory of SA, the purpose of this study was to provide educators with a best-evidence predictor model of SA in student registered nurse anesthetists (SRNAs). Seventy-one SRNAs were randomly selected from 3 US universities. A nonexperimental, correlational design and multiple regression analysis were used to measure the relationship between memory, cognition, and automaticity and SA. Findings from this study reveal cognition as the best predictor of SA in graduate SRNAs, with the addition of memory and automaticity contributing no additional predictive value to the model. The results of this study have the potential to make a positive impact on the admission, education, and training of SRNAs. This study contributes evidence for further research examining the use of high-fidelity simulation in promoting SA in SRNAs.

Position of the American Dietetic Association: the roles of registered dietitians and dietetic technicians, registered in health promotion and disease prevention.

PubMed

Stitzel, Kimberly F

2006-11-01

It is the position of the American Dietetic Association (ADA) that primary prevention is the most effective, affordable course of action for preventing and reducing risk for chronic disease. Registered dietitians and dietetic technicians, registered, are leaders in delivering preventive services in both clinical and community settings, including advocating for funding and inclusion of these services in programs and policy initiatives at local, state, and federal levels. In addition, registered dietitians are leaders in facilitating and participating in research in chronic disease prevention and health promotion. Diet, nutrition, and physical activity are important factors in the promotion and maintenance of good health throughout the life cycle. Cost-effective interventions that produce a change in personal health practices are likely to lead to substantial reductions in the incidence and severity of the leading causes of disease in the United States. In an era of increasing health care expenditures and relative decreases in availability of federal funds, there is increasing demand on health promotion and disease prevention to be economically viable. Through clinical involvement and rigorous participation in research on chronic disease prevention and health promotion, the field of dietetics can lead the way to effectively translate the impact of nutrition on all ages.

Efficient Ada multitasking on a RISC register window architecture

NASA Technical Reports Server (NTRS)

Kearns, J. P.; Quammen, D.

1987-01-01

This work addresses the problem of reducing context switch overhead on a processor which supports a large register file - a register file much like that which is part of the Berkeley RISC processors and several other emerging architectures (which are not necessarily reduced instruction set machines in the purest sense). Such a reduction in overhead is particularly desirable in a real-time embedded application, in which task-to-task context switch overhead may result in failure to meet crucial deadlines. A storage management technique by which a context switch may be implemented as cheaply as a procedure call is presented. The essence of this technique is the avoidance of the save/restore of registers on the context switch. This is achieved through analysis of the static source text of an Ada tasking program. Information gained during that analysis directs the optimized storage management strategy for that program at run time. A formal verification of the technique in terms of an operational control model and an evaluation of the technique's performance via simulations driven by synthetic Ada program traces are presented.

Ancilla-driven quantum computation for qudits and continuous variables

DOE PAGES

Proctor, Timothy; Giulian, Melissa; Korolkova, Natalia; ...

2017-05-10

Although qubits are the leading candidate for the basic elements in a quantum computer, there are also a range of reasons to consider using higher-dimensional qudits or quantum continuous variables (QCVs). In this paper, we use a general “quantum variable” formalism to propose a method of quantum computation in which ancillas are used to mediate gates on a well-isolated “quantum memory” register and which may be applied to the setting of qubits, qudits (for d>2), or QCVs. More specifically, we present a model in which universal quantum computation may be implemented on a register using only repeated applications of amore » single fixed two-body ancilla-register interaction gate, ancillas prepared in a single state, and local measurements of these ancillas. In order to maintain determinism in the computation, adaptive measurements via a classical feed forward of measurement outcomes are used, with the method similar to that in measurement-based quantum computation (MBQC). We show that our model has the same hybrid quantum-classical processing advantages as MBQC, including the power to implement any Clifford circuit in essentially one layer of quantum computation. In some physical settings, high-quality measurements of the ancillas may be highly challenging or not possible, and hence we also present a globally unitary model which replaces the need for measurements of the ancillas with the requirement for ancillas to be prepared in states from a fixed orthonormal basis. In conclusion, we discuss settings in which these models may be of practical interest.« less

Random demographic household surveys in highly mobile pastoral communities in Chad

PubMed Central

Béchir, Mahamat; Hattendorf, Jan; Bonfoh, Bassirou; Zinsstag, Jakob; Schelling, Esther

2011-01-01

Abstract Problem Reliable demographic data is a central requirement for health planning and management, and for the implementation of adequate interventions. This study addresses the lack of demographic data on mobile pastoral communities in the Sahel. Approach A total of 1081 Arab, Fulani and Gorane women and 2541 children (1336 boys and 1205 girls) were interviewed and registered by a biometric fingerprint scanner in five repeated random transect demographic and health surveys conducted from March 2007 to January 2008 in the Lake Chad region in Chad. Local setting Important determinants for the planning and implementation of household surveys among mobile pastoral communities include: environmental factors; availability of women for interviews; difficulties in defining “own” children; the need for information-education-communication campaigns; and informed consent of husbands in typically patriarchal societies. Relevant changes Due to their high mobility, only 5% (56/1081) of registered women were encountered twice. Therefore, it was not possible to establish a demographic and health cohort. Lessons learnt Prospective demographic and health cohorts are the most accurate method to assess child mortality and other demographic indices. However, their feasibility in a highly mobile pastoral setting remains to be shown. Future interdisciplinary scientific efforts need to target innovative methods, tools and approaches to include marginalized communities in operational health and demographic surveillance systems. PMID:21556307

The Nursing Performance Instrument: Exploratory and Confirmatory Factor Analyses in Registered Nurses.

PubMed

Sagherian, Knar; Steege, Linsey M; Geiger-Brown, Jeanne; Harrington, Donna

2018-04-01

The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap. The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses. The design was cross-sectional, using secondary data collected between February 2008 and April 2009 for the "Fatigue in Nursing Survey" (N = 797). The sample was predominantly dayshift female nurses working in acute care settings. Using Mplus software, exploratory and confirmatory factor analyses were applied to the NPI data, which were divided into two equal subsamples. Multiple fit indices were used to evaluate the fit of the alternative models. The three-factor model was determined to fit the data adequately. The factors that were labeled as "physical/mental decrements," "consistent practice," and "behavioral change" were moderately to strongly intercorrelated, indicating good convergent validity. The reliability coefficients for the subscales were acceptable. The NPI consists of three latent constructs. This instrument has the potentialto be used as a self-monitoring instrument that addressesnurses' perceptions of performance while providing patient care.

Leadership and Registered Nurses (RNs) working after-hours in Residential Aged Care Facilities (RACFs): A structured literature review.

PubMed

Nhongo, Dorika; Hendricks, Joyce; Bradshaw, Julie; Bail, Kasia

2018-06-12

Registered nurses (RNs) working in Residential Aged Care Facilities are required to undertake complex management tasks including leading nursing care teams, supervising non-nursing staff, and allocating workloads according to residents' care needs, staff skills and experience. Registered nurses plan, assess, manage medication, evaluate each resident's care, liaise with doctors and allied health professionals and are responsible for evidence-based practice in accordance with the Nursing Standards for Practice (2016). Researchers have commented that effective nurse leadership can improve quality of care, improved resident outcomes and reduce adverse events. The aim of this literature review is to synthesise and analyse the literature pertinent to the RN's competence and confidence to undertake the leadership role when working in residential aged care facilities after-hours and to determine any association of leadership with quality resident outcomes. A review of original research papers based on the structured methodology described by Kable, Pich and Maslin-Prothero (2012). The review was conducted according to the 12-step structured framework by Kable et al. (2012). The search included peer-reviewed papers published between 2002 and 2017 on RN leadership after-hours, factors contributing to or with relationships to nursing leadership. Nineteen papers were found that researched the impact of leadership in aged care settings. The literature review concluded that nursing leadership has been linked to the quality of care and clinical outcomes in the aged care setting. However, RNs in the aged care setting have limited opportunities to develop key leadership competencies and confidence in order to meet the many challenges found in this environment due to lack of access to aged-care-specific leadership education. Minimal publications address the importance of the leadership of after-hours RNs. Results from this literature review will inform future research in this area. Nineteen papers identified the leadership required of RNs in aged care settings. However, limited research investigating the association between nursing leadership and clinical outcomes was found. The findings from this literature review suggest that leadership in the aged care setting may be facilitated through specific educational activities such as RN shadowing shifts, continuing professional development, working with peers and by demonstrating and practising leadership competencies. Based on the literature reviewed, a need for more research in this area is required. Specifically, research into RN leadership, competence and confidence in aged care facilities after-hours is needed. Registered nurses working in the aged care setting after-hours need access to leadership education. Better quality of care, improved resident outcomes and reduced adverse events are associated with sound leadership. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Chinese nurses' perceived barriers and facilitators of ethical sensitivity.

PubMed

Huang, Fei Fei; Yang, Qing; Zhang, Jie; Khoshnood, Kaveh; Zhang, Jing Ping

2016-08-01

An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. A convergent parallel mixed-methods research design was adopted. In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire-revised version was used to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments (n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses' perceptions of the barriers and facilitators in nurturing ethical sensitivity (n = 15). The data were collected from February to June 2014. This study was approved by the Institutional Review Boards of Yale University and Central South University. Despite moderately high overall Chinese Moral Sensitivity Questionnaire-revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses' sensitivity to ethical issues. © The Author(s) 2015.

45 CFR 613.1 - General Provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PRIVACY ACT REGULATIONS § 613.1 General Provisions. This part sets forth the National Science Foundation procedures under... maintained by the National Science Foundation are published in the Federal Register. ...

45 CFR 613.1 - General Provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PRIVACY ACT REGULATIONS § 613.1 General Provisions. This part sets forth the National Science Foundation procedures under... maintained by the National Science Foundation are published in the Federal Register. ...

45 CFR 613.1 - General Provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PRIVACY ACT REGULATIONS § 613.1 General Provisions. This part sets forth the National Science Foundation procedures under... maintained by the National Science Foundation are published in the Federal Register. ...

29 CFR 1990.133 - Publication.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) IDENTIFICATION, CLASSIFICATION, AND REGULATION OF POTENTIAL OCCUPATIONAL CARCINOGENS Priority Setting § 1990.133...) The Secretary shall publish the Priority Lists in the Federal Register at least every six months and... notice requesting information concerning the classification and establishment of priorities for...

Obligatory versus elective single embryo transfer in in vitro fertilization. A population-based analysis of data from the U.K. Human Fertilisation and Embryology Authority.

PubMed

Straughen, Jennifer K; Salihu, Hamisu M; Keith, Louis; Petrozzino, Jeffrey; Jones, Christopher

2013-01-01

To determine how obligatory single embryo transfer (SET) and elective SET influence pregnancy outcome. We compared women who underwent obligatory and elective SET using data from a comprehensive, population-based register from the United Kingdom Human Fertilisation and Embryology Authority, which contained all in vitro fertilization (IVF) treatments administered between 1991 and 1998. Generalized estimating equations were used to generate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to compare clinical pregnancy, live birth, and multiple birth rates. Obligatory and elective SET had similar clinical pregnancy and live birth rates and comparable multiple birth rates. Obligatory and elective SET were equally likely to end in a live birth (OR = 1.08; 95% CI = 0.90, 1.30). Similar results were found after restricting the data to women without previous IVF births (OR = 1.18; 95% CI = 0.98, 1.42) and without previous naturally conceived live births (OR = 1.16; 95% CI = 0.95, 1.43). This study suggests that obligatory SET can achieve pregnancy and live birth rates that are at least as good as elective SET. Equally important is the low multiple birth rate which was maintained in both forms of SET. More studies comparing elective versus obligatory SET can assist with achieving optimal pregnancy rates while preventing multiple births.

Uncovering the features of negotiation in developing the patient-nurse relationship.

PubMed

Stoddart, Kathleen; Bugge, Carol

2012-02-01

This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it. The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated. Negotiation was found to be a fundamental process in patient- nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction. Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient- nurse relationship in community practice.

Family history of autoimmune diseases and risk of gastric cancer: a national cohort study.

PubMed

Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

2018-05-01

A personal history of autoimmune diseases is associated with an increased incidence of gastric cancer, but whether they share familial susceptibility is still unknown. The contribution of shared environmental or genetic factors toward the observed familial aggregation has not been determined. We used a few Swedish registers, including the Swedish Multigeneration Register and the Cancer Register, to examine the familial risk of gastric cancer among individuals with a family history of a set of autoimmune diseases. Standardized incidence ratios were used to calculate the relative risk. The overall risk of gastric cancer was 1.22 (95% confidence interval: 1.14-1.30) among individuals with a sibling affected with any of the 33 autoimmune diseases. For specific disease, siblings of individuals with Crohn's diseases, diabetes type 1, Graves'/hyperthyroidism, myasthenia gravis, psoriasis, rheumatoid arthritis, sarcoidosis, and uncreative colitis showed an association with an increased incidence of gastric cancer, with a standardized incidence ratio ranging between 1.17 and 1.64. Familial aggregation was found only for corpus cancer. No association was observed between spouses. Gastric cancer, mainly corpus cancer, shares familial susceptibility with a few autoimmune diseases, suggesting that shared genetic polymorphisms may contribute toward both Helicobacter pylori infection and autoimmune diseases.

Probabilistic registration of an unbiased statistical shape model to ultrasound images of the spine

NASA Astrophysics Data System (ADS)

Rasoulian, Abtin; Rohling, Robert N.; Abolmaesumi, Purang

2012-02-01

The placement of an epidural needle is among the most difficult regional anesthetic techniques. Ultrasound has been proposed to improve success of placement. However, it has not become the standard-of-care because of limitations in the depictions and interpretation of the key anatomical features. We propose to augment the ultrasound images with a registered statistical shape model of the spine to aid interpretation. The model is created with a novel deformable group-wise registration method which utilizes a probabilistic approach to register groups of point sets. The method is compared to a volume-based model building technique and it demonstrates better generalization and compactness. We instantiate and register the shape model to a spine surface probability map extracted from the ultrasound images. Validation is performed on human subjects. The achieved registration accuracy (2-4 mm) is sufficient to guide the choice of puncture site and trajectory of an epidural needle.

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

PubMed

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-01-01

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

Transitioning into new clinical areas of practice: An integrative review of the literature.

PubMed

Kinghorn, Grant R; Halcomb, Elizabeth J; Froggatt, Terry; Thomas, Stuart Dm

2017-12-01

To critically synthesise research related to the transition of registered nurses into new areas of clinical practice. Global workforce shortages and rising healthcare demands have encouraged registered nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced registered nurses to new clinical areas remains poorly explored. An integrative review was conducted, guided by Whittemore and Knafl (Journal of Advanced Nursing, 52, 2005, 546) framework. An electronic database search was conducted for papers published between 1996-2016. Papers were then subjected to a methodological quality appraisal, with findings synthesised using thematic analysis into core themes. Ten articles met the inclusion criteria. Three themes emerged, namely Support, Professional Development and Emotional Impact. These themes suggest that transitioning nurses experience challenges in adapting to new clinical areas and developing necessary skills. Such challenges prompted various emotional and physical responses. While formal and informal support systems were regarded as valuable by transitioning nurses, they were inconsistent across the new clinical areas. There is some evidence to highlight the initial shock and emotional stress experienced by registered nurses during transition to a new clinical area. However, the influence of formal and informal support systems for such registered nurses is far from conclusive. Further research is needed, to examine registered nurse transition into a variety of clinical areas to inform workforce support, policy and practices. The demand of health care is growing while global shortages of nursing workforce remain. To ensure retention and enhance the transition experience of registered nurses, it is important for nurse leaders, managers and policymakers to understand the transition experience and factors that impact this experience. © 2017 John Wiley & Sons Ltd.

North American landscape characterization project: The production of a continental scale three‐decade Landsat data set

USGS Publications Warehouse

Sohl, Terry L.; Dwyer, John L.

1998-01-01

The North American Landscape Characterization (NALC) project is a component of the National Aeronautics and Space Administration (NASA) Landsat Pathfinder program. Pathfinder projects are focused on the investigation of global change utilizing current remote sensing technologies. The NALC project is a cooperative effort between the U. S. Environmental Protection Agency (EPA), the U.S. Geological Survey (USGS), and NASA to make Landsat data available to the widest possible user community for scientific research and general public interest. The NALC project is principally funded by the EPA Office of Research and Development and the USGS's Earth Resources Observation Systems (EROS) Data Center (EDC).The objectives of the NALC project are to produce standardized remote sensing data sets, develop standardized analysis methods, and derive standardized land cover change products for a large portion of the North American continent (the conterminous United States and Mexico) (Lunetta and Sturdevant, 1993). The standard product is the NALC “triplicate”;, consisting of co‐registered Landsat multispectral scanner data for the years 1973, 1986, and 1991 (plus or minus one year), plus co‐registered 3 arcsecond digital terrain elevation data. Processing began with the 1986 scene, which was precision corrected (with full terrain correction) to a 60 meter Universal Transverse Mercator base. Automated cross‐correlation procedures were used to co‐register the 1970's and 1990's data to the 1980's base, and independent verifications of registration quality were performed on all triplicate components. The pertinent metadata were compiled in a relational database, which includes WRS2 path/rows, scene ID's, image dates, solar azimuth and elevation, verification RMSE's, and the number of verification control points. NALC triplicate data sets are being used for a number of applications, including the analysis of urbanization patterns, dynamics of climatic fluctuations, deforestation studies, and vegetation classification and mapping. These data are being distributed through the Earth Observing System Data and Information System (EOSDIS) Information Management System (IMS) at a cost of $15(U.S.) for each triplicate.

A nationwide register study of the characteristics, incidence and validity of diagnosed Tourette syndrome and other tic disorders.

PubMed

Leivonen, Susanna; Voutilainen, Arja; Hinkka-Yli-Salomäki, Susanna; Timonen-Soivio, Laura; Chudal, Roshan; Gissler, Mika; Huttunen, Jukka; Sourander, Andre

2014-09-01

The aim of this study was to describe the characteristics and incidence rates of diagnosed tic disorders in the Finnish Hospital Discharge Register, including changing incidence rates between 1991 and 2010. We also aimed to validate the diagnoses of Tourette's syndrome recorded in the register. Children born between January 1, 1991 and December 31, 2010, who were diagnosed with tic disorders, were identified from the Finnish Hospital Discharge Register (n = 3003). We studied the validity of the Tourette's syndrome diagnoses by reviewing the medical charts of 88 children born since 1997 and carrying out telephone interviews with 55 of their guardians. The incidence rates of all diagnosed tic disorders increased during the study period. A comorbid diagnosis of hyperkinetic disorder diagnosis was recorded in 28.2% of the children with Tourette's syndrome, and the validity of the register-based Tourette's syndrome diagnosis was approximately 95%. This is the first nationwide study to demonstrate the increasing incidence of all register-based tic disorder diagnoses. The validity of the Tourette's syndrome diagnoses in the Finnish Hospital Discharge Register was good, and the data provided are suitable for use in further register-based studies of tic disorders. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Multi-stage 3D-2D registration for correction of anatomical deformation in image-guided spine surgery

NASA Astrophysics Data System (ADS)

Ketcha, M. D.; De Silva, T.; Uneri, A.; Jacobson, M. W.; Goerres, J.; Kleinszig, G.; Vogt, S.; Wolinsky, J.-P.; Siewerdsen, J. H.

2017-06-01

A multi-stage image-based 3D-2D registration method is presented that maps annotations in a 3D image (e.g. point labels annotating individual vertebrae in preoperative CT) to an intraoperative radiograph in which the patient has undergone non-rigid anatomical deformation due to changes in patient positioning or due to the intervention itself. The proposed method (termed msLevelCheck) extends a previous rigid registration solution (LevelCheck) to provide an accurate mapping of vertebral labels in the presence of spinal deformation. The method employs a multi-stage series of rigid 3D-2D registrations performed on sets of automatically determined and increasingly localized sub-images, with the final stage achieving a rigid mapping for each label to yield a locally rigid yet globally deformable solution. The method was evaluated first in a phantom study in which a CT image of the spine was acquired followed by a series of 7 mobile radiographs with increasing degree of deformation applied. Second, the method was validated using a clinical data set of patients exhibiting strong spinal deformation during thoracolumbar spine surgery. Registration accuracy was assessed using projection distance error (PDE) and failure rate (PDE  >  20 mm—i.e. label registered outside vertebra). The msLevelCheck method was able to register all vertebrae accurately for all cases of deformation in the phantom study, improving the maximum PDE of the rigid method from 22.4 mm to 3.9 mm. The clinical study demonstrated the feasibility of the approach in real patient data by accurately registering all vertebral labels in each case, eliminating all instances of failure encountered in the conventional rigid method. The multi-stage approach demonstrated accurate mapping of vertebral labels in the presence of strong spinal deformation. The msLevelCheck method maintains other advantageous aspects of the original LevelCheck method (e.g. compatibility with standard clinical workflow, large capture range, and robustness against mismatch in image content) and extends capability to cases exhibiting strong changes in spinal curvature.

CONSIDER - Core Outcome Set in IAD Research: study protocol for establishing a core set of outcomes and measurements in incontinence-associated dermatitis research.

PubMed

Van den Bussche, Karen; De Meyer, Dorien; Van Damme, Nele; Kottner, Jan; Beeckman, Dimitri

2017-10-01

This study protocol describes the methodology for the development of a core set of outcomes and a core set of measurements for incontinence-associated dermatitis. Incontinence is a widespread disorder with an important impact on quality of life. One of the most common complications is incontinence-associated dermatitis, resulting from chemical and physical irritation of the skin barrier, triggering inflammation and skin damage. Managing incontinence-associated dermatitis is an important challenge for nurses. Several interventions have been assessed in clinical trials, but heterogeneity in study outcomes complicates the comparability and standardization. To overcome this challenge, the development of a core outcome set, a minimum set of outcomes and measurements to be assessed in clinical research, is needed. A project team, International Steering Committee and panelists will be involved to guide the development of the core outcome set. The framework of the Harmonizing Outcomes Measures for Eczema roadmap endorsed by Cochrane Skin Group Core Outcomes Set Initiative, is used to inform the project design. A systematic literature review, interviews to integrate the patients' perspective and a consensus study with healthcare researchers and providers using the Delphi procedure will be performed. The project was approved by the Ethics review Committee (April 2016). This is the first project that will identify a core outcome set of outcomes and measurements for incontinence-associated dermatitis research. A core outcome set will reduce possible reporting bias, allow results comparisons and statistical pooling across trials and strengthen evidence-based practice and decision-making. This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET) database and is part of the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN). © 2016 John Wiley & Sons Ltd.

Graphics Standards in the Computer-Aided Acquisition and Logistic Support (CALS) Program Fiscal Year 1989 Volume 2: MIL-D-28003 Revisions, CGM registration

DTIC Science & Technology

1990-05-01

Naming in CALS U Based on the above rationale and trade studies, including a basic set of trademarked names in the CALS AP should be considered I during a...names for font lists. Based on the various trade studies in this report, including the one on font substitution below the following naming technique...COPYRIGHT SIGN 2/10 -FEMININE ORDINAL INDICATOR I 2/11 LEFT ANGLE QUOTATION MARK 2/12 NOr SIGN 2/13 SOFT HYPHEN 2/14 REGISTERED TRADE MARK SIGN m 2/15

Exploring leadership roles, goals, and barriers among Kansas registered nurses: a descriptive cross-sectional study.

PubMed

Peltzer, Jill N; Ford, Debra J; Shen, Qiuhua; Fischgrund, Avery; Teel, Cynthia S; Pierce, Janet; Jamison, Marian; Waldon, Trynn

2015-01-01

The Institute of Medicine's Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). Data were collected through an online survey and analyzed using quantitative and qualitative methods. Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans. Copyright © 2015 Elsevier Inc. All rights reserved.

Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas.

PubMed

Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann

2016-08-01

The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.

Caring and technology in an intensive care unit: an ethnographic study.

PubMed

Price, Ann M

2013-11-01

Critical care practice is a mixture of caring and technological activities. There is debate about whether the balance between these two elements is correct and a concern that critical care units can dehumanize the patient. This research sought to examine aspects that might affect this balance between the caring and technology within the critical care setting. What aspects affect registered health care professionals' ability to care for patients within the technological environment of a critical care unit? A qualitative approach using ethnography was utilized as this methodology focuses on the cultural elements within a situation. Data collection involved participant observation, document review and semi-structured interviews to triangulate methods as this aids rigour for this approach. A purposeful sample to examine registered health care professionals currently working within the study area was used. A total of 19 participants took part in the study; 8 nurses were observed and 16 health care professionals were interviewed, including nurses, a doctor and 2 physiotherapists. The study took place on a District General Hospital intensive care unit and ethical approval was gained. An overarching theme of the 'Crafting process' was developed with sub themes of 'vigilance', 'focus of attention, 'being present' and 'expectations' with the ultimate goal of achieving the best interests for the individual patient. The areas reflected in this study coincide with the care, compassion, competency, commitment, communication and courage ideas detailed by the Department of Health (2012). Thus, further research to detail more specifically how these areas are measured within critical care may be useful. Caring is a complex concept that is difficult to outline but this article can inform practitioners about the aspects that help and hinder caring in the technical setting to inform training. © 2013 British Association of Critical Care Nurses.

Promoting deceased organ and tissue donation registration in family physician waiting rooms (RegisterNow-1 trial): study protocol for a pragmatic, stepped-wedge, cluster randomized controlled registry.

PubMed

Li, Alvin H; Garg, Amit X; Prakash, Versha; Grimshaw, Jeremy M; Taljaard, Monica; Mitchell, Joanna; Matti, Danny; Linklater, Stefanie; Naylor, Kyla L; Dixon, Stephanie; Faulds, Cathy; Bevan, Rachel; Getchell, Leah; Knoll, Greg; Kim, S Joseph; Sontrop, Jessica; Bjerre, Lise M; Tong, Allison; Presseau, Justin

2017-12-21

There is a worldwide shortage of organs available for transplant, leading to preventable mortality associated with end-stage organ disease. While most citizens in many countries with an intent-to-donate "opt-in" system support organ donation, registration rates remain low. In Canada, most Canadians support organ donation but less than 25% in most provinces have registered their desire to donate their organs when they die. The family physician office is a promising yet underused setting in which to promote organ donor registration and address known barriers and enablers to registering for deceased organ and tissue donation. We developed a protocol to evaluate an intervention to promote registration for organ and tissue donation in family physician waiting rooms. This protocol describes a planned, stepped-wedge, cluster randomized registry trial in six family physician offices in Ontario, Canada to evaluate the effectiveness of reception staff providing patients with a pamphlet that addresses barriers and enablers to registration including a description of how to register for organ donation. An Internet-enabled tablet will also be provided in waiting rooms so that interested patients can register while waiting for their appointments. Family physicians and reception staff will be provided with training and/or materials to support any conversations about organ donation with their patients. Following a 2-week control period, the six offices will cross sequentially into the intervention arm in randomized sequence at 2-week intervals until all offices deliver the intervention. The primary outcome will be the proportion of patients visiting the office who are registered organ donors 7 days following their office visit. We will evaluate this outcome using routinely collected registry data from provincial administrative databases. A post-trial qualitative evaluation process will assess the experiences of reception staff and family physicians with the intervention and the stepped-wedge trial design. Promoting registration for organ donation in family physician offices is a potentially useful strategy for increasing registration for organ donation. Increased registration may ultimately help to increase the number of organs available for transplant. The results of this trial will provide important preliminary data on the effectiveness of using family physician offices to promote registration for organ donation. ClinicalTrials.gov, ID: NCT03213171 . Registered on 11 July 2017.

Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

PubMed

Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

2018-03-01

To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

Evaluation of the personal dental services (wave 1) for Lambeth, Southwark and Lewisham primary care trusts--Part 1: Retrospective analyses of registration data and access issues.

PubMed

Best, Helen; Newton, Tim

2005-06-01

The purpose of the study was to undertake analyses of registration data for the personal dental services (PDS) of Lambeth, Southwark and Lewisham primary care trusts and relate the analyses to the PDS goal of increasing uptake of dental services. Secondary analyses of registration statistics provided by the Dental Practice Board were undertaken for both 1 years pre-PDS (October 1997 to September 1998) and post-PDS (October 1998 to March 2003) periods. Three sets of analyses were undertaken to consider different aspects of changing registrations: (1) Absolute numbers of patients registered at each time interval; (2) Rates of change in numbers of patients registered for the entire period after the introduction of PDS; and (3) Rates of change in numbers of patients registered for the most recent 3 years of available data. There was a significant increase in the numbers of children registered under capitation, post-PDS as compared to the pre-PDS level (all ages and both genders combined). Post-PDS, the rate of increase for the children was approximately one additional child per practice per month (0.96, 95% CI 0.41-1.52). Similarly there was a significant trend for increasing adults registrations over time of about two and a half adults per practice per month (2.42, 95% CI 0.90-3.95). There was no evidence of a change in registrations for children or adults in total over the most recent period of 3 years. The analysis of the absolute numbers of registered patients each month indicated that the PDS practices had more children registered than before the implementation of the PDS scheme, but not adults. Overall post-implementation there was a trend for increasing registrations in both children and adults, but the most recent data indicated a plateau effect. Further consideration of facilitators to achieve PDS goals of improved uptake of services is required, particularly as they relate to local contexts.

The cost of changing physical activity behaviour: evidence from a "physical activity pathway" in the primary care setting

PubMed Central

2011-01-01

Background The 'Physical Activity Care Pathway' (a Pilot for the 'Let's Get Moving' policy) is a systematic approach to integrating physical activity promotion into the primary care setting. It combines several methods reported to support behavioural change, including brief interventions, motivational interviewing, goal setting, providing written resources, and follow-up support. This paper compares costs falling on the UK National Health Service (NHS) of implementing the care pathway using two different recruitment strategies and provides initial insights into the cost of changing physical activity behaviour. Methods A combination of a time driven variant of activity based costing, audit data through EMIS and a survey of practice managers provided patient-level cost data for 411 screened individuals. Self reported physical activity data of 70 people completing the care pathway at three month was compared with baseline using a regression based 'difference in differences' approach. Deterministic and probabilistic sensitivity analyses in combination with hypothesis testing were used to judge how robust findings are to key assumptions and to assess the uncertainty around estimates of the cost of changing physical activity behaviour. Results It cost £53 (SD 7.8) per patient completing the PACP in opportunistic centres and £191 (SD 39) at disease register sites. The completer rate was higher in disease register centres (27.3% vs. 16.2%) and the difference in differences in time spent on physical activity was 81.32 (SE 17.16) minutes/week in patients completing the PACP; so that the incremental cost of converting one sedentary adult to an 'active state' of 150 minutes of moderate intensity physical activity per week amounts to £ 886.50 in disease register practices, compared to opportunistic screening. Conclusions Disease register screening is more costly than opportunistic patient recruitment. However, additional costs come with a higher completion rate and better outcomes in terms of behavioural change in patients completing the care pathway. Further research is needed to rigorously evaluate intervention efficiency and to assess the link between behavioural change and changes in quality adjusted life years (QALYs). PMID:21605400

Proposals for registered nurse prescribing: perceptions and intentions of nurses working in primary health care settings.

PubMed

Wilkinson, Jill

2015-12-01

In 2013, the Nursing Council of New Zealand consulted on a proposal for introduction of registered nurse (RN) prescribing at two levels (specialist and community) within the designated class of prescriber. The proposal builds on the success of the diabetes nurse specialist prescribing project and the experience of other countries where RN prescribing is well established. To describe the views and intentions of nurses who work in primary health care (PHC) settings about the two levels of RN prescribing proposed. The study involved a self-reported survey using a non-probability sample of RNs working in PHC settings (N=305). Quantitative and qualitative data were analysed descriptively. The respondents were experienced nurses. Overall, 82.3% expressed interest in becoming a community nurse prescriber, and 62.6% expressed interest in the specialist prescriber level. RN prescribing was expected to improve efficiency and access to medicines for high-needs populations, clarify accountability and improve nurses' autonomy. The education requirements for the specialist level were viewed as appropriate but too onerous for many. Requirements were viewed as inadequate for the community level. Concerns were raised about funding for education and support for RN prescribing roles. Nurses were positive about the proposals and see a potential to meet significant unmet health need. Nurses are already engaged in the provision of medicines to patients and prescribing authority would ensure they are suitably qualified to engage in these tasks. A clear policy platform will be needed if the proposed levels of RN prescribing are to be successfully implemented.

Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review.

PubMed

Coventry, Tracey H; Maslin-Prothero, Sian E; Smith, Gilly

2015-12-01

To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future. © 2015 John Wiley & Sons Ltd.

Setting Your Sites

ERIC Educational Resources Information Center

Benz, Stephen

2006-01-01

Schools and universities recognize that many of the people and neighborhoods they serve expect education institutions to embrace environmental stewardship and sustainable design. Standards such as the LEED-registered facility program, managed by the U.S. Green Building Council, are receiving more attention. Schools can demonstrate their commitment…

21 CFR 589.1 - Substances prohibited from use in animal food or feed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... establish, amend, or repeal a regulation under this part on the basis of new scientific evaluation or... the form set forth in § 571.1 of this chapter, and will be published in the Federal Register for...

Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

PubMed

Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

2016-06-01

The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Suitability of current definitions of ambulatory care sensitive conditions for research in emergency department patients: a secondary health data analysis.

PubMed

Frick, Johann; Möckel, Martin; Muller, Reinhold; Searle, Julia; Somasundaram, Rajan; Slagman, Anna

2017-10-22

The aim of this study was to investigate the suitability of existing definitions of ambulatory care sensitive conditions (ACSC) in the setting of an emergency department (ED) by assessing ACSC prevalence in patients admitted to hospital after their ED stay. The secondary aim was to identify ACSC suitable for specific application in the ED setting. Observational clinical study with secondary health data. Two EDs of the Charité-Universitätsmedizin Berlin. All medical ED patients of the 'The Charité Emergency Medicine Study' (CHARITEM) study, who were admitted as inpatients during the 1-year study period (n=13 536). Prevalence of ACSC. Prevalence of ACSC in the study population differed significantly depending on the respective ACSC set used. Prevalence ranged between 19.1% (95% CI 18.4% to 19.8%; n=2586) using the definition by Albrecht et al and 36.6% (95% CI 35.8% to 37.5%; n=4960) using the definition of Naumann et al . (p<0.001). Overall ACSC prevalence (ie, when using all diagnoses used in any of the assessed ACSC-definitions) was 48.1% (95% CI 47.2% to 48.9%; n=6505). Some frequently observed diagnoses such as ' convulsion and epilepsy ' (prevalence: 3.4%, 95% CI 3.1% to 3.7%; n=455), ' diseases of the urinary system ' (prevalence: 1.4%; 95% CI 1.2% to 1.6%; n=191) or ' atrial fibrillation and flutter ' (prevalence: 1.0%, 95% CI 0.8% to 1.2%, n=134) are not included in all of the current ACSC definitions. The results highlight the need for an optimised, ED-specific ACSC definition. Particular ACSC diagnoses (such as ' convulsion and epilepsy ' or ' diseases of the urinary system ' and others) seem to be of special relevance in an ED population but are not included in all available ACSC definitions. Further research towards the development of a suitable and specific ACSC definition for research in the ED setting seems warranted. German Clinical Trials Register Deutsches Register für Klinische Studien: DRKS-ID: DRKS00000261. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Work injuries among migrant workers in Denmark.

PubMed

Biering, Karin; Lander, Flemming; Rasmussen, Kurt

2017-03-01

Work migration into Denmark has increased during the recent decades, especially after the enlargement of the European Union (EU) in 2004. Whether or not migrant workers experience more work injuries than the native workforce has been debated and results are conflicting, most likely due to methodological difficulties and cultural disparities. We set out to meet these challenges using population-based work injury registers, targeting a specific and representative region in Denmark. This population-based study used data on work injuries from an emergency department (ED) and reported injuries from the ED's catchment area to the Danish Working Environment Authority during 11 years. We calculated incidences of work injury for groups of migrant workers compared with native Danes and adjusted incidence rate ratios based on information on the complete working population. The incidences of work injuries among migrant workers from the new EU countries and from the rest of the world were higher compared with Danish workers and workers from the old EU countries and other Western countries. Especially migrants older than 30 years and in low-risk industries were at higher risk. Workers who had migrated recently were at even higher risk. We found increased risk of work injuries among migrant workers. Studying migrants in registers is a methodological challenge as some migrants are not registered, for legal or illegal reasons; thus, only a selected group is studied, but this may most likely underestimate the risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses.

PubMed

Jones, Cheryl B; Toles, Mark; Knafl, George J; Beeber, Anna S

A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition. A retrospective design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation. Of 39,398 LPNs in NC between 2001 and 2013, there were 3,161 LPNs (8.0%) who had a LPN-to-RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial groups; held an associate or baccalaureate degree in their last year as an LPN (or their last year in the study if they did not transition); worked in a hospital inpatient setting; worked in the medical-surgical nursing specialty; and were from a rural area. Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups except white; of a younger age at their first LPN licensure; working in a hospital setting; working in the specialty of medical-surgical nursing; employed part-time; or working in a rural setting during the last year as an LPN. This study fills an important gap in our knowledge of LPN-to-RN transitions. Policy efforts are needed to incentivize: LPNs to make a LPN-to-RN transition; educational entities to create and communicate curricular pathways; and employers to support LPNs in making the transition. Copyright © 2017 Elsevier Inc. All rights reserved.

Primary health care registered nurses' types in implementation of health promotion practices.

PubMed

Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele

2016-09-01

Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.

Stress management techniques in the prison setting.

PubMed

Kristofersson, Gisli Kort; Kaas, Merrie J

2013-01-01

The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.

Association of GPs’ risk attitudes, level of empathy, and burnout status with PSA testing in primary care

PubMed Central

Pedersen, Anette F; Carlsen, Anders H; Vedsted, Peter

2015-01-01

Background Rates of prostate specific antigen (PSA) test ordering vary among GPs. Aim To examine whether GPs’ risk attitude, level of empathy, and burnout status are associated with PSA testing. Design and setting Register and questionnaire study including 129 solo GPs (active in the Central Denmark Region) and 76 672 of their adult male patients with no history of or current prostate cancer diagnosis. Method PSA tests from 2012 were retrieved from a register and classified as incident (that is, the first PSA test within 24 months), repeated normal, or repeated raised tests. This was merged with information on GPs’ risk attitudes, empathy, and burnout status from a 2012 survey. Results Patients registered with a GP with a high score on anxiety caused by uncertainty (odds ratio [OR] 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.025) or concern about bad outcomes (OR 1.04; 95% CI = 1.00 to 1.08, P = 0.034) were more likely to have an incident PSA test, whereas those registered with a GP with increased tolerance for ambiguity were less likely (OR 0.98, 95% CI = 0.96 to 1.00, P = 0.025). Patients registered with a GP reporting high tolerance for ambiguity (OR 0.96, 95% CI = 0.94 to 0.99, P = 0.009) or high propensity to risk-taking (OR 0.97, 95% CI = 0.93 to 1.00, P = 0.047) were less likely to have a repeated normal PSA test. Conclusion Various aspects of GPs’ risk-taking attitudes were associated with patients’ probability of having an incident and a repeated normal PSA test. The probability of having a repeated raised PSA test was not influenced by any of the psychological factors. Burnout and empathy were not associated with PSA testing. PMID:26541183

Building a population-based diabetes register: an Italian experience.

PubMed

Ballotari, Paola; Chiatamone Ranieri, Sofia; Vicentini, Massimo; Caroli, Stefania; Gardini, Andrea; Rodolfi, Rossella; Crucco, Roberto; Greci, Marina; Manicardi, Valeria; Giorgi Rossi, Paolo

2014-01-01

To describe the methodology used to set up the Reggio Emilia (northern Italy) Diabetes Register. The prevalence estimates on December 31st, 2009 are also provided. The Diabetes Register covers all residents in the Reggio Emilia province. The register was created by deterministic linkage of six routinely collected data sources through a definite algorithm able to ascertain cases and to distinguish type of diabetes and model of care: Hospital Discharge, Drug Dispensation, Biochemistry Laboratory, Disease-specific Exemption, Diabetes Outpatient Clinics, and Mortality databases. Using these data, we estimated crude prevalence on December 31st, 2009 by sex, age groups, and type of diabetes. There were 25,425 ascertained prevalent cases on December 31st, 2009. Drug Dispensation and Exemption databases made the greatest contribution to prevalence. Analyzing overlapping sources, more than 80% of cases were reported by at least two sources. Crude prevalence was 4.8% and 5.9% for the whole population and for people aged 18 years and over, respectively. Males accounted for 53.6%. Type 1 diabetes accounted for 3.8% of cases, while people with Type 2 diabetes were the overriding majority (91.2%), and Diabetes Outpatient Clinics treated 75.4% of people with Type 2 diabetes. The Register is able to quantify the burden of disease, the first step in planning, implementing, and monitoring appropriate interventions. All data sources contributed to completeness and/or accuracy of the Register. Although all cases are identified by deterministic record linkage, manual revision and General Practitioner involvement are still necessary when information is insufficient or conflicting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Theory of protective empowering for balancing patient safety and choices.

PubMed

Chiovitti, Rosalina F

2011-01-01

Registered nurses in psychiatric-mental health nursing continuously balance the ethical principles of duty to do good (beneficence) and no harm (non-maleficence) with the duty to respect patient choices (autonomy). However, the problem of nurses' level of control versus patients' choices remains a challenge. The aim of this article is to discuss how nurses accomplish their simultaneous responsibility for balancing patient safety (beneficence and non-maleficence) with patient choices (autonomy) through the theory of protective empowering. This is done by reflecting on interview excerpts about caring from 17 registered nurses taking part in a grounded theory study conducted in three acute urban psychiatric hospital settings in Canada. The interplay between the protective and empowering dimensions of the theory of protective empowering was found to correspond with international, national, and local nursing codes of ethics and standards. The overall core process of protective empowering, and its associated reflective questions, is offered as a new lens for balancing patient safety with choices.

An exploratory study of selected female registered nurses: meaning and expression of nurturance.

PubMed

Geissler, E M

1990-05-01

The words 'nurse' and 'nursing' originate in the word 'nurture' which dates back to the 14th century. 'Nurturance' appeared for the first time in the 1976 Supplement to the Oxford English Dictionary and in a United States dictionary in 1983. Etymologically and semantically bound to nursing, little is known about the term nurturance. An exploratory design using phenomenological analysis was applied to understand the female registered nurses' experience of nurturing patients throughout the life-span and to uncover behaviours commonly believed nurturant. Interviews with 14 RNs practising in diverse settings revealed 39 nurturant behaviours that were intuited into four themes describing the subjects' perceived structure of nurturance as: (1) enabling maximum potential; (2) providing physical and emotional protection; (3) engaging in a supportive interaction; and (4) conveying shared humanity. Data were formulated into an exhaustive description of the phenomenon nurturance. Additionally, the results support Greenberg-Edelstein's theoretical model of the positive reciprocity of nurturance between nurse and patient.

Measurement error in earnings data: Using a mixture model approach to combine survey and register data.

PubMed

Meijer, Erik; Rohwedder, Susann; Wansbeek, Tom

2012-01-01

Survey data on earnings tend to contain measurement error. Administrative data are superior in principle, but they are worthless in case of a mismatch. We develop methods for prediction in mixture factor analysis models that combine both data sources to arrive at a single earnings figure. We apply the methods to a Swedish data set. Our results show that register earnings data perform poorly if there is a (small) probability of a mismatch. Survey earnings data are more reliable, despite their measurement error. Predictors that combine both and take conditional class probabilities into account outperform all other predictors.

Supervised local error estimation for nonlinear image registration using convolutional neural networks

NASA Astrophysics Data System (ADS)

Eppenhof, Koen A. J.; Pluim, Josien P. W.

2017-02-01

Error estimation in medical image registration is valuable when validating, comparing, or combining registration methods. To validate a nonlinear image registration method, ideally the registration error should be known for the entire image domain. We propose a supervised method for the estimation of a registration error map for nonlinear image registration. The method is based on a convolutional neural network that estimates the norm of the residual deformation from patches around each pixel in two registered images. This norm is interpreted as the registration error, and is defined for every pixel in the image domain. The network is trained using a set of artificially deformed images. Each training example is a pair of images: the original image, and a random deformation of that image. No manually labeled ground truth error is required. At test time, only the two registered images are required as input. We train and validate the network on registrations in a set of 2D digital subtraction angiography sequences, such that errors up to eight pixels can be estimated. We show that for this range of errors the convolutional network is able to learn the registration error in pairs of 2D registered images at subpixel precision. Finally, we present a proof of principle for the extension to 3D registration problems in chest CTs, showing that the method has the potential to estimate errors in 3D registration problems.

Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

ERIC Educational Resources Information Center

Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

2013-01-01

We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

Non-invasive ventilation in amyotrophic lateral sclerosis: a 10 year population based study.

PubMed

Chiò, Adriano; Calvo, Andrea; Moglia, Cristina; Gamna, Federica; Mattei, Alessio; Mazzini, Letizia; Mora, Gabriele

2012-04-01

To evaluate the clinical characteristics and outcome of non-invasive ventilation (NIV) in an epidemiological based series of amyotrophic lateral sclerosis (ALS) patients. The study was performed using data from the Piemonte and Valle d'Aosta Register for ALS, a prospective epidemiological register enrolling all ALS incident cases in two Italian regions. Among the 1260 patients incident in the period 1995-2004, 259 (20.6%) underwent NIV. Young male patients and subjects attending the tertiary ALS centres were more likely to undergo NIV. There was a progressive significant increase in the use of NIV during the study but was limited to patients attending the ALS tertiary centres. Median survival after NIV was 289 days (95% CI 255 to 333). In an epidemiological setting, NIV represents an increasingly utilised option for the treatment of respiratory disturbances in ALS and has favourable effects on survival, in particular among patients followed by tertiary ALS centres. Sociocultural factors, such as age, gender and marital status, strongly influence the probability of undergoing NIV. Efforts should be made to remove these obstacles in order to spread the use of NIV in all ALS patients with respiratory failure.

A comparison of the Cray-2 performance before and after the installation of memory pseudo-banking

NASA Technical Reports Server (NTRS)

Schmickley, Ronald D.; Bailey, David H.

1987-01-01

A suite of 13 large Fortran benchmark codes were run on a Cray-2 configured with memory pseudo-banking circuits, and floating point operation rates were measured for each under a variety of system load configurations. These were compared with similar flop measurements taken on the same system before installation of the pseudo-banking. A useful memory access efficiency parameter was defined and calculated for both sets of performance rates, allowing a crude quantitative measure of the improvement in efficiency due to pseudo-banking. Programs were categorized as either highly scalar (S) or highly vectorized (V) and either memory-intensive or register-intensive, giving 4 categories: S-memory, S-register, V-memory, and V-register. Using flop rates as a simple quantifier of these 4 categories, a scatter plot of efficiency gain vs Mflops roughly illustrates the improvement in floating point processing speed due to pseudo-banking. On the Cray-2 system tested this improvement ranged from 1 percent for S-memory codes to about 12 percent for V-memory codes. No significant gains were made for V-register codes, which was to be expected.

Impact of transportation demand management (TDM) elements on managed lanes toll prices : [summary].

DOT National Transportation Integrated Search

2015-04-01

The 95 Express in Miami, Florida, is a set of dynamically tolled, managed lanes on I-95. : Single occupant vehicles must pay a toll to use 95 Express, but registered carpools, vanpools, : motorcycles, inherently low emission vehicles (ILEV; generally...

Monitoring Of Air Quality Parameters For Construction Of Fire Risk Detection Systems

NASA Astrophysics Data System (ADS)

Romancov, I. I.; Dashkovky, A. G.; Panin, V. F.; Melkov, D. N.

2017-01-01

The analysis of fire developmental process is given, which showed that there are seven stages of fire development, a set of phenomena (factors, signs) of fire risk condition, characterized by a set of defined parameters, corresponds to each stage. Observed that the registration of high staging factors (high ambient temperature, content of CO2, etc.) means the registration of actual low staging fire (thermal destruction of materials gases, fumes, etc.) - fire risk situation. It is shown that the decrease of registered factor staging leads to construction of fire preventive and diagnostic systems as the lower is registered stage, the more uncertain is connection between the fact of its detection and a fire. It is indicated that with development of electronic equipment the staging of fire situations factors used for detection is reducing in whole, and also it is noted that for each control object it is necessary to choose (identify) the optimal factor, in particular, in many ways the optimal factor for aircrafts are smokes and their TV image.

Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project

PubMed Central

Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

2016-01-01

Objective To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. Setting/participants A linked data set of women aged 20–69 in the Queensland Pap Smear Register (PSR; 1999–2011) and Queensland Cancer Registry (QCR; 1997–2010) formed the Initial Study Cohort. Two extracts (1995–2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20–69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. Outcome measures The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. Results There were 28 872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76 831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1 372 823 women (PSR n=1 374 401; QCR n=1955), and 5 062 118 records. Conclusions Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia. PMID:26873047

Vocal-fold collision mass as a differentiator between registers in the low-pitch range.

PubMed

Vilkman, E; Alku, P; Laukkanen, A M

1995-03-01

Register shift between the chest and falsetto register is generally studied in the higher-than-speaking pitch range. However, a similar difference can also be produced at speaking pitch level. The shift from breathy "falsetto" phonation to normal chest voice phonation was studied in normal female (pitch range 170-180 Hz) and male (pitch range 94-110 Hz) subjects. The phonations gliding from falsetto to normal chest voice were analyzed using iterative adaptive inverse filtering and electroglottography. Both trained and untrained, as well as female and male subjects, were able to produce an abrupt register shift from soft falsetto to soft chest register phonation. The differences between male and female speakers in the glottal flow waveforms were smaller than expected. The register shift is interpreted in terms of a "critical mass" concept of chest register phonation.

Factors affecting registered nurses' use of medication administration technology in acute care settings: A systematic review.

PubMed

San, Tay Hui; Lin, Serena Koh Siew; Fai, Chan Moon

Information technology to aid reduction in medication errors has been encouraged over the years and one of them is the medication administration technology. It consists of the electronic Medication Administration Record, Bar-Code Medication Administration system and Automated Medication Dispensing system. Studies had examined the effectiveness and impact of this technology to reduce medication error. However, user's acceptance towards this technology has often been neglected. To date, no systematic review has been undertaken to examine the possible factors that affect nurses' use of this technology in the acute care settings. The objective of this systematic review was to explore and determine the factors that affect nurses' use of medication administration technology in the acute care settings. All quantitative studies published in English which examined factors affecting nurses' use of the medication administration technology were considered.Primary focus was on registered nurses with experience of operating medication administration technology in the acute care settings. Other healthcare personnel were excluded.This review considered studies that evaluated factors affecting nurses' use of the medication administration technology.The outcome measures of interest were the factors that affect nurses' use of the medication administration technology in the acute care settings. The search was conducted across published and unpublished databases. A search was conducted in JBI Library of Systematic Reviews, The Cochrane Library, CINAHL, MEDLINE, Scopus, ScienceDirect, Wiley InterScience, SpringerLink, PsycINFO (ovid), Web of science, ProQuest Dissertations and Theses, and MedNar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardised critical appraisal instruments developed by the Joanna Briggs Institute. Quantitative data were extracted from papers included in the review using a standardised data extraction tool developed by the JBI. Findings were presented in narrative summary due to heterogeneity of the study designs. Six descriptive studies were included in this review. Nurses' use of the technology can be influenced by a combination of complex and inter-related factors, such as organisational factors, and user and system characteristics. In order to successfully implement medication administration technology, system, user and organisational factors have to be collaborated concurrently.Users' needs should be accommodated when designing the system features. Prior to system implementation, institutions should consider the users' demographical characteristics and provide adequate preparations and training. A supportive culture from the institution and colleagues is also important.There is a significant need for further research in this field. Further research to discover potential factors in different settings, locations and countries are suggested. Studies to evaluate nurses' use of the technology at regular intervals are also required.

Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

PubMed

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2017-10-01

The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units: a register study over 10 years

PubMed Central

Flacking, Renée; Hellström-Westas, Lena

2016-01-01

Objective There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants. Design, setting and participants This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004–2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups. Results From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22–27 weeks) from 55% to 16%, in very preterm (GA 28–31 weeks) from 41% to 34% and in moderately preterm infants (GA 32–36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants). Conclusions In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding. PMID:27965252

Screening Children for Family Violence: A Review of the Evidence for the US Preventive Services Task Force

PubMed Central

Nygren, Peggy; Nelson, Heidi D.; Klein, Jonathan

2004-01-01

BACKGROUND We wanted to evaluate the benefits and harms of screening children in primary health care settings for abuse and neglect resulting from family violence by examining the evidence on the performance of screening instruments and the effectiveness of interventions. METHODS We searched for relevant studies in MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Controlled Trials Register, and reference lists. English language abstracts with original data about family violence against children focusing on screening and interventions initiated or based in health care settings were included. We extracted selected information about study design, patient populations and settings, methods of assessment or intervention, and outcome measures, and applied a set of criteria to evaluate study quality. RESULTS All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These instruments had fairly high sensitivity but low specificity when administered in high-risk study populations and have not been widely tested in other populations. Randomized controlled trials of frequent nurse home visitation programs beginning during pregnancy that address behavioral and psychological factors indicated improved abuse measures and outcomes. No studies were identified about interventions in older children or harms associated with screening and intervention. CONCLUSIONS No trials of the effectiveness of screening in a health care setting have been published. Clinician referrals to nurse home visitation during pregnancy and in early childhood may reduce abuse in selected populations. There are no studies about harms of screening and interventions. PMID:15083858

Establishing a Twin Register: An Invaluable Resource for (Behavior) Genetic, Epidemiological, Biomarker, and 'Omics' Studies.

PubMed

Odintsova, Veronika V; Willemsen, Gonneke; Dolan, Conor V; Hottenga, Jouke-Jan; Martin, Nicholas G; Slagboom, P Eline; Ordoñana, Juan R; Boomsma, Dorret I

2018-06-01

Twin registers are wonderful research resources for research applications in medical and behavioral genetics, epidemiology, psychology, molecular genetics, and other areas of research. New registers continue to be launched all over the world as researchers from different disciplines recognize the potential to boost and widen their research agenda. In this article, we discuss multiple aspects that need to be taken into account when initiating a register, from its preliminary sketch to its actual development. This encompasses aspects related to the strategic planning and key elements of research designs, promotion and management of a twin register, including recruitment and retaining of twins and family members of twins, phenotyping, database organization, and collaborations between registers. We also present information on questions unique to twin registers and twin-biobanks, such as the assessment of zygosity by SNP arrays, the design of (biomarker) studies involving related participants, and the analyses of clustered data. Altogether, we provide a number of basic guidelines and recommendations for reflection when planning a twin register.

Wavelength optimization for in vivo multispectral photoacoustic/ultrasound tomography of hemoglobin oxygenation in ovarian cancer: clinical studies

NASA Astrophysics Data System (ADS)

Salehi, Hassan S.; Li, Hai; Kumavor, Patrick D.; Merkulov, Aleksey; Sanders, Melinda; Brewer, Molly; Zhu, Quing

2015-03-01

In this paper, wavelength selection for multispectral photoacoustic/ultrasound tomography was optimized to obtain accurate images of hemoglobin oxygen saturation (sO2) in vivo. Although wavelengths can be selected by theoretical methods, in practice the accuracy of reconstructed images will be affected by wavelength-specific and system-specific factors such as laser source power and ultrasound transducer sensitivity. By performing photoacoustic spectroscopy of mouse tumor models using 14 different wavelengths between 710 and 840 nm, we were able to identify a wavelength set which most accurately reproduced the results obtained using all 14 wavelengths via selection criteria. In clinical studies, the optimal wavelength set was successfully used to image human ovaries in vivo and noninvasively. Although these results are specific to our co-registered photoacoustic/ultrasound imaging system, the approach we developed can be applied to other functional photoacoustic and optical imaging systems.

Searching ClinicalTrials.gov and the International Clinical Trials Registry Platform to inform systematic reviews: what are the optimal search approaches?

PubMed

Glanville, Julie M; Duffy, Steven; McCool, Rachael; Varley, Danielle

2014-07-01

Since 2005, International Committee of Medical Journal Editors (ICMJE) member journals have required that clinical trials be registered in publicly available trials registers before they are considered for publication. The research explores whether it is adequate, when searching to inform systematic reviews, to search for relevant clinical trials using only public trials registers and to identify the optimal search approaches in trials registers. A search was conducted in ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) for research studies that had been included in eight systematic reviews. Four search approaches (highly sensitive, sensitive, precise, and highly precise) were performed using the basic and advanced interfaces in both resources. On average, 84% of studies were not listed in either resource. The largest number of included studies was retrieved in ClinicalTrials.gov and ICTRP when a sensitive search approach was used in the basic interface. The use of the advanced interface maintained or improved sensitivity in 16 of 19 strategies for Clinicaltrials.gov and 8 of 18 for ICTRP. No single search approach was sensitive enough to identify all studies included in the 6 reviews. Trials registers cannot yet be relied upon as the sole means to locate trials for systematic reviews. Trials registers lag behind the major bibliographic databases in terms of their search interfaces. For systematic reviews, trials registers and major bibliographic databases should be searched. Trials registers should be searched using sensitive approaches, and both the registers consulted in this study should be searched.

Interactive Database of Pulsar Flux Density Measurements

NASA Astrophysics Data System (ADS)

Koralewska, O.; Krzeszowski, K.; Kijak, J.; Lewandowski, W.

2012-12-01

The number of astronomical observations is steadily growing, giving rise to the need of cataloguing the obtained results. There are a lot of databases, created to store different types of data and serve a variety of purposes, e. g. databases providing basic data for astronomical objects (SIMBAD Astronomical Database), databases devoted to one type of astronomical object (ATNF Pulsar Database) or to a set of values of the specific parameter (Lorimer 1995 - database of flux density measurements for 280 pulsars on the frequencies up to 1606 MHz), etc. We found that creating an online database of pulsar flux measurements, provided with facilities for plotting diagrams and histograms, calculating mean values for a chosen set of data, filtering parameter values and adding new measurements by the registered users, could be useful in further studies on pulsar spectra.

Herd effect from influenza vaccination in non-healthcare settings: a systematic review of randomised controlled trials and observational studies

PubMed Central

Mertz, Dominik; Fadel, Shaza A.; Lam, Po-Po; Tran, Dat; Srigley, Jocelyn A; Asner, Sandra A; Science, Michelle; Kuster, Stefan P; Nemeth, Johannes; Johnstone, Jennie; Ortiz, Justin R; Loeb, Mark

2016-01-01

Influenza vaccination programmes are assumed to have a herd effect and protect contacts of vaccinated persons from influenza virus infection. We searched MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Global Health and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to March 2014 for studies assessing the protective effect of influenza vaccination vs no vaccination on influenza virus infections in contacts. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using a random-effects model. Of 43,082 screened articles, nine randomised controlled trials (RCTs) and four observational studies were eligible. Among the RCTs, no statistically significant herd effect on the occurrence of influenza in contacts could be found (OR: 0.62; 95% CI: 0.34–1.12). The one RCT conducted in a community setting, however, showed a significant effect (OR: 0.39; 95% CI: 0.26–0.57), as did the observational studies (OR: 0.57; 95% CI: 0.43–0.77). We found only a few studies that quantified the herd effect of vaccination, all studies except one were conducted in children, and the overall evidence was graded as low. The evidence is too limited to conclude in what setting(s) a herd effect may or may not be achieved. PMID:27784531

Correlates of mobile screen media use among children aged 0–8: a systematic review

PubMed Central

Jancey, Jonine; Subedi, Narayan; Leavy, Justine

2017-01-01

Objective This study is a systematic review of the peer-reviewed literature to identify the correlates of mobile screen media use among children aged 8 years and less. Setting Home or community-based studies were included in this review while child care or school-based studies were excluded. Participants Children aged 8 years or less were the study population. Studies that included larger age groups without subgroup analysis specific to the 0–8 years category were excluded. Eight electronic databases were searched for peer-reviewed English language primary research articles published or in press between January 2009 and March 2017 that have studied correlates of mobile screen media use in this age group. Outcome measure Mobile screen media use was the primary outcome measure. Mobile screen media use refers to children’s use of mobile screens, such as mobile phones, electronic tablets, handheld computers or personal digital assistants. Results Thirteen studies meeting the inclusion criteria were identified of which a total of 36 correlates were examined. Older children, children better skilled in using mobile screen media devices, those having greater access to such devices at home and whose parents had high mobile screen media use were more likely to have higher use of mobile screen media devices. No association existed with parent’s age, sex and education. Conclusion Limited research has been undertaken into young children’s mobile screen media use and most of the variables have been studied too infrequently for robust conclusions to be reached. Future studies with objective assessment of mobile screen media use and frequent examination of the potential correlates across multiple studies and settings are recommended. Trial registration number This review is registered with PROSPERO International Prospective Register of Ongoing Systematic Reviews (registration number: CRD42015028028). PMID:29070636

Multi-Mission Laser Altimeter Data Processing and Co-Registration of Image and Laser Data at DLR

NASA Astrophysics Data System (ADS)

Stark, A.; Matz, K.-D.; Roatsch, T.

2018-04-01

We designed a system for the processing and storage of large laser altimeter data sets for various past and operating laser altimeter instruments. Furthermore, we developed a technique to accurately co-register multi-mission laser and image data.

43 CFR 2203.3 - Public meeting.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Fee Federal Coal Deposits § 2203.3 Public meeting. Upon completion of an environmental analysis, but... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Federal Register setting a time and place where a public meeting will be held to receive public comment on...

43 CFR 2203.3 - Public meeting.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Fee Federal Coal Deposits § 2203.3 Public meeting. Upon completion of an environmental analysis, but... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Federal Register setting a time and place where a public meeting will be held to receive public comment on...

43 CFR 2203.3 - Public meeting.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Fee Federal Coal Deposits § 2203.3 Public meeting. Upon completion of an environmental analysis, but... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Federal Register setting a time and place where a public meeting will be held to receive public comment on...

43 CFR 2203.3 - Public meeting.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Fee Federal Coal Deposits § 2203.3 Public meeting. Upon completion of an environmental analysis, but... Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT... Federal Register setting a time and place where a public meeting will be held to receive public comment on...

76 FR 36939 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... of 1934 to submit their fingerprints through a registered securities exchange or a national... accounts for the bulk of the fingerprint submissions. It is estimated that 4,939 respondents submit approximately 288,000 sets of fingerprints (consisting of 133,000 electronic fingerprints and 155,000...

Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study

PubMed Central

Mortensen, Erik Lykke; Hvidtjørn, Dorte; Kesmodel, Ulrik Schiøler

2013-01-01

Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children. Design Prospective register based cohort study. Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark. Participants All children born in Denmark in 1995-2003 with follow-up in 2012 when the children were aged 8-17; 33 139 children were conceived after fertility treatment and 555 828 children were born after spontaneous conception. Main outcome measures Absolute risks and hazard ratios for overall and specific mental disorders estimated with adjustment for potential confounding variables. Estimated association between the risk of mental disorders and subtypes of procedures, hormone treatments, gamete types, and cause of infertility. Results The risk of mental disorders in children born after in vitro fertilisation or intracytoplasmic sperm injection was low, and was no higher than in spontaneously conceived children, except for a borderline significant increased risk of tic disorders (hazard ratio 1.40, 95% confidence interval 1.01 to 1.95; absolute risk 0.3%). In contrast, children born after ovulation induction with or without insemination had low but significantly increased risks of any mental disorder (1.20, 1.11 to 1.31; absolute risk 4.1%), autism spectrum disorders (1.20, 1.05 to 1.37; 1.5%), hyperkinetic disorders (1.23, 1.08 to 1.40; 1.7%), conduct, emotional, or social disorder (1.21, 1.02 to 1.45; 0.8%), and tic disorders (1.51, 1.16 to 1.96; 0.4%). There was no risk systematically related to any specific type of hormone drug treatment. Conclusions There was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination. Children born after in vitro fertilisation/intracytoplasmic sperm injection were found to have overall risk comparable with children conceived spontaneously. PMID:23833075

Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT.

PubMed

Rossen, Jenny; Yngve, Agneta; Hagströmer, Maria; Brismar, Kerstin; Ainsworth, Barbara E; Iskull, Christina; Möller, Peter; Johansson, Unn-Britt

2015-07-12

Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention. Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy. This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. ClinicalTrials.gov Identifier: NCT02374788 . Registered 28 January 2015.

Analyzing soil erosion using a multi-temporal UAV data set after one year of active agriculture in Navarra, Spain

NASA Astrophysics Data System (ADS)

Anders, Niels; Keesstra, Saskia; Masselink, Rens

2014-05-01

Unmanned Aerial System (UAS) are becoming popular tools in the geosciences due to improving technology and processing/analysis techniques. They can potentially fill the gap between spaceborne or manned aircraft remote sensing and terrestrial remote sensing, both in terms of spatial and temporal resolution. In this study we analyze a multi-temporal data set that was acquired with a fixed-wing UAS in an agricultural catchment (2 sq. km) in Navarra, Spain. The goal of this study is to register soil erosion activity after one year of agricultural activity. The aircraft was equipped with a Panasonic GX1 16MP pocket camera with a 20 mm lens to capture normal JPEG RGB images. The data set consisted of two sets of imagery acquired in the end of February in 2013 and 2014 after harvesting. The raw images were processed using Agisoft Photoscan Pro which includes the structure-from-motion (SfM) and multi-view stereopsis (MVS) algorithms producing digital surface models and orthophotos of both data sets. A discussion is presented that is focused on the suitability of multi-temporal UAS data and SfM/MVS processing for quantifying soil loss, mapping the distribution of eroded materials and analyzing re-occurrences of rill patterns after plowing.

Examining the antecedents of engaged nurses in Italy: perceived organisational support (POS); satisfaction with training and development; discretionary power.

PubMed

Trinchero, Elisabetta; Brunetto, Yvonne; Borgonovi, Elio

2013-09-01

This paper used Social Exchange Theory to empirically examine whether perceived organisational support, satisfaction with training and development and perception of discretionary power are antecedents of engagement for registered nurses working in Italian public and private hospitals (n = 827). According to Social Exchange Theory, effective workplace relationships support employees and encourage nurses to use training to enhance their workplace outcomes. This research used a cross-sectional design. Data were collected from registered nurses working in six Italian hospitals using a survey-based, self-report strategy. Regression analysis found that the variance of process-oriented supervision accounted for 6.9% of Italian registered nurse's perception of engagement, training and development accounted for 26.8% and discretionary power accounted for 2.1%. Workplace relationships enhance autonomy and engagement. Effective workplace relationship impacts positively on nurses' outcome. This paper confirms the relevance of training to enhance engagement of nurses. It also confirms the importance of workplace relationships in enhancing autonomy and engagement. Previous research has identified the importance of nurses' autonomy in an environment where there are shortages of nurses. This study confirms a similar situation for Italian nurses. The findings underline the relevance of investments in continuous professional development to enhance nurses' engagement in private and public health-care settings. © 2013 John Wiley & Sons Ltd.

Sensitivity, completeness and agreement of the tuberculosis electronic system in Ho Chi Minh City, Viet Nam.

PubMed

Thai, L H; Nhat, L M; Shah, N; Lyss, S; Ackers, M

2017-12-21

Setting: Since 2011, tuberculosis (TB) clinics in Ho Chi Minh City (HCMC), Viet Nam, have been entering data from a paper-based TB treatment register into an electronic database known as VITIMES (Viet Nam TB Information Management Electronic System), which is currently used in parallel with the paper system. Objective: To evaluate the sensitivity, completeness and agreement of data in VITIMES with that of paper-based registers among TB patients co-infected with the human immunodeficiency virus (HIV) being treated for TB in HCMC. Design: This was a retrospective data review of all TB-HIV patients receiving anti-tuberculosis treatment in each of the 24 district TB clinics in HCMC in 2013. Data were abstracted from the paper-based TB treatment registers at district level and extracted electronically at the provincial level. Records were matched based on name, age and address. The sensitivity, completeness and agreement of the electronic data were compared with data from the paper system. Results: The findings showed that the electronic system had high sensitivity (99.2%), high completeness (87-99%) and high agreement (κ 0.78-0.97) for all variables. Conclusion: The results of this study suggest that data are being correctly entered into VITIMES and that patient data can be directly entered into VITIMES instead of having a parallel, paper-based system.

Sensitivity, completeness and agreement of the tuberculosis electronic system in Ho Chi Minh City, Viet Nam

PubMed Central

Nhat, L. M.; Shah, N.; Lyss, S.; Ackers, M.

2017-01-01

Setting: Since 2011, tuberculosis (TB) clinics in Ho Chi Minh City (HCMC), Viet Nam, have been entering data from a paper-based TB treatment register into an electronic database known as VITIMES (Viet Nam TB Information Management Electronic System), which is currently used in parallel with the paper system. Objective: To evaluate the sensitivity, completeness and agreement of data in VITIMES with that of paper-based registers among TB patients co-infected with the human immunodeficiency virus (HIV) being treated for TB in HCMC. Design: This was a retrospective data review of all TB-HIV patients receiving anti-tuberculosis treatment in each of the 24 district TB clinics in HCMC in 2013. Data were abstracted from the paper-based TB treatment registers at district level and extracted electronically at the provincial level. Records were matched based on name, age and address. The sensitivity, completeness and agreement of the electronic data were compared with data from the paper system. Results: The findings showed that the electronic system had high sensitivity (99.2%), high completeness (87–99%) and high agreement (κ 0.78–0.97) for all variables. Conclusion: The results of this study suggest that data are being correctly entered into VITIMES and that patient data can be directly entered into VITIMES instead of having a parallel, paper-based system. PMID:29584795

Diabetes mellitus and treatment outcomes in Palestine refugees in UNRWA primary health care clinics in Jordan

PubMed Central

Khader, A.; Ballout, G.; Shahin, Y.; Hababeh, M.; Farajallah, L.; Zeidan, W.; Abu-Zayed, I.; Kochi, A.; Zachariah, R.; Kapur, A.; Shaikh, I.; Seita, A.

2013-01-01

Setting: Six primary health care clinics in Jordan, serving Palestine refugees diagnosed with diabetes mellitus (DM). Objectives: To report on the number and characteristics of new DM patients registered in the second quarter of 2013 and of all DM patients ever registered by 30 June 2013, with treatment outcomes and cumulative burden of late-stage complications. Design: A descriptive cohort study using routine data collected through e-Health. Results: Of the 288 new patients in Q2 2013 and 12 548 patients ever registered with DM by 30 June 2013, smoking, physical inactivity and obesity were recorded in 19%, 50% and 47%, respectively. In Q2 2013, 9740 (78%) patients attended a clinic, with >99% having undergone disease control measures: of these, 72% had postprandial blood glucose ⩽ 180 mg/dl, 71% had blood cholesterol < 200 mg/dl, 82% had blood pressure < 140/90 and 40% had body mass index < 30 kg/m2. Late-stage complications were present in 1130 (11.6%) patients who attended a clinic, with cardiovascular disease and stroke being the most common. Several differences in outcomes were found between males and females. Conclusion: There is a high burden of disease due to DM at primary health care clinics in Jordan. Cohort analysis using e-Health is a vital way to assess management and follow-up. PMID:26393043

Assessment of the Incorporation of Patient-Centric Outcomes in Studies of Minimally Invasive Glaucoma Surgical Devices

PubMed Central

Le, Jimmy T.; Viswanathan, Shilpa; Tarver, Michelle E.; Eydelman, Malvina; Li, Tianjing

2017-01-01

IMPORTANCE Minimally invasive glaucoma surgical (MIGS) devices are one option for lowering intraocular pressure in patients with glaucoma. OBJECTIVE To examine how often existing clinical studies of MIGS devices registered on ClinicalTrials.gov measure patient-centric outcomes that patients value directly. DESIGN, SETTING, AND PARTICIPANTS We searched ClinicalTrials.gov, a registry of publicly and privately supported clinical studies, on February 20, 2015, for records of MIGS device studies involving patients with glaucoma. Two investigators independently abstracted study design and outcome details from eligible records. We classified outcomes as patient-centric or not patient-centric using a prespecified definition. MAIN OUTCOMES AND MEASURES Proportion of patient-centric and nonpatient-centric outcomes registered on ClinicalTrials.gov. RESULTS We identified 51 eligible studies specifying 127 outcomes. Reduction in intraocular pressure was the most frequent outcome specified (78/127; 61%) and a primary outcome in 41 studies. Patient-centric outcomes—such as adverse events (n = 19; 15%), topical medication use (n = 16; 13%), visual acuity (n = 4; 3%), and health-related quality of life (n = 1; 1%)—were less frequently specified (n = 40; 32%) and a primary outcome in only 12 studies. CONCLUSION AND RELEVANCE Patient-centric outcomes that provide insight into the relative desirability and acceptability of the benefits and risks of MIGS devices are not well represented in current clinical studies. PMID:27389667

Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

PubMed

Swaen, Gerard M H; Carmichael, Neil; Doe, John

2011-05-01

To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

Effects of librarian-provided services in healthcare settings: a systematic review

PubMed Central

Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

2014-01-01

Objective To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Materials and methods Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Results Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Conclusions Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. PMID:24872341

The distance discordance metric - A novel approach to quantifying spatial uncertainties in intra- and inter-patient deformable image registration

PubMed Central

Saleh, Ziad H.; Apte, Aditya P.; Sharp, Gregory C.; Shusharina, Nadezhda P.; Wang, Ya; Veeraraghavan, Harini; Thor, Maria; Muren, Ludvig P.; Rao, Shyam S.; Lee, Nancy Y.; Deasy, Joseph O.

2014-01-01

Previous methods to estimate the inherent accuracy of deformable image registration (DIR) have typically been performed relative to a known ground truth, such as tracking of anatomic landmarks or known deformations in a physical or virtual phantom. In this study, we propose a new approach to estimate the spatial geometric uncertainty of DIR using statistical sampling techniques that can be applied to the resulting deformation vector fields (DVFs) for a given registration. The proposed DIR performance metric, the distance discordance metric (DDM), is based on the variability in the distance between corresponding voxels from different images, which are co-registered to the same voxel at location (X) in an arbitrarily chosen “reference” image. The DDM value, at location (X) in the reference image, represents the mean dispersion between voxels, when these images are registered to other images in the image set. The method requires at least four registered images to estimate the uncertainty of the DIRs, both for inter-and intra-patient DIR. To validate the proposed method, we generated an image set by deforming a software phantom with known DVFs. The registration error was computed at each voxel in the “reference” phantom and then compared to DDM, inverse consistency error (ICE), and transitivity error (TE) over the entire phantom. The DDM showed a higher Pearson correlation (Rp) with the actual error (Rp ranged from 0.6 to 0.9) in comparison with ICE and TE (Rp ranged from 0.2 to 0.8). In the resulting spatial DDM map, regions with distinct intensity gradients had a lower discordance and therefore, less variability relative to regions with uniform intensity. Subsequently, we applied DDM for intra-patient DIR in an image set of 10 longitudinal computed tomography (CT) scans of one prostate cancer patient and for inter-patient DIR in an image set of 10 planning CT scans of different head and neck cancer patients. For both intra- and inter-patient DIR, the spatial DDM map showed large variation over the volume of interest (the pelvis for the prostate patient and the head for the head and neck patients). The highest discordance was observed in the soft tissues, such as the brain, bladder, and rectum, due to higher variability in the registration. The smallest DDM values were observed in the bony structures in the pelvis and the base of the skull. The proposed metric, DDM, provides a quantitative tool to evaluate the performance of DIR when a set of images is available. Therefore, DDM can be used to estimate and visualize the uncertainty of intra- and/or inter-patient DIR based on the variability of the registration rather than the absolute registration error. PMID:24440838

Effect of occupational EMF exposure from radar at two different frequency bands on plasma melatonin and serotonin levels.

PubMed

Singh, Sarika; Mani, Kumar Vyonkesh; Kapoor, Neeru

2015-05-01

To delineate the effect of chronic electromagnetic field (EMF) exposure from radar on plasma melatonin and serotonin levels in occupationally exposed military personnel. A total of 166 male military personnel participated in the study out of which only 155 joined for blood draw. They were divided into three sets: Control group (n = 68), exposure group I (n = 40) exposed to 8-12 GHz and exposure group II (n = 58) working with radar at 12.5-18 GHz frequency. The three groups were further split into two groups according to their years of service (up to 10 years and > 10 years) in order to investigate the effect of years of exposure from radar. Melatonin and serotonin levels were estimated by enzyme immunoassay in fasting blood samples collected from 06:00-07:00 h. EMF measurements were recorded at different locations using Satimo EME Guard 'Personal Exposure Meter' and Narda 'Broad Band Field Meter'. The group I exposed population registered a minor though not significant decrease in plasma melatonin concentration while the other group II exposed population registered statistically significant decline in melatonin concentration when compared with controls. Highly significant increase in plasma serotonin levels was found in exposure group II when compared to control whereas marginal non-significant rise was also registered in exposure group I in comparison to control. Exposure in terms of length of service up to 10 years did not produce any significant effect in the indoleamine levels in both the exposure groups when they were compared with their respective control groups. Whereas, length of service greater than 10 years was observed to decrease and increase respectively the melatonin and serotonin concentration significantly in exposure group II but not in exposure group I. However, correlation test did not yield any significant association between years of service and melatonin or serotonin levels respectively in both the exposure sets I and II. No significant association was observed between melatonin and serotonin levels as well. The study showed the EMF ability to influence plasma melatonin and serotonin concentration in radar workers, significantly in 12.5-18 GHz range with service period greater than 10 years.

Accuracy of Coverage Survey Recall following an Integrated Mass Drug Administration for Lymphatic Filariasis, Schistosomiasis, and Soil-Transmitted Helminthiasis.

PubMed

Budge, Philip J; Sognikin, Edmond; Akosa, Amanda; Mathieu, Els M; Deming, Michael

2016-01-01

Achieving target coverage levels for mass drug administration (MDA) is essential to elimination and control efforts for several neglected tropical diseases (NTD). To ensure program goals are met, coverage reported by drug distributors may be validated through household coverage surveys that rely on respondent recall. This is the first study to assess accuracy in such surveys. Recall accuracy was tested in a series of coverage surveys conducted at 1, 6, and 12 months after an integrated MDA in Togo during which three drugs (albendazole, ivermectin, and praziquantel) were distributed. Drug distribution was observed during the MDA to ensure accurate recording of persons treated during the MDA. Information was obtained for 506, 1131, and 947 persons surveyed at 1, 6, and 12 months, respectively. Coverage (defined as the percentage of persons taking at least one of the MDA medications) within these groups was respectively 88.3%, 87.4%, and 80.0%, according to the treatment registers; it was 87.9%, 91.4% and 89.4%, according to survey responses. Concordance between respondents and registers on swallowing at least one pill was >95% at 1 month and >86% at 12 months; the lower concordance at 12 months was more likely due to difficulty matching survey respondents with the year-old treatment register rather than inaccurate responses. Respondents generally distinguished between pills similar in appearance; concordance for recall of which pills were taken was over 80% in each survey. In this population, coverage surveys provided remarkably consistent coverage estimates for up to one year following an integrated MDA. It is not clear if similar consistency will be seen in other settings, however, these data suggest that in some settings coverage surveys might be conducted as much as one year following an MDA without compromising results. This might enable integration of post-MDA coverage measurement into large, multipurpose, periodic surveys, thereby conserving resources.

Current-reported outcome domains in studies of adults with a focus on the treatment of tinnitus: protocol for a systematic review

PubMed Central

Hall, Deborah A; Szczepek, Agnieszka J; Kennedy, Veronica; Haider, Haúla

2015-01-01

Introduction In Europe alone, over 70 million people experience tinnitus. Despite its considerable socioeconomic relevance, progress in developing successful treatments has been limited. Clinical effectiveness is judged according to change in primary outcome measures, but because tinnitus is a subjective condition, the definition of outcomes is challenging and it remains unclear which distinct aspects of tinnitus (ie, ‘domains’) are most relevant for assessment. The development of a minimum outcome reporting standard would go a long way towards addressing these problems. In 2006, a consensus meeting recommended using 1 of 4 questionnaires for tinnitus severity as an outcome in clinical trials, in part because of availability in different language translations. Our initiative takes an approach motivated by clinimetrics, first by determining what to measure before seeking to determine how to measure it. Agreeing on the domains that contribute to tinnitus severity (ie, ‘what’) is the first step towards achieving a minimum outcome reporting standard for tinnitus that has been reached via a methodologically rigorous and transparent process. Methods and analysis Deciding what should be the core set of outcomes requires a great deal of discussion and so lends itself well to international effort. This protocol lays out the first-step methodology in defining a Core Domain Set for clinical trials of tinnitus by establishing existing knowledge and practice with respect to which outcome domains have been measured and which instruments used in recent registered and published clinical trials. Ethics and dissemination No ethical issues are foreseen. Findings will be reported at national and international ear, nose and throat (ENT) and audiology conferences and in a peer-reviewed journal, using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis) guidelines. Trial registration number The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): CRD42015017525. PMID:26560061

Accuracy of Coverage Survey Recall following an Integrated Mass Drug Administration for Lymphatic Filariasis, Schistosomiasis, and Soil-Transmitted Helminthiasis

PubMed Central

Budge, Philip J.; Sognikin, Edmond; Akosa, Amanda; Mathieu, Els M.; Deming, Michael

2016-01-01

Background Achieving target coverage levels for mass drug administration (MDA) is essential to elimination and control efforts for several neglected tropical diseases (NTD). To ensure program goals are met, coverage reported by drug distributors may be validated through household coverage surveys that rely on respondent recall. This is the first study to assess accuracy in such surveys. Methodology/Principal Findings Recall accuracy was tested in a series of coverage surveys conducted at 1, 6, and 12 months after an integrated MDA in Togo during which three drugs (albendazole, ivermectin, and praziquantel) were distributed. Drug distribution was observed during the MDA to ensure accurate recording of persons treated during the MDA. Information was obtained for 506, 1131, and 947 persons surveyed at 1, 6, and 12 months, respectively. Coverage (defined as the percentage of persons taking at least one of the MDA medications) within these groups was respectively 88.3%, 87.4%, and 80.0%, according to the treatment registers; it was 87.9%, 91.4% and 89.4%, according to survey responses. Concordance between respondents and registers on swallowing at least one pill was >95% at 1 month and >86% at 12 months; the lower concordance at 12 months was more likely due to difficulty matching survey respondents with the year-old treatment register rather than inaccurate responses. Respondents generally distinguished between pills similar in appearance; concordance for recall of which pills were taken was over 80% in each survey. Significance In this population, coverage surveys provided remarkably consistent coverage estimates for up to one year following an integrated MDA. It is not clear if similar consistency will be seen in other settings, however, these data suggest that in some settings coverage surveys might be conducted as much as one year following an MDA without compromising results. This might enable integration of post-MDA coverage measurement into large, multipurpose, periodic surveys, thereby conserving resources. PMID:26766287

Current-reported outcome domains in studies of adults with a focus on the treatment of tinnitus: protocol for a systematic review.

PubMed

Hall, Deborah A; Szczepek, Agnieszka J; Kennedy, Veronica; Haider, Haúla

2015-11-11

In Europe alone, over 70 million people experience tinnitus. Despite its considerable socioeconomic relevance, progress in developing successful treatments has been limited. Clinical effectiveness is judged according to change in primary outcome measures, but because tinnitus is a subjective condition, the definition of outcomes is challenging and it remains unclear which distinct aspects of tinnitus (ie, 'domains') are most relevant for assessment. The development of a minimum outcome reporting standard would go a long way towards addressing these problems. In 2006, a consensus meeting recommended using 1 of 4 questionnaires for tinnitus severity as an outcome in clinical trials, in part because of availability in different language translations. Our initiative takes an approach motivated by clinimetrics, first by determining what to measure before seeking to determine how to measure it. Agreeing on the domains that contribute to tinnitus severity (ie, 'what') is the first step towards achieving a minimum outcome reporting standard for tinnitus that has been reached via a methodologically rigorous and transparent process. Deciding what should be the core set of outcomes requires a great deal of discussion and so lends itself well to international effort. This protocol lays out the first-step methodology in defining a Core Domain Set for clinical trials of tinnitus by establishing existing knowledge and practice with respect to which outcome domains have been measured and which instruments used in recent registered and published clinical trials. No ethical issues are foreseen. Findings will be reported at national and international ear, nose and throat (ENT) and audiology conferences and in a peer-reviewed journal, using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis) guidelines. The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): CRD42015017525. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prompting one low-fat, high-fiber selection in a fast-food restaurant.

PubMed

Wagner, J L; Winett, R A

1988-01-01

Evidence increasingly links a high-fat, low-fiber diet to coronary heart disease and certain site cancers, indicating a need for large-scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A-B-A-B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast-food restaurant could increase the sales of salads, a low-fat, high-fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.

[Implementation of evidence based medicine in primary care].

PubMed

Rinnerberger, Andreas; Grafinger, Michaela; Melchardt, Thomas; Sönnichsen, Andreas

2009-01-01

The particular situation of primary care - i.e. decentralized setting, comprehensive medical care, and limited access to continuous medical education - makes it difficult to implement evidence-based medicine into daily practice. Therefore, the Institute of General Practice of the Paracelsus University (PMU) in Salzburg and Actavis GmbH Austria developed "REM" (Rechercheservice evidenzbasierte Medizin). This is a web-based enquiry service offered mainly to GPs who can submit questions arising in daily practice which are answered by the service according to current best evidence. In 8.5 months 176 physicians registered to participate. A total of 31 submitted at least one question. In total, REM processed 134 questions. The number of physicians registered and the frequency of enquiries show that REM can facilitate the implementation of evidence-based medicine in primary care. Nonetheless, only a small proportion of the physicians registered actually made use of the service. Improvements are necessary to promote interest in this new way of continuous medical education.

Manipulatives and problem situations as escalators for students' geometric understanding: a semiotic analysis

NASA Astrophysics Data System (ADS)

Daher, Wajeeh M.

2014-04-01

Mathematical learning and teaching are increasingly seen as a multimodal experience involved in cultural and social semiotic registers and means, and as such social-cultural semiotic analysis is expected to shed light on learning and teaching processes occurring in the mathematics classroom. In this research, three social-cultural semiotic frameworks were utilised to analyse elementary school students' learning of a geometric relation: the semiotic bundle, the space of action, production and communication and the theoretical framework of attention, awareness and objectification. Educational mathematical situations are described, in addition to semiotic sets, registers and means emerging in the different mathematical situations and that are relevant to the three social-cultural semiotic frameworks which the current research utilizes. Further, the students, as a consequence of (1) their multimodal experience, (2) their connecting between the different mathematical situations and semiotic registers, and (3) the teacher's questions and tasks, could objectify the geometric relation between the lengths of the triangle's edges.

Multi-bit operations in vertical spintronic shift registers

NASA Astrophysics Data System (ADS)

Lavrijsen, Reinoud; Petit, Dorothée C. M. C.; Fernández-Pacheco, Amalio; Lee, JiHyun; Mansell, Mansell; Cowburn, Russell P.

2014-03-01

Spintronic devices have in general demonstrated the feasibility of non-volatile memory storage and simple Boolean logic operations. Modern microprocessors have one further frequently used digital operation: bit-wise operations on multiple bits simultaneously. Such operations are important for binary multiplication and division and in efficient microprocessor architectures such as reduced instruction set computing (RISC). In this paper we show a four-stage vertical serial shift register made from RKKY coupled ultrathin (0.9 nm) perpendicularly magnetised layers into which a 3-bit data word is injected. The entire four stage shift register occupies a total length (thickness) of only 16 nm. We show how under the action of an externally applied magnetic field bits can be shifted together as a word and then manipulated individually, including being brought together to perform logic operations. This is one of the highest level demonstrations of logic operation ever performed on data in the magnetic state and brings closer the possibility of ultrahigh density all-magnetic microprocessors.

Multi-bit operations in vertical spintronic shift registers.

PubMed

Lavrijsen, Reinoud; Petit, Dorothée C M C; Fernández-Pacheco, Amalio; Lee, Jihyun; Mansell, Mansell; Cowburn, Russell P

2014-03-14

Spintronic devices have in general demonstrated the feasibility of non-volatile memory storage and simple Boolean logic operations. Modern microprocessors have one further frequently used digital operation: bit-wise operations on multiple bits simultaneously. Such operations are important for binary multiplication and division and in efficient microprocessor architectures such as reduced instruction set computing (RISC). In this paper we show a four-stage vertical serial shift register made from RKKY coupled ultrathin (0.9 nm) perpendicularly magnetised layers into which a 3-bit data word is injected. The entire four stage shift register occupies a total length (thickness) of only 16 nm. We show how under the action of an externally applied magnetic field bits can be shifted together as a word and then manipulated individually, including being brought together to perform logic operations. This is one of the highest level demonstrations of logic operation ever performed on data in the magnetic state and brings closer the possibility of ultrahigh density all-magnetic microprocessors.

Convergence in the Bilingual Lexicon: A Pre-registered Replication of Previous Studies.

PubMed

White, Anne; Malt, Barbara C; Storms, Gert

2016-01-01

Naming patterns of bilinguals have been found to converge and form a new intermediate language system from elements of both the bilinguals' languages. This converged naming pattern differs from the monolingual naming patterns of both a bilingual's languages. We conducted a pre-registered replication study of experiments addressing the question whether there is a convergence between a bilingual's both lexicons. The replication used an enlarged set of stimuli of common household containers, providing generalizability, and more reliable representations of the semantic domain. Both an analysis at the group-level and at the individual level of the correlations between naming patterns reject the two-pattern hypothesis that poses that bilinguals use two monolingual-like naming patterns, one for each of their two languages. However, the results of the original study and the replication comply with the one-pattern hypothesis, which poses that bilinguals converge the naming patterns of their two languages and form a compromise. Since this convergence is only partial the naming pattern in bilinguals corresponds to a moderate version of the one-pattern hypothesis. These findings are further confirmed by a representation of the semantic domain in a multidimensional space and the finding of shorter distances between bilingual category centers than monolingual category centers in this multidimensional space both in the original and in the replication study.

Intentions of hospital nurses to work with computers: based on the theory of planned behavior.

PubMed

Shoham, Snunith; Gonen, Ayala

2008-01-01

The purpose of this study was to determine registered nurses' attitudes related to intent to use computers in the hospital setting as a predictor of their future behavior. The study was further aimed at identifying the relationship between these attitudes and selected sociological, professional, and personal factors and to describe a research model integrating these various factors. The study was based on the theory of planned behavior. A random sample of 411 registered nurses was selected from a single large medical center in Israel. The study tool was a Likert-style questionnaire. Nine different indices were used: (1) behavioral intention toward computer use; (2) general attitudes toward computer use; (3) nursing attitudes toward computer use; (4) threat involved in computer use; (5) challenge involved in computer use; (6) organizational climate; (7) departmental climate; (8) attraction to technological innovations/innovativeness; (9) self-efficacy, ability to control behavior. Strong significant positive correlations were found between the nurses' attitudes (general attitudes and nursing attitudes), self-efficacy, innovativeness, and intentions to use computers. Higher correlations were found between departmental climate and attitudes than between organizational climate and attitudes. The threat and challenge that are involved in computer use were shown as important mediating variables to the understanding of the process of predicting attitudes and intentions toward using computers.

Geometrical principles of homomeric β-barrels and β-helices: Application to modeling amyloid protofilaments.

PubMed

Hayward, Steven; Milner-White, E James

2017-10-01

Examples of homomeric β-helices and β-barrels have recently emerged. Here we generalize the theory for the shear number in β-barrels to encompass β-helices and homomeric structures. We introduce the concept of the "β-strip," the set of parallel or antiparallel neighboring strands, from which the whole helix can be generated giving it n-fold rotational symmetry. In this context, the shear number is interpreted as the sum around the helix of the fixed register shift between neighboring identical β-strips. Using this approach, we have derived relationships between helical width, pitch, angle between strand direction and helical axis, mass per length, register shift, and number of strands. The validity and unifying power of the method is demonstrated with known structures including α-hemolysin, T4 phage spike, cylindrin, and the HET-s(218-289) prion. From reported dimensions measured by X-ray fiber diffraction on amyloid fibrils, the relationships can be used to predict the register shift and the number of strands within amyloid protofilaments. This was used to construct models of transthyretin and Alzheimer β(40) amyloid protofilaments that comprise a single strip of in-register β-strands folded into a "β-strip helix." Results suggest both stabilization of an individual β-strip helix and growth by addition of further β-strip helices can involve the same pair of sequence segments associating with β-sheet hydrogen bonding at the same register shift. This process would be aided by a repeat sequence. Hence, understanding how the register shift (as the distance between repeat sequences) relates to helical dimensions will be useful for nanotube design. © 2017 Wiley Periodicals, Inc.

Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.

PubMed

Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke

2013-07-01

To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

1 CFR 2.1 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Scope and purpose. 2.1 Section 2.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL GENERAL INFORMATION § 2.1 Scope and purpose. (a) This chapter sets forth the policies, procedures, and delegations under which the...

1 CFR 2.1 - Scope and purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Scope and purpose. 2.1 Section 2.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL GENERAL INFORMATION § 2.1 Scope and purpose. (a) This chapter sets forth the policies, procedures, and delegations under which the...

78 FR 15056 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... establish, document, and maintain a system of internal risk management controls. The Rule sets forth the..., documenting, and reviewing its internal risk management control system, which are designed to, among other... documenting its risk management control system is 2,000 hours and that, on average, a registered OTC...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

37 CFR 202.5 - Reconsideration Procedure for Refusals to Register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reconsidered. (b) First reconsideration. Upon receiving a written notification from the Registration and... following requirements: (1) An applicant must request in writing that the Registration and Recordation... applicant's written submissions. (2) The fee set forth in § 201.3(d)(3)(i) of this chapter must accompany...

17 CFR 49.22 - Chief compliance officer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... that the registered swap data repository provide fair and open access as set forth in § 49.27 of this...) SWAP DATA REPOSITORIES § 49.22 Chief compliance officer. (a) Definition of Board of Directors. For... data repository, or for those swap data repositories whose organizational structure does not include a...

78 FR 38455 - Energy Conservation Program: Test Procedures for Electric Motors

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... Conservation Program: Test Procedures for Electric Motors; Proposed Rule #0;#0;Federal Register / Vol. 78, No... 431 [Docket No. EERE-2012-BT-TP-0043] RIN 1904-AC89 Energy Conservation Program: Test Procedures for... establishing definitions, specifying testing set-up procedures necessary to test, and extending DOE's existing...

Medication Administration in the School Setting. Position Statement. Amended

ERIC Educational Resources Information Center

Zacharski, Susan; Kain, Carole A.; Fleming, Robin; Pontius, Deborah

2012-01-01

It is the position of the National Association of School Nurses (NASN) that school districts develop written medication administration policies and procedures that focus on safe and efficient medication administration at school by a registered professional school nurse (hereinafter referred to as school nurse). Policies should include prescription…

Service Animals in School. Position Statement

ERIC Educational Resources Information Center

Garret, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy

2014-01-01

It is the position of the National Association of School Nurses (NASN) that registered school nurses (hereinafter referred to as school nurses) are integral to the team planning process necessary to successfully integrate "service animals" into schools. A request to bring a service animal into the school setting presents questions due to…

Organizational Change, Absenteeism, and Welfare Dependency

ERIC Educational Resources Information Center

Roed, Knut; Fevang, Elisabeth

2007-01-01

Based on Norwegian register data, we set up a multivariate mixed proportional hazard model (MMPH) to analyze nurses' pattern of work, sickness absence, nonemployment, and social insurance dependency from 1992 to 2000, and how that pattern was affected by workplace characteristics. The model is estimated by means of the nonparametric…

75 FR 29818 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... computers used with the particular project are available to authorized personnel only. Records on... Research and Development Project Records--VA'' (34VA12) as set forth in the Federal Register 40 FR 38095... include electronic or other databases containing research information developed during a research project...

Medication Administration in Schools. Position Statement. Revised

ERIC Educational Resources Information Center

Hinkson, Elizabeth; Mauter, Elaine; Wilson, Louise; Johansen, Annette; Maughan, Erin D.

2017-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) be responsible for medication administration in the school setting, leading the development of written medication administration policies and procedures that focus on safe and efficient…

1 CFR 2.1 - Scope and purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Scope and purpose. 2.1 Section 2.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL GENERAL INFORMATION § 2.1 Scope and purpose. (a) This chapter sets forth the policies, procedures, and delegations under which the...

1 CFR 2.1 - Scope and purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Scope and purpose. 2.1 Section 2.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL GENERAL INFORMATION § 2.1 Scope and purpose. (a) This chapter sets forth the policies, procedures, and delegations under which the...

1 CFR 2.1 - Scope and purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Scope and purpose. 2.1 Section 2.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL GENERAL INFORMATION § 2.1 Scope and purpose. (a) This chapter sets forth the policies, procedures, and delegations under which the...

77 FR 38865 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

...) (17 CFR 240.17Ad-4) is used to document when transfer agents are exempt, or no longer exempt, from the minimum performance standards and certain recordkeeping provisions of the Commission's transfer agent rules. Rule 17Ad-4(c) sets forth the conditions under which a registered transfer agent loses its exempt...

Study protocol to a nationwide prospective cohort study on return to gainful occupation after stroke in Denmark 1996 - 2006

PubMed Central

2010-01-01

Background Successful return to work is regarded as one of the most important outcome factors for working-age post stroke patients. The present study will estimate the effect of various predictors on the odds of returning to work after stroke. Nearly twenty thousand 20-57 year-old stroke patients in Denmark who were gainfully occupied prior to the stroke will be included in the study. Methods/design Stroke patients will be followed prospectively through national registers. Multi-level logistic regression will be used to model the odds of being gainfully occupied ca. two years after the stroke as a function of the following predictors: Age (20-49 years, 50-57 years) gender, occupational class, self-employment (yes; no), onset calendar year (1996, 1997, ..., 2006), diagnosis (subarachnoid haemorrhage; intracerebral haemorrhage; cerebral infarction; stroke, not specified as haemorrhage or infarction) and 'type of municipality' (the variable is set to 1 if the person lived in a municipality which had a brain injury rehabilitation centre at the time of the stroke. Otherwise it is set to 0). Municipalities will be treated as the subjects while individual observations within municipalities are treated as correlated repeated measurements. Discussion Since our follow-up is done through registers and all people in the target population are included, the study is free from sampling bias, recall bias and non-response bias. The study is also strengthened by its size. The major weakness of the study is that it does not contain any stroke severity measures. Thus, it cannot accurately predict whether a particular stroke patient will in fact return to work. The study is, however, quite useful from a public health perspective. It can be used to estimate the proportion of patients in a certain group that is expected to return to work, and thereby provide a comparison material, which e.g. municipalities can use to evaluate their success in returning their stroke patients to work. PMID:20958997

Seventy Years of RN Effectiveness: A Database Development Project to Inform Best Practice.

PubMed

Lulat, Zainab; Blain-McLeod, Julie; Grinspun, Doris; Penney, Tasha; Harripaul-Yhap, Anastasia; Rey, Michelle

2018-03-23

The appropriate nursing staff mix is imperative to the provision of quality care. Nurse staffing levels and staff mix vary from country to country, as well as between care settings. Understanding how staffing skill mix impacts patient, organizational, and financial outcomes is critical in order to allow policymakers and clinicians to make evidence-informed staffing decisions. This paper reports on the methodology for creation of an electronic database of studies exploring the effectiveness of Registered Nurses (RNs) on clinical and patient outcomes, organizational and nurse outcomes, and financial outcomes. Comprehensive literature searches were conducted in four electronic databases. Inclusion criteria for the database included studies published from 1946 to 2016, peer-reviewed international literature, and studies focused on RNs in all health-care disciplines, settings, and sectors. Masters-prepared nurse researchers conducted title and abstract screening and relevance review to determine eligibility of studies for the database. High-level analysis was conducted to determine key outcomes and the frequency at which they appeared within the database. Of the initial 90,352 records, a total of 626 abstracts were included within the database. Studies were organized into three groups corresponding to clinical and patient outcomes, organizational and nurse-related outcomes, and financial outcomes. Organizational and nurse-related outcomes represented the largest category in the database with 282 studies, followed by clinical and patient outcomes with 244 studies, and lastly financial outcomes, which included 124 studies. The comprehensive database of evidence for RN effectiveness is freely available at https://rnao.ca/bpg/initiatives/RNEffectiveness. The database will serve as a resource for the Registered Nurses' Association of Ontario, as well as a tool for researchers, clinicians, and policymakers for making evidence-informed staffing decisions. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Development and pilot phase of a European MS register.

PubMed

Flachenecker, Peter; Khil, Laura; Bergmann, Sverrir; Kowalewski, Mariusz; Pascu, Ion; Pérez-Miralles, Francisco; Sastre-Garriga, Jaume; Zwingers, Thomas

2010-10-01

The MS-ID (Multiple Sclerosis Information Dividend) project was initiated by the European Multiple Sclerosis Platform (EMSP) in 2007 in order to identify and address major inequalities of MS treatment and care and thus eliminate disparities across the EU. One major approach to reach these goals in the longer term is the implementation of a European MS register for MS. The feasibility of an EU MS register was piloted among five countries (Germany, Iceland, Poland, Romania and Spain). Each country liaised with one documentation centre. Countries and test centres were both chosen in a way that a heterogeneous health care structure was provided. After reaching consensus about the data set, comprehension and acceptability of the two questionnaires-representing both the physician's and the patient's perspective-were tested with 20 MS patients in each country. In a 6-month data collection period, data from 547 patients were recorded. Most sections of the questionnaires were available for more than 90% of patients. The results obtained from the pilot phase of the European MS register indicate that it is feasible to collect standardized data across Europe. Thus, the European MS register may be a valuable instrument to compare treatment and care of MS across countries, estimate the cost of MS in Europe and monitor the implementation of and adherence to guidelines. It may help to reduce the disparities in MS care and treatment throughout Europe and eventually improve the quality of life of people with MS.

The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data.

PubMed

Stewart, Robert; Soremekun, Mishael; Perera, Gayan; Broadbent, Matthew; Callard, Felicity; Denis, Mike; Hotopf, Matthew; Thornicroft, Graham; Lovestone, Simon

2009-08-12

Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre (BRC) Case Register Interactive Search tool (CRIS) which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements). Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756) category followed by schizophrenia and related disorders (8158), substance misuse (7749), neuroses (7105) and organic disorders (6414). The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards.

Establishment of alien registration requirements, 7 January 1988.

PubMed

1988-01-01

On 7 January 1988, the Immigration Commissioner of the Philippines announced that all temporary or permanent aliens resident in the Philippines were required to register with the Commission on Immigration and Deportation in order to legalize their stay in the country. Those who failed to register by a March deadline were subject to immediate deportation. The Commission also set a P500,000 reward for those giving information on the whereabouts of overstaying or undesirable aliens. Effective 21 November 1988, President Corazon Aquino ordered the alien legalization program to be suspended. See Manila Radio Veritas, 18 November 1988; Foreign Broadcast Information Service, FBIS-EAS-88-224, 21 November 1988, p. 41. full text

Assessing patients' eligibility for fully funded nursing care.

PubMed

Anderson, William; Bungay, Hilary

The introduction of free nursing care in nursing homes requires that patients' needs for care from a registered nurse are determined as part of the assessment of health and social care needs. It is important that patients are assigned to the band of care that is appropriate for them so that they receive the correct contribution to their care. A minimum data set/resident assessment instrument was piloted on residents living in nursing homes as an assessment tool to see whether this agreed with decisions that had been made by the NHS-designated assessor for the registered nursing contribution to care. Comparison of findings showed that the assessment tool was a means of improving the quality of assessments.

The role of the nurse executive in fostering and empowering the advanced practice registered nurse.

PubMed

Talbert, Tukea L

2012-06-01

The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders. Copyright © 2012 Elsevier Inc. All rights reserved.

A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study.

PubMed

Thakur, Elyse R; Shapiro, Jordan; Chan, Johanna; Lumley, Mark A; Cully, Jeffrey A; Bradford, Andrea; El-Serag, Hashem B

2018-05-10

Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear. To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics. We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included. We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12-43) to controls (average n = 25.4 patients; range 12-47), whereas one study compared two active "bonafide" interventions. Psychological treatments varied (cognitive-behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments. Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.

Finnish Prenatal Study of Bipolar Disorders (FIPS-B): overview, design and description of the sample.

PubMed

Chudal, Roshan; Sucksdorff, Dan; Suominen, Auli; Lehti, Venla; Hinkka-Yli-Salomäki, Susanna; Huttunen, Jukka; Ristkari, Terja; Gissler, Mika; McKeague, Ian W; Brown, Alan S; Sourander, Andre

2014-04-01

Bipolar disorders (BPD) are chronic mental illnesses, the development of which involves genetic factors and environmental influences. The aim of this paper is to provide an overall description of the Finnish Prenatal Study of Bipolar Disorders (FIPS-B), including the study design, national registers and linkage of the registers. FIPS-B is a population-based prenatal epidemiological study of BPD with a nested case-control study design using several national registers. The registers used are: the Finnish Medical Birth Register (FMBR), the Finnish Hospital Discharge Register (FHDR), the Population Central Register and the Finnish Maternity Cohort (FMC), which are linked using the unique personal identity code (PIC). FIPS-B includes all children born from January 1, 1983 to December 31, 1998 and diagnosed with BPD in Finland by December 31, 2008. The total number of cases included in the FIPS-B is 1887. The age at first diagnosis ranged from 4 to 25 years. Half (50.4%) of the cases utilized only outpatient services, 12.7% only inpatient services and the rest (36.9%) utilized both services. Offspring of mothers with the lowest educational level had an increased odds of BPD (OR = 1.46, 95% CI 1.13-1.88). The cumulative incidence of BPD in the population aged 25 years or younger was 11.6/10,000 in 2008. FIPS-B has all the strengths of a register-based prenatal epidemiological study, along with the availability of maternal biomarkers, enabling it to examine several prenatal, perinatal and familial risk factors for BPD.

Simulation of n-qubit quantum systems. IV. Parametrizations of quantum states, matrices and probability distributions

NASA Astrophysics Data System (ADS)

Radtke, T.; Fritzsche, S.

2008-11-01

Entanglement is known today as a key resource in many protocols from quantum computation and quantum information theory. However, despite the successful demonstration of several protocols, such as teleportation or quantum key distribution, there are still many open questions of how entanglement affects the efficiency of quantum algorithms or how it can be protected against noisy environments. The investigation of these and related questions often requires a search or optimization over the set of quantum states and, hence, a parametrization of them and various other objects. To facilitate this kind of studies in quantum information theory, here we present an extension of the FEYNMAN program that was developed during recent years as a toolbox for the simulation and analysis of quantum registers. In particular, we implement parameterizations of hermitian and unitary matrices (of arbitrary order), pure and mixed quantum states as well as separable states. In addition to being a prerequisite for the study of many optimization problems, these parameterizations also provide the necessary basis for heuristic studies which make use of random states, unitary matrices and other objects. Program summaryProgram title: FEYNMAN Catalogue identifier: ADWE_v4_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADWE_v4_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 24 231 No. of bytes in distributed program, including test data, etc.: 1 416 085 Distribution format: tar.gz Programming language: Maple 11 Computer: Any computer with Maple software installed Operating system: Any system that supports Maple; program has been tested under Microsoft Windows XP, Linux Classification: 4.15 Does the new version supersede the previous version?: Yes Nature of problem: During the last decades, quantum information science has contributed to our understanding of quantum mechanics and has provided also new and efficient protocols, based on the use of entangled quantum states. To determine the behavior and entanglement of n-qubit quantum registers, symbolic and numerical simulations need to be applied in order to analyze how these quantum information protocols work and which role the entanglement plays hereby. Solution method: Using the computer algebra system Maple, we have developed a set of procedures that support the definition, manipulation and analysis of n-qubit quantum registers. These procedures also help to deal with (unitary) logic gates and (nonunitary) quantum operations that act upon the quantum registers. With the parameterization of various frequently-applied objects, that are implemented in the present version, the program now facilitates a wider range of symbolic and numerical studies. All commands can be used interactively in order to simulate and analyze the evolution of n-qubit quantum systems, both in ideal and noisy quantum circuits. Reasons for new version: In the first version of the FEYNMAN program [1], we implemented the data structures and tools that are necessary to create, manipulate and to analyze the state of quantum registers. Later [2,3], support was added to deal with quantum operations (noisy channels) as an ingredient which is essential for studying the effects of decoherence. With the present extension, we add a number of parametrizations of objects frequently utilized in decoherence and entanglement studies, such that as hermitian and unitary matrices, probability distributions, or various kinds of quantum states. This extension therefore provides the basis, for example, for the optimization of a given function over the set of pure states or the simple generation of random objects. Running time: Most commands that act upon quantum registers with five or less qubits take ⩽10 seconds of processor time on a Pentium 4 processor with ⩾2GHz or newer, and about 5-20 MB of working memory (in addition to the memory for the Maple environment). Especially when working with symbolic expressions, however, the requirements on CPU time and memory critically depend on the size of the quantum registers, owing to the exponential growth of the dimension of the associated Hilbert space. For example, complex (symbolic) noise models, i.e. with several symbolic Kraus operators, result for multi-qubit systems often in very large expressions that dramatically slow down the evaluation of e.g. distance measures or the final-state entropy, etc. In these cases, Maple's assume facility sometimes helps to reduce the complexity of the symbolic expressions, but more often only a numerical evaluation is possible eventually. Since the complexity of the various commands of the FEYNMAN program and the possible usage scenarios can be very different, no general scaling law for CPU time or the memory requirements can be given. References: [1] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 173 (2005) 91. [2] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 175 (2006) 145. [3] T. Radtke, S. Fritzsche, Comput. Phys. Comm. 176 (2007) 617.

Factors Influencing Female Registered Nurses' Work Behavior

PubMed Central

Brewer, Carol S; Kovner, Christine T; Wu, Yow-Wu; Greene, William; Liu, Yu; Reimers, Cordelia W

2006-01-01

Objective To analyze factors that are related to whether registered nurses (RNs) work (WK) or do not work (NW) in nursing; and if the RN works, whether she works full- (FT) or part-time (PT). Data Sources Secondary data from National Sample Survey of Registered Nurses 2000 (NSSRN), the InterStudy Competitive Edge Part III Regional Market Analysis (2001), and the Area Resource File (2002). Study Design Using a cross-sectional design we tested the relationship between WK or NW and FT or PT; and demographic, job-related, and metropolitan statistical area (MSA)-level variables. Data Collection/Extraction Methods We combined the data sources noted above to produce the analytic sample of 25,471 female RNs. Principal Findings Working in nursing is not independent of working FT or PT. Age (55 and older), other family income, and prior other work experience in health care are negatively related to working as an RN. The wage is not related to working as an RN, but negatively influences FT work. Age, children, minority status, student status, employment status, other income, and some job settings have a negative impact on working FT. Previous health care work has a positive effect on whether married RNs worked. Married RNs who are more dissatisfied are less likely to work FT. A greater number of market-level factors influence FT/PT than WK/NW behavior. Conclusions An important contribution of this study is demonstrating that MSA-level variables influence RN work behavior. The market environment seems to have little effect on whether a nurse works, but is influential on how much the nurse works, and has differential effects on married versus single nurses. PMID:16704517

Creating opportunities through mentorship, parental involvement, and safe spaces (COMPASS) program: multi-country study protocol to protect girls from violence in humanitarian settings.

PubMed

Falb, Kathryn L; Tanner, Sophie; Ward, Leora; Erksine, Dorcas; Noble, Eva; Assazenew, Asham; Bakomere, Theresita; Graybill, Elizabeth; Lowry, Carmen; Mallinga, Pamela; Neiman, Amy; Poulton, Catherine; Robinette, Katie; Sommer, Marni; Stark, Lindsay

2016-03-05

Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community. In order to understand what works to prevent violence against adolescent girls, a multi-component curriculum-based safe spaces program (Creating Opportunities through Mentorship, Parental involvement and Safe Spaces - COMPASS) will be implemented and evaluated. The objectives of this multi-country study are to understand the feasibility, acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian settings. Two wait-listed cluster-randomized controlled trials are being implemented in conflict-affected communities in eastern Democratic Republic of Congo (N = 886 girls aged 10-14 years) and in refugee camps in western Ethiopia (N = 919 girls aged 13-19 years). The intervention consists of structured facilitated sessions delivered in safe spaces by young female mentors, caregiver discussion groups, capacity-building activities with service providers, and community engagement. In Ethiopia, the research centers on the overall impact of COMPASS compared to a wait-list group. In DRC, the research objective is to understand the incremental effectiveness of the caregiver component in addition to the other COMPASS activities as compared to a wait-list group. The primary outcome is change in sexual violence. Secondary outcomes include decreased physical and emotional abuse, reduced early marriage, improved gender norms, and positive interpersonal relationships, among others. Qualitative methodologies seek to understand girls' perceptions of safety within their communities, key challenges they face, and to identify potential pathways of change. These trials will add much needed evidence for the humanitarian community to meet the unique needs of adolescent girls and to promote their safety and well-being, as well as contributing to how multi-component empowerment programming for adolescent girls could be adapted across humanitarian settings. Clinical Trials NCT02384642 (Registered: 2/24/15) & NCT02506543 (Registered: 7/19/15).

Quality of registration for clinical trials published in emergency medicine journals.

PubMed

Jones, Christopher W; Platts-Mills, Timothy F

2012-10-01

In 2005, the International Committee of Medical Journal Editors established clinical trial registration as a requirement for articles submitted to member journals, with the goal of improving the transparency of clinical research. The objective of this study is to characterize the registration of clinical trials published in emergency medicine journals. Randomized trials involving human subjects and published between June 1, 2008, and May 31, 2011 in the 5 emergency medicine journals with the highest impact factors were included. We assessed the clarity of registered primary outcomes, timing of registration relative to patient enrollment, and consistency between registered and published outcomes. Of the 123 trials included, registry entries were identified for 57 (46%). Of the 57 registered studies, 45 (79%) were registered after the initiation of subject enrollment, 9 (16%) had registered outcomes that were unclear, and 26 (46%) had discrepancies between registered and published outcomes. Only 5 studies were registered before patient enrollment with a clear primary outcome that was consistent with the published primary outcome. Annals of Emergency Medicine was the only journal in which the majority of trials were registered. Current compliance with clinical trial registration guidelines is poor among trials published in emergency medicine journals. Copyright © 2012. Published by Mosby, Inc.

Workplace bullying and subsequent psychotropic medication: a cohort study with register linkages

PubMed Central

Lallukka, Tea; Haukka, Jari; Partonen, Timo; Rahkonen, Ossi; Lahelma, Eero

2012-01-01

Objectives We aimed to examine longitudinally whether workplace bullying was associated with subsequent psychotropic medication among women and men. Design A cohort study. Setting Helsinki, Finland. Participants Employees of the City of Helsinki, Finland (n=6606, 80% women), 40–60 years at baseline in 2000–2002, and a register-based follow-up on medication. Primary and secondary outcome measures Workplace bullying comprised questions about current and earlier bullying as well as observing bullying. The Finnish Social Insurance Institution's register data on purchases of prescribed reimbursed psychotropic medication were linked with the survey data. All psychotropic medication 3 years prior to and 5 years after the baseline survey was included. Covariates included age, prior psychotropic medication, childhood bullying, occupational class, and body mass index. Cox proportional hazard models (HR, 95% CI) were fitted and days until the first purchase of prescribed psychotropic medication after baseline were used as the time axis. Results Workplace bullying was associated with subsequent psychotropic medication after adjusting for age and prior medication among both women (HR 1.51, 95% CI 1.18 to 1.93) and men (HR 2.15, 95% CI 1.36 to 3.41). Also observing bullying was associated with subsequent psychotropic medication among women (HR 1.53, 95% CI 1.25 to 1.88) and men (HR 1.92, 95% CI 1.23 to 2.99). The associations only modestly attenuated after full adjustment. Conclusions Our findings highlight the significance of workplace bullying to subsequent psychotropic medication reflecting medically confirmed mental problems. Tackling workplace bullying likely helps prevent mental problems among employees. PMID:23242240

Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis.

PubMed

van Eck van der Sluijs, Jonna F; Castelijns, Hilde; Eijsbroek, Vera; Rijnders, Cees A Th; van Marwijk, Harm W J; van der Feltz-Cornelis, Christina M

Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed. The protocol for this systematic review and meta-analysis has been registered at the International Prospective Register of Systematic Reviews (PROSPERO) on February 19th 2016: http://www.crd.york.ac.uk/PROSPERO/DisplayPDF.php?ID=CRD42016035553. Copyright © 2017 Elsevier Inc. All rights reserved.

Smallpox vaccination and all-cause infectious disease hospitalization: a Danish register-based cohort study.

PubMed

Sørup, Signe; Villumsen, Marie; Ravn, Henrik; Benn, Christine Stabell; Sørensen, Thorkild I A; Aaby, Peter; Jess, Tine; Roth, Adam

2011-08-01

There is growing evidence from observational studies and randomized trials in low-income countries that vaccinations have non-specific effects. Administration of live vaccines reduces overall child morbidity and mortality, presumably due to protection against non-targeted infections. In Denmark, the live vaccine against smallpox was phased out in the 1970s due to the eradication of smallpox. We used the phasing-out period to investigate the effect of smallpox vaccination on the risk of hospitalization for infections. From the Copenhagen School Health Records Register, a cohort of 4048 individuals was sampled, of whom 3559 had information about receiving or not receiving smallpox vaccination. Infectious disease hospitalizations were identified in the Danish National Patient Register. During 87,228 person-years of follow-up, 1440 infectious disease hospitalizations occurred. Smallpox-vaccinated individuals had a reduced risk of all-cause infectious disease hospitalization compared with smallpox-unvaccinated individuals [hazard ratio (HR) 0.84; 95% confidence interval (CI) 0.72-0.98]. The reduced risk of hospitalizations was seen for most subgroups of infectious diseases. The effect may have been most pronounced after early smallpox vaccination (vaccination age <3.5 years: HR 0.81; 95% CI 0.69-0.95; vaccination age ≥ 3.5 years: HR 0.91 95% CI 0.76-1.10). Among the smallpox-vaccinated, the risk of infectious disease hospitalization increased 6% with each 1-year increase in vaccination age (HR 1.06; 95% CI 1.02-1.10). Smallpox vaccination is associated with a reduced risk of infectious disease hospitalization in a high-income setting.

Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

PubMed

Quanjel, Tessa C C; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

2017-09-06

In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+. The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results. This study will evaluate a cardiology PC+ centre using quantitative and supplementary qualitative methods. The findings of both sub-studies will fill a gap in knowledge about the effects of PC+ and in particular whether PC+ is able to pursue the Triple Aim outcomes. NTR6629 (Data registered: 25-08-2017) (registered retrospectively).

Social relations and healthcare utilisation among middle-aged and older people: study protocol for an implementation and register-based study in Denmark.

PubMed

Mikkelsen, Anne Sophie Bech; Lund, Rikke; Kristiansen, Maria

2017-11-15

While previous research establishes an association between social relations, health and use of healthcare services among older people, how to implement this knowledge in real-life settings has received much less attention. This study will explore the relationship between social relations, health and use of healthcare services in a Danish mid-life population sample. In addition, the study will explore individual and contextual factors affecting the implementation of a group-based life story intervention aimed at establishing and strengthening social relations among older people at nursing homes in Denmark. A combined quantitative register-based approach and a qualitative implementation approach will be applied in this study. First, we will quantitatively analyse the relationship between social relations, health status and use of healthcare services among middle-aged people in Denmark by linking survey data on social relations, loneliness, self-perceived health and disease status from the Copenhagen Aging and Midlife Biobank (CAMB) (n = 7191) with national registries through the Public Health Database on use of healthcare services and demographic and socioeconomic factors. Second, we will qualitatively analyse individual and contextual factors affecting the implementation process of the group-based life story intervention based on semi-structured interviews (n = 16), observations and field notes with and among intervention stakeholders, i.e., participants and group leaders facilitating the intervention. The results of this study are expected to improve knowledge about mechanisms through which social relations are associated with health status and use of healthcare services and to inform the implementation of future interventions targeting social relations among older people at nursing homes. The study has been registered and approved by the Danish Data Protection Agency. Seperate approvals have been attained for the qualitative data (Approval No. SUND-2016-08), and for the quantitative data in the CAMB database which has also received approval from the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814, respectively).

Ongoing university studies and the risk of suicide: a register-based nationwide cohort study of 5 million young and middle-aged individuals in Sweden, 1993–2011

PubMed Central

Lageborn, Christine Takami; Vaez, Marjan; Dahlin, Marie

2017-01-01

Objectives To investigate the risk of suicide, unnatural death and all-cause death in university students compared with non-students, taking previous educational attainment into account. Design Open cohort study of all residents aged 18–39 and living in Sweden at any time between 1 January 1993 and 31 December 2011. Setting We linked data from national registers and calculated person-years during university studies for three time periods (1993–1999, 2000–2005 and 2006–2011). Time as non-student was calculated and categorised according to attained educational level. Incidence rate ratios (IRR) with 95% CIs were calculated with Poisson regression models, controlling for age and period. Participants The cohort consisted of 5 039 419 individuals, 51% men and 49% women. Main outcome measures Incidence of suicide (International Classification of Diseases (ICD)-9: E950–E959, ICD-10: X60–X84) or death with undetermined intent (ICD-9: E980-E989, ICD-10: Y10-Y34), unnatural death (ICD-9: E800-E999 and ICD-10: V01-Y99) and all-cause death. Results A total of 7316 deaths due to suicide were identified, of which 541 were registered among university students. The risk of suicide was twofold during ongoing university studies compared with when having attained university education, IRR 2.37 (95% CI 2.07 to 2.72) in men and IRR 2.15 (95% CI 1.77 to 2.61) in women. Conclusions Having ongoing university studies was associated with a higher risk of suicide compared with having attained university-level education. This finding highlights the importance of achieving a deeper understanding of suicidal behaviour during years at university. Further studies should assess risk factors for suicide and suicidal behaviour in university students. PMID:28363927

Knowledge Confidence and Desire for Further Diabetes-Management Education among Nurses and Personal Support Workers in Long-Term Care.

PubMed

Vincent, Corita; Hall, Peter; Ebsary, Sally; Hannay, Scott; Hayes-Cardinal, Lynn; Husein, Nadira

2016-06-01

Diabetes care in the long-term care (LTC) setting is complicated by increased prevalence of comorbidities, age-related changes in medication tolerance, frailty and limited resources. Registered nurses (RNs), registered practical nurses (RPNs) and personal support workers (PSWs) are responsible for front-line diabetes care; however, there is limited formal diabetes education in this setting. The current study aimed to assess the knowledge confidence and desire for additional diabetes education among nurses and PSWs in the LTC setting. We studied 89 RNs, RPNs and PSWs (Mage=43.6, 94.3% female) in 2 LTC facilities in the Kitchener-Waterloo area who participated in an online survey assessing knowledge and confidence in 6 key areas of diabetes care (nutrition, insulin, oral medications, hypoglycemia, hyperglycemia and sick-day management). Interest in further diabetes education was also explored. Self-rated knowledge and confidence were generally moderate to high, ranging from 46% to 79% being moderately to very knowledgeable and from 61% to 74% being moderately to very confident. Knowledge and confidence was highest for nutrition and management of hypo- and hyperglycemia and lower for sick-day management, oral medications and insulin. There were significant differences between clinicians such that PSWs reported less knowledge and confidence than RNs and RPNs on most parameters. Among the whole sample, 85% wanted education about diabetes, and this rate did not vary by occupation. The most commonly reported areas for additional education concerning diabetes were for management of hypo- and hyperglycemia (30% to 31%) and insulin (31%). Overall, the findings indicate moderate levels of self-rated knowledge across diabetes care areas; however, most clinicians feel there is room for more diabetes-care education, particularly regarding insulin and management of hypo- and hyperglycemia. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Thai health education program for improving TB migrant's compliance.

PubMed

Khortwong, Pornsak; Kaewkungwal, Jaranit

2013-03-01

Investigate the effectiveness of health education programs by using the PRECEDE-PROCEED Model to improve non-Thai migrant TB patient's compliance during treatment. This quasi-intervention study was conducted in three targeted hospitals, between August 2009 and December 2010. The study sample consisted of 100 cases, 50 cases who registered in Samutsakorn Province served as the intervention group and 50 cases who registered in Samutprakarn Province served as the control group. At the end of the health education intervention, the intervention group showedsignificantly improved health-behavior scores in nine domains-health promotion, health education, predisposing, reinforcing, enabling factors, behavior and lifestyle, environment, and health status, which were also significantly higher than the control group (p < 0.001). The percentage of patients achieving successful treatment outcomes was 76% in the intervention group and 62% in the control group. The tuberculosis treatment and care program, and the associated health education interventions enabled migrants to complete the treatment regimen and achieve treatment success. It could also help TB staff develop an appropriate program and clear understanding of TB control among migrants. It is recommended that this type of information and health education program be used in other hospitals and healthcare settings providing TB services for migrants throughout the nation.

Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting.

PubMed

Hennerby, Cathy; Joyce, Pauline

2011-03-01

This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. The increased number of registered general agency nurses working in an acute children's hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about 'near misses', parental dissatisfaction, perceived competency weaknesses and rising cost associated with their use. [Young's (2009) Journal of Organisational Change, 22, 524-548] nine-stage change framework was used to guide the implementation of the competency assessment tool within a paediatric acute care setting. The ongoing success of the initiative, from a nurse manager's perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managers' persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health

PubMed Central

Gissler, M; Merilainen, J; Vuori, E; Hemminki, E

2003-01-01

Study objective: Several studies on differences in infant outcome by socioeconomic position have been done, but these have usually been based on ad hoc data linkages. The aim of this paper was to investigate whether socioeconomic differences in perinatal health in Finland could be regularly monitored using routinely collected data from one single register. Design and setting: Since October 1990, the Finnish Medical Birth Register (MBR) has included data on maternal occupation. A special computer program that converted the occupation name into an occupational code and into a socioeconomic position was prepared. Perinatal health was measured with five different indicators. The Finnish MBR data for years 1991 to 1999 (n=565 863 newborns) were used in the study. The study period was divided into three, three year periods to study time trends. Results: An occupational code was derived for 95% of women, but it was not possible to define a socioeconomic position for 22% of women, including, for example, students and housewives (the group "Others"). For the rest, the data showed socioeconomic differences in all perinatal health indicators. Maternal smoking explained up to half of the excess risk for adverse perinatal outcome in the lowest socioeconomic group. The socioeconomic differences narrowed during the 1990s: infant outcome improved in the lowest socioeconomic group, but remained at the same level or even deteriorated in other groups. When comparing the lowest group with the highest group, the odds ratios (OR) adjusted for maternal background characteristics at least halved for prematurity (from 1.32 (95% confidence intervals 1.24 to 1.43) in 1991–1993 to 1.16 (1.08 to 1.25) in 1997–1999), for low birth weight (from 1.49 (1.36 to 1.63) to 1.25 (1.17 to 1.40)), and for perinatal mortality (from 1.79 (1.44 to 2.21) to 1.33 (1.07 to 1.66)). Conclusions: Social inequality in perinatal health outcomes exists in Finland, but seems to have diminished in the 1990s. These data showed that routinely collected birth register data provide a good source for studies on socioeconomic health differences in the perinatal period, but that uncertainty, mainly attributable to the large group of women with difficult to classify socioeconomic status, remains. PMID:12775790

Frequency of postlicensure registered nurse boundary violations with patients in the state of Ohio: a comparison based on type of prelicensure registered nurse education.

PubMed

Jones, Jeffrey S; Fitzpatrick, Joyce J; Drake, Virginia K

2008-12-01

Nurse-Patient boundary violations remain a problem. Efforts to address the problem through postlicensure education and stronger disciplinary measures are well documented. However, efforts to understand this problem based on prelicensure components are less studied. Using data from The Ohio Board of Nursing from 2002 to 2006, the difference in frequency of incidents of violations between associate degree-prepared registered nurses and baccalaureate degree-prepared registered nurses was studied. A statistically significant difference was found through chi-square analysis: Associate degree-prepared nurses had higher frequency of boundary violations. Further studies on prelicensure curricular influences on registered nurses' postlicensure behavior, particularly in relation to curricular content focused on interpersonal skill development, are recommended.

Registered Nurses' views on their professional role.

PubMed

Furåker, Carina

2008-11-01

The aim is to study Registered Nurses' opinions and reflections about their work tasks, competence and organization in acute hospital care. The definition of the role of nurses has changed over time and it is often discussed whether Registered Nurses have a professional status or not. A qualitative research design was used. Data were derived from written reflections on diaries and from focus group interviews. All respondents had difficulties in identifying the essence of their work. It can be argued that being 'a spider in the web' is an important aspect of the nursing profession. Registered Nurses tend to regard their professional role as vague. Managers must be considered key persons in defining the professional role of Registered Nurses. This study contributes to an understanding of the managers' and the importance of nursing education in Registered Nurses professional development.

a Discussion about Effective Ways of Basic Resident Register on GIS

NASA Astrophysics Data System (ADS)

Oku, Naoya; Nonaka, Yasuaki; Ito, Yutaka

2016-06-01

In Japan, each municipality keeps a database of every resident's name, address, gender and date of birth called the Basic Resident Register. If the address information in the register is converted into coordinates by geocoding, it can be plotted as point data on a map. This would enable prompt evacuation from disaster, analysis of distribution of residents, integrating statistics and so on. Further, it can be used for not only analysis of the current situation but also future planning. However, the geographic information system (GIS) incorporating the Basic Resident Register is not widely used in Japan because of the following problems: - Geocoding In order to plot address point data, it is necessary to match the Basic Resident Register and the address dictionary by using the address as a key. The information in the Basic Resident Register does not always match the actual addresses. As the register is based on applications made by residents, the information is prone to errors, such as incorrect Kanji characters. - Security policy on personal information In the register, the address of a resident is linked with his/her name and date of birth. If the information in the Basic Resident Register were to be leaked, it could be used for malicious purposes. This paper proposes solutions to the above problems. The suitable solutions for the problems depend on the purpose of use, thus it is important that the purpose should be defined and a suitable way of the application for each purpose should be chosen. In this paper, we mainly focus on the specific purpose of use: to analyse the distribution of the residents. We provide two solutions to improve the matching rate in geocoding. First, regarding errors in Kanji characters, a correction list of possible errors should be compiled in advance. Second, some sort of analyses such as distribution of residents may not require exactly correct position for the address point. Therefore we set the matching level in order: prefecture, city, town, city-block, house-code, house, and decided to accept up to city-block level for the matching. Moreover, in terms of security policy on personal information, some part of information may not be needed for the distribution analysis. For example, the personal information like resident's name should be excluded from the attribute of address point in order to secure the safety operation of the system.

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

PubMed

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

2017-10-01

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

Architectural-level power estimation and experimentation

NASA Astrophysics Data System (ADS)

Ye, Wu

With the emergence of a plethora of embedded and portable applications and ever increasing integration levels, power dissipation of integrated circuits has moved to the forefront as a design constraint. Recent years have also seen a significant trend towards designs starting at the architectural (or RT) level. Those demand accurate yet fast RT level power estimation methodologies and tools. This thesis addresses issues and experiments associate with architectural level power estimation. An execution driven, cycle-accurate RT level power simulator, SimplePower, was developed using transition-sensitive energy models. It is based on the architecture of a five-stage pipelined RISC datapath for both 0.35mum and 0.8mum technology and can execute the integer subset of the instruction set of SimpleScalar . SimplePower measures the energy consumed in the datapath, memory and on-chip buses. During the development of SimplePower , a partitioning power modeling technique was proposed to model the energy consumed in complex functional units. The accuracy of this technique was validated with HSPICE simulation results for a register file and a shifter. A novel, selectively gated pipeline register optimization technique was proposed to reduce the datapath energy consumption. It uses the decoded control signals to selectively gate the data fields of the pipeline registers. Simulation results show that this technique can reduce the datapath energy consumption by 18--36% for a set of benchmarks. A low-level back-end compiler optimization, register relabeling, was applied to reduce the on-chip instruction cache data bus switch activities. Its impact was evaluated by SimplePower. Results show that it can reduce the energy consumed in the instruction data buses by 3.55--16.90%. A quantitative evaluation was conducted for the impact of six state-of-art high-level compilation techniques on both datapath and memory energy consumption. The experimental results provide a valuable insight for designers to develop future power-aware compilation frameworks for embedded systems.

Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality

PubMed Central

2012-01-01

Background Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1). The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5) % and 58.5 (95% CI: 51.1 – 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6) % and 98.9 (95% CI: 98.3 – 99.3) %. Conclusions The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week. PMID:22894644

Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality.

PubMed

Stapelfeldt, Christina Malmose; Jensen, Chris; Andersen, Niels Trolle; Fleten, Nils; Nielsen, Claus Vinther

2012-08-15

Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 - 95.5) % and 58.5 (95% CI: 51.1 - 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 - 88.6) % and 98.9 (95% CI: 98.3 - 99.3) %. The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.

Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway

PubMed Central

Feiring, Berit; Laake, Ida; Molden, Tor; Cappelen, Inger; Håberg, Siri E; Magnus, Per; Steingrímsdóttir, Ólöf Anna; Strand, Bjørn Heine; Stålcrantz, Jeanette; Trogstad, Lill

2015-01-01

Objective Vaccine against human papillomavirus (HPV) has been offered free of charge to all 12-year-old girls in Norway since 2009. Nevertheless, the uptake of HPV vaccine is lower than for other childhood vaccines. The aim of this study was to examine whether parental education and income are associated with initiation and completion of HPV vaccination. Design Nationwide register-based study. Setting Publicly funded childhood immunisation programme in Norway. Participants 91 405 girls born between 1997 and 1999 and registered in the Norwegian Central Population Registry were offered HPV vaccine during the first 3 programme years. Of these, 84 139 had complete information on all variables and were included in the study. Measurements Information on HPV-vaccination status was obtained from the Norwegian Immunisation Registry. Data on socioeconomic factors were extracted from Statistics Norway. Risk differences (RDs) and CIs were estimated with Poisson regression. Results In the study sample, 78.3% received at least one dose of HPV vaccine and 73.6% received all three doses. High maternal education was significantly associated with lower probability of initiating HPV vaccination (multivariable RD=−5.5% (95% CI −7.0% to −4.0%) for highest compared with lowest education level). In contrast, high maternal income was significantly associated with higher probability of initiating vaccination (multivariable RD=10.1% (95% CI 9.0% to 11.3%) for highest compared with lowest quintile). Paternal education and income showed similar, but weaker, associations. The negative association between education and initiation was only seen for incomes below the median value. Conclusions In spite of the presumably equal access to HPV vaccine in Norway, we found socioeconomic disparities in vaccine uptake. More studies are needed to explain the underlying factors responsible for the observed socioeconomic differences. Insight into these factors is necessary to target information and increase vaccination coverage to ultimately reduce HPV-related disease across socioeconomic barriers. PMID:25991445

Demographic factors affect willingness to register as an organ donor more than a personal relationship with a transplant candidate

PubMed Central

Regalia, Kirsten; Zheng, Patricia; Sillau, Stefan; Aggarwal, Anuj; Bellevue, Oliver; Fix, Oren K.; Prinz, Jennifer; Dunn, Susan; Biggins, Scott W.

2014-01-01

Background Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation. Aim To assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs). Methods A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor. Results In Denver, 83% of TCCs vs 68% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender (OR 2.4), Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p<0.05. In San Francisco, 58% of TCCs vs 70% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p<0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register. Conclusions Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor. PMID:24519521

Examining the accuracy of foodservice in a hospital setting.

PubMed

Glover, N S; Keane, T M

1984-09-01

Although a great deal of research has been conducted to determine the appropriate diets for the prevention and treatment of various illnesses, there is very little in the literature about research that directly assesses the accuracy of the prescribed diets served to patients in a hospital setting. The present study was designed to evaluate the accuracy of meals served to patients by identifying critical errors and more general errors on trays about to be served. The results indicated that the error rate was greater on weekends and holidays than during the week. Significantly, a correlational analysis revealed that error rate was inversely related to the total number of foodservice supervisors and more specifically to the number of food production supervisors and registered dietitians present. The implications of the results for possible interventions and training are discussed.

The science is in the data.

PubMed

Helliwell, John R; McMahon, Brian; Guss, J Mitchell; Kroon-Batenburg, Loes M J

2017-11-01

Understanding published research results should be through one's own eyes and include the opportunity to work with raw diffraction data to check the various decisions made in the analyses by the original authors. Today, preserving raw diffraction data is technically and organizationally viable at a growing number of data archives, both centralized and distributed, which are empowered to register data sets and obtain a preservation descriptor, typically a 'digital object identifier'. This introduces an important role of preserving raw data, namely understanding where we fail in or could improve our analyses. Individual science area case studies in crystallography are provided.

The science is in the data

PubMed Central

Kroon-Batenburg, Loes M. J.

2017-01-01

Understanding published research results should be through one’s own eyes and include the opportunity to work with raw diffraction data to check the various decisions made in the analyses by the original authors. Today, preserving raw diffraction data is technically and organizationally viable at a growing number of data archives, both centralized and distributed, which are empowered to register data sets and obtain a preservation descriptor, typically a ‘digital object identifier’. This introduces an important role of preserving raw data, namely understanding where we fail in or could improve our analyses. Individual science area case studies in crystallography are provided. PMID:29123672

Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden.

PubMed

Gunningberg, Lena; Mårtensson, Gunilla; Mamhidir, Anna-Greta; Florin, Jan; Muntlin Athlin, Åsa; Bååth, Carina

2015-08-01

The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes 'nutrition' (83·1%) and 'risk assessment' (75·7%). The lowest scores were found in the themes 'reduction in the amount of pressure and shear' (47·5%) and 'classification and observation' (55·5%). RNs and SNs had higher scores than ANs on 'aetiology and causes'. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Career Consultation and Experiential Learning in a Classroom Setting

ERIC Educational Resources Information Center

Parks, Rodney L.; Rich, Jonathan W.; Getch, Yvette Q.

2012-01-01

This paper is presented as a conceptual practice analysis of an experiential learning activity that took place during the fall 2011 academic term. Graduate students registered in a graduate-level career counseling course at a major Southeastern university were given the opportunity to conduct one-on-one career consultations with students enrolled…

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

76 FR 41186 - Salmonella Verification Sampling Program: Response to Comments on New Agency Policies and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... Service [Docket No. FSIS-2008-0008] Salmonella Verification Sampling Program: Response to Comments on New... establishments that participate in SIP. The Agency intends to conduct its own unannounced, small- set sampling to... considering publishing verification sampling results for other product classes. In the 2006 Federal Register...

20 CFR 10.518 - Does OWCP provide services to help employees return to work?

Code of Federal Regulations, 2010 CFR

2010-04-01

... rehabilitation services as authorized by 5 U.S.C. 8104. These services include assistance from registered nurses working under the direction of OWCP. Among other things, these nurses visit the worksite, ensure that the... setting. The nurses do not evaluate medical evidence; OWCP claims staff perform this function. (b...

Allergy/Anaphylaxis Management in the School Setting. Position Statement. Revised

ERIC Educational Resources Information Center

Zacharski, Susan; DeSisto, Marie; Pontius, Deborah; Sheets, Jodi; Richesin, Cynthia

2012-01-01

It is the position of the National Association of School Nurses (NASN) that the safe and effective management of allergies and anaphylaxis in schools requires a collaborative, multidisciplinary team approach. The registered professional school nurse (hereinafter referred to as the school nurse), is the leader in a comprehensive management approach…

30 CFR 730.11 - Inconsistent and more stringent State laws and regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulations. 730.11 Section 730.11 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... Register setting forth the text or a summary of any State law or regulation initially determined by him to... stringent land use and environmental controls and regulations of coal exploration and surface coal mining...

An Investigation of the Lived Experiences of Registered Nurses Facilitating Supernumerary Nursing Students.

ERIC Educational Resources Information Center

O'Callaghan, Nora; Slevin, Eamonn

2003-01-01

Interviews with 10 Irish nurses supervising student nurses in clinical placements revealed different interpretations of students' status in clinical settings. They viewed their role as facilitative. Although the experience was rewarding, they felt ill prepared for it. They approved the move to higher education for nurses, although most had not…

77 FR 19015 - Announcement of Requirements and Registration for Beat Down Blood Pressure Challenge

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... Down Blood Pressure Challenge AGENCY: Office of the National Coordinator for Health Information... Register (77 FR 17060) announcing requirements and registration for a Beat Down Blood Pressure Video... you to visit http://BloodPressure.Challenge.gov for a complete set of rules and requirements for this...

The Recruitment and Retention of People with Disabilities. Report 301.

ERIC Educational Resources Information Center

Dench, S.; And Others

A British survey of employers examined the recruitment and retention of people with disabilities (PWDs). Telephone interviews were conducted with two samples of employers: a random sample of 1,250 and a sample of 250 registered users of the Employment Service's "Disability Symbol," which sets a good practice standard for the employment…

Developing case managers for chronically ill children: Florida's registered nurse specialist program.

PubMed

Urbano, M T; vonWindeguth, B; Siderits, P; Parker, J; Studenic-Lewis, C

1991-01-01

This article describes the Florida Health and Rehabilitative Services/Children's Medical Services Nurse Specialist Program. This program is a statewide training and service delivery system designed to prepare selected nurses to provide comprehensive, family-centered case management services to children with special health care needs, within the home and community settings.

77 FR 22632 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-16

...--Repository (SCIDO-R)-VA'' (108VA11S) as set forth in the Federal Register 74 FR 11185-11186 dated March 16.... SUPPLEMENTARY INFORMATION: The Spinal Cord Injury and Disorders Outcomes--Repository (SCIDO-R) provides a registry of veterans with spinal cord injury and disorders (SCI&D). This repository contains pertinent...

75 FR 21666 - Canadian Standards Association; Application for Expansion of Recognition

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... provides its final decision on the application. These notices set forth the NRTL's scope of recognition or... . Each NRTL's scope of recognition has three elements: (1) The type of products the NRTL may test, with.... OSHA will publish a public notice of this final decision in the Federal Register. Authority and...

75 FR 72873 - Privacy Act Of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

...) is amending two existing systems of records 121VA19, ``National Patient Databases--VA'', and 136VA19E... being amended for additional databases. DATES: Comments on the amendment of these systems of records... system identified as 121VA19, ``National Patient Databases--VA,'' as set forth in the Federal Register...

75 FR 2105 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... Inspector General Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical... Register notice sets forth the recently issued OIG Updated Special Fraud Alert addressing telemarketing by durable medical equipment (DME) suppliers. For the most part, OIG Special Fraud Alerts address national...

Ethical environment: reports of practicing nurses.

PubMed

McDaniel, C

1998-06-01

Reports from the development of the Ethics Environment Questionnaire identify three critical features for ethical environments in health care settings of registered nurses. They are the ability of nurses to engage in discussions about patient care, support from administrators, and the development of policies-procedures that support their practice. Implications for clinical practicing nurses are explored.

1 CFR 11.3 - Code of Federal Regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Code of Federal Regulations. 11.3 Section 11.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL... complete set of the Code of Federal Regulations is $1,019 per year for the bound, paper edition, or $247...

40 CFR 147.550 - State-administered program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... was approved by the Director of the OFR in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies... was published in the Federal Register on April 19, 1984 (49 FR 15553); the effective date of this...'s program application: (a) Incorporation by reference. The requirements set forth in the State...

Injury rate as an indicator of business success.

PubMed

Holizki, Theresa; Nelson, Larry; McDonald, Rose

2006-01-01

Health and safety professionals and organizations have often suggested that promoting and improving health and safety in the workplace will improve business success. We conducted a study of all new small businesses that registered with the Workers' Compensation Board of British Columbia (WCB of BC) in the years 1993, 1995, 1996 and 1997, assessing their injury rate in the first 5 complete years of business. The data set represents 53,913 new businesses and 19,332 claims. Businesses were grouped by the number of years between registering for WCB coverage and termination of coverage. Injury rates were determined for each calendar year for each industry sector as injuries per 100 person-years, based on payroll information provided by the businesses. Across all industries, businesses that failed between 1 and 2 yr of start-up had an average injury rate of 9.71 while businesses that survived more than 5 yr had an average injury rate of only 3.89 in their first year of business (p<0.000001). The WCB of BC demonstrated a statistical correlation between health and safety in the workplace and the survival of a small business.

The effect of berberine on insulin resistance in women with polycystic ovary syndrome: detailed statistical analysis plan (SAP) for a multicenter randomized controlled trial.

PubMed

Zhang, Ying; Sun, Jin; Zhang, Yun-Jiao; Chai, Qian-Yun; Zhang, Kang; Ma, Hong-Li; Wu, Xiao-Ke; Liu, Jian-Ping

2016-10-21

Although Traditional Chinese Medicine (TCM) has been widely used in clinical settings, a major challenge that remains in TCM is to evaluate its efficacy scientifically. This randomized controlled trial aims to evaluate the efficacy and safety of berberine in the treatment of patients with polycystic ovary syndrome. In order to improve the transparency and research quality of this clinical trial, we prepared this statistical analysis plan (SAP). The trial design, primary and secondary outcomes, and safety outcomes were declared to reduce selection biases in data analysis and result reporting. We specified detailed methods for data management and statistical analyses. Statistics in corresponding tables, listings, and graphs were outlined. The SAP provided more detailed information than trial protocol on data management and statistical analysis methods. Any post hoc analyses could be identified via referring to this SAP, and the possible selection bias and performance bias will be reduced in the trial. This study is registered at ClinicalTrials.gov, NCT01138930 , registered on 7 June 2010.

Cricothyroid muscle and thyroarytenoid muscle dominance in vocal register control: preliminary results.

PubMed

Kochis-Jennings, Karen Ann; Finnegan, Eileen M; Hoffman, Henry T; Jaiswal, Sanyukta; Hull, Darcey

2014-09-01

Headmix and head registers use cricothyroid (CT) muscle dominant voicing, whereas chest and chestmix registers use thyroarytenoid (TA) muscle dominant voicing. Cross-sectional study. CT and TA electromyographic data obtained from five untrained singers and two trained singers were analyzed to determine CT and TA muscle dominance as a function of register. Simultaneous recordings of TA and CT muscle activity and audio were obtained during production of pitch glides and a variety of midrange and upper pitches in chest, chestmix, headmix, and head registers. TA dominant phonation was only observed for chest productions and headmix/head register productions below 300 Hz. All phonation above 300 Hz, regardless of register, showed CT:TA muscle activity ratios that were CT dominant or close to 1, indicating nearly equal CT and TA muscle activity. This was true for all subjects on all vocal tasks. For the subjects sampled in this study, pitch level appeared to have a greater effect on TA and CT muscle dominance than vocal register. Preliminary findings regarding CT and TA dominance and register control do not support the assumption that all chest and chestmix production has greater TA muscle activity than CT muscle activity or that all headmix and head production require greater CT muscle activity than TA muscle activity. The data indicate that pitch level may play a greater role in determining TA and CT dominance than register. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Well-informed by national registers? A comparison of national ART registers in Germany, France and the United Kingdom.

PubMed

Kadi, Selma; Wiesing, Urban

2017-12-01

National registers which document assisted reproductive technology (ART) treatments are important for a range of stakeholders. Their websites and reports are a source of information for ART practitioners, (future) patients and the public. The aim of our study was to compare national ART registers in the three European countries with the largest populations and evaluate whether ART registers currently meet the information needs of the different groups. We compared the publications of national registers in three European countries (the United Kingdom, France and Germany) with diverse regulatory approaches. Our analysis focused on two criteria: data quality and patient orientation. Our findings suggest that the German and French registers' publications fulfil the criteria to a lesser degree than the British register publications, by collecting data that are likely to be less accurate and publishing less information specifically targeted at patients. Differences in the publications and the data collection methods of the three registers impact the opportunities of various stakeholders to access information about ART from their respective national registers.

Overview of registered studies in orthodontics: Evaluation of the ClinicalTrials.gov registry.

PubMed

Allareddy, Veerasathpurush; Rampa, Sankeerth; Masoud, Mohamed I; Lee, Min Kyeong; Nalliah, Romesh; Allareddy, Veerajalandhar

2014-11-01

The Food and Drug Administration Modernization Act of 1997 made it mandatory for all phase II through IV trials regulated by this Act to be registered. After this, the National Institutes of Health created ClinicalTrials.gov, which is a registry of publicly and privately supported clinical studies of human participants. The objective of this study was to examine the characteristics of registered studies in orthodontics. The ClinicalTrials.gov Web site was used to query all registered orthodontic studies. The search term used was "orthodontics." No limitations were placed for the time period. All registered studies regardless of their recruitment status, study results, and study type were selected for analysis. A total of 64 orthodontic studies were registered as of January 1, 2014. Of these, 52 were interventional, and 12 were observational. Close to 60% of the interventional studies and 66.7% of the observational studies had sample sizes of 50 or fewer subjects. About 21.2% of the interventional studies and 16.7% of the observational studies had sample sizes greater than 100. Only 1 study was funded by the National Institutes of Health, and the rest were funded by "other" or "industry" sources. Close to 87.7% of the interventional studies were randomized. Interventional model assignments included factorial assignment (3.9%), parallel assignments (74.5%), crossover assignment (7.8%), and single-group assignment (13.7%). Most studies were treatment oriented (80.4%). The types of masking used by the interventional studies included open label (28.9%), single blind (44.2%), and double blind (26.9%). Outcome assessors were blinded in only 6 studies. Orthodontic studies registered in ClinicalTrials.gov are dominated by small single-center studies. There are wide variations with regard to treatment allocation approaches and randomization methods in the studies. These results also indicate the need for multicenter clinical studies in orthodontics. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Development of a web-based register for the Dutch national study on biologicals in JIA: www.ABC-register.nl.

PubMed

Prince, F H M; Ferket, I S; Kamphuis, S; Armbrust, W; Ten Cate, R; Hoppenreijs, E P A H; Koopman-Keemink, Y; van Rossum, M A J; van Santen-Hoeufft, M; Twilt, M; van Suijlekom-Smit, L W A

2008-09-01

Most clinical studies use paper case record forms (CRFs) to collect data. In the Dutch multi-centre observational study on biologicals we encountered several disadvantages of using the paper CRFs. These are delay in data collection, lack of overview in collected data and difficulties in obtaining up-to-date interim reports. Therefore, we wanted to create a more effective method of data collection compared with CRFs on paper in a multi-centre study. We designed a web-based register with the intention to make it easy to use for participating physicians and at the same time accurate and up-to-date. Security demands were taken into account to secure the safety of the patient data. The web-based register was tested with data from 161 juvenile idiopathic arthritis patients from nine different centres. Internal validity was obtained and user-friendliness guaranteed. To secure the completeness of the data automatically generated e-mail alerts were implemented into the web-based register. More transparency of data was achieved by including the option to automatically generate interim reports of data in the web-based register. The safety was tested and approved. By digitalizing the CRF we achieved our aim to provide easy, rapid and safe access to the database and contributed to a new way of data collection. Although the web-based register was designed for the current multi-centre observational study, this type of instrument can also be applied to other types of studies. We expect that especially collaborative study groups will find it an efficient tool to collect data.

Simulation of n-qubit quantum systems. I. Quantum registers and quantum gates

NASA Astrophysics Data System (ADS)

Radtke, T.; Fritzsche, S.

2005-12-01

During recent years, quantum computations and the study of n-qubit quantum systems have attracted a lot of interest, both in theory and experiment. Apart from the promise of performing quantum computations, however, these investigations also revealed a great deal of difficulties which still need to be solved in practice. In quantum computing, unitary and non-unitary quantum operations act on a given set of qubits to form (entangled) states, in which the information is encoded by the overall system often referred to as quantum registers. To facilitate the simulation of such n-qubit quantum systems, we present the FEYNMAN program to provide all necessary tools in order to define and to deal with quantum registers and quantum operations. Although the present version of the program is restricted to unitary transformations, it equally supports—whenever possible—the representation of the quantum registers both, in terms of their state vectors and density matrices. In addition to the composition of two or more quantum registers, moreover, the program also supports their decomposition into various parts by applying the partial trace operation and the concept of the reduced density matrix. Using an interactive design within the framework of MAPLE, therefore, we expect the FEYNMAN program to be helpful not only for teaching the basic elements of quantum computing but also for studying their physical realization in the future. Program summaryTitle of program:FEYNMAN Catalogue number:ADWE Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADWE Program obtainable from:CPC Program Library, Queen's University of Belfast, N. Ireland Licensing provisions:None Computers for which the program is designed:All computers with a license of the computer algebra system MAPLE [Maple is a registered trademark of Waterlo Maple Inc.] Operating systems or monitors under which the program has been tested:Linux, MS Windows XP Programming language used:MAPLE 9.5 (but should be compatible with 9.0 and 8.0, too) Memory and time required to execute with typical data:Storage and time requirements critically depend on the number of qubits, n, in the quantum registers due to the exponential increase of the associated Hilbert space. In particular, complex algebraic operations may require large amounts of memory even for small qubit numbers. However, most of the standard commands (see Section 4 for simple examples) react promptly for up to five qubits on a normal single-processor machine ( ⩾1GHz with 512 MB memory) and use less than 10 MB memory. No. of lines in distributed program, including test data, etc.: 8864 No. of bytes in distributed program, including test data, etc.: 493 182 Distribution format: tar.gz Nature of the physical problem:During the last decade, quantum computing has been found to provide a revolutionary new form of computation. The algorithms by Shor [P.W. Shor, SIAM J. Sci. Statist. Comput. 26 (1997) 1484] and Grover [L.K. Grover, Phys. Rev. Lett. 79 (1997) 325. [2

Virtual reality for stroke rehabilitation: an abridged version of a Cochrane review.

PubMed

Laver, K; George, S; Thomas, S; Deutsch, J E; Crotty, M

2015-08-01

Virtual reality and interactive video gaming have emerged as new treatment approaches in stroke rehabilitation settings over the last ten years. The primary objective of this review was to determine the effectiveness of virtual reality on upper limb function and activity after stroke. The impact on secondary outcomes including gait, cognitive function and activities of daily living was also assessed. Randomized and quasi-randomized controlled trials comparing virtual reality with an alternative intervention or no intervention were eligible to be included in the review. The authors searched a number of electronic databases including: the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, clinical trial registers, reference lists, Dissertation Abstracts and contacted key researchers in the field. Search results were independently examined by two review authors to identify studies meeting the inclusion criteria. A total of 37 randomized or quasi randomized controlled trials with a total of 1019 participants were included in the review. Virtual reality was found to be significantly more effective than conventional therapy in improving upper limb function (standardized mean difference [SMD] 0.28, 95% confidence intervals [CI] 0.08 to 0.49) based on 12 studies and significantly more effective than no therapy in improving upper limber function (SMD 0.44 [95% CI 0.15 to 0.73]) based on nine studies. The use of virtual reality also significantly improved activities of daily living function when compared to more conventional therapy approaches (SMD 0.43 [95% CI 0.18 to 0.69]) based on eight studies. While there are a large number of studies assessing the efficacy of virtual reality they tend to be small and many are at risk of bias. While there is evidence to support the use of virtual reality intervention as part of upper limb training programs, more research is required to determine whether it is beneficial in terms of improving lower limb function and gait and cognitive function.

Comparative analysis of premature mortality among urban immigrants in Bremen, Germany: a retrospective register-based linkage study

PubMed Central

Makarova, Nataliya; Brand, Tilman; Brünings-Kuppe, Claudia; Pohlabeln, Hermann; Luttmann, Sabine

2016-01-01

Objectives The main objective of this study was to explore differences in mortality patterns among two large immigrant groups in Germany: one from Turkey and the other from the former Soviet Union (FSU). To this end, we investigated indicators of premature mortality. Design This study was conducted as a retrospective population-based study based on mortality register linkage. Using mortality data for the period 2004–2010, we calculated age-standardised death rates (SDR) and standardised mortality ratios (SMR) for premature deaths (

CTRI – Clicking to greater transparency and accountability

PubMed Central

George, Bobby

2012-01-01

A clinical trial registry (CTR) is an official platform for registering a clinical trial (CT) with an objective of providing increased transparency and access to CTs to the public at large. Clinical Trials Registry - India (CTRI) is a free online public record system for registration of CTs being conducted in India. The vision of the CTRI is to ensure that every CT conducted in the region is prospectively registered with full disclosure of the trial data set items. With more number of CTs being conducted in the country, with a large number being global multicentre trials, it is binding on the industry/investigators/sponsor to comply with the requirements laid down. While there are pros and cons, there is enough scope for improvement of CTRI. PMID:23293758

Effects of librarian-provided services in healthcare settings: a systematic review.

PubMed

Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

2014-01-01

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) case register: development and descriptive data

PubMed Central

Stewart, Robert; Soremekun, Mishael; Perera, Gayan; Broadbent, Matthew; Callard, Felicity; Denis, Mike; Hotopf, Matthew; Thornicroft, Graham; Lovestone, Simon

2009-01-01

Background Case registers have been used extensively in mental health research. Recent developments in electronic medical records, and in computer software to search and analyse these in anonymised format, have the potential to revolutionise this research tool. Methods We describe the development of the South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre (BRC) Case Register Interactive Search tool (CRIS) which allows research-accessible datasets to be derived from SLAM, the largest provider of secondary mental healthcare in Europe. All clinical data, including free text, are available for analysis in the form of anonymised datasets. Development involved both the building of the system and setting in place the necessary security (with both functional and procedural elements). Results Descriptive data are presented for the Register database as of October 2008. The database at that point included 122,440 cases, 35,396 of whom were receiving active case management under the Care Programme Approach. In terms of gender and ethnicity, the database was reasonably representative of the source population. The most common assigned primary diagnoses were within the ICD mood disorders (n = 12,756) category followed by schizophrenia and related disorders (8158), substance misuse (7749), neuroses (7105) and organic disorders (6414). Conclusion The SLAM BRC Case Register represents a 'new generation' of this research design, built on a long-running system of fully electronic clinical records and allowing in-depth secondary analysis of both numerical, string and free text data, whilst preserving anonymity through technical and procedural safeguards. PMID:19674459

Clinical Evaluation of positioning verification using digital tomosynthesis (DTS) based on bony anatomy and soft tissues for prostate image-guided radiation therapy (IGRT)

PubMed Central

Yoo, Sua; Wu, Q. Jackie; Godfrey, Devon; Yan, Hui; Ren, Lei; Das, Shiva; Lee, William R.; Yin, Fang-Fang

2008-01-01

Purpose To evaluate on-board digital tomosynthesis (DTS) for patient positioning in comparison with 2D-radiographs and 3D-CBCT. Methods and Materials A total of 92 image sessions from 9 prostate cancer patients were analyzed. An on-board image set was registered to a corresponding reference image set. Four pairs of image sets were used; DRR vs. on-board orthogonal paired radiograph for the 2D method, coronal-reference-DTS (RDTS) vs. on-board coronal-DTS for the coronal-DTS method, sagittal-RDTS vs. on-board sagittal-DTS for the sagittal-DTS method, and planning CT vs. CBCT for the CBCT method. Registration results were compared. Results The systematic errors in all methods were less than 1 mm/1°. When registering bony anatomy, the mean vector differences were 0.21±0.11 cm between 2D and CBCT, 0.11±0.08 cm between CBCT and coronal-DTS, and 0.14±0.07 cm between CBCT and sagittal-DTS. The correlation of CBCT to DTS was stronger (coefficients=0.92–0.95) than the correlation between 2D and CBCT or DTS (coefficients=0.81–0.83). When registering soft tissue, the mean vector differences were 0.18±0.11 cm between CBCT and coronal-DTS and 0.29±0.17 cm between CBCT and sagittal-DTS. The correlation coefficients of CBCT to sagittal-DTS and to coronal-DTS were 0.84 and 0.92, respectively. Conclusions DTS could provide equivalent results to CBCT when bony anatomy is used as landmarks for prostate IGRT. For soft tissue-based positioning verification, coronal-DTS produced equivalent results to CBCT and sagittal-DTS alone was insufficient. DTS could allow comparable soft tissue-based target localization with faster scanning time and less imaging dose compared to CBCT. PMID:19100923

Changes to registration elements and results in a cohort of Clinicaltrials.gov trials were not reflected in published articles.

PubMed

Pranić, Shelly; Marušić, Ana

2016-02-01

To assess effectiveness of legislative initiatives to stimulate public registration of trial results, we assessed adherence to protocol and results reporting, changes to registry, and publication data for randomized controlled trials (RCTs) after introduction of Food and Drug Administration Amendment Act (FDAAA). Observational study of a cohort of ClinicalTrials.gov registered FDAAA-covered RCTs found through ClinicalTrials.gov between 2009 and 2012 and data from corresponding publications. WHO Minimum Data Set items were abstracted by one author and verified by the other author. Among 81 eligible trials, most were industry-funded, with a drug intervention in parallel assignment. Secondary outcomes at the initial and last registration were omitted for 17% and 19.7% of RCTs, respectively. RCT registration changes mostly involved scientific title (18.8%). Inclusion criteria omission was most common (88%) in publications. Inferential statistical methods for primary and secondary outcomes matched between registry and publication for 53.4% and 28.6% of RCTs, respectively. Serious and other adverse events (AEs) that were absent for 23.8% and 4.8% of RCTs, respectively, were published as nonoccurring. Discrepancies remain relatively high between registered and published outcomes, particularly regarding registered omissions in publications and concomitant reporting, nature of statistical method used, and reporting of AEs. This seriously undermines transparency of clinical trials and needs immediate attention of all stakeholders in health research. Copyright © 2016 Elsevier Inc. All rights reserved.

The female menstrual cycle does not influence testosterone concentrations in male partners.

PubMed

Strom, Jakob O; Ingberg, Edvin; Druvefors, Emma; Theodorsson, Annette; Theodorsson, Elvar

2012-01-03

The time of ovulation has since long been believed to be concealed to male heterosexual partners. Recent studies have, however, called for revision of this notion. For example, male testosterone concentrations have been shown to increase in response to olfactory ovulation cues, which could be biologically relevant by increasing sexual drive and aggressiveness. However, this phenomenon has not previously been investigated in real-life human settings. We therefore thought it of interest to test the hypothesis that males' salivary testosterone concentrations are influenced by phases of their female partners' menstrual cycle; expecting a testosterone peak at ovulation. Thirty young, healthy, heterosexual couples were recruited. During the course of 30-40 days, the women registered menses and ovulation, while the men registered sexual activity, physical exercise, alcohol intake and illness (confounders), and obtained daily saliva samples for testosterone measurements. All data, including the registered confounders, were subjected to multiple regression analysis. In contrast to the hypothesis, the ovulation did not affect the testosterone levels, and the resulting testosterone profile during the menstrual cycle was on the average flat. The specific main hypothesis, that male testosterone levels on the day of ovulation would be higher than day 4 of the cycle, was clearly contradicted by a type II error(β)-analysis (< 14.3% difference in normalized testosterone concentration; β = 0.05). Even though an ovulation-related salivary testosterone peak was observed in individual cases, no significant effect was found on a group level.

How did the recent increase in the supply of coronary operations in Finland affect socioeconomic and gender equity in their use?

PubMed Central

Hetemaa, T; Keskimaki, I; Manderbacka, K; Leyland, A; Koskinen, S

2003-01-01

Design: Register based linkage study; information on coronary procedures from the Finnish Hospital Discharge Register in 1988 and 1996 was individually linked to national population censuses in 1970–1995 to obtain patients' socioeconomic data. Data on both hospitalisations and mortality attributable to coronary heart disease obtained from similar linkage schemes were used to approximate the relative need of procedures in socioeconomic groups. Setting: Finland, 2 094 846 inhabitants in 1988 and 2 401 027 in 1996 aged 40 years and older, and Discharge Register data from all Finnish hospitals offering coronary procedures in 1988 and 1996. Main results: The overall rate of coronary revascularisations in Finland increased by about 140% for men and 250% for women from 1988 to 1996. Over the same period, socioeconomic and gender disparities in operation rates diminished, as did the influence of regional supply of procedures on the extent of these differences. However, men, and better off groups in terms of occupation, education, and family income, continued to receive more operations than women and the worse off with the same level of need. Conclusions: Although revascularisations in Finland increased 2.5-fold overall, some socioeconomic and gender inequities persisted in the use of cardiac operations relative to need. To improve equity, a further increase of resources may be needed, and practices taking socioeconomic and gender equity into account should be developed for the referral of coronary heart disease patients to hospital investigations. PMID:12594194

The female menstrual cycle does not influence testosterone concentrations in male partners

PubMed Central

2012-01-01

Background The time of ovulation has since long been believed to be concealed to male heterosexual partners. Recent studies have, however, called for revision of this notion. For example, male testosterone concentrations have been shown to increase in response to olfactory ovulation cues, which could be biologically relevant by increasing sexual drive and aggressiveness. However, this phenomenon has not previously been investigated in real-life human settings. We therefore thought it of interest to test the hypothesis that males' salivary testosterone concentrations are influenced by phases of their female partners' menstrual cycle; expecting a testosterone peak at ovulation. Methods Thirty young, healthy, heterosexual couples were recruited. During the course of 30-40 days, the women registered menses and ovulation, while the men registered sexual activity, physical exercise, alcohol intake and illness (confounders), and obtained daily saliva samples for testosterone measurements. All data, including the registered confounders, were subjected to multiple regression analysis. Results In contrast to the hypothesis, the ovulation did not affect the testosterone levels, and the resulting testosterone profile during the menstrual cycle was on the average flat. The specific main hypothesis, that male testosterone levels on the day of ovulation would be higher than day 4 of the cycle, was clearly contradicted by a type II error(β)-analysis (< 14.3% difference in normalized testosterone concentration; β = 0.05). Conclusions Even though an ovulation-related salivary testosterone peak was observed in individual cases, no significant effect was found on a group level. PMID:22214343

Organizational climate and hospital nurses' caring practices: a mixed-methods study.

PubMed

Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P

2014-06-01

Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices. © 2014 Wiley Periodicals, Inc.

Standards Applicable to Generators of Hazardous Waste; Alternative Requirements for Hazardous Waste Determination and Accumulation of Unwanted Material at Laboratories Owned by Colleges and Universities and Other Eligible Academic Entities Formally Affiliated With Colleges and Universities. Final Rule. Federal Register, Environmental Protection Agency. 40 CFR Parts 261 and 262. Part II

ERIC Educational Resources Information Center

National Archives and Records Administration, 2008

2008-01-01

The Environmental Protection Agency (EPA or the Agency) is finalizing an alternative set of generator requirements applicable to laboratories owned by eligible academic entities, as defined in this final rule. The rule provides a flexible and protective set of regulations that address the specific nature of hazardous waste generation and…

Co-registration of Laser Altimeter Tracks with Digital Terrain Models and Applications in Planetary Science

NASA Technical Reports Server (NTRS)

Glaeser, P.; Haase, I.; Oberst, J.; Neumann, G. A.

2013-01-01

We have derived algorithms and techniques to precisely co-register laser altimeter profiles with gridded Digital Terrain Models (DTMs), typically derived from stereo images. The algorithm consists of an initial grid search followed by a least-squares matching and yields the translation parameters at sub-pixel level needed to align the DTM and the laser profiles in 3D space. This software tool was primarily developed and tested for co-registration of laser profiles from the Lunar Orbiter Laser Altimeter (LOLA) with DTMs derived from the Lunar Reconnaissance Orbiter (LRO) Narrow Angle Camera (NAC) stereo images. Data sets can be co-registered with positional accuracy between 0.13 m and several meters depending on the pixel resolution and amount of laser shots, where rough surfaces typically result in more accurate co-registrations. Residual heights of the data sets are as small as 0.18 m. The software can be used to identify instrument misalignment, orbit errors, pointing jitter, or problems associated with reference frames being used. Also, assessments of DTM effective resolutions can be obtained. From the correct position between the two data sets, comparisons of surface morphology and roughness can be made at laser footprint- or DTM pixel-level. The precise co-registration allows us to carry out joint analysis of the data sets and ultimately to derive merged high-quality data products. Examples of matching other planetary data sets, like LOLA with LRO Wide Angle Camera (WAC) DTMs or Mars Orbiter Laser Altimeter (MOLA) with stereo models from the High Resolution Stereo Camera (HRSC) as well as Mercury Laser Altimeter (MLA) with Mercury Dual Imaging System (MDIS) are shown to demonstrate the broad science applications of the software tool.

Registered Nurses' perceptions of their work and professional development.

PubMed

Hallin, Karin; Danielson, Ella

2008-01-01

This paper is a report of a study to elucidate Registered Nurses' perceptions of their work and professional development 6 years after graduation. Nursing education and health care has rapidly changed in the last two decades. Education and experience are important components in Registered Nurses' ability to promote a high quality of care, but a great deal depends on their work circumstances. This study emphasizes Registered Nurses' view of their work in health care, at a time in their career when they have several years of experience. Data were collected in 2003 from in-depth interviews with 15 Registered Nurses 6 years after their graduation. The interviews were semi-structured and analysed with interpretive content analysis. The findings revealed two themes and five sub-themes. The first theme, An appropriate but demanding profession, consisted of two sub-themes: 'having found one's niche' and 'growing old in nursing may be difficult'. The second theme, A profession with opportunities and obstacles, consisted of three sub-themes: 'being aware of Registered Nurses' potential', 'having knowledge that is seldom made use of' and 'attaining professional growth is no matter of course'. Keeping Registered Nurses' satisfied and avoiding their dissatisfaction is crucial for both educators and employers. It is essential that employers give priority to Registered Nurses' time with patients and to motivate and support them in professional development. Further intervention studies regarding a change of the balance between obstacles and opportunities are needed.

[Features of Clinical Register of Chinese Medicine and Pharmacy Based on ClinicalTrials.gov. (USA)].

PubMed

Lu, Peng-fei; Liao, Xing; Xie, Yan-ming; Wang, Zhi-guo

2015-11-01

In recent 10 years, clinical trials of Chinese medicine and pharmacy (cMP) at clinicalTrials.gov.(USA) are gradually increasing. In order to analyze features of CMP clinical register, ClinicalTrials.gov register database were comprehensively retrieved in this study. Included clinical trials were input one item after another using EXCEL. A final of 348 CMP clinical trials were included. Results showed that China occupied the first place in CMP clinical register, followed by USA. CMP clinical trials, sponsored mainly by colleges/universities and hospitals, mostly covered interventional studies on evaluating safety/effectiveness of CMP. The proportions of studies, sponsored by mainland China and companies, recruitment trials and multi-center clinical trials in interventional trials were increasing. The proportions of studies sponsored by Hong Kong and Taiwan, research completed trials, unclear research status, phase III clinical trials, and published research trials in interventional trials were decreasing. Published ratios of CMP clinical trials were quite low. There were more missing types and higher proportions in trial register information.

'Good ethics and moral standing': a qualitative study of aesthetic leadership in clinical nursing practice.

PubMed

Mannix, Judy; Wilkes, Lesley; Daly, John

2015-06-01

To explore how aesthetic leadership is embodied by clinical leaders in the nursing workplace. A number of different leadership styles have been developed, theorised and applied to the nursing workforce over the years. Many of these styles lack an explicit moral dimension in their identified leader attributes, due to a shift in theorising of leadership to focus on the impact of leader traits on followers. It is timely to look at aesthetic leadership, with its explicit moral dimension, as a way of improving outcomes for nurses, patients and health care organisations. Qualitative design, using conversation-style interviews with experienced registered nurses in designated clinical leadership roles. Twelve experienced registered nurses who worked in designated clinical leadership roles participated in an individual, digitally recorded, semi-structured conversation-style interview. Narrative data were transcribed and subject to thematic analysis. Three main themes emerged: 'True to their beliefs': embodying principled practice; 'Not all policies fit every patient': ethical leadership in ambiguous situations; and 'Being open to people's concerns': providing fair and just solutions. A strong moral compass shaped and guided participants' day-to-day clinical leadership activities. Participants provided a rich narrative on how aesthetic leadership is embodied in the clinical nursing setting. It was evident that their clinical leadership is shaped and guided by a strong moral compass. By incorporating into their practice an aesthetic world-view with its strong moral purpose, participants in this study have shown how aesthetic leadership can enhance the clinical nursing workplace. Nurses in the clinical setting value clinical leaders who embrace and operate with a strong moral compass. Aesthetic leadership, with its explicit strong moral purpose, offers a way of incorporating morality into clinical leadership in the nursing workplace. © 2015 John Wiley & Sons Ltd.

Health-related physical fitness and physical activity in elementary school students.

PubMed

Chen, Weiyun; Hammond-Bennett, Austin; Hypnar, Andrew; Mason, Steve

2018-01-30

This study examined associations between students' physical fitness and physical activity (PA), as well as what specific physical fitness components were more significant correlates to being physically active in different settings for boys and girls. A total of 265 fifth-grade students with an average age of 11 voluntarily participated in this study. The students' physical fitness was assessed using four FitnessGram tests, including Progressive Aerobic Cardiovascular Endurance Run (PACER), curl-up, push-up, and trunk lift tests. The students' daily PA was assessed in various settings using a daily PA log for 7 days. Data was analyzed with descriptive statistics, univariate analyses, and multiple R-squared liner regression methods. Performance on the four physical fitness tests was significantly associated with the PA minutes spent in physical education (PE) class and recess for the total sample and for girls, but not for boys. Performance on the four fitness tests was significantly linked to participation in sports/dances outside school and the total weekly PA minutes for the total sample, boys, and girls. Further, boys and girls who were the most physically fit spent significantly more time engaging in sports/dances and had greater total weekly PA than boys and girls who were not physically fit. In addition, the physically fit girls were more physically active in recess than girls who were not physically fit. Overall, students' performance on the four physical fitness tests was significantly associated with them being physically active during PE and in recess and engaging in sports/dances, as well as with their total weekly PA minutes, but not with their participation in non-organized physical play outside school. ClinicalTrials.gov ID: NCT03015337 , registered date: 1/09/2017, as "retrospectively registered".

Challenges for Nurses Caring for Patients With Peripherally Inserted Central Catheters in Skilled Nursing Facilities

PubMed Central

Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

2016-01-01

Objectives To understand frontline nurses’ (registered nurses and licensed practical nurses), unit nurse managers’ and skilled nursing facility (SNF) administrators’ perceived preparedness in providing care for patients with peripherally inserted central catheters (PICCs) in SNFs. Design An exploratory, qualitative pilot study. Setting Two community based SNFs. Participants Patients, frontline nurses (registered nurses and licensed practical nurses), unit nurse managers and SNF administrators. Methods Over 36-weeks, we observed and conducted informal interviews with 56 patients with PICCs and their nurses focusing on PICC care practices and documentation. In addition, we collected baseline PICC data including placement indication (e.g., antimicrobial administration), placement setting (hospital vs. SNF), and dwell time. We then conducted focus groups with frontline nurses and unit nurse managers and semi-structured interviews with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Results During weekly informal interviews and observations variations in documentation were observed. Differences between patient-reported PICC concerns (quality-of-life) and those described by frontline nurses were noted. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs and gaps in training and education were highlighted as barriers in improving practice and safety. Conclusion Our study suggests that practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions and increase resource availability in SNFs appear necessary to enhance PICC care and patient safety. PMID:27603747

An analysis of characteristics of post-authorisation studies registered on the ENCePP EU PAS Register

PubMed Central

Carroll, Robert; Ramagopalan, Sreeram V.; Cid-Ruzafa, Javier; Lambrelli, Dimitra; McDonald, Laura

2017-01-01

Background: The objective of this study was to investigate the study design characteristics of Post-Authorisation Studies (PAS) requested by the European Medicines Agency which were recorded on the European Union (EU) PAS Register held by the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). Methods: We undertook a cross-sectional descriptive analysis of all studies registered on the EU PAS Register as of 18 th October 2016. Results: We identified a total of 314 studies on the EU PAS Register, including 81 (26%) finalised, 160 (51%) ongoing and 73 (23%) planned. Of those studies identified, 205 (65%) included risk assessment in their scope, 133 (42%) included drug utilisation and 94 (30%) included effectiveness evaluation. Just over half of the studies (175; 56%) used primary data capture, 135 (43%) used secondary data and 4 (1%) used a hybrid design combining both approaches. Risk assessment and effectiveness studies were more likely to use primary data capture (60% and 85% respectively as compared to 39% and 14% respectively for secondary). The converse was true for drug utilisation studies where 59% were secondary vs. 39% for primary. For type 2 diabetes mellitus, database studies were more commonly used (80% vs 3% chart review, 3% hybrid and 13% primary data capture study designs) whereas for studies in oncology, primary data capture were more likely to be used (85% vs 4% chart review, and 11% database study designs). Conclusions: Results of this analysis show that PAS design varies according to study objectives and therapeutic area. PMID:29188016

Electroglottographic parameterization of the effects of gender, vowel and phonatory registers on vocal fold vibratory patterns: an Indian perspective.

PubMed

Paul, Nilanjan; Kumar, Suman; Chatterjee, Indranil; Mukherjee, Biswarup

2011-01-01

In-depth study on laryngeal biomechanics and vocal fold vibratory patterns reveal that a single vibratory cycle can be divided into two major phases, the closed and open phase, which is subdivided into opening and closing phases. Studies reveal that the relative time course of abduction and adduction, which in turn is dependent on the relative relaxing and tensing of the vocal fold cover and body, to be the determining factor in production of a particular vocal register like the modal (or chest), falsetto, glottal fry registers. Studies further point out Electroglottography to be particularly suitable for the study of vocal vibratory patterns during register changes. However, to date, there has been limited study on quantitative parameterization of EGG wave form in vocal fry register. Moreover, contradictory findings abound in literature regarding effects of gender and vowel types on vocal vibratory patterns, especially during phonation at different registers. The present study endeavors to find out the effects of vowel and gender differences on the vocal fold vibratory patterns in different registers and how these would be reflected in standard EGG parameters of Contact Quotient (CQ) and Contact Index (CI), taking into consideration the Indian sociolinguistic context. Electroglottographic recordings of 10 young adults (5 males and 5 females) were taken while the subjects phonated the three vowels /a/,/i/,/u/ each in two vocal registers, modal and vocal fry. Obtained raw EGG were further normalized using the Derived EGG algorithm and theCQ and CI values were derived. Obtained data were subject to statistical analysis using the 3-way ANOVA with gender, vowel and vocal register as the three variables. Post-hoc Dunnett C multiple comparison analysis were also performed. Results reveal that CQ values are significantly higher in vocal fry than modal phonation for both males and females, indicating a relatively hyperconstricted vocal system during vocal fry. The males have significantly greater CQ values than females both at modal and vocal fry phonations which indicate that the males are predisposed to greater vocal fold constriction. Females demonstrated no significant increase in CI values in vocal fry state; and in some cases actually decrease in the CI values which suggest an inherently distinct vocal fold physiological adjustment from that in males. No vowel effects were found in any conditions. Perturbation values (CQP and CIP) are significantly more in vocal fry register than in modal register, and the increase was more in case of females than males. The findings give strong evidence to certain hypotheses in literature regarding effects of vowel, gender and phonatory register on vocal fold vibratory patterns.

Regulation of veterinary antibiotics in Australia.

PubMed

Dyke, T M

2003-01-01

The Australian Pesticides and Veterinary Medicines Authority (APVMA)* registers veterinary antibiotic products before they can be supplied, distributed or sold in Australia. Extensive scientific assessment on all new veterinary antibiotic products is undertaken for the APVMA by experts in other government agencies including the Therapeutic Goods Administration (toxicology), the National Occupational Health and Safety Commission (occupational health and safety), Environment Australia (environmental hazards) and state departments of agriculture or primary industry (efficacy and safety) as well as APVMA assessments on food residues, trade and manufacturing. The National Health and Medical Research Council Expert Advisory Group on Antimicrobial Resistance provides advice to the APVMA on the potential transfer of antibiotic resistance from the use of antibiotics in animals to humans, and the impact transfer may have on public health. Food Standards Australia New Zealand (previously Australia New Zealand Food Authority) set maximum residue levels for human foods. The APVMA monitors registered product use through compliance activities and an adverse experience reporting program, and reviews registered products as necessary. The import, manufacture, supply and use of veterinary antibiotics are regulated by Commonwealth and State governments in Australia.

Registered nurse buddies: Educators by proxy?

PubMed

Rebeiro, Geraldine; Evans, Alicia; Edward, Karen-Leigh; Chapman, Rose

2017-08-01

The informal clinical teaching role of the buddy nurse seems to be a uniquely Australian title, with little consistency in terminology for informal nurse educator roles internationally. Not all registered nurses are professionally developed for the informal role of facilitating the clinical learning of students in clinical settings, yet these roles are expected by nursing professional bodies. In Australia the registered nurses (RN) experience of being a buddy nurse has been reported as lacking clarity, being unsupported and structureless. Whist there is a plethora of literature published about formal RN educator roles, little is available on the informal buddy nurse role. A view of the buddy nurse role in reference to the limited but available literature in the Australian context is offered in this paper. International perspectives are also gathered describing informal clinical education RN's roles with similar responsibilities to the Australian buddy nurse. The significance of this dialogue is to ignite debate about the role, potentially informing policy for the improved support of the role within the Australian nursing landscape. Copyright © 2017 Elsevier Ltd. All rights reserved.

Auditing patient registration in the Swedish quality register for acute coronary syndrome.

PubMed

Rosvall, Maria; Ohlsson, Henrik; Hansen, Ole; Chaix, Basile; Merlo, Juan

2010-07-01

The present study aims to quantify non-participation in the RIKS-HIA register during 2005 and to compare acute myocardial infarction (AMI) patients registered and not registered in RIKS-HIA, in relation to sociodemographic factors, prevalent disease, and 7-day and 30-day survival. We linked information on sociodemographic characteristics, treatments, morbidity, and mortality from the LOMAS (Longitudinal Multilevel Analysis in Scania) database with the RIKS-HIA register. The study population consisted of individuals younger than 85 years living in Scania by 31 December 2004 who had one or more AMI during 2005 (n = 2968). The 70% of the AMI patients included in the register were generally younger, more often men, generally more healthy, more often had AMI as the main diagnosis, and more often underwent revascularisation procedures than AMI patients not included. Among both men (OR(adjusted) = 0.19; 95% CI 0.14-0.27) and women (OR(adjusted) = 0.30; 95% CI 0.20-0.44), registered patients had a lower 30-day mortality than patients not registered in RIKS-HIA. Even though RIKS-HIA conveys a clear quality improvement for the care of patients with acute coronary syndrome in Sweden, it is important to be aware that the register does not include the entire AMI population, but rather a selected and healthier population of AMI patients. This circumstance decreases the external validity of the information obtained from the RIKS-HIA register. Such an effect might be reduced over time and data from 2006 shows an inclusion rate of 76% among AMI patients aged less than 80 years.

Comparison of early socialization practices used for litters of small-scale registered dog breeders and nonregistered dog breeders.

PubMed

Korbelik, Juraj; Rand, Jacquie S; Morton, John M

2011-10-15

OBJECTIVE-To compare early socialization practices between litters of breeders registered with the Canine Control Council (CCC) and litters of nonregistered breeders advertising puppies for sale in a local newspaper. DESIGN-Retrospective cohort study. Animals-80 litters of purebred and mixed-breed dogs from registered (n = 40) and non-registered (40) breeders. PROCEDURES-Registered breeders were randomly selected from the CCC website, and nonregistered breeders were randomly selected from a weekly advertising newspaper. The litter sold most recently by each breeder was then enrolled in the study. Information pertaining to socialization practices for each litter was obtained through a questionnaire administered over the telephone. RESULTS-Registered breeders generally had more breeding bitches and had more litters than did nonregistered breeders. Litters of registered breeders were more likely to have been socialized with adult dogs, people of different appearances, and various environmental stimuli, compared with litters of nonregistered breeders. Litters from registered breeders were also much less likely to have been the result of an unplanned pregnancy. CONCLUSIONS AND CLINICAL RELEVANCE-Among those breeders represented, litters of registered breeders received more socialization experience, compared with litters of nonregistered breeders. People purchasing puppies from nonregistered breeders should focus on socializing their puppies between the time of purchase and 14 weeks of age. Additional research is required to determine whether puppies from nonregistered breeders are at increased risk of behavioral problems and are therefore more likely to be relinquished to animal shelters or euthanized, relative to puppies from registered breeders.

A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

PubMed Central

McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

2003-01-01

Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

Strategies for successful trauma registry implementation in low- and middle-income countries-protocol for a systematic review.

PubMed

Paradis, Tiffany; St-Louis, Etienne; Landry, Tara; Poenaru, Dan

2018-02-21

The benefits of trauma registries have been well described. The crucial data they provide may guide injury prevention strategies, inform resource allocation, and support advocacy and policy. This has been shown to reduce trauma-related mortality in various settings. Trauma remains a leading cause of mortality in low- and middle-income countries (LMICs). However, the implementation of trauma registries in LMICs can be challenging due to lack of funding, specialized personnel, and infrastructure. This study explores strategies for successful trauma registry implementation in LMICs. The protocol was registered a priori (CRD42017058586). A peer-reviewed search strategy of multiple databases will be developed with a senior librarian. As per PRISMA guidelines, first screen of references based on abstract and title and subsequent full-text review will be conducted by two independent reviewers. Disagreements that cannot be resolved by discussion between reviewers shall be arbitrated by the principal investigator. Data extraction will be performed using a pre-defined data extraction sheet. Finally, bibliographies of included articles will be hand-searched. Studies of any design will be included if they describe or review development and implementation of a trauma registry in LMICs. No language or period restrictions will be applied. Summary statistics and qualitative meta-narrative analyses will be performed. The significant burden of trauma in LMIC environments presents unique challenges and limitations. Adapted strategies for deployment and maintenance of sustainable trauma registries are needed. Our methodology will systematically identify recommendations and strategies for successful trauma registry implementation in LMICs and describe threats and barriers to this endeavor. The protocol was registered on the PROSPERO international prospective register of systematic reviews ( CRD42017058586 ).

Risk factors for unnatural death: Fatal accidental intoxication, undetermined intent and suicide: Register follow-up in a criminal justice population with substance use problems.

PubMed

Olsson, Martin O; Bradvik, Louise; Öjehagen, Agneta; Hakansson, Anders

2016-05-01

Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively. A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested in bivariate analysis with the respective cause of death, yielding significant risk factors further analyzed in three Cox regression models. In Cox regression analyses, death from fatal accidental intoxication was associated with male gender (HR 4.09), use of heroin (HR 2.86), and use of cannabis (HR 1.94), and death from intoxication/injury of undetermined intent was associated with use of heroin (HR 3.48), binge drinking of alcohol (HR 2.46) and previous psychiatric hospitalization (HR 2.41), while negatively associated with depression (HR 0.33). Death from suicide was associated with previous suicide attempts (HR 2.78) and use of sedatives (HR 2.17). In this population of criminal justice clients with reported substance use problems, fatal injuries/intoxications with undetermined intent - like fatal accidental intoxications - appear to be associated with substance use variables, and cannot readily be assumed to represent the same background factors as suicide. Copyright © 2016. Published by Elsevier Ireland Ltd.

Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis

PubMed Central

McLean, Susannah; Nurmatov, Ulugbek; Liu, Joseph LY; Pagliari, Claudia; Car, Josip; Sheikh, Aziz

2012-01-01

Background Chronic obstructive pulmonary disease (COPD) is common. Telehealthcare, involving personalised health care over a distance, is seen as having the potential to improve care for people with COPD. Aim To systematically review the effectiveness of telehealthcare interventions in COPD to improve clinical and process outcomes. Design and setting Cochrane Systematic Review of randomised controlled trials. Methods The study involved searching the Cochrane Airways Group Register of Trials, which is derived from the Cochrane Central Register of Controlled Trials, MEDLINE®, embase™, and CINAHL®, as well as searching registers of ongoing and unpublished trials. Randomised controlled trials comparing a telehealthcare intervention with a control intervention in people with a clinical diagnosis of COPD were identified. The main outcomes of interest were quality of life and risk of emergency department visit, hospitalisation, and death. Two authors independently selected trials for inclusion and extracted data. Study quality was assessed using the Cochrane Collaboration’s risk of bias method. Meta-analysis was undertaken using fixed effect and/or random effects modelling. Results Ten randomised controlled trials were included. Telehealthcare did not improve COPD quality of life: mean difference –6.57 (95% confidence interval [CI] = –13.62 to 0.48). However, there was a significant reduction in the odds ratios (ORs) of emergency department attendance (OR = 0.27; 95% CI = 0.11 to 0.66) and hospitalisation (OR = 0.46; 95% CI = 0.33 to 0.65). There was a non-significant change in the OR of death (OR = 1.05; 95% CI = 0.63 to 1.75). Conclusion In COPD, telehealthcare interventions can significantly reduce the risk of emergency department attendance and hospitalisation, but has little effect on the risk of death. PMID:23211177

Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990–2010: a comprehensive register-based cohort study

PubMed Central

Laukkala, T; Parkkola, K; Henriksson, M; Pirkola, S; Kaikkonen, N; Pukkala, E; Jousilahti, P

2016-01-01

Objectives To estimate total and cause-specific mortality after international peacekeeping deployments among the Finnish military peacekeeping personnel in comparison to the general population of similar age and sex. Design A register-based study of a cohort of military peacekeeping personnel in 1990–2010 followed for mortality until the end of 2013. Causes of death were obtained from the national Causes of Death Register. The standardised mortality ratio (SMR) for total and cause-specific mortality was calculated as the ratio of observed and expected number of deaths. Setting Finland (peacekeeping operations in different countries in Africa, Asia and in an area of former Yugoslavia in Europe). Participants 14 584 men and 418 women who had participated in international military peacekeeping operations ending between 1990 and 2010. Interventions Participation in military peacekeeping operations. Main outcome Total and cause-specific mortality. Results 209 men and 3 women died after their peacekeeping service. The SMR for all-cause mortality was 0.55 (95% CI 0.48 to 0.62). For the male peacekeeping personnel, the SMR for all diseases was 0.44 (95% CI 0.35 to 0.53) and for accidental and violent deaths 0.69 (95% CI 0.57 to 0.82). The SMR for suicides was 0.71 (95% CI 0.53 to 0.92). Conclusions Even though military peacekeeping personnel are working in unique and often stressful conditions, their mortality after their service is lower compared with the general population. Military peacekeeping personnel appear to be a selected population group with low general mortality and no excess risk of any cause of death after peacekeeping service. PMID:27799241

Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: a descriptive cross-sectional study.

PubMed

Strand, Tillan; Lindgren, Margareta

2010-12-01

Pressure ulcer incidence varies between 1 and 56% in intensive care and prevention is an important quest for nursing staff. Critically ill patients that develop pressure ulcers suffer from increased morbidity and mortality and also requires prolonged intensive care. The aim of this study was to investigate registered nurses' and enrolled nurses' (1) attitudes, (2) knowledge and (3) perceived barriers and opportunities towards pressure ulcer prevention, in an ICU setting. These are important aspects in the Theory of Planned Behaviour, a conceptual framework when trying to predict, understand and change specific behaviours. The study is descriptive. Questionnaires were distributed to registered nurses and enrolled nurses in four ICUs in a Swedish hospital. The mean score regarding attitude was 34 ± 4. Correct categorisation of pressure ulcers was made by 46.8% of nursing staff with enrolled nurses having significantly less correct categorisation (p=0.019). Pressure relief (97.3%) and nutritional support (36.1%) were the most frequently reported preventive measures. Reported barriers were lack of time (57.8%) and severely ill patients (28.9%); opportunities were knowledge (38%) and access to pressure relieving equipment (35.5%). This study highlights areas where measures can be made to facilitate pressure ulcer prevention in intensive care units, such as raising knowledge and making pressure ulcer prevention a part of daily care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

PubMed Central

Wartha, Olivia; Dreyhaupt, Jens; Lämmle, Christine; Friedemann, Eva-Maria; Kelso, Anne; Kutzner, Claire; Hermeling, Lina

2017-01-01

Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. PMID:28303253

Results of a Multi-Institutional Benchmark Test for Cranial CT/MR Image Registration

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

Ulin, Kenneth; Urie, Marcia M., E-mail: murie@qarc.or; Cherlow, Joel M.

2010-08-01

Purpose: Variability in computed tomography/magnetic resonance imaging (CT/MR) cranial image registration was assessed using a benchmark case developed by the Quality Assurance Review Center to credential institutions for participation in Children's Oncology Group Protocol ACNS0221 for treatment of pediatric low-grade glioma. Methods and Materials: Two DICOM image sets, an MR and a CT of the same patient, were provided to each institution. A small target in the posterior occipital lobe was readily visible on two slices of the MR scan and not visible on the CT scan. Each institution registered the two scans using whatever software system and method itmore » ordinarily uses for such a case. The target volume was then contoured on the two MR slices, and the coordinates of the center of the corresponding target in the CT coordinate system were reported. The average of all submissions was used to determine the true center of the target. Results: Results are reported from 51 submissions representing 45 institutions and 11 software systems. The average error in the position of the center of the target was 1.8 mm (1 standard deviation = 2.2 mm). The least variation in position was in the lateral direction. Manual registration gave significantly better results than did automatic registration (p = 0.02). Conclusion: When MR and CT scans of the head are registered with currently available software, there is inherent uncertainty of approximately 2 mm (1 standard deviation), which should be considered when defining planning target volumes and PRVs for organs at risk on registered image sets.« less

Effects of lifestyle education program for type 2 diabetes patients in clinics: study design of a cluster randomized trial.

PubMed

Adachi, Misa; Yamaoka, Kazue; Watanabe, Mariko; Nishikawa, Masako; Hida, Eisuke; Kobayashi, Itsuro; Tango, Toshiro

2010-11-30

The number of patients with type 2 diabetes is drastically increasing worldwide. It is a serious health problem in Japan as well. Lifestyle interventions can reduce progression from impaired glucose tolerance to type 2 diabetes, and glycemic control has been shown to improve postprandial plasma glucose levels. Moreover, several studies have suggested that continuous interventions (combined diet and exercise) can improve the plasma glucose level and reduce dosage of hypoglycemic agents.Although many interventional studies of lifestyle education for persons with diabetes in hospitals have been reported, only a few have been clinic-based studies employing an evidence-based lifestyle education program. This article describes the design of a cluster randomized controlled trial of the effectiveness of lifestyle education for patients with type 2 diabetes in clinics by registered dietitians. In Japan, general practitioners generally have their own medical clinics to provide medical care for outpatients in the community, including those with type 2 diabetes. With the collaboration of such general practitioners, the study patients were enrolled in the present study. Twenty general practitioners were randomly allocated to each provide patients for entry into either an intervention group (10) or a control group (10). In total, 200 participants will be included in the study. The intervention group will receive intensive education on lifestyle improvement related to type 2 diabetes by registered dietitians in clinics. Lifestyle education will be conducted several times during the study period. The control group will receive information on dietary intake and standard advice on glycemic control by registered dietitians. The primary endpoint is the change from the baseline value of HbA1c at 6 months. Data on health behavior and related issues will be gathered continuously over a 6-month period. This is the first study to evaluate lifestyle education in clinics by a cluster randomization trial in Japan. The proposed study will provide practical information about the usefulness of the intensive lifestyle improvement education program in primary care settings. The study was started in September 2007 and entry of subjects was completed in December 2010. Data on the effect evaluation will be available in 2011. UMIN000004049.

Predictiveness of Disease Risk in a Global Outreach Tourist Setting in Thailand Using Meteorological Data and Vector-Borne Disease Incidences

PubMed Central

Ninphanomchai, Suwannapa; Chansang, Chitti; Hii, Yien Ling; Rocklöv, Joacim; Kittayapong, Pattamaporn

2014-01-01

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate. PMID:25325356

Male RNs: Work Factors Influencing Job Satisfaction and Intention to Stay in the Profession.

PubMed

Rajacich, Dale; Kane, Debbie; Lafreniere, Kathryn; Freeman, Michelle; Cameron, Sheila; Daabous, James

2014-09-01

Males represent approximately 6.8% of registered nurses in Canada and consequently constitute an untapped health workforce resource. The authors investigated environmental work factors in the acute-care setting and their influence on male RNs' job satisfaction and intention to stay in the profession. They conducted a cross-sectional study of male RNs employed in acute-care settings in the province of Ontario. Correlations and multiple regression analyses were used to examine career satisfaction and intentions. Nurses who were most satisfied with their career valued extrinsic rewards (pay, vacation, and benefits), control and responsibility, and opportunities for professional development; those who were least satisfied and voiced their intention to leave the profession tended to work part time, experience gender mistreatment, and be dissatisfied with extrinsic awards, scheduling, and organizational support. A unique finding of this study relates to the significant predictive relationship between gender mistreatment and males' intention to leave. Copyright© by Ingram School of Nursing, McGill University.

A Comparison of Reasoning Processes in a Collaborative Modelling Environment: Learning about genetics problems using virtual chat

NASA Astrophysics Data System (ADS)

Pata, Kai; Sarapuu, Tago

2006-09-01

This study investigated the possible activation of different types of model-based reasoning processes in two learning settings, and the influence of various terms of reasoning on the learners’ problem representation development. Changes in 53 students’ problem representations about genetic issue were analysed while they worked with different modelling tools in a synchronous network-based environment. The discussion log-files were used for the “microgenetic” analysis of reasoning types. For studying the stages of students’ problem representation development, individual pre-essays and post-essays and their utterances during two reasoning phases were used. An approach for mapping problem representations was developed. Characterizing the elements of mental models and their reasoning level enabled the description of five hierarchical categories of problem representations. Learning in exploratory and experimental settings was registered as the shift towards more complex stages of problem representations in genetics. The effect of different types of reasoning could be observed as the divergent development of problem representations within hierarchical categories.

Predictiveness of disease risk in a global outreach tourist setting in Thailand using meteorological data and vector-borne disease incidences.

PubMed

Ninphanomchai, Suwannapa; Chansang, Chitti; Hii, Yien Ling; Rocklöv, Joacim; Kittayapong, Pattamaporn

2014-10-16

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate.

Increasing Rates of Brain Tumours in the Swedish National Inpatient Register and the Causes of Death Register

PubMed Central

Hardell, Lennart; Carlberg, Michael

2015-01-01

Radiofrequency emissions in the frequency range 30 kHz–300 GHz were evaluated to be Group 2B, i.e., “possibly”, carcinogenic to humans by the International Agency for Research on Cancer (IARC) at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR) and Causes of Death Register (CDR) to further study the incidence comparing with the Cancer Register data for the time period 1998–2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC) +4.25%, 95% CI +1.98, +6.57% during 2007–2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008–2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk. PMID:25854296

Increasing rates of brain tumours in the Swedish national inpatient register and the causes of death register.

PubMed

Hardell, Lennart; Carlberg, Michael

2015-04-03

Radiofrequency emissions in the frequency range 30 kHz-300 GHz were evaluated to be Group 2B, i.e., "possibly", carcinogenic to humans by the International Agency for Research on Cancer (IARC) at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR) and Causes of Death Register (CDR) to further study the incidence comparing with the Cancer Register data for the time period 1998-2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC) +4.25%, 95% CI +1.98, +6.57% during 2007-2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008-2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk.

Vocal and neural responses to unexpected changes in voice pitch auditory feedback during register transitions

PubMed Central

Patel, Sona; Lodhavia, Anjli; Frankford, Saul; Korzyukov, Oleg; Larson, Charles R.

2016-01-01

Objective/Hypothesis It is known that singers are able to control their voice to maintain a relatively constant vocal quality while transitioning between vocal registers; however, the neural mechanisms underlying this effect are not understood. It was hypothesized that greater attention to the acoustical feedback of the voice and increased control of the vocal musculature during register transitions compared to singing within a register would be represented as neurological differences in event-related potentials (ERPs). Study Design/Methods Nine singers sang musical notes at the high end of the modal register (the boundary between the modal and head/falsetto registers) and at the low end (the boundary between the modal and fry/pulse registers). While singing, the pitch of the voice auditory feedback was unexpectedly shifted either into the adjacent register (“toward” the register boundary) or within the modal register (“away from” the boundary). Singers were instructed to maintain a constant pitch and ignore any changes to their voice feedback. Results Vocal response latencies and magnitude of the accompanying N1 and P2 ERPs were greatest at the lower (modal-fry) boundary when the pitch shift carried the subjects’ voices into the fry register as opposed to remaining within the modal register. Conclusions These findings suggest that when a singer lowers the pitch of their voice such that it enters the fry register from the modal register, there is increased sensory-motor control of the voice, reflected as increased magnitude of the neural potentials to help minimize qualitative changes in the voice. PMID:26739860

76 FR 1333 - Suspension of Limitations Under the Jerusalem Embassy Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

... #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 76, No. 6 / Monday, January 10, 2011 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 1333... limitations set forth in sections 3(b) and 7(b) of the Act. You are hereby authorized and directed to transmit...

77 FR 63763 - Regulatory Capital Rules: Standardized Approach for Risk-Weighted Assets; Market Discipline and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... BCBS in 2006 and 2009, as well as other proposals set forth in consultative papers of the BCBS. Section... provided in this Federal Register document, which describes the economic impact of the Standardized... in recent consultative papers of the BCBS.\\2\\ In the Standardized Approach NPR, the agencies also...

The Cinematic Genesis of the Mel Casas Humanscape, 1965-1967

ERIC Educational Resources Information Center

Cordova, Ruben C.

2011-01-01

The 153 paintings that San Antonio-based artist Mel Casas calls Humanscapes were inspired by a glimpse of a drive-in movie screen. This article treats the first three years of work on this series, a period in which the artist referenced cinematic settings and audiences while registering aspects of the sexual revolution. Marshall McLuhan's…

77 FR 71850 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... end-user defined filters (the ``Service''). Spread Crawler, which was developed by MEB, listens to a... based on a registered end-user input (i.e. custom-set parameters for particular symbols or industry...-user(s), if any, would be interested in seeing this order. These filtering rules are contained in a...

The Use of Restraints or Seclusion in the School Setting. Position Statement

ERIC Educational Resources Information Center

Clark, Elizabeth; Compton, Linda; Westendorf, Georgene; Buswell, Sue; Chau, Elizabeth

2014-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is an essential advocate for the health and well-being of all students. Promoting a safe and secure environment is vital to the educational success and emotional development of children. The…

Ordering Sushi: The Intersection of Linguistic Form, Culture and Social Setting in the United States and Japan

ERIC Educational Resources Information Center

Kuroshima, Satomi

2010-01-01

This dissertation examines interactions between sushi chefs and customers at sushi bar counters, using both ethnography and conversation analysis methods, with a particular focus on the communicative practices and embodied actions participants deploy both to make requests for food, and to receive and register these requests. It is argued that…

Whole School, Whole Community, Whole Child: Implications for 21st Century School Nurses. Position Statement

ERIC Educational Resources Information Center

Neumann, Linda; Combe, Laurie; Lambert, Patrice; Bartholomew, Kim; Morgan, Susan; Bobo, Nichole

2017-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) be knowledgeable about and participate in the implementation of Whole School, Whole Community, Whole Child (WSCC) approach in the educational setting (ASCD & Centers for Disease Control…

"Curriculum Development for Home and Health Nursing," January 1995-1996. Final Report on Project.

ERIC Educational Resources Information Center

Nagel, Mary

In 1995, Southwestern College, in California, participated in a project to develop a home health course for registered nurses and students interested in working in home health settings. The course was intended to provide nurses and students with the knowledge and clinical skills required for home health care, improve collaboration among community…

More than First Aid

ERIC Educational Resources Information Center

Schoessler, Sally

2011-01-01

The school nurse is an important member of the school team since school health services keep students in school, in the classroom, and ready to learn. Although school nurses are often seen as the people who deliver first aid at school, their role is much deeper and has such breadth that only a registered, professional nurse has the skill set to…

77 FR 1877 - Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs: Negotiated Pricing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... theories under which we might have such authority. Also in the January 12, 2009 Federal Register, we..., and our final rule with comment period set forth three theories under which we might have such authority. These legal theories are described in detail in our January 12, 2009 final rule with comment...

Revision rates after knee replacement. Cumulative results from worldwide clinical studies versus joint registers.

PubMed

Pabinger, C; Berghold, A; Boehler, N; Labek, G

2013-02-01

To assess revision rates after knee arthroplasty by comparing the cumulative results from worldwide clinical studies and arthroplasty registers. We hypothesised that the revision rate of all clinical studies of a given implant and register data would not differ significantly. A systematic review of clinical studies in indexed peer-reviewed journals was performed followed by internal and external validation. Parameters for measurement of revision were applied (Revision for any reason, Revisions per 100 observed component years). Register data served as control group. Thirty-six knee arthroplasty systems were identified to meet the inclusion criteria: 21 total knee arthroplasty (TKA) systems, 14 unicondylar knee arthroplasty (UKA) systems, one patello-femoral implant system. For 13 systems (36%), no published study was available that contained revision data. For 17 implants (47%), publications were available dealing with radiographic, surgical or technical details, but power was too weak to compare revision rates at a significant level. Six implant systems (17%) had a significant number of revisions published and were finally analysed. In general, developers report better results than independent users. Studies from developers represent an overproportional share of all observed component years. Register data report overall 10-year revision rates of TKA of 6.2% (range: 4.9-7.8%), rates for UKA are 16.5% (range: 9.7-19.6%). Revision rates of all clinical studies of a given implant do not differ significantly from register data. However, significant differences were found between the revision rates published by developers and register data. Therefore the different data need to be interpreted in the context of the source of the information. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

PubMed

Akl, Elie A; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field.

The influence of learning environment on trainee pharmacy technicians' education and training experiences.

PubMed

Schafheutle, Ellen I; Jee, Samuel D; Willis, Sarah C

2017-12-16

In Great Britain (GB), pharmacy technicians (PTs) are registered professionals, with their education and training regulated; little is known about this or the learning environment in which it takes place. This study aimed to profile recently registered pre-registration trainee pharmacy technicians (PTPTs) in GB and capture views on PTPTs' training experiences, focussing on differences in community and hospital settings. A mixed methods study was conducted in 2013-14, following university ethics approval. One-to-one, semi-structured telephone interviews with face-to-face and distance education providers, and hospital and community pharmacy employers of PTPTs explored views on education delivery, work-based learning, and assessment. Interviews were transcribed verbatim, analysed thematically and findings informed design of a census survey of all 1457 recently registered PTs, investigating satisfaction with various aspects of their training. Quantitative data were analysed using SPSS v20, employing comparative statistics (Mann-Whitney U, Chi-Square). Six-hundred and forty-six questionnaires were returned (response rate 44.3%), 632 were usable. Three-quarters (75.9%) of respondents had trained in community; the majority (88.0%) were female, the average age was 35.26 ± 10.22. Those based in hospitals were more satisfied with their training: hospital trainees worked in larger teams and tended to be better supported, they had more study time, and were more likely to complete their training in the intended two-year period. Interviews with staff in 17 Further Education colleges, 6 distance providers, 16 community pharmacies and 15 NHS organisations confirmed survey findings and offered explanations into why differences in training experiences may exist. This study has identified differences between PTPTs' work-based experiences in hospital and community pharmacy. Perceiving PTPTs as 'apprentices' vs. 'employees' may define how their training is managed by employers. Clarity in PTs' roles, responsibilities, and expected competencies upon registration can ensure training is structured and delivered in a suitable and equitable manner across sectors. Copyright © 2017 Elsevier Inc. All rights reserved.

Prenatal exposure to antiepileptic drugs and use of primary healthcare during childhood: a population-based cohort study in Denmark

PubMed Central

Würtz, Anne Mette; Vestergaard, Claus Høstrup; Vestergaard, Mogens; Bech, Bodil Hammer

2017-01-01

Objective Prenatal exposure to antiepileptic drugs (AEDs) has been associated with adverse outcomes in the offspring such as congenital malformations and neuropsychiatric disorders. The objective of this study was to investigate whether prenatal exposure to AEDs is also associated with more frequent use of primary healthcare during childhood. Design Population-based cohort study. Setting Nationwide national registers in Denmark. Participants All live-born singletons in Denmark during 1997–2012 identified in the Danish National Patient Register and followed until 31 December 2013 (n=963 010). Information on prenatal exposure to AEDs for maternal indication of epilepsy and other neurological conditions was obtained from the Danish Register of Medicinal Product Statistics. Main outcome measures The primary outcome measure was the number and type of contacts with the general practitioner (GP), excluding routine well-child visits and vaccinations. The secondary outcome measure was specific services provided at the GP contact. The association between prenatal exposure to AEDs and contacts with the GP was estimated by using negative binomial regression adjusting for sex and date of birth of the child, maternal age, cohabitation status, income, education, substance abuse, depression, severe psychiatric disorders and use of antipsychotics, antidepressants and insulin. Results Children exposed prenatally to AEDs (n=4478) had 3% (95% CI 0 to 5%) more GP contacts during the study period than unexposed children. This was primarily accounted for by the number of phone contacts. Within each year of follow-up, exposed children tended to have more contacts than unexposed children, but the differences were small. We found no difference between exposed and unexposed children with regard to specific services provided at the GP contact. For the individual AEDs, we found that exposure to valproate or oxcarbazepine was associated with more GP contacts. Conclusions We found only minor differences between prenatally AED-exposed and unexposed children in the number of GP contacts. PMID:28069620

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

PubMed Central

Akl, Elie A.; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Background Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. Methods We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Results Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. Conclusion This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field. PMID:26332670

Law machines: scale models, forensic materiality and the making of modern patent law.

PubMed

Pottage, Alain

2011-10-01

Early US patent law was machine made. Before the Patent Office took on the function of examining patent applications in 1836, questions of novelty and priority were determined in court, within the forum of the infringement action. And at all levels of litigation, from the circuit courts up to the Supreme Court, working models were the media through which doctrine, evidence and argument were made legible, communicated and interpreted. A model could be set on a table, pointed at, picked up, rotated or upended so as to display a point of interest to a particular audience within the courtroom, and, crucially, set in motion to reveal the 'mode of operation' of a machine. The immediate object of demonstration was to distinguish the intangible invention from its tangible embodiment, but models also'machined' patent law itself. Demonstrations of patent claims with models articulated and resolved a set of conceptual tensions that still make the definition and apprehension of the invention difficult, even today, but they resolved these tensions in the register of materiality, performativity and visibility, rather than the register of conceptuality. The story of models tells us something about how inventions emerge and subsist within the context of patent litigation and patent doctrine, and it offers a starting point for renewed reflection on the question of how technology becomes property.

Towards adaptive radiotherapy for head and neck patients: validation of an in-house deformable registration algorithm

NASA Astrophysics Data System (ADS)

Veiga, C.; McClelland, J.; Moinuddin, S.; Ricketts, K.; Modat, M.; Ourselin, S.; D'Souza, D.; Royle, G.

2014-03-01

The purpose of this work is to validate an in-house deformable image registration (DIR) algorithm for adaptive radiotherapy for head and neck patients. We aim to use the registrations to estimate the "dose of the day" and assess the need to replan. NiftyReg is an open-source implementation of the B-splines deformable registration algorithm, developed in our institution. We registered a planning CT to a CBCT acquired midway through treatment for 5 HN patients that required replanning. We investigated 16 different parameter settings that previously showed promising results. To assess the registrations, structures delineated in the CT were warped and compared with contours manually drawn by the same clinical expert on the CBCT. This structure set contained vertebral bodies and soft tissue. Dice similarity coefficient (DSC), overlap index (OI), centroid position and distance between structures' surfaces were calculated for every registration, and a set of parameters that produces good results for all datasets was found. We achieve a median value of 0.845 in DSC, 0.889 in OI, error smaller than 2 mm in centroid position and over 90% of the warped surface pixels are distanced less than 2 mm of the manually drawn ones. By using appropriate DIR parameters, we are able to register the planning geometry (pCT) to the daily geometry (CBCT).

Delineation of soil temperature regimes from HCMM data

NASA Technical Reports Server (NTRS)

Day, R. L.; Petersen, G. W. (Principal Investigator)

1982-01-01

The subsetting of HCMM data into ORSER format was completed for four dates using a modified SUBSET program. Large areas (approximately 2500 scan lines, 1680 elements) were selected to increase the occurrence of suitable control points for registration. Average daily temperatures (ADT) were calculated for each date. The MERGE program combined registered daytime temperature (DAY-IR) with nighttime temperature (NIGHT-IR) to form a separate two-channel data set. The SUBTRAN program averaged the DAY-IR and NIGHT-IR creating a third ADT channel. Registration equations for the four ADT data sets were generated. A one dimensional soil heat flow equation was modified to allow for mean annual soil temperature predictions using merged ADT data sets.

Comparison of IVF cycles reported in a voluntary ART registry with a mandatory registry in Spain.

PubMed

Luceño, F; Castilla, J A; Gómez-Palomares, J L; Cabello, Y; Hernández, J; Marqueta, J; Herrero, J; Vidal, E; Fernández-Shaw, S; Coroleu, B

2010-12-01

Monitoring assisted reproductive technology (ART) is essential to evaluate the performance of fertility treatment and its impact on birth rates. In Europe, there are two kinds of ART registers: voluntary and mandatory. The validity of register data is very important with respect to the quality of register-based observational studies. The aim of this paper is to determine the degree of agreement between voluntary and mandatory ART registers. The two sources for the data compared in this study (referring to 2005 and 2006) were FIVCAT.NET (an official compulsory Assisted Reproduction Registry within the Health Ministry of the Regional Government of Catalonia, to which all authorized clinics, both public and private, performing assisted reproduction in the region are obliged to report) and the register of the Spanish Fertility Society (SEF), to which data are provided on a voluntary basis. The SEF register data were divided into two groups: (i) data from clinics in Catalonia (SEF-CAT); (ii) data from the rest of Spain, excluding Catalonia (SEF-wCAT). The techniques compared were IVF cycle using patients' own eggs (IVF cycle) versus donor egg cycles. For IVF cycles, the voluntary ART register reflected 77.2% of those on the official one, but the corresponding figure was only 34.4% with respect to donated eggs. The variables analysed in the IVF cycle (insemination technique used, patients' age, number of embryos transferred, pregnancy rates, multiple pregnancies and deliveries) were similar in the three groups studied. However, we observed significant differences in donor egg cycles with regard to the insemination technique used, pregnancy rates and multiple pregnancies between the voluntary and the official register. Data from the voluntary ART register for IVF cycles are valid, but those for donor egg cycles are not. Further study is necessary to determine the reasons for this difference.

A study of patients not registered in the Swedish Cancer Register but reported to the Swedish Register of Palliative Care 2009 as deceased due to cancer.

PubMed

Nilsson, Martin; Tavelin, Björn; Axelsson, Bertil

2014-03-01

The Swedish Cancer Register (SCR), an old and reputable health data register, contributes a large amount of data used in research. The quality of the research using SCR data depends on the completeness and validity of the register. In Sweden, every healthcare provider is obligated to report newly detected cases of cancer to the SCR regardless of the diagnostic basis. This study aimed to clarify whether there is an under-reporting of patients with cancer to the SCR or an over-reporting of cancer as cause of death to the SRPC as all patients do not appear in both registers. In addition, this study looked at the distribution of under-reporting or over-reporting related to age, sex, type of cancer, diagnostic basis, and department responsible for cancer diagnosis. Of the 10 559 patients whose cause of death was cancer as reported to the SRPC (2009), 1394 patients (13.2%) were not registered in the SCR (1958-2009). Medical records from a representative sample of 203 patients were collected and reviewed. The medical records for 193 patients were obtained; of those, 183 (95%) patients should have been reported to the SCR. Among these, radiologic investigation was the most common basis for diagnosis and there was a significant over-representation of cancer of the pancreas, lung, liver, and bile ducts. This study cannot quantify the completeness of the SCR. The findings indicate that 12.5% of patients dying of cancer in palliative care are not reported, that specialized hospital departments diagnose the vast majority of the unreported patients, and that routines for how to report patients to the SCR based on radiological findings should be revised.

Registration practices for observational studies on ClinicalTrials.gov indicated low adherence.

PubMed

Boccia, Stefania; Rothman, Kenneth J; Panic, Nikola; Flacco, Maria Elena; Rosso, Annalisa; Pastorino, Roberta; Manzoli, Lamberto; La Vecchia, Carlo; Villari, Paolo; Boffetta, Paolo; Ricciardi, Walter; Ioannidis, John P A

2016-02-01

The study aims to assess the status of registration of observational studies. We identified studies on cancer research with prospective recruitment of participants that were registered from February 2000 to December 2011 in ClinicalTrials.gov. We recorded the dates of registration and start of recruitment, outcomes, and description of statistical method. We searched for publications corresponding to the registered studies through May 31, 2014. One thousand one hundred nine registered studies were eligible. Primary and secondary outcomes were reported in 809 (73.0%) and 464 (41.8%) of them. The date of registration preceded the month of the study start in 145 (13.8%) and coincided in 205 (19.5%). A total of 151 publications from 120 (10.8%) registered studies were identified. In 2 (33.3%) of the 6 publications where ClinicalTrials.gov reported that the study started recruitment after registration, and in 9 (50.0%) of 18 publications where ClinicalTrials.gov reported the same date for registration and start of recruitment, the articles showed that the study had actually started recruiting before registration. During the period reviewed, few observational studies have been registered. Registration usually occurred after the study started, and prespecification of outcomes and statistical analysis rarely occurred. Copyright © 2016 Elsevier Inc. All rights reserved.

Population attitudes towards research use of health care registries: a population-based survey in Finland.

PubMed

Eloranta, Katariina; Auvinen, Anssi

2015-07-17

Register-based research can provide important and valuable contributions to public health research, but involves ethical issues concerning the balance of public health benefits and individual autonomy. This study aimed to describe the opinions of the Finnish public about these issues. Mail survey questionnaire sent to a random sample of 1000 Finns. Participation proportion was 42%, with 258 women and 160 men. The majority of the participants (61%) were willing to provide their identifiable health information for research. Almost half of the participants (48%) would, nevertheless, like to be informed when their information is used. A third (30%) indicated no need for informed consent in register-based research, a similar proportion felt it should be obtained for every study, and 40% thought it necessary in some situations, such as studies addressing a sensitive study topic. As for the best policy for obtaining consent, the majority (86%) favoured broader consent methods: one consent covering a certain register or a research topic. Half of the participants (55%) desired a required ethical evaluation from register-based research addressing a sensitive issue. Privacy protection was the most common concern for register-based research. More than half of the participants were either content with the current Finnish laws concerning register-based research or wanted to liberalize them to advance research. The Finnish public is supportive of register-based research, but the requirement for informed consent divides opinions and many would at least like to be informed of the research use of their information.

Criminality and suicide: a longitudinal Swedish cohort study

PubMed Central

Stenbacka, M; Romelsjö, A; Jokinen, J

2014-01-01

Objectives This study aimed to investigate whether violent and non-violent offending were related to elevated risk of suicide. We also investigated whether the risk was higher among those with repeated offences and how experiences of substance misuse and suicide attempt modified the relationship. Design A nationwide prospective cohort study. Setting A register study of 48 834 conscripted men in 1969/1970 in Sweden followed up during a 35-year period in official registers. Participants A birth cohort of 48 834 men who were mandatory conscripted for military service in 1969/70 at the age of 18–20 years. Possible confounders were retrieved from psychological assessments at conscription and the cohort was linked to mortality and hospitalisation and crime records from 1970 onwards. Estimates of suicide risks were calculated as HR with 95% CIs using Cox proportional regression analyses with adjustment for potential confounding by family, psychological and behavioural factors including substance use and psychiatric disorders. Results Of the total cohort, 2671 (5.5%) persons died during the follow-up period. Of these, 615 (23%) persons died due to suicide. Non-violent criminality was evident for 29% and violent criminality for 4.7% of all the participants. In the crude model, the violent offenders had nearly five times higher risk (HR=4.69, 3.56 to 6.19) to die from suicide and non-violent criminals had about two times higher risk (HR=2.08, 1.72 to 2.52). In the fully adjusted model, the HRs were still significant for suicide in the non-violent group. Conclusions Experiences of violent or non-violent criminality were associated with increased risk of suicide. Comorbidity with alcohol and substance use and psychiatric disorders modified the risk, but the suicide risk remained significantly elevated for non-violent criminals. It is crucial to identify offenders and especially repeated offenders who also suffer from alcohol or substance misuse and psychiatric illness in clinical settings in order to prevent suicide. PMID:24491380

‘Our Care through Our Eyes’. Impact of a co-produced digital educational programme on nurses’ knowledge, confidence and attitudes in providing care for children and young people who have self-harmed: a mixed-methods study in the UK

PubMed Central

Manning, Joseph C; Carter, Tim; Latif, Asam; Horsley, Angela; Cooper, Joanne; Armstrong, Marie; Crew, Jamie; Wood, Damian; Callaghan, Patrick

2017-01-01

Objectives (1) To determine the impact of a digital educational intervention on the knowledge, attitudes, confidence and behavioural intention of registered children’s nurses working with children and young people (CYP) admitted with self-harm. (2) To explore the perceived impact, suitability and usefulness of the intervention. Intervention A digital educational intervention that had been co-produced with CYP service users, registered children’s nurses and academics. Setting A prospective, uncontrolled, intervention study with preintervention and postintervention measurement, conducted at a large acute NHS Trust in the UK. Participants From a pool of 251 registered children’s nurses and 98 participants were recruited to complete the intervention (response rate=39%). At follow-up, 52% of participants completed the postintervention questionnaire, with 65% (n=33) of those reporting to have completed the digital educational intervention. Primary outcome measures Attitude towards self-harm in CYP was measured using a 13-item questionnaire; knowledge of self-harm in CYP was measured through an adapted 12-item questionnaire; confidence in different areas of practice was measured through Likert Scale responses; self-efficacy for working with CYP who have self-harmed was measured through an adapted version of the Self-efficacy Towards Helping Scale; clinical behavioural intention was measured by the Continuing Professional Development Reaction Questionnaire. Semistructured interviews were undertaken with a purposive sample of participants. Results For those who completed the intervention (n=33), improvements were observed in knowledge (effect size, ES: 0.69), confidence, and in some domains relating to attitudes (effectiveness domain-ES: 0.49), and clinical behavioural intention (belief about consequences-ES:0.49; moral norm-ES: 0.43; beliefs about capability-ES: 0.42). Qualitative findings suggest participants experienced skill development, feelings of empowerment and reflection on own practice. Conclusions The effect of the intervention is promising and demonstrates the potential it has in improving registered children’s nurse’s knowledge, confidence and attitudes. However, further testing is required to confirm this. PMID:28473515

Evaluation of a Hockey Deceased Organ Donation Awareness Campaign: A Population-Based Cohort Study

PubMed Central

Naylor, Kyla L.; McKenzie, Susan; Cherry, Cindy; McArthur, Eric; Li, Alvin H.; McCallum, Megan K.; Kim, S. Joseph; Prakash, Versha; Knoll, Gregory A.; Garg, Amit X.

2017-01-01

Background: The Kidney Foundation of Canada developed a pilot campaign to educate persons attending junior hockey league games in London, Ontario, Canada, on deceased organ donation. Objective: To evaluate the impact of a hockey campaign on the number of new organ and tissue donor registrants. Design: Population-based retrospective cohort study. Setting: Residents of London, Ontario. Patients: We included 255 476 individuals eligible to register for organ donation with a London, Ontario postal code. Measurements: We compared the number of new deceased organ donor registrants in London, Ontario, during the campaign period (March 12 to April 16, 2015) with 3 different time periods (December 30, 2014 to February 3, 2015; February 4 to March 11, 2015; April 17 to May 22, 2015). We also compared registration rates in London with 2 Ontario cities (Kitchener-Waterloo and Hamilton) matching in a 1:1 ratio on age, sex, and income quintile. Methods: To compare registrations across time periods, we used binomial regression with an identity link function and generalized estimating equations with an independence correlation structure. We used modified Poisson regression to compare registration rates between cities. Results: During the campaign period, there were slightly more registrations (1218 registered of 252 832 unregistered individuals [0.48%]) compared with an earlier time period (risk difference: 0.09%; 95% confidence interval [CI]: 0.05%-0.12%). However, there was no significant difference compared with 2 time periods immediately before and after the campaign. London had slightly more registrations during the campaign period compared with the matched city of Hamilton (1180 registered of 236 582 unregistered individuals [0.50%] vs 490 registered of 236 582 unregistered individuals [0.21%]; risk ratio: 2.41; 95% CI: 2.17-2.68). The registration rate in London did not significantly differ from Kitchener-Waterloo. Limitations: Unable to conclude whether the minor increase in deceased organ donor registration was the result of the campaign or other factors (e.g., simultaneous organ registration events, seasonality). Conclusions: Overall, a minor increase in deceased organ donor registration was observed during the hockey organ donation awareness campaign; however, the specific impact of the campaign on organ donor registration could not be determined. PMID:28748101