Exploring the Use of Enterprise Content Management Systems in Unification Types of Organizations

NASA Astrophysics Data System (ADS)

Izza Arshad, Noreen; Mehat, Mazlina; Ariff, Mohamed Imran Mohamed

2014-03-01

The aim of this paper is to better understand how highly standardized and integrated businesses known as unification types of organizations use Enterprise Content Management Systems (ECMS) to support their business processes. Multiple case study approach was used to study the ways two unification organizations use their ECMS in their daily work practices. Arising from these case studies are insights into the differing ways in which ECMS is used to support businesses. Based on the comparisons of the two cases, this study proposed that unification organizations may use ECMS in four ways, for: (1) collaboration, (2) information sharing that supports a standardized process structure, (3) building custom workflows that support integrated and standardized processes, and (4) providing links and access to information systems. These findings may guide organizations that are highly standardized and integrated in fashion, to achieve their intended ECMS-use, to understand reasons for ECMS failures and underutilization and to exploit technologies investments.

JPL Thermal Design Modeling Philosophy and NASA-STD-7009 Standard for Models and Simulations - A Case Study

NASA Technical Reports Server (NTRS)

Avila, Arturo

2011-01-01

The Standard JPL thermal engineering practice prescribes worst-case methodologies for design. In this process, environmental and key uncertain thermal parameters (e.g., thermal blanket performance, interface conductance, optical properties) are stacked in a worst case fashion to yield the most hot- or cold-biased temperature. Thus, these simulations would represent the upper and lower bounds. This, effectively, represents JPL thermal design margin philosophy. Uncertainty in the margins and the absolute temperatures is usually estimated by sensitivity analyses and/or by comparing the worst-case results with "expected" results. Applicability of the analytical model for specific design purposes along with any temperature requirement violations are documented in peer and project design review material. In 2008, NASA released NASA-STD-7009, Standard for Models and Simulations. The scope of this standard covers the development and maintenance of models, the operation of simulations, the analysis of the results, training, recommended practices, the assessment of the Modeling and Simulation (M&S) credibility, and the reporting of the M&S results. The Mars Exploration Rover (MER) project thermal control system M&S activity was chosen as a case study determining whether JPL practice is in line with the standard and to identify areas of non-compliance. This paper summarizes the results and makes recommendations regarding the application of this standard to JPL thermal M&S practices.

[Comparison of the effect of different diagnostic criteria of subclinical hypothyroidism and positive TPO-Ab on pregnancy outcomes].

PubMed

He, Yiping; He, Tongqiang; Wang, Yanxia; Xu, Zhao; Xu, Yehong; Wu, Yiqing; Ji, Jing; Mi, Yang

2014-11-01

To explore the effect of different diagnositic criteria of subclinical hypothyroidism using thyroid stimulating hormone (TSH) and positive thyroid peroxidase antibodies (TPO-Ab) on the pregnancy outcomes. 3 244 pregnant women who had their antenatal care and delivered in Child and Maternity Health Hospital of Shannxi Province August from 2011 to February 2013 were recruited prospectively. According to the standard of American Thyroid Association (ATA), pregnant women with normal serum free thyroxine (FT4) whose serum TSH level> 2.50 mU/L were diagnosed as subclinical hypothyroidism in pregnancy (foreign standard group). According to the Guideline of Diagnosis and Therapy of Prenatal and Postpartum Thyroid Disease made by Chinese Society of Endocrinology and Chinese Society of Perinatal Medicine in 2012, pregnant women with serum TSH level> 5.76 mU/L, and normal FT4 were diagnosed as subclinical hypothyroidism in pregnancy(national standard group). Pregnant women with subclinical hypothyroidism whose serum TSH levels were between 2.50-5.76 mU/L were referred as the study observed group; and pregnant women with serum TSH level< 2.50 mU/L and negative TPO- Ab were referred as the control group. Positive TPO-Ab results and the pregnancy outcomes were analyzed. (1) There were 635 cases in the foreign standard group, with the incidence of 19.57% (635/3 244). And there were 70 cases in the national standard group, with the incidence of 2.16% (70/3 244). There were statistically significant difference between the two groups (P < 0.01). There were 565 cases in the study observed group, with the incidence of 17.42% (565/3 244). There was statistically significant difference (P < 0.01) when compared with the national standard group; while there was no statistically significant difference (P > 0.05) when compared with the foreign standard group. (2) Among the 3 244 cases, 402 cases had positive TPO-Ab. 318 positive cases were in the foreign standard group, and the incidence of subclinical hypothyroidism was 79.10% (318/402). There were 317 negative cases in the foreign standard group, with the incidence of 11.15% (317/2 842). The difference was statistically significant (P < 0.01) between them. In the national standard group, 46 cases had positive TPO-Ab, with the incidence of 11.44% (46/402), and 24 cases had negative result, with the incidence of 0.84% (24/2 842). There were statistically significant difference (P < 0.01) between them. In the study observed group, 272 cases were TPO-Ab positive, with the incidence of 67.66% (272/402), and 293 cases were negative, with the incidence of 10.31% (293/2 842), the difference was statistically significant (P < 0.01). (3) The incidence of miscarriage, premature delivery, gestational hypertension disease, gestational diabetes mellitus(GDM)in the foreign standard group had statistically significant differences (P < 0.05) when compared with the control group, respectively. While there was no statistically significant difference (P > 0.05) in the incidence of placental abruption or fetal distress. And the incidence of miscarriage, premature delivery, gestational hypertension disease, GDM in the national standard group had statistical significant difference (P < 0.05) compared with the control group, respectively. While there was no statistically significant difference (P > 0.05) in the incidence of placental abruption or fetal distress. This study observed group of pregnant women's abortion, gestational hypertension disease, GDM incidence respectively compared with control group, the difference had statistical significance (P < 0.05); but in preterm labor, placental abruption, and fetal distress incidence, there were no statistically significant difference (P > 0.05). (4) The incidence of miscarriage, premature delivery, gestational hypertension disease, GDM, placental abruption, fetal distress in the TPO-Ab positive cases of the national standard group showed an increase trend when compared with TPO-Ab negative cases, with no statistically significant difference (P > 0.05). The incidence of gestational hypertension disease and GDM in the TPO-Ab positive cases of the study observed group had statistical significance difference (P < 0.05) when compared with TPO-Ab negative cases; while the incidence of miscarriage, premature birth, placental abruption, fetal distress had no statistically significant difference (P > 0.05). The incidence of gestational hypertension disease and GDM in the TPO-Ab positive cases had statistically significance difference when compared with TPO-Ab negtive cases of foreign standard group (P < 0.05). (1) The incidence of subclinical hypothyroidism is rather high during early pregnancy and can lead to adverse pregnancy outcome. (2) Positive TPO-Ab result has important predictive value of the thyroid dysfunction and GDM. (3) Relatively, the ATA standard of diagnosis (serum TSH level> 2.50 mU/L) is safer for the antenatal care; the national standard (serum TSH level> 5.76 mU/L) is not conducive to pregnancy management.

The use of standard operating procedures in day case anterior cruciate ligament reconstruction.

PubMed

Khan, T; Jackson, W F; Beard, D J; Marfin, A; Ahmad, M; Spacie, R; Jones, R; Howes, S; Barker, K; Price, A J

2012-08-01

The current rate of day-case anterior cruciate ligament reconstruction (ACLR) in the UK remains low. Although specialised care pathways with standard operating procedures (SOPs) have been effective in reducing length of stay following some surgical procedures, this has not been previously reported for ACLR. We evaluate the effectiveness of SOPs for establishing day-case ACLR in a specialist unit. Fifty patients undergoing ACLR between May and September 2010 were studied prospectively ("study group"). SOPs were designed for pre-operative assessment, anaesthesia, surgical procedure, mobilisation and discharge. We evaluated length of stay, readmission rates, patient satisfaction and compliance to SOPs. A retrospective analysis of 50 patients who underwent ACLR prior to implementation of the day-case pathway was performed ("standard practice group"). Eighty percent of patients in the study group were discharged on the day of surgery (mean length of stay=5.3h) compared to 16% in the standard practice group (mean length of stay=21.6h). This difference was statistically significant (p<0.05, Mann-Whitney U test). All patients were satisfied with the day case pathway. Ninety-two percent of the study group were discharged on the day of surgery when all SOPs were followed and 46% where they were not. High rates of day-case ACLR with excellent patient satisfaction can be achieved with the use of a specialised patient pathway with SOPs. Copyright © 2011 Elsevier B.V. All rights reserved.

Teacher Efficacy and Professional Development Needs of Mid-Career Agriculture Educators Integrating the Next Generation Science Standards and Other Content Areas

ERIC Educational Resources Information Center

Drape, Tiffany A.; Lopez, Megan; Radford, Donna

2016-01-01

The purpose of this case study was to examine the phenomenon regarding agriculture education teacher's efficacy by integrating the Next Gen Science Standards and other content areas into their classroom teaching. This was a single case study with two units of analysis consisting of two agriculture education programs in the Eastern United States…

Assessment of severe malaria in a multicenter, phase III, RTS, S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care

PubMed Central

2011-01-01

Background An effective malaria vaccine, deployed in conjunction with other malaria interventions, is likely to substantially reduce the malaria burden. Efficacy against severe malaria will be a key driver for decisions on implementation. An initial study of an RTS, S vaccine candidate showed promising efficacy against severe malaria in children in Mozambique. Further evidence of its protective efficacy will be gained in a pivotal, multi-centre, phase III study. This paper describes the case definitions of severe malaria used in this study and the programme for standardized assessment of severe malaria according to the case definition. Methods Case definitions of severe malaria were developed from a literature review and a consensus meeting of expert consultants and the RTS, S Clinical Trial Partnership Committee, in collaboration with the World Health Organization and the Malaria Clinical Trials Alliance. The same groups, with input from an Independent Data Monitoring Committee, developed and implemented a programme for standardized data collection. The case definitions developed reflect the typical presentations of severe malaria in African hospitals. Markers of disease severity were chosen on the basis of their association with poor outcome, occurrence in a significant proportion of cases and on an ability to standardize their measurement across research centres. For the primary case definition, one or more clinical and/or laboratory markers of disease severity have to be present, four major co-morbidities (pneumonia, meningitis, bacteraemia or gastroenteritis with severe dehydration) are excluded, and a Plasmodium falciparum parasite density threshold is introduced, in order to maximize the specificity of the case definition. Secondary case definitions allow inclusion of co-morbidities and/or allow for the presence of parasitaemia at any density. The programmatic implementation of standardized case assessment included a clinical algorithm for evaluating seriously sick children, improvements to care delivery and a robust training and evaluation programme for clinicians. Conclusions The case definition developed for the pivotal phase III RTS, S vaccine study is consistent with WHO recommendations, is locally applicable and appropriately balances sensitivity and specificity in the diagnosis of severe malaria. Processes set up to standardize severe malaria data collection will allow robust assessment of the efficacy of the RTS, S vaccine against severe malaria, strengthen local capacity and benefit patient care for subjects in the trial. Trial registration Clinicaltrials.gov NCT00866619 PMID:21816031

Exploring the Impact of a Standards-Based Mathematics and Pedagogy Class on Preservice Teachers' Beliefs and Subject Matter Knowledge

ERIC Educational Resources Information Center

Stohlmann, Micah Stephen

2012-01-01

This case study explored the impact of a standards-based mathematics and pedagogy class on preservice elementary teachers' beliefs and conceptual subject matter knowledge of linear functions. The framework for the standards-based mathematics and pedagogy class in this study involved the National Council of Teachers of Mathematics Standards,…

22 CFR 96.52 - Performance of Convention communication and coordination functions in incoming cases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... prospective adoptive parent(s) and/or the child background study to the authorities that forwarded them. (e... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Performance of Convention communication and... 2000 (IAA) Standards for Convention Accreditation and Approval Standards for Cases in Which A Child Is...

Nested case-control studies: should one break the matching?

PubMed

Borgan, Ørnulf; Keogh, Ruth

2015-10-01

In a nested case-control study, controls are selected for each case from the individuals who are at risk at the time at which the case occurs. We say that the controls are matched on study time. To adjust for possible confounding, it is common to match on other variables as well. The standard analysis of nested case-control data is based on a partial likelihood which compares the covariates of each case to those of its matched controls. It has been suggested that one may break the matching of nested case-control data and analyse them as case-cohort data using an inverse probability weighted (IPW) pseudo likelihood. Further, when some covariates are available for all individuals in the cohort, multiple imputation (MI) makes it possible to use all available data in the cohort. In the paper we review the standard method and the IPW and MI approaches, and compare their performance using simulations that cover a range of scenarios, including one and two endpoints.

The California Clinical Data Project: a case study in the adoption of clinical data standards for quality improvement.

PubMed

Sujansky, Walter; Chang, Sophia

2006-01-01

The California Clinical Data Project is a statewide initiative to remove barriers to the widespread and effective use of information technology to improve chronic disease care. The project is a case study in the development and widespread adoption of clinical data standards by varied and often competing stakeholders. As an initial step, the project defined precise data standards for the batch reporting of pharmacy claims data and laboratory results data. These uniform standards facilitate the flow of existing electronic clinical information into disease registries and electronic health record systems. Pharmacy and lab results data now are being exchanged electronically with this standard among the largest health plans, medical groups, and clinical laboratories participating in California's pay-for-performance programs. Lessons from this project may apply to the development and adoption of data standards for other states and locales and for the emerging national health information infrastructure.

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study).

PubMed

Mukhopadhyay, Sanjay; Feldman, Michael D; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G; Cathro, Helen P; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E; Gill, Ryan M; Heaton, Robert P; Kerstens, René; Lindberg, Guy M; Malhotra, Reenu K; Mandell, James W; Manlucu, Ellen D; Mills, Anne M; Mills, Stacey E; Moskaluk, Christopher A; Nelis, Mischa; Patil, Deepa T; Przybycin, Christopher G; Reynolds, Jordan P; Rubin, Brian P; Saboorian, Mohammad H; Salicru, Mauricio; Samols, Mark A; Sturgis, Charles D; Turner, Kevin O; Wick, Mark R; Yoon, Ji Y; Zhao, Po; Taylor, Clive R

2018-01-01

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types.

Endoscope-assisted approach to excision of branchial cleft cysts.

PubMed

Teng, Stephanie E; Paul, Benjamin C; Brumm, John D; Fritz, Mark; Fang, Yixin; Myssiorek, David

2016-06-01

The purpose of this study is to describe an endoscope-assisted surgical technique for the excision of branchial cleft cysts and compare it to the standard approach. Retrospective case series review. Twenty-seven cases described as branchial cleft excisions performed by a single surgeon at one academic medical center were identified between 2007 and 2014. Twenty-five cases (8 endoscopic, 17 standard approach) were included in the study. Cases were excluded if final pathology was malignant. Patient charts were reviewed, and two techniques were compared through analysis of incision size, operative time, and surgical outcomes. This study showed that the length of incision required for the endoscopic approach (mean = 2.13 ± 0.23) was significantly less than that of the standard approach (mean = 4.10 ± 1.46, P = 0.008) despite the fact that there was no significant difference in cyst size between the two groups (P = 0.09). The other variables examined, including operative time and surgical outcomes, were not significantly different between the two groups. This transcervical endoscope-assisted approach to branchial cleft cyst excision is a viable option for uncomplicated cases. It provides better cosmetic results than the standard approach and does not negatively affect outcomes, increase operative time, or result in recurrence. 4. Laryngoscope, 126:1339-1342, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Automated surface quality inspection with ARGOS: a case study

NASA Astrophysics Data System (ADS)

Kiefhaber, Daniel; Etzold, Fabian; Warken, Arno F.; Asfour, Jean-Michel

2017-06-01

The commercial availability of automated inspection systems for optical surfaces specified according to ISO 10110-7 promises unsupervised and automated quality control with reproducible results. In this study, the classification results of the ARGOS inspection system are compared to the decisions by well-trained inspectors based on manual-visual inspection. Both are found to agree in 93.6% of the studied cases. Exemplary cases with differing results are studied, and shown to be partly caused by shortcomings of the ISO 10110-7 standard, which was written for the industry standard manual-visual inspection. Applying it to high resolution images of the whole surface of objective machine vision systems brings with it a few challenges which are discussed.

[Municipal landfill site in Krzyz near Tarnów as source of microbiological factors harmful to environment and human health].

PubMed

Fraczek, Krzysztof; Barabasz, Wiesław

2004-01-01

The present study aimed to evaluate microbiological pollution of air with microorganisms belonging to different taxonomic and physiological groups, and to examine whether the effect of the municipal landfill site in Krzyz changes at various study sites located: in so called "zero zone" (operating landfill), at different distances from the landfill and in Tarnów. Microbiological studies of atmospheric air were carried out from May 1998 to April 2001. Measurements were taken at 10 study sites located at the operating municipal landfill site in Krzyz, inside and outside of its protection zone. Microbial air pollution standard (PN-89/Z-04111/02 and PN-89/Z-04111/03) were used to evaluate the impact of municipal landfill site on the atmospheric environment. The standards were most often exceeded by hemolytic bacteria, (277 cases out of 360 measurements) i.e. 76.9%, and Actinomycetes (213 cases out of 360 measurements) i.e 59.1%, while by fungi (26 cases out of 360 measurements) i.e 7.2% and bacteria (42 cases out of 360 measurements) i.e 11.6% in a lesser degree. The standards were most often exceeded in operating land fill site sector, at the gateway to the land fill site and in partially reclaimed sector. Fewest cases of standard exceedance were recorded in control site (located outside the landfill site), near built-up area and before the entrance to the land fill site.

Case reports: Publication standards in forensic psychiatry.

PubMed

Hanson, Annette; Martinez, Richard; Candilis, Philip J

2014-01-01

Psychiatrists who publish case reports are required to seek informed consent from their subjects on the basis of the ethics-related obligation to maintain patient confidentiality. Academic journals have developed editorial standards to fulfill this obligation. Forensic evaluations do not create a doctor-patient relationship in the traditional sense, and information obtained through a forensic evaluation may also be found in the public domain. This public exposure is particularly likely, given the development of open access publishing standards, online journals, and increasing professional involvement in social media. This article outlines the ethics of informed consent in published case reports for general and forensic psychiatry and offers recommendations for forensic case study publishing. The authors suggest changes in the current requirements stated in The Journal for publication of case reports. © 2014 American Academy of Psychiatry and the Law.

Use of standardized multidimensional evaluation tools and the emergence of the case manager's professional identity in France.

PubMed

Nugue, Mathilde; De Stampa, Matthieu; Couturier, Yves; Somme, Dominique

2012-01-01

In France, the national public health plan proposes a group of innovations including the initiation of case management for older adults in complex situations, particularly those with cognitive disorders. In this context, public authorities asked case managers to use a standardized multidimensional evaluation tool. The results of a qualitative study on the pertinence of such a tool relative to the emergence of this new professional field are described. Early use of an evaluation tool seems to be linked to the emergence of a new professional identity for recently recruited case managers. Factors determining the strength of this link are training tool standardization, computerization, and local structure's involvement. Our results contribute to identifying one of the ways by which professional identity can be changed to become a case manager.

Preparing Students for Critical-Thinking Applications on Standardized Tests

ERIC Educational Resources Information Center

Hendricks, Jacquelyn Kaye

2010-01-01

Student performance on critical-thinking applications on standardized tests in a southwestern U.S. state has been low for several years. The purpose of this instrumental case study was to explore how one school district prepared students for critical-thinking applications on standardized tests. The study was informed by cognitivism and…

The Implementation of Standards-Based Teacher Evaluation in Vietnamese Secondary Schools: A Case Study in Dong Thap

ERIC Educational Resources Information Center

Pham, Huy Q.

2013-01-01

Teacher quality has become a critical area of concern in Vietnamese education. Recently, new professional standards for teachers in secondary schools have been developed, piloted, and implemented. This study explores the perceptions of teachers, school principals, and other administrators about the new teacher professional standards, the…

State Initiatives on Industry-Based Skill Standards and Credentials.

ERIC Educational Resources Information Center

Ganzglass, Evelyn; Simon, Martin

A study examined state initiatives for industry-based skill standards and credentials. Officials in 19 states were interviewed, case studies of programs in 3 states (Georgia, Pennsylvania, and Texas) were conducted, and focus group discussions were held with 25 individuals. State skill standards were generally found to be tied to broader efforts…

The "Glocalization" of Medical School Accreditation: Case Studies From Taiwan, South Korea, and Japan.

PubMed

Ho, Ming-Jung; Abbas, Joan; Ahn, Ducksun; Lai, Chi-Wan; Nara, Nobuo; Shaw, Kevin

2017-12-01

In an age of globalized medical education, medical school accreditation has been hailed as an approach to external quality assurance. However, accreditation standards can vary widely across national contexts. To achieve recognition by the World Federation for Medical Education (WFME), national accrediting bodies must develop standards suitable for both local contexts and international recognition. This study framed this issue in terms of "glocalization" and aimed to shine light on this complicated multistakeholder process by exploring accreditation in Taiwan, South Korea, and Japan. This study employed a comparative case-study design, examining the national standards that three accreditation bodies in East Asia developed using international reference standards. In 2015-2016, the authors conducted document analysis of the English versions of the standards to identify the differences between the national and international reference standards as well as how and why external standards were adapted. Each country's accreditation body sought to balance local needs with global demands. Each used external standards as a template (e.g., Liaison Committee on Medical Education, General Medical Council, or WFME standards) and either revised (Taiwan, South Korea) or annotated (Japan) the standards to fit the local context. Four categories of differences emerged to account for how and why national standards departed from external references: structural, regulatory, developmental, and aspirational. These countries' glocalization of medical accreditation standards serve as examples for others seeking to bring their accreditation practices in line with global standards while ensuring that local values and societal needs are given adequate consideration.

The Common Core State Standards and the Role of Instructional Materials: A Case Study on EdReports.org

ERIC Educational Resources Information Center

Watt, Michael G.

2016-01-01

The purpose of this study was to review research studies investigating the role of instructional materials in relation to the Common Core State Standards and to evaluate whether a new organisation, EdReports.org, founded to evaluate the alignment of instructional materials to the Common Core State Standards, has achieved its objectives. Content…

Affirm VPIII microbial identification test can be used to detect gardnerella vaginalis, Candida albicans and trichomonas vaginalis microbial infections in Korean women.

PubMed

Byun, Seung Won; Park, Yeon Joon; Hur, Soo Young

2016-04-01

The aim of this study was to compare Affirm VPIII Microbial Identification Test results for Korean women to those obtained for Gardnerella vaginalis through Nugent score, Candida albicans based on vaginal culture and Trichomonas vaginalis based on wet smear diagnostic standards. Study participants included 195 women with symptomatic or asymptomatic vulvovaginitis under hospital obstetric or gynecologic care. A definite diagnosis was made based on Nugent score for Gardnerella, vaginal culture for Candida and wet prep for Trichomonas vaginalis. Affirm VPIII Microbial Identification Test results were then compared to diagnostic standard results. Of the 195 participants, 152 were symptomatic, while 43 were asymptomatic. Final diagnosis revealed 68 (37.87%) cases of Gardnerella, 29 (14.87%) cases of Candida, one (0.51%) case of Trichomonas, and 10 (5.10%) cases of mixed infections. The detection rates achieved by each detection method (Affirm assay vs diagnostic standard) for Gardnerella and Candida were not significantly different (33.33% vs 34.8% for Gardnerella, 13.33% vs 14.87% for Candida, respectively). The sensitivity and specificity of the Affirm test for Gardnerella compared to the diagnostic standard were 75.0% and 88.98%, respectively. For Candida, the sensitivity and specificity of the Affirm test compared to the diagnostic standard were 82.76% and 98.80%, respectively. The number of Trichomonas cases was too small (1 case) to be statistically analyzed. The Affirm test is a quick tool that can help physicians diagnose and treat patients with infectious vaginitis at the point of care. © 2016 Japan Society of Obstetrics and Gynecology.

Alignment of single-case design (SCD) research with individuals who are deaf or hard of hearing with the what Works Clearinghouse standards for SCD research.

PubMed

Wendel, Erica; Cawthon, Stephanie W; Ge, Jin Jin; Beretvas, S Natasha

2015-04-01

The authors assessed the quality of single-case design (SCD) studies that assess the impact of interventions on outcomes for individuals who are deaf or hard-of-hearing (DHH). More specifically, the What Works Clearinghouse (WWC) standards for SCD research were used to assess design quality and the strength of evidence of peer-reviewed studies available in the peer-reviewed, published literature. The analysis yielded four studies that met the WWC standards for design quality, of which two demonstrated moderate to strong evidence for efficacy of the studied intervention. Results of this review are discussed in light of the benefits and the challenges to applying the WWC design standards to research with DHH individuals and other diverse, low-incidence populations. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

DICOM Standard Conformance in Veterinary Medicine in Germany: a Survey of Imaging Studies in Referral Cases.

PubMed

Brühschwein, Andreas; Klever, Julius; Wilkinson, Tom; Meyer-Lindenberg, Andrea

2018-02-01

In 2016, the recommendations of the DICOM Standards Committee for the use of veterinary identification DICOM tags had its 10th anniversary. The goal of our study was to survey veterinary DICOM standard conformance in Germany regarding the specific identification tags veterinarians should use in veterinary diagnostic imaging. We hypothesized that most veterinarians in Germany do not follow the guidelines of the DICOM Standards Committee. We analyzed the metadata of 488 imaging studies of referral cases from 115 different veterinary institutions in Germany by computer-aided DICOM header readout. We found that 25 (5.1%) of the imaging studies fully complied with the "veterinary DICOM standard" in this survey. The results confirmed our hypothesis that the recommendations of the DICOM Standards Committee for the consistent and advantageous use of veterinary identification tags have found minimal acceptance amongst German veterinarians. DICOM does not only enable connectivity between machines, DICOM also improves communication between veterinarians by sharing correct and valuable metadata for better patient care. Therefore, we recommend that lecturers, universities, societies, authorities, vendors, and other stakeholders should increase their effort to improve the spread of the veterinary DICOM standard in the veterinary world.

Development and testing of a tool for assessing and resolving medication-related problems in older adults in an ambulatory care setting: the individualized medication assessment and planning (iMAP) tool.

PubMed

Crisp, Ginny D; Burkhart, Jena Ivey; Esserman, Denise A; Weinberger, Morris; Roth, Mary T

2011-12-01

Medication is one of the most important interventions for improving the health of older adults, yet it has great potential for causing harm. Clinical pharmacists are well positioned to engage in medication assessment and planning. The Individualized Medication Assessment and Planning (iMAP) tool was developed to aid clinical pharmacists in documenting medication-related problems (MRPs) and associated recommendations. The purpose of our study was to assess the reliability and usability of the iMAP tool in classifying MRPs and associated recommendations in older adults in the ambulatory care setting. Three cases, representative of older adults seen in an outpatient setting, were developed. Pilot testing was conducted and a "gold standard" key developed. Eight eligible pharmacists consented to participate in the study. They were instructed to read each case, make an assessment of MRPs, formulate a plan, and document the information using the iMAP tool. Inter-rater reliability was assessed for each case, comparing the pharmacists' identified MRPs and recommendations to the gold standard. Consistency of categorization across reviewers was assessed using the κ statistic or percent agreement. The mean κ across the 8 pharmacists in classifying MRPs compared with the gold standard was 0.74 (range, 0.54-1.00) for case 1 and 0.68 (range, 0.36-1.00) for case 2, indicating substantial agreement. For case 3, percent agreement was 63% (range, 40%-100%). The mean κ across the 8 pharmacists when classifying recommendations compared with the gold standard was 0.87 (range, 0.58-1.00) for case 1 and 0.88 (range, 0.75-1.00) for case 2, indicating almost perfect agreement. For case 3, percent agreement was 68% (range, 40%-100%). Clinical pharmacists found the iMAP tool easy to use. The iMAP tool provides a reliable and standardized approach for clinical pharmacists to use in the ambulatory care setting to classify MRPs and associated recommendations. Future studies will explore the predictive validity of the tool on clinical outcomes such as health care utilization. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

ERIC Educational Resources Information Center

Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

2006-01-01

This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

CERN IT Book Fair 2009 - Special talk by Bjarne Stroustrup: "The Design of C++0x"

ScienceCinema

Stroustrup, Bjarne

2018-05-24

A draft for a revised ISO C++ standard, C++0x, has been produced. The speaker will present the background of C++, its aims, the standards process (with opinions), some of the guiding design principles (with tiny code examples), and two case studies.The case studies are initialization (a general and uniform syntax and semantics for initializers in all contexts) and concurrent support facilities (memory model, threads, locks, futures).

Building Accountability in California: A Review of State Standards and Requirements for K-12 Public School Facility Planning and Design

ERIC Educational Resources Information Center

Vincent, Jeffrey M.

2016-01-01

This study aims to inform the California Department of Education (CDE) in ensuring the standards contained in Title 5 appropriately promote the planning and design of healthy, safe and educationally suitable K-12 school facilities. The study gathers and analyzes K-12 facility standards in ten case study states across the country to understand…

A Descriptive Case Study of Writing Standards-Based Individualized Education Plan Goals via Problem-Based Learning in a Virtual World

ERIC Educational Resources Information Center

Blair, Peter J.

2017-01-01

The goal of this study was to examine the professional development experiences of two contrastive participants while they were creating standards-based individualized education plan (IEP) goals using a virtual world called TeacherSim. Two specific focuses of the study were on how special educators engaged with the task of creating standards-based…

Fulfillment of GMP standard, halal standard, and applying HACCP for production process of beef floss (Case study: Ksatria enterprise)

NASA Astrophysics Data System (ADS)

A'diat, Arkan Addien Al; Liquiddanu, Eko; Laksono, Pringgo Widyo; Sutopo, Wahyudi; Suletra, I. Wayan

2018-02-01

Along with the increasing number of the modern retail business in Indonesia, give an opportunity to small and medium enterprise (SME) to sell its products through the modern retailer. There are some obstacles faced by the SMEs, one of them is about product standard. Product standard that must be owned by SMEs are GMP standard and halal standard. This research was conducted to know the fulfillment by the beef floss enterprise in jagalan in fulfilling the GMP standard and halal. In addition, Hazard Analysis and Critical Control Points (HACCP) system was applied to analyze the process. HACCP which used in this research was based on the seven principles in SNI (Indonesian National Standard) 01-4852-1998. The seven principles included hazard analysis, critical control point (CCP) determination, critical limit establishment, CCP monitor system establishment, corrective action establishment, verification, and also documentation establishment that must be applied in preparing HACCP plan. Based on this case study, it is concluded that there were 5 CCPs : the boiling process, roasting process, frying process, the beef floss draining process, and the packaging process.

Integrating preventive care and nursing standardized terminologies in nursing education: a case study.

PubMed

Burkhart, Lisa; Sommer, Sheryl

2007-01-01

This study investigated the development of a community-focused curriculum integrating primary, secondary, and tertiary prevention and nursing standardized terminologies as an organizing infrastructure. This is a case study of the curriculum redesign of the Marcella Niehoff School of Nursing, Loyola University Chicago. Faculty developed a conceptual framework integrating core concepts into curriculum design, course content, and clinical applications. A coherent curriculum was designed using a community-focused approach; primary, secondary, and tertiary prevention strategies; and standardized terminologies as the organizing infrastructure to teach and apply nursing practice. The curriculum provides a meaningful correlation between the classroom and clinical experience. Students journey with their patients throughout the health care experience, applying nursing concepts using standardized terminologies. Clinical experiences provide students with the opportunity to transfer knowledge to the health experiences of patients in their care. Patient encounters, whether at the primary, secondary, or tertiary level of prevention, are used to assist students in developing critical thinking skills through the use of standardized nursing terminologies.

Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

PubMed

Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

2013-01-01

As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

Standardization of Clinical Assessment and Sample Collection Across All PERCH Study Sites

PubMed Central

Prosperi, Christine; Baggett, Henry C.; Brooks, W. Abdullah; Deloria Knoll, Maria; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Murdoch, David R.; O’Brien, Katherine L.; Thea, Donald M.; Awori, Juliet O.; Bunthi, Charatdao; DeLuca, Andrea N.; Driscoll, Amanda J.; Ebruke, Bernard E.; Goswami, Doli; Hidgon, Melissa M.; Karron, Ruth A.; Kazungu, Sidi; Kourouma, Nana; Mackenzie, Grant; Moore, David P.; Mudau, Azwifari; Mwale, Magdalene; Nahar, Kamrun; Park, Daniel E.; Piralam, Barameht; Seidenberg, Phil; Sylla, Mamadou; Feikin, Daniel R.; Scott, J. Anthony G.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fancourt, Nicholas; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey

2017-01-01

Abstract Background. Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods. Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency was assessed throughout 24 months of enrollment with multiple-choice question (MCQ) examinations, a video quiz, and checklist evaluations of practical skills. Results. MCQ evaluation was confined to 158 clinical staff members who enrolled PERCH cases and controls, with scores obtained for >86% of eligible staff at each time-point. Median scores after baseline training were ≥80%, and improved by 10 percentage points with refresher training, with no significant intersite differences. Percentage agreement with the clinical trainer on the presence or absence of clinical signs on video clips was high (≥89%), with interobserver concordance being substantial to high (AC1 statistic, 0.62–0.82) for 5 of 6 signs assessed. Staff attained median scores of >90% in checklist evaluations of practical skills. Conclusions. Satisfactory clinical standardization was achieved within and across all PERCH sites, providing reassurance that any etiological or clinical differences observed across the study sites are true differences, and not attributable to differences in application of the clinical case definition, interpretation of clinical signs, or in techniques used for clinical measurements or specimen collection. PMID:28575355

Methodology issues in implementation science.

PubMed

Newhouse, Robin; Bobay, Kathleen; Dykes, Patricia C; Stevens, Kathleen R; Titler, Marita

2013-04-01

Putting evidence into practice at the point of care delivery requires an understanding of implementation strategies that work, in what context and how. To identify methodological issues in implementation science using 4 studies as cases and make recommendations for further methods development. Four cases are presented and methodological issues identified. For each issue raised, evidence on the state of the science is described. Issues in implementation science identified include diverse conceptual frameworks, potential weaknesses in pragmatic study designs, and the paucity of standard concepts and measurement. Recommendations to advance methods in implementation include developing a core set of implementation concepts and metrics, generating standards for implementation methods including pragmatic trials, mixed methods designs, complex interventions and measurement, and endorsing reporting standards for implementation studies.

Validation of asthma recording in electronic health records: a systematic review

PubMed Central

Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

2017-01-01

Objective To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research. Methods We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were summarized in two tables. Results Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%). Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion Attaining high PPVs (>80%) is possible using each of the discussed validation methods. Identifying asthma cases in electronic health records is possible with high sensitivity, specificity or PPV, by combining multiple data sources, or by focusing on specific test measures. Studies testing a range of case definitions show wide variation in the validity of each definition, suggesting this may be important for obtaining asthma definitions with optimal validity. PMID:29238227

Improving Diabetes Care in the Military Primary Care Clinic: Case Study Review

DTIC Science & Technology

2016-03-23

This research study combines qualitative and quantitative methodology in reflectively exploring positive case studies to ascertain strategies that...enabled patients to engage in self-management. Moreover, this study seeks to better understand how applying the ADA Standards of Care in a military

[Influence of cow's milk protein allergy on the diagnosis of functional gastrointestinal diseases based on the Rome IV standard in infants and young children].

PubMed

Feng, Bo-Wen; Fu, Si-Mao; Zhang, Quan-Shan; Long, Xiao-Ling; Xie, Xiao-Ling; Ren, Wei; Liang, Zhan-Tu; Yang, Zhu-Ling; Chen, Ang

2018-01-01

To study the influence of cow's milk protein allergy (CMPA) on the diagnosis of functional gastrointestinal diseases (FGID) based on the Rome IV standard in infants and young children. A total of 84 children aged 1 month to 3 years who were diagnosed with CMPA were enrolled as the case group, and 84 infants and young children who underwent physical examination and had no CMPA were enrolled as the control group. The pediatricians specializing in gastroenterology asked parents using a questionnaire for the diagnosis of FGID based on the Rome IV standard to assess clinical symptoms and to diagnose FGID. The case group had a significantly higher incidence rate of a family history of allergies than the control group (P<0.05). In the case group, 38 (45%) met the Rome IV standard for the diagnosis of FGID, while in the control group, 13 (15%) met this standard (P<0.05). According to the Rome IV standard for FGID, the case group had significantly higher diagnostic rates of reflex, functional diarrhea, difficult defecation, and functional constipation than the control group (P<0.05). The children who were diagnosed with FIGD in the control group were given conventional treatment, and those in the case group were asked to avoid the intake of cow's milk protein in addition to the conventional treatment. After 3 months of treatment, the case group had a significantly higher response rate to the treatment than the control group (P<0.05). In infants and young children, CMPA has great influence on the diagnosis of FGID based on the Rome IV standard. The possibility of CMPA should be considered during the diagnosis of FGID.

A Prospective Study of the Use of Fetal Intelligent Navigation Echocardiography (FINE) to Obtain Standard Fetal Echocardiography Views

PubMed Central

Veronese, Paola; Bogana, Gianna; Cerutti, Alessia; Yeo, Lami; Romero, Roberto; Gervasi, Maria Teresa

2016-01-01

Objective To evaluate the performance of Fetal Intelligent Navigation Echocardiography (FINE) applied to spatiotemporal image correlation (STIC) volume datasets of the normal fetal heart in generating standard fetal echocardiography views. Methods In this prospective cohort study of patients with normal fetal hearts (19-30 gestational weeks), one or more STIC volume datasets were obtained of the apical four-chamber view. Each STIC volume successfully obtained was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates for standard fetal echocardiography views using diagnostic planes and/or Virtual Intelligent Sonographer Assistance (VIS-Assistance®) were calculated. Results One or more STIC volumes (n=463 total) were obtained in 246 patients. A single STIC volume per patient was analyzed using the FINE method. In normal cases, FINE was able to generate nine fetal echocardiography views using: 1) diagnostic planes in 76-100% of cases; 2) VIS-Assistance® in 96-100% of cases; and 3) a combination of diagnostic planes and/or VIS-Assistance® in 96-100% of cases. Conclusion FINE applied to STIC volumes can successfully generate nine standard fetal echocardiography views in 96-100% of cases in the second and third trimesters. This suggests that the technology can be used as a method to screen for congenital heart disease. PMID:27309391

How Is Cancer Risk Measured?

MedlinePlus

... more groups. The people in one group (the control group ) may be given a standard screening test (if one exists) or no screening test. The ... for the human papillomavirus (HPV) and those who test negative for HPV. The ... Case-control studies Case-control studies are like cohort studies ...

The impact of leadership and team behavior on standard of care delivered during human patient simulation: a pilot study for undergraduate medical students.

PubMed

Carlson, Jim; Min, Elana; Bridges, Diane

2009-01-01

Methodology to train team behavior during simulation has received increased attention, but standard performance measures are lacking, especially at the undergraduate level. Our purposes were to develop a reliable team behavior measurement tool and explore the relationship between team behavior and the delivery of an appropriate standard of care specific to the simulated case. Authors developed a unique team measurement tool based on previous work. Trainees participated in a simulated event involving the presentation of acute dyspnea. Performance was rated by separate raters using the team behavior measurement tool. Interrater reliability was assessed. The relationship between team behavior and the standard of care delivered was explored. The instrument proved to be reliable for this case and group of raters. Team behaviors had a positive relationship with the standard of medical care delivered specific to the simulated case. The methods used provide a possible method for training and assessing team performance during simulation.

Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard.

PubMed

Lowe, Nancy K; Neal, Jeremy L; Ryan-Wenger, Nancy A

2009-01-01

To estimate the accuracy of the clinical diagnosis of the three most common causes of acute vulvovaginal symptoms (bacterial vaginosis, candidiasis vaginitis, and trichomoniasis vaginalis) using a traditional, standardized clinical diagnostic protocol compared with a DNA probe laboratory standard. This prospective clinical comparative study had a sample of 535 active-duty United States military women presenting with vulvovaginal symptoms. Clinical diagnoses were made by research staff using a standardized protocol of history, physical examination including pelvic examination, determination of vaginal pH, vaginal fluid amines test, and wet-prep microscopy. Vaginal fluid samples were obtained for DNA analysis. The research clinicians were blinded to the DNA results. The participants described a presenting symptom of abnormal discharge (50%), itching/irritation (33%), malodor (10%), burning (4%), or others such as vulvar pain and vaginal discomfort. According to laboratory standard, there were 225 cases (42%) of bacterial vaginosis, 76 cases (14%) of candidiasis vaginitis, 8 cases (1.5%) of trichomoniasis vaginalis, 87 cases of mixed infections (16%), and 139 negative cases (26%). For each single infection, the clinical diagnosis had a sensitivity and specificity of 80.8% and 70.0% for bacterial vaginosis, 83.8% and 84.8% for candidiasis vaginitis, and 84.6% and 99.6% for trichomoniasis vaginalis when compared with the DNA probe standard. Compared with a DNA probe standard, clinical diagnosis is 81-85% sensitive and 70-99% specific for bacterial vaginosis, Candida vaginitis, and trichomoniasis. Even under research conditions that provided clinicians with sufficient time and materials to conduct a thorough and standardized clinical evaluation, the diagnosis and, therefore, subsequent treatment of these common vaginal problems remains difficult. II.

A Standards-Based Approach to Catholic Principal Preparation: A Case Study

ERIC Educational Resources Information Center

Morten, Sandria D.; Lawler, Geralyn A.

2016-01-01

Illinois' recent redesign of the principal certification program requires the integration of the Interstate School Leaders Licensure (ISLLC) standards as well as the Southern Regional Education Board Critical Success Factors standards into the coursework and internship, establishing a focus on preparation for instructional leadership. The…

Models of Teaching: Connecting Student Learning with Standards

ERIC Educational Resources Information Center

Dell'Olio, Jeanine M.; Donk, Tony

2007-01-01

"Models of Teaching: Connecting Student Learning with Standards" features classic and contemporary models of teaching appropriate to elementary and secondary settings. Authors Jeanine M. Dell'Olio and Tony Donk use detailed case studies to discuss 10 models of teaching and demonstrate how the models can incorporate state content standards and…

LCA – Unique and Controversial Case Studies

EPA Science Inventory

This session will focus on case studies and applications that have a unique or controversial aspect. Some of the most recent topics that seem to have significant interest include: LCA-based product declarations, LCA-based standards, LCA-based labels, alternative energy, agricul...

The Trouble with Unifying Narratives: African Americans and the Civil Rights Movement in U.S. History Content Standards

ERIC Educational Resources Information Center

Anderson, Carl B.

2013-01-01

This textual analysis is a collective case study of K-12 United States History content standards in light of how they represent the historical experiences of African Americans during the Civil Rights Movement. The study uses a multi-perspective critical conceptual framework to evaluate the standards for nine state-level polities on both the…

Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

2017-11-01

To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

A Comparison of Higher-Order Thinking between the Common Core State Standards and the 2009 New Jersey Content Standards in High School

ERIC Educational Resources Information Center

Sforza, Dario; Tienken, Christopher H.; Kim, Eunyoung

2016-01-01

The creators and supporters of the Common Core State Standards claim that the Standards require greater emphasis on higher-order thinking than previous state standards in mathematics and English language arts. We used a qualitative case study design with content analysis methods to test the claim. We compared the levels of thinking required by the…

Testing Pneumonia Vaccines in the Elderly: Determining a Case Definition for Pneumococcal Pneumonia in the Absence of a Gold Standard.

PubMed

Jokinen, Jukka; Snellman, Marja; Palmu, Arto A; Saukkoriipi, Annika; Verlant, Vincent; Pascal, Thierry; Devaster, Jeanne-Marie; Hausdorff, William P; Kilpi, Terhi M

2018-06-01

Clinical assessments of vaccines to prevent pneumococcal community-acquired pneumonia (CAP) require sensitive and specific case definitions, but there is no gold standard diagnostic test. To develop a new case definition suitable for vaccine efficacy studies, we applied latent class analysis (LCA) to the results from 7 diagnostic tests for pneumococcal etiology on clinical specimens from 323 elderly persons with radiologically confirmed pneumonia enrolled in the Finnish Community-Acquired Pneumonia Epidemiology study during 2005-2007. Compared with the conventional use of LCA, which is mainly to determine sensitivities and specificities of different tests, we instead used LCA as an appropriate instrument to predict the probability of pneumococcal etiology for each CAP case based on individual test profiles, and we used the predictions to minimize the sample size that would be needed for a vaccine efficacy trial. When compared with the conventional laboratory criteria of encapsulated pneumococci in culture, in blood culture or high-quality sputum culture, or urine antigen positivity, our optimized case definition for pneumococcal CAP resulted in a trial sample size that was almost 20,000 subjects smaller. We believe that the novel application of LCA detailed here to determine a case definition for pneumococcal CAP could also be similarly applied to other diseases without a gold standard.

"Family Autonomy" or "Coercive Intervention"? Ambiguity and Conflict in the Proposed Standards for Child Abuse and Neglect.

ERIC Educational Resources Information Center

Bourne, Richard; Newberger, Eli H.

Criticized are standards for child abuse and neglect drafted by the Juvenile Justice Standards Project of the Institute of Judicial Administration and the American Bar Association. It is claimed that the standards unduly limit state intervention. Case study examples are cited and revisions are suggested for the following areas: providing services…

Privacy and Ethics in the Age of the Smartphone: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Balyeat, Jake

2013-01-01

Smartphones are fundamentally transforming almost all aspects of modern life. This case study examines moral and ethical issues surrounding the use of powerful smartphones that can be used to discreetly capture the activities of unsuspecting people. This case shows how a standard iPhone, coupled with widely available apps, can be used in a…

Standardization of SOPs to Evaluations: Impacts on Regulatory Decisions using Learning and Memory as Case Studies

EPA Science Inventory

In an era of global trade and regulatory cooperation, consistent and scientifically based interpretation of developmental neurotoxicity (DNT) studies is essential, particularly for non­ standard assays and variable endpoints. Because there is flexibility in the selection of ...

Emergency Support Function 15 Standard Operating Procedures

DTIC Science & Technology

2013-08-01

learned from numerous incidents to include the BP oil spill, the Fukushima nuclear incident, Hurricane Sandy and the Boston Marathon attack. Guidance is...Staffing  Operations  Activation  Incident Operations  Case Study - 2013 Boston Marathon Bombing  Case Study - 2011 Fukushima Nuclear Crisis...Quick Summary  Radiological Dispersal Device (RDD)  Improvised Nuclear Device (IND)  Federal Response  Case Studies – 2011 Fukushima Nuclear

A standardized method for sampling and extraction methods for quantifying microplastics in beach sand.

PubMed

Besley, Aiken; Vijver, Martina G; Behrens, Paul; Bosker, Thijs

2017-01-15

Microplastics are ubiquitous in the environment, are frequently ingested by organisms, and may potentially cause harm. A range of studies have found significant levels of microplastics in beach sand. However, there is a considerable amount of methodological variability among these studies. Methodological variation currently limits comparisons as there is no standard procedure for sampling or extraction of microplastics. We identify key sampling and extraction procedures across the literature through a detailed review. We find that sampling depth, sampling location, number of repeat extractions, and settling times are the critical parameters of variation. Next, using a case-study we determine whether and to what extent these differences impact study outcomes. By investigating the common practices identified in the literature with the case-study, we provide a standard operating procedure for sampling and extracting microplastics from beach sand. Copyright © 2016 Elsevier Ltd. All rights reserved.

A standardized mean difference effect size for multiple baseline designs across individuals.

PubMed

Hedges, Larry V; Pustejovsky, James E; Shadish, William R

2013-12-01

Single-case designs are a class of research methods for evaluating treatment effects by measuring outcomes repeatedly over time while systematically introducing different condition (e.g., treatment and control) to the same individual. The designs are used across fields such as behavior analysis, clinical psychology, special education, and medicine. Emerging standards for single-case designs have focused attention on methods for summarizing and meta-analyzing findings and on the need for effect sizes indices that are comparable to those used in between-subjects designs. In the previous work, we discussed how to define and estimate an effect size that is directly comparable to the standardized mean difference often used in between-subjects research based on the data from a particular type of single-case design, the treatment reversal or (AB)(k) design. This paper extends the effect size measure to another type of single-case study, the multiple baseline design. We propose estimation methods for the effect size and its variance, study the estimators using simulation, and demonstrate the approach in two applications. Copyright © 2013 John Wiley & Sons, Ltd.

The conception of fashion products for children: reflections on safety parameters.

PubMed

Prete, Lígia Gomes Pereira; Emidio, Lucimar de Fátima Bilmaia; Martins, Suzana Barreto

2012-01-01

The purpose of this study is to reflect on safety requirements for children's clothing, based on the standardization proposed by the ABNT (Technical Standardization Brazilian Association). Bibliographic research and case studies were considered on writing this work. We also discuss the importance of adding other safety requirements to the current standardization, as well as the increasing of the actual age range specified by the ABNT, following the children's clothing safety standardizations in Portugal and the United States, also stated here.

Applying the CONSORT and STROBE statements to evaluate the reporting quality of neovascular age-related macular degeneration studies.

PubMed

Fung, Anne E; Palanki, Ram; Bakri, Sophie J; Depperschmidt, Eric; Gibson, Andrea

2009-02-01

To evaluate the quality of reporting in the neovascular age-related macular degeneration (nvAMD) literature by applying the Consolidated Standards for Reporting Trials (CONSORT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement writing standards. CONSORT and STROBE impact analysis; literature review. Phase III randomized controlled trials (RCTs) of verteporfin photodynamic therapy, pegaptanib, and ranibizumab, and interventional case studies of bevacizumab for nvAMD. A literature search identified eligible articles published before October 31, 2007. We assessed the report quality of Phase III RCTs using the CONSORT statement and case series publications using the STROBE statement, both with indicators relevant to nvAMD. Presence or absence of CONSORT or STROBE statement indicators. Seven publications of Phase III RCTs and 29 publications on bevacizumab interventional case studies for nvAMD met our inclusion criteria. Of 37 possible CONSORT writing guideline items, the mean report quality for RCTs was 30.6 (83%), with a range from 23 to 35 (65%-95%). Of 35 possible STROBE writing guideline items, the mean report quality grade for intravitreal bevacizumab case series was 23 (70%), with a range from 16 to 31 (46%-94%). Among the bevacizumab studies, more than 90% reported scientific background, drug dose and administration, baseline characteristics, unadjusted results, and adverse events. Fewer than 20% reported study size calculations, handling of missing data, or a discussion of bias. Since the adoption of the CONSORT standards by Ophthalmology and other journals in 1996, the reporting quality for RCTs has further improved among this cohort of nvAMD articles. On the other hand, no reporting standards for case series have existed until the recent publication of the STROBE statement. In this first application of the STROBE standards to ophthalmology, we found that the small interventional studies in our series had an average reporting score lower than the RCTs, but also that some individual scores were higher than the RCTs. This outcome demonstrates that good, useful articles can be written about small studies. Although not a direct measure of the quality of a study, good reporting allows a reader to assess the validity and applicability of the study's findings. Proprietary or commercial disclosure may be found after the references.

Tracking the Gender Pay Gap: A Case Study

ERIC Educational Resources Information Center

Travis, Cheryl B.; Gross, Louis J.; Johnson, Bruce A.

2009-01-01

This article provides a short introduction to standard considerations in the formal study of wages and illustrates the use of multiple regression and resampling simulation approaches in a case study of faculty salaries at one university. Multiple regression is especially beneficial where it provides information on strength of association, specific…

Applications of surface metrology in firearm identification

NASA Astrophysics Data System (ADS)

Zheng, X.; Soons, J.; Vorburger, T. V.; Song, J.; Renegar, T.; Thompson, R.

2014-01-01

Surface metrology is commonly used to characterize functional engineering surfaces. The technologies developed offer opportunities to improve forensic toolmark identification. Toolmarks are created when a hard surface, the tool, comes into contact with a softer surface and causes plastic deformation. Toolmarks are commonly found on fired bullets and cartridge cases. Trained firearms examiners use these toolmarks to link an evidence bullet or cartridge case to a specific firearm, which can lead to a criminal conviction. Currently, identification is typically based on qualitative visual comparison by a trained examiner using a comparison microscope. In 2009, a report by the National Academies called this method into question. Amongst other issues, they questioned the objectivity of visual toolmark identification by firearms examiners. The National Academies recommended the development of objective toolmark identification criteria and confidence limits. The National Institute of Standards and Technology (NIST) have applied its experience in surface metrology to develop objective identification criteria, measurement methods, and reference artefacts for toolmark identification. NIST developed the Standard Reference Material SRM 2460 standard bullet and SRM 2461 standard cartridge case to facilitate quality control and traceability of identifications performed in crime laboratories. Objectivity is improved through measurement of surface topography and application of unambiguous surface similarity metrics, such as the maximum value (ACCFMAX) of the areal cross correlation function. Case studies were performed on consecutively manufactured tools, such as gun barrels and breech faces, to demonstrate that, even in this worst case scenario, all the tested tools imparted unique surface topographies that were identifiable. These studies provide scientific support for toolmark evidence admissibility in criminal court cases.

[Study on relationship between operation timing and clinical prognosis of cases with Bell palsy].

PubMed

Liu, Sufu; Li, Jiandong; Wang, Xueyong; Zhao, Liang; Ji, Wei; Wang, Jia; Bai, Juan; Wei, Bojun

2013-07-01

To study on relationship between diverse handling time following onset and clinical prognosis of cases with Bell palsy. Two hundred and sixteen cases with Bell palsy, who were admitted in our department between Jun. 2006 and Dec. 2009, were collected and divided into 6 groups according to disease time: 1-2 months, > 2 - 3 months, > 3 - 4 months, > 4 - 5 months, > 5 - 6 months, and > 6 months. Cases in all groups received subtotal course decompression of facial nerve and other compound treatment, and the relationship between handling timing and clinical prognosis were compared. It was found that the difference of prognosis and handling timing was statistically significant, after comparison between all groups with Facial Grading Standards (H-B) as the standard to assess prognosis. Clinical prognosis of cases with Bell palsy was related to alternative handling time, and subtotal course decompression of facial nerve was recommended to be performed as early as possible for those cases who were irresponsive after conservative treatment for one month.

Standards Collection Development and Management in an Academic Library: A Case Study at the University of Western Ontario Libraries

ERIC Educational Resources Information Center

Dunn, Linda K.; Xie, Shiyi

2017-01-01

How can academic libraries ensure their standards collections meet the teaching and research needs of science and engineering faculties? Nowadays, most academic libraries face financial constraints that greatly impact collection development. This article documents an academic library's experience with standards collections and the investigation…

Alignment of World Language Standards and Assessments: A Multiple Case Study

ERIC Educational Resources Information Center

Kaplan, Carolyn Shemwell

2016-01-01

Previous research has examined world language classroom-based assessment practices as well as the impact of the Standards for Foreign Language Learning in the 21st Century (National Standards in Foreign Language Education Project, 1999) on practice. However, the extent to which K-12 teachers' assessment practices reflect national and state…

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology

PubMed Central

Mukhopadhyay, Sanjay; Feldman, Michael D.; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G.; Cathro, Helen P.; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E.; Gill, Ryan M.; Heaton, Robert P.; Kerstens, René; Lindberg, Guy M.; Malhotra, Reenu K.; Mandell, James W.; Manlucu, Ellen D.; Mills, Anne M.; Mills, Stacey E.; Moskaluk, Christopher A.; Nelis, Mischa; Patil, Deepa T.; Przybycin, Christopher G.; Reynolds, Jordan P.; Rubin, Brian P.; Saboorian, Mohammad H.; Salicru, Mauricio; Samols, Mark A.; Sturgis, Charles D.; Turner, Kevin O.; Wick, Mark R.; Yoon, Ji Y.; Zhao, Po

2018-01-01

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, −0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types. PMID:28961557

Zinc as an adjunct treatment for reducing case fatality due to clinical severe infection in young infants: study protocol for a randomized controlled trial.

PubMed

Wadhwa, Nitya; Basnet, Sudha; Natchu, Uma Chandra Mouli; Shrestha, Laxman P; Bhatnagar, Shinjini; Sommerfelt, Halvor; Strand, Tor A; Ramji, Siddarth; Aggarwal, K C; Chellani, Harish; Govil, Anuradha; Jajoo, Mamta; Mathur, N B; Bhatt, Meenakshi; Mohta, Anup; Ansari, Imran; Basnet, Srijana; Chapagain, Ram H; Shah, Ganesh P; Shrestha, Binod M

2017-07-10

An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal. In a 1:1 ratio, we will randomly assign young infants to receive 10 mg of elemental zinc or placebo orally in addition to the standard therapy for a total of 14 days. The primary outcomes hospital case fatality, which is death due to any cause and at any time after enrolment while hospitalized for the illness episode, and extended case fatality, which encompasses the period until 12 weeks after enrolment. A previous study showed a beneficial effect of zinc in reducing the risk of treatment failure, as well as a non-significant effect on case fatality. This study was not powered to detect an effect on case fatality, which this current study is. If the results are consistent with this earlier trial, we would have provided strong evidence for recommending zinc as an adjunct to standard therapy for clinical severe infection in young infants. Universal Trial Number: U1111-1187-6479, Clinical Trials Registry - India: CTRI/2017/02/007966 : Registered on February 27, 2017.

DEVELOPING STANDARDS FOR ASSESSING ENVIRONMENTAL CHEMICAL, PHYSICAL, AND BIOLOGICAL STRESSORS THROUGH ASTM COMMITTEE E47: A PAST FOUNDATION OF PROVEN STANDARDS, A FUTURE OF GREAT POTENTIAL AND OPPORTUNITY

EPA Science Inventory

Development of standards associated with assessing the bioavailability of contaminants in sediment will be used as a case study for how standards have been developed through Committee E47. In 1987, Committee E47 established Subcommittee E47.03 on Sediment Assessment and Toxicity....

Tensions in the field: teaching standards of practice in optometry case presentations.

PubMed

Spafford, Marlee M; Lingard, Lorelei; Schryer, Catherine F; Hrynchak, Patricia K

2004-10-01

Professional identity formation and its relationship to case presentations were studied in an optometry school's onsite clinic. Eight optometry students and six faculty optometrists were audio-recorded during 31 oral case presentations and the teaching exchanges related to them. Using convenience sampling, interviews were audio-recorded of four of the students and four of the optometrists from the field observations. After transcribing these audio-recordings, the research team members applied a grounded theory method to identify, test, and revise emergent themes. The theme reported herein pertains to communicating standards of practice. Faculty optometrists demonstrated three ways of communicating standards of practice to optometry students during case presentations: Official Way, Our Way, and My Way. Although there were differences between these standards, the rationale for the disparities was rarely explicitly articulated by the instructors to the students. Without this information, the incongruity among the standards was left to the students to interpret on their own. The risk created by faculty not articulating the rationale underlying standards of practice was that students misinterpreted the optometrists' ways as idiosyncratic. Thus, opportunities were missed in the educational setting to assist students in making responsible decisions, locating their position in practice, and shaping their professional identity. Competing responsibilities of patient care and student education left instructors with little time to articulate rationale for standards of practice. Therefore, educators must reflect on innovative ways to bring into relief the logic behind their actions when working with novices.

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.

PubMed

Eastwood, K; Paterson, B J; Levi, C; Givney, R; Loewenthal, M; DE Malmanche, T; Lai, K; Granerod, J; Durrheim, D N

2015-11-01

Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

Family Advocacy Program Standards and Self-Assessment Tool

DTIC Science & Technology

1992-08-01

child abuse and neglect and spouse abuse. The standards are based upon a complete review of relevant criteria, accepted professional practices and current military FAP practices. Standards are... Child Abuse and Neglect Cases; Intervention and Treatment in Spouse Abuse Cases; Case Accountability in FAP Cases; Staffing for FAP Services;

Metropolitan Forensic Anthropology Team (MFAT) studies in identification: 1. Race and sex assessment by discriminant function analysis of the postcranial skeleton.

PubMed

Taylor, J V; DiBennardo, R; Linares, G H; Goldman, A D; DeForest, P R

1984-07-01

A case study is presented to demonstrate the utility of the team approach to the identification of human remains, and to illustrate a methodological innovation developed by MFAT. Case 1 represents the first of several planned case studies, each designed to present new methodological solutions to standard problems in identification. The present case describes a test, by application, of race and sex assessment of the postcranial skeleton by discriminant function analysis.

Real life juvenile toxicity case studies: the good, the bad and the ugly.

PubMed

De Schaepdrijver, Luc; Rouan, Marie-Claude; Raoof, Araz; Bailey, Graham P; De Zwart, Loeckie; Monbaliu, Johan; Coogan, Timothy P; Lammens, Lieve; Coussement, Werner

2008-09-01

With the growing experience in the conduct of juvenile toxicity studies for multiple classes of compound, the 'case-by-case' approach has become under much more pressure. Instead, a general screen or 'standard design' is now commonly expected by regulatory authorities with more routine inclusion of neurological and reproductive assessments. Minor modifications or additions can be made to the design to address specific questions according to the class of drug or intended clinical use. This drift from a 'case-by-case' approach to a 'standard design' approach is present within certain reviewing divisions of the FDA, often requesting by default a rodent and non-rodent juvenile animal study. However, juvenile animal studies should be designed thoughtfully to fulfil a purpose based on scientific rationale, with each endpoint carefully considered in terms of practicality and interpretability of data generated. Only when using the appropriate strategy and design may juvenile studies add value by (1) identifying potential safety or pharmacokinetic issues for drugs intended for paediatric use, (2) suggesting additional clinical endpoints and (3) adding new information to the product label. As the knowledge from juvenile animal studies in various species grows, a better understanding of the significance/relevance of findings will be achieved.

The surveillance of nursing standards: an organisational case study.

PubMed

Cooke, Hannah

2006-11-01

Quality assurance has acquired increasing prominence in contemporary healthcare systems and there has been an 'explosion' of audit activity. Some authors have begun to investigate the impact of audit activity on organisational and professional cultures. This paper considers data from a wider study of the management of the 'problem' nurse. Nurses and managers had contrasting perceptions of the value of different methods of assessing ward standards and their views are presented here. The study involved organisational case studies in three healthcare Trusts in the north of England. The fieldwork for this study was funded by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting under their research scholarship programme. Multiple methods were employed including observation, interviewing and documentary analysis. A total of 144 informal interviews were carried out with ward nurses and their managers. The study demonstrated different viewpoints regarding the surveillance of nursing standards at top management, middle management and ward levels. The paper considers the discrepancies between these different viewpoints. None of the participants placed a high value on audit as a method of assessing ward standards. Complaints data and informal methods were more highly valued by managers. Ward nurses stressed the importance of presence and vigilance in assuring high standards of nursing care.

A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

PubMed Central

Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

2014-01-01

Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

The epidemiological and histological trend of bladder cancer in Iran.

PubMed

Rafiemanesh, Hosein; Lotfi, Zahra; Bakhtazad, Sima; Ghoncheh, Mahshid; Salehiniya, Hamid

2018-01-01

Bladder cancer is the ninth common cancer in the world, the third common cancer among men in the Arabic and Western Asian countries, and the second in some regions of Iran (a country in the Middle East). There was no study on the epidemiological and histological trend of bladder cancer in Iran. This study aimed to the epidemiological and histological trend of bladder cancer in Iran. In this study, data were extracted from annual cancer registry reports of Iranian Ministry of Health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. A total of 23,291 cases were reported. Almost 17.70% (4127 cases) were women and 82.30% (19,170 cases) men. The sex ratio (male to female) was 4.65. Joinpoint analysis showed the significant increased trend of age-standardized incidence rate (ASIR) for both sexes. The annual percentage change of standardized incidence rate was 11.5 (confidence interval [CI]: 9.0-14.0) in women and 10.8 (CI: 8.0-13.6) in men. Two histological types of transitional cell carcinoma (TCC), not otherwise specified and papillary TCC included 43.89% and 49.86% of all cancer cases, respectively. According to this study the trend of ASIR of bladder cancer in Iran is rising, so it is necessary to conduct further researches in future to provide accurate information on the cancer and investigate related risk factors and implement prevention programs in Iran.

Epidemiology of amyotrophic lateral sclerosis in Minnesota: a year-long population based study.

PubMed

Harper, Caitlin J; Sorenson, Eric J; Mandrekar, Jay

2015-01-01

This is the largest population based study of ALS in the U.S., encompassing the population of Minnesota (> 5.4 million people) from July 2013 to July 2014. Data on gender, age at diagnosis, and residential county were collected for all Minnesota residents who registered with the Minnesota/North Dakota/South Dakota chapter of the ALS Association from July 2013 to July 2014. Incidence rates were calculated as the number of new cases of ALS per 100,000 people per year. The standardized incidence rates for the 2013 U.S. population and the 2013 European standard population were also reported. Results showed that the crude incidence rate of ALS was 2.2 cases per 100,000 person-years. Incidence increased with age, peaking at 70-79 years (8.3 per 100,000) with mean age at diagnosis 64 years, and was greater in males (2.4 per 100,000) than in females (1.5 per 100,000). Standardized incidence rates for the 2013 U.S. and European standard population were 2.2 and 2.39 cases per 100,000 person-years, respectively. In conclusion, the overall incidence and age and gender patterns of ALS in Minnesota are comparable to those reported by European studies ( 1-5 ).

Talk, Decisions, and Action in Curriculum-Making: Reflections on the "ILS" and "L97" Case Studies

ERIC Educational Resources Information Center

Westbury, Ian

2016-01-01

Previous papers in this issue of "JCS" have presented case studies of the state-based curriculum commissions that developed the "Illinois Learning Standards" of 1997 and Norway's "Laereplanverket 1997" ("L97") (1997). The studies were developed using as a framework a body of German research that sees…

State-Based Curriculum Work and Curriculum-Making: Norway's "Laereplanverket 1997"

ERIC Educational Resources Information Center

Sivesind, Kirsten; Westbury, Ian

2016-01-01

This case study of the development of the Norwegian compulsory school curriculum of 1997, "Laereplanverket 1997," parallels a study of the development of the "Illinois Learning Standards" of 1997. The pair of case studies is designed to explore the administration of state-based curriculum-making and, in particular, the use in…

Science Education for Environmental Sustainability: A Case Study of the Palouse Watershed

ERIC Educational Resources Information Center

Lyman, Samson E.

2009-01-01

This study uses case study and qualitative content analysis methodologies to answer the question: What is the relationship between Washington State's k-12 science education standards and the environmental sustainability needs of the Palouse River Watershed? After defining the Palouse Watershed's attributes, the author presents a land use history…

Learning from Engineering Failures: A Case Study of the Deepwater Horizon

ERIC Educational Resources Information Center

Rose, Mary Annette; Hunt, Brian

2012-01-01

Natural catastrophes and engineering failures provide timely, motivating, and conceptually rich backdrops for learning. Engineering educators have long embraced case studies of engineering failures as a sound pedagogical strategy for meeting several learning standards, such as "design within realistic constraints", and teaching failure…

A Case Study of Teachers' Development of Well-Structured Mathematical Modelling Activities

ERIC Educational Resources Information Center

Stohlmann, Micah; Maiorca, Cathrine; Allen, Charlie

2017-01-01

This case study investigated how three teachers developed mathematical modelling activities integrated with content standards through participation in a course on mathematical modelling. The class activities involved experiencing a mathematical modelling activity, reading and rating example mathematical modelling activities, reading articles about…

A Study of Three Cultures: Germany, Japan and the United States--An Overview of the TIMSS Case Study Project.

ERIC Educational Resources Information Center

Stevenson, Harold W.

1998-01-01

Discusses case studies of the United States, Germany, and Japan included in the Third International Mathematics and Science Study (TIMSS). Highlights national standards, teacher training and working conditions, attitudes toward dealing with ability differences, and the place of school in adolescents' lives. Compared to Japanese and German…

Opinions of Art Teachers on the Standards of the International Society for Technology in Education: the Case of Western Mediterranean Region, Turkey

ERIC Educational Resources Information Center

Konak, Armagan

2018-01-01

The purpose of this study, which is based on qualitative data, is to reveal the opinions of art teachers on the teacher standards set by the International Society for Technology in Education. It has been observed that the majority of participants of a study group are not aware of these standards, use social networks but do not use mobile…

Association between biomass fuel and pulmonary tuberculosis: a nested case-control study.

PubMed

Kolappan, C; Subramani, R

2009-08-01

To quantify the association between biomass fuel usage and sputum-positive pulmonary tuberculosis. A tuberculosis prevalence survey was conducted in a random sample of 50 rural units (villages) and three urban units in the Tiruvallur district of Tamilnadu, India during the period 2001-2003. Additional data regarding exposure to tobacco smoking, alcohol consumption, biomass fuel usage and Standard of Living Index (SLI) were also collected from the study participants. A nested case-control study was carried out in this population. Cases are defined as bacteriological-positive cases diagnosed by either sputum smear or culture examination. For each case, five age- (within +/-5 years of age) and sex-matched controls were selected randomly from the non-cases residing in the same village/unit. Thus, 255 cases and 1275 controls were included in this study. The unadjusted OR measured from univariate analysis for biomass fuel is 2.9 (95% CI 1.8 to 4.7). The adjusted OR measured from multivariate analysis using Cox regression is 1.7 (95% CI 1.0 to 2.9). Thirty-six percent of cases are attributable to biomass fuel usage. The findings from this case-control study add to the evidence for an independent association between biomass smoke and pulmonary tuberculosis. Improvement in standards of living brought about by economic development will lead to more people using cleaner fuels for cooking than biomass fuel which in turn will lead to a reduction in the occurrence of pulmonary tuberculosis in the community.

Designing a Bridging Discourse: Re-Mediation of a Mathematical Learning Disability

ERIC Educational Resources Information Center

Lewis, Katherine E.

2017-01-01

Students with disabilities present a unique instructional design challenge. These students often have qualitatively different ways of processing information, meaning that standard instructional approaches may not be effective. In this study I present a case study of a student with a mathematical learning disability for whom standard instruction on…

A Case Study of Rural New Mexico K-12 Teachers' Perceptions of Standardized Testing

ERIC Educational Resources Information Center

Hite-Pope, Kim

2017-01-01

The purpose of this paper was to examine K-12 teachers' classroom experiences with standardized testing in rural New Mexico schools. Standardized tests have significantly changed the landscape of education with the use of students' test scores as a determining factor for advancement or failure for teachers (Simpson, Lacava, & Graner, 2013).…

Teachers' Perceptions of Preparedness Related to National Common Core State Standards for Mathematics

ERIC Educational Resources Information Center

Brown, Tykier

2016-01-01

With the adoption of the National Common Core State Standards in Mathematics (CCSSM) in many states and the lack of understanding and strategies to implement the new standards by classroom teachers, implementing effective professional development is vital. The focus of this qualitative case study was to provide insight into elementary school…

[Common law study of the legal responsibility of health care staff related to drug reformulation].

PubMed

Reche-Castex, F J; Alonso Herreros, J M

2005-01-01

To analyze the responsibility of health care staff in drug reformulation (change of dose, pharmaceutical form or route of administration of medicinal products) based on the common law of the High Court and the National Court. Search and analysis of common law and legal studies included in databases "El Derecho", "Difusión Jurídica" and "Indret". Health care staff has means--not outcomes--obligations according to the care standards included in the "Lex Artis" that can go beyond the mere legal standards. Failure to apply these care standards, denial of assistance or disrespect to the autonomy of the patient can be negligent behavior. We found 4 cases in common law. In the two cases in which care standards were complied with, including reformulation, health care professionals were acquitted, whereas in the other two cases in which reformulations were not used even though the "Lex Artis" required them, the professionals were condemned. Reformulation of medicinal products, as set forth in the Lex Artis, is a practice accepted by the High Court and the National Court and failure to use it when the scientific knowledge advises so is a cause for conviction.

Is There a Difference in Cost Between Standard and Virtual Surgical Planning for Orthognathic Surgery?

PubMed

Resnick, Cory M; Inverso, Gino; Wrzosek, Mariusz; Padwa, Bonnie L; Kaban, Leonard B; Peacock, Zachary S

2016-09-01

Virtual surgical planning (VSP) and 3-dimensional printing of surgical splints are becoming the standard of care for orthognathic surgery, but costs have not been thoroughly evaluated. The purpose of this study was to compare the cost of VSP and 3-dimensional printing of splints ("VSP") versus that of 2-dimensional cephalometric evaluation, model surgery, and manual splint fabrication ("standard planning"). This is a retrospective cohort study including patients planned for bimaxillary surgery from January 2014 to January 2015 at Massachusetts General Hospital. Patients were divided into 3 groups by case type: symmetric, nonsegmental (group 1); asymmetric (group 2); and segmental (group 3). All cases underwent both VSP and standard planning with times for all activities recorded. The primary and secondary predictor variables were method of treatment planning and case type, respectively. Time-driven activity-based micro-costing analysis was used to quantify the differences in cost. Results were analyzed using a paired t test and analysis of variance. The sample included 43 patients (19 in group 1, 17 in group 2, and 7 in group 3). The average times and costs were 194 ± 14.1 minutes and $2,765.94, respectively, for VSP and 540.9 ± 99.5 minutes and $3,519.18, respectively, for standard planning. For the symmetric, nonsegmental group, the average times and costs were 188 ± 17.8 minutes and $2,700.52, respectively, for VSP and 524.4 ± 86.1 minutes and $3,380.17, respectively, for standard planning. For the asymmetric group, the average times and costs were 187.4 ± 10.9 minutes and $2,713.69, respectively, for VSP and 556.1 ± 94.1 minutes and $3,640.00, respectively, for standard planning. For the segmental group, the average times and costs were 208.8 ± 13.5 minutes and $2,883.62, respectively, for VSP and 542.3 ± 118.4 minutes and $3,537.37, respectively, for standard planning. All time and cost differences were statistically significant (P < .001). The results of this study indicate that VSP for bimaxillary orthognathic surgery takes significantly less time and is less expensive than standard planning for the 3 types of cases analyzed. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The importance of sampling standardization for comparisons of insect herbivory in deep time: a case study from the late Palaeozoic

NASA Astrophysics Data System (ADS)

Schachat, Sandra R.; Labandeira, Conrad C.; Maccracken, S. Augusta

2018-03-01

Sampling standardization has not been fully addressed for the study of insect herbivory in the fossil record. The effects of sampling within a single locality were explored almost a decade ago, but the importance of sampling standardization for comparisons of herbivory across space and time has not yet been evaluated. Here, we present a case study from the Permian in which we evaluate the impact of sampling standardization on comparisons of insect herbivory from two localities that are similar in age and floral composition. Comparisons of insect damage type (DT) diversity change dramatically when the number of leaves examined is standardized by surface area. This finding suggests that surface area should always be taken into account for comparisons of DT diversity. In addition, the three most common metrics of herbivory-DT diversity, proportion of leaves herbivorized and proportion of leaf surface area herbivorized-are inherently decoupled from each other. The decoupling of the diversity and intensity of insect herbivory necessitates a reinterpretation of published data because they had been conflated in previous studies. Future studies should examine the divergent ecological factors that underlie these metrics. We conclude with suggestions to guide the sampling and analysis of herbivorized leaves in the fossil record.

Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

PubMed

Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

2015-08-01

When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

Standard line slopes as a measure of a relative matrix effect in quantitative HPLC-MS bioanalysis.

PubMed

Matuszewski, B K

2006-01-18

A simple experimental approach for studying and identifying the relative matrix effect (for example "plasma-to-plasma" and/or "urine-to-urine") in quantitative analyses by HPLC-MS/MS is described. Using as a database a large number of examples of methods developed in recent years in our laboratories, the relationship between the precision of standard line slopes constructed in five different lots of a biofluid (for example plasma) and the reliability of determination of concentration of an analyte in a particular plasma lot (or subject) was examined. In addition, the precision of standard line slopes was compared when stable isotope-labeled analytes versus analogs were used as internal standards (IS). Also, in some cases, a direct comparison of standard line slopes was made when different HPLC-MS interfaces (APCI versus ESI) were used for the assay of the same compound, using the same IS and the same sample preparation and chromatographic separation conditions. In selected cases, the precision of standard line slopes in five different lots of a biofluid was compared with precision values determined five times in a single lot. The results of these studies indicated that the variability of standard line slopes in different lots of a biofluid [precision of standard line slopes expressed as coefficient of variation, CV (%)] may serve as a good indicator of a relative matrix effect and, it is suggested, this precision value should not exceed 3-4% for the method to be considered reliable and free from the relative matrix effect liability. Based on the results presented, in order to assess the relative matrix effect in bioanalytical methods, it is recommended to perform assay precision and accuracy determination in five different lots of a biofluid, instead of repeat (n=5) analysis in the same, single biofluid lot, calculate standard line slopes and precision of these slopes, and to use <3-4% slope precision value as a guide for method applicability to support clinical studies. It was also demonstrated that when stable isotope-labeled analytes were used as internal standards, the precision of standard line slopes in five different lots of a biofluid was

Occupational Course of Study Diploma Track: A Case Study of Post-School Employment Readiness

ERIC Educational Resources Information Center

Doiel, Patrick W.

2017-01-01

The North Carolina Occupational Course of Study (NCOCS) program is an alternative diploma track with a vocational focus toward post school employment to assist students who would not otherwise graduate with a standard course of study. The purpose of this qualitative single case study was to explore the local causes of low post-school employment…

Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

PubMed

Paliwoda, Michelle; New, Karen; Bogossian, Fiona

2016-09-01

All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of care. The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Job and industry classifications associated with sarcoidosis in A Case-Control Etiologic Study of Sarcoidosis (ACCESS).

PubMed

Barnard, Juliana; Rose, Cecile; Newman, Lee; Canner, Martha; Martyny, John; McCammon, Chuck; Bresnitz, Eddy; Rossman, Milt; Thompson, Bruce; Rybicki, Benjamin; Weinberger, Steven E; Moller, David R; McLennan, Geoffrey; Hunninghake, Gary; DePalo, Louis; Baughman, Robert P; Iannuzzi, Michael C; Judson, Marc A; Knatterud, Genell L; Teirstein, Alvin S; Yeager, Henry; Johns, Carol J; Rabin, David L; Cherniack, Reuben

2005-03-01

To determine whether specific occupations and industries may be associated with sarcoidosis. A Case Control Etiologic Study of Sarcoidosis (ACCESS) obtained occupational and environmental histories on 706 newly diagnosed sarcoidosis cases and matched controls. We used Standard Industrial Classification (SIC) and Standard Occupational Classification (SOC) to assess occupational contributions to sarcoidosis risk. Univariable analysis identified elevated risk of sarcoidosis for workers with industrial organic dust exposures, especially in Caucasian workers. Workers for suppliers of building materials, hardware, and gardening materials were at an increased risk of sarcoidosis as were educators. Work providing childcare was negatively associated with sarcoidosis risk. Jobs with metal dust or metal fume exposures were negatively associated with sarcoidosis risk, especially in Caucasian workers. In this study, we found that exposures in particular occupational settings may contribute to sarcoidosis risk.

Case studies of violations of workers' freedom of association: migrant agricultural workers.

PubMed

2002-01-01

As part of its report "Unfair Advantage: Workers' Freedom of Association in the United States under International Human Rights Standards," Human Rights Watch conducted a series of case studies in a dozen states, covering a variety of industries and employment sectors, analyzing the U.S. experience in the light of both national law and international human rights and labor rights norms. Presented here are the case studies of migrant agricultural workers.

A Framework for Implementing Virtual Collaborative Networks - Case Study on Automobile Components Production Industry

NASA Astrophysics Data System (ADS)

Parvinnia, Elham; Khayami, Raouf; Ziarati, Koorush

Virtual collaborative networks are composed of small companies which take most advantage from the market opportunity and are able to compete with large companies. So some frameworks have been introduced for implementing this type of collaboration; although none of them has been standardized completely. In this paper we specify some instances that need to be standardized for implementing virtual enterprises. Then, a framework is suggested for implementing virtual collaborative networks. Finally, based on that suggestion, as a case study, we design a virtual collaborative network in automobile components production industry.

Using Performance Analysis for Training in an Organization Implementing ISO-9000 Manufacturing Practices: A Case Study.

ERIC Educational Resources Information Center

Kunneman, Dale E.; Sleezer, Catherine M.

2000-01-01

This case study examines the application of the Performance Analysis for Training (PAT) Model in an organization that was implementing ISO-9000 (International Standards Organization) processes for manufacturing practices. Discusses the interaction of organization characteristics, decision maker characteristics, and analyst characteristics to…

Case Study in Modeling Accessibility for Online Instruction

ERIC Educational Resources Information Center

Conway, Thomas Hayes

2017-01-01

The purpose of this qualitative multiple case study was to explore how accessibility standards are adapted to create online learning environments that are accessible to people who use assistive technology, or have navigational challenges due to physical or intellectual disabilities. Rogers diffusion of innovation was used as the contextual…

The Regional Accreditation Process at Community Colleges: A Case Study of Effectiveness

ERIC Educational Resources Information Center

Young, Alissa L.

2013-01-01

This companion dissertation reports the findings of applied case study research on four community college organizational units that consistently meet or exceed standard performance measures. In addition, prior ample evidence confirms that performance extended significantly beyond what might be explained by available tangible resources alone. The…

Assessment and Evaluation: Exploring Their Principles and Purposes in Relation to Neoliberalism through a Social Studies Case Study

ERIC Educational Resources Information Center

Broom, Catherine

2012-01-01

This paper begins with a discussion of Canadian and international work that has identified a number of shortcomings with standardized assessments, which are framed within neoliberal ideology. It then explores the principles of good assessment and applies them to an analysis of British Columbia's standardized Social Studies 11 exam. It finds that…

10 CFR 430.41 - Prescriptions of a rule.

Code of Federal Regulations, 2014 CFR

2014-01-01

... prescribed an energy conservation standard, water conservation standard (in the case of faucets, showerheads... Federal energy conservation standard or water conservation standard is applicable, the Secretary shall... water conservation standard (in the case of faucets, showerheads, water closets, and urinals) or other...

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Standard Reporting and Evaluation Guidelines: Results of a National Institutes of Health Working Group.

PubMed

Maverakis, Emanual; Wang, Elizabeth A; Shinkai, Kanade; Mahasirimongkol, Surakameth; Margolis, David J; Avigan, Mark; Chung, Wen-Hung; Goldman, Jennifer; La Grenade, Lois; Pirmohamed, Munir; Shear, Neil H; Tassaeeyakul, Wichittra; Hoetzenecker, Wolfram; Klaewsongkram, Jettanong; Rerkpattanapipat, Ticha; Manuyakorn, Wiparat; Yasuda, Sally Usdin; Sharon, Victoria R; Sukhov, Andrea; Micheletti, Robert; Struewing, Jeff; French, Lars E; Cheng, Michelle Y

2017-06-01

Toxic epidermal necrolysis (TEN) and Stevens-Johnson Syndrome (SJS) are rare, acute, life-threatening dermatologic disorders involving the skin and mucous membranes. Research into these conditions is hampered by a lack of standardization of case reporting and data collection. To establish a standardized case report form to facilitate comparisons and maintain data quality based on an international panel of SJS/TEN experts who performed a Delphi consensus-building exercise. The elements presented for committee scrutiny were adapted from previous case report forms and from PubMed literature searches of highly cited manuscripts pertaining to SJS/TEN. The expert opinions and experience of the members of the consensus group were included in the discussion. Overall, 21 out of 29 experts who were invited to participate in the online Delphi exercise agreed to participate. Surveys at each stage were administered via an online survery software tool. For the first 2 Delphi rounds, results were analyzed using the Interpercentile Range Adjusted for Symmetry method and statements that passed consensus formulated a new case report form. For the third Delphi round, the case report form was presented to the committee, who agreed that it was "appropriate and useful" for documenting cases of SJS/TEN, making it more reliable and valuable for future research endeavors. With the consensus of international experts, a case report form for SJS/TEN has been created to help standardize the collection of patient information in future studies and the documentation of individual cases.

Content Metadata Standards for Marine Science: A Case Study

USGS Publications Warehouse

Riall, Rebecca L.; Marincioni, Fausto; Lightsom, Frances L.

2004-01-01

The U.S. Geological Survey developed a content metadata standard to meet the demands of organizing electronic resources in the marine sciences for a broad, heterogeneous audience. These metadata standards are used by the Marine Realms Information Bank project, a Web-based public distributed library of marine science from academic institutions and government agencies. The development and deployment of this metadata standard serve as a model, complete with lessons about mistakes, for the creation of similarly specialized metadata standards for digital libraries.

Academic performance: A case study of mathematics and science educators from rural Washington high schools

NASA Astrophysics Data System (ADS)

Hancock, Tira K.

A qualitative descriptive case study explored courses of action for educators and leaders of math and science educators to implement to help students achieve state assessment standard and postsecondary success. The problem focused on two demographically similar rural high schools in Southwest Washington that demonstrated inadequate rates of student achievement in mathematics and science. The research question investigated courses of action that may assist educators and leaders of secondary math and science educators to help students achieve WASL standards and postsecondary success in compliance with the No Child Left Behind (NCLB) Act of 2001. Senge's learning organization theory (1990, 2006) and Fullan's (2001) contributions to leading and learning in times of change provided the theoretical framework for the study. Twenty study participant responses analyzed with qualitative analysis software QSR NVivo 7 revealed six themes. Triangulation of responses with secondary data from WASL assessment scores and case study school assessment data identified 14 courses of action and three recommendations for educators and leaders of math and science educators to help students meet state standards and postsecondary success. Critical factors identified in the study as needed to assist educators to help students succeed included professional development, collaboration, teaching practices, funding, student accountability, and parental involvement.

LAVA Simulations for the 3rd AIAA CFD High Lift Prediction Workshop with Body Fitted Grids

NASA Technical Reports Server (NTRS)

Jensen, James C.; Stich, Gerrit-Daniel; Housman, Jeffrey A.; Denison, Marie; Kiris, Cetin C.

2018-01-01

In response to the 3rd AIAA CFD High Lift Prediction Workshop, the workshop cases were analyzed using Reynolds-averaged Navier-Stokes flow solvers within the Launch Ascent and Vehicle Aerodynamics (LAVA) solver framework. For the workshop cases the advantages and limitations of both overset-structured an unstructured polyhedral meshes were assessed. The workshop included 3 cases: a 2D airfoil validation case, a mesh convergence study using the High Lift Common Research Model, and a nacelle/pylon integration study using the JAXA (Japan Aerospace Exploration Agency) Standard Model. The 2D airfoil case from the workshop is used to verify the implementation of the Spalart-Allmaras turbulence model along with some of its variants within the solver. The High Lift Common Research Model case is used to assess solver performance and accuracy at varying mesh resolutions, as well as identify the minimum mesh fidelity required for LAVA on this class of problem. The JAXA Standard Model case is used to assess the solver's sensitivity to the turbulence model and to compare the structured and unstructured mesh paradigms. These workshop cases have helped establish best practices for high lift flow configurations for the LAVA solver.

When Mathematics Works in Black: A Case Study of Effective Mathematics Instruction for African American Children

ERIC Educational Resources Information Center

Hakim, Khalel

2014-01-01

The purpose of this study was to describe and explain the 5th grade mathematics teaching practice of an African American female teacher in a predominantly African American classroom that consistently meets and/or exceeds Michigan's mathematics proficiency standards. Using multiple emancipatory lenses, and a single case study method that employed…

Toward a standardized investigation protocol in sudden unexpected deaths in infancy in South Africa: a multicenter study of medico-legal investigation procedures and outcomes.

PubMed

du Toit-Prinsloo, Lorraine; Dempers, Johan; Verster, Janette; Hattingh, Christa; Nel, Hestelle; Brandt, V D; Jordaan, Joyce; Saayman, Gert

2013-09-01

South Africa manifests a socio-economic dichotomy that shows features of both a developed and developing country. As a result of this, areas exist where a lack of resources and expertise prevents the implementation of a highly standardized protocol for the investigation of sudden and unexpected deaths in infants (SUDI). Although the medico-legal mortuaries attached to academic centers have the capacity to implement standardized protocols, a previous study conducted at two large medico-legal mortuaries indicated otherwise. This study also revealed that the exact number and incidence of sudden infant death syndrome (SIDS) cases was unknown. These findings prompted a multicenter study of the medico-legal investigation procedures and outcomes in five academic centers in South Africa. A retrospective case audit was conducted for a 5-year period (2005-2009) at medico-legal laboratories attached to universities in Bloemfontein, Cape Town-Tygerberg, Durban, Johannesburg, and Pretoria. The total case load as well as the total number of infants younger than 1 year of age admitted to these mortuaries was documented. The case files on all infants younger than 1 year of age who were admitted as sudden and unexpected or unexplained deaths were included in the study population. Data collected on the target population included demographic details, the nature and scope of the post-mortem examinations, as well as the final outcome (cause of death). A total case load of 80,399 cases were admitted to the mortuaries over the 5 year period with a total of 3,295 (6.5 %) infants. In the infant group, 591 (0.7 %) died from non-natural causes and 2,704 (3.3 %) cases of sudden, unexpected and/or unexplained deaths in infants were admitted and included in the detailed case analysis study. One hundred and ninety-nine babies were between 0 and 7 days of age and 210 babies between 8 and 30 days. The remaining 2,295 infants were between 1 month and 12 months of age. Death scene investigation was done in a total of 14 (0.5 %) cases. Discrepancies were present in the extent of the macroscopic post-mortem examinations, as well as the type and extent of the ancillary investigations performed. The investigations were completed in 2,583 of the cases. The majority of these infants died from natural disease processes [1,976 infants (76.5 %)]. Bronchopneumonia was the leading cause of natural deaths at all the mortuaries [674 cases (26.1 %)]. SIDS was diagnosed in only 224 cases (8.7 %) and in 383 (14.8 %) cases, where a full post-mortem examination with ancillary investigations was conducted; the cause of death was recorded as "unascertained." This study indicated that the admission criteria (to medico-legal mortuaries) and the investigative process/protocols in cases of SUDI differ greatly among 5 of the largest academic medical institutions in South Africa. Establishing and implementing standardized admission criteria (to medico-legal mortuaries) and implementing uniform investigative and autopsy protocols would appear to be an essential prerequisite to gain better understanding of the mystery of SIDS in South Africa.

10 CFR 430.70 - Enforcement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... writing concerning the energy performance or water performance (in the case of faucets, showerheads, water... standard or water performance standard (in the case of faucets, showerheads, water closets, and urinals... standard (in the case of faucets, showerheads, water closets, and urinals) shall be based on the testing...

Naturalness, dark matter, and the muon anomalous magnetic moment in supersymmetric extensions of the standard model with a pseudo-Dirac gluino

NASA Astrophysics Data System (ADS)

Li, Chuang; Zhu, Bin; Li, Tianjun

2018-02-01

We study the naturalness, dark matter, and muon anomalous magnetic moment in the Supersymmetric Standard Models (SSMs) with a pseudo-Dirac gluino (PDGSSMs) from hybrid F- and D-term supersymmetry (SUSY) breakings. To obtain the observed dark matter relic density and explain the muon anomalous magnetic moment, we find that the low energy fine-tuning measures are larger than about 30 due to strong constraints from the LUX and PANDAX experiments. Thus, to study the natural PDGSSMs, we consider multi-component dark matter and then the relic density of the lightest supersymmetric particle (LSP) neutralino is smaller than the correct value. We classify our models into six kinds: (i) Case A is a general case, which has small low energy fine-tuning measure and can explain the anomalous magnetic moment of the muon; (ii) Case B with the LSP neutralino and light stau coannihilation; (iii) Case C with Higgs funnel; (iv) Case D with Higgsino LSP; (v) Case E with light stau coannihilation and Higgsino LSP; (vi) Case F with Higgs funnel and Higgsino LSP. We study these Cases in details, and show that our models can be natural and consistent with the LUX and PANDAX experiments, as well as explain the muon anomalous magnetic moment. In particular, all these cases except the stau coannihilation can even have low energy fine-tuning measures around 10.

Evidence of Virtual Patients as a Facilitative Learning Tool on an Anesthesia Course

ERIC Educational Resources Information Center

Leung, Joseph Y. C.; Critchley, Lester A. H.; Yung, Alex L. K.; Kumta, Shekhar M.

2015-01-01

Virtual patients are computerised representations of realistic clinical cases. They were developed to teach clinical reasoning skills through delivery of multiple standardized patient cases. The anesthesia course at The Chinese University of Hong Kong developed two novel types of virtual patients, formative assessment cases studies and storyline,…

Exploring Prospective Teachers' Critical Thinking: Case-Based Pedagogy and the Standards of Professional Practice

ERIC Educational Resources Information Center

Cherubini, Lorenzo

2009-01-01

This qualitative constructivist research study employed a unique professional case-based pedagogy to investigate how concurrent Education undergraduate students made sense of the complex dilemmas inherent in the cases and in particular, the factors that influenced their critical thinking processes. The paper identifies three core categories that…

Effective Change: A Case Study of Implementation of A Standards Based Grading Initiative

ERIC Educational Resources Information Center

MacCrindle, Amy N.

2017-01-01

This study followed mindset changes in elementary teachers as they transitioned from traditional grading to standards based grading during the earliest stages of the change process. A pre- and post-survey of mindsets of participants, individual interviews, and a focus group interview were conducted. While the results of the pre- and post-survey…

Standard Errors for National Trends in International Large-Scale Assessments in the Case of Cross-National Differential Item Functioning

ERIC Educational Resources Information Center

Sachse, Karoline A.; Haag, Nicole

2017-01-01

Standard errors computed according to the operational practices of international large-scale assessment studies such as the Programme for International Student Assessment's (PISA) or the Trends in International Mathematics and Science Study (TIMSS) may be biased when cross-national differential item functioning (DIF) and item parameter drift are…

Impacts of Professional Development on High School Mathematics Teachers as They Implement Common Core State Standards

ERIC Educational Resources Information Center

Saucedo, Ana A.

2017-01-01

The purpose of this qualitative study was to understand the perceptions of high school mathematics teachers regarding the support provided through professional development (PD) as they engage in the implementation of the Common Core State Standards (CCSS). By means of a qualitative instrumental case study, eight high school mathematics teachers…

Study on Chinese common allergens of contact dermatitis.

PubMed

Fan, W X; Zhao, B

1990-01-01

Patch tests were performed according to the European Standard Allergens (ESA) in 204 cases suspected of contact dermatitis. The reaction was positive in 58.33% of the cases. The common allergens were nickel (15.7%), fragrance mix (11.8%) p-phenylenediamine (8.8%), colophony (6.9%), benzocaine (6.4%), formaldehyde (5.9%), black rubber mix (4.9%), cobalt (4.4%), balsam of Peru (3.9%), potassium dichromate (3.4%), thiuram mix (2.9%) and mercapto mix (2.9%). In 85 cases of negative reaction to the European Standard Allergens, 36 were patch tested to suspected agents based on the individual case histories, of which 21 positively reacted. The common sensitizing agents were ampicillin and thiomersal. Of 204 cases, 107 were cases of facial contact dermatitis. Patch tests showed that the most common allergens were p-phenylenediamine (15.9%), nickel (13.1%) and fragrance mix (14.95%).

Comparison of INTERGROWTH-21 and Fenton growth standards to assess size at birth and extrauterine growth in very preterm infants.

PubMed

Tuzun, Funda; Yucesoy, Ebru; Baysal, Bora; Kumral, Abdullah; Duman, Nuray; Ozkan, Hasan

2018-09-01

This study aimed to compare the recently published prescriptive INTERGROWTH-21st standards with commonly used intrauterine based Fenton growth standards in terms of birth size classification and extrauterine growth restriction (EUGR) incidence in a sample of very preterm infants. The anthropometric measures of preterm infants born before 32 weeks of gestation at the Dokuz Eylul University Hospital during the period from January 2012 to February 2016 were obtained at birth, at the 36th gestational weeks or at the time of discharge. Birth and growth data were presented as percentiles according to the two reference standards. A total of 248 infants with mean gestational age of 29.1 ± 2.1 weeks were included. The small for gestational age (SGA) rate was significantly higher (12 versus 15%, p = .004) and the EUGR rate was significantly lower (40.2 versus 31.5%, p < .001) with the INTERGROWTH-21st charts compared with the Fentons'. Twenty-four per cent of the infants who were accepted as SGA according to the INTERGROWTH-21st standards were appropriate for gestational age (AGA) according to the Fenton preterm growth charts. However, these newly identified SGA infants according to the Intergrowth-21st standards did not have increased risks of early morbidities. Furthermore, 77% of the cases who had EUGR due to the Fenton standards were categorized as EUGR when evaluated using the INTERGROWTH-21st standards. Results indicated that almost one out of every five cases assessed as EUGR according to Fenton standards was within the normal interval according to Intergrowth standards. On the contrary, one out of every four cases assessed as SGA according to the INTERGROWTH-21st standards was within the normal interval according to Fentons'. These differences observed with INTERGROWTH-21st standards may affect in-hospital and postdischarge nutrition plan of these vulnerable infants. However, new standards are needed to be evaluated against currently used ones before they are implemented and further studies should be conducted to evaluate the functional impact of these differences on long-term outcomes including neurologic and cardio-metabolic morbidities.

The effect of standardized patient feedback in teaching surgical residents informed consent: results of a pilot study.

PubMed

Leeper-Majors, Kristine; Veale, James R; Westbrook, Thomas S; Reed, Kendall

2003-01-01

The purpose of this pilot study was to determine the effectiveness of using feedback from a standardized patient (SP) to teach a surgical resident (SR) informed consent (IC) protocol. Four general case types of increasing difficulty were tested in a longitudinal experimental design format. The four types of cases were appendectomy, cholecystectomy, colorectal cancer, and breast cancer. Eight SRs of varying years of completion in medical school served as subjects-four in the experimental group (received performance feedback from an SP) and four in the control group (received no SP feedback). Both the control and experimental groups participated in two patient encounters per case type. The first patient encounter served as the pretest, and the second patient encounter was the posttest. In each encounter, an SP rated the resident on 14 measures using an open-ended seven-point rating scale adopted and modified from the Brown University Interpersonal Skill Evaluation (BUISE). Each resident also reviewed a videotape of an expert giving IC between pretest and the posttest for basic instructional protocol. Random stratified sampling was used to equally distribute the residents by postgraduate years. A total of 16 SPs were used in this study. All patient/SR encounters were videotaped. There was a statistically significant overall change--pretest to posttest and across cases (p = 0.001). The group effect was statistically significant (p = 0.000), with the experimental group averaging about 10 points greater than the control group. Standardized patient feedback is an effective modality in teaching surgical residents informed consent protocol. This conclusion is tentative, due to the limitations of sample size. The results of this study support continued research on the effects of standardized patient feedback to teach informed consent to surgical residents.

[Breast cancer screening process indicators in Mexico: a case study].

PubMed

Uscanga-Sánchez, Santos; Torres-Mejía, Gabriela; Ángeles-Llerenas, Angélica; Domínguez-Malpica, Raúl; Lazcano-Ponce, Eduardo

2014-01-01

To identify, measure and compare the performance indicators of productivity, effective access and quality service for the early detection breast cancer program in Mexico. By means of a study case based on the 2011 Women Cancer Information System (SICAM), the indicators were measured and compared with the Mexican official standard NOM-041-SSA2-2011 and international standards. The analysis showed insufficient installed capacity (37%), low coverage in screening (15%), diagnostic evaluation (16%), biopsy (44%) and treatment (57%), and very low effectiveness in confirmed cases by the total number of screening mammograms performed (0.04%). There was no information available, from SICAM, to estimate the rest of the indicators proposed. Efficient health information systems are required in order to monitor indicators and generate performance observatories of screening programs.

Accountability Policy Implementation and the Case of Smaller School District Capacity: Three Contrasting Cases that Examine the Flow and Use of NCLB Accountability Data

ERIC Educational Resources Information Center

Miller, Christopher L.

2010-01-01

The No Child Left Behind Act increases pressure on schools and districts to use standardized state test data. Seeking to learn about the process of turning accountability data into actionable information, this paper presents findings from three case studies of small to medium sized school districts. The study examines the flow of state science…

A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

PubMed

Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

2014-12-01

General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

[Comparison of Flu Outbreak Reporting Standards Based on Transmission Dynamics Model].

PubMed

Yang, Guo-jing; Yi, Qing-jie; Li, Qin; Zeng, Qing

2016-05-01

To compare the current two flu outbreak reporting standards for the purpose of better prevention and control of flu outbreaks. A susceptible-exposed-infectious/asymptomatic-removed (SEIAR) model without interventions was set up first, followed by a model with interventions based on real situation. Simulated interventions were developed based on the two reporting standards, and evaluated by estimated duration of outbreaks, cumulative new cases, cumulative morbidity rates, decline in percentage of morbidity rates, and cumulative secondary cases. The basic reproductive number of the outbreak was estimated as 8. 2. The simulation produced similar results as the real situation. The effect of interventions based on reporting standard one (10 accumulated new cases in a week) was better than that of interventions based on reporting standard two (30 accumulated new cases in a week). The reporting standard one (10 accumulated new cases in a week) is more effective for prevention and control of flu outbreaks.

Building a gold standard to construct search filters: a case study with biomarkers for oral cancer.

PubMed

Frazier, John J; Stein, Corey D; Tseytlin, Eugene; Bekhuis, Tanja

2015-01-01

To support clinical researchers, librarians and informationists may need search filters for particular tasks. Development of filters typically depends on a "gold standard" dataset. This paper describes generalizable methods for creating a gold standard to support future filter development and evaluation using oral squamous cell carcinoma (OSCC) as a case study. OSCC is the most common malignancy affecting the oral cavity. Investigation of biomarkers with potential prognostic utility is an active area of research in OSCC. The methods discussed here should be useful for designing quality search filters in similar domains. The authors searched MEDLINE for prognostic studies of OSCC, developed annotation guidelines for screeners, ran three calibration trials before annotating the remaining body of citations, and measured inter-annotator agreement (IAA). We retrieved 1,818 citations. After calibration, we screened the remaining citations (n = 1,767; 97.2%); IAA was substantial (kappa = 0.76). The dataset has 497 (27.3%) citations representing OSCC studies of potential prognostic biomarkers. The gold standard dataset is likely to be high quality and useful for future development and evaluation of filters for OSCC studies of potential prognostic biomarkers. The methodology we used is generalizable to other domains requiring a reference standard to evaluate the performance of search filters. A gold standard is essential because the labels regarding relevance enable computation of diagnostic metrics, such as sensitivity and specificity. Librarians and informationists with data analysis skills could contribute to developing gold standard datasets and subsequent filters tuned for their patrons' domains of interest.

Aligning IT and Business Strategy: An Australian University Case Study

ERIC Educational Resources Information Center

Dent, Alan

2015-01-01

Alignment with business objectives is considered to be an essential outcome of information technology (IT) strategic planning. This case study examines the process of creating an IT strategy for an Australian university using an industry standard methodology. The degree of alignment is determined by comparing the strategic priorities supported by…

Adopting National Vocational Qualifications in the Offshore Industry: A Case Study.

ERIC Educational Resources Information Center

Fuller, Alison; John, Debbie

1994-01-01

From a case study of the introduction of National Vocational Qualifications (NVQs) in the British petroleum industry emerged three key issues: (1) their credibility depends on how closely they reflect employment standards; (2) context is important; and (3) although NVQs should provide wider access to opportunities, the offshore industry's…

Methods and Case Studies for Teaching and Learning about Failure and Safety.

ERIC Educational Resources Information Center

Bignell, Victor

1999-01-01

Discusses methods for analyzing case studies of failures of technological systems. Describes two distance learning courses that compare standard models of failure and success with the actuality of given scenarios. Provides teaching and learning materials and information sources for application to aspects of design, manufacture, inspection, use,…

Using ITS to Create an Insurance Industry Application: A Joint Case Study.

ERIC Educational Resources Information Center

Boies, Stephen J.; And Others

1993-01-01

Presents an empirical case study of the use of ITS, a software development environment designed by IBM, by Continental Insurance for underwriting applications. Use of a rule-based user interface style that made electronic forms look like standard insurance industry paper forms and worked according to Continental's guidelines is described.…

Academic Performance: A Case Study of Mathematics and Science Educators from Rural Washington High Schools

ERIC Educational Resources Information Center

Hancock, Tira K.

2009-01-01

A qualitative descriptive case study explored courses of action for educators and leaders of math and science educators to implement to help students achieve state assessment standard and postsecondary success. The problem focused on two demographically similar rural high schools in Southwest Washington that demonstrated inadequate rates of…

Pragmatic Language Impairment: Case Studies of Social and Pragmatic Language Therapy

ERIC Educational Resources Information Center

Adams, Catherine; Baxendale, Janet; Lloyd, Julian; Aldred, Catherine

2005-01-01

The current position on speech and language intervention for children who have pragmatic language impairment (PLI) is limited by a lack of evidence to support practice. Two intervention outcome case studies of children with PLI, aimed at establishing efficacy, are presented in this paper. Standardized language tests and conversational sampling…

Democratic Possibilities for Student Voice within Schools Undergoing Reform: A Student Counterpublic Case Study

ERIC Educational Resources Information Center

Diera, Claudia

2016-01-01

Public schools failing to meet accountability standards have been shut down, taken over by charter organizations, or undergone reconstitution. This article challenges deficit views of students as passive and complacent in a schooling context dictated by accountability sanctions. Drawing from counterpublic theory, it describes a case study that…

Analysis of Industry Responses to Federal Regulations in Safety Requirements for New Automobiles

DOT National Transportation Integrated Search

1978-03-01

This report presents findings of an initial study of how the automobile industry has responded to the promulgation of motor vehicle standards by the U.S. goverment. The report examines three safety standards as evaluative cases: MVS 203--Steering col...

Airside HVAC BESTEST. Adaptation of ASHRAE RP 865 Airside HVAC Equipment Modeling Test Cases for ASHRAE Standard 140. Volume 1, Cases AE101-AE445

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

Neymark, J.; Kennedy, M.; Judkoff, R.

This report documents a set of diagnostic analytical verification cases for testing the ability of whole building simulation software to model the air distribution side of typical heating, ventilating and air conditioning (HVAC) equipment. These cases complement the unitary equipment cases included in American National Standards Institute (ANSI)/American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs, which test the ability to model the heat-transfer fluid side of HVAC equipment.

Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year.

PubMed

Karch, Debra L; Chen, Mi; Tang, Tian

2014-01-01

In 2009, the Centers for Disease Control and Prevention completed migration of all 59 surveillance project areas (PAs) from the case-based HIV/AIDS Reporting System to the document-based Enhanced HIV/AIDS Reporting System. We conducted a PA-level assessment of Enhanced HIV/AIDS Reporting System process and outcome standards for HIV infection cases. Process standards were reported by PAs and outcome standards were calculated using standardized Centers for Disease Control and Prevention SAS code. A total of 59 PAs including 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the Virgin Islands). Cases diagnosed or reported to the PA surveillance system between January 1, 2011, and December 31, 2011, using data collected through December 2012. Process standards for death ascertainment and intra- and interstate case de-duplication; outcome standards for completeness and timeliness of case reporting, data quality, intrastate duplication rate, risk factor ascertainment, and completeness of initial CD4 and viral load reporting. Fifty-five of 59 PAs (93%) reported linking cases to state vital records death certificates during 2012, 76% to the Social Security Death Master File, and 59% to the National Death Index. Seventy percent completed monthly intrastate, and 63% completed semiannual interstate de-duplication. Eighty-three percent met the 85% or more case ascertainment standard, and 92% met the 66% or more timeliness standard; 75% met the 97% or more data quality standard; all PAs met the 5% or less intrastate duplication rate; 41% met the 85% or more risk factor ascertainment standard; 90% met the 50% or more standard for initial CD4; and 93% met the same standard for viral load reporting. Overall, 7% of PAs met all 11 process and outcome standards. Findings support the need for continued improvement in HIV surveillance activities and monitoring of system outcomes.

10 CFR 430.50 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... standards or water conservation standards (in the case of faucets, showerheads, water closets, and urinals... exemptions from applicable energy conservation standards or water conservation standards (in the case of... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Small Business...

10 CFR 430.50 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Small Business... standards or water conservation standards (in the case of faucets, showerheads, water closets, and urinals... exemptions from applicable energy conservation standards or water conservation standards (in the case of...

10 CFR 430.50 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Small Business... standards or water conservation standards (in the case of faucets, showerheads, water closets, and urinals... exemptions from applicable energy conservation standards or water conservation standards (in the case of...

10 CFR 430.50 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Small Business... standards or water conservation standards (in the case of faucets, showerheads, water closets, and urinals... exemptions from applicable energy conservation standards or water conservation standards (in the case of...

10 CFR 430.50 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Small Business... standards or water conservation standards (in the case of faucets, showerheads, water closets, and urinals... exemptions from applicable energy conservation standards or water conservation standards (in the case of...

Two-year outcome of team-based intensive case management for patients with schizophrenia.

PubMed

Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

1995-12-01

Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010-2016.

PubMed

Wright, Marc-Oliver; Allen-Bridson, Katherine; Hebden, Joan N

2017-06-01

The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance definitions are the most widely used criteria for health care-associated infection (HAI) surveillance. NHSN participants agree to conduct surveillance in accordance with the NHSN protocol and criteria. To assess the application of these standardized surveillance specifications and offer infection preventionists (IPs) opportunities for ongoing education, a series of case studies, with questions related to NHSN definitions and criteria were published. Beginning in 2010, case studies with multiple-choice questions based on standard surveillance criteria and protocols were written and published in the American Journal of Infection Control with a link to an online survey. Participants anonymously submitted their responses before receiving the correct answers. The 22 case studies had 7,950 respondents who provided 27,790 responses to 75 questions during the first 6 years. Correct responses were selected 62.5% of the time (17,376 out of 27,290), but ranged widely (16%-87%). In a subset analysis, 93% of participants self-identified as IPs (3,387 out of 3,640), 4.5% were public health professionals (163 out of 3,640), and 2.5% were physicians (90 out of 3,640). IPs responded correctly (62%) more often than physicians (55%) (P = .006). Among a cohort of voluntary participants, accurate application of surveillance criteria to case studies was suboptimal, highlighting the need for continuing education, competency development, and auditing. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Epidemiology and Trends in Incidence of Kidney Cancer in Iran.

PubMed

Mirzaei, Maryam; Pournamdar, Zahra; Salehiniya, Hamid

2015-01-01

Kidney cancer has shown an increasing trend in recent decades. This study aimed to determine change in the incidence rate between 2003 and 2009 in Iran. In this study, national cancer registry data were used. Crude incidence rates were calculated per 100,000 and age-standardized incidence rates (ASRs) were computed using the direct standardization method and the world standard population. Significant trend of incidence rates was examined by the Cochran-Armitage test for linear trend. A total of 6,944 cases of kidney cancer were reported. The incidence cases increased from 595 patients in 2003 to 1,387 patients in 2009. Sex ratio (male to female) was 1.67. ASR also increased from 1.18 in 2003 to 2.52 in 2009 per 100,000, but the increasing trend was not significant. A slow increasing trend of incidence rate was observed in the study population. This may be due to an increase of risk factors. It is suggested to perform a study on risk factors for the cancer.

A Case Study of the Texas Teacher Study: Technical Report. Project: Effects of Testing Reforms and Standards.

ERIC Educational Resources Information Center

Shepard, Lorrie A.; And Others

The Texas Examination of Current Administrators and Teachers is a basic literacy test that was administered to 202,000 practicing educators in March 1986. An in-depth case study was undertaken to examine the effects of the test as an instrument of educational reform and policy making. The two-year study involved 10 separate data-collection phases…

Probing CP violation with non-unitary mixing in long-baseline neutrino oscillation experiments: DUNE as a case study

DOE PAGES

Escrihuela, F. J.; Forero, D. V.; Miranda, O. G.; ...

2017-09-08

When neutrino masses arise from the exchange of neutral heavy leptons, as in most seesaw schemes, the effective lepton mixing matrix N describing neutrino propagation is non-unitary, hence neutrinos are not exactly orthonormal. New CP violation phases appear in N that could be confused with the standard phasemore » $${\\delta }_{\\mathrm{CP}}$$ characterizing the three neutrino paradigm.We study the potential of the long-baseline neutrino experiment DUNE in probing CP violation induced by the standard CP phase in the presence of non-unitarity. In order to accomplish this we develop our previous formalism, so as to take into account the neutrino interactions with the medium, important in long baseline experiments such as DUNE. In this study we find that the expected CP sensitivity of DUNE is somewhat degraded with respect to that characterizing the standard unitary case. However the effect is weaker than might have been expected thanks mainly to the wide neutrino beam. We also investigate the sensitivity of DUNE to the parameters characterizing non-unitarity. In this case we find that there is no improvement expected with respect to the current situation, unless the near detector setup is revamped.« less

Probing CP violation with non-unitary mixing in long-baseline neutrino oscillation experiments: DUNE as a case study

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

Escrihuela, F. J.; Forero, D. V.; Miranda, O. G.

When neutrino masses arise from the exchange of neutral heavy leptons, as in most seesaw schemes, the effective lepton mixing matrix N describing neutrino propagation is non-unitary, hence neutrinos are not exactly orthonormal. New CP violation phases appear in N that could be confused with the standard phasemore » $${\\delta }_{\\mathrm{CP}}$$ characterizing the three neutrino paradigm.We study the potential of the long-baseline neutrino experiment DUNE in probing CP violation induced by the standard CP phase in the presence of non-unitarity. In order to accomplish this we develop our previous formalism, so as to take into account the neutrino interactions with the medium, important in long baseline experiments such as DUNE. In this study we find that the expected CP sensitivity of DUNE is somewhat degraded with respect to that characterizing the standard unitary case. However the effect is weaker than might have been expected thanks mainly to the wide neutrino beam. We also investigate the sensitivity of DUNE to the parameters characterizing non-unitarity. In this case we find that there is no improvement expected with respect to the current situation, unless the near detector setup is revamped.« less

Standardization of Type 2 Diabetes Outpatient Expenditure with Bundled Payment Method in China.

PubMed

Xu, Guo-Chao; Luo, Yun; Li, Qian; Wu, Meng-Fan; Zhou, Zi-Jun

2016-04-20

In recent years, the prevalence of type 2 diabetes among Chinese population has been increasing by years, directly leading to an average annual growth rate of 19.90% of medical expenditure. Therefore, it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China. Therefore, in this study, we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services. This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012. Based on the analysis of outpatient expenditure and its influential factors, we adopted decision tree approach to conduct a case-mix analysis. In the end, we built a case-mix model to calculate the standard expenditure and the upper limit of each combination. We found that age, job status, and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes. Through the analysis of the decision tree, we used six variables (complication, age, diabetic foot, diabetic nephropathy, cardiac-cerebrovascular disease, and neuropathy) to group the cases, and obtained 11 case-mix groups. We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services. Bundled payment is effective to control the increase of outpatient expenditure. Further improvements are needed for the implementation of bundled payment reimbursement standards, together with relevant policies and measures.

Group study of an "undercover" test for visuospatial neglect: invisible cancellation can reveal more neglect than standard cancellation.

PubMed

Wojciulik, E; Rorden, C; Clarke, K; Husain, M; Driver, J

2004-09-01

Visual neglect is a relatively common deficit after brain damage, particularly strokes. Cancellation tests provide standard clinical measures of neglect severity and deficits in daily life. A recent single-case study introduced a new variation on standard cancellation. Instead of making a visible mark on each target found, the patient made invisible marks (recorded with carbon paper underneath, for later scoring). Such invisible cancellation was found to reveal more neglect than cancellation with visible marks. Here we test the generality of this. Twenty three successive cases with suspected neglect each performed cancellation with visible or invisible marks. Neglect of contralesional targets was more pronounced with invisible marks. Indeed, about half of the patients only showed neglect in this version. For cases showing more neglect with invisible marks, stronger neglect of contralesional targets correlated with more revisits to ipsilesional targets for making additional invisible marks upon them. These results indicate that cancellation with invisible marks can reveal more neglect than standard cancellation with visible marks, while still providing a practical bedside test. Our observations may be consistent with recent proposals that demands on spatial working memory (required to keep track of previously found items only when marked invisibly) can exacerbate spatial neglect.

Variations on an Historical Case Study

ERIC Educational Resources Information Center

Field, Patrick

2006-01-01

The National Inquiry Standard for Science Education Preparation requires science teachers to introduce students to scientific inquiry to solve problems by various methods, including active learning in a collaborative environment. In order for science teachers to comply with this inquiry standard, activities must be designed for students to…

FLOOD MANAGEMENT: A CASE STUDY TO LINK SOCIO-ECONOMIC AND ENVIRONMENTAL POLICY

EPA Science Inventory

Human living standards are inextricably linked through the economy to the integrity of the natural resources from which they are derived. The complex trade-offs needed to shape sustainable living standards will require a much greater ability to predict the consequences of public...

Qualification Journey in Teacher Training: Case in Northern Cyprus

ERIC Educational Resources Information Center

Erden, Hale

2016-01-01

Problem Statement: The identification of professional teaching standards has great value on initial teacher training, hiring teachers, assessing teacher performance, as well as planning and organizing teacher professional development. In Northern Cyprus there are not any identified professional teaching standards. This study aimed at filling this…

The Value of Analysis of Standardized Placement Exams: A Case Study of Cell Structure.

ERIC Educational Resources Information Center

Blystone, Robert V.

This study focused on potential pedagological uses of standardized placement exams. A sample of 250 exams of the May 1984 Biology Advanced Placement (AP) exam was obtained and student responses to the question on cell structure were analyzed. The frequency of particular responses to the question is listed and trends and patterns in the responses…

Exploring Support for the Extracurriculum in a Time of Fiscal Constraint and Standards-Based Reform: A Case Study of One Pennsylvania School District

ERIC Educational Resources Information Center

Murphy, Mark Patrick

2012-01-01

Although much has been researched and written about the value of extracurricular programs in U.S. public schools, few studies have addressed the combined effect that school reform initiatives, including myriad standardized tests, accountability measures, and massive financial crisis which have become more commonplace during periods of economic…

Elementary School Teachers' Experiences in a Professional Learning Community Addressing the Gender Gap

ERIC Educational Resources Information Center

Boyles, Glenda F.

2011-01-01

International research and academic performance measures indicate that boys are scoring lower on standardized tests than girls in reading and writing. At the time of this study, boys had lower standardized test scores than girls in an elementary school in a southeastern state in the United States. The purpose of this qualitative case study was to…

Assessment in Education: A Case for Quality and Standards within the Context of Open and Distance Education--A Case Study of One Zimbabwean University

ERIC Educational Resources Information Center

Samkange, Wellington

2012-01-01

A study was carried out to assess the assessment procedures used at one Open and Distance Learning (ODL) institution in Zimbabwe. The study focused on the views and perceptions of current and former students of the university. The study also analyzed some documents on assessment procedures at the university. The study used the qualitative…

Host model uncertainties in aerosol radiative forcing estimates: results from the AeroCom Prescribed intercomparison study

NASA Astrophysics Data System (ADS)

Stier, P.; Schutgens, N. A. J.; Bellouin, N.; Bian, H.; Boucher, O.; Chin, M.; Ghan, S.; Huneeus, N.; Kinne, S.; Lin, G.; Ma, X.; Myhre, G.; Penner, J. E.; Randles, C. A.; Samset, B.; Schulz, M.; Takemura, T.; Yu, F.; Yu, H.; Zhou, C.

2013-03-01

Simulated multi-model "diversity" in aerosol direct radiative forcing estimates is often perceived as a measure of aerosol uncertainty. However, current models used for aerosol radiative forcing calculations vary considerably in model components relevant for forcing calculations and the associated "host-model uncertainties" are generally convoluted with the actual aerosol uncertainty. In this AeroCom Prescribed intercomparison study we systematically isolate and quantify host model uncertainties on aerosol forcing experiments through prescription of identical aerosol radiative properties in twelve participating models. Even with prescribed aerosol radiative properties, simulated clear-sky and all-sky aerosol radiative forcings show significant diversity. For a purely scattering case with globally constant optical depth of 0.2, the global-mean all-sky top-of-atmosphere radiative forcing is -4.47 Wm-2 and the inter-model standard deviation is 0.55 Wm-2, corresponding to a relative standard deviation of 12%. For a case with partially absorbing aerosol with an aerosol optical depth of 0.2 and single scattering albedo of 0.8, the forcing changes to 1.04 Wm-2, and the standard deviation increases to 1.01 W-2, corresponding to a significant relative standard deviation of 97%. However, the top-of-atmosphere forcing variability owing to absorption (subtracting the scattering case from the case with scattering and absorption) is low, with absolute (relative) standard deviations of 0.45 Wm-2 (8%) clear-sky and 0.62 Wm-2 (11%) all-sky. Scaling the forcing standard deviation for a purely scattering case to match the sulfate radiative forcing in the AeroCom Direct Effect experiment demonstrates that host model uncertainties could explain about 36% of the overall sulfate forcing diversity of 0.11 Wm-2 in the AeroCom Direct Radiative Effect experiment. Host model errors in aerosol radiative forcing are largest in regions of uncertain host model components, such as stratocumulus cloud decks or areas with poorly constrained surface albedos, such as sea ice. Our results demonstrate that host model uncertainties are an important component of aerosol forcing uncertainty that require further attention.

An entropy-based statistic for genomewide association studies.

PubMed

Zhao, Jinying; Boerwinkle, Eric; Xiong, Momiao

2005-07-01

Efficient genotyping methods and the availability of a large collection of single-nucleotide polymorphisms provide valuable tools for genetic studies of human disease. The standard chi2 statistic for case-control studies, which uses a linear function of allele frequencies, has limited power when the number of marker loci is large. We introduce a novel test statistic for genetic association studies that uses Shannon entropy and a nonlinear function of allele frequencies to amplify the differences in allele and haplotype frequencies to maintain statistical power with large numbers of marker loci. We investigate the relationship between the entropy-based test statistic and the standard chi2 statistic and show that, in most cases, the power of the entropy-based statistic is greater than that of the standard chi2 statistic. The distribution of the entropy-based statistic and the type I error rates are validated using simulation studies. Finally, we apply the new entropy-based test statistic to two real data sets, one for the COMT gene and schizophrenia and one for the MMP-2 gene and esophageal carcinoma, to evaluate the performance of the new method for genetic association studies. The results show that the entropy-based statistic obtained smaller P values than did the standard chi2 statistic.

10 CFR 430.62 - Submission of data.

Code of Federal Regulations, 2011 CFR

2011-01-01

... product subject to the applicable energy conservation standard or water conservation standard (in the case of faucets, showerheads, water closets, and urinals) set forth in subpart C of this part shall... applicable energy conservation standard or water conservation standard (in the case of faucets, showerheads...

Soil quality: Some basic considerations and case studies

Treesearch

Dale W. Johnson

2010-01-01

Some fundamental properties of soils that pertain to the concept of soil quality are discussed including a discussion of what can and cannot be changed with management.Case studies showing the effects of N-fixing vegetation and N-enrichment effects on invasive species are provided to illustrate the complications that may arise from applying one soil quality standard to...

Using Six Sigma for Performance Improvement in Business Curriculum: A Case Study

ERIC Educational Resources Information Center

Kukreja, Anil; Ricks, Joe M., Jr.; Meyer, Jean A.

2009-01-01

During the last few decades, a number of quality improvement methodologies have been used by organizations. This article provides a brief review of the quality improvement literature related to academia and a case study using Six Sigma methodology to analyze students' performance in a standardized examination. We found Six Sigma to be an effective…

Quality Standards Matter: A Comparative Case Study Examining Interactive Writing in the Preschool Setting

ERIC Educational Resources Information Center

Hall, Anna H.

2017-01-01

Interactive writing is a research-based early literacy strategy that has been found effective at increasing young children's oral language skills, alphabet knowledge, phonemic awareness, concepts of print, and early writing skills. This paper reports on a case study which explored the feasibility and fidelity of implementing interactive writing in…

Joint models for longitudinal and time-to-event data: a review of reporting quality with a view to meta-analysis.

PubMed

Sudell, Maria; Kolamunnage-Dona, Ruwanthi; Tudur-Smith, Catrin

2016-12-05

Joint models for longitudinal and time-to-event data are commonly used to simultaneously analyse correlated data in single study cases. Synthesis of evidence from multiple studies using meta-analysis is a natural next step but its feasibility depends heavily on the standard of reporting of joint models in the medical literature. During this review we aim to assess the current standard of reporting of joint models applied in the literature, and to determine whether current reporting standards would allow or hinder future aggregate data meta-analyses of model results. We undertook a literature review of non-methodological studies that involved joint modelling of longitudinal and time-to-event medical data. Study characteristics were extracted and an assessment of whether separate meta-analyses for longitudinal, time-to-event and association parameters were possible was made. The 65 studies identified used a wide range of joint modelling methods in a selection of software. Identified studies concerned a variety of disease areas. The majority of studies reported adequate information to conduct a meta-analysis (67.7% for longitudinal parameter aggregate data meta-analysis, 69.2% for time-to-event parameter aggregate data meta-analysis, 76.9% for association parameter aggregate data meta-analysis). In some cases model structure was difficult to ascertain from the published reports. Whilst extraction of sufficient information to permit meta-analyses was possible in a majority of cases, the standard of reporting of joint models should be maintained and improved. Recommendations for future practice include clear statement of model structure, of values of estimated parameters, of software used and of statistical methods applied.

Gold standards and expert panels: a pulmonary nodule case study with challenges and solutions

NASA Astrophysics Data System (ADS)

Miller, Dave P.; O'Shaughnessy, Kathryn F.; Wood, Susan A.; Castellino, Ronald A.

2004-05-01

Comparative evaluations of reader performance using different modalities, e.g. CT with computer-aided detection (CAD) vs. CT without CAD, generally require a "truth" definition based on a gold standard. There are many situations in which a true invariant gold standard is impractical or impossible to obtain. For instance, small pulmonary nodules are generally not assessed by biopsy or resection. In such cases, it is common to use a unanimous consensus or majority agreement from an expert panel as a reference standard for actionability in lieu of the unknown gold standard for disease. Nonetheless, there are three major concerns about expert panel reference standards: (1) actionability is not synonymous with disease (2) it may be possible to obtain different conclusions about which modality is better using different rules (e.g. majority vs. unanimous consensus), and (3) the variability associated with the panelists is not formally captured in the p-values or confidence intervals that are generally produced for estimating the extent to which one modality is superior to the other. A multi-reader-multi-case (MRMC) receiver operating characteristic (ROC) study was performed using 90 cases, 15 readers, and a reference truth based on 3 experienced panelists. The primary analyses were conducted using a reference truth of unanimous consensus regarding actionability (3 out of 3 panelists). To assess the three concerns noted above: (1) additional data from the original radiology reports were compared to the panel (2) the complete analysis was repeated using different definitions of truth, and (3) bootstrap analyses were conducted in which new truth panels were constructed by picking 1, 2, or 3 panelists at random. The definition of the reference truth affected the results for each modality (CT with CAD and CT without CAD) considered by itself, but the effects were similar, so the primary analysis comparing the modalities was robust to the choice of the reference truth.

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

PubMed

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

Puerto Rican Vocational Students' Experiences Regarding Standardized Tests

ERIC Educational Resources Information Center

Segui, Nomara I.

2016-01-01

Vocational high school students are not passing state tests and are not meeting adequate yearly progress (AYP) requirements in Puerto Rico. Limited qualitative research has been conducted to examine the experiences of vocational high school students regarding mandated standardized tests. Using a qualitative case study, the experiences of Puerto…

Differences in Students' Reading Comprehension of International Financial Reporting Standards: A South African Case

ERIC Educational Resources Information Center

Coetzee, Stephen A.; Janse van Rensburg, Cecile; Schmulian, Astrid

2016-01-01

This study explores differences in students' reading comprehension of International Financial Reporting Standards in a South African financial reporting class with a heterogeneous student cohort. Statistically significant differences were identified for prior academic performance, language of instruction, first language and enrolment in the…

Leadership Strategies in Implementation of High-School Standards-Based Grading Systems

ERIC Educational Resources Information Center

Pritzl, Jerome

2016-01-01

This multi-site case study examined leadership strategies used during successful implementation of standards-based grading systems in three Wisconsin high schools. It found that leaders' reported commitment, patience, and persistence showed evidence of sustainable, high-functioning systems. It drew two main conclusions: first, school leaders need…

Standardized Test Results: An Opportunity for English Program Improvement

ERIC Educational Resources Information Center

Jiménez, Maureyra; Rodríguez, Caroll; Rey Paba, Lourdes

2017-01-01

This case study explores the relationship between the results obtained by a group of Industrial Engineering students on a national standardized English test and the impact these results had on language program improvement. The instruments used were interviews, document analysis, observations, surveys, and test results analysis. Findings indicate…

EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event Case Study

EPA Pesticide Factsheets

In June, 2007, participants from EPA headquarters, EPA Region 7, and the four States in EPA Region 7 (IA, KS, MO, and NE) conducted a Lean business kaizen event on the EPA–State process for developing and revising water quality standards (WQS).

Analyzing Sustainability Themes in State Science Standards: Two Case Studies

ERIC Educational Resources Information Center

Miller, Hannah K.; Jones, Linda Cronin

2014-01-01

Due to the interdisciplinary nature of environmental education, addressing the range of socioscientific issues included under the umbrella of sustainability can be challenging for educators working within the context of mandated state subject area standards. Two states (Washington and Vermont) have been recognized as leaders in incorporating…

Pure retroperitoneal natural orifice translumenal endoscopic surgery (NOTES) transvaginal nephrectomy using standard laparoscopic instruments: a safety and feasibility study in a porcine model.

PubMed

Wei, Dechao; Han, Yili; Li, Mingchuan; Wang, Yongxing; Chen, Yatong; Luo, Yong; Jiang, Yongguang

2016-06-11

Among the different organs used for NOTES (natural orifice translumenal endoscopic surgery) technique, the transvaginal approach may be the optimal choice because of a simple and secure closure of colpotomy site. Pure and hybrid NOTES transvaginal operations were routinely performed via transperitoneal access. In this study, we investigate the safety and feasibility of pure retroperitoneal natural orifice translumenal endoscopic surgery (NOTES) transvaginal nephrectomy using conventional laparoscopic techniques in a porcine model. Six female pigs, weighing an average of 30 kg, were used in this study. Under general anesthesia, pure retroperitoneal NOTES transvaginal nephrectomy was conducted using standard laparoscopic instruments. Posterolateral colpotomy was performed, and the incision was enlarged laterally using blunt dissection and pneumatic dilation. A single-port device was inserted to construct the operative channel. The retroperitoneal space was created using sharp and blunt dissection under endoscopic guidance up to the level of the kidney. Dissection and removal of the kidney were performed according to standard surgical procedure, and the colpotomy site was closed using interrupted sutures. The survival and complications were observed 1 week postoperatively. Our results showed that two cases failed because of peritoneal rupture. One case was successful, but required the assistance of an extra 5 mm laparoscopic trocar inserted in the flank. Three cases of pure retroperitoneal NOTES transvaginal nephrectomy were completed, and survived 1 week after the operation. In these three cases, no intra- or postoperative complications were observed. All findings confirmed the safety and feasibility of the retroperitoneal pure retroperitoneal NOTES transvaginal nephrectomy using standard laparoscopic instruments, which suggested the possibility of clinical application in human beings in the future.

Laparoscopy Using Room Air Insufflation in a Rural African Jungle Hospital: The Bongolo Hospital Experience, January 2006 to December 2013.

PubMed

O'Connor, Zachary; Faniriko, Marco; Thelander, Keir; O'Connor, Jennifer; Thompson, David; Park, Adrian

2017-06-01

Carbon dioxide is the standard insufflation gas for laparoscopy. However, in many areas of the world, bottled carbon dioxide is not available. Laparoscopy offers advantages over open surgery and has been practiced using filtered room air insufflation since 2006 at Bongolo Hospital in Gabon, Africa. Our primary goal was to evaluate the safety of room air insufflation related to intraoperative and postoperative complications. Our secondary aim was to review the types of cases performed laparoscopically at our institution. This retrospective review evaluates laparoscopic cases performed at Bongolo Hospital between January 2006 and December 2013. Demographic and perioperative information for patients undergoing laparoscopic procedures was collected. Insufflation was achieved using a standard, oil-free air compressor using filtered air and a standard insufflation regulator. A total of 368 laparoscopic procedures were identified within the time period. The majority of cases were gynecologic (43%). There was a 2% (8/368) complication rate with one perioperative death. The 2 complications related to insufflation were episodes of hypotension responsive to standard corrective measures. No intracorporeal combustion events were observed in any cases in which the use of diathermy and room air insufflation were combined. The other complications and the death were unrelated to the use of insufflation with air. Insufflation complications with room air occurred in our study. However, the complications related to insufflation with room air in our study were no different than those described in the literature using carbon dioxide. As room air is less costly than carbon dioxide and readily available, confirming the safety of room air insufflation in prospective studies is warranted. Room air appears to be safe for establishing and maintaining pneumoperitoneum, making laparoscopic surgery more accessible to patients in low-resource settings.

Design and Implementation of an Enterprise Internet of Things

NASA Astrophysics Data System (ADS)

Sun, Jing; Zhao, Huiqun; Wang, Ka; Zhang, Houyong; Hu, Gongzhu

Since the notion of "Internet of Things" (IoT) introduced about 10 years ago, most IoT research has focused on higher level issues, such as strategies, architectures, standardization, and enabling technologies, but studies of real cases of IoT are still lacking. In this paper, a real case of Internet of Things called ZB IoT is introduced. It combines the Service Oriented Architecture (SOA) with EPC global standards in the system design, and focuses on the security and extensibility of IoT in its implementation.

Use of the Outdoor Classroom and Nature-Study to Support Science and Literacy Learning: A Narrative Case Study of a Third-Grade Classroom

ERIC Educational Resources Information Center

Eick, Charles J.

2012-01-01

A case study of an exemplary third grade teacher's use of the outdoor classroom for meeting both state science and language arts standards is described. Data from the researcher's field journal, teacher lesson plans, and teacher interviews document how this teacher used nature-study to bridge outdoor classroom experiences with the state science…

Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies

ERIC Educational Resources Information Center

Harned, Melanie S.; Linehan, Marsha M.

2008-01-01

Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat…

Synthesizing Single-Case Research to Identify Evidence-Based Practices: Some Brief Reflections

ERIC Educational Resources Information Center

Horner, Robert H.; Kratochwill, Thomas R.

2012-01-01

The purposes of this paper are to (a) propose an operational standard for defining a "practice," (b) encourage development of professional standards for visual and statistical analysis of single-case research, and (c) propose a standard for using single-case research results to identify practices that are "evidence-based." These topics are not new…

Starworld: Preparing Accountants for the Future: A Case-Based Approach to Teach International Financial Reporting Standards Using ERP Software

ERIC Educational Resources Information Center

Ragan, Joseph M.; Savino, Christopher J.; Parashac, Paul; Hosler, Jonathan C.

2010-01-01

International Financial Reporting Standards now constitute an important part of educating young professional accountants. This paper looks at a case based process to teach International Financial Reporting Standards using integrated Enterprise Resource Planning software. The case contained within the paper can be used within a variety of courses…

Pathology and medical malpractice. Academic and trainee empirical review of cases by State of Texas physicians.

PubMed

Allen, Timothy Craig; Stafford, Mehary; Liang, Bryan A

2014-04-01

This study examines whether the assumptions that pathologists understand the medical malpractice negligence rule and have a clear single standard of care are reasonable. Two hundred eighty-one Texas academic pathologists and trainees were presented 10 actual pathology malpractice cases from publicly available sources, representing the tort system's signal. Of the respondents, 55.52% were trainees, and 44.48% were pathology faculty. Only in two cases did more than 50% of respondents correctly identify the behavior of pathologists as defined by legal outcomes. In only half of the cases did more than 50% of pathologists concur with the jury verdict. This study provides further evidence that physicians do not understand the legal rule of negligence. Pathologists have a poor understanding of negligence and cannot accurately predict a jury verdict. There is significant divergence from the single standard of care assumption. Alternative methods to provide appropriate compensation and to establish physician accountability should be explored. Additional education about medical negligence is needed.

The influence of tie strength on evolutionary games on networks: An empirical investigation

NASA Astrophysics Data System (ADS)

Buesser, Pierre; Peña, Jorge; Pestelacci, Enea; Tomassini, Marco

2011-11-01

Extending previous work on unweighted networks, we present here a systematic numerical investigation of standard evolutionary games on weighted networks. In the absence of any reliable model for generating weighted social networks, we attribute weights to links in a few ways supported by empirical data ranging from totally uncorrelated to weighted bipartite networks. The results of the extensive simulation work on standard complex network models show that, except in a case that does not seem to be common in social networks, taking the tie strength into account does not change in a radical manner the long-run steady-state behavior of the studied games. Besides model networks, we also included a real-life case drawn from a coauthorship network. In this case also, taking the weights into account only changes the results slightly with respect to the raw unweighted graph, although to draw more reliable conclusions on real social networks many more cases should be studied as these weighted networks become available.

Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

ERIC Educational Resources Information Center

Grego Bolli, Giuliana

2014-01-01

This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

A Case Study of the Alignment between Curriculum and Assessment in the New York State Earth Science Standards-Based System

ERIC Educational Resources Information Center

Contino, Julie

2013-01-01

In a standards-based system, it is important for all components of the system to align in order to achieve the intended goals. No Child Left Behind law mandates that assessments be fully aligned with state standards, be valid, reliable and fair, be reported to all stakeholders, and provide evidence that all students in the state are meeting the…

78 FR 37885 - Approval of American Society of Mechanical Engineers' Code Cases

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

...), standard design certifications, standard design approvals and manufacturing licenses, to use the Code Cases... by the ASME. The three RGs that would be incorporated by reference are RG 1.84, ``Design, Fabrication... nuclear power plant licensees, and applicants for CPs, OLs, COLs, standard design certifications, standard...

Using standardized fishery data to inform rehabilitation efforts

USGS Publications Warehouse

Spurgeon, Jonathan J.; Stewart, Nathaniel T.; Pegg, Mark A.; Pope, Kevin L.; Porath, Mark T.

2016-01-01

Lakes and reservoirs progress through an aging process often accelerated by human activities, resulting in degradation or loss of ecosystem services. Resource managers thus attempt to slow or reverse the negative effects of aging using a myriad of rehabilitation strategies. Sustained monitoring programs to assess the efficacy of rehabilitation strategies are often limited; however, long-term standardized fishery surveys may be a valuable data source from which to begin evaluation. We present 3 case studies using standardized fishery survey data to assess rehabilitation efforts stemming from the Nebraska Aquatic Habitat Plan, a large-scale program with the mission to rehabilitate waterbodies within the state. The case studies highlight that biotic responses to rehabilitation efforts can be assessed, to an extent, using standardized fishery data; however, there were specific areas where minor increases in effort would clarify the effectiveness of rehabilitation techniques. Management of lakes and reservoirs can be streamlined by maximizing the utility of such datasets to work smarter, not harder. To facilitate such efforts, we stress collecting both biotic (e.g., fish lengths and weight) and abiotic (e.g., dissolved oxygen, pH, and turbidity) data during standardized fishery surveys and designing rehabilitation actions with an appropriate experimental design.

The Common Core State Standards and the Elementary Social Studies Curriculum: A Case Study of Teacher Perceptions in Florida

ERIC Educational Resources Information Center

Nadeau, Kacie M.

2017-01-01

The most recent phase of curriculum reform in the era of accountability is the Common Core State Standards (CCSS) which have essentially reshaped the landscape of public education. Its objective of preparing K-12 students for college and career upon high school graduation have prioritized English language arts, mathematics, and science over social…

Selection, Evaluation, and Modification of a Standard Operating Procedure as a Mechanism for Introducing an Undergraduate Student to Chemical Research: A Case Study

ERIC Educational Resources Information Center

Claycomb, Gregory D.; Venable, Frances A.

2015-01-01

In an effort to broaden the selection of research opportunities available to a student registered in a one-semester, upper-level independent study course at a primarily undergraduate institution (PUI), a highly motivated student was asked to select, evaluate, and modify a standard operating procedure (SOP). The student gained valuable experience…

Evaluation of Probation Case Management (PCM) for Drug-Involved Women Offenders

ERIC Educational Resources Information Center

Chan, Monica; Guydish, Joseph; Prem, Rosemary; Jessup, Martha A.; Cervantes, Armando; Bostrom, Alan

2005-01-01

Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention(n = 65) or standard probation(n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened.…

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

A case-control pilot study of low-intensity IVF in good-prognosis patients.

PubMed

Gleicher, Norbert; Weghofer, Andrea; Barad, David H

2012-04-01

Low-intensity IVF (LI-IVF) is rapidly gaining in popularity. Yet studies comparing LI-IVF to standard IVF are lacking. This is a case-control pilot study, reporting on 14 first LI-IVF and 14 standard IVF cycles in women with normal age-specific ovarian reserve under age 38, matched for age, laboratory environment, staff and time of cycle. LI-IVF cycles underwent mild ovarian stimulation, utilizing clomiphene citrate, augmented by low-dose gonadotrophin stimulation. Control patients underwent routine ovarian stimulation. LI-IVF and regular IVF patients were similar in age, body mass index, FSH and anti-Müllerian hormone. Standard IVF utilized more gonadotrophins (P<0.001), yielded more oocytes (P<0.001) and cryopreserved more embryos (P<0.001). With similar embryo numbers transferred, after ethnicity adjustments, standard IVF demonstrated better odds for pregnancy (OR 7.07; P=0.046) and higher cumulative pregnancy rates (63.3% versus 21.4%; OR 6.6; P=0.02). Adjustments for age, ethnicity and diagnosis maintained significance but oocyte adjustment did not. Cost assessments failed to reveal differences between LI-IVF and standard IVF. In this small study, LI-IVF reduced pregnancy chances without demonstrating cost advantages, raising questions about its utility. In the absence of established clinical and/or economic foundations, LI-IVF should be considered an experimental procedure. Low-intensity IVF (LI-IVF) is increasingly propagated as an alternative to standard IVF. LI-IVF has, however, never been properly assessed in comparison to standard IVF. Such a comparison is presented in the format of a small pilot study, matching LI-IVF cycles with regular IVF cycles and comparing outcomes as well as costs. The study suggests that LI-IVF, at least in this setting, is clinically inferior and economically at best similar to standard IVF. LI-IVF should, therefore, as of this point not be offered as routine IVF treatment but only as an experimental procedure. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Neurodevelopmental outcome at 2 years in twin-twin transfusion syndrome survivors randomized for the Solomon trial.

PubMed

van Klink, Jeanine M M; Slaghekke, Femke; Balestriero, Marina A; Scelsa, Barbara; Introvini, Paola; Rustico, Mariangela; Faiola, Stefano; Rijken, Monique; Koopman, Hendrik M; Middeldorp, Johanna M; Oepkes, Dick; Lopriore, Enrico

2016-01-01

The preferred treatment for twin-twin transfusion syndrome is fetoscopic laser coagulation of inter-twin vascular anastomoses on the monochorionic placenta. Severe postoperative complications can occur when inter-twin vascular anastomoses remain patent including twin-anemia polycythemia sequence or recurrent twin-twin transfusion syndrome. To minimize the occurrence of residual anastomoses, a modified laser surgery technique, the Solomon technique, was developed in which the entire vascular equator is coagulated. In the Solomon randomized controlled trial (NTR1245), the Solomon technique was associated with a significant reduction in twin-anemia polycythemia sequence and recurrence of twin-twin transfusion syndrome when compared with the standard laser surgery technique. Although a significant improvement in perinatal outcome was shown after the Solomon technique, the clinical importance should also be ascertained with long-term follow-up evaluation of the surviving children. The purpose of this study was to compare the long-term neurodevelopmental outcome in surviving children with twin-twin transfusion syndrome who were included in the Solomon randomized trial and treated with either the Solomon technique or standard laser surgery technique. Routine standardized follow-up evaluation in survivors, at least 2 years after the estimated date of delivery, was performed at 2 of the 5 centers that participated in the Solomon trial: Buzzi Hospital Milan (Italy) and Leiden University Medical Center (The Netherlands). The primary outcome of this follow-up study was survival without long-term neurodevelopmental impairment at age 2 years. Neurodevelopmental impairment was defined as cerebral palsy, cognitive and/or motor development score of <85, bilateral blindness, or deafness. Cognitive and motor development was evaluated with the use of Bayley-III. All analyses per fetus, neonate, or child were conducted with the generalized estimated equation module to account for the effect that observations between co-twins are not independent. The primary outcome (survival without neurodevelopmental impairment) was detected in 95 of 141 cases (67%) in the Solomon group and in 99 of 146 cases (68%) in the standard group (P = .92). Neurodevelopmental impairment in long-term survivors who were included for follow-up evaluation was detected in 12 of 107 cases (11%) in the Solomon and in 10 of 109 cases (9%) in the standard group (P = .61). Neurodevelopmental impairment was due to cerebral palsy in 1 case (1%; spastic unilateral) in the Solomon group and in 2 cases (2%; spastic unilateral and spastic bilateral) in the standard group (P = .58). Cognitive development <85 cases was detected in 2 of 105 children (2%) in the Solomon group and in 6 of 106 children (6%) in the standard group (P = .23). Motor development <85 occurred in 8 of 103 children (8%) in the Solomon group and 3 of 104 children (3%) in the standard group (P = .23). We found no difference in survival without neurodevelopmental impairment between the Solomon and standard laser techniques. In view of the reduction of short-term complications and the absence of increased adverse long-term effects, these data support the use of the Solomon technique in the treatment of twin-twin transfusion syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Automated Transformation of CDISC ODM to OpenClinica.

PubMed

Gessner, Sophia; Storck, Michael; Hegselmann, Stefan; Dugas, Martin; Soto-Rey, Iñaki

2017-01-01

Due to the increasing use of electronic data capture systems for clinical research, the interest in saving resources by automatically generating and reusing case report forms in clinical studies is growing. OpenClinica, an open-source electronic data capture system enables the reuse of metadata in its own Excel import template, hampering the reuse of metadata defined in other standard formats. One of these standard formats is the Operational Data Model for metadata, administrative and clinical data in clinical studies. This work suggests a mapping from Operational Data Model to OpenClinica and describes the implementation of a converter to automatically generate OpenClinica conform case report forms based upon metadata in the Operational Data Model.

Study of a Secondary Power System Based on an Intermediate Bus Converter and POLs

NASA Astrophysics Data System (ADS)

Santoja, Almudena; Fernandez, Arturo; Tonicello, Ferdinando

2014-08-01

Secondary power systems in satellites are everything but standard nowadays. All sorts of options can be found and, in the end, a new custom design is used in most of the cases. Even though this might be interesting in some specific cases, for most of them it would be more convenient to have a straightforward system based on standard components. One of the options to achieve this is to design the secondary power system with an Intermediate Bus Converter (IBC) and Point of Load converters (POLs). This paper presents a study of this architecture and some experimental verifications to establish some basic rules devoted to achieve an optimum design of this system.

The Case for Forensic Toxicology

ERIC Educational Resources Information Center

Baker, William P.; DeBeus, Elizabeth; Jones, Carleton

2006-01-01

Understanding natural and human-induced hazards is an important part of the standards-based science curriculum. Experience, however, indicates that the topic is a difficult one for many students. We have developed an exciting investigative laboratory exercise that uses simulated food-based case studies to promote critical thinking and improve…

Temporal trends in prevalence, incidence, and mortality for rheumatoid arthritis in Quebec, Canada: a population-based study.

PubMed

Jean, Sonia; Hudson, Marie; Gamache, Philippe; Bessette, Louis; Fortin, Paul R; Boire, Gilles; Bernatsky, Sasha

2017-12-01

Health administrative data are a potentially efficient resource to conduct population-based research and surveillance, including trends in incidence and mortality over time. Our objective was to explore time trends in incidence and mortality for rheumatoid arthritis (RA), as well as estimating period prevalence. Our RA case definition was based on one or more hospitalizations with a RA diagnosis code, or three or more RA physician-billing codes, over 2 years, with at least one RA billing code by a rheumatologist, orthopedic surgeon, or internist. To identify incident cases, a "run-in" period of 5 years (1996-2000) was used to exclude prevalent cases. Crude age and sex-specific incidence rates were calculated (using data from 2001 to 2015), and sex-specific incidence rates were also standardized to the 2001 age structure of the Quebec population. We linked the RA cohort (both prevalent and incident patients) to the vital statistics registry, and standardized mortality rate ratios were generated. Negative binomial regression was used to test for linear change in standardized incidence rates and mortality ratios. The linear trends in standardized incidence rates did not show significant change over the study period. Mortality in RA was significantly higher than the general population and this remained true throughout the study period. Our prevalence estimate suggested 0.8% of the Quebec population may be affected by RA. RA incidence appeared relatively stable, and mortality was substantially higher in RA versus the general population and remained so over the study period. This suggests the need to optimize long-term RA outcomes.

Early return visits by primary care patients: a retail nurse practitioner clinic versus standard medical office care.

PubMed

Rohrer, James E; Angstman, Kurt B; Garrison, Gregory

2012-08-01

The purpose of this study was to compare return visits made by patients within 2 weeks after using retail nurse practitioner clinics to return visits made by similar patients after using standard medical office clinics. Retail medicine clinics have become widely available. However, their impact on return visit rates compared to standard medical office visits for similar patients has not been extensively studied. Electronic medical records of adult primary care patients seen in a large group practice in Minnesota in 2009 were analyzed for this study. Patients who were treated for sinusitis were selected. Two groups of patients were studied: those who used one of 2 retail walk-in clinics staffed by nurse practitioners and a comparison group who used one of 4 regular office clinics. The dependent variable was a return office visit to any site within 2 weeks. Multiple logistic regression analysis was used to adjust for case-mix differences between groups. Unadjusted odds of return visits were lower for retail clinic patients than for standard office care patients. After adjustment for case mix, patients with more outpatient visits in the previous 6 months had higher odds of return visits within 2 weeks (2-6 prior visits: odds ratio [OR]=1.99, P=0.00; 6 or more prior visits: OR=6.80, P=0.00). The odds of a return visit within 2 weeks were not different by clinic type after adjusting for propensity to use services (OR=1.17, P=0.28). After adjusting for case mix differences, return visit rates did not differ by clinic type.

Progressing From Initially Ambiguous Functional Analyses: Three Case Examples

PubMed Central

Tiger, Jeffrey H.; Fisher, Wayne W.; Toussaint, Karen A.; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994). These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments. PMID:19233611

From Boutique to Big Box: A Case Study Concerning Teacher Change Transitioning to a Public Montessori Elementary School

ERIC Educational Resources Information Center

Van Acker, Teresa A.

2013-01-01

Public Montessori schools have grown in number significantly in the United States. This case study chronicles the journey of teachers as they navigate the tension of balancing the Montessori approach with an accountability Standards model. Although Montessori may be in demand among parents in the nation, exhibited by the increase in public…

The Internationalization of Experiential Learning for Deaf and Hard of Hearing College Students: A Case Study of Accessibility and Globalization

ERIC Educational Resources Information Center

Peisner, Elizabeth Suzanne

2011-01-01

Utilizing a qualitative case study, this dissertation analyzed how one university provided accessibility to international experiential learning opportunities for a primarily disabled student population. The Council for the Advancement of Standards (CAS, 2006) in Higher Education consists of a self-assessment guide adapted as a framework to analyze…

Deploying an Intelligent Pairing Assistant for Air Operation Centers

DTIC Science & Technology

2016-06-23

primary contributions of this case study are applying artificial intelligence techniques to a novel domain and discussing the software evaluation...their standard workflows. The primary contributions of this case study are applying artificial intelligence techniques to a novel domain and...users for more efficient and accurate pairing? Participants Participants in the evaluation consisted of three SMEs employed at Intelligent Software

A Case Study of Middle School Teachers' Preparations for High-Stakes Assessments

ERIC Educational Resources Information Center

Yeary, David Lee

2017-01-01

Students, educators, and schools across the country have been presented with challenges as a result of rigorous standards and high-complexity tests. The problem addressed in this case study was that teachers in a rural middle school in a southeastern state were preparing students to take a new high-stakes state-mandated assessment in English…

Predictive Ability from ePortfolios of Student Achievement Associated with Professional Teaching Standards: An Exploratory Case Study

ERIC Educational Resources Information Center

Payne, Phillip; Burrack, Frederick

2017-01-01

This exploratory case study, focused on a music teacher preparation program, examined the coursework ePortfolios of pre-service music teachers to determine if any parts of the ePortfolio process predicted teaching effectiveness in the classroom during the student teaching semester. Sixty-five undergraduate pre-service music teachers made up the…

Case Study Analyses of Play Behaviors of 12-Month-Old Infants Later Diagnosed with Autism

ERIC Educational Resources Information Center

Mulligan, Shelley

2015-01-01

Case study research methodology was used to describe the play behaviors of three infants at 12 months of age, who were later diagnosed with an autism spectrum disorder. Data included standardized test scores, and analyses of video footage of semi-structured play sessions from infants identified as high risk for autism, because of having a sibling…

Measuring Primary Students' Graph Interpretation Skills via a Performance Assessment: A Case Study in Instrument Development

ERIC Educational Resources Information Center

Peterman, Karen; Cranston, Kayla A.; Pryor, Marie; Kermish-Allen, Ruth

2015-01-01

This case study was conducted within the context of a place-based education project that was implemented with primary school students in the USA. The authors and participating teachers created a performance assessment of standards-aligned tasks to examine 6-10-year-old students' graph interpretation skills as part of an exploratory research…

Detection Monitoring of Crown Condition in South Carolina: A Case Study

Treesearch

William A. Bechtold; John W. Coulston

2005-01-01

This article presents a case study of how indicators of forest health can be adjusted for natural factors, standardized to a common basis, and subjected to spatial analysis for the purpose of detecting potential problems related to forest health. Two of five Forest Inventory and Analysis inventory panels in South Carolina and surrounding States were completed in 2000...

Standardization of Type 2 Diabetes Outpatient Expenditure with Bundled Payment Method in China

PubMed Central

Xu, Guo-Chao; Luo, Yun; Li, Qian; Wu, Meng-Fan; Zhou, Zi-Jun

2016-01-01

Background: In recent years, the prevalence of type 2 diabetes among Chinese population has been increasing by years, directly leading to an average annual growth rate of 19.90% of medical expenditure. Therefore, it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China. Therefore, in this study, we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services. Methods: This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012. Based on the analysis of outpatient expenditure and its influential factors, we adopted decision tree approach to conduct a case-mix analysis. In the end, we built a case-mix model to calculate the standard expenditure and the upper limit of each combination. Results: We found that age, job status, and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes. Through the analysis of the decision tree, we used six variables (complication, age, diabetic foot, diabetic nephropathy, cardiac-cerebrovascular disease, and neuropathy) to group the cases, and obtained 11 case-mix groups. Conclusions: We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services. Bundled payment is effective to control the increase of outpatient expenditure. Further improvements are needed for the implementation of bundled payment reimbursement standards, together with relevant policies and measures. PMID:27064041

Location tests for biomarker studies: a comparison using simulations for the two-sample case.

PubMed

Scheinhardt, M O; Ziegler, A

2013-01-01

Gene, protein, or metabolite expression levels are often non-normally distributed, heavy tailed and contain outliers. Standard statistical approaches may fail as location tests in this situation. In three Monte-Carlo simulation studies, we aimed at comparing the type I error levels and empirical power of standard location tests and three adaptive tests [O'Gorman, Can J Stat 1997; 25: 269 -279; Keselman et al., Brit J Math Stat Psychol 2007; 60: 267- 293; Szymczak et al., Stat Med 2013; 32: 524 - 537] for a wide range of distributions. We simulated two-sample scenarios using the g-and-k-distribution family to systematically vary tail length and skewness with identical and varying variability between groups. All tests kept the type I error level when groups did not vary in their variability. The standard non-parametric U-test performed well in all simulated scenarios. It was outperformed by the two non-parametric adaptive methods in case of heavy tails or large skewness. Most tests did not keep the type I error level for skewed data in the case of heterogeneous variances. The standard U-test was a powerful and robust location test for most of the simulated scenarios except for very heavy tailed or heavy skewed data, and it is thus to be recommended except for these cases. The non-parametric adaptive tests were powerful for both normal and non-normal distributions under sample variance homogeneity. But when sample variances differed, they did not keep the type I error level. The parametric adaptive test lacks power for skewed and heavy tailed distributions.

Improved clonality detection in Hodgkin lymphoma using a semi-nested modification of the BIOMED-2 PCR assay for IGH and IGK rearrangements: A paraffin-embedded tissue study.

PubMed

Han, Shusen; Masaki, Ayako; Sakamoto, Yuma; Takino, Hisashi; Murase, Takayuki; Iida, Shinsuke; Inagaki, Hiroshi

2018-05-01

The BIOMED-2 PCR protocols targeting IGH and IGK genes may be useful for detecting clonality in Hodgkin lymphoma (HL). The clonality detection rates, however, have not been very high with these methods using paraffin-embedded tumor sections. We previously described the usefulness of the semi-nested BIOMED-2 IGH assay in B-cell malignancies. In this study, we devised a novel semi-nested BIOMED-2 IGK assay. Employing 58 cases of classical HL, we carried out the standard BIOMED-2, BIOMED-2 followed by BIOMED-2 re-amplification, and BIOMED-2 followed by semi-nested BIOMED-2, all targeting IGH and IGK, using paraffin-embedded tissues. In both IGH and IGK assays, semi-nested assays yielded significantly higher clonality detection rates than the standard assays and re-amplification assays. Clonality was detected in 13/58 (22.4%) classical HL cases using the standard IGH/IGK assays while it was detected in 38/58 (65.5%) cases using semi-nested IGH/IGK assays. The detection rates were not associated with the HL subtypes, CD30-positive cell density, CD20-positive cell density, or Epstein-Barr virus (EBV) positivity. In conclusion, tumor clonality was detected in nearly two-thirds of classical HL cases using semi-nested BIOMED-2 IGH/IGK assays using paraffin tumor sections. These semi-nested assays may be useful when the standard IGH/IGK assays fail to detect clonality in histopathologically suspected HLs. © 2018 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

Innovative Digital Tools and Surveillance Systems for the Timely Detection of Adverse Events at the Point of Care: A Proof-of-Concept Study.

PubMed

Hoppe, Christian; Obermeier, Patrick; Muehlhans, Susann; Alchikh, Maren; Seeber, Lea; Tief, Franziska; Karsch, Katharina; Chen, Xi; Boettcher, Sindy; Diedrich, Sabine; Conrad, Tim; Kisler, Bron; Rath, Barbara

2016-10-01

Regulatory authorities often receive poorly structured safety reports requiring considerable effort to investigate potential adverse events post hoc. Automated question-and-answer systems may help to improve the overall quality of safety information transmitted to pharmacovigilance agencies. This paper explores the use of the VACC-Tool (ViVI Automated Case Classification Tool) 2.0, a mobile application enabling physicians to classify clinical cases according to 14 pre-defined case definitions for neuroinflammatory adverse events (NIAE) and in full compliance with data standards issued by the Clinical Data Interchange Standards Consortium. The validation of the VACC-Tool 2.0 (beta-version) was conducted in the context of a unique quality management program for children with suspected NIAE in collaboration with the Robert Koch Institute in Berlin, Germany. The VACC-Tool was used for instant case classification and for longitudinal follow-up throughout the course of hospitalization. Results were compared to International Classification of Diseases , Tenth Revision (ICD-10) codes assigned in the emergency department (ED). From 07/2013 to 10/2014, a total of 34,368 patients were seen in the ED, and 5243 patients were hospitalized; 243 of these were admitted for suspected NIAE (mean age: 8.5 years), thus participating in the quality management program. Using the VACC-Tool in the ED, 209 cases were classified successfully, 69 % of which had been missed or miscoded in the ED reports. Longitudinal follow-up with the VACC-Tool identified additional NIAE. Mobile applications are taking data standards to the point of care, enabling clinicians to ascertain potential adverse events in the ED setting and during inpatient follow-up. Compliance with Clinical Data Interchange Standards Consortium (CDISC) data standards facilitates data interoperability according to regulatory requirements.

Continuing education in ethical decision making using case studies from medical social work.

PubMed

McCormick, Andrew J; Stowell-Weiss, Patti; Carson, Jennifer; Tebo, Gerald; Hanson, Inga; Quesada, Bianca

2014-01-01

Medical social workers have needs for training in ethics that is specific to dilemmas that arise while providing service to patients who are very ill, mentally compromised, or in a terminal condition. A social work department developed a continuing education training to educate social workers in bioethics related to determining decisional capacity and understanding standards of ethical decision making. Case studies are used to illustrate ethical conflicts and the role of social workers in resolving them. The benefits of case study training are discussed.

Case management.

PubMed

Woodward, Judy; Rice, Eve

2015-03-01

Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Student Generated Case Studies: Addressing the Standard of Ethical Leadership

ERIC Educational Resources Information Center

Derrington, Mary Lynne; Larsen, Donald

2009-01-01

Educational administration instructors seek methods that will engage students' interest in the subject matter and also link educational theory to realities experienced on the job. An equally important goal and a most important lesson to impart to aspiring education administrators are the competencies exhibited in ISLLC Standard 5, act with…

Transnational Factors Influencing the Establishment of Educational Standards for Professional Licensure.

ERIC Educational Resources Information Center

Mirone, John A.

1999-01-01

Derives a connection between the quality of accreditation and education in one country and the public protection function of professional regulation in another, and highlights the critical importance of international standards for quality assurance of accreditation and education for consumer protection. The U.S. is used as a case study to outline…

Embedding Academic Literacy Support within the Electrical Engineering Curriculum: A Case Study

ERIC Educational Resources Information Center

Skinner, I.; Mort, P.

2009-01-01

This paper reports the integration of supplementary training in academic literacy, for those without the assumed entry standard, into a standard electrical engineering program without compromising any other educational objectives. All students who commenced an engineering degree were tested as part of their first session's assessment activities.…

A Case Study of Interactive Whiteboard Professional Development for Elementary Mathematics Teachers

ERIC Educational Resources Information Center

Essig, Dawn

2011-01-01

In a northeastern US state, the higher the grade the level, the more students do not meet the state mathematics standards. Teachers need effective professional development in classroom strategies and tools, such as interactive whiteboards (IWB), to assist them in preparing students to meet state standards. Multimedia learning theory and…

The Role of District Office Leaders in the Adoption and Implementation of the Common Core State Standards in Elementary Schools

ERIC Educational Resources Information Center

Durand, Francesca T.; Lawson, Hal A.; Wilcox, Kristen Campbell; Schiller, Kathryn S.

2016-01-01

Purpose: This multiple case study investigated district leaders' orientations and strategies as their elementary schools proceeded with state-mandated implementation of the Common Core State Standards (CCSS). We identified differences between schools achieving above-predicted outcomes on state CCSS assessments ("odds-beaters") and…

Big Earth Data Initiative: Metadata Improvement: Case Studies

NASA Technical Reports Server (NTRS)

Kozimor, John; Habermann, Ted; Farley, John

2016-01-01

Big Earth Data Initiative (BEDI) The Big Earth Data Initiative (BEDI) invests in standardizing and optimizing the collection, management and delivery of U.S. Government's civil Earth observation data to improve discovery, access use, and understanding of Earth observations by the broader user community. Complete and consistent standard metadata helps address all three goals.

An Analysis of Grade 4 Teachers' Mathematical Instructional Strategies

ERIC Educational Resources Information Center

Wilson-Patrick, Dedra

2016-01-01

The standardized math test scores of approximately 48 African American and Hispanic students from 4 different classes at a rural Title I elementary school located in the southern United States decreased by 10 points on the Palmetto Assessment of State Standards Test. For this qualitative case study, purposive sampling was used to recruit four…

Evaluative Case Study on the Efficacy of the ELPS Program in Mathematics

ERIC Educational Resources Information Center

Perez, Malia Ann

2013-01-01

The English Language Proficiency Standards (ELPS) program was developed to address the need to effectively integrate second language acquisition with quality content area instruction. English language learners (ELLs) have struggled on standardized tests and there has been little empirical evidence regarding the impact of the ELPS program on…

Short Shrift to Long Lists: An Alternative Approach to the Development of Performance Standards for School Principals.

ERIC Educational Resources Information Center

Louden, William; Wildy, Helen

1999-01-01

Describes examples of standards frameworks for principals' work operant in three countries and describes an alternative approach based on interviewing 40 Australian principals. By combining qualitative case studies with probabilistic measurement techniques, the alternative approach provides contextually rich descriptions of growth in performance…

Can Standards Be Met and Evaluated through an Online Teacher Education Technology Course? A Case Study.

ERIC Educational Resources Information Center

Crawford, Caroline M.; Willis, Jana

The continual evolution of the national technology standards creates a continual state of flux within the world of instructional technology. However, this creative online environment offers the possibilities that may not be available within other specialization areas; namely, the opportunity to reinvent conceptual frameworks of understanding and…

What Can Students Do with the Words They Know? An ELA Teacher Takes on Science

ERIC Educational Resources Information Center

Hayden, H. Emily; Eades-Baird, Michelle

2016-01-01

The Common Core State Standard and Next Generation Science Standards emphasize language and literacy across disciplines, requiring shifts in teaching practices and inventive approaches. This case study focuses on the instructional decision-making and activities of one uniquely experienced and qualified seventh-grade science teacher, whose English…

Examining the Role of the Principal: Case Study of a High-Poverty, High-Performing Rural Elementary School

ERIC Educational Resources Information Center

Coleman, Howard D.

2013-01-01

Since the inception of high-stakes standardized testing, schools have been labeled as either succeeding or failing based on student standardized assessment performance. If students perform adequately, the building principal receives acknowledgement for being an effective instructional leader. Conversely, if students perform poorly, the principal…

Low clinical diagnostic accuracy of early vs advanced Parkinson disease: clinicopathologic study.

PubMed

Adler, Charles H; Beach, Thomas G; Hentz, Joseph G; Shill, Holly A; Caviness, John N; Driver-Dunckley, Erika; Sabbagh, Marwan N; Sue, Lucia I; Jacobson, Sandra A; Belden, Christine M; Dugger, Brittany N

2014-07-29

Determine diagnostic accuracy of a clinical diagnosis of Parkinson disease (PD) using neuropathologic diagnosis as the gold standard. Data from the Arizona Study of Aging and Neurodegenerative Disorders were used to determine the predictive value of a clinical PD diagnosis, using 2 clinical diagnostic confidence levels, PossPD (never treated or not clearly responsive) and ProbPD (responsive to medications). Neuropathologic diagnosis was the gold standard. Based on first visit, 9 of 34 (26%) PossPD cases had neuropathologically confirmed PD while 80 of 97 (82%) ProbPD cases had confirmed PD. PD was confirmed in 8 of 15 (53%) ProbPD cases with <5 years of disease duration and 72 of 82 (88%) with ≥5 years of disease duration. Using final diagnosis at time of death, 91 of 107 (85%) ProbPD cases had confirmed PD. Clinical variables that improved diagnostic accuracy were medication response, motor fluctuations, dyskinesias, and hyposmia. Using neuropathologic findings of PD as the gold standard, this study establishes the novel findings of only 26% accuracy for a clinical diagnosis of PD in untreated or not clearly responsive subjects, 53% accuracy in early PD responsive to medication (<5 years' duration), and >85% diagnostic accuracy of longer duration, medication-responsive PD. Caution is needed when interpreting clinical studies of PD, especially studies of early disease that do not have autopsy confirmation. The need for a tissue or other diagnostic biomarker is reinforced. This study provides Class II evidence that a clinical diagnosis of PD identifies patients who will have pathologically confirmed PD with a sensitivity of 88% and specificity of 68%. © 2014 American Academy of Neurology.

Diagnostic accuracy of administrative data algorithms in the diagnosis of osteoarthritis: a systematic review.

PubMed

Shrestha, Swastina; Dave, Amish J; Losina, Elena; Katz, Jeffrey N

2016-07-07

Administrative health care data are frequently used to study disease burden and treatment outcomes in many conditions including osteoarthritis (OA). OA is a chronic condition with significant disease burden affecting over 27 million adults in the US. There are few studies examining the performance of administrative data algorithms to diagnose OA. The purpose of this study is to perform a systematic review of administrative data algorithms for OA diagnosis; and, to evaluate the diagnostic characteristics of algorithms based on restrictiveness and reference standards. Two reviewers independently screened English-language articles published in Medline, Embase, PubMed, and Cochrane databases that used administrative data to identify OA cases. Each algorithm was classified as restrictive or less restrictive based on number and type of administrative codes required to satisfy the case definition. We recorded sensitivity and specificity of algorithms and calculated positive likelihood ratio (LR+) and positive predictive value (PPV) based on assumed OA prevalence of 0.1, 0.25, and 0.50. The search identified 7 studies that used 13 algorithms. Of these 13 algorithms, 5 were classified as restrictive and 8 as less restrictive. Restrictive algorithms had lower median sensitivity and higher median specificity compared to less restrictive algorithms when reference standards were self-report and American college of Rheumatology (ACR) criteria. The algorithms compared to reference standard of physician diagnosis had higher sensitivity and specificity than those compared to self-reported diagnosis or ACR criteria. Restrictive algorithms are more specific for OA diagnosis and can be used to identify cases when false positives have higher costs e.g. interventional studies. Less restrictive algorithms are more sensitive and suited for studies that attempt to identify all cases e.g. screening programs.

Tackling Poverty in Rural Mexico: A Case Study of Economic Development. Toward a Better World Series, Learning Kit No. 4.

ERIC Educational Resources Information Center

Baldwin, Harriet; Ross-Larson, Bruce, Ed.

This World Bank (Washington, D.C.) kit is a case study designed to teach secondary school social studies students about an integrated rural development project in Mexico, and how it is helping to raise the standard of living for six million Mexicans in 131 microregions throughout Mexico. The kit contains a pamphlet, a booklet, a sound filmstrip,…

A case study: The original intentions of the designers of the science content standards

NASA Astrophysics Data System (ADS)

Eucker, Penelope Hudson

This case study research examined the original intentions of the designers of the science content standards in the historical context of educational reforms and legislation. The content standards are the keystone of standards-based education. Originally, national science content standards were part of a cohesive program to increase the occurrence of quality science K--12. Through assessment policies set into motion by state and federal legislation, science curriculum is increasingly fixed and standardized. Scripting teachers is becoming more common. Unintended outcomes of standards-based education are prevalent in all classrooms. Recording the original intentions of the designers of the science content standards in a historical context is significant to document their beliefs and purposes. The shared beliefs of the six scholars included: (a) science had become overstuffed curriculum with students learning very few concepts; (b) science teachers required assistance to decide which concepts are most important for students to learn; (c) standards-based education will most likely endure for a very long time; (d) science is a specific way of knowing and inquiry must be part of science instruction; (e) few teachers teach to the science content standards. The scholars disagreed about whether the power to decide what to teach had moved from the classroom to the legislators and if standards-based education has preferentially helped some groups of students while diminishing the science education of others. Implications from the findings reveal the tension between a defined science content and the resultant assessment template that further trims the instructional range offered. Foreshadowing of increasing trend toward profits made from testing companies as state and federal legislation increase mandated assessments. Significantly, the educational research that clearly demonstrate many pathways lead to educated students such as the Eight-Year Study were suppressed in favor of the bi-partisan supported standards-based education. One of the stated goals of standards-based education was equity. With documented corrupted curriculum sometimes devoid of all science, equity remains an elusive goal. This research documents the original intentions of the designers of the science content standards. The story continues to unfold with new state and federal legislation as teachers attempt to teach the mandated content standards.

The Social Networks and Paradoxes of the Opt-out Movement Amid the Common Core State Standards Implementation: The Case of New York

ERIC Educational Resources Information Center

Wang, Yinying

2017-01-01

Opting out of state standardized tests has recently become a movement--a series of grassroots, organized efforts to refuse to take high-stakes state standardized tests. In particular, the opt-out rates in the state of New York reached 20% in 2015 and 21% in 2016. This study aims to illustrate the social networks and examine the paradoxes that have…

Generalized t-statistic for two-group classification.

PubMed

Komori, Osamu; Eguchi, Shinto; Copas, John B

2015-06-01

In the classic discriminant model of two multivariate normal distributions with equal variance matrices, the linear discriminant function is optimal both in terms of the log likelihood ratio and in terms of maximizing the standardized difference (the t-statistic) between the means of the two distributions. In a typical case-control study, normality may be sensible for the control sample but heterogeneity and uncertainty in diagnosis may suggest that a more flexible model is needed for the cases. We generalize the t-statistic approach by finding the linear function which maximizes a standardized difference but with data from one of the groups (the cases) filtered by a possibly nonlinear function U. We study conditions for consistency of the method and find the function U which is optimal in the sense of asymptotic efficiency. Optimality may also extend to other measures of discriminatory efficiency such as the area under the receiver operating characteristic curve. The optimal function U depends on a scalar probability density function which can be estimated non-parametrically using a standard numerical algorithm. A lasso-like version for variable selection is implemented by adding L1-regularization to the generalized t-statistic. Two microarray data sets in the study of asthma and various cancers are used as motivating examples. © 2014, The International Biometric Society.

Comparison of time required for traditional versus virtual orthognathic surgery treatment planning.

PubMed

Wrzosek, M K; Peacock, Z S; Laviv, A; Goldwaser, B R; Ortiz, R; Resnick, C M; Troulis, M J; Kaban, L B

2016-09-01

Virtual surgical planning (VSP) is a tool for predicting complex surgical movements in three dimensions and it may reduce preoperative laboratory time. A prospective study to compare the time required for standard preoperative planning versus VSP was conducted at Massachusetts General Hospital from January 2014 through January 2015. Workflow data for bimaxillary cases planned by both standard techniques and VSP were recorded in real time. Time spent was divided into three parts: (1) obtaining impressions, face-bow mounting, and model preparation; (2) occlusal analysis and modification, model surgery, and splint fabrication; (3) online VSP session. Average times were compared between standard treatment planning (sum of parts 1 and 2) and VSP (sum of parts 1 and 3). Of 41 bimaxillary cases included, 20 were simple (symmetric) and 21 were complex (asymmetry and segmental osteotomies). Average times for parts 1, 2, and 3 were 4.43, 3.01, and 0.67h, respectively. The average time required for standard treatment planning was 7.45h and for VSP was 5.10h, a 31% time reduction (P<0.001). By eliminating all or some components of part 1, time savings may increase to as much as 91%. This study indicates that in an academic setting, VSP reduces the time required for treatment planning of bimaxillary orthognathic surgery cases. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Age-standardized incidence rates of primordial cyst (keratocyst) on the Witwatersrand.

PubMed

Rachanis, C C; Shear, M

1978-11-01

Cases of primordial cysts derived from the records of all the hospital pathology departments and private pathology practices on the Witwatersrand, were recorded for the 10-year period 1965-74. The population at risk (1970 census) was 974,390 Whites and 1,567,280 Blacks. Age-specific morbidity rates for each sex and race were calculated, as well as age-standardized incidence rates standardized against African, World and European standard populations. The age-standardized incidence rates for primordial cysts, standardized against a World standard population, per million per year are 0.61, 0, 4.86 and 3.50 for Black males and females and White males and females, respectively. In the population at risk, primordial cysts are much more common in Whites than in Blacks, the incidence being eight times higher in White males than in Black males. The present study confirms that there is a bimodal age distribution but with a higher incidence of the cyst in the age group 50-64 years than previously suspected. This may be either because a substantial number of cases remain undiagnosed for many years or because there are two groups of primordial cyst: one which is triggered in young patients and the other in older patients.

Arthroscopic assessment for intra-articular disorders in residual ankle disability after sprain.

PubMed

Takao, Masato; Uchio, Yuji; Naito, Kohei; Fukazawa, Ikuo; Ochi, Mitsuo

2005-05-01

After ankle sprain, there can be many causes of disability, the origins of which cannot be determined using standard diagnostic tools. Ankle arthroscopy is a useful tool in identifying intra-articular disorders of the talocrural joint in cases of residual ankle disability after sprain. Cohort study (diagnosis); Level of evidence, 2. The authors gathered the independent diagnostic results of physical examination, standard mortise and lateral radiography, stress radiography of the talocrural joint, and magnetic resonance imaging for 72 patients with residual ankle disability lasting more than 2 months after injury (mean, 7 months after injury). They performed arthroscopic procedures and compared the double-blind results. In all cases, the arthroscopic results matched those of other means of diagnosis. In 14 cases, the arthroscopic approach exceeded the capabilities of the other methods. Including duplications, 39 patients (54.2%) had anterior talofibular ligament injuries, 17 patients (23.6%) had distal tibiofibular ligament injuries, 29 patients (40.3%) had osteochondral lesions, 13 patients (18%) had symptomatic os subfibulare, 3 patients (4.2%) had anterior impingement exostosis, and 3 patients (4.2%) had impingement due to abnormally fibrous bands. There were only 2 cases in which the cause of symptoms could not be detected by ankle arthroscopy, compared with 16 cases in which the cause of disability could not be detected using standard methods. In 3 cases (17.6%) of distal tibiofibular ligament injuries, 8 cases (27.6%) of osteochondral lesions, and all 3 cases (100%) of impingement of an abnormal fibrous band, ankle arthroscopy was the only method capable of diagnosing the cause of residual ankle pain after a sprain. The present results suggest that arthroscopy can be used to diagnose the cause of residual pain after an ankle sprain in most cases that are otherwise undiagnosable by clinical examination and imaging study.

Case Formulation in TADS CBT

ERIC Educational Resources Information Center

Rogers, Gregory M.; Reinecke, Mark A.; Curry, John F.

2005-01-01

For the Treatment for Adolescents With Depression Study (TADS), a cognitive-behavioral therapy (CBT) manual was developed with the aim of balancing standardization and flexibility. In this article, we describe the manual's case formulation procedures, which served as one major mechanism of flexibility in TADS CBT. We first describe the essential…

Blaming the Victim and Exonerating the Perpetrator in Cases of Rape and Robbery: Is There a Double Standard?

ERIC Educational Resources Information Center

Bieneck, Steffen; Krahe, Barbara

2011-01-01

Research in legal decision making has demonstrated the tendency to blame the victim and exonerate the perpetrator of sexual assault. This study examined the hypothesis of a special leniency bias in rape cases by comparing them to cases of robbery. N = 288 participants received descriptions of rape and robbery of a female victim by a male…

Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: Proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group.

PubMed

Holtfreter, Birte; Albandar, Jasim M; Dietrich, Thomas; Dye, Bruce A; Eaton, Kenneth A; Eke, Paul I; Papapanou, Panos N; Kocher, Thomas

2015-05-01

Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are severely hampered and inferences regarding the global variation in prevalence can hardly be drawn. To overcome these limitations, the authors suggest standardized principles for the reporting of the prevalence and severity of periodontal diseases in future epidemiological studies. These principles include the comprehensive reporting of the study design, the recording protocol, and specific subject-related and oral data. Further, a range of periodontal data should be reported in the total population and within specific age groups. Periodontal data include the prevalence and extent of clinical attachment loss (CAL) and probing depth (PD) on site and tooth level according to specific thresholds, mean CAL/PD, the CDC/AAP case definition, and bleeding on probing. Consistent implementation of these standards in future studies will ensure improved reporting quality, permit meaningful comparisons of the prevalence of periodontal diseases across populations, and provide better insights into the determinants of such variation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Glocal clinical registries: pacemaker registry design and implementation for global and local integration--methodology and case study.

PubMed

da Silva, Kátia Regina; Costa, Roberto; Crevelari, Elizabeth Sartori; Lacerda, Marianna Sobral; de Moraes Albertini, Caio Marcos; Filho, Martino Martinelli; Santana, José Eduardo; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; Barros, Jacson V

2013-01-01

The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries.

Evaluation of occupational exposure to infrasonic noise in Poland.

PubMed

Pawlaczyk-Luszczyńska, M

1999-01-01

A short review of infrasound sources and effects on humans is presented. Polish standard PN-86/N-01338 and international standards ISO 7196:1995 and ISO 9612:1997 concerning the measuring techniques of infrasonic noise are described. The results of infrasonic noise measurements performed in the work environment in Poland are discussed. The study concerned the noise emitted by 124 different types of industrial machinery, appliances and means of transport. The measurements were made in typical working conditions with reference to Polish and international standards. The sound pressure levels exceeding Polish admissible values for: (a) workers' health protection were found in 5 (4.0%) cases, (b) ensuring proper conditions for performing basic functions in observational dispatcher cabins etc. in 77 (62.1%) cases; and (c) administration premises, design offices etc. in 92 (74.2%) cases. The admissible sound pressure levels for workers' health protection are in fact the permissible levels for hearing protection, however they do not correspond with the hearing threshold of infrasound the G-weighting characteristic is associated with. The hearing threshold of infrasound (G86 curve) was exceeded in 66.9% of all the industrial machinery and means of transport under study.

Agreement, the F-Measure, and Reliability in Information Retrieval

PubMed Central

Hripcsak, George; Rothschild, Adam S.

2005-01-01

Information retrieval studies that involve searching the Internet or marking phrases usually lack a well-defined number of negative cases. This prevents the use of traditional interrater reliability metrics like the κ statistic to assess the quality of expert-generated gold standards. Such studies often quantify system performance as precision, recall, and F-measure, or as agreement. It can be shown that the average F-measure among pairs of experts is numerically identical to the average positive specific agreement among experts and that κ approaches these measures as the number of negative cases grows large. Positive specific agreement—or the equivalent F-measure—may be an appropriate way to quantify interrater reliability and therefore to assess the reliability of a gold standard in these studies. PMID:15684123

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140: Preprint

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Determination of chemical purity and isotopic composition of natural and carbon-13-labeled arsenobetaine bromide standards by quantitative(1)H-NMR.

PubMed

Le, Phuong-Mai; Ding, Jianfu; Leek, Donald M; Mester, Zoltan; Robertson, Gilles; Windust, Anthony; Meija, Juris

2016-10-01

In this study, we report the characterization of three arsenobetaine-certified reference materials by quantitative NMR. We have synthesized an arsenobetaine bromide high-purity standard of natural isotopic composition (ABET-1) and two carbon-13-labeled isotopic standards (BBET-1 and CBET-1). Assignments of the chemical purity and isotopic composition are not trivial in the case of arsenobetaine, and in this study we utilized quantitative(1)H-NMR techniques for the determination of the mass fractions (chemical purity). The isotopic purity of all three standards was also assessed by NMR from the carbon-13 satellite signals. The standards are non-hygroscopic, high-purity (ca. 0.99 g/g), and the carbon-13 enrichment for both isotopic standards is x((13)C)≈0.99. These standards are designed for use as primary calibrators for mass spectrometric determination of arsenobetaine in environmental samples.

Thermal Modeling of the Injection of Standard and Thermally Insulated Cored Wire

NASA Astrophysics Data System (ADS)

Castro-Cedeno, E.-I.; Jardy, A.; Carré, A.; Gerardin, S.; Bellot, J. P.

2017-12-01

Cored wire injection is a widespread method used to perform alloying additions during ferrous and non-ferrous liquid metal treatment. The wire consists of a metal casing that is tightly wrapped around a core of material; the casing delays the release of the material as the wire is immersed into the melt. This method of addition presents advantages such as higher repeatability and yield of cored material with respect to bulk additions. Experimental and numerical work has been performed by several authors on the subject of alloy additions, spherical and cylindrical geometries being mainly considered. Surprisingly this has not been the case for cored wire, where the reported experimental or numerical studies are scarce. This work presents a 1-D finite volume numerical model aimed for the simulation of the thermal phenomena which occurs when the wire is injected into a liquid metal bath. It is currently being used as a design tool for the conception of new types of cored wire. A parametric study on the effect of injection velocity and steel casing thickness for an Al cored wire immersed into a steel melt at 1863 K (1590 °C) is presented. The standard single casing wire is further compared against a wire with multiple casings. Numerical results show that over a certain range of injection velocities, the core contents' release is delayed in the multiple casing when compared to a single casing wire.

Effect of a legal prime on clinician's assessment of suicide risk.

PubMed

Berman, Noah Chase; Sullivan, Alexandra; Wilhelm, Sabine; Cohen, I Glenn

2016-01-01

The present study evaluates how liability influences mental health clinicians' assessment of suicide risk. In this online vignette-based experiment, clinicians (N = 268) were either primed with a legal standard prior to a case vignette or presented the case vignette alone. Clinicians then rated the patient's likelihood of suicide and need for hospitalization. Results indicated that trainees provided significantly lower ratings of suicide risk following presentation of the legal standard, but this was not associated with hospitalization endorsement. Results have training and legal implications for improving the accuracy of suicide risk assessment in both trainees and licensed professionals.

The Perceptions of Administrators in the Implementation of Professional Learning Communities: A Case Study in an Oklahoma School District

ERIC Educational Resources Information Center

Jaques, Shelley

2010-01-01

In January of 2002, President George Bush implemented the No Child left behind act that required all students to be proficient on state standards by the year 2014. One way a school district in Oklahoma met these new requirements was through the implementation of the principles of a Professional Learning Community. This case study was designed…

Connecting Marketing and Implementation Research and Library Program Development: A Case Study of the Implementation of [U.S.] National Guidelines and Standards.

ERIC Educational Resources Information Center

Haycock, Ken; Cavill, Pat

This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as…

Learning to Mean in Spanish Writing: A Case Study of a Genre-Based Pedagogy for Standards-Based Writing Instruction

ERIC Educational Resources Information Center

Troyan, Francis J.

2016-01-01

This case study reports the results of a genre-based approach, which was used to explicitly teach the touristic landmark description to fourth-grade students of Spanish as a foreign language. The instructional model and unit of instruction were informed by the pedagogies of the Sydney School of Linguistics and an instructional model for…

Older Sibling Support of Younger Siblings' Socio-Emotional Development: A Multiple-Case Study of Second-Generation Mexican and Honduran Children's Initiative and Co-Construction

ERIC Educational Resources Information Center

Palacios, Natalia; Kibler, Amanda K.; Yoder, Michelle; Baird, Ashley Simpson; Bergey, Rebecca

2016-01-01

Siblings play a critical role in the socialization experiences of their younger siblings. Societal values, standards, and customs are transmitted and created through the process of modeling and the construction of shared meaning. It follows, therefore, that the process of socialization may be culturally dependent. Using multiple case studies of…

It Is Just a Game (of Jews vs. Nazi Beer Pong): A Case Study on Law, Ethics, and Social Media

ERIC Educational Resources Information Center

Monseau, Susanna; Lasher, Nancy

2017-01-01

The Association to Advance Collegiate Schools of Business (AACSB) accreditation standards on learning and teaching, adopted in 2013, require students to "engage in experiential and active learning designed to improve skills and the application of knowledge in practice." The discussion of the facts of real life case studies is a great way…

A study of science leadership and science standards in exemplary standards-based science programs

NASA Astrophysics Data System (ADS)

Carpenter, Wendy Renae

The purpose for conducting this qualitative study was to explore best practices of exemplary standards-based science programs and instructional leadership practices in a charter high school and in a traditional high school. The focus of this study included how twelve participants aligned practices to National Science Education Standards to describe their science programs and science instructional practices. This study used a multi-site case study qualitative design. Data were obtained through a review of literature, interviews, observations, review of educational documents, and researcher's notes collected in a field log. The methodology used was a multi-site case study because of the potential, through cross analysis, for providing greater explanation of the findings in the study (Merriam, 1988). This study discovered six characteristics about the two high school's science programs that enhance the literature found in the National Science Education Standards; (a) Culture of expectations for learning-In exemplary science programs teachers are familiar with a wide range of curricula. They have the ability to examine critically and select activities to use with their students to promote the understanding of science; (b) Culture of varied experiences-In exemplary science programs students are provided different paths to learning, which help students, take in information and make sense of concepts and skills that are set forth by the standards; (c) Culture of continuous feedback-In exemplary science programs teachers and students work together to engage students in ongoing assessments of their work and that of others as prescribed in the standards; (d) Culture of Observations-In exemplary science programs students, teachers, and principals reflect on classroom instructional practices; teachers receive ongoing evaluations about their teaching and apply feedback towards improving practices as outlined in the standards; (e) Culture of continuous learning-In exemplary science programs teachers value continuous personal development, teachers are provided on-going science professional development opportunities to improve instructional practices, teachers reflect and share professional practices, and teachers establish professional learning communities within their classrooms; and (f) Culture of shared leadership-In exemplary science programs instructional leadership purposes and values are consistently shared among all stakeholders which are outlined in the standards. These results are potentially useful for understanding exemplary standards-based science programs and science instructional leadership practices as a model for science programs trying to improve science education so that all students can have a true scientific learning experience.

Standardization as an Arena for Open Innovation

NASA Astrophysics Data System (ADS)

Grøtnes, Endre

This paper argues that anticipatory standardization can be viewed as an arena for open innovation and shows this through two cases from mobile telecommunication standardization. One case is the Android initiative by Google and the Open Handset Alliance, while the second case is the general standardization work of the Open Mobile Alliance. The paper shows how anticipatory standardization intentionally uses inbound and outbound streams of research and intellectual property to create new innovations. This is at the heart of the open innovation model. The standardization activities use both pooling of R&D and the distribution of freely available toolkits to create products and architectures that can be utilized by the participants and third parties to leverage their innovation. The paper shows that the technology being standardized needs to have a systemic nature to be part of an open innovation process.

Robust logistic regression to narrow down the winner's curse for rare and recessive susceptibility variants.

PubMed

Kesselmeier, Miriam; Lorenzo Bermejo, Justo

2017-11-01

Logistic regression is the most common technique used for genetic case-control association studies. A disadvantage of standard maximum likelihood estimators of the genotype relative risk (GRR) is their strong dependence on outlier subjects, for example, patients diagnosed at unusually young age. Robust methods are available to constrain outlier influence, but they are scarcely used in genetic studies. This article provides a non-intimidating introduction to robust logistic regression, and investigates its benefits and limitations in genetic association studies. We applied the bounded Huber and extended the R package 'robustbase' with the re-descending Hampel functions to down-weight outlier influence. Computer simulations were carried out to assess the type I error rate, mean squared error (MSE) and statistical power according to major characteristics of the genetic study and investigated markers. Simulations were complemented with the analysis of real data. Both standard and robust estimation controlled type I error rates. Standard logistic regression showed the highest power but standard GRR estimates also showed the largest bias and MSE, in particular for associated rare and recessive variants. For illustration, a recessive variant with a true GRR=6.32 and a minor allele frequency=0.05 investigated in a 1000 case/1000 control study by standard logistic regression resulted in power=0.60 and MSE=16.5. The corresponding figures for Huber-based estimation were power=0.51 and MSE=0.53. Overall, Hampel- and Huber-based GRR estimates did not differ much. Robust logistic regression may represent a valuable alternative to standard maximum likelihood estimation when the focus lies on risk prediction rather than identification of susceptibility variants. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

High efficiency endocrine operation protocol: From design to implementation.

PubMed

Mascarella, Marco A; Lahrichi, Nadia; Cloutier, Fabienne; Kleiman, Simcha; Payne, Richard J; Rosenberg, Lawrence

2016-10-01

We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program. Copyright © 2016 Elsevier Inc. All rights reserved.

Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement.

PubMed

Argo, Joshua L; Vick, Catherine C; Graham, Laura A; Itani, Kamal M F; Bishop, Michael J; Hawn, Mary T

2009-11-01

This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system. CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities. Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive. Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

How Twenty-Five People Shook the Archival World: The Case of Descriptive Standards

ERIC Educational Resources Information Center

Davis, Susan E.

2006-01-01

This study explores the development of the archival profession during the 1980s, a period that experienced rapid change and the adoption of the first descriptive standards. The research focuses on the leadership roles played by individuals acting independently and on behalf of their employing institutions and professional associations in the…

Who Gets In, and Who Doesn't Selecting Medical Students: An Australian Case Study

ERIC Educational Resources Information Center

Mercer, Annette

2009-01-01

Medicine is a profession with a long history of research and high standards of methodological rigour and evidence-based decision making. These standards are being transferred into medical education. Universities are starting to collect high-quality data on their admissions systems. This has not been a short-term proposition. Medical courses are…

Critical Multimodal Literacy and the Common Core: Subversive Curriculum in the Age of Accountability

ERIC Educational Resources Information Center

Perttula, Jill

2017-01-01

The purpose of this case study research was to understand the ways in which an innovative, urban secondary English teacher (Ms. B) approached English Language Arts, when a set, standardized curriculum and testing were in place. The Common Core standards were prescribed within a required module-based presentation format. New literacies pedagogy…

Integrating GIS in the Middle School Curriculum: Impacts on Diverse Students' Standardized Test Scores

ERIC Educational Resources Information Center

Goldstein, Donna; Alibrandi, Marsha

2013-01-01

This case study conducted with 1,425 middle school students in Palm Beach County, Florida, included a treatment group receiving GIS instruction (256) and a control group without GIS instruction (1,169). Quantitative analyses on standardized test scores indicated that inclusion of GIS in middle school curriculum had a significant effect on student…

A Case Study of Implications and Applications of Standardized Nomenclature for Asset Management in Healthcare

ERIC Educational Resources Information Center

DeFrancesco, Jennifer A.

2016-01-01

Healthcare organizations strive to adapt to the continuous change in what has become a fast-paced, high technology environment. Many organizations are charged to find efficiencies to better manage medical device assets. Increasingly, healthcare leaders opt to adopt a standardized medical device nomenclature under the purview of a set of national…

Utilizing Innovative Video Chat Technology to Meet National Standards: A Case Study on a STARTALK Hindi Language Program

ERIC Educational Resources Information Center

Parveen, Shaheen; Pater, Cayley

2012-01-01

Responding to the need for foreign language fluency in ever-globalizing business and cultural spheres, the federal government and foreign language institutions in an eleven-member task force collaboratively published a set of nationally recognized, foundational standards for foreign language teaching. Rather than rely on teacher-centered…

A joint labor-management hazard communication training program: a case study in worker health and safety training.

PubMed

Robins, T G; Hugentobler, M K; Kaminski, M; Klitzman, S

1994-01-01

The 1983 OSHA Hazard Communication Standard requires training of employees exposed to hazardous chemicals. The authors provide a detailed look at the successes and failures of a joint labor-management training program that was designed to bring a firm with more than 50 manufacturing facilities into compliance with the standard.

Teachers' Conceptions of Standards in South African Basic Education and Training: A Case Study

ERIC Educational Resources Information Center

Sosibo, Lungi; Nomlomo, Vuyokazi

2014-01-01

In South Africa, the Department of Basic Education and Training (DBE) is responsible for primary and secondary education (Grades R-12). In an effort to improve educational standards in literacy, numeracy and mathematics, especially in the Foundation Phase (FP) levels of education, the DBE has developed several initiatives and campaigns. To monitor…

Working within the System: The Effects of Standardized Testing on Education Outreach and Community Writing

ERIC Educational Resources Information Center

Parfitt, Elizabeth; Shane, Stephen

2016-01-01

This snapshot describes and reflects upon two case studies of community writing projects between Emerson College and Boston Public Schools. Emerson College students were asked to tutor 10th grade BPS students for the English Language Arts portion of the state standardized assessment. Through both quantitative results and qualitative reflection,…

A Multiple Case Study of Ethical Preparedness of Guam K12 Principals in High Poverty Public Schools

ERIC Educational Resources Information Center

Quitano, Elwin Champaco

2016-01-01

The answer to effective formal principal preparation reform across the nation has been to adopt and implement the "Interstate School Leaders Licensure Consortium" (ISLLC) standards, which in most instances begins with graduate program courses and field training within higher learning institutions. Close adherence to Standard 5, a…

A Seven-Step Process To Align Curriculum with Oregon State Content Standards.

ERIC Educational Resources Information Center

Golden, Nancy; Lane, Marilyn

1998-01-01

The University of Oregon (UO) and Captain Robert Gray Elementary School formed a partnership where UO students used the elementary school as a case study for curriculum research. This document gives an overview of the 7-step process the students used to align the school's curriculum with Oregon's content and performance standards. The text opens…

A Case Study of Common Core Implementation in a Linked Learning Environment

ERIC Educational Resources Information Center

Biolchino, Erin Broun

2016-01-01

California is in the midst of significant educational reform initiatives, especially at the secondary level. The Common Core State Standards (CCSS) were adopted in 2010, and these new standards contain significant changes in the areas of math, English, and literacy across all subjects. Many districts are also implementing new initiatives to engage…

Joint Inquiry: Teachers' Collective Learning about the Common Core in High-Poverty Urban Schools

ERIC Educational Resources Information Center

Stosich, Elizabeth Leisy

2016-01-01

Recent research on the relationship between standards and teachers' practice suggests that teachers are unlikely to make changes to practice without extensive opportunities for learning about standards with colleagues. This article extends this line of research, using a comparative case study of three high-poverty urban schools to examine the…

Why IEP Teams Assign Low Performers with Mild Disabilities to the Alternate Assessment Based on Alternate Achievement Standards

ERIC Educational Resources Information Center

Cho, Hyun-Jeong; Kingston, Neal

2013-01-01

The purpose of this case study was to determine teachers' rationales for assigning students with mild disabilities to alternate assessment based on alternate achievement standards (AA-AAS). In interviews, special educators stated that their primary considerations in making the assignments were low academic performance, student use of extended…

Mortality Measures to Profile Hospital Performance for Patients With Septic Shock.

PubMed

Walkey, Allan J; Shieh, Meng-Shiou; Liu, Vincent X; Lindenauer, Peter K

2018-04-30

Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions. Retrospective cohort study. U.S. acute care hospitals. Hospitalized with septic shock at admission, identified by either implicit diagnosis criteria (charges for antibiotics, cultures, and vasopressors) or by explicit International Classification of Diseases, 9th revision, codes. None. We used hierarchical logistic regression models to determine hospital risk-standardized mortality rates and hospital performance outliers. We assessed agreement in hospital mortality rankings when septic shock cases were identified by either explicit International Classification of Diseases, 9th revision, codes or implicit diagnosis criteria. Kappa statistics and intraclass correlation coefficients were used to assess agreement in hospital risk-standardized mortality and hospital outlier status, respectively. Fifty-six thousand six-hundred seventy-three patients in 308 hospitals fulfilled at least one case definition for septic shock, whereas 19,136 (33.8%) met both the explicit International Classification of Diseases, 9th revision, and implicit septic shock definition. Hospitals varied widely in risk-standardized septic shock mortality (interquartile range of implicit diagnosis mortality: 25.4-33.5%; International Classification of Diseases, 9th revision, diagnosis: 30.2-38.0%). The median absolute difference in hospital ranking between septic shock cohorts defined by International Classification of Diseases, 9th revision, versus implicit criteria was 37 places (interquartile range, 16-70), with an intraclass correlation coefficient of 0.72, p value of less than 0.001; agreement between case definitions for identification of outlier hospitals was moderate (kappa, 0.44 [95% CI, 0.30-0.58]). Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.

A case study of ISO 11064 in control centre design in the Norwegian petroleum industry.

PubMed

Aas, Andreas Lumbe; Skramstad, Torbjørn

2010-12-01

In 2006-2008 we performed a case study for the purpose of assessing the industrial application of the seven part Control Centre (CC) design standard ISO 11064 to identify positive and negative experiences among stakeholders in the Norwegian petroleum sector. We mainly focussed on ISO 11064 Part 1, because this was the most commonly used among the identified stakeholders. ISO 11064 is generally appreciated and applied in the industry, but we did observe a significant variance in use between the different parts of the standard. We also identified potential areas for improvements, like scope and application adaptation. Thus we suggest a more goal-based approach based on one normative part only. Copyright © 2010 Elsevier Ltd. All rights reserved.

Green and sustainable remediation (GSR) evaluation: framework, standards, and tool. A case study in Taiwan.

PubMed

Huang, Wen-Yen; Hung, Weiteng; Vu, Chi Thanh; Chen, Wei-Ting; Lai, Jhih-Wei; Lin, Chitsan

2016-11-01

Taiwan has a large number of poorly managed contaminated sites in need of remediation. This study proposes a framework, a set of standards, and a spreadsheet-based evaluation tool for implementing green and sustainable principles into remediation projects and evaluating the projects from this perspective. We performed a case study to understand how the framework would be applied. For the case study, we used a spreadsheet-based evaluation tool (SEFA) and performed field scale cultivation tests on a site contaminated with total petroleum hydrocarbons (TPHs). The site was divided into two lots: one treated by chemical oxidation and the other by bioremediation. We evaluated five core elements of green and sustainable remediation (GSR): energy, air, water resources, materials and wastes, and land and ecosystem. The proposed evaluation tool and field scale cultivation test were found to efficiently assess the effectiveness of the two remediation alternatives. The framework and related tools proposed herein can potentially be used to support decisions about the remediation of contaminated sites taking into account engineering management, cost effectiveness, and social reconciliation.

Retrospective review of Contura HDR breast cases to improve our standardized procedure

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

Iftimia, Ileana, E-mail: Ileana.n.iftimia@lahey.org; Cirino, Eileen T.; Ladd, Ron

2013-07-01

To retrospectively review our first 20 Contura high dose rate breast cases to improve and refine our standardized procedure and checklists. We prepared in advance checklists for all steps, developed an in-house Excel spreadsheet for second checking the plan, and generated a procedure for efficient contouring and a set of optimization constraints to meet the dose volume histogram criteria. Templates were created in our treatment planning system for structures, isodose levels, optimization constraints, and plan report. This study reviews our first 20 high dose rate Contura breast treatment plans. We followed our standardized procedure for contouring, planning, and second checking.more » The established dose volume histogram criteria were successfully met for all plans. For the cases studied here, the balloon-skin and balloon-ribs distances ranged between 5 and 43 mm and 1 and 33 mm, respectively; air{sub s}eroma volume/PTV{sub E}val volume≤5.5% (allowed≤10%); asymmetry<1.2 mm (goal≤2 mm); PTV{sub E}val V90%≥97.6%; PTV{sub E}val V95%≥94.9%; skin max dose≤98%Rx; ribs max dose≤137%Rx; V150%≤29.8 cc; V200%≤7.8 cc; the total dwell time range was 225.4 to 401.9 seconds; and the second check agreement was within 3%. Based on this analysis, more appropriate ranges for the total dwell time and balloon diameter tolerance were found. Three major problems were encountered: balloon migration toward the skin for small balloon-to-skin distances, lumen obstruction, and length change for the flexible balloon. Solutions were found for these issues and our standardized procedure and checklists were updated accordingly. Based on our review of these cases, the use of checklists resulted in consistent results, indicating good coverage for the target without sacrificing the critical structures. This review helped us to refine our standardized procedure and update our checklists.« less

Measuring Primary Students' Graph Interpretation Skills Via a Performance Assessment: A case study in instrument development

NASA Astrophysics Data System (ADS)

Peterman, Karen; Cranston, Kayla A.; Pryor, Marie; Kermish-Allen, Ruth

2015-11-01

This case study was conducted within the context of a place-based education project that was implemented with primary school students in the USA. The authors and participating teachers created a performance assessment of standards-aligned tasks to examine 6-10-year-old students' graph interpretation skills as part of an exploratory research project. Fifty-five students participated in a performance assessment interview at the beginning and end of a place-based investigation. Two forms of the assessment were created and counterbalanced within class at pre and post. In situ scoring was conducted such that responses were scored as correct versus incorrect during the assessment's administration. Criterion validity analysis demonstrated an age-level progression in student scores. Tests of discriminant validity showed that the instrument detected variability in interpretation skills across each of three graph types (line, bar, dot plot). Convergent validity was established by correlating in situ scores with those from the Graph Interpretation Scoring Rubric. Students' proficiency with interpreting different types of graphs matched expectations based on age and the standards-based progression of graphs across primary school grades. The assessment tasks were also effective at detecting pre-post gains in students' interpretation of line graphs and dot plots after the place-based project. The results of the case study are discussed in relation to the common challenges associated with performance assessment. Implications are presented in relation to the need for authentic and performance-based instructional and assessment tasks to respond to the Common Core State Standards and the Next Generation Science Standards.

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

PubMed Central

Monsen, Karen A.; Elsbernd, Scott A.; Barnhart, Linda; Stock, Jacquie; Prock, Carla E.; Looman, Wendy S.; Nardella, Maria

2013-01-01

Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems. PMID:23533804

Data standards for clinical research data collection forms: current status and challenges.

PubMed

Richesson, Rachel L; Nadkarni, Prakash

2011-05-01

Case report forms (CRFs) are used for structured-data collection in clinical research studies. Existing CRF-related standards encompass structural features of forms and data items, content standards, and specifications for using terminologies. This paper reviews existing standards and discusses their current limitations. Because clinical research is highly protocol-specific, forms-development processes are more easily standardized than is CRF content. Tools that support retrieval and reuse of existing items will enable standards adoption in clinical research applications. Such tools will depend upon formal relationships between items and terminological standards. Future standards adoption will depend upon standardized approaches for bridging generic structural standards and domain-specific content standards. Clinical research informatics can help define tools requirements in terms of workflow support for research activities, reconcile the perspectives of varied clinical research stakeholders, and coordinate standards efforts toward interoperability across healthcare and research data collection.

Small hydropower plants standardization, between myth and reality

NASA Astrophysics Data System (ADS)

Paraschivescu, A. V.; Ahmad-Rashid, K.; Popa, F.; Popa, B.

2017-01-01

Many providers for small hydropower plants equipment have tried to standardize the components and even the entire equipment. So called “compact turbines” were launched on the market, ensuring the pre-designed solution of the modular components, but usually with lower efficiency then turbines specially designed for a certain site. For civil works it is possible to standardize some components, such as the powerhouse, the surge tank or the headrace, but not the intake and the weir. Part of the hydropower plants can be standardized, but not the entire project, because there are a lot of variables that influence the design. Among these, the dimension, materials and design of the canal and the penstock are given by the hydrology, topography and the geology of the project’s area. This paper presents an attempt at standardization by using different heads and different installed flows. The case study is made on the Lukosi River from Tanzania, because there is a good hydrological database on power and energy calculation. For the powerhouse, pressure tower and intake dimensioning, the assumptions and materials considered cover all challenges that could appear in the geological and topographical structure of the project’s area (worst case, most expensive). The study has highlighted African climatologic and hydrological conditions and the adapting of current technology to these conditions.

Addressing the Nets for Students through Constructivist Technology Use in K-12 Classrooms

ERIC Educational Resources Information Center

Niederhauser, Dale S.; Lindstrom, Denise L.

2006-01-01

The National Educational Technology Standards for Students promote constructivist technology use for K-12 students in U.S. schools. In this study, researchers reported on 716 cases in which teachers described technology-based activities they conducted with their students. Narrative analysis was used to examine case transcripts relative to the…

What Works Clearinghouse Standards and Generalization of Single-Case Design Evidence

ERIC Educational Resources Information Center

Hitchcock, John H.; Kratochwill, Thomas R.; Chezan, Laura C.

2015-01-01

A recent review of existing rubrics designed to help researchers evaluate the internal and external validity of single-case design (SCD) studies found that the various options yield consistent results when examining causal arguments. The authors of the review, however, noted considerable differences across the rubrics when addressing the…

Haemophilus haemolyticus Isolates Causing Clinical Disease

PubMed Central

Wang, Xin; Briere, Elizabeth C.; Katz, Lee S.; Cohn, Amanda C.; Clark, Thomas A.; Messonnier, Nancy E.; Mayer, Leonard W.

2012-01-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification. PMID:22573587

78 FR 58328 - Change-1 to Navigation and Inspection Circular 04-08

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

...-simplified the process to a ``go/no-go'' decision that would not allow all factors to be considered. In... by immersion in sea simulation and video electronystagmography to study their vestibular systems. The... stricter standards on a case-by-case basis as needed. The Coast Guard disagrees that sea simulation and...

Haemophilus haemolyticus isolates causing clinical disease.

PubMed

Anderson, Raydel; Wang, Xin; Briere, Elizabeth C; Katz, Lee S; Cohn, Amanda C; Clark, Thomas A; Messonnier, Nancy E; Mayer, Leonard W

2012-07-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification.

Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey.

PubMed

Selton-Suty, Christine; Célard, Marie; Le Moing, Vincent; Doco-Lecompte, Thanh; Chirouze, Catherine; Iung, Bernard; Strady, Christophe; Revest, Matthieu; Vandenesch, François; Bouvet, Anne; Delahaye, François; Alla, François; Duval, Xavier; Hoen, Bruno

2012-05-01

Observational studies showed that the profile of infective endocarditis (IE) significantly changed over the past decades. However, most studies involved referral centers. We conducted a population-based study to control for this referral bias. The objective was to update the description of characteristics of IE in France and to compare the profile of community-acquired versus healthcare-associated IE. A prospective population-based observational study conducted in all medical facilities from 7 French regions (32% of French individuals aged ≥18 years) identified 497 adults with Duke-Li-definite IE who were first admitted to the hospital in 2008. Main measures included age-standardized and sex-standardized incidence of IE and multivariate Cox regression analysis for risk factors of in-hospital death. The age-standardized and sex-standardized annual incidence of IE was 33.8 (95% confidence interval [CI], 30.8-36.9) cases per million inhabitants. The incidence was highest in men aged 75-79 years. A majority of patients had no previously known heart disease. Staphylococci were the most common causal agents, accounting for 36.2% of cases (Staphylococcus aureus, 26.6%; coagulase-negative staphylococci, 9.7%). Healthcare-associated IE represented 26.7% of all cases and exhibited a clinical pattern significantly different from that of community-acquired IE. S. aureus as the causal agent of IE was the most important factor associated with in-hospital death in community-acquired IE (hazard ratio [HR], 2.82 [95% CI, 1.72-4.61]) and the single factor in healthcare-associated IE (HR, 2.54 [95% CI, 1.33-4.85]). S. aureus became both the leading cause and the most important prognostic factor of IE, and healthcare-associated IE appeared as a major subgroup of the disease.

Systematic review of the methodological and reporting quality of case series in surgery.

PubMed

Agha, R A; Fowler, A J; Lee, S-Y; Gundogan, B; Whitehurst, K; Sagoo, H K; Jeong, K J L; Altman, D G; Orgill, D P

2016-09-01

Case series are an important and common study type. No guideline exists for reporting case series and there is evidence of key data being missed from such reports. The first step in the process of developing a methodologically sound reporting guideline is a systematic review of literature relevant to the reporting deficiencies of case series. A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, Embase, Cochrane Methods Register, Science Citation Index and Conference Proceedings Citation index, from the start of indexing to 5 November 2014. Independent screening, eligibility assessments and data extraction were performed. Included articles were then analysed for five areas of deficiency: failure to use standardized definitions, missing or selective data (including the omission of whole cases or important variables), transparency or incomplete reporting, whether alternative study designs were considered, and other issues. Database searching identified 2205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequencies of methodological and reporting issues identified were: failure to use standardized definitions (57 per cent), missing or selective data (66 per cent), transparency or incomplete reporting (70 per cent), whether alternative study designs were considered (11 per cent) and other issues (52 per cent). The methodological and reporting quality of surgical case series needs improvement. The data indicate that evidence-based guidelines for the conduct and reporting of case series may be useful. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

PubMed

Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin; Elahi, Elham; Barati, Hojatollah

2016-01-01

A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Requirements for construction of nuclear system components at elevated temperatures (supplement to ASME Code Cases 1592, 1593, 1594, 1595, and 1596)

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

Not Available

This standard provides rules for the construction of Class 1 nuclear components, parts, and appurtenances for use at elevated temperatures. This standard is a complete set of requirements only when used in conjunction with Section III of the ASME Boiler and Pressure Vessel Code (ASME Code) and addenda, ASME Code Cases 1592, 1593, 1594, 1595, and 1596, and RDT E 15-2NB. Unmodified paragraphs of the referenced Code Cases are not repeated in this standard but are a part of the requirements of this standard.

Spread of epidemic disease on networks

NASA Astrophysics Data System (ADS)

Newman, M. E.

2002-07-01

The study of social networks, and in particular the spread of disease on networks, has attracted considerable recent attention in the physics community. In this paper, we show that a large class of standard epidemiological models, the so-called susceptible/infective/removed (SIR) models can be solved exactly on a wide variety of networks. In addition to the standard but unrealistic case of fixed infectiveness time and fixed and uncorrelated probability of transmission between all pairs of individuals, we solve cases in which times and probabilities are nonuniform and correlated. We also consider one simple case of an epidemic in a structured population, that of a sexually transmitted disease in a population divided into men and women. We confirm the correctness of our exact solutions with numerical simulations of SIR epidemics on networks.

Casimir force in a Lorentz violating theory

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

Frank, Mariana; Turan, Ismail

2006-08-01

We study the effects of the minimal extension of the standard model including Lorentz violation on the Casimir force between two parallel conducting plates in the vacuum. We provide explicit solutions for the electromagnetic field using scalar field analogy, for both the cases in which the Lorentz violating terms come from the CPT-even or CPT-odd terms. We also calculate the effects of the Lorentz violating terms for a fermion field between two parallel conducting plates and analyze the modifications of the Casimir force due to the modifications of the Dirac equation. In all cases under consideration, the standard formulas formore » the Casimir force are modified by either multiplicative or additive correction factors, the latter case exhibiting different dependence on the distance between the plates.« less

[Usefulness of stratigraphy and computerized tomography in the initial staging of osteosarcoma of the extremities. Retrospective study of 217 cases].

PubMed

Pelotti, P; Ciminari, R; Bacci, G; Avella, M; Briccoli, A

1988-01-01

The value of stratigraphy and pulmonary CT in the initial work-up of osteosarcoma of the extremities is assessed with reference to 217 patients encountered in the Bone Tumour Centre of Rizzoli Orthopaedic Institute in May 1983-May 1986. Stratigraphy revealed lung metastases not identified by standard radiography in 4 patients (1.8%), while CT revealed metastases not identified by either standard X-rays or stratigraphy in a further 6 cases (2.7%). It is concluded that the increase in the percentage of cures (about 30%) reported in the last 10 years in osteosarcoma cases given adjuvant chemotherapy cannot be explained by any difference in initial selection due to the use of these techniques that were not adopted in the historical series.

Parameter estimation in Cox models with missing failure indicators and the OPPERA study.

PubMed

Brownstein, Naomi C; Cai, Jianwen; Slade, Gary D; Bair, Eric

2015-12-30

In a prospective cohort study, examining all participants for incidence of the condition of interest may be prohibitively expensive. For example, the "gold standard" for diagnosing temporomandibular disorder (TMD) is a physical examination by a trained clinician. In large studies, examining all participants in this manner is infeasible. Instead, it is common to use questionnaires to screen for incidence of TMD and perform the "gold standard" examination only on participants who screen positively. Unfortunately, some participants may leave the study before receiving the "gold standard" examination. Within the framework of survival analysis, this results in missing failure indicators. Motivated by the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study, a large cohort study of TMD, we propose a method for parameter estimation in survival models with missing failure indicators. We estimate the probability of being an incident case for those lacking a "gold standard" examination using logistic regression. These estimated probabilities are used to generate multiple imputations of case status for each missing examination that are combined with observed data in appropriate regression models. The variance introduced by the procedure is estimated using multiple imputation. The method can be used to estimate both regression coefficients in Cox proportional hazard models as well as incidence rates using Poisson regression. We simulate data with missing failure indicators and show that our method performs as well as or better than competing methods. Finally, we apply the proposed method to data from the OPPERA study. Copyright © 2015 John Wiley & Sons, Ltd.

The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study.

PubMed

Scott, J Anthony G; Wonodi, Chizoba; Moïsi, Jennifer C; Deloria-Knoll, Maria; DeLuca, Andrea N; Karron, Ruth A; Bhat, Niranjan; Murdoch, David R; Crawley, Jane; Levine, Orin S; O'Brien, Katherine L; Feikin, Daniel R

2012-04-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1-59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing.

The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

PubMed Central

Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O’Brien, Katherine L.; Feikin, Daniel R.

2012-01-01

To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing. PMID:22403224

Epidemiology of Breast Cancer among Females in Basrah.

PubMed

S Habib, Omran; A Hameed, Lamis; A Ajeel, Narjis; Al-Hawaz, Mazin H; Al-Faddagh, Zaki A; N Nasr, Ghalib; Al-Sodani, Ali H; A Khalaf, Asaad; M Hasson, Hasson; Lname, Aida A; Abdul-Samad, Fname

2016-01-01

Breast cancer is the most frequent cancer in females. Its incidence is higher in developed countries than in developing ones partly due to variation in risk exposure and partly due to better detection methods. Scattered evidence in Basrah, Iraq, suggests that breast cancer has been increasing at a significant pace in recent years. This study aimed to measure the current level of risk of breast cancer among females in Basrah and to describe the time trend over almost a decade of years. Data on breast cancer cases from all sources of cancer registration in Basrah governorate were compiled for the years 2005-2012. The data for each year were first checked separately for duplicate reporting of cases among various sources. Then the eight files were pooled together and checked again for any duplicate cases among years of registration. The final set of data contained 2,284 cases of breast cancer (2,213 female cases and 71 male cases). All patients were inhabitants of Basrah governorate at the time of diagnosis. Figures on the Basrah population were obtained from various sources including the Ministry of Health, Ministry of Planning and Developmental Collaboration and local household surveys. It was possible to have total population estimates for each year and by age and sex. The data were imported into SPSS (version 17) software. Age specific and year specific incidence rates were calculated. The age standardized incidence rate was also calculated using world population as the standard population to be 34.9 per 100,000 females. Age-wise, no case was reported among children aged less than 15 years and the incidence increased with advancing age reaching a peak of 123.8/100,000 females at the age range of 50-54 years. The time trend of the crude incidence rate showed only modest increased risk with passage of years and no age shift could be documented in this study. Breast cancer in females in Basrah is a significant health problem. The current incidence rate (crude, 23.7/100,000, age-standardized, 34.9/100,000) is high and justifies intensive efforts to improve early detection of cases, provide better treatment amenities and introduce long term preventive measures. Using the age standardized incidence rate as reported in this paper, it is possible to put the risk in Basrah within a regional and international context.

Using standardized patients to assess the communication skills of graduating physicians for the comprehensive osteopathic medical licensing examination (COMLEX) level 2-performance evaluation (level 2-PE).

PubMed

Weidner, Angela C; Gimpel, John R; Boulet, John R; Solomon, Mia

2010-01-01

Standardized patients can be trained to assess the communication and interpersonal skills of medical students and graduates. The purpose of this study is to present data to support the psychometric adequacy of the communication ratings provided by standardized patients. Using the data from testing of 3, 450 examinees over a 1-year period, a number of psychometric analyses were undertaken. These included a variance component analysis, the calculation of various validity coefficients, the comparison of communication ratings for select examinee cohorts and case characteristics, and the investigation of some potential sources of score invalidity. Communication skills scores are moderately correlated to other competencies (knowledge, skills) and may be influenced by candidate characteristics such as gender and English language proficiency. They are not dependant on the age of the examinees, the clinical case content, or the gender of the standardized patients. For a multistation assessment, a reasonably precise and valid estimate of a candidate's communication ability can be obtained from trained standardized patients.

49 CFR 1111.9 - Procedural schedule in cases using simplified standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION... the simplified standards: (1) In cases relying upon the Simplified-SAC methodology: Day 0—Complaint... dominance. (b) Defendant's second disclosure. In cases using the Simplified-SAC methodology, the defendant...

Standardized classification unsuitable for spontaneous reporting: the example of osteonecrosis of the jaw.

PubMed

de Boissieu, Paul; Trenque, Thierry

2015-07-01

This study assessed the impact of using a standardized definition of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the analysis of a spontaneous reporting database. All notifications of osteonecrosis of the jaw (ONJ) in the French National Pharmacovigilance Database as of 31 December 2013 were analyzed. First, we considered all reports of ONJ with bisphosphonates as BRONJ. Second, we applied the 2014 definition of BRONJ from the American Association of Oral and Maxillofacial Surgeons (AAOMS), retaining only bisphosphonates as antiresorptive medication. In the absence of any one of these criteria, or missing data, cases were not considered as BRONJ. The first analysis found 158 cases of ONJ, among which 153 were associated with bisphosphonate use. The second analysis identified only 43 cases of BRONJ (28.1%). The definition of BRONJ as laid down by the AAOMS is not suitable for use in spontaneous reporting database. The use of the AAOMS definition alone should be avoided, as it leads to the exclusion of over 70% of cases. When cases of ONJ are identified, all results should be presented including confirmed and excluded cases.

Meeting Common Core English Language Arts and English Language Development Standards with Character Education Lesson Plans in Alternative Education Grades 9 through 12

ERIC Educational Resources Information Center

Hoedel, Joseph M.; Lee, Robert E.

2016-01-01

This is a case study in which the Character Development and Leadership Program replaced an alternative high school's traditional English language offerings. A triangulated case study used student records, field notes, and interviews of stakeholders to compare the academic year prior to this substitution and the 2 academic years following it. All 3…

Cause and motivation in cases of non-fatal drug overdoses in opiate addicts.

PubMed

Pfab, R; Eyer, F; Jetzinger, E; Zilker, Thomas

2006-01-01

Drug overdose (OD) is a frequent incident among opiate addicts. Survivors of ODs are at risk for additional and eventually fatal ODs. ODs may be classified as accidental (aOD) or deliberate (dOD). Investigations into the connection between OD and suicide attempts have led to insconsistent results. (1) to determine how many non-fatal ODs were dODs and how many were aODs; (2) to determine how many cases of dODs were motivated by explicit or by ambivalent suicidal intentions; (3) to determine how many cases of aODs had causes that might respond to preventative measures; (4) to compare the addiction histories of dODs and aODs; (5) to compare the drugs causing the ODs; and (6) to compare the severity of the ODs in both groups. Prospective study utilizing a standardized questionnaire to evaluate opiate-addicted patients admitted to our treatment unit for OD. All cases underwent standardized drug testing to identify drug use patterns. Seventy-four cases of OD underwent standardized interviews after awakening. Forty-three percent of the cases were dOD. Cases of dOD had significantly more OA in substitution programs, more previous ODs, and more often consumed methadone and cocaine. Among dODs, 22.5% had suicidal intention and 9.6% were ambivalent about committing suicide; background motivations were most often conflicts with spouses. Fifty-seven percent of the cases were aOD. Cases of aODs had significantly more potential lethal intoxications and had heroin detected more frequently. aODs happened with unexpected pure heroin (46%), in combination with alcohol (36%), as relapse after abstinence (40%) or after institutionalized treatment (19%). This group should be accessible for targeted education.

Evaluation of mycobactericidal activity of selected chemical disinfectants and antiseptics according to European standards

PubMed Central

Bocian, Ewa; Grzybowska, Wanda; Tyski, Stefan

2014-01-01

Background The history of the investigation of standardized mycobactericidal activity of disinfectants and antiseptics is not very long. There is growing interest among the manufacturers of disinfectants in carrying out research on the antimicrobial activities in accordance with European standards (EN). This research could facilitate the introduction of high-quality disinfectants to the market. The aim of this study was to evaluate the mycobactericidal activity of selected chemical disinfectants and antiseptics used in the medical and veterinary fields. Material/Methods This study included 19 products submitted to the National Medicines Institute in Poland for evaluation of mycobactericidal activity. These products contain in their composition active substances belonging to different chemical groups, including aldehydes, alcohols, amines, quaternary ammonium compounds, phenols, guanidine, and oxidizing compounds. This study, conducted according to the manufacturers’ description of the preparations, was carried out in accordance with European standards, which also met the Polish standards: PN-EN 14204: 2013, PN-EN 14348: 2006, and PN-EN 14563: 2012. Results Tested products for disinfection and antiseptics containing active substances from different chemical groups showed high mycobactericidal activity and met the requirements of the appropriate European standards in most cases. In the case of products containing guanidine and amine compounds, the concentration of active ingredients used in the test and the test conditions specified by the manufacturer did not provide the mycobactericidal activity required by the standards. Conclusions Prior to the launch of a new product on the market, it is important to establish the appropriate usage and testing conditions of the preparation, such as its practical concentration, contact time, and environment condition (clean or dirty). PMID:24755666

Population-based stroke survey in Mumbai, India: incidence and 28-day case fatality.

PubMed

Dalal, P M; Malik, S; Bhattacharjee, M; Trivedi, N D; Vairale, J; Bhat, P; Deshmukh, S; Khandelwal, K; Mathur, V D

2008-01-01

The aims of this study were (1) to establish a prospective community-based stroke registry in Mumbai of subjects having 'first-ever stroke' (FES) and (2) to collect standardized data on annual incidence, stroke subtypes, and case fatality rate at 28 days during the years 2005 and 2006. An estimated 5.8 million people died from stroke (cerebrovascular disease) in 2005, two thirds of them were from low-/middle-income countries but reliable population-based studies are scarce. The manual on WHO STEPwise approach to stroke surveillance (STEPS Stroke; http://www.who.int/chp/steps/Manual pdf) was the operational protocol. We selected a well-defined community (H-district) having verifiable census data and being representative of the population structure of Mumbai (Bombay). Of 337,391 permanent residents, 156,861 persons between the age of 25 and 94+ years who were eligible for survey were screened. The responses to a predefined questionnaire (version 2.0) were entered in coded data sheets for analysis. During the 2-year study period (January 2005 to December 2006), 456 (238 males and 218 females) had FES, indicating an annual incidence in subjects of 25 years and above of 145/100,000 persons (CI 95%: 120-170); for males it is 149/100,000 persons (CI 95%: 120-170) and for females it is 141/100,000 persons (CI 95%: 120-160). The age-standardized rate for study population (both sexes) by the direct method using Segi's 1996 world population is 152/100,000/year (CI 95%: 132-172). Stroke diagnosis was supported by computed tomography in 407 (89.2%) of 456 FES cases: 366 (80.2%) had ischemic stroke, 81 (17.7%) had hemorrhagic stroke and 9 (1.9%) were in the unspecified category. The mean age was 66 +/- (SD) 13.60 years, women were older as compared to men (mean age 68.9 +/- 13.12 years vs. 63.4 +/- 13.53 years). Case fatality: at 28 days, 320 (70%) of 456 FES cases were still alive and 136 (29.8%) had died. Of the 320 surviving patients 38.5% had moderate to severe disability by the modified Rankin scale. The results of Mumbai stroke study, using uniform definitions and methodologies, show that the annual standardized incidence rates, stroke subtypes and case fatality rate are very similar to those reported from developed nations. To plan effective intervention and prevention strategies, standardized data in representative samples of regional populations are urgently needed. Copyright 2008 S. Karger AG, Basel.

Choosing the Standard of Care in Private Individual Defamation Cases.

ERIC Educational Resources Information Center

Caudill, Susan

1989-01-01

Examines private individual defamation cases that include discussion of whether the reasonably prudent publisher/editor or the reasonably prudent person should set the standard of care when negligence is at issue. Considers the implication of judicial reasoning in adopting one standard of care rather than the other. (RS)

Inquiry Teaching in High School Chemistry Classrooms: The Role of Knowledge and Beliefs

NASA Astrophysics Data System (ADS)

Roehrig, Gillian H.; Luft, Julie A.

2004-10-01

"Science as inquiry" is a key content standard in the National Science Education Standards, yet implementation of inquiry-based teaching is rare in secondary chemistry classrooms. This paper is the result of a study conducted to understand factors that effect the inquiry-based instruction of ten novice secondary chemistry teachers. The study focused on the influence of teaching beliefs and content knowledge on the instructional practices of these ten teachers. Case and cross-case comparisons revealed that chemistry teachers' intentions to implement inquiry teaching were strongly influenced by their teaching beliefs rather than their knowledge of chemistry. The quality of inquiry lessons, however, was found to depend on the teachers' knowledge of chemistry content. This study reinforces the need for chemistry-focused inservice training for beginning chemistry teachers that focuses on both inquiry teaching strategies and teaching beliefs.

CONTROL FUNCTION ASSISTED IPW ESTIMATION WITH A SECONDARY OUTCOME IN CASE-CONTROL STUDIES.

PubMed

Sofer, Tamar; Cornelis, Marilyn C; Kraft, Peter; Tchetgen Tchetgen, Eric J

2017-04-01

Case-control studies are designed towards studying associations between risk factors and a single, primary outcome. Information about additional, secondary outcomes is also collected, but association studies targeting such secondary outcomes should account for the case-control sampling scheme, or otherwise results may be biased. Often, one uses inverse probability weighted (IPW) estimators to estimate population effects in such studies. IPW estimators are robust, as they only require correct specification of the mean regression model of the secondary outcome on covariates, and knowledge of the disease prevalence. However, IPW estimators are inefficient relative to estimators that make additional assumptions about the data generating mechanism. We propose a class of estimators for the effect of risk factors on a secondary outcome in case-control studies that combine IPW with an additional modeling assumption: specification of the disease outcome probability model. We incorporate this model via a mean zero control function. We derive the class of all regular and asymptotically linear estimators corresponding to our modeling assumption, when the secondary outcome mean is modeled using either the identity or the log link. We find the efficient estimator in our class of estimators and show that it reduces to standard IPW when the model for the primary disease outcome is unrestricted, and is more efficient than standard IPW when the model is either parametric or semiparametric.

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

PubMed

King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.

Writing to the Common Core: Teachers' Responses to Changes in Standards and Assessments for Writing in Elementary Schools

ERIC Educational Resources Information Center

Wilcox, Kristen Campbell; Jeffery, Jill V.; Gardner-Bixler, Andrea

2016-01-01

This multiple case study investigated how the Common Core State Standards (CCSS) for writing and teacher evaluation system based in part on CCSS assessments might be influencing writing instruction in elementary schools. The sample included nine schools: Six achieved above-predicted performance on English Language Arts (ELA) as well as prior ELA…

Equity for Cities in School Finance Reform: A Case for an "Equal Educational Offering" Standard in Public Education.

ERIC Educational Resources Information Center

Silard, John; And Others

In this study, focus is upon the question of the standard for educational expenditure rather than on the alternative taxing methods for securing school district funding equalization. Chapter I begins by examining the major issues vital to urban education which the "Serrano" principle leaves unresolved. Then in Chapter II, particular elements of…

Examining Perceptions over the Effectiveness of Professional Development and Available Resources on the Common Core State Standards Implementation in Arkansas

ERIC Educational Resources Information Center

Sheppard, Julie Trammell

2013-01-01

The purpose of this qualitative case study is to examine the perceptions of teachers and curriculum specialists over the effectiveness of professional development and available resources of the Common Core State Standards (CCSS) implementation process in Arkansas. Arkansas divided the implementation process into three stages: Phase I implemented…

A Qualitative Case Study of the Congruence between Fraternal Organizations' and Members' Values, Principles, and Standards

ERIC Educational Resources Information Center

Lizza, Joseph P.

2017-01-01

Fraternal organizations are unique in how their very existence is routed in their espoused values, principles, and standards. These ideals spotlight what their organization was founded upon, and how those who associate themselves with the organization should conduct themselves. There are few instances where an organization is forced to be as…

FireSmart®-ForestWise: Managing Wildlife and Wildfire Risk in the Wildland/Urban Interface-a Canadian Case Study

Treesearch

Alan Westhaver; Richard D. Revel; Brad C. Hawkes

2007-01-01

Reducing the risk of losses from wildfires that threaten homes and communities is a growing priority in Canada. To reduce risk, “FireSmart®” standards have been adopted nationwide for managing forest fuel. However, these standards largely disregard interests of wildlife and conservation of wildlife habitat – thus raising concerns...

Education under the Regime of PISA & Co.: Global Standards and Local Traditions in Conflict--The Case of Germany

ERIC Educational Resources Information Center

Münch, Richard

2014-01-01

Background: The PISA study (assessing the competences of 15-year-old students in their mother tongue, in mathematics and in natural sciences) deals with the benchmarking of the OECD member states when it comes to meeting globally defined educational standards. Transnational educational experts now form the most powerful group within the…

The Teacher as Examiner of L2 Oral Tests: A Challenge to Standardization

ERIC Educational Resources Information Center

Sundqvist, Pia; Wikström, Peter; Sandlund, Erica; Nyroos, Lina

2018-01-01

The present paper looks at the issue of standardization in L2 oral testing. Whereas external examiners are frequently used globally, some countries opt for test-takers' own teachers as examiners instead. In the present study, Sweden is used as a case in point, with a focus on the mandatory, high-stakes, summative, ninth-grade national test in…

Effect of policy-based bioenergy demand on southern timber markets: A case study of North Carolina

Treesearch

Robert C. Abt; Karen L. Abt; Frederick W. Cubbage; Jesse D. Henderson

2010-01-01

Key factors driving renewable energy demand are state and federal policies requiring the use of renewable feedstocks to produce energy (renewable portfolio standards) and liquid fuels (renewable fuel standards). However, over the next decade, the infrastructure for renewable energy supplies is unlikely to develop as fast as both policy- and market-motivated renewable...

Survey of Professional Ethics of Teachers in Institutions of Higher Education: Case Study of an Institution in Central China

ERIC Educational Resources Information Center

Zheng, Lou; Hui, Song

2005-01-01

The standard of professional ethics among teachers directly determines the educational standards of a school; they are an essential component of education. In order to clarify the current situation with regard to the professional ethics of teachers in institutions of higher education, this article analyzes how society evaluates those ethics and…

The Opposite Intended Effect: A Case Study of How Over-Standardization Can Reduce Efficacy of Teacher Education

ERIC Educational Resources Information Center

Hughes, Bob

2004-01-01

The hyper-regulation of education (and most recently the teacher preparation component of education) thrives on the premise that any perceived deficiencies in the educational system can be alleviated by reducing differences among the ways in which people are educated and by demanding adherence to standards. In its impact, however, this…

The measures for achieving nZEB standard of retrofitted educational building for specific polish location - case study

NASA Astrophysics Data System (ADS)

Kwiatkowski, Jerzy; Mijakowski, Maciej; Trząski, Adrian

2017-11-01

Most of the EU member states have already set a definition of nZEB for new buildings and some of the countries also done it for existing buildings. As there is no definition of nZEB for existing buildings in Poland, the paper will include various considerations of such a standard. Next, a case study of educational building retrofitting to a proposed nZEB standard will be presented. The aim of the paper is to present what measures can be used in order to decrease energy consumption in existing building. The measures are divided into three parts: architectural and construction, installations and energy sources. Thus a complexity of the solutions are presented. As the nZEB standard is related to available energy sources, also an influence of local condition will be considered. Building chosen for analysis is located in an area under historic protection which makes the work even more difficult. It was proved that used solutions were chosen not only to reduce energy demand or increase energy production from renewable energy sources, but also to increase social and aesthetic features of the building.

Barriers to the widespread adoption of health data standards: an exploratory qualitative study in tertiary healthcare organizations in Saudi Arabia.

PubMed

Alkraiji, Abdullah; Jackson, Thomas; Murray, Ian

2013-04-01

Although health data standards are perceived to be the essential solution for interoperability barriers within medical IT systems, the level of adoption of those standards still remains frustratingly low. Little is known about the barriers facing their adoption within the healthcare organizations context. In addressing this gap in the literature, based on IT related standards adoption theories such as Diffusion of Innovation Theory and the theories surrounding the Economics of Standards, a qualitative multiple-case study was undertaken in Saudi Arabia to investigate those barriers. The results exposed that few standards were adopted because of four broad reasons, managerial, technical, educational and governmental. While some of the findings can be rooted to those related standards theories, others can be underpinned through the normative literature. Core barriers are the lack of a national regulator and a data exchange plan, and the lack of an adequate policy regarding medical IT systems and information management and national healthcare system; also important are technical barriers and the switching costs to the standards. The outcome of this study can be used in forming effective interventions when planning to use health data standards and, in particular those in developing countries.

Effect of transsphenoidal surgery and standard care on fertility related indicators of patients with prolactinomas during child-bearing period

PubMed Central

Yan, Zhiyue; Wang, Yiming; Shou, Xuefei; Su, Jianguang; Lang, Liwei

2015-01-01

Objective: To explore the surgical therapeutic effects in the endocrine and reproductive system of women with prolactinoma at child-bearing age, and to investigate the potential influencing factors for therapeutic outcome. Methods: This retrospective study was performed using the medical records of 99 cases of female patients with pituitary PRL adenomas at child-bearing age, who underwent transsphenoidal surgery and took standard perioperative care from January, 2013 to June, 2013 in Huashan hospital, in which micro adenoma (≤1 cm) of 68 cases, large adenomas (> 1 cm) of 31 cases, 88 cases were total resection, 9 cases were subtotal resection, and 2 cases were massive resection. Retrospective study on the preoperative serum level of PRL, menstruation, galactorrhea and reproductive function, etc. Patients were followed up in 1, 3, 6 and 12 months after operation for endocrine indicators, the situation of menstruation and pregnancy. Results: Overall, 88.9%, 9.1%, and 2% patients underwent total, subtotal, and massive resection of prolactinoma in 99 cases of patients. Before accepting transsphenoidal surgery and standard care, all 99 cases with serum PRL level higher than normal 25 ng/ml, 71.7% (71 cases, all total resection) patients had their serum PRL < 25 ng/ml on the first day after surgery, and micro adenomas remission rate of 80.9% (55 cases) was significantly higher than 51.6% of large adenomas (16 cases) (P < 0.05); the postoperative PRL of 11 cases of total or massive resection in patients were not back to normal, Chi-square test results showed that the PRL remission rate after total resection were significantly higher than that of subtotal or massive resection (P < 0.01). 67.3% (66/98) irregular menstruation patients had menstruation recovery after surgery, in addition, total resection of the tumor, micro- adenoma, preoperative PRL < 200 ng/ml and first day of postoperative PRL ≤25 ng/ml were favorable factors for menstrual improvement (P < 0.05). 83.6% (51/61) of patients with galactorrhea symptoms got alliviated after surgery, but had no association to the types of tumor (P > 0.05). 14 patients out of 17 infertility patients got pregnant after surgery. Conclusion: Transsphenoidal operation combining standardized nursing measures is an effective way to treat pituitary PRL adenoma, and it has high cure rate on abnormal menstruation caused by pituitary PRL adenoma which can recover the fertility of female patients. The preoperative serum level of prolactin could be used as an indicator for postoperative improvement in the endocrine system. The serum level of prolactin on the first day after operation could accurately reflect prognosis, so be regarded as one of the assessment factors for surgical therapeutic effect. PMID:26885105

Effect of transsphenoidal surgery and standard care on fertility related indicators of patients with prolactinomas during child-bearing period.

PubMed

Yan, Zhiyue; Wang, Yiming; Shou, Xuefei; Su, Jianguang; Lang, Liwei

2015-01-01

To explore the surgical therapeutic effects in the endocrine and reproductive system of women with prolactinoma at child-bearing age, and to investigate the potential influencing factors for therapeutic outcome. This retrospective study was performed using the medical records of 99 cases of female patients with pituitary PRL adenomas at child-bearing age, who underwent transsphenoidal surgery and took standard perioperative care from January, 2013 to June, 2013 in Huashan hospital, in which micro adenoma (≤1 cm) of 68 cases, large adenomas (> 1 cm) of 31 cases, 88 cases were total resection, 9 cases were subtotal resection, and 2 cases were massive resection. Retrospective study on the preoperative serum level of PRL, menstruation, galactorrhea and reproductive function, etc. Patients were followed up in 1, 3, 6 and 12 months after operation for endocrine indicators, the situation of menstruation and pregnancy. Overall, 88.9%, 9.1%, and 2% patients underwent total, subtotal, and massive resection of prolactinoma in 99 cases of patients. Before accepting transsphenoidal surgery and standard care, all 99 cases with serum PRL level higher than normal 25 ng/ml, 71.7% (71 cases, all total resection) patients had their serum PRL < 25 ng/ml on the first day after surgery, and micro adenomas remission rate of 80.9% (55 cases) was significantly higher than 51.6% of large adenomas (16 cases) (P < 0.05); the postoperative PRL of 11 cases of total or massive resection in patients were not back to normal, Chi-square test results showed that the PRL remission rate after total resection were significantly higher than that of subtotal or massive resection (P < 0.01). 67.3% (66/98) irregular menstruation patients had menstruation recovery after surgery, in addition, total resection of the tumor, micro- adenoma, preoperative PRL < 200 ng/ml and first day of postoperative PRL ≤25 ng/ml were favorable factors for menstrual improvement (P < 0.05). 83.6% (51/61) of patients with galactorrhea symptoms got alliviated after surgery, but had no association to the types of tumor (P > 0.05). 14 patients out of 17 infertility patients got pregnant after surgery. Transsphenoidal operation combining standardized nursing measures is an effective way to treat pituitary PRL adenoma, and it has high cure rate on abnormal menstruation caused by pituitary PRL adenoma which can recover the fertility of female patients. The preoperative serum level of prolactin could be used as an indicator for postoperative improvement in the endocrine system. The serum level of prolactin on the first day after operation could accurately reflect prognosis, so be regarded as one of the assessment factors for surgical therapeutic effect.

Applying a Genetic Algorithm to Reconfigurable Hardware

NASA Technical Reports Server (NTRS)

Wells, B. Earl; Weir, John; Trevino, Luis; Patrick, Clint; Steincamp, Jim

2004-01-01

This paper investigates the feasibility of applying genetic algorithms to solve optimization problems that are implemented entirely in reconfgurable hardware. The paper highlights the pe$ormance/design space trade-offs that must be understood to effectively implement a standard genetic algorithm within a modem Field Programmable Gate Array, FPGA, reconfgurable hardware environment and presents a case-study where this stochastic search technique is applied to standard test-case problems taken from the technical literature. In this research, the targeted FPGA-based platform and high-level design environment was the Starbridge Hypercomputing platform, which incorporates multiple Xilinx Virtex II FPGAs, and the Viva TM graphical hardware description language.

High prevalence of the c.74A>C SPINK1 variant in miniature and standard Schnauzers.

PubMed

Furrow, E; Armstrong, P J; Patterson, E E

2012-01-01

Variants in the serine protease inhibitor Kazal type 1 (SPINK1) gene have been associated with pancreatitis in Miniature Schnauzers. Replication of the association in an independent population is necessary to determine if genetic screening for SPINK1 variants should be considered in clinical practice. An association between the SPINK1 exonic variant c.74A > C and pancreatitis exists in Miniature Schnauzers. In addition, the variant is absent or rare in Standard Schnauzers, a related breed that is not reported to have an increased risk for pancreatitis. Case-control study. Seventeen Miniature Schnauzers with pancreatitis (cases), 60 mature Miniature Schnauzers with no substantial history of gastrointestinal signs in their lifetime (controls), and 31 Standard Schnauzers of unknown pancreatitis status. A PCR-RFLP assay was used to genotype dogs for the c.74A > C SPINK1 variant. Allele and genotype frequencies were reported for Schnauzers and compared between case and control Miniature Schnauzers. The c.74A > C variant was the major allele in both Schnauzer breeds with a frequency of 0.77 in Miniatures and 0.55 in Standards. The allele and genotype frequencies were similar between Miniature Schnauzers with and without a history of pancreatitis and did not impart an increased risk for pancreatitis. Genotyping a larger population of the Miniature Schnauzer breed than a previous study, along with a Standard Schnauzer cohort, demonstrated that the SPINK1 c.74A > C variant is a common polymorphism in the Schnauzer lineage. Furthermore, we were unable to confirm a relationship between the variant and clinically detectable pancreatitis in Miniature Schnauzers. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Introducing a design exigency to promote student learning through assessment: A case study.

PubMed

Grealish, Laurie A; Shaw, Julie M

2018-02-01

Assessment technologies are often used to classify student and newly qualified nurse performance as 'pass' or 'fail', with little attention to how these decisions are achieved. Examining the design exigencies of classification technologies, such as performance assessment technologies, provides opportunities to explore flexibility and change in the process of using those technologies. Evaluate an established assessment technology for nursing performance as a classification system. A case study analysis that is focused on the assessment approach and a priori design exigencies of performance assessment technology, in this case the Australian Nursing Standards Assessment Tool 2016. Nurse assessors are required to draw upon their expertise to judge performance, but that judgement is described as a source of bias, creating confusion. The definition of satisfactory performance is 'ready to enter practice'. To pass, the performance on each criterion must be at least satisfactory, indicating to the student that no further improvement is required. The Australian Nursing Standards Assessment Tool 2016 does not have a third 'other' category, which is usually found in classification systems. Introducing a 'not yet competent' category and creating a two-part, mixed methods assessment process can improve the Australian Nursing Standards Assessment Tool 2016 assessment technology. Using a standards approach in the first part, judgement is valued and can generate learning opportunities across a program. Using a measurement approach in the second part, student performance can be 'not yet competent' but still meet criteria for year level performance and a graded pass. Subjecting the Australian Nursing Standards Assessment Tool 2016 assessment technology to analysis as a classification system provides opportunities for innovation in design. This design innovation has the potential to support students who move between programs and clinicians who assess students from different universities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards.

PubMed

Handrakis, John P; Trbovich, Michelle; Hagen, Ellen Merete; Price, Michael

2017-01-01

The ability to maintain core body temperature (Tcore) within a narrow range (37 ± 0.6 °C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction. Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion. The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.

Self-Management for Primary School Students Demonstrating Problem Behavior in Regular Classrooms: Evidence Review of Single-Case Design Research

ERIC Educational Resources Information Center

Busacca, Margherita L.; Anderson, Angelika; Moore, Dennis W.

2015-01-01

This review evaluates self-management literature targeting problem behaviors of primary school students in general education settings. Thirty-one single-case design studies met inclusion criteria, of which 16 demonstrated adequate methodological rigor, according to What Works Clearinghouse (WWC) design standards. Visual analysis and WWC…

Leading for Instructional Improvement in the Context of Accountability: Central Office Leadership

ERIC Educational Resources Information Center

Rigby, Jessica Goodman; Corriell, Rebecca; Kuhl, Katie J.

2018-01-01

This case was written to help prepare central office leaders who are expected to design systems and lead toward instructional improvement in the context of both educational accountability and implementation of standards with increased rigor. The intent of this case study is to encourage educators to examine the complex and multiple challenges of…

Acute pesticide poisoning among children in South Korea: findings from National Health Insurance claims data, 2006-2009.

PubMed

Lee, Won Jin; Ko, Yousun; Cha, Eun Shil

2014-02-01

The aim of this study was to estimate the incidence of acute pesticide poisoning among children in South Korea and describe the related epidemiologic characteristics. We evaluated the age-standardized rates of incidence of pesticide poisoning among children in South Korea from 2006 through 2009 using National Health Insurance claims data. A total of 1232 children aged 0-14 years were identified from the acute pesticide poisoning cases reported across South Korea during the study period. The annual average age-standardized rate of incidence from acute pesticide poisoning was 3.6 per 100 000. The majority of the cases were identified in the categories of the 1-4-year-old age-group (56.5%), outpatients (80.0%), single-day visit to a hospital (70.4%) and summer occurrence (43.3%). Acute pesticide poisoning is prevalent among children in South Korea; therefore, intervention efforts are needed to reduce the cases of pesticide poisoning among children.

Small laser spot versus standard laser spot photodynamic therapy for idiopathic choroidal neovascularization: a randomized controlled study.

PubMed

Li, Xiao-xin; Tao, Yong

2012-12-01

Idiopathic choroidal neovascularization (ICNV) affects young patients and thus may have a significant impact on vision and life quality over a patient's lifespan. This study was designed to compare the visual outcome and retinal pigment epithelium (RPE) damage after photodynamic therapy (PDT) with small laser spot and PDT with standard laser spot for idiopathic choroidal neovascularization (ICNV). This was a randomized controlled study. Fifty-two patients with ICNV were enrolled and randomly divided into a study group (small laser spot PDT, n = 27) and a control group (standard laser spot PDT, n = 25). Best corrected visual acuity (BCVA), optic coherence tomography (OCT) and fluorescein angiography (FA) findings were the main measurements. The patients were followed up 1 week, 1, 3, 6, 9 months and 1 year after PDT. BCVA improvement was statistically significantly higher in the study group than the control group at 6-month ((25.53 ± 15.01) letters vs. (14.71 ± 11.66) letters, P = 0.025) and 9-month follow-ups ((27.53 ± 17.78) letters vs. (15.59 ± 12.21) letters, P = 0.039). At 3- and 6-month follow-ups, the quadrants of RPE damage between the two groups varied significantly (P < 0.001 and P = 0.023, respectively). In each follow-up, the number of cases with decreased or unchanged leakage of choroidal neovascularization by FA and reduced subretinal fluid by OCT did not vary significantly between the two groups. Ten cases (37.0%) in the study group and eight cases (32.0%) in the control group suffered from recurrent CNV (P = 0.703). Better visual improvements, less RPE damage, a similar recurrent rate of CNV and change of subretinal fluid were observed in the small laser spot PDT group than in the standard laser spot PDT group for ICNV.

Variation in worldwide incidence of amyotrophic lateral sclerosis: a meta-analysis.

PubMed

Marin, Benoît; Boumédiene, Farid; Logroscino, Giancarlo; Couratier, Philippe; Babron, Marie-Claude; Leutenegger, Anne Louise; Copetti, Massimilano; Preux, Pierre-Marie; Beghi, Ettore

2017-02-01

To assess the worldwide variation of amyotrophic lateral sclerosis (ALS) incidence, we performed a systematic review and meta-analysis of population-based data published to date. We reviewed Medline and Embase up to June 2015 and included all population-based studies of newly diagnosed ALS cases, using multiple sources for case ascertainment. ALS crude and standardized incidence (on age and sex using the US 2010 population) were calculated. Random effect meta-analysis and meta-regression were performed using the subcontinent as the main study level covariate. Sources of heterogeneity related to the characteristics of the study population and the study methodology were investigated. Among 3216 records, 44 studies were selected, covering 45 geographical areas in 11 sub-continents. A total of 13 146 ALS cases and 825 million person-years of follow-up (PYFU) were co-nsidered. The overall pooled worldwide crude ALS incidence was at 1.75 (1.55-1.96)/100 000 PYFU; 1.68 (1.50-1.85)/100 000 PYFU after standardization. Heterogeneity was identified in ALS standardized incidence between North Europe [1.89 (1.46-2.32)/100 000 PYFU] and East Asia [0.83 (0.42-1.24)/100 000 PYFU, China and Japan P = 0.001] or South Asia [0.73 (0.58-0.89)/100 000/PYFU Iran, P = 0.02]. Conversely, homogeneous rates have been reported in populations from Europe, North America and New Zealand [pooled ALS standardized incidence of 1.81 (1.66-1.97)/100 000 PYFU for those areas]. This review confirms a heterogeneous distribution worldwide of ALS, and sets the scene to sustain a collaborative study involving a wide international consortium to investigate the link between ancestry, environment and ALS incidence. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

Toward the Development of Reporting Standards for Evaluations

ERIC Educational Resources Information Center

Montrosse-Moorhead, Bianca; Griffith, James C.

2017-01-01

This article first makes a case for the need to establish evaluation reporting standards, support for which is rooted in the growing demand for professionalization, in the growing meta evaluation literature, and in growing efforts to develop reporting standards for inquiry efforts. Then, a case is made for a particular set of such standards…

Automated microaneurysm detection method based on double ring filter in retinal fundus images

NASA Astrophysics Data System (ADS)

Mizutani, Atsushi; Muramatsu, Chisako; Hatanaka, Yuji; Suemori, Shinsuke; Hara, Takeshi; Fujita, Hiroshi

2009-02-01

The presence of microaneurysms in the eye is one of the early signs of diabetic retinopathy, which is one of the leading causes of vision loss. We have been investigating a computerized method for the detection of microaneurysms on retinal fundus images, which were obtained from the Retinopathy Online Challenge (ROC) database. The ROC provides 50 training cases, in which "gold standard" locations of microaneurysms are provided, and 50 test cases without the gold standard locations. In this study, the computerized scheme was developed by using the training cases. Although the results for the test cases are also included, this paper mainly discusses the results for the training cases because the "gold standard" for the test cases is not known. After image preprocessing, candidate regions for microaneurysms were detected using a double-ring filter. Any potential false positives located in the regions corresponding to blood vessels were removed by automatic extraction of blood vessels from the images. Twelve image features were determined, and the candidate lesions were classified into microaneurysms or false positives using the rule-based method and an artificial neural network. The true positive fraction of the proposed method was 0.45 at 27 false positives per image. Forty-two percent of microaneurysms in the 50 training cases were considered invisible by the consensus of two co-investigators. When the method was evaluated for visible microaneurysms, the sensitivity for detecting microaneurysms was 65% at 27 false positives per image. Our computerized detection scheme could be improved for helping ophthalmologists in the early diagnosis of diabetic retinopathy.

A study on the protective activity of kefir against gastric ulcer.

PubMed

Orhan, Yahya T; Karagözlü, Cem; Sarioğlu, Sülen; Yilmaz, Osman; Murat, Nergiz; Gıdener, Sedef

2012-08-01

The effect of kefir on peptic ulcer disease was evaluated in an experimental model, with non-steroid anti-inflammatory drugs, together with the determination of gastric mucus secretion by quantitative digital histochemistry. The experimental group included 28 male albino Wistar rats. After a diet with standard rat bait for 7 days, 14 rats were fed with kefir for 7 days while the others were kept on the same diet. At the 14th day, indomethacin was injected to 7 of the rats fed on kefir and to 7 of the rats on standard rat bait. All the rats were sacrificed after 4 hours. Gastric erosion and ulceration were scored histopathologically. Mucosal mucus was quantified by image analysis, and periodic acid-Schiff stained area percentage was determined. Erosion and ulceration were identified only in cases that received indomethacin. In the cases on kefir, erosion was identified in 6 cases (86%) and ulceration in 1 case. Rats fed on standard diet had erosion in 4 cases (57%) and ulceration in 3 (43%), but the difference was statistically insignificant (Mann-Whitney test, p=0.25). The stained area percentage for gastric mucus was not different between the four groups (Kruskal-Wallis test, p=0.313). These findings suggest that kefir does not change gastric mucus secretion. Although statistically insignificant, as there were more cases with ulceration in cases on the rat diet, kefir might have a beneficial effect on peptic ulcer disease induced by non-steroid anti-inflammatory drug. This requires further evaluation in larger series.

Learning from Adverse Events in Obstetrics: Is a Standardized Computer Tool an Effective Strategy for Root Cause Analysis?

PubMed

Murray-Davis, Beth; McDonald, Helen; Cross-Sudworth, Fiona; Ahmed, Rashid; Simioni, Julia; Dore, Sharon; Marrin, Michael; DeSantis, Judy; Leyland, Nicholas; Gardosi, Jason; Hutton, Eileen; McDonald, Sarah

2015-08-01

Adverse events occur in up to 10% of obstetric cases, and up to one half of these could be prevented. Case reviews and root cause analysis using a structured tool may help health care providers to learn from adverse events and to identify trends and recurring systems issues. We sought to establish the reliability of a root cause analysis computer application called Standardized Clinical Outcome Review (SCOR). We designed a mixed methods study to evaluate the effectiveness of the tool. We conducted qualitative content analysis of five charts reviewed by both the traditional obstetric quality assurance methods and the SCOR tool. We also determined inter-rater reliability by having four health care providers review the same five cases using the SCOR tool. The comparative qualitative review revealed that the traditional quality assurance case review process used inconsistent language and made serious, personalized recommendations for those involved in the case. In contrast, the SCOR review provided a consistent format for recommendations, a list of action points, and highlighted systems issues. The mean percentage agreement between the four reviewers for the five cases was 75%. The different health care providers completed data entry and assessment of the case in a similar way. Missing data from the chart and poor wording of questions were identified as issues affecting percentage agreement. The SCOR tool provides a standardized, objective, obstetric-specific tool for root cause analysis that may improve identification of risk factors and dissemination of action plans to prevent future events.

A case-based reasoning system based on weighted heterogeneous value distance metric for breast cancer diagnosis.

PubMed

Gu, Dongxiao; Liang, Changyong; Zhao, Huimin

2017-03-01

We present the implementation and application of a case-based reasoning (CBR) system for breast cancer related diagnoses. By retrieving similar cases in a breast cancer decision support system, oncologists can obtain powerful information or knowledge, complementing their own experiential knowledge, in their medical decision making. We observed two problems in applying standard CBR to this context: the abundance of different types of attributes and the difficulty in eliciting appropriate attribute weights from human experts. We therefore used a distance measure named weighted heterogeneous value distance metric, which can better deal with both continuous and discrete attributes simultaneously than the standard Euclidean distance, and a genetic algorithm for learning the attribute weights involved in this distance measure automatically. We evaluated our CBR system in two case studies, related to benign/malignant tumor prediction and secondary cancer prediction, respectively. Weighted heterogeneous value distance metric with genetic algorithm for weight learning outperformed several alternative attribute matching methods and several classification methods by at least 3.4%, reaching 0.938, 0.883, 0.933, and 0.984 in the first case study, and 0.927, 0.842, 0.939, and 0.989 in the second case study, in terms of accuracy, sensitivity×specificity, F measure, and area under the receiver operating characteristic curve, respectively. The evaluation result indicates the potential of CBR in the breast cancer diagnosis domain. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of a digital drainage system (Thopaz) in over 250 cases at a single site: A retrospective case-control study.

PubMed

Arai, Hiromasa; Tajiri, Michihiko; Kameda, Yohei; Shiino, Kimihisa; Ando, Kohei; Okudela, Koji; Masuda, Munetaka

2018-04-01

The aim of this study was to evaluate the efficacy of the Thopaz system, a new drainage system in management of general thoracic surgery, based on a review of our clinical practice and a comparison of the utility of the Thopaz device compared with a standard drainage system. A review of 540 thoracic surgeries at our hospital was performed. These cases were divided into 275 treated with the Thopaz system from April 2014 to March 2015 and 265 treated with a standard system from April 2013 to March 2014. The characteristics of patients and outcomes after surgery were compared in these 2 groups. The characteristics of the patients were similar in the 2 groups. Outcomes after surgery, including types of operation, period of chest tube placement, chest tube reinsertion rate and clamping test rate also did not differ significantly between the groups. The non-inferiority of the Thopaz system compared to a standard system was verified statistically. With advantages of providing objective data as a small portable system, in addition to the quietness of the unit and the ease of setup and operation, Thopaz system is likely to become mainstream in postoperative management in general thoracic surgery. © 2017 John Wiley & Sons Ltd.

Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

PubMed

Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

2017-05-01

Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

Use of standards in papers published in dental journals.

PubMed

Bona, Alvaro Della; Bello, Yuri Dal; Sartoretto, Suelen C

2012-01-01

This study evaluated the use de standards in papers published in Brazilian and international dental journals. Papers published from January 2006 to December 2010 in the following journals were examined: Brazilian Dental Journal (BDJ), Brazilian Oral Research (BOR), Journal of Applied Oral Sciences (JAOS), Journal of Dental Research (JDR) and Dental Materials (DM). In addition to the title and type of study, issue, volume and year of publication, the following information was recorded from each paper: identification of any standard reported in the study; in case of no reported standard, indication if a standard could be used in the study. A total of 3,046 papers were examined, being 937 from DM, 936 from JDR, 489 from JAOS, 348 from BDJ, and 336 from BOR. Considering the papers that could use some standard, DM showed the highest percentage (24.9%) of reporting standards/paper, followed by JAOS (10.3%), BOR (10.1%), BDJ (6.3%) and JDR (2.4%), meaning for example that, from 936 papers examined from the JDR, 623 could use some standard but only 15 papers reported them. From all papers examined, 309 (10.1%) reported using some standard. The ISO standards were mostly reported (57.8%), followed by ASTM standards (23.7%) and 74 (18.5%) standards from other international organizations (e.g. ADA and CIE). Despite of the high impact factors of the selected dental journals, their published papers could use standards more often. This study should assist journal editors to encourage authors to consult and refer to available standards to support the scientific papers.

Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem.

PubMed

Fritz, Peter; Dippon, Jürgen; Müller, Simon; Goletz, Sven; Trautmann, Christian; Pappas, Xenophon; Ott, German; Brauch, Hiltrud; Schwab, Matthias; Winter, Stefan; Mürdter, Thomas; Brinkmann, Friedhelm; Faisst, Simone; Rössle, Susanne; Gerteis, Andreas; Friedel, Godehard

2018-03-01

In this retrospective study, we compared breast cancer patients treated with and without mistletoe lectin I (ML-I) in addition to standard breast cancer treatment in order to determine a possible effect of this complementary treatment. This study included 18,528 patients with invasive breast cancer. Data on additional ML-I treatments were reported for 164 patients. We developed a "similar case" method with a distance measure retrieved from the beta variable in Cox regression to compare these patients, after stage adjustment, with their non-ML-1 treated counterparts in order to answer three hypotheses concerning overall survival, recurrence free survival and life quality. Raw data analysis of an additional ML-I treatment yielded a worse outcome (p=0.02) for patients with ML treatment, possibly due to a bias inherent in the ML-I-treated patients. Using the "similar case" method (a case-based reasoning approach) we could not confirm this harm for patients using ML-I. Analysis of life quality data did not demonstrate reliable differences between patients treated with ML-I treatment and those without proven ML-I treatment. Based on a "similar case" model we did not observe any differences in the overall survival (OS), recurrence-free survival (RFS), and quality of life data between breast cancer patients with standard treatment and those who in addition to standard treatment received ML-I treatment. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Understanding diagnostic variability in breast pathology: lessons learned from an expert consensus review panel

PubMed Central

Allison, Kimberly H; Reisch, Lisa M; Carney, Patricia A; Weaver, Donald L; Schnitt, Stuart J; O’Malley, Frances P; Geller, Berta M; Elmore, Joann G

2015-01-01

Aims To gain a better understanding of the reasons for diagnostic variability, with the aim of reducing the phenomenon. Methods and results In preparation for a study on the interpretation of breast specimens (B-PATH), a panel of three experienced breast pathologists reviewed 336 cases to develop consensus reference diagnoses. After independent assessment, cases coded as diagnostically discordant were discussed at consensus meetings. By the use of qualitative data analysis techniques, transcripts of 16 h of consensus meetings for a subset of 201 cases were analysed. Diagnostic variability could be attributed to three overall root causes: (i) pathologist-related; (ii) diagnostic coding/study methodology-related; and (iii) specimen-related. Most pathologist-related root causes were attributable to professional differences in pathologists’ opinions about whether the diagnostic criteria for a specific diagnosis were met, most frequently in cases of atypia. Diagnostic coding/study methodology-related root causes were primarily miscategorizations of descriptive text diagnoses, which led to the development of a standardized electronic diagnostic form (BPATH-Dx). Specimen-related root causes included artefacts, limited diagnostic material, and poor slide quality. After re-review and discussion, a consensus diagnosis could be assigned in all cases. Conclusions Diagnostic variability is related to multiple factors, but consensus conferences, standardized electronic reporting formats and comments on suboptimal specimen quality can be used to reduce diagnostic variability. PMID:24511905

[Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure].

PubMed

del Saz Moreno, Vicente; Alberquilla Menéndez-Asenjo, Ángel; Camacho Hernández, Ana M; Lora Pablos, David; Enríquez de Salamanca Lorente, Rafael; Magán Tapia, Purificación

2016-02-01

To determine if the process of care in primary health, affects the risk of avoidable hospitalizations for ambulatory care sensitive conditions (ACSH) for heart failure (HF). Case-control study analyzing the risk of hospitalization for HF. The exposure factor was the process of care for HF in primary health. Health area of the region of Madrid (n=466.901). There were included all adult patients (14 years or older) with a documented diagnosis of HF in the electronic medical record of primary health (n=3.277). The cases were patients who were hospitalized for HF while the controls did not require admission, during 2007. risk of ACSH for HF related to the process of care considered both overall and for each separate standard of appropiate care. Differences in clinical complexity of the groups were measured using the Adjusted Clinical Group (ACG) classification system. 227 cases and 3.050 controls. Clinical complexity was greater in cases. The standards of appropriate care were met to a greater degree in the control group, but none of the two groups met all the standards that would define a process of care as fully appropriate. A significantly lower risk of ACSH was seen for only two standards of appropriate care. For each additional standard of appropriate care not met, the probability of admission was significantly greater (OR: 1,33, 95% CI: 1,19-1,49). Higher quality in the process of care in primary health was associated with a lower risk of hospitalization for HF. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

The Upper Midwest Health Study: industry and occupation of glioma cases and controls.

PubMed

Ruder, Avima M; Waters, Martha A; Carreón, Tania; Butler, Mary A; Calvert, Geoffrey M; Davis-King, Karen E; Waters, Kathleen M; Schulte, Paul A; Mandel, Jack S; Morton, Roscoe F; Reding, Douglas J; Rosenman, Kenneth D

2012-09-01

Understanding glioma etiology requires determining which environmental factors are associated with glioma. Upper Midwest Health Study case-control participant work histories collected 1995-1998 were evaluated for occupational associations with glioma. "Exposures of interest" from our study protocol comprise our a priori hypotheses. Year-long or longer jobs for 1,973 participants were assigned Standard Occupational Classifications (SOC) and Standard Industrial Classifications (SIC). The analysis file includes 8,078 SIC- and SOC-coded jobs. For each individual, SAS 9.2 programs collated employment with identical SIC-SOC coding. Distributions of longest "total employment duration" (total years worked in jobs with identical industry and occupation codes, including multiple jobs, and non-consecutive jobs) were compared between cases and controls, using an industrial hygiene algorithm to group occupations. Longest employment duration was calculated for 780 cases and 1,156 controls. More case than control longest total employment duration was in the "engineer, architect" occupational group [16 cases, 10 controls, odds ratio (OR) 2.50, adjusted for age group, sex, age and education, 95% confidence interval (CI) 1.12-5.60]. Employment as a food processing worker [mostly butchers and meat cutters] was of borderline significance (27 cases, 21 controls, adjusted OR: 1.78, CI: 0.99-3.18). Among our exposures of interest work as engineers or as butchers and meat cutters was associated with increased glioma risk. Significant associations could be due to chance, because of multiple comparisons, but similar findings have been reported for other glioma studies. Our results suggest some possible associations but by themselves could not provide conclusive evidence. Copyright © 2012 Wiley Periodicals, Inc.

Letter-case information and the identification of brand names.

PubMed

Perea, Manuel; Jiménez, María; Talero, Fernanda; López-Cañada, Soraya

2015-02-01

A central tenet of most current models of visual-word recognition is that lexical units are activated on the basis of case-invariant abstract letter representations. Here, we examined this assumption by using a unique type of words: brand names. The rationale of the experiments is that brand names are archetypically printed either in lowercase (e.g., adidas) or uppercase (e.g., IKEA). This allows us to present the brand names in their standard or non-standard case configuration (e.g., adidas, IKEA vs. ADIDAS, ikea, respectively). We conducted two experiments with a brand-decision task ('is it a brand name?'): a single-presentation experiment and a masked priming experiment. Results in the single-presentation experiment revealed faster identification times of brand names in their standard case configuration than in their non-standard case configuration (i.e., adidas faster than ADIDAS; IKEA faster than ikea). In the masked priming experiment, we found faster identification times of brand names when they were preceded by an identity prime that matched its standard case configuration than when it did not (i.e., faster response times to adidas-adidas than to ADIDAS-adidas). Taken together, the present findings strongly suggest that letter-case information forms part of a brand name's graphemic information, thus posing some limits to current models of visual-word recognition. © 2014 The British Psychological Society.

Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.

PubMed

Sminkey, Patrice V; LeDoux, Jeannie

2016-01-01

The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.

Using InterWave Aberrometry to Measure and Improve the Quality of Vision in LASIK Surgery

PubMed Central

Thompson, Keith P.; Staver, P. Randall; Garcia, Jose R.; Burns, Stephen A.; Webb, Robert H.; Stulting, R. Doyle

2005-01-01

Objective To compare visual outcomes in eyes undergoing aberrometry-guided (InterWave) LASIK with those in eyes undergoing standard LASIK treatment based upon refractive measures. Design Single-center, comparative, interventional, consecutive case series. Participants Four hundred two consecutive eyes undergoing LASIK were analyzed retrospectively. One group, 106 eyes undergoing primary LASIK and 224 eyes undergoing LASIK enhancement, was treated with standard LASIK treatment using a 5.5-mm optical zone, 1.5-mm transition zone laser with the settings determined by manifest refraction. The second group, 44 untreated (primary) eyes and 28 previously treated (enhancement) eyes, received a multipass, multistage treatment in which the laser settings for each stage were determined by aberrometry measurements. Eyes with desired monovision (undercorrected) outcome and preoperative hyperopia were excluded from the study. Intervention An aberrometry-guided laser treatment (InterWave LASIK) was compared with the standard LASIK treatment based upon the manifest refraction. Main Outcome Measures Uncorrected visual acuity (VA), manifest refraction, best spectacle-corrected VA (BSCVA), severity of halos, and root mean square (RMS) retinal blur area measured at 3 months postoperatively. Results Three months postoperatively there was no difference in uncorrected VA, BSCVA, refraction, or RMS retinal blur areas for pupil sizes of 3.5 mm between eyes treated by InterWave and those treated by standard LASIK. However, InterWave LASIK reduced the retinal blur area by 48% (P<0.0103) and 58% (P<0.0004) in primary cases and 43% (P<0.0430) and 74% (P<0.0271) in enhancement cases, respectively, for pupil sizes of 4.5 and 6.5 mm relative to standard LASIK treatments. Patients undergoing InterWave-guided treatment reported less severity of halo (0.37 vs. 0.98 [P<0.016] for primary cases and 0.35 vs. 0.73 [P<0.04] for enhancement cases). Conclusion InterWave LASIK achieved acuity and refractive results equivalent to those of standard LASIK treatment based upon refraction, but resulted in superior quality mesopic vision. PMID:15234139

Early recurrence in standard-risk medulloblastoma patients with the common idic(17)(p11.2) rearrangement

PubMed Central

Bien-Willner, Gabriel A.; López-Terrada, Dolores; Bhattacharjee, Meena B.; Patel, Kayuri U.; Stankiewicz, Paweł; Lupski, James R.; Pfeifer, John D.; Perry, Arie

2012-01-01

Medulloblastoma is diagnosed histologically; treatment depends on staging and age of onset. Whereas clinical factors identify a standard- and a high-risk population, these findings cannot differentiate which standard-risk patients will relapse and die. Outcome is thought to be influenced by tumor subtype and molecular alterations. Poor prognosis has been associated with isochromosome (i)17q in some but not all studies. In most instances, molecular investigations document that i17q is not a true isochromosome but rather an isodicentric chromosome, idic(17)(p11.2), with rearrangement breakpoints mapping within the REPA/REPB region on 17p11.2. This study explores the clinical utility of testing for idic(17)(p11.2) rearrangements using an assay based on fluorescent in situ hybridization (FISH). This test was applied to 58 consecutive standard- and high-risk medulloblastomas with a 5-year minimum of clinical follow-up. The presence of i17q (ie, including cases not involving the common breakpoint), idic(17)(p11.2), and histologic subtype was correlated with clinical outcome. Overall survival (OS) and disease-free survival (DFS) were consistent with literature reports. Fourteen patients (25%) had i17q, with 10 (18%) involving the common isodicentric rearrangement. The presence of i17q was associated with a poor prognosis. OS and DFS were poor in all cases with anaplasia (4), unresectable disease (7), and metastases at presentation (10); however, patients with standard-risk tumors fared better. Of these 44 cases, tumors with idic(17)(p11.2) were associated with significantly worse patient outcomes and shorter mean DFS. FISH detection of idic(17)(p11.2) may be useful for risk stratification in standard-risk patients. The presence of this abnormal chromosome is associated with early recurrence of medulloblastoma. PMID:22573308

The role of standardized data and terminological systems in computerized clinical decision support systems: literature review and survey.

PubMed

Ahmadian, Leila; van Engen-Verheul, Mariette; Bakhshi-Raiez, Ferishta; Peek, Niels; Cornet, Ronald; de Keizer, Nicolette F

2011-02-01

Clinical decision support systems (CDSSs) should be seamlessly integrated with existing clinical information systems to enable automatic provision of advice at the time and place where decisions are made. It has been suggested that a lack of agreed data standards frequently hampers this integration. We performed a literature review to investigate whether CDSSs used standardized (i.e. coded or numerical) data and which terminological systems have been used to code data. We also investigated whether a lack of standardized data was considered an impediment for CDSS implementation. Articles reporting an evaluation of a CDSS that provided a computerized advice based on patient-specific data items were identified based on a former literature review on CDSS and on CDSS studies identified in AMIA's 'Year in Review'. Authors of these articles were contacted to check and complete the extracted data. A questionnaire among the authors of included studies was used to determine the obstacles in CDSS implementation. We identified 77 articles published between 1995 and 2008. Twenty-two percent of the evaluated CDSSs used only numerical data. Fifty one percent of the CDSSs that used coded data applied an international terminology. The most frequently used international terminology were the ICD (International Classification of Diseases), used in 68% of the cases and LOINC (Logical Observation Identifiers Names and Codes) in 12% of the cases. More than half of the authors experienced barriers in CDSS implementation. In most cases these barriers were related to the lack of electronically available standardized data required to invoke or activate the CDSS. Many CDSSs applied different terminological systems to code data. This diversity hampers the possibility of sharing and reasoning with data within different systems. The results of the survey confirm the hypothesis that data standardization is a critical success factor for CDSS development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Host model uncertainties in aerosol radiative forcing estimates: results from the AeroCom prescribed intercomparison study

NASA Astrophysics Data System (ADS)

Stier, P.; Schutgens, N. A. J.; Bian, H.; Boucher, O.; Chin, M.; Ghan, S.; Huneeus, N.; Kinne, S.; Lin, G.; Myhre, G.; Penner, J. E.; Randles, C.; Samset, B.; Schulz, M.; Yu, H.; Zhou, C.

2012-09-01

Simulated multi-model "diversity" in aerosol direct radiative forcing estimates is often perceived as measure of aerosol uncertainty. However, current models used for aerosol radiative forcing calculations vary considerably in model components relevant for forcing calculations and the associated "host-model uncertainties" are generally convoluted with the actual aerosol uncertainty. In this AeroCom Prescribed intercomparison study we systematically isolate and quantify host model uncertainties on aerosol forcing experiments through prescription of identical aerosol radiative properties in nine participating models. Even with prescribed aerosol radiative properties, simulated clear-sky and all-sky aerosol radiative forcings show significant diversity. For a purely scattering case with globally constant optical depth of 0.2, the global-mean all-sky top-of-atmosphere radiative forcing is -4.51 W m-2 and the inter-model standard deviation is 0.70 W m-2, corresponding to a relative standard deviation of 15%. For a case with partially absorbing aerosol with an aerosol optical depth of 0.2 and single scattering albedo of 0.8, the forcing changes to 1.26 W m-2, and the standard deviation increases to 1.21 W m-2, corresponding to a significant relative standard deviation of 96%. However, the top-of-atmosphere forcing variability owing to absorption is low, with relative standard deviations of 9% clear-sky and 12% all-sky. Scaling the forcing standard deviation for a purely scattering case to match the sulfate radiative forcing in the AeroCom Direct Effect experiment, demonstrates that host model uncertainties could explain about half of the overall sulfate forcing diversity of 0.13 W m-2 in the AeroCom Direct Radiative Effect experiment. Host model errors in aerosol radiative forcing are largest in regions of uncertain host model components, such as stratocumulus cloud decks or areas with poorly constrained surface albedos, such as sea ice. Our results demonstrate that host model uncertainties are an important component of aerosol forcing uncertainty that require further attention.

Comparison of US EPA and European emission standards for combustion and incineration technologies

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

Licata, A.; Hartenstein, H.U.; Terracciano, L.

1997-12-01

There has been considerable debate, misunderstanding, and controversy when comparing emission standards used in Europe and the United States. One of the first questions you hear whenever U.S. EPA publishes a new emission standard is, {open_quotes}Is it as restrictive or is it the same as the German standard{close_quotes}. Although both systems of regulation call for the use of CEMS for compliance, there are substantial differences in how emission standards are structured in Europe and in the U.S. They include reference points, averaging times, sampling methods, and technology. Generally, the European standards tend to be more restrictive, due in part tomore » the fact that the facilities are of necessity sited in close proximity to residential areas. In Germany, for example, regulations in general are comprehensive and include both design standards and emission limits while U.S. EPA`s rules are source specific and, in most cases, limited to numerical emission standards. In some cases, comparisons can be made between emission standards and, in some cases, comparisons can only be made with restrictive caveats. The paper will present a comprehensive overview of the emission standards and how they are applied.« less

A Spatial Analysis of County-level Variation in Syphilis and Gonorrhea in Guangdong Province, China

PubMed Central

Tan, Nicholas X.; Messina, Jane P.; Yang, Li-Gang; Yang, Bin; Emch, Michael; Chen, Xiang-Sheng; Cohen, Myron S.; Tucker, Joseph D.

2011-01-01

Background Sexually transmitted infections (STI) have made a resurgence in many rapidly developing regions of southern China, but there is little understanding of the social changes that contribute to this spatial distribution of STI. This study examines county-level socio-demographic characteristics associated with syphilis and gonorrhea in Guangdong Province. Methods/Principal Findings This study uses linear regression and spatial lag regression to determine county-level (n = 97) socio-demographic characteristics associated with a greater burden of syphilis, gonorrhea, and a combined syphilis/gonorrhea index. Data were obtained from the 2005 China Population Census and published public health data. A range of socio-demographic variables including gross domestic product, the Gender Empowerment Measure, standard of living, education level, migrant population and employment are examined. Reported syphilis and gonorrhea cases are disproportionately clustered in the Pearl River Delta, the central region of Guangdong Province. A higher fraction of employed men among the adult population, higher fraction of divorced men among the adult population, and higher standard of living (based on water availability and people per room) are significantly associated with higher STI cases across all three models. Gross domestic product and gender inequality measures are not significant predictors of reported STI in these models. Conclusions/Significance Although many ecological studies of STIs have found poverty to be associated with higher reported STI, this analysis found a greater number of reported syphilis cases in counties with a higher standard of living. Spatially targeted syphilis screening measures in regions with a higher standard of living may facilitate successful control efforts. This analysis also reinforces the importance of changing male sexual behaviors as part of a comprehensive response to syphilis control in China. PMID:21573127

Software Safety Risk in Legacy Safety-Critical Computer Systems

NASA Technical Reports Server (NTRS)

Hill, Janice L.; Baggs, Rhoda

2007-01-01

Safety Standards contain technical and process-oriented safety requirements. Technical requirements are those such as "must work" and "must not work" functions in the system. Process-Oriented requirements are software engineering and safety management process requirements. Address the system perspective and some cover just software in the system > NASA-STD-8719.13B Software Safety Standard is the current standard of interest. NASA programs/projects will have their own set of safety requirements derived from the standard. Safety Cases: a) Documented demonstration that a system complies with the specified safety requirements. b) Evidence is gathered on the integrity of the system and put forward as an argued case. [Gardener (ed.)] c) Problems occur when trying to meet safety standards, and thus make retrospective safety cases, in legacy safety-critical computer systems.

Mobile phones as a new memory aid: a preliminary investigation using case studies.

PubMed

Wade, T K; Troy, J C

2001-04-01

Memory impairment is one of the most common concerns following a brain injury of any severity. The use of effective external memory aids can help minimize the devastating effects such memory impairment can have on an individual's everyday life. Reviewed in this report are case studies of five individuals suffering significant everyday memory problems that were given a new memory aid that utilizes standard mobile phones. Measurements included diary-format observations and qualitative feedback. The results of the study show promising outcomes for all of the cases, and have led to recent adaptations to allow for wider and more effective use of this memory aid.

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA – case series from the University of California, Davis, USA

PubMed Central

Scharnhorst, Günther; Kanthaswamy, Sree

2011-01-01

Aim To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. Methods A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. Results While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. Conclusion This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services. PMID:21674824

An assessment of scientific and technical aspects of closed investigations of canine forensics DNA--case series from the University of California, Davis, USA.

PubMed

Scharnhorst, Günther; Kanthaswamy, Sree

2011-06-01

To describe and assess the scientific and technical aspects of animal forensic testing at the University of California, Davis. The findings and recommendations contained in this report are designed to assess the past, evaluate the present, and recommend reforms that will assist the animal forensic science community in providing the best possible services that comply with court standards and bear judicial scrutiny. A batch of 32 closed files of domestic dog DNA cases processed at the University of California, Davis, between August 2003 and July 2005 were reviewed in this study. The case files comprised copies of all original paperwork, copies of the cover letter or final report, laboratory notes, notes on analyses, submission forms, internal chains of custody, printed images and photocopies of evidence, as well as the administrative and technical reviews of those cases. While the fundamental aspects of animal DNA testing may be reliable and acceptable, the scientific basis for forensic testing animal DNA needs to be improved substantially. In addition to a lack of standardized and validated genetic testing protocols, improvements are needed in a wide range of topics including quality assurance and quality control measures, sample handling, evidence testing, statistical analysis, and reporting. This review implies that although a standardized panel of short tandem repeat and mitochondrial DNA markers and publicly accessible genetic databases for canine forensic DNA analysis are already available, the persistent lack of supporting resources, including standardized quality assurance and quality control programs, still plagues the animal forensic community. This report focuses on closed cases from the period 2003-2005, but extends its scope more widely to include other animal DNA forensic testing services.

A Standardized Mean Difference Effect Size for Single Case Designs

ERIC Educational Resources Information Center

Hedges, Larry V.; Pustejovsky, James E.; Shadish, William R.

2012-01-01

Single case designs are a set of research methods for evaluating treatment effects by assigning different treatments to the same individual and measuring outcomes over time and are used across fields such as behavior analysis, clinical psychology, special education, and medicine. Emerging standards for single case designs have focused attention on…

18 CFR 4.106 - Standard terms and conditions of case-specific exemption from licensing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... LICENSES, PERMITS, EXEMPTIONS, AND DETERMINATION OF PROJECT COSTS Exemption of Small Hydroelectric Power Projects of 5 Megawatts or Less § 4.106 Standard terms and conditions of case-specific exemption from licensing. Any case-specific exemption from licensing granted for a small hydroelectric power project is...

18 CFR 4.106 - Standard terms and conditions of case-specific exemption from licensing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... LICENSES, PERMITS, EXEMPTIONS, AND DETERMINATION OF PROJECT COSTS Exemption of Small Hydroelectric Power Projects of 5 Megawatts or Less § 4.106 Standard terms and conditions of case-specific exemption from licensing. Any case-specific exemption from licensing granted for a small hydroelectric power project is...

18 CFR 4.106 - Standard terms and conditions of case-specific exemption from licensing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... LICENSES, PERMITS, EXEMPTIONS, AND DETERMINATION OF PROJECT COSTS Exemption of Small Hydroelectric Power Projects of 5 Megawatts or Less § 4.106 Standard terms and conditions of case-specific exemption from licensing. Any case-specific exemption from licensing granted for a small hydroelectric power project is...

Treatment outcomes in 3 modes of orthodontic practice.

PubMed

Poulton, Donald R; Baumrind, Sheldon; Vlaskalic, Vicki

2002-02-01

This study examined differences in pretreatment severity and treatment outcome among orthodontic patients treated in 3 different practice-management modes. Samples of pretreatment (T1) and end of treatment (T2) study casts were selected from traditional private practices (TPP, 3 offices, 81 cases), a dental corporation (COMP, 2 offices, 53 cases), and a dental management service organization (DMSO, 1 office, 36 cases). Orthodontic specialists had treated all patients. Cases were initially selected on a consecutive start basis. From each practice, the first 30 cases satisfying the study criteria were included in the sample. The T1 and T2 study casts were evaluated with the PAR and HLD indexes. The PAR and HLD indexes showed a high level of agreement on T1 cast scores but not on the T2 casts. Mean T1 scores were highest in the COMP cases, followed by the DMSO and the TPP cases. T2 scores were lowest in the TPP cases, followed by the DMSO and the COMP cases. The percentage of PAR score reduction showed that, in all 3 modes, patients were treated to a high standard.

Multicenter study of combination DEP regimen as a salvage therapy for adult refractory hemophagocytic lymphohistiocytosis.

PubMed

Wang, Yini; Huang, Wenqiu; Hu, Liangding; Cen, Xinan; Li, Lihong; Wang, Jijun; Shen, Jianliang; Wei, Na; Wang, Zhao

2015-11-05

Hemophagocytic lymphohistiocytosis (HLH) is a refractory immune disorder with a significant risk of death. Although standard therapy has dramatically improved survival in HLH patients, approximately 30%, especially adults, show no response to current treatment strategies. This prospective study aimed to investigate the efficacy of liposomal doxorubicin treatment combined with etoposide and methylprednisolone (doxorubicin-etoposide-methylprednisolone; DEP) as a salvage therapy for adult refractory HLH. Adult patients who did not achieve at least partial response 2 weeks after initial standard HLH therapy were enrolled in this study between June 2013 and June 2014. Response to salvage therapy was assessed at 2 and 4 weeks after initiation of DEP therapy and patients were followed until death or until November 2014. Sixty-three refractory HLH patients were enrolled, including 29 cases of lymphoma-associated HLH, 22 cases of Epstein-Barr virus-associated HLH, and 4 cases of familial HLH. There were 8 cases with unknown underlying diseases. Seventeen cases (27.0%) achieved complete response and 31 cases (49.2%) achieved partial response. The overall response was 76.2% (48/63). Patients who showed no response to DEP died within 4 weeks after salvage therapy. Twenty-nine of the 48 patients who achieved partial or complete response survived to subsequent chemotherapy, allogenic hematopoietic stem cell transplantation, or splenectomy. Our study suggests that DEP regimen is an effective salvage regimen for adult refractory HLH, which can prolong patient survival as we continue to understand the responsible mechanisms and bridge the gap between HLH and its underlying diseases. This study was registered in the Chinese Clinical Trials Registry Platform (http://www.chictr.org.cn/) as ChiCTR-IPC-14005514. © 2015 by The American Society of Hematology.

Nature of Science as Portrayed in the Middle School Science and Technology Curriculum: The Case of Turkey

ERIC Educational Resources Information Center

Izci, Kemal

2017-01-01

Representation of nature of science (NOS) within curricula including standards, grade level expectations, and textbooks and their alignment with each other to achieve teaching NOS is crucial. Thus, the aims of the study were to a) assess how NOS is portrayed in standards, grade level expectations and a teacher edition of seventh grade textbook of…

Instituting a Standards-Based K--12 Science Curriculum Supplement Program at the National Institutes of Health: A Case Study

ERIC Educational Resources Information Center

Witherly, Jeffre

2010-01-01

Research on student achievement indicates the U.S. K-12 education system is not adequately preparing American students to compete in the 21st century global economy in the areas of science and mathematics. Congress has asked the scientific entities of the federal government to help increase K-12 science learning by creating standards-based…

Examining the (False) Dichotomy between "Care" and "Education" in Early Childhood Programs: A Descriptive Case Study of Teacher-Child Relationships within a Standardized Curriculum Model

ERIC Educational Resources Information Center

Ostrove, Randi

2016-01-01

Public preschool programs using standardized curriculum models are increasing rapidly, and while research has shown that teacher-child relationships have been used successfully as an intervention and compensatory measure, it is unclear what influence the public preschool setting and the use of a curriculum model have on teacher-child…

An evaluation of the effectiveness of a case-specific approach to challenging behaviour associated with dementia.

PubMed

Bird, Michael; Llewellyn-Jones, Robert H; Korten, Ailsa

2009-01-01

Treatment of challenging behaviour in dementia using standardized psychopharmacological or psychosocial approaches remains problematical. A case-specific approach was trialled in this study, based on extensive evidence that each case is different in aetiology, the effects of the behaviour on others and what interventions are possible given the available resources. Forty-four consecutive referrals for challenging behaviour (two-thirds in residential care) were assessed across multiple causal domains. Both assessment and development of interventions were undertaken in collaboration with family carers and care staff. Measures of behaviour and associated carer distress, as well as medication and service use, were taken pre-intervention and at 2- and 5-month follow-ups. Psychotropic medication was used with a minority of participants but, overall, antipsychotic use was reduced. Psychosocial methods predominated, with 77% of cases judged as mainly or entirely psychosocial by an expert panel. There were significant mean improvements in behaviour and carer distress. Using conservative criteria there was a 65.9% clinical success rate. Results confirm those of other studies which have used multifaceted interventions tailored to the unique needs of each case. They compare favourably with results from trials of standardized psycho-pharmacological or psychosocial approaches. More trials are needed, necessarily involving further development of robust methodologies which reflect the case-specific nature of challenging behaviour associated with dementia.

Maternal Exposure to Bisphenol-A and Fetal Growth Restriction: A Case-Referent Study

PubMed Central

Burstyn, Igor; Martin, Jonathan W.; Beesoon, Sanjay; Bamforth, Fiona; Li, Qiaozhi; Yasui, Yutaka; Cherry, Nicola M.

2013-01-01

We conducted a case-referent study of the effect of exposure to bisphenol-A on fetal growth in utero in full-term, live-born singletons in Alberta, Canada. Newborns <10 percentile of expected weight for gestational age and sex were individually matched on sex, maternal smoking and maternal age to referents with weight appropriate to gestational age. Exposure of the fetus to bisphenol-A was estimated from maternal serum collected at 15–16 weeks of gestation. We pooled sera across subjects for exposure assessment, stratified on case-referent status and sex. Individual 1:1 matching was maintained in assembling 69 case and 69 referent pools created from 550 case-referent pairs. Matched pools had an equal number of aliquots from individual women. We used an analytical strategy conditioning on matched set and total pool-level values of covariates to estimate individual-level effects. Pools of cases and referents had identical geometric mean bisphenol-A concentrations (0.5 ng/mL) and similar geometric standard deviations (2.3–2.5). Mean difference in concentration between matched pools was 0 ng/mL, standard deviation: 1 ng/mL. Stratification by sex and control for confounding did not suggest bisphenol-A increased fetal growth restriction. Our analysis does not provide evidence to support the hypothesis that bisphenol-A contributes to fetal growth restriction in full-term singletons. PMID:24336026

Risk of bias and confounding of observational studies of Zika virus infection: A scoping review of research protocols.

PubMed

Reveiz, Ludovic; Haby, Michelle M; Martínez-Vega, Ruth; Pinzón-Flores, Carlos E; Elias, Vanessa; Smith, Emma; Pinart, Mariona; Broutet, Nathalie; Becerra-Posada, Francisco; Aldighieri, Sylvain; Van Kerkhove, Maria D

2017-01-01

Given the severity and impact of the current Zika virus (ZIKV) outbreak in the Americas, numerous countries have rushed to develop research studies to assess ZIKV and its potential health consequences. In an effort to ensure that studies are comprehensive, both internally and externally valid, and with reliable results, the World Health Organization, the Pan American Health Organization, Institut Pasteur, the networks of Fiocruz, the Consortia for the Standardization of Influenza Seroepidemiology (CONSISE) and the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) have generated six standardized clinical and epidemiological research protocols and questionnaires to address key public health questions on ZIKV. We conducted a systematic search of ongoing study protocols related to ZIKV research. We analyzed the content of protocols of 32 cohort studies and 13 case control studies for systematic bias that could produce erroneous results. Additionally we aimed to characterize the risks of bias and confounding in observational studies related to ZIKV and to propose ways to minimize them, including the use of six newly standardized research protocols. Observational studies of ZIKV face an array of challenges, including measurement of exposure and outcomes (microcephaly and Guillain-Barré Syndrome). Potential confounders need to be measured where known and controlled for in the analysis. Selection bias due to non-random selection is a significant issue, particularly in the case-control design, and losses to follow-up is equally important for the cohort design. Observational research seeking to answer key questions on the ZIKV should consider these restrictions and take precautions to minimize bias in an effort to provide reliable and valid results. Utilization of the standardized research protocols developed by the WHO, PAHO, Institut Pasteur, and CONSISE will harmonize the key methodological aspects of each study design to minimize bias at different stages of the study. Biases need to be considered by researchers implementing the standardized protocols as well as by users of observational epidemiological studies of ZIKV.

How global MS prevalence is changing: A retrospective chart review in the United Arab Emirates.

PubMed

Schiess, Nicoline; Huether, Katherine; Fatafta, Taghreed; Fitzgerald, Kathryn C; Calabresi, Peter A; Blair, Iain; Alsaadi, Taoufik; Szolics, Miklos

2016-09-01

Multiple Sclerosis (MS) is an autoimmune disorder leading to central nervous system inflammation. Traditionally, reported MS prevalence rates in the Middle East are low. Few studies include age/sex standardization giving an unreliable estimate of regional prevalence. to determine the prevalence, incidence and characteristics of MS in Abu Dhabi, United Arab Emirates. A retrospective chart review was conducted at the four largest hospitals in Abu Dhabi Emirate between 2010 and 2014. Data collected included MS type, age and symptoms at onset, expanded disability status scale, treatment, laboratory findings and family history. 510 patients were identified consisting of 318 (62.2%) Emiratis and 192 (37.6%) expatriates. Total crude prevalence rate was 18/100,000 (95% CI: 10-30/100,000). Crude prevalence rate in Emiratis was 57.09 (95% CI:50 to 63/100,000) but increased to 64.44 (95% CI: 57 to 72/100,000) when age standardized. Age-standardized incidence rate in Emiratis was 6.0 MS cases per 100,000 person-years (95% CI: 5.5 to 6.5 cases per 100,000 person-years). At 64.44/100,000, the Abu Dhabi Emirati population has one of the highest, most reliable prevalence rate on the Arab peninsula. Age/sex standardized prevalence rates, uncommonly reported in the Middle East, should be standard for all prevalence studies. Copyright © 2016 Elsevier B.V. All rights reserved.

An analysis of Indonesia’s information security index: a case study in a public university

NASA Astrophysics Data System (ADS)

Yustanti, W.; Qoiriah, A.; Bisma, R.; Prihanto, A.

2018-01-01

Ministry of Communication and Informatics of the Republic of Indonesia has issued the regulation number 4-2016 about Information Security Management System (ISMS) for all kind organizations. Public university as a government institution must apply this standard to assure its level of information security has complied ISO 27001:2013. This research is a preliminary study to evaluate the readiness of university IT services (case study in a public university) meets the requirement of ISO 27001:2013 using the Indonesia’s Information Security Index (IISI). There are six parameters used to measure the level of information security, these are the ICT role, governance, risk management, framework, asset management and technology. Each parameter consists of serial questions which must be answered and convert to a numeric value. The result shows the level of readiness and maturity to apply ISO 27001 standard.

Computerized bioterrorism education and training for nurses on bioterrorism attack agents.

PubMed

Nyamathi, Adeline M; Casillas, Adrian; King, Major L; Gresham, Louise; Pierce, Elaine; Farb, Daniel; Wiechmann, Carrie; Weichmann, Carrie

2010-08-01

Biological agents have the ability to cause large-scale mass casualties. For this reason, their likely use in future terrorist attacks is a concern for national security. Recent studies show that nurses are ill prepared to deal with agents used in biological warfare. Achieving a goal for bioterrorism preparedness is directly linked to comprehensive education and training that enables first-line responders such as nurses to diagnose infectious agents rapidly. The study evaluated participants' responses to biological agents using a computerized bioterrorism education and training program versus a standard bioterrorism education and training program. Both programs improved participants' ability to complete and solve case studies involving the identification of specific biological agents. Participants in the computerized bioterrorism education and training program were more likely to solve the cases critically without reliance on expert consultants. However, participants in the standard bioterrorism education and training program reduced the use of unnecessary diagnostic tests.

Glocal Clinical Registries: Pacemaker Registry Design and Implementation for Global and Local Integration – Methodology and Case Study

PubMed Central

da Silva, Kátia Regina; Costa, Roberto; Crevelari, Elizabeth Sartori; Lacerda, Marianna Sobral; de Moraes Albertini, Caio Marcos; Filho, Martino Martinelli; Santana, José Eduardo; Vissoci, João Ricardo Nickenig; Pietrobon, Ricardo; Barros, Jacson V.

2013-01-01

Background The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. Purpose Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. Methods and Results We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. Conclusion This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries. PMID:23936257

Identification of Occupational Cancer Risks in British Columbia, Canada: A Population-Based Case—Control Study of 1,155 Cases of Colon Cancer

PubMed Central

Fang, Raymond; Le, Nhu; Band, Pierre

2011-01-01

Objective Cancer has been recognized to have environmental origin, but occupational cancer risk studies have not been fully documented. The objective of this paper was to identify occupations and industries with elevated colon cancer risk based on lifetime occupational histories collected from 15,463 incident cancer cases. Method A group matched case-control design was used. All cases were diagnosed with histologically proven colon cancers, with cancer controls being all other cancer sites, excluding rectum, lung and unknown primary, diagnosed at the same period of time from the British Columbia Cancer Registry. Data analyses were done on all 597 Canadian standard occupation titles and 1,104 standard industry titles using conditional logistic regression for matched data sets and the likelihood ratio test. Results Excess colon cancer risks was observed in a number of occupations and industries, particularly those with low physical activity and those involving exposure to asbestos, wood dusts, engine exhaust and diesel engine emissions, and ammonia. Discussion The results of our study are in line with those from the literature and further suggest that exposure to wood dusts and to ammonia may carry an increased occupational risk of colon cancer. PMID:22073015

Impact of operator on determining functional parameters of nuclear medicine procedures.

PubMed

Mohammed, A M; Naddaf, S Y; Mahdi, F S; Al-Mutawa, Q I; Al-Dossary, H A; Elgazzar, A H

2006-01-01

The study was designed to assess the significance of the interoperator variability in the estimation of functional parameters for four nuclear medicine procedures. Three nuclear medicine technologists with varying years of experience processed the following randomly selected 20 cases with diverse functions of each study type: renography, renal cortical scans, myocardial perfusion gated single-photon emission computed tomography (MP-GSPECT) and gated blood pool ventriculography (GBPV). The technologists used the same standard processing routines and were blinded to the results of each other. The means of the values and the means of differences calculated case by case were statistically analyzed by one-way ANOVA. The values were further analyzed using Pearson correlation. The range of the mean values and standard deviation of relative renal function obtained by the three technologists were 50.65 +/- 3.9 to 50.92 +/- 4.4% for renography, 51.43 +/- 8.4 to 51.55 +/- 8.8% for renal cortical scans, 57.40 +/- 14.3 to 58.30 +/- 14.9% for left ventricular ejection fraction from MP-GSPECT and 54.80 +/- 12.8 to 55.10 +/- 13.1% for GBPV. The difference was not statistically significant, p > 0.9. The values showed a high correlation of more than 0.95. Calculated case by case, the mean of differences +/- SD was found to range from 0.42 +/- 0.36% in renal cortical scans to 1.35 +/- 0.87% in MP-GSPECT with a maximum difference of 4.00%. The difference was not statistically significant, p > 0.19. The estimated functional parameters were reproducible and operator independent as long as the standard processing instructions were followed. Copyright 2006 S. Karger AG, Basel.

Characterizing facial features in individuals with craniofacial microsomia: A systematic approach for clinical research.

PubMed

Heike, Carrie L; Wallace, Erin; Speltz, Matthew L; Siebold, Babette; Werler, Martha M; Hing, Anne V; Birgfeld, Craig B; Collett, Brent R; Leroux, Brian G; Luquetti, Daniela V

2016-11-01

Craniofacial microsomia (CFM) is a congenital condition with wide phenotypic variability, including hypoplasia of the mandible and external ear. We assembled a cohort of children with facial features within the CFM spectrum and children without known craniofacial anomalies. We sought to develop a standardized approach to assess and describe the facial characteristics of the study cohort, using multiple sources of information gathered over the course of this longitudinal study and to create case subgroups with shared phenotypic features. Participants were enrolled between 1996 and 2002. We classified the facial phenotype from photographs, ratings using a modified version of the Orbital, Ear, Mandible, Nerve, Soft tissue (OMENS) pictorial system, data from medical record abstraction, and health history questionnaires. The participant sample included 142 cases and 290 controls. The average age was 13.5 years (standard deviation, 1.3 years; range, 11.1-17.1 years). Sixty-one percent of cases were male, 74% were white non-Hispanic. Among cases, the most common features were microtia (66%) and mandibular hypoplasia (50%). Case subgroups with meaningful group definitions included: (1) microtia without other CFM-related features (n = 24), (2) microtia with mandibular hypoplasia (n = 46), (3) other combinations of CFM- related facial features (n = 51), and (4) atypical features (n = 21). We developed a standardized approach for integrating multiple data sources to phenotype individuals with CFM, and created subgroups based on clinically-meaningful, shared characteristics. We hope that this system can be used to explore associations between phenotype and clinical outcomes of children with CFM and to identify the etiology of CFM. Birth Defects Research (Part A) 106:915-926, 2016.© 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A Retrospective Study on the Incidence of Seizures among Neurosurgical Patients Who Treated with Imipenem/Cilastatin or Meropenem.

PubMed

Wu, Yuanxing; Chen, Kai; Shi, Zhonghua; Wang, Qiang

2014-01-01

We sought to evaluate the safety of imipenem and meropenem in the treatment of infections in neurosurgical patients. An observational retrospective study was conducted of consecutive cases treated with imipenem from Sept. 2007 to Sept. 2009 and meropenem within 1 year from Sept. 2008 in Beijing Tiantan Hospital, China. Data including the dosage and duration of the drug use, occurrence of seizures and mortality outcome was collected from the electronic pharmacy records. The incidence of epilepsy, epileptic standardized morbidity rate (SMR) were reported. Attention was paid to the relationship between the use of imipenem/meropenem and the incidence of epilepsy. The imipenem patients within two years amounted to 71, with mean age 45.9±20.2 years, male to female ratio 46/25. The incidence of epilepsy was 11.3% (8 cases). Among them, 1 case occurred during treatment (1/633, 1.6/1000 patient-days), and the remaining 7 cases occurred before treatment (7/2819, 2.5/1000 patient-days), with the standardized incidence rate 0.64, 95% CI (0.08-5.18).The meropenem patients within one year amounted to 92, mean age 45.1±19.4 years, male to female ratio 51/41. The incidence of epilepsy was 6.5% (6 cases). 2 occurred during treatment (2/582, 2.0/1000 patients-hospital days) and 4 before treatment (4/2047, 3.4/1000 patients-inpatient days), standardized incidence rate 1.76, 95% CI (0.32-9.63). Despite many other epileptogenic factors, imipenem or meropenem did not increase the risk of seizures in neurosurgical patients. There was not further risk for patients with pre-existing seizures or creatinine clearance abnormalities when dosed appropriate.

A Protocol for Annotating Parser Differences. Research Report. ETS RR-16-02

ERIC Educational Resources Information Center

Bruno, James V.; Cahill, Aoife; Gyawali, Binod

2016-01-01

We present an annotation scheme for classifying differences in the outputs of syntactic constituency parsers when a gold standard is unavailable or undesired, as in the case of texts written by nonnative speakers of English. We discuss its automated implementation and the results of a case study that uses the scheme to choose a parser best suited…

Are Residents Losing Their Edge in Public University Admissions? The Case at the University of Washington. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Blume, Grant; Roza, Marguerite

2012-01-01

This case study examines admissions data at the University of Washington (UW) in order to quantify the effect on admissions standards for residents versus nonresidents. Like many other state flagship universities, the UW has suffered from constrained state revenues during the recent recessionary years. The findings suggest that Washington…

Thermal management improvement of an air-cooled high-power lithium-ion battery by embedding metal foam

NASA Astrophysics Data System (ADS)

Mohammadian, Shahabeddin K.; Rassoulinejad-Mousavi, Seyed Moein; Zhang, Yuwen

2015-11-01

Effect of embedding aluminum porous metal foam inside the flow channels of an air-cooled Li-ion battery module was studied to improve its thermal management. Four different cases of metal foam insert were examined using three-dimensional transient numerical simulations. The effects of permeability and porosity of the porous medium as well as state of charge were investigated on the standard deviation of the temperature field and maximum temperature inside the battery in all four cases. Compared to the case of no porous insert, embedding aluminum metal foam in the air flow channel significantly improved the thermal management of Li-ion battery cell. The results also indicated that, decreasing the porosity of the porous structure decreases both standard deviation of the temperature field and maximum temperature inside the battery. Moreover, increasing the permeability of the metal foam drops the maximum temperature inside the battery while decreasing this property leads to improving the temperature uniformity. Our results suggested that, among the all studied cases, desirable temperature uniformity and maximum temperature were achieved when two-third and the entire air flow channel is filled with aluminum metal foam, respectively.

Characterizing mammographic images by using generic texture features

PubMed Central

2012-01-01

Introduction Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. Methods A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Results Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Conclusions Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy. PMID:22490545

Extended pancreatectomy as defined by the ISGPS: useful in selected cases of pancreatic cancer but invaluable in other complex pancreatic tumors.

PubMed

Mitra, Abhishek; Pai, Esha; Dusane, Rohit; Ranganathan, Priya; DeSouza, Ashwin; Goel, Mahesh; Shrikhande, Shailesh V

2018-03-01

Extended pancreatectomy aimed at R0 resection of pancreatic tumors with adjacent vessel and organ involvement may be the only option for cure. This study was done with an objective to analyze the short- and long-term outcomes of extended pancreatic resections. All pancreatectomies performed between 2006 and 2015 were included. The pancreatectomies were classified as standard or extended, as per the International Study Group for Pancreatic Surgery. All surgical complications and terminologies were according to Clavien-Dindo classification and International Study Group for Pancreatic Surgery guidelines. Morbidity and mortality were primary outcomes and disease-free survival was a secondary outcome. Sixty-three extended and 620 standard pancreatectomies were performed. Major morbidity (Clavien grades III, IV and V) (37 vs. 29%, p = 0.21) and mortality (6 vs. 4%, p = 0.3) for extended pancreatectomies were comparable to those for standard pancreatectomies. Blood loss > 855 ml, need for blood transfusion, and tumor size were independent risk factors for morbidity, and the latter two for mortality. Standard pancreatectomies were associated with better 3-year disease-free survival than extended pancreatectomies (67 vs. 41%, p < 0.001). Extended pancreatectomies resulted in a significantly better median disease-free survival for non-pancreatic adenocarcinoma vs. pancreatic adenocarcinoma (33.3 vs. 9.5 months, p = 0.01). Extended pancreatectomies resulted in similar peri-operative morbidity and mortality compared to standard pancreatectomies. Although the survival of patients undergoing these complex procedures is inferior to standard pancreatectomies, they should be undertaken not only in selected cases of pancreatic cancer but even more so in other complex pancreatic tumors.

Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school.

PubMed

Kadagad, P; Tekian, A; Pinto, P X; Jirge, V L

2012-05-01

Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees. © 2011 John Wiley & Sons A/S.

The stage-value model: Implications for the changing standards of care.

PubMed

Görtz, Daniel Patrik; Commons, Michael Lamport

2015-01-01

The standard of care is a legal and professional notion against which doctors and other medical personnel are held liable. The standard of care changes as new scientific findings and technological innovations within medicine, pharmacology, nursing and public health are developed and adopted. This study consists of four parts. Part 1 describes the problem and gives concrete examples of its occurrence. The second part discusses the application of the Model of Hierarchical Complexity on the field, giving examples of how standards of care are understood at different behavioral developmental stage. It presents the solution to the problem of standards of care at a Paradigmatic Stage 14. The solution at this stage is a deliberative, communicative process based around why certain norms should or should not apply in each specific case, by the use of "meta-norms". Part 3 proposes a Cross-Paradigmatic Stage 15 view of how the problem of changing standards of care can be solved. The proposed solution is to found the legal procedure in each case on well-established behavioral laws. We maintain that such a behavioristic, scientifically based justice would be much more proficient at effecting restorative legal interventions that create desired behaviors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Taking a proactive approach to mild to moderate chronic oedema: a case study.

PubMed

Jehu, Diane; Jenkins, Linda; Morgan, Karen; Thomas, Melanie J

2018-02-02

This case study demonstrates the benefits of early intervention and a proactive approach for a patient with chronic oedema living in the community. These benefited the patient and also supported value-based healthcare in the NHS. The patient's health and wellbeing significantly improved with an assessment of his chronic oedema and a management plan consisting of skincare, an exercise and movement programme and the introduction of a class 1 British standard compression garment.

Epidemiology of cutaneous melanoma and non-melanoma skin cancer in Schleswig-Holstein, Germany: incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer).

PubMed

Katalinic, A; Kunze, U; Schäfer, T

2003-12-01

Population-based figures on skin cancer are essential for a realistic assessment of the personal disease burden, prevention modes and the need for caring. The Robert Koch Institute in Germany estimates the incidence of melanoma skin cancer as seven cases in 100 000 persons (age-standardized by the European standard rate). Population-based studies presumably show higher incidence rates of 10-16 cases in 100 000 persons. Few data exist for non-melanoma skin cancer (NMSC) as this is not systematically registered in Germany. To present the first population-based results from the Schleswig-Holstein (Germany) Cancer Registry on incidence, stage distribution, clinical types and localization of skin cancer and to compare the results with other studies. The Cancer Registry of the Bundesland Schleswig-Holstein with 3500 registering institutions, 100 of which are dermatological institutions, investigates all notifiable incident cancer cases according to international standards. From the recorded data all melanoma and NMSC cases were identified and evaluated. Between 1998 and 2001, 1784 malignant melanoma (MM) and 12 956 NMSC cases underwent diagnostic and analytical evaluation. For MM, age-standardized incidence rates were 12.3 and 14.8 in 100 000 men and women, respectively, and the mean age of men was greater than that of women (56.6 vs. 54.9 years, P < 0.05). Superficial spreading melanoma was the most frequent clinical type (39.1%). The tumours were predominantly located on the trunk in men (46.8%) in contrast to leg and hip in women (39.5%). For NMSC, the age-standardized incidence rates were 100.2 and 72.6 in 100 000 men and women, respectively. More than 80% of all tumours were basal cell carcinoma. The first population-based data from Schleswig-Holstein on the characteristics (age, sex, histological subtypes, localization and stage) of skin tumours agree well with the existing literature and may thus be regarded as representative. However, markedly higher incidences for MM and NMSC in the north of Germany compared with other parts of the country were observed. As the incidence rates from the north of Germany fit well into the European geographical pattern, we assume no regional increase. Therefore, the official German estimates on cutaneous tumours may largely depend on regional factors and may not be regarded as representative for all regions in Germany.

Improving rational thermal comfort prediction by using subpopulation characteristics: A case study at Hermitage Amsterdam

PubMed Central

Kramer, Rick; Schellen, Lisje; Schellen, Henk; Kingma, Boris

2017-01-01

ABSTRACT This study aims to improve the prediction accuracy of the rational standard thermal comfort model, known as the Predicted Mean Vote (PMV) model, by (1) calibrating one of its input variables “metabolic rate,” and (2) extending it by explicitly incorporating the variable running mean outdoor temperature (RMOT) that relates to adaptive thermal comfort. The analysis was performed with survey data (n = 1121) and climate measurements of the indoor and outdoor environment from a one year-long case study undertaken at Hermitage Amsterdam museum in the Netherlands. The PMVs were calculated for 35 survey days using (1) an a priori assumed metabolic rate, (2) a calibrated metabolic rate found by fitting the PMVs to the thermal sensation votes (TSVs) of each respondent using an optimization routine, and (3) extending the PMV model by including the RMOT. The results show that the calibrated metabolic rate is estimated to be 1.5 Met for this case study that was predominantly visited by elderly females. However, significant differences in metabolic rates have been revealed between adults and elderly showing the importance of differentiating between subpopulations. Hence, the standard tabular values, which only differentiate between various activities, may be oversimplified for many cases. Moreover, extending the PMV model with the RMOT substantially improves the thermal sensation prediction, but thermal sensation toward extreme cool and warm sensations remains partly underestimated. PMID:28680934

Improving rational thermal comfort prediction by using subpopulation characteristics: A case study at Hermitage Amsterdam.

PubMed

Kramer, Rick; Schellen, Lisje; Schellen, Henk; Kingma, Boris

2017-01-01

This study aims to improve the prediction accuracy of the rational standard thermal comfort model, known as the Predicted Mean Vote (PMV) model, by (1) calibrating one of its input variables "metabolic rate," and (2) extending it by explicitly incorporating the variable running mean outdoor temperature (RMOT) that relates to adaptive thermal comfort. The analysis was performed with survey data ( n = 1121) and climate measurements of the indoor and outdoor environment from a one year-long case study undertaken at Hermitage Amsterdam museum in the Netherlands. The PMVs were calculated for 35 survey days using (1) an a priori assumed metabolic rate, (2) a calibrated metabolic rate found by fitting the PMVs to the thermal sensation votes (TSVs) of each respondent using an optimization routine, and (3) extending the PMV model by including the RMOT. The results show that the calibrated metabolic rate is estimated to be 1.5 Met for this case study that was predominantly visited by elderly females. However, significant differences in metabolic rates have been revealed between adults and elderly showing the importance of differentiating between subpopulations. Hence, the standard tabular values, which only differentiate between various activities, may be oversimplified for many cases. Moreover, extending the PMV model with the RMOT substantially improves the thermal sensation prediction, but thermal sensation toward extreme cool and warm sensations remains partly underestimated.

Epidemiology characteristics and trends of incidence and morphology of stomach cancer in Iran.

PubMed

Almasi, Zeinab; Rafiemanesh, Hosein; Salehiniya, Hamid

2015-01-01

Stomach cancer is the fourth most common cancer and the second leading cause of cancer- related death through the world. It is predicted that the number of new cancer cases will be more than 15 million cases by 2020. Regarding the lack of studies on this topic in the country, we have thoroughly examined the patho-epidemiology of stomach cancer in Iran. In this cross- sectional study data were collected retrospectively reviewing all new stomach cancer patients in Cancer Registry Center report of health deputy for Iran during a 6-year period (2003-2008). The study also examined the morphology of common stomach cancers. Trends in incidence and morphology underwent joinpoint regression analysis. During the six-year period, a total of 35,171 cases of stomach cancer were registered. Average age standardized rate for females and males were equal to 7.1 and 15.1 per 100,000 persons, respectively. Most common histological type was adenocarcinoma, NOS with 21,980 cases (62.50%). The annual percentage change (APC) in age-standardized incidence rate (per 100,000) was increase in both females and males at 11.1 (CI: 4.3 to 18.3) and 9.2 (CI: 5.2 to 13.4), respectively. According to our results, the incidence of gastric cancer is increasing in Iran, so further epidemiological studies into the etiology and early detection are essential.

Neural response in obsessive-compulsive washers depends on individual fit of triggers

PubMed Central

Baioui, Ali; Pilgramm, Juliane; Merz, Christian J.; Walter, Bertram; Vaitl, Dieter; Stark, Rudolf

2013-01-01

Background: Patients with obsessive-compulsive disorder (OCD) have highly idiosyncratic triggers. To fully understand which role this idiosyncrasy plays in the neurobiological mechanisms behind OCD, it is necessary to elucidate the impact of individualization regarding the applied investigation methods. This functional magnetic resonance imaging (fMRI) study explores the neural correlates of contamination/washing-related OCD with a highly individualized symptom provocation paradigm. Additionally, it is the first study to directly compare individualized and standardized symptom provocation. Methods: Nineteen patients with washing compulsions created individual OCD hierarchies, which later served as instructions to photograph their own individualized stimulus sets. The patients and 19 case-by-case matched healthy controls participated in a symptom provocation fMRI experiment with individualized and standardized stimulus sets created for each patient. Results: OCD patients compared to healthy controls displayed stronger activation in the basal ganglia (nucleus accumbens, nucleus caudatus, pallidum) for individualized symptom provocation. Using standardized symptom provocation, this group comparison led to stronger activation in the nucleus caudatus. The direct comparison of between-group effects for both symptom provocation approaches revealed stronger activation of the orbitofronto-striatal network for individualized symptom provocation. Conclusions: The present study provides insight into the differential impact of individualized and standardized symptom provocation on the orbitofronto-striatal network of OCD washers. Behavioral and neural responses imply a higher symptom-specificity of individualized symptom provocation. PMID:23630478

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards.

PubMed

Karimi, Zohreh; Ashrafi-Rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). The results showed that the students' information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). This study showed that the training was effective on enhancing students' information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area.

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies

PubMed Central

Palmer, Tom M; Holmes, Michael V; Keating, Brendan J; Sheehan, Nuala A

2017-01-01

Abstract Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors. PMID:29106476

Teaching Undergraduate Accounting Majors How to Interpret the Accounting Standards Codification: An Alternative to Research Cases

ERIC Educational Resources Information Center

Toerner, Michael C.; Swindle, C. Bruce; Burckel, Daryl V.

2014-01-01

Professional accountants regularly search the FASB'S Accounting Standards Codification to find answers to financial accounting questions. Accounting educators know this and frequently use research cases in an attempt to help students begin developing this ability. But many students struggle with these cases because they have not been taught how to…

Software archeology: a case study in software quality assurance and design

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

Macdonald, John M; Lloyd, Jane A; Turner, Cameron J

2009-01-01

Ideally, quality is designed into software, just as quality is designed into hardware. However, when dealing with legacy systems, demonstrating that the software meets required quality standards may be difficult to achieve. As the need to demonstrate the quality of existing software was recognized at Los Alamos National Laboratory (LANL), an effort was initiated to uncover and demonstrate that legacy software met the required quality standards. This effort led to the development of a reverse engineering approach referred to as software archaeology. This paper documents the software archaeology approaches used at LANL to document legacy software systems. A case studymore » for the Robotic Integrated Packaging System (RIPS) software is included.« less

Creation of a cerebellar diameter reference standard and its clinical application to the detection of cerebellar hypoplasia unique to trisomy 18.

PubMed

Hayata, Kei; Hiramatsu, Yuji; Masuyama, Hisashi; Etou, Eriko; Nobumoto, Etsuko; Mitsui, Takashi

2015-12-01

We created a new reference standard focusing on the hemispheric anteroposterior cerebellar diameter (APCD) in addition to the transverse cerebellar diameter (TCD) and discussed whether or not the cerebellar measurement was useful for the detection of trisomy 18 (T18). In 150 normal fetuses between 14 and 36 weeks of gestational age (GA), the TCD and APCD were prospectively measured. In 26 cases with T18, the value was compared with the control. At <22 weeks of gestation, the TCD reference standard was calculated as follows: TCD = (1.027 × GA) - 0.674 (R(2) = 0.97, P < 0.001). The reference standard of the APCD was calculated as follows: APCD = (0.682 × GA) - 3.925 (R(2) = 0.73, P < 0.001). In eight cases with T18, the TCD was below the 5th percentile value in 7/8 (88%) cases and the APCD was below the 5th percentile value in 8/8 (100%) cases. At >22 weeks of gestation, the reference standard of the TCD was calculated as follows: TCD = (1.603 × GA) - 13.216 (R(2) = 0.92, P < 0.001). The reference standard of the APCD was calculated as follows: APCD = (0.859 × GA) - 7.30 (R(2) = 0.84, P < 0.001). In 18 cases with T18, the TCD was below the 5th percentile value in 14/18 (78%) cases and the APCD was below the 5th percentile value in 18/18 (100%) cases. APCD reference standard, divided by the gestational age of more or less than 22 weeks, might be useful to diagnose T18. © 2015 Japan Society of Obstetrics and Gynecology.

FLOCK cluster analysis of plasma cell flow cytometry data predicts bone marrow involvement by plasma cell neoplasia.

PubMed

Dorfman, David M; LaPlante, Charlotte D; Li, Betty

2016-09-01

We analyzed plasma cell populations in bone marrow samples from 353 patients with possible bone marrow involvement by a plasma cell neoplasm, using FLOCK (FLOw Clustering without K), an unbiased, automated, computational approach to identify cell subsets in multidimensional flow cytometry data. FLOCK identified discrete plasma cell populations in the majority of bone marrow specimens found by standard histologic and immunophenotypic criteria to be involved by a plasma cell neoplasm (202/208 cases; 97%), including 34 cases that were negative by standard flow cytometric analysis that included clonality assessment. FLOCK identified discrete plasma cell populations in only a minority of cases negative for involvement by a plasma cell neoplasm by standard histologic and immunophenotypic criteria (38/145 cases; 26%). Interestingly, 55% of the cases negative by standard analysis, but containing a FLOCK-identified discrete plasma cell population, were positive for monoclonal gammopathy by serum protein electrophoresis and immunofixation. FLOCK-identified and quantitated plasma cell populations accounted for 3.05% of total cells on average in cases positive for involvement by a plasma cell neoplasm by standard histologic and immunophenotypic criteria, and 0.27% of total cells on average in cases negative for involvement by a plasma cell neoplasm by standard histologic and immunophenotypic criteria (p<0.0001; area under the curve by ROC analysis=0.96). The presence of a FLOCK-identified discrete plasma cell population was predictive of the presence of plasma cell neoplasia with a sensitivity of 97%, compared with only 81% for standard flow cytometric analysis, and had specificity of 74%, PPV of 84% and NPV of 95%. FLOCK analysis, which has been shown to provide useful diagnostic information for evaluating patients with suspected systemic mastocytosis, is able to identify neoplastic plasma cell populations analyzed by flow cytometry, and may be helpful in the diagnostic evaluation of bone marrow samples for involvement by plasma cell neoplasia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Residential Radon Exposure and Risk of Lung Cancer in Missouri

Cancer.gov

A case-control study of lung cancer and residential radon exposure in which investigators carried out both standard year-long air measurements and CR-39 alpha detector measurements (call surface monitors)

Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin.

PubMed

Edoh, Thierry Oscar; Teege, Gunnar

2011-10-01

One of the problems in health care in developing countries is the bad accessibility of medicine in pharmacies for patients. Since this is mainly due to a lack of organization and information, it should be possible to improve the situation by introducing information and communication technology. However, for several reasons, standard solutions are not applicable here. In this paper, we describe a case study in Benin, a West African developing country. We identify the problem and the existing obstacles for applying standard ECommerce solutions. We develop an adapted system approach and describe a practical test which has shown that the approach has the potential of actually improving the pharmaceutical care delivery. Finally, we consider the security aspects of the system and propose an organizational solution for some specific security problems.

Stringency of workplace air contaminant exposure limits: a case study of OSHA risk management.

PubMed

Hakes, J K

1999-12-01

Political context may play a large role in influencing the efficiency of environmental and health regulations. This case study uses data from a 1989 update of the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limits (PELs) program to determine the relative effects of legislative mandates, costly acquisition of information by the agency, and pressure applied by special interest groups upon exposure standards. The empirical analysis suggests that federal agencies successfully thwart legislative attempts to limit agency discretion, and that agencies exercise bounded rationality by placing greater emphasis on more easily obtained information. The 1989 PELs were less significantly related to more costly information, contained "safety factors" for chemicals presenting relatively more ambiguous risks, and the proposed standard stringencies showed evidence of being influenced by vying industry and labor interests.

Assessment of hospital performance with a case-mix standardized mortality model using an existing administrative database in Japan.

PubMed

Miyata, Hiroaki; Hashimoto, Hideki; Horiguchi, Hiromasa; Fushimi, Kiyohide; Matsuda, Shinya

2010-05-19

Few studies have examined whether risk adjustment is evenly applicable to hospitals with various characteristics and case-mix. In this study, we applied a generic prediction model to nationwide discharge data from hospitals with various characteristics. We used standardized data of 1,878,767 discharged patients provided by 469 hospitals from July 1 to October 31, 2006. We generated and validated a case-mix in-hospital mortality prediction model using 50/50 split sample validation. We classified hospitals into two groups based on c-index value (hospitals with c-index > or = 0.8; hospitals with c-index < 0.8) and examined differences in their characteristics. The model demonstrated excellent discrimination as indicated by the high average c-index and small standard deviation (c-index = 0.88 +/- 0.04). Expected mortality rate of each hospital was highly correlated with observed mortality rate (r = 0.693, p < 0.001). Among the studied hospitals, 446 (95%) had a c-index of >/=0.8 and were classified as the higher c-index group. A significantly higher proportion of hospitals in the lower c-index group were specialized hospitals and hospitals with convalescent wards. The model fits well to a group of hospitals with a wide variety of acute care events, though model fit is less satisfactory for specialized hospitals and those with convalescent wards. Further sophistication of the generic prediction model would be recommended to obtain optimal indices to region specific conditions.

Australians are not equally protected from industrial air pollution

NASA Astrophysics Data System (ADS)

Dobbie, B.; Green, D.

2015-05-01

Australian air pollution standards are set at national and state levels for a number of chemicals harmful to human health. However, these standards do not need to be met when ad hoc pollution licences are issued by state environment agencies. This situation results in a highly unequal distribution of air pollution between towns and cities, and across the country. This paper examines these pollution regulations through two case studies, specifically considering the ability of the regulatory regime to protect human health from lead and sulphur dioxide pollution in the communities located around smelters. It also considers how the proposed National Clean Air Agreement, once enacted, might serve to reduce this pollution equity problem. Through the case studies we show that there are at least three discrete concerns relating to the current licencing system. They are: non-onerous emission thresholds for polluting industry; temporal averaging thresholds masking emission spikes; and ineffective penalties for breaching licence agreements. In conclusion, we propose a set of new, legally-binding national minimum standards for industrial air pollutants must be developed and enforced, which can only be modified by more (not less) stringent state licence arrangements.

The ethics of HIV research in developing nations.

PubMed

Resnik, David B

1998-10-01

This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.

Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review

PubMed Central

Culpan, Anne-Marie; Watts, Catriona; Munyombwe, Theresa; Wolstenhulme, Stephen

2017-01-01

Background and aim Neonatal respiratory distress syndrome is a leading cause of morbidity in preterm new-born babies (<37 weeks gestation age). The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation. The aim of this review was to compare the diagnostic accuracy of lung ultrasound against the reference standard in symptomatic neonates of ≤42 weeks gestation age. Methods A systematic search of literature published between 1990 and 2016 identified 803 potentially relevant studies. Six studies met the review inclusion criteria and were retrieved for analysis. Quality assessment was performed before data extraction and meta-analysis. Results Four prospective cohort studies and two case control studies included 480 neonates. All studies were of moderate methodological quality although heterogeneity was evident across the studies. The pooled sensitivity and specificity of lung ultrasound were 97% (95% confidence interval [CI] 94–99%) and 91% (CI: 86–95%) respectively. False positive diagnoses were made in 16 cases due to pneumonia (n = 8), transient tachypnoea (n = 3), pneumothorax (n = 1) and meconium aspiration syndrome (n = 1); the diagnoses of the remaining three false positive results were not specified. False negatives diagnoses occurred in nine cases, only two were specified as air-leak syndromes. Conclusions Lung ultrasound was highly sensitive for the detection of neonatal respiratory distress syndrome although there is potential to miss co-morbid air-leak syndromes. Further research into lung ultrasound diagnostic accuracy for neonatal air-leak syndrome and economic modelling for service integration is required before lung ultrasound can replace chest radiography as the imaging component of the reference standard. PMID:28567102

Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology.

PubMed

Hensen, P; Fürstenberg, T; Luger, T A; Steinhoff, M; Roeder, N

2005-09-01

The changing healthcare environment world-wide is leading to extensive use of per case payment systems based on diagnosis-related groups (DRG). The aim of this study was to examine the impact of application of different DRG systems used in the German healthcare system. We retrospectively analysed 2334 clinical data sets of inpatients discharged from an academic dermatological inpatient unit in 2003. Data were regarded as providing high coding quality in compliance with the diagnosis and procedure classifications as well as coding standards. The application of the Australian AR-DRG version 4.1, the German G-DRG version 1.0, and the German G-DRG version 2004 was considered in detail. To evaluate more specific aspects, data were broken down into 11 groups based on the principle diagnosis. DRG cost weights and case mix index were used to compare coverage of inpatient dermatological services. Economic impacts were illustrated by case mix volumes and calculation of DRG payments. Case mix index results and the pending prospective revenues vary tremendously from the application of one or another of the DRG systems. The G-DRG version 2004 provides increased levels of case mix index that encourages, in particular, medical dermatology. The AR-DRG version 4.1 and the first German DRG version 1.0 appear to be less suitable to adequately cover inpatient dermatology. The G-DRG version 2004 has been greatly improved, probably due to proceeding calculation standards and DRG adjustments. The future of inpatient dermatology is subject to appropriate depiction of well-established treatment standards.

Roux-en-Y gastric bypass procedure performed with the da Vinci robot system: is it worth it?

PubMed

Hubens, G; Balliu, L; Ruppert, M; Gypen, B; Van Tu, T; Vaneerdeweg, W

2008-07-01

The Roux-en-Y gastric bypass procedure (RYGBP) is in many countries the gold standard for obtaining long-lasting weight reduction and improvement of obesity-related comorbidities. However, performing this operation by standard laparoscopic techniques requires important surgical skills because of the anastomoses involved. The da Vinci surgical robot system with its enhanced degrees of freedom in motion and three-dimensional vision is designed to overcome the difficulties encountered in traditional laparoscopic surgery with suturing and delicate tissue handling. For this study, 45 patients (9 men) with a mean body mass index (BMI) of 44.2 (range, 35.1-55.4) underwent RYGBP with the aid of the da Vinci robot system. They were compared with 45 consecutive patients with a mean BMI of 43.9 (range, 35.1-56.2) who underwent a laparoscopic RYGBP by the same surgeon during the same period. Overall, the total operating time was shorter for the laparoscopic cases (127 vs 212 min; p < 0.05). However, the last 10 robotic cases were performed in the same time span as the laparoscopic cases (136 vs 127 min). The total robotic setup time remained constant at about 30 min. There were no differences in postoperative complications between the two groups in terms of anastomotic leakage or stenosis. In the robotic group, more conversions to open surgery were noted. Early in the study, four patients (9%) had to undergo conversion to standard laparoscopic techniques due to inadequate setup of the robotic arms. Five patients (11%), however, had to undergo conversion to open surgery because of intestinal laceration during manipulation of the intestines with the robotic instruments. The costs were higher for robotic surgery than for standard laparoscopic RYGBP, mainly because of the extra equipment used, such as ultrasonic devices. The RYGBP procedure can be performed safely with the da Vinci robot after a learning curve of about 35 cases. At this writing, however, it is not clear whether the da Vinci system offers a real advantage over standard laparoscopic techniques.

Standardization by ISO to Ensure the Sustainability of Space Activities

NASA Astrophysics Data System (ADS)

Kato, A.; Lazare, B.; Oltrogge, D.; Stokes, H.

2013-08-01

The ISO / Technical Committee 20 / Sub-committee 14 develops debris-related standards and technical reports to mitigate debris and help ensure mission and space sustainability. While UN Guidelines and the IADC Guidelines encourage national governments and agencies to promote debris mitigation design and operation, the ISO standards will help the global space industry promote and sustain its space-related business. In this paper the scope and status of each ISO standard is discussed within an overall framework. A comparison with international guidelines is also provided to demonstrate the level of consistency. Finally, as a case study, the ISO standards are applied to a CubeSat mission, thus demonstrating their usability on a relatively recent and popular class of satellite.

ProForma: A Standard Proteoform Notation

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

LeDuc, Richard D.; Schwämmle, Veit; Shortreed, Michael R.

The Consortium for Top-Down Proteomics (CTDP) proposes a standardized notation, ProForma, for writing the sequence of fully characterized proteoforms. ProForma provides a means to communicate any proteoform by writing the amino acid sequence using standard one-letter notation and specifying modifications or unidentified mass shifts within brackets following certain amino acids. The notation is unambiguous, human readable, and can easily be parsed and written by bioinformatic tools. This system uses seven rules and supports a wide range of possible use cases, ensuring compatibility and reproducibility of proteoform annotations. Standardizing proteoform sequences will simplify storage, comparison, and reanalysis of proteomic studies, andmore » the Consortium welcomes input and contributions from the research community on the continued design and maintenance of this standard.« less

A review of medical terminology standards and structured reporting.

PubMed

Awaysheh, Abdullah; Wilcke, Jeffrey; Elvinger, François; Rees, Loren; Fan, Weiguo; Zimmerman, Kurt

2018-01-01

Much effort has been invested in standardizing medical terminology for representation of medical knowledge, storage in electronic medical records, retrieval, reuse for evidence-based decision making, and for efficient messaging between users. We only focus on those efforts related to the representation of clinical medical knowledge required for capturing diagnoses and findings from a wide range of general to specialty clinical perspectives (e.g., internists to pathologists). Standardized medical terminology and the usage of structured reporting have been shown to improve the usage of medical information in secondary activities, such as research, public health, and case studies. The impact of standardization and structured reporting is not limited to secondary activities; standardization has been shown to have a direct impact on patient healthcare.

E-Learning Quality Standards for Consumer Protection and Consumer Confidence: A Canadian Case Study in E-Learning Quality Assurance

ERIC Educational Resources Information Center

Barker, Kathryn Chang

2007-01-01

Emerging concerns about quality of e-learning products and services animated a project in Canada to create quality standards that derived primarily from the needs of consumer, that could be used to guide the development and choice of e-learning at all levels of education and training, and that could be implemented in a simple manner. A set of…

Higher Education Pushes for Energy Education: GVSU Case Study

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

none,

2013-03-01

Grand Valley State University (GVSU) partnered with the Department of Energy (DOE) to develop and implement solutions to build new, low-energy buildings that are at least 50% below Standard 90.1-2007 of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), the American National Standards Institute (ANSI), and the Illuminating Engineering Society of North America (IESNA) as part of DOE’s Commercial Building Partnerships (CBP).

The Effective Use of System and Software Architecture Standards for Software Technology Readiness Assessments

DTIC Science & Technology

2011-05-01

IEC 42010 Technology Viewpoint • Case Study – Multimedia Conferencing System – Technology Specification • Risks of Software TRL Determination...fully support the required threshold functionality . • Relevant Environment for Space* – A satellite from launch to standard operation in space is...Analytical and experimental critical function and/or characteristic f f t TRL 4 TRL 3 proo o concep Technology concept and/or application

A multisite validation of whole slide imaging for primary diagnosis using standardized data collection and analysis.

PubMed

Wack, Katy; Drogowski, Laura; Treloar, Murray; Evans, Andrew; Ho, Jonhan; Parwani, Anil; Montalto, Michael C

2016-01-01

Text-based reporting and manual arbitration for whole slide imaging (WSI) validation studies are labor intensive and do not allow for consistent, scalable, and repeatable data collection or analysis. The objective of this study was to establish a method of data capture and analysis using standardized codified checklists and predetermined synoptic discordance tables and to use these methods in a pilot multisite validation study. Fifteen case report form checklists were generated from the College of American Pathology cancer protocols. Prior to data collection, all hypothetical pairwise comparisons were generated, and a level of harm was determined for each possible discordance. Four sites with four pathologists each generated 264 independent reads of 33 cases. Preestablished discordance tables were applied to determine site by site and pooled accuracy, intrareader/intramodality, and interreader intramodality error rates. Over 10,000 hypothetical pairwise comparisons were evaluated and assigned harm in discordance tables. The average difference in error rates between WSI and glass, as compared to ground truth, was 0.75% with a lower bound of 3.23% (95% confidence interval). Major discordances occurred on challenging cases, regardless of modality. The average inter-reader agreement across sites for glass was 76.5% (weighted kappa of 0.68) and for digital it was 79.1% (weighted kappa of 0.72). These results demonstrate the feasibility and utility of employing standardized synoptic checklists and predetermined discordance tables to gather consistent, comprehensive diagnostic data for WSI validation studies. This method of data capture and analysis can be applied in large-scale multisite WSI validations.

Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.

PubMed

Park, Eun-Jun; Park, Mihyun

2015-11-01

The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.

The effect of personalized versus standard patient protocols for radiostereometric analysis (RSA).

PubMed

Muharemovic, O; Troelsen, A; Thomsen, M G; Kallemose, T; Gosvig, K K

2018-05-01

Increasing pressure in the clinic requires a more standardized approach to radiostereometric analysis (RSA) imaging. The aim of this study was to investigate whether implementation of personalized RSA patient protocols could increase image quality and decrease examination time and the number of exposure repetitions. Forty patients undergoing primary total hip arthroplasty were equally randomized to either a case or a control group. Radiographers in the case group were assisted by personalized patient protocols containing information about each patient's post-operative RSA imaging. Radiographers in the control group used a standard RSA protocol. At three months, radiographers in the case group significantly reduced (p < 0.001) the number of exposures by 1.6, examination time with 19.2 min, and distance between centrum of prosthesis and centrum of calibration field with 34.1 mm when compared to post-operative (baseline) results. At twelve months, the case group significantly reduced (p < 0.001) number of exposures by two, examination time with 22.5 min, and centrum of prosthesis to centrum of calibration field distance with 43.1 mm when compared to baseline results. No significant improvements were found in the control group at any time point. There is strong evidence that personalized RSA patient protocols have a positive effect on image quality and radiation dose savings. Implementation of personal patient protocols as a RSA standard will contribute to the reduction of examination time, thus ensuring a cost benefit for department and patient safety. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

The Upper Midwest Health Study: Industry and Occupation of Glioma Cases and Controls

PubMed Central

Ruder, Avima M.; Waters, Martha A.; Carreón, Tania; Butler, Mary A.; Calvert, Geoffrey M.; Davis-King, Karen E.; Waters, Kathleen M.; Schulte, Paul A.; Mandel, Jack S.; Morton, Roscoe F.; Reding, Douglas J.; Rosenman, Kenneth D.

2015-01-01

Background Understanding glioma etiology requires determining which environmental factors are associated with glioma. Upper Midwest Health Study case–control participant work histories collected 1995–1998 were evaluated for occupational associations with glioma. “Exposures of interest” from our study protocol comprise our a priori hypotheses. Materials and Methods Year-long or longer jobs for 1,973 participants were assigned Standard Occupational Classifications (SOC) and Standard Industrial Classifications (SIC). The analysis file includes 8,078 SIC- and SOC-coded jobs. For each individual, SAS 9.2 programs collated employment with identical SIC-SOC coding. Distributions of longest “total employment duration” (total years worked in jobs with identical industry and occupation codes, including multiple jobs, and non-consecutive jobs) were compared between cases and controls, using an industrial hygiene algorithm to group occupations. Results Longest employment duration was calculated for 780 cases and 1,156 controls. More case than control longest total employment duration was in the “engineer, architect” occupational group [16 cases, 10 controls, odds ratio (OR) 2.50, adjusted for age group, sex, age and education, 95% confidence interval (CI) 1.12–5.60]. Employment as a food processing worker [mostly butchers and meat cutters] was of borderline significance (27 cases, 21 controls, adjusted OR: 1.78, CI: 0.99–3.18). Conclusions Among our exposures of interest work as engineers or as butchers and meat cutters was associated with increased glioma risk. Significant associations could be due to chance, because of multiple comparisons, but similar findings have been reported for other glioma studies. Our results suggest some possible associations but by themselves could not provide conclusive evidence. PMID:22715102

Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group.

PubMed

Mitchell, Alex J; Meader, Nick; Davies, Evan; Clover, Kerrie; Carter, Gregory L; Loscalzo, Matthew J; Linden, Wolfgang; Grassi, Luigi; Johansen, Christoffer; Carlson, Linda E; Zabora, James

2012-10-01

To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer settings. We used a standardized rating system. We excluded 11 tools without at least two independent studies, leaving 8 tools for comparison. Across all cancer stages there were 56 diagnostic validity studies (n=10,009). For case-finding, one stem question, two stem questions and the BDI-II all had level 2 evidence (2a, 2b and 2c respectively) and given their better acceptability we gave the stem questions a grade B recommendation. For screening, two stem questions had level 1b evidence (with high acceptability) and the BDI-II had level 2c evidence. For every 100 people screened in advanced cancer, the two questions would accurately detect 18 cases, while missing only 1 and correctly reassure 74 with 7 falsely identified. For every 100 people screened in non-palliative settings the BDI-II would accurately detect 17 cases, missing 2 and correctly re-assure 70, with 11 falsely identified as cases. The main cautions are the reliance on DSM-IV definitions of major depression, the large number of small studies and the paucity of data for many tools in specific settings. Although no single tool could be offered unqualified support, several tools are likely to improve upon unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

New categories for traditional medicine in the Economic Botany Data Collection Standard.

PubMed

Gruca, Marta; Cámara-Leret, Rodrigo; Macía, Manuel J; Balslev, Henrik

2014-09-11

The Economic Botany Data Collection Standard (EBDCS) has been successfully followed by ethnobotanists investigating plant uses in many parts of the world. However, we have encountered some cases in our study of traditional medicine where the standard seems incomplete and inaccurate when it is applied to plant uses of rural or indigenous societies in developing countries. We propose two categories to be added to the EBDCS: Cultural Diseases and Disorders, and Ritual/Magical Uses. Adding these categories, we believe will give a more accurate insight into traditional medicine and will contribute to developing an integrative ethnomedicinal data collection protocol, which will make ethnomedicinal studies more comparable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Audit of a Scientific Data Center for Certification as a Trustworthy Digital Repository: A Case Study

NASA Astrophysics Data System (ADS)

Downs, R. R.; Chen, R. S.

2011-12-01

Services that preserve and enable future access to scientific data are necessary to ensure that the data that are being collected today will be available for use by future generations of scientists. Many data centers, archives, and other digital repositories are working to improve their ability to serve as long-term stewards of scientific data. Trust in sustainable data management and preservation capabilities of digital repositories can influence decisions to use these services to deposit or obtain scientific data. Building on the Open Archival Information System (OAIS) Reference Model developed by the Consultative Committee for Space Data Systems (CCSDS) and adopted by the International Organization for Standardization as ISO 14721:2003, new standards are being developed to improve long-term data management processes and documentation. The Draft Information Standard ISO/DIS 16363, "Space data and information transfer systems - Audit and certification of trustworthy digital repositories" offers the potential to evaluate digital repositories objectively in terms of their trustworthiness as long-term stewards of digital resources. In conjunction with this, the CCSDS and ISO are developing another draft standard for the auditing and certification process, ISO/DIS 16919, "Space data and information transfer systems - Requirements for bodies providing audit and certification of candidate trustworthy digital repositories". Six test audits were conducted of scientific data centers and archives in Europe and the United States to test the use of these draft standards and identify potential improvements for the standards and for the participating digital repositories. We present a case study of the test audit conducted on the NASA Socioeconomic Data and Applications Center (SEDAC) and describe the preparation, the audit process, recommendations received, and next steps to obtain certification as a trustworthy digital repository, after approval of the ISO/DIS standards.

Issues of human rabies immunoglobulin and vaccine: policy versus practice.

PubMed

Folb, Jonathan E; Cooke, Richard P D

2007-03-01

A retrospective audit was conducted of all issues of rabies vaccine or human rabies immunoglobulin (HRIG) from the Clinical Microbiology Department at University Hospital Aintree for post-exposure prophylaxis. The appropriateness of management was reviewed by a blinded panel, which used guidelines issued by the Health Protection Agency (HPA) as a standard. Thirty-six enquiries, on average 9 days following exposure, led to issues of HRIG, rabies vaccine or both. Dog bites accounted for the majority of incidents. In no cases was the biting animal recorded as having been observed for signs of rabies. Management was judged to have been inappropriate in 9 cases, and documentation was judged to have been unsatisfactory in 13 cases. This study has highlighted several areas of ambiguity in the current guidelines, and a number of deficiencies in the information prompted by the standardized proformas used to deal with post-exposure queries.

Fifteen-month follow up of an assertive community treatment program for chronic patients with mental illness.

PubMed

Kim, Tae-Won; Jeong, Jong-Hyun; Kim, Young-Hee; Kim, Yura; Seo, Ho-Jun; Hong, Seung-Chul

2015-09-16

The aim of this study was to evaluate the effect of an Assertive Community Treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness. Participants were patients at the Suwon Mental Health Center. Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS). No significant differences were noted in the sociodemographic characteristics of the ACT and the case-management group. According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the degree of change of recovery-promoting relationships through time flow between groups was not significantly different. In this study, we observed that ACT was significantly better at improving the GAF than case management and that participation in ACT was associated with a significant decrease in BPRS scores. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT may have some advantages over a standard case management approach.

Determining the status quo of infection prevention and control standards in the hospitals of iran: a case study in 23 hospitals.

PubMed

Shojaee, Jalil; Moosazadeh, Mahmood

2014-02-01

Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals. The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran. This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirmed validity and reliability. . In this regard, 260 managers, section supervisors and infection control nurses participated in the study according to census basis. SPSS software version 16 was employed to analyze the data through descriptive and analytical statistics. Among the studied hospitals, 18 hospitals were public. Hospitals enjoyed 77.2% of leadership and programming, 80.8% of focus of programs, 67.4% of isolating methods, 88.2% of hand health and protection techniques, 78.8% of improving patient's safety and quality, 90.3% of training personnel, and 78.7% of the average status quo of PCI standards. This study revealed that PCI standards were significantly observed in the studied hospitals and that there were necessary conditions for full deployment of nosocomial infection surveillance.

Airside HVAC BESTEST: HVAC Air-Distribution System Model Test Cases for ASHRAE Standard 140

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

Judkoff, Ronald; Neymark, Joel; Kennedy, Mike D.

This paper summarizes recent work to develop new airside HVAC equipment model analytical verification test cases for ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs. The analytical verification test method allows comparison of simulation results from a wide variety of building energy simulation programs with quasi-analytical solutions, further described below. Standard 140 is widely cited for evaluating software for use with performance-path energy efficiency analysis, in conjunction with well-known energy-efficiency standards including ASHRAE Standard 90.1, the International Energy Conservation Code, and other international standards. Airside HVAC Equipment is a common area ofmore » modelling not previously explicitly tested by Standard 140. Integration of the completed test suite into Standard 140 is in progress.« less

Association Between Kidney Cancer and Occupational Exposure to Trichloroethylene.

PubMed

Buhagen, Morten; Grønskag, Anna; Ragde, Siri Fenstad; Hilt, Bjørn

2016-09-01

This study investigates the association between occupational exposure to trichloroethylene (TCE) and kidney cancer, as this correlation has been questioned. The incidence of cancers was studied in a dynamic cohort of 997 male workers who for many years had been occupationally exposed to TCE. During a 50-year observation period, 13 cases of kidney cancer were observed (7.5 expected) with a standardized incidence ratio of 1.7 and a 95% confidence interval of 1.0 to 3.0. Four other cases, not included in the SIR analysis, were also observed. Long-term TCE exposure was positively confirmed for 14 of the 17 incident cases. There is reason to assume that the remaining cases also had been exposed to TCE. The present study supports the view that TCE is a kidney carcinogen.

Nursing diagnoses in pemphigus vulgaris: a case study.

PubMed

Pena, Silvana B; Guimarães, Heloísa C Q C P; Bassoli, Sidinéia R B; Casarin, Santina N A; Herdman, Trace Heather; de Barros, Alba L B L

2013-10-01

This case study illustrates the use of the nursing process based upon the standardized nursing diagnoses approved by NANDA International (NANDA-I), and using the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC) in the care of a patient with pemphigus vulgaris (PV). The published literature on PV and the experience and expertise of the authors in working with people with impaired skin integrity and PV were used to develop this case study. The accuracy of nursing diagnoses and appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Impaired skin integrity is a human response diagnosed by nurses, and early treatment is important due to the vulnerability of these patients. The case study contributes to nursing knowledge for professionals who care for patients with PV. © 2013 NANDA International.

Progressing from initially ambiguous functional analyses: three case examples.

PubMed

Tiger, Jeffrey H; Fisher, Wayne W; Toussaint, Karen A; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982)]. These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments.

Software for improving the quality of project management, a case study: international manufacture of electrical equipment

NASA Astrophysics Data System (ADS)

Preradović, D. M.; Mićić, Lj S.; Barz, C.

2017-05-01

Production conditions in today’s world require software support at every stage of production and development of new products, for quality assurance and compliance with ISO standards. In addition to ISO standards such as usual metrics of quality, companies today are focused on other optional standards, such as CMMI (Capability Maturity Model Integrated) or prescribing they own standards. However, while there is intensive progress being made in the PM (project management), there is still a significant number of projects, at the global level, that are failures. These have failed to achieve their goals, within budget or timeframe. This paper focuses on checking the role of software tools through the rate of success in projects implemented in the case of internationally manufactured electrical equipment. The results of this research show the level of contribution of the project management software used to manage and develop new products to improve PM processes and PM functions, and how selection of the software tools affects the quality of PM processes and successfully completed projects.

CT and MR Protocol Standardization Across a Large Health System: Providing a Consistent Radiologist, Patient, and Referring Provider Experience.

PubMed

Sachs, Peter B; Hunt, Kelly; Mansoubi, Fabien; Borgstede, James

2017-02-01

Building and maintaining a comprehensive yet simple set of standardized protocols for a cross-sectional image can be a daunting task. A single department may have difficulty preventing "protocol creep," which almost inevitably occurs when an organized "playbook" of protocols does not exist and individual radiologists and technologists alter protocols at will and on a case-by-case basis. When multiple departments or groups function in a large health system, the lack of uniformity of protocols can increase exponentially. In 2012, the University of Colorado Hospital formed a large health system (UCHealth) and became a 5-hospital provider network. CT and MR imaging studies are conducted at multiple locations by different radiology groups. To facilitate consistency in ordering, acquisition, and appearance of a given study, regardless of location, we minimized the number of protocols across all scanners and sites of practice with a clinical indication-driven protocol selection and standardization process. Here we review the steps utilized to perform this process improvement task and insure its stability over time. Actions included creation of a standardized protocol template, which allowed for changes in electronic storage and management of protocols, designing a change request form, and formation of a governance structure. We utilized rapid improvement events (1 day for CT, 2 days for MR) and reduced 248 CT protocols into 97 standardized protocols and 168 MR protocols to 66. Additional steps are underway to further standardize output and reporting of imaging interpretation. This will result in an improved, consistent radiologist, patient, and provider experience across the system.

Is high pressure liquid chromatography an effective screening tool for characterization of molecular defects in hemoglobinopathies?

PubMed

Moorchung, Nikhil; Phillip, Joseph; Sarkar, Ravi Shankar; Prasad, Rupesh; Dutta, Vibha

2013-01-01

Hemoglobinopathies constitute entities that are generated by either abnormal hemoglobin or thalassemias. high pressure liquid chromatography (HPLC) is one of the best methods for screening and detection of various hemoglobinopathies but it has intrinsic interpretive problems. The study was designed to evaluate the different mutations seen in cases of hemoglobinopathies and compare the same with screening tests. 68 patients of hemoglobinopathies were screened by HPLC. Mutation studies in the beta globin gene was performed using the polymerase chain reaction (PCR)-based allele-specific Amplification Refractory Mutation System (ARMS). Molecular analysis for the sickle cell mutation was done by standard methods. The IVS 1/5 mutation was the commonest mutation seen and it was seen in 26 (38.23%) of the cases. This was followed by the IVS 1/1, codon 41/42, codon 8/9, del 22 mutation, codon 15 mutation and the -619 bp deletion. No mutation was seen in eight cases. There was a 100% concordance between the sickle cell trait as diagnosed by HPLC and genetic testing. Our study underlies the importance of molecular testing in all cases of hemoglobinopathies. Although HPLC is a useful screening tool, molecular testing is very useful in accurately diagnosing the mutations. Molecular testing is especially applicable in cases with an abnormal hemoglobin (HbD, HbE and HbS) because there may be a concomitant inheritance of a beta thalassemia mutation. Molecular testing is the gold standard when it comes to the diagnosis of hemoglobinopathies.

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

Double-hit follicular lymphoma with MYC and BCL2 translocations: a study of 7 cases with a review of literature.

PubMed

Miao, Yuan; Hu, Shimin; Lu, Xinyan; Li, Shaoying; Wang, Wei; Medeiros, L Jeffrey; Lin, Pei

2016-12-01

Follicular lymphoma with MYC and BCL2 translocations, so-called double-hit follicular lymphoma (DH-FL), is rare. Here, we report the clinicopathological features of 7 cases of DH-FL. All neoplasms had a follicular pattern (1 partially diffuse). Five cases were predominantly low grade, 4 of which had focal (≤20%) grade 3A areas, and 2 cases were of grade 3. All cases were positive for pan-B-cell antigens, CD10, and BCL6; 6 cases were positive for BCL2. Ki-67 was less than or equal to 50% in 6 cases and 90% in 1 grade 3 case. Three patients presented with stage IV disease and 3 had a Follicular Lymphoma International Prognostic Index score of greater than 2. Six patients received immunochemotherapy, and 1 is still under induction therapy with rituximab, ibrutinib, and lenalidomide. Four achieved complete remission and two had a partial response with persistent or refractory disease. The median follow-up time was 25 months (range, 8.5-53.7 months). Two patients treated with standard regimen for follicular lymphoma had relapsed or refractory disease, and 1 died from complications of allogeneic stem cell transplant administered for relapse. In contrast, all 4 patients treated with more intensive regimen for double-hit lymphoma achieved complete remission. In summary, despite predominantly low-grade histology, cases of DH-FL in this study were aggressive and responded better to more intensive than standard treatment regimens, suggesting DH-FL is part of the spectrum of double-hit high-grade lymphoma. Copyright © 2016 Elsevier Inc. All rights reserved.

Performance measurement for case management: principles and objectives for developing standard measures.

PubMed

Howe, Rufus

2005-01-01

Developing standardized performance measurements for case management (CM) has become the holy grail of the field. The Council for Case Management Accountability (CCMA), a leadership committee of the Case Management Society of America (CMSA), has been grappling with the concept since early 2003. This article lays out a theoretical framework for performance measurement and then outlines the progress on a specific initiative begun by CCMA to correlate CM practices with improved outcome measures.

A real-time digital computer program for the simulation of a single rotor helicopter

NASA Technical Reports Server (NTRS)

Houck, J. A.; Gibson, L. H.; Steinmetz, G. G.

1974-01-01

A computer program was developed for the study of a single-rotor helicopter on the Langley Research Center real-time digital simulation system. Descriptions of helicopter equations and data, program subroutines (including flow charts and listings), real-time simulation system routines, and program operation are included. Program usage is illustrated by standard check cases and a representative flight case.

"I Don't Write, I Print": A Case Study in Literacy.

ERIC Educational Resources Information Center

Price-Miller, Carol

A copy of a letter to a cable company, printed in large block letters and not following standard rules of spelling and syntax, serves as a catalyst for thoughts about the person who wrote the letter and a discussion about what constitutes literacy. Despite the appearances of the letter, a case can be made for the author as a writer. A close look…

Estimates and Standard Errors for Ratios of Normalizing Constants from Multiple Markov Chains via Regeneration

PubMed Central

Doss, Hani; Tan, Aixin

2017-01-01

In the classical biased sampling problem, we have k densities π1(·), …, πk(·), each known up to a normalizing constant, i.e. for l = 1, …, k, πl(·) = νl(·)/ml, where νl(·) is a known function and ml is an unknown constant. For each l, we have an iid sample from πl,·and the problem is to estimate the ratios ml/ms for all l and all s. This problem arises frequently in several situations in both frequentist and Bayesian inference. An estimate of the ratios was developed and studied by Vardi and his co-workers over two decades ago, and there has been much subsequent work on this problem from many different perspectives. In spite of this, there are no rigorous results in the literature on how to estimate the standard error of the estimate. We present a class of estimates of the ratios of normalizing constants that are appropriate for the case where the samples from the πl’s are not necessarily iid sequences, but are Markov chains. We also develop an approach based on regenerative simulation for obtaining standard errors for the estimates of ratios of normalizing constants. These standard error estimates are valid for both the iid case and the Markov chain case. PMID:28706463

Estimates and Standard Errors for Ratios of Normalizing Constants from Multiple Markov Chains via Regeneration.

PubMed

Doss, Hani; Tan, Aixin

2014-09-01

In the classical biased sampling problem, we have k densities π 1 (·), …, π k (·), each known up to a normalizing constant, i.e. for l = 1, …, k , π l (·) = ν l (·)/ m l , where ν l (·) is a known function and m l is an unknown constant. For each l , we have an iid sample from π l , · and the problem is to estimate the ratios m l /m s for all l and all s . This problem arises frequently in several situations in both frequentist and Bayesian inference. An estimate of the ratios was developed and studied by Vardi and his co-workers over two decades ago, and there has been much subsequent work on this problem from many different perspectives. In spite of this, there are no rigorous results in the literature on how to estimate the standard error of the estimate. We present a class of estimates of the ratios of normalizing constants that are appropriate for the case where the samples from the π l 's are not necessarily iid sequences, but are Markov chains. We also develop an approach based on regenerative simulation for obtaining standard errors for the estimates of ratios of normalizing constants. These standard error estimates are valid for both the iid case and the Markov chain case.

Instituting a standards-based K--12 science curriculum supplement program at the National Institutes of Health: A case study

NASA Astrophysics Data System (ADS)

Witherly, Jeffre

Research on student achievement indicates the U.S. K-12 education system is not adequately preparing American students to compete in the 21st century global economy in the areas of science and mathematics. Congress has asked the scientific entities of the federal government to help increase K-12 science learning by creating standards-based learning tools for science classrooms as part of a "voluntary curriculum." One problem facing federal entities, such as the National Institutes of Health (NIH), is the need to create science-learning tools that conform to the National Science Education Standards (NSES) for curriculum materials and, therefore, are standards-based and applicable to the K-12 curriculum. This case study sought to better understand the change process at one federal agency as it went from producing K-12 learning tools that were educational in nature to a program that produced K-12 standards-based learning tools: the NIH Science Curriculum Supplement Program (NIH SCSP). The NIH SCSP was studied to gain insight into how this change in educational approach occurred, what factors enabled or inhibited the change process, and what the long-term benefits of the NIH SCSP are to the NIH. Kurt Lewin's three-step theory of change guided data gathering and data analysis. Semi-structured interviews and programmatic document review served as the major data gathering sources. Details describing the process of organizational change at the NIH were revealed during analysis of these data following the coding of interview transcripts and written record documents. The study found the process of change at the NIH proceeded in a manner generally predicted by the Lewinian change model. Enablers to the change were cost-sharing with individual institutes, support of senior leadership, and crediting the role of individual institutes prominently in each supplement. The cost of creating a supplement was reported as the single inhibitor to the program. This case study yielded a detailed description of the process of change at this federal institution that may offer valuable insights to similar federal organizations confronting educational change. The study may also contribute to the existing body of knowledge regarding the process of organizational change in a federal setting.

Combating Terrorism: A Case Study of Nigeria Against Boko Haram Terrorist Group

DTIC Science & Technology

2014-06-13

RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE 19b. PHONE NUMBER (include area code) (U) (U) (U) (U) 135 Standard Form 298 (Rev. 8-98...penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number . PLEASE DO NOT RETURN...2014 4. TITLE AND SUBTITLE Combating Terrorism: A Case Study of Nigeria Against Boko Haram Terrorist Group 5a. CONTRACT NUMBER 5b. GRANT

Performable Case Studies in Ethics Education.

PubMed

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Performable Case Studies in Ethics Education

PubMed Central

Robeson, Richard; King, Nancy M. P.

2017-01-01

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. PMID:28895903

Measuring the Air Quality and Transportation Impacts of Infill Development

EPA Pesticide Factsheets

This report summarizes three case studies. The analysis shows how standard forecasting tools can be modified to capture at least some of the transportation and air quality benefits of brownfield and infill development.

Revised Standard Rules Tender Governing Motor Carrier Transportation

DOT National Transportation Integrated Search

2002-05-10

The following case study provides an in-depth view of the deployment of the safety information exchange components of the Commercial Vehicle Information Systems and Networks (CVISN) technology program in Connecticut. It describes successful practices...

Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

PubMed

McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I

2012-10-01

This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ≥0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ≥0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ≥0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ≥0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ≥0.6 contacts seen per index case based on index case report, and ≥0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting.

Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets

PubMed Central

2011-01-01

Background Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. Methods Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC) developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO) standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. Results Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths). Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. Conclusions This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems. PMID:21816095

Standardization of Sonographic Lung-to-Head Ratio Measurements in Isolated Congenital Diaphragmatic Hernia: Impact on the Reproducibility and Efficacy to Predict Outcomes.

PubMed

Britto, Ingrid Schwach Werneck; Sananes, Nicolas; Olutoye, Oluyinka O; Cass, Darrell L; Sangi-Haghpeykar, Haleh; Lee, Timothy C; Cassady, Christopher I; Mehollin-Ray, Amy; Welty, Stephen; Fernandes, Caraciolo; Belfort, Michael A; Lee, Wesley; Ruano, Rodrigo

2015-10-01

The purpose of this study was to evaluate the impact of standardization of the lung-to-head ratio measurements in isolated congenital diaphragmatic hernia on prediction of neonatal outcomes and reproducibility. We conducted a retrospective cohort study of 77 cases of isolated congenital diaphragmatic hernia managed in a single center between 2004 and 2012. We compared lung-to-head ratio measurements that were performed prospectively in our institution without standardization to standardized measurements performed according to a defined protocol. The standardized lung-to-head ratio measurements were statistically more accurate than the nonstandardized measurements for predicting neonatal mortality (area under the receiver operating characteristic curve, 0.85 versus 0.732; P = .003). After standardization, there were no statistical differences in accuracy between measurements regardless of whether we considered observed-to-expected values (P > .05). Standardization of the lung-to-head ratio did not improve prediction of the need for extracorporeal membrane oxygenation (P> .05). Both intraoperator and interoperator reproducibility were good for the standardized lung-to-head ratio (intraclass correlation coefficient, 0.98 [95% confidence interval, 0.97-0.99]; bias, 0.02 [limits of agreement, -0.11 to +0.15], respectively). Standardization of lung-to-head ratio measurements improves prediction of neonatal outcomes. Further studies are needed to confirm these results and to assess the utility of standardization of other prognostic parameters.

40 CFR 121.30 - Review and advice.

Code of Federal Regulations, 2011 CFR

2011-07-01

... determinations, definitions and interpretations with respect to the meaning and content of water quality... the application of all applicable water quality standards in particular cases and in specific... by dischargers with the conditions and requirements of applicable water quality standards. In cases...

40 CFR 121.30 - Review and advice.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determinations, definitions and interpretations with respect to the meaning and content of water quality... the application of all applicable water quality standards in particular cases and in specific... by dischargers with the conditions and requirements of applicable water quality standards. In cases...

48 CFR 750.7106 - Standards for deciding cases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Standards for deciding cases. 750.7106 Section 750.7106 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect...

Profile of osteopathic practice in Spain: results from a standardized data collection study.

PubMed

Alvarez Bustins, Gerard; López Plaza, Pedro-Victor; Carvajal, Sonia Roura

2018-04-11

There is limited research regarding patients' profiles and consumer attitudes and habits of osteopathy in Spain. The purpose of this study was to profile patients who regularly receive osteopathic care in Spain using an internationally developed standardized data collection tool. During the period between April 2014 and December 2015, a UK-developed standardized data collection tool was distributed to Spanish osteopaths who voluntarily agreed to participate in this cross-sectional study. Thirty-six osteopaths participated in this study and returned a total of 314 completed datasets. Of 314 patients, 61% were women and 39% were men, with a mean age of 40 years (SD 17.02 years, range 0 to 83 years). Forty-four percent were full-time salaried workers, and in 78% of cases, receiving osteopathic treatment was the patient's own choice. Chronic spinal pain presentations were the most frequent reasons for consultation. Seventy-five percent of patients presented with a coexisting condition, mainly gastrointestinal disorders and headaches. The main treatment approach consisted of mobilization techniques, followed by soft tissue, cranial and high velocity thrust techniques. Improvement or resolution of the complaint was experienced by 93% of patients after a small number of sessions. Adverse events were minor and occurred in 7% of all cases. This is the first study carried out in Spain analyzing the profile of patients who receive osteopathic care. The typical patient who receives osteopathic care in Spain is middle-aged, presents mainly with chronic spinal pain, and voluntarily seeks osteopathic treatment. Osteopathic treatment produces a significant improvement in the majority of cases with a low rate of minor adverse events reported.

Adapting dialectical behavior therapy for outpatient adult anorexia nervosa--a pilot study.

PubMed

Chen, Eunice Y; Segal, Kay; Weissman, Jessica; Zeffiro, Thomas A; Gallop, Robert; Linehan, Marsha M; Bohus, Martin; Lynch, Thomas R

2015-01-01

Anorexia Nervosa (AN) is associated with excessive self-control. This iterative case series describes the augmentation of Dialectical Behavior Therapy (DBT) for outpatient adult AN with skills addressing emotional and behavioral overcontrol. An overly controlled style is theorized to develop from the transaction between an individual with heightened threat sensitivity and reduced reward sensitivity, interacting with an environment reinforcing overcontrol and punishing imperfection. Case Series 1 utilized standard DBT, resulting in retention of 5/6 patients and a body mass index (BMI) effect size increase of d = -0.5 from pre- to post-treatment. Case series 2, using standard DBT augmented with skills addressing overcontrol, resulted in retention of 8/9 patients with an effect size increase in BMI at post-treatment that was maintained at 6- and 12-months follow-up (d = -1.12, d = -0.87, and d = -1.12). Findings suggest that skills training targeting rigidity and increasing openness and social connectedness warrant further study of this model and treatment for AN. © 2014 Wiley Periodicals, Inc.

Constraints on new physics from K → π ν {\\bar{ν }}

NASA Astrophysics Data System (ADS)

He, Xiao-Gang; Valencia, German; Wong, Keith

2018-06-01

We study generic effects of new physics on the rare decay modes K_L → π ^0 ν {\\bar{ν }} and K^+ → π ^+ ν {\\bar{ν }}. We discuss several cases: left-handed neutrino couplings; right handed neutrino couplings; neutrino lepton flavour violating (LFV) interactions; and Δ I =3/2 interactions. The first of these cases has been studied before as it covers many new physics extensions of the standard model; the second one requires the existence of a new light (sterile) right-handed neutrino and its contribution to both branching ratios is always additive to the SM. The case of neutrino LFV couplings introduces a CP conserving contribution to K_L → π ^0 ν {\\bar{ν }} which affects the rates in a similar manner as a right handed neutrino as neither one of these interferes with the standard model amplitudes. Finally, we consider new physics with Δ I =3/2 interactions to go beyond the Grossman-Nir bound. We find that the rare kaon rates are only sensitive to new physics scales up to a few GeV for this scenario.

Assessment of Snared-Loop Technique When Standard Retrieval of Inferior Vena Cava Filters Fails

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

Doody, Orla, E-mail: orla_doody@hotmail.com; Noe, Geertje; Given, Mark F.

Purpose To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. Methods A retrospective review of all Cook Guenther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. Results The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range,more » 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. Conclusion The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.« less

Assessing the role of case mix in cesarean delivery rates.

PubMed

Lieberman, E; Lang, J M; Heffner, L J; Cohen, A

1998-07-01

Implicit in comparisons of unadjusted cesarean rates for hospitals and providers is the assumption that differences result from management practices rather than differences in case mix. This study proposes a method for comparison of cesarean rates that takes the effect of case mix into account. All women delivered of infants at our institution from December 1, 1994, through July 31, 1995, were classified according to whether they received care from community-based practitioners (N=3913) or from the hospital-based practice that serves a higher-risk population (N=1556). Women were categorized according to both obstetric history (nulliparas, multiparas without a previous cesarean, multiparas with a previous cesarean) and the presence of obstetric conditions influencing the risk of cesarean delivery (multiple birth, breech presentation or transverse lie, preterm, no trial of labor for a medical indication). We determined the percent of women in each parity-obstetric condition subgroup and calculated a standardized cesarean rate for the hospital-based practice using the case mix of the community-based practitioners as the standard. The crude cesarean rate was higher for the hospital-based practice (24.4%) than for the community-based practitioners (21.5%), a rate difference of 2.9% (95% confidence interval=0.4%, 5.4%; P=.02). However, the proportion of women falling into categories conferring a high risk of cesarean delivery (multiple pregnancy, breech presentation or transverse lie, preterm, no trial of labor permitted) was twice as high for the hospital-based practice (24.4% hospital, 12.1% community). The standardization indicates that if the hospital-based practitioners had the same case mix as community-based practitioners, their overall cesarean rate would be 20.1%, similar to the 21.5% rate of community providers (rate difference=-1.4%, 95% confidence interval =-3.1%, 0.3%; P=.11). Standardization for case mix provides a mechanism for distinguishing differences in cesarean rates resulting from case mix from those relating to differences in practice. The methodology is not complex and could be applied to facilitate fairer comparisons of rates among providers and across institutions.

Use of Evidence-Based Decision-Making in Comprehensive Dental Treatment of a Patient with Meth Mouth-A Case Report.

PubMed

Al Hazzani, Saad A

2017-06-01

This case report illustrates the use of evidence-based practice in formulating a comprehensive dental treatment plan for a patient who presented himself with signs of oral health debilitation accompanying methamphetamine (MA) abuse called "meth mouth" with the goal of providing dental care practitioners in Saudi Arabia with an insight into the global problem of MA abuse and its impact on oral health. This report documents the case of a 22-year-old male patient who reported to the clinic with rampant caries caused due to MA abuse exacerbated by poor oral hygiene and smoking habit. The treatment plan of this present case was formulated on the lines of the evidence-based dentistry approach. A clinical question was composed based on the Problem, Intervention, Comparison, and Outcome format to identify past studies and case reports on meth mouth. A standard search was conducted on PubMed Central. Standard guidelines on the treatment of meth mouth were extracted from the Web site of the American Dental Association. A total of 2 systematic reviews, 7 review articles, 4 epidemiologic studies, 5 case reports, and 1 American Dental Association guideline were found. Accelerated dental decay leading to rampant caries in young and middle-aged adults is a characteristic oral finding in MA abusers. The most important factor that affects the prognosis of dental care is complete cessation of MA use by the patient. Copyright © 2017 Elsevier Inc. All rights reserved.

Association between oral health and gastric precancerous lesions.

PubMed

Salazar, Christian R; Francois, Fritz; Li, Yihong; Corby, Patricia; Hays, Rosemary; Leung, Celine; Bedi, Sukhleen; Segers, Stephanie; Queiroz, Erica; Sun, Jinghua; Wang, Beverly; Ho, Hao; Craig, Ronald; Cruz, Gustavo D; Blaser, Martin J; Perez-Perez, Guillermo; Hayes, Richard B; Dasanayake, Ananda; Pei, Zhiheng; Chen, Yu

2012-02-01

Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09-7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37-5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions.

Evaluation of record linkage of two large administrative databases in a middle income country: stillbirths and notifications of dengue during pregnancy in Brazil.

PubMed

Paixão, Enny S; Harron, Katie; Andrade, Kleydson; Teixeira, Maria Glória; Fiaccone, Rosemeire L; Costa, Maria da Conceição N; Rodrigues, Laura C

2017-07-17

Due to the increasing availability of individual-level information across different electronic datasets, record linkage has become an efficient and important research tool. High quality linkage is essential for producing robust results. The objective of this study was to describe the process of preparing and linking national Brazilian datasets, and to compare the accuracy of different linkage methods for assessing the risk of stillbirth due to dengue in pregnancy. We linked mothers and stillbirths in two routinely collected datasets from Brazil for 2009-2010: for dengue in pregnancy, notifications of infectious diseases (SINAN); for stillbirths, mortality (SIM). Since there was no unique identifier, we used probabilistic linkage based on maternal name, age and municipality. We compared two probabilistic approaches, each with two thresholds: 1) a bespoke linkage algorithm; 2) a standard linkage software widely used in Brazil (ReclinkIII), and used manual review to identify further links. Sensitivity and positive predictive value (PPV) were estimated using a subset of gold-standard data created through manual review. We examined the characteristics of false-matches and missed-matches to identify any sources of bias. From records of 678,999 dengue cases and 62,373 stillbirths, the gold-standard linkage identified 191 cases. The bespoke linkage algorithm with a conservative threshold produced 131 links, with sensitivity = 64.4% (68 missed-matches) and PPV = 92.5% (8 false-matches). Manual review of uncertain links identified an additional 37 links, increasing sensitivity to 83.7%. The bespoke algorithm with a relaxed threshold identified 132 true matches (sensitivity = 69.1%), but introduced 61 false-matches (PPV = 68.4%). ReclinkIII produced lower sensitivity and PPV than the bespoke linkage algorithm. Linkage error was not associated with any recorded study variables. Despite a lack of unique identifiers for linking mothers and stillbirths, we demonstrate a high standard of linkage of large routine databases from a middle income country. Probabilistic linkage and manual review were essential for accurately identifying cases for a case-control study, but this approach may not be feasible for larger databases or for linkage of more common outcomes.

Standardizing Descemet Membrane Endothelial Keratoplasty Graft Preparation Method in the Eye Bank-Experience of 527 Descemet Membrane Endothelial Keratoplasty Tissues.

PubMed

Parekh, Mohit; Baruzzo, Mattia; Favaro, Elisa; Borroni, Davide; Ferrari, Stefano; Ponzin, Diego; Ruzza, Alessandro

2017-12-01

To share the experience and provide a standardized protocol for Descemet membrane endothelial keratoplasty (DMEK) graft preparation. A retrospective study based on 527 prestripped DMEK tissues that were prepared between 2014 and 2017. The experience of using different instruments and techniques has been described, and a standardized technique for preparing DMEK grafts has been identified. The tissues in general were prepared by superficially tapping the endothelial side with a Moria trephine (9.5 mm diameter). The plane of cleavage was identified using a cleavage hook, and the DMEK graft was deadhered from the trephined site throughout the circumference for ease of excising the graft. The DMEK graft was peeled using either one or multiple quadrant methods depending on the challenges faced during excision. The graft was finally marked with the letter "F" to identify the orientation during surgery. Data on endothelial cell loss (ECL) and challenging cases were observed, monitored, and recorded during this period. Less than 1 percent trypan blue-positive cells with tissue wastage of <6% was observed during the study period. Our standardized stripping technique has resulted in an overall ECL of 4.6%. Marking Descemet membrane showed 0.5% cell mortality. Standardizing DMEK technique using specific tools and simple techniques would help new surgeons to decide the instruments and improve their tissue preparation skills also in challenging cases such as previous cataract incisions or horseshoe-shaped tears, further reducing ECL or tissue wastage.

Evaluation of the measurement uncertainty when measuring the resistance of solid isolating materials to tracking

NASA Astrophysics Data System (ADS)

Stare, E.; Beges, G.; Drnovsek, J.

2006-07-01

This paper presents the results of research into the measurement of the resistance of solid isolating materials to tracking. Two types of tracking were investigated: the proof tracking index (PTI) and the comparative tracking index (CTI). Evaluation of the measurement uncertainty in a case study was performed using a test method in accordance with the IEC 60112 standard. In the scope of the tests performed here, this particular test method was used to ensure the safety of electrical appliances. According to the EN ISO/IEC 17025 standard (EN ISO/IEC 17025), in the process of conformity assessment, the evaluation of the measurement uncertainty of the test method should be carried out. In the present article, possible influential parameters that are in accordance with the third and fourth editions of the standard IEC 60112 are discussed. The differences, ambiguities or lack of guidance referring to both editions of the standard are described in the article 'Ambiguities in technical standards—case study IEC 60112—measuring the resistance of solid isolating materials to tracking' (submitted for publication). Several hundred measurements were taken in the present experiments in order to form the basis for the results and conclusions presented. A specific problem of the test (according to the IEC 60112 standard) is the great variety of influential physical parameters (mechanical, electrical, chemical, etc) that can affect the results. At the end of the present article therefore, there is a histogram containing information on the contributions to the measurement uncertainty.

Technical assistance for law-enforcement communications: Case study report two

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Two case histories are presented. In one study the feasibility of consolidating dispatch center operations for small agencies is considered. System load measurements were taken and queueing analysis applied to determine numbers of personnel required for each separate agency and for a consolidated dispatch center. Functional requirements were developed and a cost model was designed to compare relative costs of various alternatives including continuation of the present system, consolidation of a manual system, and consolidated computer-aided dispatching. The second case history deals with the consideration of a multi-regional, intrastate radio frequency for improved interregional communications. Sample standards and specifications for radio equipment are provided.

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

PubMed

Baltazar, J C; Tiglao, T V; Tempongko, S B

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

PubMed Central

Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed. PMID:8324851

Establishment of Kawasaki disease database based on metadata standard.

PubMed

Park, Yu Rang; Kim, Jae-Jung; Yoon, Young Jo; Yoon, Young-Kwang; Koo, Ha Yeong; Hong, Young Mi; Jang, Gi Young; Shin, Soo-Yong; Lee, Jong-Keuk

2016-07-01

Kawasaki disease (KD) is a rare disease that occurs predominantly in infants and young children. To identify KD susceptibility genes and to develop a diagnostic test, a specific therapy, or prevention method, collecting KD patients' clinical and genomic data is one of the major issues. For this purpose, Kawasaki Disease Database (KDD) was developed based on the efforts of Korean Kawasaki Disease Genetics Consortium (KKDGC). KDD is a collection of 1292 clinical data and genomic samples of 1283 patients from 13 KKDGC-participating hospitals. Each sample contains the relevant clinical data, genomic DNA and plasma samples isolated from patients' blood, omics data and KD-associated genotype data. Clinical data was collected and saved using the common data elements based on the ISO/IEC 11179 metadata standard. Two genome-wide association study data of total 482 samples and whole exome sequencing data of 12 samples were also collected. In addition, KDD includes the rare cases of KD (16 cases with family history, 46 cases with recurrence, 119 cases with intravenous immunoglobulin non-responsiveness, and 52 cases with coronary artery aneurysm). As the first public database for KD, KDD can significantly facilitate KD studies. All data in KDD can be searchable and downloadable. KDD was implemented in PHP, MySQL and Apache, with all major browsers supported.Database URL: http://www.kawasakidisease.kr. © The Author(s) 2016. Published by Oxford University Press.

Role of intraoperative ultrasound in achieving complete resection of intra-axial solid brain tumours.

PubMed

Mari, Abdul Razaque; Shah, Irfanullah; Imran, Muhammed; Ashraf, Junaid

2014-12-01

To determine the frequency of completeness of resection for intra-axial solid brain tumours with the help of intra-operative ultrasound to detect residual brain tumour. The cross-sectional study was conducted at the Department of Neurosurgery, Dow University of Health Sciences and Civil Hospital Karachi, from September 2009 to June 2010 and comprised patients with intra-axial solid brain lesion. During operation following standard craniotomy, multi-plane sonographic examination was performed using intra-operative ultrasound for tumour localisation and calculation of dimension, followed by tumour resection in the standard fashion. At the end of tumour resection ultrasound was again used for the detection of any residual tumour. Results of intra-operative ultrasound were compared with post-operative contrast magnetic resonance imaging. Of the 39 cases in which intra-operative ultrasound was performed, 32(82.1%) were males and 7(17.9%) were females, with an overall mean age of 42.6±19.7 years. Intra-operative ultrasonography was able to localise and delineate the tumour in all 39 (100%) cases. It showed no residual tumour in 36 (92.3%) cases, but in 3(7.7%) cases residual tumour was detected. Post-operative contrast enhancing magnetic resonance imaging showed no residual tumour in 35(89.7%) cases and in 4(10.3%) cases residual tumour was detected. The frequency of completely resected intra-axial solid brain tumour was 35(89.7%), while in 4(10.3%) cases incomplete resection was observed. The study concluded that intra-operative ultrasonography has an important role in achieving increased frequency of completely resected intra-axial solid brain tumours.

An Evaluation of Comparability between NEISS and ICD-9-CM Injury Coding

PubMed Central

Thompson, Meghan C.; Wheeler, Krista K.; Shi, Junxin; Smith, Gary A.; Xiang, Huiyun

2014-01-01

Objective To evaluate the National Electronic Injury Surveillance System’s (NEISS) comparability with a data source that uses ICD-9-CM coding. Methods A sample of NEISS cases from a children’s hospital in 2008 was selected, and cases were linked with their original medical record. Medical records were reviewed and an ICD-9-CM code was assigned to each case. Cases in the NEISS sample that were non-injuries by ICD-9-CM standards were identified. A bridging matrix between the NEISS and ICD-9-CM injury coding systems, by type of injury classification, was proposed and evaluated. Results Of the 2,890 cases reviewed, 13.32% (n = 385) were non-injuries according to the ICD-9-CM diagnosis. Using the proposed matrix, the comparability of the NEISS with ICD-9-CM coding was favorable among injury cases (κ = 0.87, 95% CI: 0.85–0.88). The distribution of injury types among the entire sample was similar for the two systems, with percentage differences ≥1% for only open wounds or amputation, poisoning, and other or unspecified injury types. Conclusions There is potential for conducting comparable injury research using NEISS and ICD-9-CM data. Due to the inclusion of some non-injuries in the NEISS and some differences in type of injury definitions between NEISS and ICD-9-CM coding, best practice for studies using NEISS data obtained from the CPSC should include manual review of case narratives. Use of the standardized injury and injury type definitions presented in this study will facilitate more accurate comparisons in injury research. PMID:24658100

An evaluation of comparability between NEISS and ICD-9-CM injury coding.

PubMed

Thompson, Meghan C; Wheeler, Krista K; Shi, Junxin; Smith, Gary A; Xiang, Huiyun

2014-01-01

To evaluate the National Electronic Injury Surveillance System's (NEISS) comparability with a data source that uses ICD-9-CM coding. A sample of NEISS cases from a children's hospital in 2008 was selected, and cases were linked with their original medical record. Medical records were reviewed and an ICD-9-CM code was assigned to each case. Cases in the NEISS sample that were non-injuries by ICD-9-CM standards were identified. A bridging matrix between the NEISS and ICD-9-CM injury coding systems, by type of injury classification, was proposed and evaluated. Of the 2,890 cases reviewed, 13.32% (n = 385) were non-injuries according to the ICD-9-CM diagnosis. Using the proposed matrix, the comparability of the NEISS with ICD-9-CM coding was favorable among injury cases (κ = 0.87, 95% CI: 0.85-0.88). The distribution of injury types among the entire sample was similar for the two systems, with percentage differences ≥1% for only open wounds or amputation, poisoning, and other or unspecified injury types. There is potential for conducting comparable injury research using NEISS and ICD-9-CM data. Due to the inclusion of some non-injuries in the NEISS and some differences in type of injury definitions between NEISS and ICD-9-CM coding, best practice for studies using NEISS data obtained from the CPSC should include manual review of case narratives. Use of the standardized injury and injury type definitions presented in this study will facilitate more accurate comparisons in injury research.

Recommendations to the Federal Railroad Administration concerning critical factors in railroad employee medical standards.

DOT National Transportation Integrated Search

1976-03-01

This report discusses critical factors which should be considered in the preparation of medical standards for locomotive engineers or other individuals who operate moving equipment. In many instances, a guideline is not proposed because case by case ...

32 CFR 220.8 - Reasonable charges.

Code of Federal Regulations, 2012 CFR

2012-07-01

... pass through payments). Additional adjustments are made for long stay outlier cases. Like the CHAMPUS... diagnosis involved. The average charge per case shall be published annually as an inpatient standardized... standardized amounts, one for large urban, other urban/rural, and overseas area, utilizing the same...

[A comparison of assessments of criminal responsibility between psychiatrists and judges: analyses of 50 judicial cases based on a national-wide survey].

PubMed

Osawa, Tatsuya

2007-01-01

In spite of the mounting concerns about forensic psychiatric examination, there are no concrete standards of assessment with regard to criminal responsibility in Japan. Also, some cases have led to disagreements between psychiatrists and judges. To elucidate the tendency in the assessment of criminal responsibility, this study retrospectively examined seventy-one psychiatric assessments and sixty-four judgments in fifty judicial cases. The results revealed that: 1) 97.2% of psychiatrists and 100% of judges assessed the criminal responsibility of defendants based on the gnostic approach; 2) 56.3% of psychiatric assessments of criminal responsibility were consistent with the court's decision; 3) in comparison with judges, psychiatrists did not significantly examine situational factors when they assessed their cases; and 4) their descriptions of the assessment were variable and not standardized. These results show that we psychiatrists should consider at least fourteen factors: motive/cause, modus operandi, hesitation, surrendering, escape, knowledge of crime, their statements, their specific behaviors/emotions (before, during and after the fact), and memory, as considerable items. To standardize the classification and description of the psychiatric assessment of criminal responsibility, the German five-grade assessment (responsible, diminished responsibility cannot be excluded, diminished responsibility, non-responsibility cannot be excluded, and non-responsibility) is applicable to the Japanese criminal justice system.

When Increasing Stakes Need Not Mean Increasing Standards: The Case of the New York State Global History and Geography Exam

ERIC Educational Resources Information Center

Grant, S. G.; Derme-Insinna, Alison; Gradwell, Jill M.; Pullano, Lynn; Lauricella, Ann Marie; Tzezo, Kathryn

2002-01-01

In New York, state-level policymakers have invested considerable political and economic capital in new tests as both a measure of accountability and as a vehicle for increased educational standards. In this study, we look at how 9th and 10th grade global history teachers are making sense of the first administration of a new 10th grade global…

Strategic Reinvention: The Rodel Foundation of Delaware's Journey to Catalyzing a System of World-Class Schools. Principles for Effective Education Grantmaking. Case Study No. 10

ERIC Educational Resources Information Center

Jenkins, Lynn; Wisdom, Michelle

2014-01-01

As the summer of 2014 began, Paul Herdman, President and CEO of the Rodel Charitable Foundation of Delaware, paused to reflect on what Delaware had accomplished over the past decade in the public education realm. Academic standards had been raised across the K-12 system, and a new assessment system aligned to those standards was being implemented.…

Decision Making for Borderline Cases in Pass/Fail Clinical Anatomy Courses: The Practical Value of the Standard Error of Measurement and Likelihood Ratio in a Diagnostic Test

ERIC Educational Resources Information Center

Severo, Milton; Silva-Pereira, Fernanda; Ferreira, Maria Amelia

2013-01-01

Several studies have shown that the standard error of measurement (SEM) can be used as an additional “safety net” to reduce the frequency of false-positive or false-negative student grading classifications. Practical examinations in clinical anatomy are often used as diagnostic tests to admit students to course final examinations. The aim of this…

The Improvement of Particle Swarm Optimization: a Case Study of Optimal Operation in Goupitan Reservoir

NASA Astrophysics Data System (ADS)

Li, Haichen; Qin, Tao; Wang, Weiping; Lei, Xiaohui; Wu, Wenhui

2018-02-01

Due to the weakness in holding diversity and reaching global optimum, the standard particle swarm optimization has not performed well in reservoir optimal operation. To solve this problem, this paper introduces downhill simplex method to work together with the standard particle swarm optimization. The application of this approach in Goupitan reservoir optimal operation proves that the improved method had better accuracy and higher reliability with small investment.

The Impact of Standards-Based Reforms on the Art of Teaching: A Narrative Case Study of the Perceptions of Highly Effective Teachers in Grades 7-12

ERIC Educational Resources Information Center

Thornton, Susan W.

2013-01-01

In the 12 years subsequent to the passing of No Child Left Behind (NCLB), the ensuing standards-based reforms (SBRs) have created multiple effects that have permeated every aspect of the educational process, and teachers have reported specific constraints being placed upon them as a result. Grounded in Eisner's (2002b) theory of aesthetic teaching…

A Case Study of an Aeronautical Systems Division System Program Office.

DTIC Science & Technology

1982-09-01

11111 -’.-- m 1 1.25 111111.4 1 1.6_ MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS-1963-A If. t 1’ I I( N 2> - .~.. * .~ .~-I ~ k~’ ~K ~r...office....assesses.................. 8 Section 11 The Standard Aircraft Sensor UnitProgram........ 32 Section III Terms and Defnition ...contracts with industry, (b) test programs with both industry and other DOD organizations, (c) aircraft production or modification programs with both

Brief Report: Prevalence of Pervasive Developmental Disorder in Brazil--A Pilot Study

ERIC Educational Resources Information Center

Paula, Cristiane S.; Ribeiro, Sabrina H.; Fombonne, Eric; Mercadante, Marcos T.

2011-01-01

This pilot study presents preliminary results concerning the prevalence of Pervasive Developmental Disorder (PDD) in South America. It was a three-phase study conducted in a typical town in Southeast Brazil. Case definition was based in a combination of standardized instruments and clinical evaluations by experts. The prevalence of PDD was…

Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat.

PubMed

Iftikhar, Imran H; Hoyos, Camilla M; Phillips, Craig L; Magalang, Ulysses J

2015-04-15

We sought to conduct an updated meta-analysis of randomized controlled trials (RCTs) on the effect of continuous positive airway pressure (CPAP) on insulin resistance, as measured by homeostasis model assessment of insulin resistance (HOMA-IR), visceral abdominal fat (VAF), and adiponectin. Additionally, we performed a separate meta-analysis and meta-regression of studies on the association of insulin resistance and obstructive sleep apnea (OSA). All included studies were searched from PubMed (from conception to March 15, 2014). Data were pooled across all included RCTs as the mean difference in HOMA-IR and VAF, and as the standardized mean difference in the case of adiponectin analysis. From the included case-control studies, data on the difference of HOMA-IR between cases and controls were pooled across all studies, as the standardized mean difference (SMD). There was a significant difference in HOMA-IR (-0.43 [95% CIs: -0.75 to -0.11], p = 0.008) between CPAP treated and non CPAP treated participants. However, there was no significant difference in VAF or adiponectin; (-47.93 [95% CI: -112.58 to 16.72], p = 0.14) and (-0.06 [95% CI: -0.28 to 0.15], p = 0.56), respectively. Meta-analysis of 16 case-control studies showed a pooled SMD in HOMA-IR of 0.51 (95% CI: 0.28 to 0.75), p ≤ 0.001, between cases and controls. The results of our meta-analyses show that CPAP has a favorable effect on insulin resistance. This effect is not associated with any significant changes in total adiponectin levels or amount of VAF. Our findings also confirm a significant association between OSA and insulin resistance. © 2015 American Academy of Sleep Medicine.

A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions

PubMed Central

2017-01-01

The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897

The Exceptional Responders Initiative: Welcoming More Cases

Cancer.gov

The initiative is studying tissue, clinical, and genomic data from patients with cancer who have had dramatic and long-lasting responses to standard and experimental treatments that were not seen in similar patients who received the same treatment.

Pattern of congenital heart diseases in Rwandan children with genetic defects

PubMed Central

Teteli, Raissa; Uwineza, Annette; Butera, Yvan; Hitayezu, Janvier; Murorunkwere, Seraphine; Umurerwa, Lamberte; Ndinkabandi, Janvier; Hellin, Anne-Cécile; Jamar, Mauricette; Caberg, Jean-Hubert; Muganga, Narcisse; Mucumbitsi, Joseph; Rusingiza, Emmanuel Kamanzi; Mutesa, Leon

2014-01-01

Introduction Congenital heart diseases (CHD) are commonly associated with genetic defects. Our study aimed at determining the occurrence and pattern of CHD association with genetic defects among pediatric patients in Rwanda. Methods A total of 125 patients with clinical features suggestive of genetic defects were recruited. Echocardiography and standard karyotype studies were performed in all patients. Results CHDs were detected in the majority of patients with genetic defects. The commonest isolated CHD was ventricular septal defect found in many cases of Down syndrome. In total, chromosomal abnormalities represented the majority of cases in our cohort and were associated with various types of CHDs. Conclusion Our findings showed that CHDs are common in Rwandan pediatric patients with genetic defects. These results suggest that a routine echocardiography assessment combined with systematic genetic investigations including standard karyotype should be mandatory in patients presenting characteristic clinical features in whom CHD is suspected to be associated with genetic defect. PMID:25722758

Obsolete Laws: Economic and Moral Aspects, Case Study-Composting Standards.

PubMed

Vochozka, Marek; Maroušková, Anna; Šuleř, Petr

2017-12-01

From the early days of philosophy, ethics and justice, there is wide consensus that the constancy of the laws establishes the legal system. On the other hand, the rate at which we accumulate knowledge is gaining speed like never before. Due to the recently increased attention of academics to climate change and other environmental issues, a lot of new knowledge has been obtained about carbon management, its role in nature and mechanisms regarding the formation and degradation of organic matter. A multidisciplinary techno-economic assessment of current composting standards and laws that took into account the current state of knowledge about carbon management was carried out as a case study. Economic and environmental damage caused by outdated laws was revealed. In addition, it was found that the introduction of the best composts into the market is permitted, causing additional negative environmental as well as economic impacts.

Prospects and Problems of Transferring Quality-Improvement Methods from Health Care to Social Services: Two Case Studies

PubMed Central

Neubeck, Truls; Elg, Mattias; Schneider, Thomas; Andersson-Gäre, Boel

2014-01-01

Introduction: This study examines the use of quality-improvement (QI) methods in social services. Particularly the key aspects—generalizable knowledge, interprofessional teamwork, and measurements—are studied in projects from the QI program Forum for Values in Sweden. Methods: This is a mixed-method case study. Two projects using standard QI methods and tools as used in health care were chosen as critical cases to highlight some problems and prospects with the use of QI in social services. The cases were analyzed through documented results and qualitative interviews with participants one year after the QI projects ended. Results: The social service QI projects led to measurable improvements when they used standard methods and tools for QI in health care. One year after the projects, the improvements were either not continuously measured or not reported in any infrastructure for measurements. The study reveals that social services differ from health care regarding the availability and use of evidence, the role of professional expertise, and infrastructure for measurements. Conclusions: We argue that QI methods as used in health care are applicable in social services and can lead to measurable improvements. The study gives valuable insights for QI, not only in social services but also in health care, on how to assess and sustain improvements when infrastructures for measurements are lacking. In addition, when one forms QI teams, the focus should be on functions instead of professions, and QI methods can be used to support implementation of evidence-based practice. PMID:24867549

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies.

PubMed

Palmer, Tom M; Holmes, Michael V; Keating, Brendan J; Sheehan, Nuala A

2017-11-01

Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Case study: a young male with auditory hallucinations in paranoid schizophrenia.

PubMed

Kotowski, Abigail

2012-02-01

The purpose of this case study is to demonstrate use of the nursing process and the standardized nursing languages of NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a young male with paranoid schizophrenia to deal with auditory hallucinations. Data were obtained from the experience and expertise of the author and published literature. This case study demonstrates nurses' clinical decision making in providing care for an adolescent with mental illness. This case study provides the pertinent nursing diagnosis, patient outcomes, and nursing interventions for a young male with auditory hallucinations in paranoid schizophrenia. The use of NANDA-I, NOC, and NIC can provide the necessary framework for enhancing and improving the management of care with patients who experience auditory hallucinations in paranoid schizophrenia. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

The Welfare of Bears in Zoos: A Case Study of Poland.

PubMed

Maślak, Robert; Sergiel, Agnieszka; Bowles, David; Paśko, Łukasz

2016-01-01

The welfare of captive bears became a big issue of concern in Poland when a case of a bear being ill-treated became a high-profile case in the media. This case created a challenge to verify, study, and understand the main problems associated with bear keeping so that zoos could significantly improve the conditions in which they keep bears or ensure they keep bears at the minimum required standards. The results presented here are from 1 of the few countrywide studies of captive bear conditions conducted in all the captive institutions in Poland that keep bears. Thirteen institutions kept bears at the time of the study (2007-2009), including 54 individuals of 5 species. Major welfare problems were identified, and the results have been used to challenge zoos to address the changes required and focus the government's attention on areas that require legislative improvement.

Designing image segmentation studies: Statistical power, sample size and reference standard quality.

PubMed

Gibson, Eli; Hu, Yipeng; Huisman, Henkjan J; Barratt, Dean C

2017-12-01

Segmentation algorithms are typically evaluated by comparison to an accepted reference standard. The cost of generating accurate reference standards for medical image segmentation can be substantial. Since the study cost and the likelihood of detecting a clinically meaningful difference in accuracy both depend on the size and on the quality of the study reference standard, balancing these trade-offs supports the efficient use of research resources. In this work, we derive a statistical power calculation that enables researchers to estimate the appropriate sample size to detect clinically meaningful differences in segmentation accuracy (i.e. the proportion of voxels matching the reference standard) between two algorithms. Furthermore, we derive a formula to relate reference standard errors to their effect on the sample sizes of studies using lower-quality (but potentially more affordable and practically available) reference standards. The accuracy of the derived sample size formula was estimated through Monte Carlo simulation, demonstrating, with 95% confidence, a predicted statistical power within 4% of simulated values across a range of model parameters. This corresponds to sample size errors of less than 4 subjects and errors in the detectable accuracy difference less than 0.6%. The applicability of the formula to real-world data was assessed using bootstrap resampling simulations for pairs of algorithms from the PROMISE12 prostate MR segmentation challenge data set. The model predicted the simulated power for the majority of algorithm pairs within 4% for simulated experiments using a high-quality reference standard and within 6% for simulated experiments using a low-quality reference standard. A case study, also based on the PROMISE12 data, illustrates using the formulae to evaluate whether to use a lower-quality reference standard in a prostate segmentation study. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

National Policy and the Development of Inclusive School Practices: A Case Study

ERIC Educational Resources Information Center

Dyson, Alan; Gallannaugh, Frances

2007-01-01

National education policy in England under New Labour Governments has encompassed both a "standards agenda" and an "inclusion agenda", with schools required to respond to both simultaneously. Some previous studies have seen these agendas as contradictory and have seen schools' efforts to develop inclusive practices as being…

The Complete Guide to Training Delivery: A Competency-Based Approach.

ERIC Educational Resources Information Center

King, Stephen B.; King, Marsha; Rothwell, William J.

This guide focuses on 14 instructor competencies identified by the International Board of Standards for Training, Performance, and Instruction. It provides examples, job aids, worksheets, case studies, and sample dialogs and contains actual experiences and critical incidents faced by trainers who participated in the survey study. Strategies to…

What Role Do Race, Ethnicity, Language and Gender Play in the Teaching Profession?

ERIC Educational Resources Information Center

Nguyen, Huong Tran

2012-01-01

"Critical race theory" and "standard language ideology" are employed as theoretical and analytical frames for conceptualizing and understanding the entry perspectives and experiences of some Vietnamese American pre-service teachers in US schools. Study findings from a qualitative case study approach suggest that race,…

Implementing Competence Frameworks in Mexico

ERIC Educational Resources Information Center

de Anda, Maria Luisa

2011-01-01

This article is based on the Mexican case study undertaken as part of the comparative study of the implementation and impact of National Qualifications Frameworks (NQF). Even though Mexico does not have a comprehensive NQF, the country has considerable experience in the development of labour competence technical standards; these share some aims…

Chinese Junior High School Students' Perceptions of Geographic Fieldwork: A Case Study

ERIC Educational Resources Information Center

Yang, Daihu; Wang, Ziying; Xu, Di; Wang, Chuanbing; Deng, Zhengzheng

2013-01-01

After nearly ten years of implementation of the first junior high school geography standards, Chinese geography educators have been increasingly incorporating fieldwork into their geography teaching. This study examined student perceptions of fieldwork from an international perspective by reviewing student fieldwork reports and administering a…

Entrepreneurship Education and Graduates Unemployment in Oyo State, Nigeria

ERIC Educational Resources Information Center

Emunemu, B. O.; Kasali, O. J.

2014-01-01

This study investigated entrepreneurship and graduates' unemployment in Nigeria.The problem of unemployment in Nigeria has become endemic. There have been reported cases of under-employment, seasonal, casual and full blown unemployment. Previous studies on unemployment and factors influencing it in Nigeria identify poor educational standards,…

On Logic and Standards for Structuring Documents

NASA Astrophysics Data System (ADS)

Eyers, David M.; Jones, Andrew J. I.; Kimbrough, Steven O.

The advent of XML has been widely seized upon as an opportunity to develop document representation standards that lend themselves to automated processing. This is a welcome development and much good has come of it. That said, present standardization efforts may be criticized on a number of counts. We explore two issues associated with document XML standardization efforts. We label them (i) the dynamic point and (ii) the logical point. Our dynamic point is that in many cases experience has shown that the search for a final, or even reasonably permanent, document representation standard is futile. The case is especially strong for electronic data interchange (EDI). Our logical point is that formalization into symbolic logic is materially helpful for understanding and designing dynamic document standards.

[Methods for evaluating diagnostic tests in Enfermedades Infecciosas y Microbiología Clínica].

PubMed

Ramos, J M; Hernández, I

1998-04-01

In the field of infectious diseases and clinical microbiology, the evaluation of diagnostic tests (DT) is an important research area. The specific difficulties of this type of research has motivated that have not caught the severity methodological of others areas of clinical research. This article try to asses and characterize the methodology of articles about DT published in Enfermedades Infecciosas y Microbiología Clínica (EIMC) journal. Forty-five articles was selected in the EIMC journal during the 1990-1996 period, because of determinate the sensitivity and specificity of different DT. Methodological standards, extensively accepted was used. In all of articles, except one (98%) the gold standard was specified yours use, however in 4 studies (9%) include the DT in the gold standard (incorporation bias). The correct description of DT was reported in 75% of cases, but only in 11% cases the reproducibility of test was evaluated. The description of source of reference population, standard of inclusion and spectrum of composition was described in 58, 33 and 40% of articles, respectively. In 33% of studies presented workup bias, only 6% commented blind-analysis of results, and 11% presented indeterminate test results. Half of the studies reported test indexes for clinical subgroups, only one article (2%) provided numerical precision for test indexes, and only 7% reported receiver operating characteristics curves. The methodological quality of DT research in the EIMC journal may improve in different aspects of design and presentation of results.

The Higgs boson can delay reheating after inflation

NASA Astrophysics Data System (ADS)

Freese, Katherine; Sfakianakis, Evangelos I.; Stengel, Patrick; Visinelli, Luca

2018-05-01

The Standard Model Higgs boson, which has previously been shown to develop an effective vacuum expectation value during inflation, can give rise to large particle masses during inflation and reheating, leading to temporary blocking of the reheating process and a lower reheat temperature after inflation. We study the effects on the multiple stages of reheating: resonant particle production (preheating) as well as perturbative decays from coherent oscillations of the inflaton field. Specifically, we study both the cases of the inflaton coupling to Standard Model fermions through Yukawa interactions as well as to Abelian gauge fields through a Chern-Simons term. We find that, in the case of perturbative inflaton decay to SM fermions, reheating can be delayed due to Higgs blocking and the reheat temperature can decrease by up to an order of magnitude. In the case of gauge-reheating, Higgs-generated masses of the gauge fields can suppress preheating even for large inflaton-gauge couplings. In extreme cases, preheating can be shut down completely and must be substituted by perturbative decay as the dominant reheating channel. Finally, we discuss the distribution of reheat temperatures in different Hubble patches, arising from the stochastic nature of the Higgs VEV during inflation and its implications for the generation of both adiabatic and isocurvature fluctuations.