Measuring Resource Utilization: A Systematic Review of Validated Self-Reported Questionnaires.

PubMed

Leggett, Laura E; Khadaroo, Rachel G; Holroyd-Leduc, Jayna; Lorenzetti, Diane L; Hanson, Heather; Wagg, Adrian; Padwal, Raj; Clement, Fiona

2016-03-01

A variety of methods may be used to obtain costing data. Although administrative data are most commonly used, the data available in these datasets are often limited. An alternative method of obtaining costing is through self-reported questionnaires. Currently, there are no systematic reviews that summarize self-reported resource utilization instruments from the published literature.The aim of the study was to identify validated self-report healthcare resource use instruments and to map their attributes.A systematic review was conducted. The search identified articles using terms like "healthcare utilization" and "questionnaire." All abstracts and full texts were considered in duplicate. For inclusion, studies had to assess the validity of a self-reported resource use questionnaire, to report original data, include adult populations, and the questionnaire had to be publically available. Data such as type of resource utilization assessed by each questionnaire, and validation findings were extracted from each study.In all, 2343 unique citations were retrieved; 2297 were excluded during abstract review. Forty-six studies were reviewed in full text, and 15 studies were included in this systematic review. Six assessed resource utilization of patients with chronic conditions; 5 assessed mental health service utilization; 3 assessed resource utilization by a general population; and 1 assessed utilization in older populations. The most frequently measured resources included visits to general practitioners and inpatient stays; nonmedical resources were least frequently measured. Self-reported questionnaires on resource utilization had good agreement with administrative data, although, visits to general practitioners, outpatient days, and nurse visits had poorer agreement.Self-reported questionnaires are a valid method of collecting data on healthcare resource utilization.

42 CFR 476.96 - Review period and reopening of initial denial determinations and changes as a result of DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.96 Review period and reopening of...

Utility installation review system : implementation report.

DOT National Transportation Integrated Search

2009-03-01

Each year, the Texas Department of Transportation (TxDOT) issues thousands of approvals that enable new : utility installations to occupy the state right of way (ROW). The current utility installation review process : relies on the physical delivery ...

42 CFR 476.73 - Notification of QIO designation and implementation of review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of review. 476.73 Section 476.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

42 CFR 456.507 - Review and granting of waiver requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.507 Review and...

Utility installation review (UIR) system training materials.

DOT National Transportation Integrated Search

2008-10-01

The Texas Department of Transportation (TxDOT) issues thousands of approvals every year that : enable new utility installations to occupy the state right-of-way (ROW). The utility installation : review process currently in place is manual, tedious, a...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 476.83 - Initial denial determinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

....83 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.100 - Use of norms and criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2011 CFR

2011-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2013 CFR

2013-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2014 CFR

2014-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2012 CFR

2012-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

A Practical Guide to Conducting a Systematic Review and Meta-analysis of Health State Utility Values.

PubMed

Petrou, Stavros; Kwon, Joseph; Madan, Jason

2018-05-10

Economic analysts are increasingly likely to rely on systematic reviews and meta-analyses of health state utility values to inform the parameter inputs of decision-analytic modelling-based economic evaluations. Beyond the context of economic evaluation, evidence from systematic reviews and meta-analyses of health state utility values can be used to inform broader health policy decisions. This paper provides practical guidance on how to conduct a systematic review and meta-analysis of health state utility values. The paper outlines a number of stages in conducting a systematic review, including identifying the appropriate evidence, study selection, data extraction and presentation, and quality and relevance assessment. The paper outlines three broad approaches that can be used to synthesise multiple estimates of health utilities for a given health state or condition, namely fixed-effect meta-analysis, random-effects meta-analysis and mixed-effects meta-regression. Each approach is illustrated by a synthesis of utility values for a hypothetical decision problem, and software code is provided. The paper highlights a number of methodological issues pertinent to the conduct of meta-analysis or meta-regression. These include the importance of limiting synthesis to 'comparable' utility estimates, for example those derived using common utility measurement approaches and sources of valuation; the effects of reliance on limited or poorly reported published data from primary utility assessment studies; the use of aggregate outcomes within analyses; approaches to generating measures of uncertainty; handling of median utility values; challenges surrounding the disentanglement of utility estimates collected serially within the context of prospective observational studies or prospective randomised trials; challenges surrounding the disentanglement of intervention effects; and approaches to measuring model validity. Areas of methodological debate and avenues for future research are highlighted.

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.523 - Revised UR plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality of...

42 CFR 456.523 - Revised UR plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality of...

In-Situ Resource Utilization (ISRU) Capability Roadmap Progress Review

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.; Duke, Michael

2005-01-01

A progress review on In-Situ Resource Utilization (ISRU) capability is presented. The topics include: 1) In-Situ Resource Utilization (ISRU) Capability Roadmap: Level 1; 2) ISRU Emphasized Architecture Overview; 3) ISRU Capability Elements: Level 2 and below; and 4) ISRU Capability Roadmap Wrap-up.

42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Review of the quality of care of risk-basis health... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control...

42 CFR 456.233 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... must provide that— (a) When a recipient is admitted to the mental hospital under admission review... will be reviewed; (b) If an individual applies for Medicaid while in the mental hospital, the committee...

Medical Utilization of Kiosks in the Delivery of Patient Education: A Systematic Review

PubMed Central

Yvonne Chan, Yu-Feng; Nagurka, Roxanne; Bentley, Suzanne; Ordonez, Edgardo; Sproule, William

2014-01-01

Background: The utilization of kiosks has previously been shown to be effective for collecting information, delivering educational modules, and providing access to health information. We discuss a review of current literature for the utilization of kiosks for the delivery of patient education. Methods: The criteria for inclusion in this literature review were: (1) study discusses the utilization of kiosks for patient health education; (2) study discusses the use of touch screens for patient health information; (3) published in English. Our review includes searches via MEDLINE databases and Google Scholar for the years 1996-2014. Results: Overall, 167 articles were screened for final eligibility, and after discarding duplicates and non-eligible studies with abstract. Full-text review of 28 articles was included in the final analysis. Conclusion: The review of available literature demonstrates the effectiveness of touch screen kiosks to educate patients and to improve healthcare, both at a performance and cost advantage over other modes of patient education. PMID:25097831

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Director, OCHAMPUS. These contractors may include contractors that have exclusive functions in the area of utilization and quality review, fiscal intermediary contractors (which perform these functions along with a... functions concerning management of the delivery and financing of health care services under CHAMPUS...

42 CFR 456.231 - Continued stay review required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... a review of each recipient's continued stay in the mental hospital to decide whether it is needed...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

ETV Programmes: Review of Research.

ERIC Educational Resources Information Center

Chaudhary, Sohanvir; Panda, Santosh

1997-01-01

Reviews research on educational television (ETV), focusing on teacher and student attitudes; impact on children and teachers and in-service education in media; and utilization. Also reviews a few studies on the impact and utilization of educational radio broadcasts. Draws broad conclusions about the use, design, and learning process of ETV. (PEN)

42 CFR 476.93 - Opportunity to discuss proposed initial denial determination and changes as a result of a DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.93 Opportunity to discuss proposed...

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.85 Conclusive effect of QIO initial...

Analysis of instruments measuring nurses' attitudes towards research utilization: a systematic review.

PubMed

Frasure, Jamey

2008-01-01

This paper is a report of a systematic review describing instruments used to measure nurses' attitudes towards research utilization. Researchers need to have the tools to measure nurses' attitudes. However, limited literature critically analyses instruments and the concepts that comprise nurses' attitudes towards research utilization. A search of the literature from 1982 to 2007 was performed using the Cumulative Index to Nursing and Allied Health Literature, Health and Psychosocial Instruments, PubMed and MEDLINE data bases. The search terms were nursing research, research utilization, instruments, and nurses' attitudes. A total of 186 sources were identified, of which 25 were reviewed. Fourteen instruments met the criteria for in-depth critical analysis of psychometric properties and concepts, and were included in the final review. Each instrument item was judged to be relevant to direct, indirect, persuasive and overall research utilization as defined by Estabrooks. Instruments were arranged from the strongest to the weakest reliability of the subscales to determine the instrument with the strongest psychometric properties. Indirect and overall research utilization was measured by all of the instruments. Ten instruments measured direct research utilization and nine instruments measured persuasive research utilization. The Research Utilization in Nursing Survey by Estabrooks, as adapted by Kenny, was an instrument with strong psychometric properties measuring all four concepts of nurses' attitudes towards using and participating in research and was clinically feasible. Many published instruments are available for use by nurse researchers to measure nurses' attitude towards research utilization, but only one has been subjected to rigorous testing: the Research Utilization in Nursing Survey by Estabrooks.

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

Utilization and Limitations of the American College Health Association's National College Health Assessment Instrument: A Systematic Review

ERIC Educational Resources Information Center

Rahn, Rhonda N.; Pruitt, Buster; Goodson, Patricia

2016-01-01

Objective: To analyze the literature in which researchers have utilized the National College Health Assessment (NCHA) I or the NCHA II. Participants and Methods: The authors selected peer-reviewed articles published between 2004 and July 2013 utilizing a single search term: National College Health Assessment. Articles were assessed for instrument…

Integrated concurrent utilization quality review, Part one.

PubMed

Caterinicchio, R P

1987-01-01

This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

Individual determinants of research utilization by nurses: a systematic review update.

PubMed

Squires, Janet E; Estabrooks, Carole A; Gustavsson, Petter; Wallin, Lars

2011-01-05

Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods.

Individual determinants of research utilization by nurses: a systematic review update

PubMed Central

2011-01-01

Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. Conclusions This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods. PMID:21208425

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review

PubMed Central

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-01-01

Introduction Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. Methods and analysis A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. Trial registration number PROSPERO CRD42016037146. PMID:28193848

Simulation modeling for stratified breast cancer screening - a systematic review of cost and quality of life assumptions.

PubMed

Arnold, Matthias

2017-12-02

The economic evaluation of stratified breast cancer screening gains momentum, but produces also very diverse results. Systematic reviews so far focused on modeling techniques and epidemiologic assumptions. However, cost and utility parameters received only little attention. This systematic review assesses simulation models for stratified breast cancer screening based on their cost and utility parameters in each phase of breast cancer screening and care. A literature review was conducted to compare economic evaluations with simulation models of personalized breast cancer screening. Study quality was assessed using reporting guidelines. Cost and utility inputs were extracted, standardized and structured using a care delivery framework. Studies were then clustered according to their study aim and parameters were compared within the clusters. Eighteen studies were identified within three study clusters. Reporting quality was very diverse in all three clusters. Only two studies in cluster 1, four studies in cluster 2 and one study in cluster 3 scored high in the quality appraisal. In addition to the quality appraisal, this review assessed if the simulation models were consistent in integrating all relevant phases of care, if utility parameters were consistent and methodological sound and if cost were compatible and consistent in the actual parameters used for screening, diagnostic work up and treatment. Of 18 studies, only three studies did not show signs of potential bias. This systematic review shows that a closer look into the cost and utility parameter can help to identify potential bias. Future simulation models should focus on integrating all relevant phases of care, using methodologically sound utility parameters and avoiding inconsistent cost parameters.

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... Quality Control Quality Improvement Organization (QIO) (or the review component of a QIO subcontractor) in... sought under Title XVIII of the Act. Aggregate statistical data means any utilization, admission...

42 CFR 476.70 - Statutory bases and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 476.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476...

42 CFR 476.76 - Cooperation with health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions...

The PSRO hospital review system.

PubMed

Goran, M J; Roberts, J S; Kellogg, M A; Fielding, J; Jessee, W

1975-04-01

The 1972 Social Security amendments contained the landmark Professional Standards Review Organization (PSRO) provisions as well as several sections upgrading existing utilization review (UR) requirements under Medicare and Medicaid. With issuance of the PSRO Program Manual and the recent publication of the new UR regulations, HEW for the first time has brought Medicare and Medicaid hospital review requirements into conformity and made them compatible with and supportive of the PSRO program. This article defines the PSRO hospital review system, describes how the three major components-concurrent review, medical care evaluation studies, and profile analysis-interrelate and provides examples of each of these components. Under utilization review requirements or PSRO, hospitals will be required to implement an integrated system of review designed to assure appropriate utilization practices and improve the quality of care. These aims are to be accomplished through the application of concepts of peer review, the use of norms, criteria, and standards, the identification of deficiencies in the quality, administration, or appropriateness of health care services, and their correction through linkage with programs of continuing medical education. Although PSROs are initially responsible for review in hospitals, they will likely provide the locus for a community-wide system of peer review for all services provided under National Health Insurance.

Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.

PubMed

Abraha, Yosef G; Gebrie, Serebe A; Garoma, Desalegn A; Deribe, Fasil M; Tefera, Mamuye H; Morankar, Sudhakar

2017-07-01

The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research.

PubMed

Phillips, Kathryn A; Deverka, Patricia A; Sox, Harold C; Khoury, Muin J; Sandy, Lewis G; Ginsburg, Geoffrey S; Tunis, Sean R; Orlando, Lori A; Douglas, Michael P

2017-10-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address.Genet Med advance online publication 13 April 2017.

A systematic review of health economic models and utility estimation methods in schizophrenia.

PubMed

Németh, Bertalan; Fasseeh, Ahmad; Molnár, Anett; Bitter, István; Horváth, Margit; Kóczián, Kristóf; Götze, Árpád; Nagy, Balázs

2018-06-01

There is a growing need for economic evaluations describing the disease course, as well as the costs and clinical outcomes related to the treatment of schizophrenia. Areas covered: A systematic review on studies describing health economic models in schizophrenia and a targeted literature review on utility mapping algorithms in schizophrenia were carried out. Models found in the review were collated and assessed in detail according to their type and various other attributes. Fifty-nine studies were included in the review. Modeling techniques varied from simple decision trees to complex simulation models. The models used various clinical endpoints as value drivers, 47% of the models used quality-adjusted life years, and eight percent used disability-adjusted life years to measure benefits, while others applied various clinical outcomes. Most models considered patients switching between therapies, and therapeutic adherence, compliance or persistence. The targeted literature review identified four main approaches to map PANSS scores to utility values. Expert commentary: Health economic models developed for schizophrenia showed great variability, with simulation models becoming more frequently used in the last decade. Using PANSS scores as the basis of utility estimations is justifiable.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research

PubMed Central

Phillips, Kathryn A.; Deverka, Patricia A.; Sox, Harold C.; Khoury, Muin J.; Sandy, Lewis G.; Ginsburg, Geoffrey S.; Tunis, Sean R.; Orlando, Lori A.; Douglas, Michael P.

2017-01-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address. Genet Med advance online publication 13 April 2017 PMID:28406488

Health State Utility Value in Chronic Obstructive Pulmonary Disease (COPD); The Challenge of Heterogeneity: A Systematic Review and Meta-Analysis.

PubMed

Moayeri, Foruhar; Hsueh, Ya-Seng Arthur; Clarke, Philip; Hua, Xinyang; Dunt, David

2016-06-01

Chronic obstructive pulmonary disease (COPD) has a considerable impact on quality of life and well-being of patients. Health state utility value (HSUV) is a recognized measure for health economic appraisals and is extensively used as an indicator for decision-making studies. This study is a systematic review of literature aimed to estimate mean utility value in COPD using meta-analysis and explore degree of heterogeneity in the utility values across a variety of clinical and study characteristic. The literature review covers studies that used EQ-5D to estimate utility value for patient level research in COPD. Studies that reported utility values elicited by EQ-5D in COPD patients were selected for random-effect meta-analysis addressing inter-study heterogeneity and subgroup analyses. Thirty-two studies were included in the general utility meta-analysis. The estimated general utility value was 0.673 (95% CI 0.653 to 0.693). Meta-analyses of COPD stages utility values showed influence of airway obstruction on utility value. The utility values ranged from 0.820 (95% CI 0.767 to 0.872) for stage I to 0.624 (95% CI 0.571 to 0.677) for stage IV. There was substantial heterogeneity in utility values: I(2) = 97.7%. A more accurate measurement of utility values in COPD is needed to refine valid and generalizable scores of HSUV. Given the limited success of the factors studied to reduce heterogeneity, an approach needs to be developed how best to use mean utility values for COPD in health economic evaluation.

42 CFR 476.82 - Continuation of functions not assumed by QIOs.

Code of Federal Regulations, 2010 CFR

2010-10-01

....82 Section 476.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.80 - Coordination with Medicare fiscal intermediaries and carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and carriers. 476.80 Section 476.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

A Systematic Review of the Impact of Alcohol Use Disorders on HIV Treatment Outcomes, Adherence to Antiretroviral Therapy and Health Care Utilization *

PubMed Central

Azar, Marwan M.; Springer, Sandra A.; Meyer, Jaimie P.; Altice, Frederick L.

2010-01-01

Background Alcohol use disorders (AUDs) are highly prevalent and associated with non-adherence to antiretroviral therapy, decreased health care utilization and poor HIV treatment outcomes among HIV-infected individuals. Objectives To systematically review studies assessing the impact of AUDs on: (1) medication adherence, (2) health care utilization and (3) biological treatment outcomes among people living with HIV/AIDS (PLWHA). Data Sources Six electronic databases and Google Scholar were queried for articles published in English, French and Spanish from 1988 to 2010. Selected references from primary articles were also examined. Review Methods Selection criteria included: 1) AUD and adherence (N=20); 2) AUD and health services utilization (N=11); or 3) AUD with CD4 count or HIV-1 RNA treatment outcomes (N=10). Reviews, animal studies, non-peer reviewed documents and ongoing studies with unpublished data were excluded. Studies that did not differentiate HIV+ from HIV- status and those that did not distinguish between drug and alcohol use were also excluded. Data were extracted, appraised and summarized. Data Synthesis and Conclusions Our findings consistently support an association between AUDs and decreased adherence to antiretroviral therapy and poor HIV treatment outcomes among HIV-infected individuals. Their effect on health care utilization, however, was variable. PMID:20705402

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2012 CFR

2012-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2014 CFR

2014-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

Leadership Principles Leveraged from Key Civil War Battles

DTIC Science & Technology

2017-05-15

primary research method utilized for this research paper. The purpose of the literature review was to find data and information regarding analysis of...review was the primary research method utilized for this research paper. The purpose of the literature review was to find data and information...data generation and analysis. Organizational Research Methods , 15 (2), 316-335. Becker, W.S. & Burke, M.J. (2014). Instructional staff

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review.

PubMed

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-02-13

Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. PROSPERO CRD42016037146. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The validity and clinical utility of the Disabilities of the Arm Shoulder and Hand questionnaire for hand injuries in developing country contexts: A systematic review.

PubMed

de Klerk, Susan; Buchanan, Helen; Jerosch-Herold, Christina

Systematic review. The Disabilities of the Arm Shoulder and Hand Questionnaire has multiple language versions from many countries around the world. In addition there is extensive research evidence of its psychometric properties. The purpose of this study was to systematically review the evidence available on the validity and clinical utility of the Disabilities of the Arm Shoulder and Hand as a measure of activity and participation in patients with musculoskeletal hand injuries in developing country contexts. We registered the review with international prospective register of systematic reviews prior to conducting a comprehensive literature search and extracting descriptive data. Two reviewers independently assessed methodological quality with the Consensus-Based Standards for the Selection of Health Measurement Instruments critical appraisal tool, the checklist to operationalize measurement characteristics of patient-rated outcome measures and the multidimensional model of clinical utility. Fourteen studies reporting 12 language versions met the eligibility criteria. Two language versions (Persian and Turkish) had an overall rating of good, and one (Thai) had an overall rating of excellent for cross-cultural validity. The remaining 9 language versions had an overall poor rating for cross-cultural validity. Content and construct validity and clinical utility yielded similar results. Poor quality ratings for validity and clinical utility were due to insufficient documentation of results and inadequate psychometric testing. With the increase in migration and globalization, hand therapists are likely to require a range of culturally adapted and translated versions of the Disabilities of the Arm Shoulder and Hand. Recommendations include rigorous application and reporting of cross-cultural adaptation, appropriate psychometric testing, and testing of clinical utility in routine clinical practice. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Should "standard gamble" and "'time trade off" utility measurement be used more in mental health research?

PubMed

Flood, Chris

2010-06-01

This review and discussion paper demonstrates that utility and preference measurement in mental health research is increasing. However there is still a general reluctance around using the methods due to methodological challenges and concerns around the capacity of users to understand utility methods during the research process. This paper sets out to describe and review some of the previously documented difficulties of using utility measurements in mental health services research and to highlight where they have been used successfully as measures. Additionally the paper aims to discuss a means of improving the methods used to capture service user utility and preference measurement and why decision making would be better informed as a result. International literature on utility measurement is reviewed, specifically examining the use of standard gamble and time trade off methods in mental health. Utility measurement in mental health is increasing though as the review demonstrates, concerns still exist over its application. A number of methods can be used to improve the approach overall and these are discussed as well as specific areas worthy of utility measurement including 'disutility' of admission, medication and medication side effects. Overall this paper argues that it is necessary to persist with efforts to conduct utility measurement calculation albeit with a critical eye on the methods in an attempt to ensure improvements are continually made. Utility and preference scores may be limited in that they only provide a rough score but they are defended as a means of providing some form of strength of preference for health states. The review is limited to English only texts. The debate on whether to use standard gamble and time trade off has implications for health services resource allocations, decision making, health economics research, policy making and health services research generally involving psychiatric service users. The paper argues that the absence of utility measurement in mental health runs the risk of mental health being disadvantaged in decisions around resource allocation. Institutions involved in decision making like the United Kingdom's National Institute for Health and Clinical Excellence, would be better served in their decision making and calculation of Quality Adjusted Life Years if more utility measurement in psychiatric research was carried out. Other arguments for using utility measurement include the desirability of using utility measurement to elicit a patient dimension of risk. Future utility research should aim for better involvement of service users in the design stage, the changing of time frames offered to users in health state scenarios used, a greater need for comparative work of utilities scoring across illness and between standard gamble and time trade off and more staff training in the use of utility methodology with mental health service users.

Instruments to assess patient comfort during hospitalization: A psychometric review.

PubMed

Lorente, Sonia; Losilla, Josep-Maria; Vives, Jaume

2018-05-01

To analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization. There are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost-benefit ratios for the institution. Psychometric review. MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google. We limited our search to studies published between 1990-2015. The psychometric analysis was performed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost-efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290. Instruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort. The methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions. © 2017 John Wiley & Sons Ltd.

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Subsequent continued stay review dates. 456.234 Section 456.234 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... each continued stay of a recipient in the mental hospital, the committee, subgroup or designee reviews... committee, subgroup or designee finds that a recipient's continued stay in the mental hospital is needed...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2010 CFR

2010-10-01

... practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.86 - Correlation of Title XI functions with Title XVIII functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... functions. 476.86 Section 476.86 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

How to interpret a healthcare economic analysis.

PubMed

Brown, Melissa M; Brown, Gary C

2005-06-01

The purpose of the review is to present guidelines to help the clinician to interpret healthcare economic analyses and review pertinent recent analysis in the ophthalmic literature. There are four variants of healthcare economic analyses: (1) cost-minimization analysis; (2) cost-benefit analysis; (3) cost-effectiveness analysis and (4) cost-utility analysis. Cost-utility utility analysis has assumed an increasingly important role in healthcare, with increasing number of analyses occurring in the peer-reviewed ophthalmic literature. These include cost-utility analyses of cataract surgery in the first and second eyes, amblyopia treatment, and cost-utility analyses encompassing the vitreoretinal interventions of the following: (1) laser photocoagulation for exudative macular degeneration; (2) laser treatment for diabetic retinopathy; (3) laser photocoagulation for branch retinal vein obstruction; (4) diabetic vitrectomy; (5) treatment of proliferative retinopathy of prematurity and (6) treatment of retinal detachment associated with proliferative vitreoretinopathy. As an increasing number of cost-utility analyses become available they will provide the information system for the practice of value-based medicine, or medicine based upon the patient-perceived value conferred by interventions. Increasing numbers of cost-utility analysis in the ophthalmic literature suggest that ophthalmic interventions, including vitreoretinal interventions, are cost effective. Cost-utility analysis is a major tool in value-based medicine, the practice of medicine based upon the patient-perceived value conferred by healthcare interventions.

Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools.

PubMed

Lichtner, Valentina; Dowding, Dawn; Esterhuizen, Philip; Closs, S José; Long, Andrew F; Corbett, Anne; Briggs, Michelle

2014-12-17

There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence.

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

2004-01-01

To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances. A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY. The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.

VALUE-BASED MEDICINE AND OPHTHALMOLOGY: AN APPRAISAL OF COST-UTILITY ANALYSES

PubMed Central

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

2004-01-01

ABSTRACT Purpose To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Methods Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year ($/QALY) was ascertained in all instances. Results A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was $5,219/QALY, with a range from $746/QALY to $6.5 million/QALY. Conclusions The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended. PMID:15747756

Equity in maternal health care service utilization: a systematic review for developing countries.

PubMed

Çalışkan, Zafer; Kılıç, Dilek; Öztürk, Selcen; Atılgan, Emre

2015-11-01

The objective was to explore progress of equity in the utilization of maternal health care services in developing countries since maternal care is a crucial factor in reducing maternal mortality, which is targeted by the Millennium Development Goal 5. A systematic review of quantitative studies was done. PubMed Central, Web of Science, and Science Direct databases were searched for peer-reviewed and English-language articles published between 2005 and 2015. Thirty-six articles were included in the review. The results reveal the lack of equity in the utilization of maternal health care in developing countries. Thirty-three out of 36 studies found evidence supporting severe inequities while three studies found evidence of equity or at least improvement in terms of equity. Most of the literature devoted to utilization of maternal health care generally provides information on the level of maternal care used and ignore the equity problem. Research in this area should focus not only on the level of maternal care used but also on the most disadvantaged segments of the population in terms of utilization of maternal care in order to reach the set targets.

Federal policies to promote the widespread utilization of photovoltaic systems. Supplement: Review and critique

NASA Technical Reports Server (NTRS)

Smith, J. L.

1980-01-01

Review comments of the Congressional report entitled 'Federal Policies to Promote the Widespread Utilization of Photovoltaic Systems' are presented. Responses to the review comments by the Jet Propulsion Laboratory, preparer of the Congressional report, are also presented. The Congressional report discussed various issues related to promoting the deployment of photovoltaic systems through the Federal Photovoltaic Program. Various program strategies and funding levels were examined.

42 CFR 456.23 - Post-payment review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Post-payment review process. 456.23 Section 456.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456...

Drug utilization review: mechanisms to improve its effectiveness and broaden its scope. The U.S. Pharmacopeia Drug Utilization Review Advisory Panel.

PubMed

2000-01-01

To address important problems and needed changes in online and retrospective drug utilization review (DUR) programs. Emphasis is placed on reliability of DUR criteria and the shift of traditional retrospective DUR programs toward disease management and health care outcomes. Published literature evaluating the role of online and retrospective DUR programs. Particular attention was given to studies assessing DUR criteria reliability and new interventions with retrospective DUR programs. A literature review was conducted along with an expert summary from the U.S. Pharmacopeia Drug Utilization Review Advisory Panel. Studies have revealed variations in DUR criteria that could be affecting clinical practice and patient care. Appropriate formal methodologies and use of consistent procedures in developing online prospective DUR programs and systems could help resolve these problems. Traditional retrospective DUR is also shifting to incorporate disease management and methodologies from health outcomes and pharmacoeconomics studies. Refinements are needed to improve the reliability and validity of online DUR criteria and to minimize false positive messages. Databases created as a result of DUR efforts have been used in new and innovative ways to incorporate health outcomes data and disease management interventions. Additional outcomes data, combined with quality assurance efforts, should increase the utility of DUR/disease management efforts in evaluating health systems while improving the effectiveness and efficiency of pharmacists' health care interventions.

Impact of comorbidity and healthcare utilization on colorectal cancer stage at diagnosis: literature review

PubMed Central

Corkum, Mark; Urquhart, Robin; Burge, Fred; Porter, Geoffrey; Johnston, Grace

2013-01-01

Purpose Individuals diagnosed with cancer close to death have low access to enrollment in palliative care programs. The purpose of this literature review was to assess the usefulness of pre-diagnostic comorbidity and healthcare utilization as indicators of late-stage colorectal cancer (CRC) diagnosis, to help with early identification of individuals who may benefit from palliative care. Methods A literature search was conducted in relevant databases using title/abstract terms which included “cancer,” “stage,” “diagnosis,” “determinants,” “predictors,” and “associated.” Included studies examined whether comorbidity and/or healthcare utilization had an impact on the stage at which CRC was diagnosed. A standardized data abstraction form was used to assess the eligibility of each study. Thirteen articles were included in the literature review. These studies were assessed and synthesized using qualitative methodology. Results We found much heterogeneity among study variables. The findings of this literature review point to the presence of comorbidity and non-emergent healthcare utilization as having no association with late-stage diagnosis. Conversely, emergency room presentation (ERP) was associated with late-stage diagnosis. Conclusions The results of this literature review did not find strong evidence to suggest that comorbidity and healthcare utilization are potential indicators of late-stage diagnosis. However, ERP may be useful as a flag for consideration of prompt referral to palliative care. Additional research is required to identify potential indicators of late-stage diagnosis that may be available in administrative databases, particularly in the area of healthcare utilization. PMID:22101505

U.S. Refining Capacity Utilization

EIA Publications

1995-01-01

This article briefly reviews recent trends in domestic refining capacity utilization and examines in detail the differences in reported crude oil distillation capacities and utilization rates among different classes of refineries.

Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

PubMed

Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

2014-01-01

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

A systematic review of utility values for chemotherapy-related adverse events.

PubMed

Shabaruddin, Fatiha H; Chen, Li-Chia; Elliott, Rachel A; Payne, Katherine

2013-04-01

Chemotherapy offers cancer patients the potential benefits of improved mortality and morbidity but may cause detrimental outcomes due to adverse drug events (ADEs), some of which requiring time-consuming, resource-intensive and costly clinical management. To appropriately assess chemotherapy agents in an economic evaluation, ADE-related parameters such as the incidence, (dis)utility and cost of ADEs should be reflected within the model parameters. To date, there has been no systematic summary of the existing literature that quantifies the utilities of ADEs due to healthcare interventions in general and chemotherapy treatments in particular. This review aimed to summarize the current evidence base of reported utility values for chemotherapy-related ADEs. A structured electronic search combining terms for utility, utility valuation methods and generic terms for cancer treatment was conducted in MEDLINE and EMBASE in June 2011. Inclusion criteria were: (1) elicitation of utility values for chemotherapy-related ADEs and (2) primary data. Two reviewers identified studies and extracted data independently. Any disagreements were resolved by a third reviewer. Eighteen studies met the inclusion criteria from the 853 abstracts initially identified, collectively reporting 218 utility values for chemotherapy-related ADEs. All 18 studies used short descriptions (vignettes) to obtain the utility values, with nine studies presenting the vignettes used in the valuation exercises. Of the 218 utility values, 178 were elicited using standard gamble (SG) or time trade-off (TTO) approaches, while 40 were elicited using visual analogue scales (VAS). There were 169 utility values of specific chemotherapy-related ADEs (with the top ten being anaemia [34 values], nausea and/or vomiting [32 values], neuropathy [21 values], neutropenia [12 values], diarrhoea [12 values], stomatitis [10 values], fatigue [8 values], alopecia [7 values], hand-foot syndrome [5 values] and skin reaction [5 values]) and 49 of non-specific chemotherapy-related adverse events. In most cases, it was difficult to directly compare the utility values as various definitions and study-specific vignettes were used for the ADEs of interest. This review was designed to provide an overall description of existing literature reporting utility values for chemotherapy-related ADEs. The findings were not exhaustive and were limited to publications that could be identified using the search strategy employed and those reported in the English language. This review identified wide ranges in the utility values reported for broad categories of specific chemotherapy-related ADEs. There were difficulties in comparing the values directly as various study-specific definitions were used for these ADEs and most studies did not make the vignettes used in the valuation exercises available. It is recommended that a basic minimum requirement be developed for the transparent reporting of study designs eliciting utility values, incorporating key criteria such as reporting how the vignettes were developed and presenting the vignettes used in the valuation tasks as well as valuing and reporting the utility values of the ADE-free base states. It is also recommended, in the future, for studies valuing the utilities of chemotherapy-related ADEs to define the ADEs according to the National Cancer Institute (NCI) definitions for chemotherapy-related ADEs as the use of the same definition across studies would ease the comparison and selection of utility values and make the overall inclusion of adverse events within economic models of chemotherapy agents much more straightforward.

A review of utility issues for the integration of wind electric generators

NASA Technical Reports Server (NTRS)

Reddoch, T. W.; Barnes, P. R.

1982-01-01

A review of issues and concerns of the electric utility industry for the integration of wind electric generation is offered. The issues have been categorized in three major areas: planning, operations, and dynamic interaction. Representative studies have been chosen for each area to illustrate problems and to alleviate some concerns. The emphasis of this paper is on individual large wind turbines (WTs) and WT arrays for deployment at the bulk level in a utility system.

Cost-Utility Analysis of Cancer Prevention, Treatment, and Control: A Systematic Review.

PubMed

Winn, Aaron N; Ekwueme, Donatus U; Guy, Gery P; Neumann, Peter J

2016-02-01

Substantial innovation related to cancer prevention and treatment has occurred in recent decades. However, these innovations have often come at a significant cost. Cost-utility analysis provides a useful framework to assess if the benefits from innovation are worth the additional cost. This systematic review on published cost-utility analyses related to cancer care is from 1988 through 2013. Analyses were conducted in 2013-2015. This review analyzed data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), a comprehensive registry with detailed information on 4,339 original cost-utility analyses published in the peer-reviewed medical and economic literature through 2013. There were 721 cancer-related cost-utility analyses published from 1998 through 2013, with roughly 12% of studies focused on primary prevention and 17% focused on secondary prevention. The most often studied cancers were breast cancer (29%); colorectal cancer (11%); and prostate cancer (8%). The median reported incremental cost-effectiveness ratios (in 2014 U.S. dollars) were $25,000 for breast cancer, $24,000 for colorectal cancer, and $34,000 for prostate cancer. The current evidence indicates that there are many interventions that are cost effective across cancer sites and levels of prevention. However, the results highlight the relatively small number of cancer cost-utility analyses devoted to primary prevention compared with secondary or tertiary prevention. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

42 CFR 456.171 - Medicaid agency review of need for admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.171 Section 456.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs... and a reasonable amount of time to respond to a request for information about a claim, and if the...

42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and are...

The Influence of Peer Reviewer Expertise on the Evaluation of Research Funding Applications

PubMed Central

Sullivan, Joanne H.; Glisson, Scott R.

2016-01-01

Although the scientific peer review process is crucial to distributing research investments, little has been reported about the decision-making processes used by reviewers. One key attribute likely to be important for decision-making is reviewer expertise. Recent data from an experimental blinded review utilizing a direct measure of expertise has found that closer intellectual distances between applicant and reviewer lead to harsher evaluations, possibly suggesting that information is differentially sampled across subject-matter expertise levels and across information type (e.g. strengths or weaknesses). However, social and professional networks have been suggested to play a role in reviewer scoring. In an effort to test whether this result can be replicated in a real-world unblinded study utilizing self-assessed reviewer expertise, we conducted a retrospective multi-level regression analysis of 1,450 individual unblinded evaluations of 725 biomedical research funding applications by 1,044 reviewers. Despite the large variability in the scoring data, the results are largely confirmatory of work from blinded reviews, by which a linear relationship between reviewer expertise and their evaluations was observed—reviewers with higher levels of self-assessed expertise tended to be harsher in their evaluations. However, we also found that reviewer and applicant seniority could influence this relationship, suggesting social networks could have subtle influences on reviewer scoring. Overall, these results highlight the need to explore how reviewers utilize their expertise to gather and weight information from the application in making their evaluations. PMID:27768760

Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review.

PubMed

Gardner, Preston; Flis, Diana; Chaiyasate, Kongkrit

2017-01-01

Morel-Lavallée lesions are irregularly occurring and often overlooked results of traumatic injuries, resulting in potential long-term encapsulation of fluid between soft-tissue layers. The objective in this review was to discuss the delayed presentation of a Morel-Lavallée lesion and operative utility of liposuction in the patient's treatment and review literature with particular focus on diagnosis and therapeutic interventions. The reviewed case demonstrates the presentation and successful therapy of a young female presenting with a MLL and contour deformity.

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options so that HUD may determine whether or how to implement utility benchmarking to be effective in FY 2011...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options so that HUD may determine whether or how to implement utility benchmarking to be effective in FY 2011...

Drug utilization and medication costs at the end of life.

PubMed

Pont, Lisa; Jansen, Kristian; Schaufel, Margrete Aase; Haugen, Dagny Faksvåg; Ruths, Sabine

2016-01-01

In the end stages of life, drug treatment goals shift to symptom control and quality of life and as such changes in drug utilization are expected. The aim of this paper is to review the extent to which costs are considered in drug utilization research at the end of life, with a particular focus on the outcome measures being used. This systematic review identified seven studies across varied settings studies reporting both drug utilization and medication cost outcome measures. The main factors identified that impacted medication use and cost were the time period considered and the provision of specialist palliative care services. Combining drug utilization and medication cost outcomes is critical for the allocation of healthcare resources and the development of a sound health policy.

Health utility of patients with Crohn's disease and ulcerative colitis: a systematic review and meta-analysis.

PubMed

Malinowski, Krzysztof Piotr; Kawalec, Paweł

2016-08-01

The aim of this systematic review was to collect and summarize the current data on the utilities of patients with Crohn's disease (CD) and ulcerative colitis (UC). A meta-analysis of the obtained utilities was performed using a random-effects model and meta-regression by the disease type and severity. A bootstrap analysis was performed as it does not require assumption on distribution of the data. The highest utility among patients with CD and UC was observed when the diseases were in remission. The meta-regression analysis showed that both disease severity and an instrument/method/questionnaire used to obtain utilities were significant predictors of utility. Utility was the lowest for severe disease and the highest for disease in remission, the association was more notable in patients with CD compared with UC. Expert commentary: The issue of patients' utility is important for healthcare decision makers but it has not been fully investigated and requires further study.

The dynamics of utilization review: a case study of 44 Massachusetts hospitals.

PubMed

Gertman, P M; Egdahl, R E

1978-10-01

Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.

45 CFR 1356.71 - Federal review of the eligibility of children in foster care and the eligibility of foster care...

Code of Federal Regulations, 2010 CFR

2010-10-01

... by ACF statistical staff from the Adoption and Foster Care Analysis and Reporting System (AFCARS... primary review utilizing probability sampling methodologies. Usually, the chosen methodology will be simple random sampling, but other probability samples may be utilized, when necessary and appropriate. (3...

42 CFR 476.94 - Notice of QIO initial denial determination and changes as a result of a DRG validation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... validation; (2) For day outliers in hospitals, the date on which the stay or services in the facility will...

Review of the Technology-Utilization Level of String Instrument Teachers

ERIC Educational Resources Information Center

Döger, Didem; Kiliç, Ilgim

2016-01-01

The purpose of this study is to determine the technology-utilization level of Fine Arts High School string instrument teachers. A pattern based on descriptive method has been used to conduct the researchers. Research data has been collected via literature review and questionnaire developed and prepared by the researcher. SPSS program has been…

Job satisfaction in relation to energy resource consciousness and perceptions of energy utilization in selected Illinois manufacturing firms

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

Haynes, T.S.

1986-01-01

This study was developed through a synthesis and review of literature and research related to the current status of job satisfaction, energy resources, and perceptions of how energy is utilized in the manufacturing work environment. This synthesis and review revolved around several proven contributing factors of job satisfaction, such as age, education, and challenge from work itself. Quality of work life programs and their components are discussed in relation to their impact on job satisfaction. The nature of energy resource utilization is traced back through history with an emphasis on the limitations of current resources and options for the future.more » The review highlights the current debate over what should be the future path of energy resource development. The concept of satisfaction of human needs is reviewed and related to job satisfaction and energy resources. The purpose of this research study was to contribute to the understanding of how perceptions of energy resources relate to job satisfaction. Results of the study indicated that there were no significant differences between an individual's energy resource consciousness and perceptions of energy utilization in the work place, energy resource consciousness and job satisfaction, and job satisfaction and perceptions of energy utilization in the workplace.« less

Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

PubMed

de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

2015-02-01

A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

Best Practices in School-to-Careers: The Utilities Industry.

ERIC Educational Resources Information Center

National Employer Leadership Council, Washington, DC.

This document highlights the school-to-careers (STC) partnerships connecting workplace experiences to classroom learning to prepare students for successful employment in the utilities industry. First, the current state of the utilities industry and careers in the utilities industry are reviewed. Next, the following organizations and employers are…

Home Health Care Utilization: A Review of the Research for Social Work

ERIC Educational Resources Information Center

Kadushin, Goldie

2004-01-01

The author reviewed the literature to identify the variables associated with home health care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Home health care was defined as in-home skilled nursing,…

The Dynamics of Mobile Learning Utilization in Vocational Education: Frame Model Perspective Review

ERIC Educational Resources Information Center

Mahande, Ridwan Daud; Susanto, Adhi; Surjono, Herman Dwi

2017-01-01

This study aimed to describe the dynamics of content aspects, user aspects and social aspects of mobile learning utilization (m-learning) in vocational education from the FRAME Model perspective review. This study was quantitative descriptive research. The population in this study was teachers and students of state vocational school and private…

Music Therapy with Children: A Review of Clinical Utility and Application to Special Populations.

ERIC Educational Resources Information Center

Yeaw, John David Andrew

This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…

Unmanned Maritime Systems Incremental Acquisition Approach

DTIC Science & Technology

2016-12-01

We find that current UMS acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and...peer review. Additional cost and schedule benefits could result from contractor competition during build processes in each incremental process. We...acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and peer review. Additional

Delivery of health services to migrant and seasonal farmworkers.

PubMed

Arcury, Thomas A; Quandt, Sara A

2007-01-01

Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

76 FR 80729 - Intergovernmental Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Rural Utilities Service 7 CFR Part 4274 Intergovernmental Review AGENCIES: Rural Housing Service, Rural... reference to RD Instruction 1940-J, Intergovernmental Review.'' This action is necessary since the affected... offices have current guidance on intergovernmental review of proposed projects being reviewed pursuant to...

Factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review.

PubMed

Benenson, Irina; Jadotte, Yuri; Echevarria, Mercedes

2017-03-01

Painful vaso-occlusive crisis is a hallmark of sickle cell disease (SCD) that commonly results in utilization of hospital services. Recurrent use of hospital services by SCD patients is associated with high healthcare costs and adverse clinical outcomes. Understanding the factors influencing the pattern of utilization is a first step in improving medical care of this patient population while reducing healthcare expenditures. The primary objective of this systematic review was to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult SCD patients. Adult SCD patients of both sexes who utilized hospital services for acute or emergency care. Non-modifiable and modifiable factors influencing utilization of hospital services. Prospective and retrospective cohort studies, case-control and analytical cross-sectional studies. The primary outcome of interest was high utilization of hospital services by adult SCD patients based on non-modifiable and modifiable factors measured as an odds ratio (analytical outcome). The secondary outcome was the prevalence of non-modifiable and modifiable factors among SCD patients who utilized hospital services measured as an event rate (descriptive outcome). A comprehensive multi-step search was undertaken to find both published and unpublished studies. Only studies published in the English language were included. The search was not limited by year of publication. Retrieved papers were assessed for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Data were extracted using a researcher-developed tool. Included studies were combined in a statistical meta-analysis. The meta-analysis was based on a random effect model. For studies that did not allow statistical pooling, the findings have been presented in a narrative form. Fourteen studies were included in this review. The analysis demonstrated that male patients accounted for 40.8% (95% confidence interval [CI] 0.370-0.447) of all utilizing patients. Sickle cell disease patients who were publically insured accounted for 76.5% (95% CI 0.632-0.861) of all patients who had hospital encounters. Patients aged 25-35 years had the highest rate of utilization, and the rate of utilization declined in patients older than 50 years. High utilizing patients had more diagnoses of acute chest syndrome and sepsis than patients who were moderate or low utilizers. The majority of SCD patients who utilized hospital services were women, young people and publically insured individuals. Patients with particularly high level of utilization had more frequent diagnoses of acute chest syndrome and sepsis.

Facilities Utilization Program Implementation Handbook

NASA Technical Reports Server (NTRS)

1987-01-01

This Facilities Utilization Program Implementation Handbook (FUPIH) prescribes procedures for the review and the reporting on the utilization of NASA facilities. The Directors of NASA Field Installations should designate an Installation Official responsible for coordinating the assignment of buildings space and implementing the facilities utilization reviews and annual report preparation. The individual designated shall be known as the 'Facilities Utilization Officer (FUO).' Functional responsibilities of the FUO are detailed in NASA Management Instruction (NMI) 7234.1. It is recognized that titles used in the implementation of the Facilities Utilization Program may vary between field installations. The Facilities Utilization Program (FUP) is designed to provide a uniform and orderly process for meeting or addressing the following objectives: the establishment of sound facilities requirements to meet NASA's programmatic and institutional needs; the optimum allocation of available facilities and related resources to meet these requirements; and the early identification and request for required additional facilities resources. The detailed review and reporting system enacted by NMI 7234.1 should encourage more comprehensive utilization planning for all NASA facilities and ensure, to the maximum extent practicable, that all such facilities are put to their highest and best use consistent with NASA programmatic and institutional priorities. A principal purpose of the FUP is the early identification of NASA facilities which may be or may become underutilized or excess to NASA needs and to provide a timely reference point from which corrective actions (i.e., consolidation, elimination of duplication, improved utilization of disposal) may be taken. Because the supply of this handbook is limited, distribution should be controlled at the field installation level.

Review of utility values for economic modeling in type 2 diabetes.

PubMed

Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

2014-06-01

Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Health State Utility Values for Age-Related Macular Degeneration: Review and Advice.

PubMed

Butt, Thomas; Tufail, Adnan; Rubin, Gary

2017-02-01

Health state utility values are a major source of uncertainty in economic evaluations of interventions for age-related macular degeneration (AMD). This review identifies and critiques published utility values and methods for eliciting de novo utility values in AMD. We describe how utility values have been used in healthcare decision making and provide guidance on the choice of utility values for future economic evaluations for AMD. Literature was searched using PubMed, and health technology assessments (HTA) were searched using HTA agency websites to identify articles reporting utility values or approaches to derive utility values in AMD and articles applying utilities for use in healthcare decision making relating to treatments for AMD. A total of 70 studies qualified for data extraction, 22 of which were classified as containing utility values and/or elicitation methods, and 48 were classified as using utility values in decision making. A large number of studies have elicited utility values for AMD, although those applied to decision making have focused on a few of these. There is an appreciation of the challenges in the measurement and valuation of health states, with recent studies addressing challenges such as the insensitivity of generic health-related quality of life (HRQoL) questionnaires and utility in the worse-seeing eye. We would encourage careful consideration when choosing utility values in decision making and an explicit critique of their applicability to the decision problem.

Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

PubMed Central

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

Factors involved in access and utilization of adult hearing healthcare: A systematic review.

PubMed

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B; Bush, Matthew L

2017-05-01

Hearing loss is a public health concern, yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation toward improved access of care, a deeper understanding of motivators, barriers, and compliance factors can aid in delivery of effective and efficient hearing healthcare. Laryngoscope, 127:1187-1194, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Controlling inpatient psychiatric utilization through managed care.

PubMed

Wickizer, T M; Lessler, D; Travis, K M

1996-03-01

There is little current understanding of how managed care strategies affect hospital inpatient psychiatric care for mentally ill patients. This study examined one prominent form of managed care, utilization management, which reviews requests for psychiatric care and authorizes provision of care deemed appropriate and clinically necessary. The authors analyzed data on 2,265 utilization management reviews conducted during 1989-1992 for patients insured by a single large commercial insurance company. Three utilization management procedures were examined: preadmission review, continued-stay review, and case management. The performance indicators analyzed included percent of admission requests granted, number of days requested and approved, and number of treatment extensions granted. Utilization management initially approved inpatient psychiatric treatment for nearly all (98.8%) of the patients but authorized, on average, only one-third of the days requested (6.9 versus 19.0). On average, 23.5 (total) days of care were requested and 16.8 days were approved. Care for patients with alcohol or drug dependence diagnoses was more restricted than was care for other patients. These data suggest that managed care does restrict inpatient psychiatric care, primarily by managing length of stay. The fact that almost all patients were approved for the same initial length of stay implies adherence to strict treatment protocols that do not distinguish among different clinical or patient factors. There is a need for careful study of the effects of managed care on outcomes and quality of psychiatric care.

42 CFR 456.181 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... evaluation or plan. Utilization Review (UR) Plan: General Requirements ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis

PubMed Central

Higa, Janelle; Trentacosta, Christopher J.; Herschell, Amy D.; Kolko, David J.

2013-01-01

We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment–control ES =.31, p < .01 for skill acquisition and ES =.20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a “common elements” perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills. PMID:23649324

A review of mobile applications to help adolescent and young adult cancer patients

PubMed Central

Wesley, Kimberly M; Fizur, Philip J

2015-01-01

Objective To review research articles utilizing mobile applications with adolescent and young adult (AYA) cancer patients. Materials and methods We identified articles via online searches and reference lists (eg, PsycInfo, PubMed). Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. Results Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications). One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. Conclusion Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area. PMID:26316835

Synthetic Biology and Metabolic Engineering for Marine Carotenoids: New Opportunities and Future Prospects

PubMed Central

Wang, Chonglong; Kim, Jung-Hun; Kim, Seon-Won

2014-01-01

Carotenoids are a class of diverse pigments with important biological roles such as light capture and antioxidative activities. Many novel carotenoids have been isolated from marine organisms to date and have shown various utilizations as nutraceuticals and pharmaceuticals. In this review, we summarize the pathways and enzymes of carotenoid synthesis and discuss various modifications of marine carotenoids. The advances in metabolic engineering and synthetic biology for carotenoid production are also reviewed, in hopes that this review will promote the exploration of marine carotenoid for their utilizations. PMID:25233369

Synthetic biology and metabolic engineering for marine carotenoids: new opportunities and future prospects.

PubMed

Wang, Chonglong; Kim, Jung-Hun; Kim, Seon-Won

2014-09-17

Carotenoids are a class of diverse pigments with important biological roles such as light capture and antioxidative activities. Many novel carotenoids have been isolated from marine organisms to date and have shown various utilizations as nutraceuticals and pharmaceuticals. In this review, we summarize the pathways and enzymes of carotenoid synthesis and discuss various modifications of marine carotenoids. The advances in metabolic engineering and synthetic biology for carotenoid production are also reviewed, in hopes that this review will promote the exploration of marine carotenoid for their utilizations.

Proceedings of the 1999 U.S. DOE Hydrogen Program Review

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

NREL

2000-08-28

The Proceedings of the 1999 US Department of Energy (DOE) Hydrogen Program Review serve as an important technology reference for the DOE Hydrogen Program. This document contains technical progress reports on 60 research and technology validation projects funded by the DOE Hydrogen Program in Fiscal Year 1999, in support of its mission to make hydrogen a cost-effective energy carrier for utility, building, and transportation applications. Each year, the Program conducts a rigorous review of its portfolio of projects, utilizing teams of experts to provide vital feedback on the progress of research.

NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

Energy minimization strategies and renewable energy utilization for desalination: a review.

PubMed

Subramani, Arun; Badruzzaman, Mohammad; Oppenheimer, Joan; Jacangelo, Joseph G

2011-02-01

Energy is a significant cost in the economics of desalinating waters, but water scarcity is driving the rapid expansion in global installed capacity of desalination facilities. Conventional fossil fuels have been utilized as their main energy source, but recent concerns over greenhouse gas (GHG) emissions have promoted global development and implementation of energy minimization strategies and cleaner energy supplies. In this paper, a comprehensive review of energy minimization strategies for membrane-based desalination processes and utilization of lower GHG emission renewable energy resources is presented. The review covers the utilization of energy efficient design, high efficiency pumping, energy recovery devices, advanced membrane materials (nanocomposite, nanotube, and biomimetic), innovative technologies (forward osmosis, ion concentration polarization, and capacitive deionization), and renewable energy resources (solar, wind, and geothermal). Utilization of energy efficient design combined with high efficiency pumping and energy recovery devices have proven effective in full-scale applications. Integration of advanced membrane materials and innovative technologies for desalination show promise but lack long-term operational data. Implementation of renewable energy resources depends upon geography-specific abundance, a feasible means of handling renewable energy power intermittency, and solving technological and economic scale-up and permitting issues. Copyright © 2011 Elsevier Ltd. All rights reserved.

Silk-based delivery systems of bioactive molecules

PubMed Central

Numata, Keiji; Kaplan, David L

2010-01-01

Silks are biodegradable, biocompatible, self-assemblying proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes are reviewed. PMID:20298729

Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model.

PubMed

Zeeman, Jacqueline M; McLaughlin, Jacqueline E; Cox, Wendy C

2017-11-01

With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model. A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty. The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty. Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.

Utility interface issues for grid-connected photovoltaic systems

NASA Astrophysics Data System (ADS)

Chu, D.; Key, T.; Fitzer, J.

Photovoltaic (PV) balance-of-system research and development has focused on interconnection with the utility grid as the most promising future application for photovoltaic energy production. These sysems must be compatible with the existing utility grid to be accepted. Compatibility encompasses many technical, economic and institutional issues, from lineman safety to revenue metering and power quality. This paper reviews DOE/PV sponsored research for two of the technical interconnection issues: harmonic injection, and power factor control. Explanations and rationale behind these two issues will be reviewed, and the status of current research and plans for required future work will be presented.

A Study of Alternate Approaches to Utilization Review of Laboratory Services within an Army Medical Center

DTIC Science & Technology

1983-06-06

solubility Hgb F quantitation, alkali denaturation Clot retraction Unstable Ggb studies Cryofibrinogen Methemoglobin Parasitology Blood , Occult and Gross...Performance Standards ........ .................... ... 24 4 Types of Information to be Recorded Under Course of Treatment . 25 5 Factors Contributing to...examine external environmental factors implicating the need for utilization review of ancillary services within an Army Medical Center. (Hereinafter the

The Effect of Utilization Review on Emergency Department Operations.

PubMed

Desai, Shoma; Gruber, Phillip F; Eiting, Erick; Seabury, Seth A; Mack, Wendy J; Voyageur, Christian; Vasquez, Veronica; Kim, Hyung T; Terp, Sophie

2017-11-01

Increasingly, hospitals are using utilization review software to reduce hospital admissions in an effort to contain costs. Such practices have the potential to increase the number of unsafe discharges, particularly in public safety-net hospitals. Utilization review software tools are not well studied with regard to their effect on emergency department (ED) operations. We study the effect of prospectively used admission decision support on ED operations. In 2012, Los Angeles County + University of Southern California Medical Center implemented prospective use of computerized admission criteria. After implementation, only ED patients meeting primary review (diagnosis-based criteria) or secondary review (medical necessity as determined by an on-site emergency physician) were assigned inpatient beds. Data were extracted from electronic medical records from September 2011 through December 2013. Outcomes included operational metrics, 30-day ED revisits, and 30-day admission rates. Excluding a 6-month implementation period, monthly summary metrics were compared pre- and postimplementation with nonparametric and negative binomial regression methods. All adult ED visits, excluding incarcerated and purely behavioral health visits, were analyzed. The primary outcomes were disposition rates. Secondary outcomes were 30-day ED revisits, 30-day admission rate among return visitors to the ED, and estimated cost. Analysis of 245,662 ED encounters was performed. The inpatient admission rate decreased from 14.2% to 12.8%. Increases in discharge rate (82.4% to 83.4%) and ED observation unit utilization (2.5% to 3.4%) were found. Thirty-day revisits increased (20.4% to 24.4%), although the 30-day admission rate decreased (3.2% to 2.8%). Estimated cost savings totaled $193.17 per ED visit. The prospective application of utilization review software in the ED led to a decrease in the admission rate. This was tempered by a concomitant increase in ED observation unit utilization and 30-day ED revisits. Cost savings suggest that resources should be redirected to the more highly affected ED and ED observation unit, although more work is needed to confirm the generalizability of these findings. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions...

42 CFR 456.500 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.500 Purpose. For hospitals and mental hospitals, this subpart— (a...

MENU OF NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

[Utilization of dental services for children: a review of the influencing factors and the possible improvements].

PubMed

Cheng, M L; Si, Y

2017-05-09

It has been reported that children's oral health conditions are correlated with their attendance to dental health services. Evaluating the influencing factors of utilization of dental services for children may give ways to improve the services per se, and furtherly the children's oral health. The present review retrieved and summarized domestic and foreign studies on the utilization of oral health services for children based on the Andersen behavior model. It was concluded that the utilization of dental services for children was affected by demographic characteristics, social structure, health belief, family factors, community factors and perceived/evaluated needs. To improve the utilization of dental services for children, effort should be made by means of changing caregivers' health belief, developing oral health insurance system, setting up regular oral health resources and increasing the financial support for oral health services by government.

Evidence-based nursing practice: both state of the art in general and specific to pressure sores.

PubMed

Buss, I C; Halfens, R J; Abu-Saad, H H; Kok, G

1999-01-01

The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate. Furthermore, an overview of planned research utilization activities focusing on pressure sore prevention and treatment in nursing is presented. The results of these studies show that planned research utilization activities performed in individual organizations lead to positive outcomes in almost all cases. Therefore, it could be concluded that implementing planned research utilization activities in individual health care institutions seems to be an effective strategy to decrease pressure sore incidence and prevalence rates.

An integrative review on coping skills in nursing students: implications for policymaking.

PubMed

Labrague, L J; McEnroe-Petitte, D M; Al Amri, M; Fronda, D C; Obeidat, A A

2018-06-01

This study critically appraised both quantitative and qualitative studies describing coping strategies utilized by nursing students when faced with stress. Stress in nursing students during clinical training is well documented in the nursing literature. The need to utilize positive-coping strategies is necessary to effectively deal with stress and its accompanying stressors. An integrative review method was used in this review. PsycINFO, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and Scopus were the databases used in searching for relevant literature using the following search terms; 'coping', 'nursing students', clinical training', 'ways of coping' and 'clinical practice'. A total of 27 studies published from 2001 to 2016 were included in this review. Findings demonstrated that nursing students utilized problem-focused coping strategies rather than emotion-focused coping strategies. Specific coping behaviours utilized included problem-solving behaviours, self-confident approaches and seeking of support from family and friends. The review contributes to the growing literature on coping strategies in nursing students and may have implications on nursing education and nursing policy. This review also demonstrated a scarcity of studies that links specific coping strategies to nursing school stressors and examines predictors of coping skills in nursing students. Institutionalization of structured student orientation programme, implementation of well-planned mentoring programmes and establishment of support unit/centres may be helpful in supporting nursing students during their clinical placement. By developing empirically based interventions, nursing faculty can assist nursing students in strengthening their positive-coping skills to effectively deal with various stressors encountered. © 2017 International Council of Nurses.

Cost-Utility Analysis of Cancer Prevention, Treatment, and Control

PubMed Central

Winn, Aaron N.; Ekwueme, Donatus U.; Guy, Gery P.; Neumann, Peter J.

2018-01-01

Context Substantial innovation related to cancer prevention and treatment has occurred in recent decades. However, these innovations have often come at a significant cost. Cost-utility analysis provides a useful framework to assess if the benefits from innovation are worth the additional cost. This systematic review on published cost-utility analyses related to cancer care is from 1988 through 2013. Analyses were conducted in 2013–2015. Evidence acquisition This review analyzed data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), a comprehensive registry with detailed information on 4,339 original cost-utility analyses published in the peer-reviewed medical and economic literature through 2013. Evidence synthesis There were 721 cancer-related cost-utility analyses published from 1998 through 2013, with roughly 12% of studies focused on primary prevention and 17% focused on secondary prevention. The most often studied cancers were breast cancer (29%); colorectal cancer (11%); and prostate cancer (8%). The median reported incremental cost-effectiveness ratios (in 2014 U.S. dollars) were $25,000 for breast cancer, $24,000 for colorectal cancer, and $34,000 for prostate cancer. Conclusions The current evidence indicates that there are many interventions that are cost effective across cancer sites and levels of prevention. However, the results highlight the relatively small number of cancer cost-utility analyses devoted to primary prevention compared with secondary or tertiary prevention. PMID:26470806

42 CFR 456.505 - Applicability of waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.505 Applicability of...

42 CFR 456.521 - Conditions for granting variance requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.508 - Withdrawal of waiver.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and..., 1978, as amended at 61 FR 38399, July 24, 1996] UR Plan: Remote Facility Variances from Time...

Silk-based delivery systems of bioactive molecules.

PubMed

Numata, Keiji; Kaplan, David L

2010-12-30

Silks are biodegradable, biocompatible, self-assembling proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes is reviewed. Copyright © 2010 Elsevier B.V. All rights reserved.

Ethanolamine utilization in Vibrio alginolyticus

PubMed Central

2012-01-01

Abstract Ethanolamine is used as an energy source by phylogenetically diverse bacteria including pathogens, by the concerted action of proteins from the eut-operon. Previous studies have revealed the presence of eutBC genes encoding ethanolamine-ammonia lyase, a key enzyme that breaks ethanolamine into acetaldehyde and ammonia, in about 100 bacterial genomes including members of gamma-proteobacteria. However, ethanolamine utilization has not been reported for any member of the Vibrio genus. Our comparative genomics study reveals the presence of genes that are involved in ethanolamine utilization in several Vibrio species. Using Vibrio alginolyticus as a model system we demonstrate that ethanolamine is better utilized as a nitrogen source than as a carbon source. Reviewers This article was reviewed by Dr. Lakshminarayan Iyer and Dr. Vivek Anantharaman (nominated by Dr. L Aravind). PMID:23234435

A scoping review of scoping reviews: advancing the approach and enhancing the consistency.

PubMed

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-12-01

The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

Medicare program; acquisition, protection and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Proposed rule.

PubMed

1984-04-16

This proposal would govern the acquisition, protection and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organizations (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on the disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations would implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded, and used only for proper purposes.

System review: a method for investigating medical errors in healthcare settings.

PubMed

Alexander, G L; Stone, T T

2000-01-01

System analysis is a process of evaluating objectives, resources, structure, and design of businesses. System analysis can be used by leaders to collaboratively identify breakthrough opportunities to improve system processes. In healthcare systems, system analysis can be used to review medical errors (system occurrences) that may place patients at risk for injury, disability, and/or death. This study utilizes a case management approach to identify medical errors. Utilizing an interdisciplinary approach, a System Review Team was developed to identify trends in system occurrences, facilitate communication, and enhance the quality of patient care by reducing medical errors.

42 CFR 456.201 - UR plan required for inpatient mental hospital services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for...

A public utility model for managing public land recreation enterprises.

Treesearch

Tom Quinn

2002-01-01

Through review of relevant economic principles and judicial precedent, a case is made that public-land recreation enterprises are analogous to traditionally recognized public utilities. Given the historical concern over the societal value of recreation and associated pricing issues, public-land management policies failing to acknowledge these utility-like...

Case Studies of Water Utility Climate Change Vulnerability Assessment [External Review Draft Report

EPA Science Inventory

This report presents a series of case studies describing the approaches taken by four water utilities in the United States to assess their vulnerability to climate change. The report is not intended to be a comprehensive listing of assessment approaches or utilities conducting v...

77 FR 67380 - Submission for OMB Review; Comment Request: Ethical Dilemmas in Surgery and Utilization of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

...; Comment Request: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A..., unless it displays a currently valid OMB control number. Proposed Collection: Title: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A Survey. Type of Information Collection...

75 FR 32494 - Energy Conservation for PHA-Owned or Leased Project-Audits, Utility Allowances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

...-Owned or Leased Project-Audits, Utility Allowances AGENCY: Office of the Chief Information Officer, HUD... complete energy audits, benefit/cost analyses for individual vs. master metering. PHAs review tenant...-Audits, Utility Allowances. OMB Approval Number: 2577-0062. Form Numbers: HUD-50078. Description of the...

75 FR 77866 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-14

... Approval; Comment Request; NSPS for Electric Utility Steam Generating (Renewal) AGENCY: Environmental... the electronic docket, go to http://www.regulations.gov . Title: NSPS for Electric Utility Steam.../Affected Entities: Owners or operators of electric utility steam generating units. Estimated Number of...

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Prospective drug review. 456.705 Section 456.705... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.705 Prospective drug review. (a) General...

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Prospective drug review. 456.705 Section 456.705... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.705 Prospective drug review. (a) General...

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Prospective drug review. 456.705 Section 456.705... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.705 Prospective drug review. (a) General...

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Prospective drug review. 456.705 Section 456.705... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.705 Prospective drug review. (a) General...

Interventions to improve cultural competency in healthcare: a systematic review of reviews

PubMed Central

2014-01-01

Background Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. Methods A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. Results Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. Conclusion This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs. PMID:24589335

Review: Milking robot utilization, a successful precision livestock farming evolution.

PubMed

John, A J; Clark, C E F; Freeman, M J; Kerrisk, K L; Garcia, S C; Halachmi, I

2016-09-01

Automatic milking systems (AMS), one of the earliest precision livestock farming developments, have revolutionized dairy farming around the world. While robots control the milking process, there have also been numerous changes to how the whole farm system is managed. Milking is no longer performed in defined sessions; rather, the cow can now choose when to be milked in AMS, allowing milking to be distributed throughout a 24 h period. Despite this ability, there has been little attention given to milking robot utilization across 24 h. In order to formulate relevant research questions and improve farm AMS management there is a need to determine the current knowledge gaps regarding the distribution of robot utilization. Feed, animal and management factors and their interplay on levels of milking robot utilization across 24 h for both indoor and pasture-based systems are here reviewed. The impact of the timing, type and quantity of feed offered and their interaction with the distance of feed from the parlour; herd social dynamics, climate and various other management factors on robot utilization through 24 h are provided. This novel review draws together both the opportunities and challenges that exist for farm management to use these factors to improved system efficiency and those that exist for further research.

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

Using QALYs in telehealth evaluations: a systematic review of methodology and transparency.

PubMed

Bergmo, Trine S

2014-08-03

The quality-adjusted life-year (QALY) is a recognised outcome measure in health economic evaluations. QALY incorporates individual preferences and identifies health gains by combining mortality and morbidity into one single index number. A literature review was conducted to examine and discuss the use of QALYs to measure outcomes in telehealth evaluations. Evaluations were identified via a literature search in all relevant databases. Only economic evaluations measuring both costs and QALYs using primary patient level data of two or more alternatives were included. A total of 17 economic evaluations estimating QALYs were identified. All evaluations used validated generic health related-quality of life (HRQoL) instruments to describe health states. They used accepted methods for transforming the quality scores into utility values. The methodology used varied between the evaluations. The evaluations used four different preference measures (EQ-5D, SF-6D, QWB and HUI3), and utility scores were elicited from the general population. Most studies reported the methodology used in calculating QALYs. The evaluations were less transparent in reporting utility weights at different time points and variability around utilities and QALYs. Few made adjustments for differences in baseline utilities. The QALYs gained in the reviewed evaluations varied from 0.001 to 0.118 in implying a small but positive effect of telehealth intervention on patient's health. The evaluations reported mixed cost-effectiveness results. The use of QALYs in telehealth evaluations has increased over the last few years. Different methodologies and utility measures have been used to calculate QALYs. A more harmonised methodology and utility measure is needed to ensure comparability across telehealth evaluations.

Rocky Mountain spotted fever: 'starry sky' appearance with diffusion-weighted imaging in a child.

PubMed

Crapp, Seth; Harrar, Dana; Strother, Megan; Wushensky, Curtis; Pruthi, Sumit

2012-04-01

We present a case of Rocky Mountain spotted fever encephalitis in a child imaged utilizing diffusion-weighted MRI. Although the imaging and clinical manifestations of this entity have been previously described, a review of the literature did not reveal any such cases reported in children utilizing diffusion-weighted imaging. The imaging findings and clinical history are presented as well as a brief review of this disease.

A need for an augmented review when reviewing rehabilitation research.

PubMed

Gerber, Lynn H; Nava, Andrew; Garfinkel, Steven; Goel, Divya; Weinstein, Ali A; Cai, Cindy

2016-10-01

There is a need for additional strategies for performing systematic reviews (SRs) to improve translation of findings into practice and to influence health policy. SRs critically appraise research methodology and determine level of evidence of research findings. The standard type of SR identifies randomized controlled trials (RCTs) as providing the most valid data and highest level of evidence. RCTs are not among the most frequently used research design in disability and health research. RCTs usually measure impairments for the primary research outcome rather than improved function, participation or societal integration. It forces a choice between "validity" and "utility/relevance." Other approaches have effectively been used to assess the validity of alternative research designs, whose outcomes focus on function and patient-reported outcomes. We propose that utilizing existing evaluation tools that measure knowledge, dissemination and utility of findings, may help improve the translation of findings into practice and health policy. Copyright © 2016 Elsevier Inc. All rights reserved.

Economic evaluations and their use in infection prevention and control: a narrative review.

PubMed

Rennert-May, Elissa; Conly, John; Leal, Jenine; Smith, Stephanie; Manns, Braden

2018-01-01

The objective of this review is to provide a comprehensive overview of the different types of economic evaluations that can be utilized by Infection Prevention and Control practitioners with a particular focus on the use of the quality adjusted life year, and its associated challenges. We also highlight existing economic evaluations published within Infection Prevention and Control, research gaps and future directions. Narrative Review. To date the majority of economic evaluations within Infection Prevention and Control are considered partial economic evaluations. Acknowledging the challenges, which include variable utilities within infection prevention and control, a lack of randomized controlled trials, and difficulty in modelling infectious diseases in general, future economic evaluation studies should strive to be consistent with published guidelines for economic evaluations. This includes the use of quality adjusted life years. Further research is required to estimate utility scores of relevance within Infection Prevention and Control.

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 476.71 - QIO review requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care) for the palliation and management of terminal illness; (2) Whether the quality of the services... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities...

42 CFR 456.700 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System... outpatient DUR program that includes prospective drug review, retrospective drug use review, and an... optional point-of-sale electronic claims management system for processing claims for covered outpatient...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

Motivation for Healthy Behavior: A Review of Health Promotion Research

ERIC Educational Resources Information Center

Dunsmore, Sarah; Goodson, Patricia

2006-01-01

Authors reviewed the theoretical history of the "motivation" construct, and its utilization within past/current health behavior research. Textbooks and review articles functioned as sources for the theoretical history review. Research published within a 10-year period (1993-2002) in four health promotion journals (all with impact factors greater…

Implementing a Successful Faculty, Data Driven Model for Program Review.

ERIC Educational Resources Information Center

Beal, Suzanne; Davis, Shirley

Frederick Community College (Maryland) utilizes both the Instructional Accountability Program Review (IAPR) and the Career Program Review (CPR) to assess program outcomes and determine progress in meeting goals and objectives. The IAPR is a comprehensive review procedure conducted by faculty and associate deans to evaluate all transfer, career,…

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review.

PubMed

Rostad, Hanne Marie; Utne, Inger; Grov, Ellen Karine; Puts, Martine; Halvorsrud, Liv

2017-11-02

The Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and clinical utility of the scale. We conducted a systematic search in three databases (CINAHL, Medline and PsycINFO) for studies published in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers independently reviewed titles and abstracts and performed the quality assessment and data abstraction. A total of 24 studies were included in this systematic review. The quality of the studies varied, but many lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies addressed various aspects of the scale's feasibility and clinical utility, but their results are limited and inconsistent across settings and samples. Support for the scale's reliability, validity and responsiveness varied widely across the studies. Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the scale's validity and responsiveness was incomplete. Additional high-quality studies are warranted to determine in which populations of older adults with cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully quantify pain, measure treatment response and improve patient outcomes also needs further investigation. PROSPERO reg. no.: CRD42016049697 registered 20. Oct. 2016.

Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants.

PubMed

Ayanore, Martin Amogre; Pavlova, Milena; Groot, Wim

2016-01-16

Identifying relevant measures of women's reproductive health needs is critical to improve women's chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa. Evidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic settings in West African countries was systematically reviewed. The review included recent English language publications (from January 2009 - March 2014). Clinical studies particularly on obstetric care services and reproductive services in relation to HIV/AIDS were excluded. We acknowledge the possibility to have excluded non-English publications and yet-to-be-published articles related to the study aim and objectives. Outcomes and determinants were assessed and defined at three main levels; contraceptive use, obstetric care, and antenatal care utilization. Results show increasing unmet need for women's reproductive health needs. Socio-cultural norms and practices resulting in discontinuation of service use, economic constraints, travel distance to access services and low education levels of women were found to be key predictors of service utilization for contraception, antenatal and obstetric care services. Outcome measures were mainly assessed based on service utilization, satisfaction, cost, and quality of services available as core measures across the three levels assessed in this review. Evidence from this review indicates that currently applied measures of women's reproductive health needs might be inadequate in attaining best maternal outcomes since they appear rather broad. More support and research for developing and advancing context-related measures may help to improve women's maternal health.

42 CFR 456.524 - Notification of Administrator's action and duration of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote...

Current state of virtual reality simulation in robotic surgery training: a review.

PubMed

Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

2016-06-01

Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.

PubMed

Vest, Joshua R; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B

2015-12-01

Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

PubMed Central

Vest, Joshua R.; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B.

2016-01-01

Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. PMID:26614882

Novel Magnetic Nanomaterials Inspired by Magnetotactic Baterial: Topical Review

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

Prozorov, Tanya; Bazylinki, Dennis A.; Mallapragada, Surya K.

2013-05-14

Magnetotactic bacteria, known to produce magnetic nanocrystals with uniform shapes and sizes at physiological conditions, serve as an inspiration and source of a number of biological macromolecules used for the biomimetic synthesis of a variety of magnetic nanomaterials. This review discusses the current state of understanding of magnetosome biomineralization in magnetotactic bacteria, as well as the ways in which iron biomineralization processes can be utilized for tailored in vivo formation of complex magnetic nanomaterials, not occurring in magnetotactic bacteria naturally. The review assesses the current efforts on in vitro synthesis of a variety of magnetic nanoparticles using bioinspired approaches bymore » utilizing mineralization proteins from magnetotactic bacteria, and surveys biomimetic strategies for the rational synthesis of various magnetic nanomaterials under ambient conditions. Finally, this review presents magnetic characterization of nanoparticles, highlighting differences in magnetic behavior between magnetic nanoparticles produced using bioinspired in vivo and in vitro strategies, compared to those produced using conventional methods. This in turn impacts their utility in a wide range of applications for magnetic nanoparticles, which are examined in detail, where bioinspired synthesis methods have potentially provided added advantages.« less

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... least every 90 days each time it decides under § 456.236 that the continued stay is needed; and (c) The...

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... institutions under review with the following information— (a) The title and address of the person responsible...

Utility deregulation and AMR technology. [Automated Meter Reading

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

Moore, G.

1991-06-15

This article reviews the effects of deregulation on other utilities and services and examines how the electric utilities can avoid the worst of these effects and capitalize of the best aspects of competition in achieving marketing excellence. The article presents deregulation as a customer service and underscores the need for utilities to learn to compete aggressively and intelligently and provide additional services available through technology such as automated meter reading.

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

PubMed Central

2011-01-01

Background In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization. Objectives The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures. Methods We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the Standards for Educational and Psychological Testing. Results Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's r coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) Standards validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source. Conclusions This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (i.e., the Standards) in future research utilization measurement studies. PMID:21794144

A review of patient-centred post-fracture interventions in the context of theories of health behaviour change.

PubMed

Sujic, R; Gignac, M A; Cockerill, R; Beaton, D E

2011-08-01

The purpose of this literature review is to determine whether and to what extent current post-fracture osteoporosis interventions utilize theories of health behaviour change and whether those that are theory-based are more successful in producing desired behaviour changes. Studies were identified by applying additional criteria to the final selection stage of a systematic review of non-surgical osteoporosis interventions in the orthopaedic environment. We identified 42 primary studies targeted at patients and improving post-fracture osteoporosis care. As well as describing the studies (in terms of design, population, interventions, outcomes), we focused on theoretical framework and elements of behaviour change models. The 42 studies included in this review utilized a variety of post-fracture interventions; however, none of them reported using an underlying theoretical base. Only three studies drew on what we felt to be elements of a theoretical framework. The lack of theoretically based studies points to a currently under-utilized area of behaviour change research that could be applied to post-fracture interventions in order to make them more effective. Despite an abundance of literature supporting theories of behaviour change, post-fracture osteoporosis interventions do not report utilizing these theories. Theories of behaviour change could be applied to post-fracture osteoporosis interventions to explain why patients initiate osteoporosis management. Future research should explore the application of theories of health behaviour change to post-fracture interventions.

A scoping review of scoping reviews: advancing the approach and enhancing the consistency

PubMed Central

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-01-01

Background The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. Methods A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. Results The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Conclusions Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. PMID:26052958

A systematic review of the quality of economic models comparing thrombosis inhibitors in patients with acute coronary syndrome undergoing percutaneous coronary intervention.

PubMed

Hatz, Maximilian H M; Leidl, Reiner; Yates, Nichola A; Stollenwerk, Björn

2014-04-01

Thrombosis inhibitors can be used to treat acute coronary syndromes (ACS). However, there are various alternative treatment strategies, of which some have been compared using health economic decision models. To assess the quality of health economic decision models comparing thrombosis inhibitors in patients with ACS undergoing percutaneous coronary intervention, and to identify areas for quality improvement. The literature databases MEDLINE, EMBASE, EconLit, National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA). A review of the quality of health economic decision models was conducted by two independent reviewers, using the Philips checklist. Twenty-one relevant studies were identified. Differences were apparent regarding the model type (six decision trees, four Markov models, eight combinations, three undefined models), the model structure (types of events, Markov states) and the incorporation of data (efficacy, cost and utility data). Critical issues were the absence of particular events (e.g. thrombocytopenia, stroke) and questionable usage of utility values within some studies. As we restricted our search to health economic decision models comparing thrombosis inhibitors, interesting aspects related to the quality of studies of adjacent medical areas that compared stents or procedures could have been missed. This review identified areas where recommendations are indicated regarding the quality of future ACS decision models. For example, all critical events and relevant treatment options should be included. Models also need to allow for changing event probabilities to correctly reflect ACS and to incorporate appropriate, age-specific utility values and decrements when conducting cost-utility analyses.

Systematic donor selection review process improves cardiac transplant volumes and outcomes.

PubMed

Smith, Jason W; O'Brien, Kevin D; Dardas, Todd; Pal, Jay D; Fishbein, Daniel P; Levy, Wayne C; Mahr, Claudius; Masri, Sofia C; Cheng, Richard K; Stempien-Otero, April; Mokadam, Nahush A

2016-01-01

Heart transplant remains the definitive therapy for advanced heart failure patients but is limited by organ availability. We identified a large number of donor hearts from our organ procurement organization (OPO) being exported to other regions. We engaged a multidisciplinary team including transplant surgeons, cardiologists, and our OPO colleagues to identify opportunities to improve our center-specific organ utilization rate. We performed a retrospective analysis of donor offers before and after institution of a novel review process. Each donor offer made to our program was reviewed on a monthly basis from July 2013 to June 2014 and compared with the previous year. This review process resulted in a transplant utilization rate of 28% for period 1 versus 49% for period 2 (P = .007). Limiting the analysis to offers from our local OPO changed our utilization rate from 46% to 75% (P = .02). Transplant volume increased from 22 to 35 between the 2 study periods. Thirty-day and 1-year mortality were unchanged over the 2 periods. A total of 58 hearts were refused by our center and transplanted at other centers. During period 1, the 30-day and 1-year survival rates for recipients of those organs were 98% and 90%, respectively, comparable with our historical survival data. The simple process of systematically reviewing donor turndown events as a group tended to reduce variability, increase confidence in expanded criteria for donors, and resulted in improved donor organ utilization and transplant volumes. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Suggested Guidelines for the Administrative Review Offices of Medical Education.

ERIC Educational Resources Information Center

Meleca, C. Benjamin

1987-01-01

A general description and guidelines are presented for a program review process for departments of medical education of the administrative units within colleges of medicine. After a discussion of the purposes of reviews, a suggested review process is described. The process to be utilized should be negotiated by the principle units, the…

75 FR 70268 - Submission for OMB Review; Comment Request; NIH NCI Central Institutional Review Board (CIRB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... number. Proposed Collection: Title: NIH NCI Central Institutional Review Board (CIRB). Type of... is absent of conflicts of interest with the protocols under review. Tools utilized to accomplish this... information on workflow and processes of CIRB operations as well as a non-disclosure agreement. A conflict of...

Reporting of Systematic Reviews of Micronutrients and Health: A Critical Appraisal

USDA-ARS?s Scientific Manuscript database

Context: Systematic review is a valuable tool for evaluating nutrition-related research and formulating nutrition recommendation. Lack of standardized criteria for generating these reviews has restricted their potential utility. Objective: To evaluate the characteristics and reporting quality of pub...

Design, Development and Utilization Perspectives on Database Management Systems

ERIC Educational Resources Information Center

Shneiderman, Ben

1977-01-01

This paper reviews the historical development of integrated data base management systems and examines competing approaches. Topics include management and utilization, implementation and design, query languages, security, integrity, privacy and concurrency. (Author/KP)

Second generation photodynamic agents: a review.

PubMed

Sternberg, E D; Dolphin, D

1993-10-01

Over the last decade, laser treatment of neoplastic diseases has become routine. The ability of these light-induced therapies to effect positive results is increased with the utilization of photosensitizing dyes. The approval of Photofrin in Canada as a first generation photodynamic therapeutic agent for the treatment of some forms of bladder cancer is being followed by the development of other agents with improved properties. At this time a number of second generation photosensitizing dyes are under study in phase I/II clinical trials. A review of the status of these trials along with mechanistic aspects is reviewed in this article. In addition, a review of the status of lasers to be utilized for photodynamic therapy gives some indication of which instruments could be considered for this therapy in the future.

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

PubMed Central

Flink, Dina M.; Sheeder, Jeanelle

2017-01-01

Purpose: The American Society of Clinical Oncology issued practice guidelines in 2006 to provide critical information about fertility impact to adolescents and young adults (AYA) at the time of cancer diagnosis. Survivors continue to express concerns about their long-term reproductive health after cancer therapy even as treatment options for fertility preservation evolve. An underutilization of fertility preservation methods by cancer patients continues to persist. A review of the literature cites barriers and challenges that limit fertility information and preservation options for AYA cancer patients. Methods: A review of medical literature was conducted to examine current practice for patients receiving fertility information and the barriers to patients receiving fertility preservation services. Results: A total of 69 publications were included in this review. The review summarizes (1) patient experiences with receiving fertility information and (2) patient desires, barriers, and challenges to utilizing fertility preservation services. Conclusions: Despite advances in fertility preservation, there are challenges for patients to utilizing fertility preservation services. Barriers include the following: urgency to initiate treatment, inadequate information, clinic time constraints, and perceptions around patients' gender, age, cost, parity, race, relationship, and sociodemographic status influence whether patients receive fertility preservation consultation. Patients report a lack of adequate information to make informed fertility decisions. PMID:27529573

Health state utilities among contemporary prostate cancer patients on active surveillance.

PubMed

Loeb, Stacy; Curnyn, Caitlin; Walter, Dawn; Fagerlin, Angela; Siebert, Uwe; Mühlberger, Nick; Braithwaite, R Scott; Schwartz, Mark D; Lepor, Herbert; Sedlander, Erica

2018-04-01

Active surveillance (AS) is the most rapidly expanding management option for favorable-risk prostate cancer (PCa). Early studies suggested substantial decrements in utility (quality of life weights) from disease-related anxiety. Our objective was to determine utilities for contemporary AS patients using different instruments. We performed a systematic review of PubMed, PMC and OVID for utility measurements in modern AS patients. We then examined utilities among 37 men on AS participating in focus groups between 2015-2016 using the generic EurQol five dimensions questionnaire (EQ-5D-3L) and Patient Oriented Prostate Utility Scale (PORPUS), a PCa-specific instrument. The systematic review found previous studies with utilities for PCa treatment and historical watchful waiting populations, but none specifically in contemporary AS. In our AS population, the mean EQ-5D-3L score was 0.90±0.16 (median, 1.00; range, 0.21-1.00) and PORPUS was 0.98±0.03 (median, 0.99; range, 0.84-1.00). The Spearman correlation between the EQ-5D-3L and PORPUS was 0.87 (P<0.0001), and 38% of patients had a difference >0.1 between instruments. Most contemporary AS patients had high utility scores suggesting that they perceive themselves in good health without a major decrement in quality of life from the disease. However, some patients had substantial differences in utility measured with generic versus disease-specific instruments. Further study is warranted into the optimal instrument for utility assessment in contemporary AS patients.

76 FR 14895 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... DEPARTMENT OF AGRICULTURE Submission for OMB Review; Comment Request March 14, 2011. The Department of Agriculture has submitted the following information collection requirement(s) to OMB for review... agency, including whether the information will have practical utility; (b) the accuracy of the agency's...

7 CFR 1779.59 - Review of requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Review of requirements. 1779.59 Section 1779.59 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.59 Review of requirements...

Electrical deicing utilizing carbon fiber tape for asphalt approach and crosswalk phase I - literature review.

DOT National Transportation Integrated Search

2016-06-30

The purpose of this study is to provide a comprehensive literature review of electrical deicing technology for possible application in asphalt approach and crosswalks. A : thorough review of existing and emerging deicing technology for snow/ice melti...

FSSC Science Tools: Pulsar Analysis

NASA Technical Reports Server (NTRS)

Thompson, Dave

2010-01-01

This slide presentation reviews the typical pulsar analysis, giving tips for screening of the data, the use of time series analysis, and utility tools. Specific information about analyzing Vela data is reviewed.

75 FR 20568 - Agency Information Collection Activities Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

...: The United Kingdom, Australia, Brazil, Germany, Canada, France, Spain, New Zealand, Singapore, Taiwan... time needed to review instructions; develop, acquire, install, and utilize technology and systems for...

42 CFR 456.238 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Review of Need for Continued Stay § 456.238 Time limits for...

Bellwether Social Studies Programs.

ERIC Educational Resources Information Center

Daetz, Denney

1985-01-01

Describes and reviews commercially-available computer software for social studies (SS). They are: "Jury Trial II" (utilizes artificial intelligence); "Africa" (utilizes creative graphics to teaching SS facts; "Revolutions: Past, Present and Future"; "The Other Side" (examines world peace using values…

A review of light-scattering techniques for the study of colloids in natural waters

USGS Publications Warehouse

Rees, T.F.

1987-01-01

In order to understand the movement of colloidal materials in natural waters, we first need to have a means of quantifying their physical characteristics. This paper reviews three techniques which utilize light-scattering phenomena to measure the translational diffusion coefficient, the rotational diffusion coefficient, and the electrophoretic mobility of colloids suspended in water. Primary emphasis is to provide sufficient theoretical detail so that hydrologists can evaluate the utility of photon correlation spectrometry, electrophoretic light scattering, and electric birefringence analysis. ?? 1987.

A Study to Determine the Cost of Quality Assurance to the Department of Surgery at US Army Medical Department Activity. Fort Benning, Georgia

DTIC Science & Technology

1984-07-01

to make maximum use of available time. General Surgery averaged ninety-six operative procedures per month during 1983, ophthalmology averaged fifteen...health care providers 2. Document evaluation of: a) Surgical care review (tissue review) b) Blood utilization c) Antibiotics utilization d) Pharmacy and...21. Number Surgical Procedures Performed 470 470 on Patients Undergoing all Types of Surgery APPENDIX L EXAMPLES OF AUDIT CRITERIA 103 SERVICE MONTH

Value-added uses for crude glycerol--a byproduct of biodiesel production

PubMed Central

2012-01-01

Biodiesel is a promising alternative, and renewable, fuel. As its production increases, so does production of the principle co-product, crude glycerol. The effective utilization of crude glycerol will contribute to the viability of biodiesel. In this review, composition and quality factors of crude glycerol are discussed. The value-added utilization opportunities of crude glycerol are reviewed. The majority of crude glycerol is used as feedstock for production of other value-added chemicals, followed by animal feeds. PMID:22413907

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Factors associated with institutional delivery service utilization in Ethiopia.

PubMed

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel-Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I (2) test. People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women's autonomy was not significantly associated with institutional delivery service utilization. Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.

Ethical implications of digital images for teaching and learning purposes: an integrative review.

PubMed

Kornhaber, Rachel; Betihavas, Vasiliki; Baber, Rodney J

2015-01-01

Digital photography has simplified the process of capturing and utilizing medical images. The process of taking high-quality digital photographs has been recognized as efficient, timely, and cost-effective. In particular, the evolution of smartphone and comparable technologies has become a vital component in teaching and learning of health care professionals. However, ethical standards in relation to digital photography for teaching and learning have not always been of the highest standard. The inappropriate utilization of digital images within the health care setting has the capacity to compromise patient confidentiality and increase the risk of litigation. Therefore, the aim of this review was to investigate the literature concerning the ethical implications for health professionals utilizing digital photography for teaching and learning. A literature search was conducted utilizing five electronic databases, PubMed, Embase (Excerpta Medica Database), Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and Scopus, limited to English language. Studies that endeavored to evaluate the ethical implications of digital photography for teaching and learning purposes in the health care setting were included. The search strategy identified 514 papers of which nine were retrieved for full review. Four papers were excluded based on the inclusion criteria, leaving five papers for final analysis. Three key themes were developed: knowledge deficit, consent and beyond, and standards driving scope of practice. The assimilation of evidence in this review suggests that there is value for health professionals utilizing digital photography for teaching purposes in health education. However, there is limited understanding of the process of obtaining and storage and use of such mediums for teaching purposes. Disparity was also highlighted related to policy and guideline identification and development in clinical practice. Therefore, the implementation of policy to guide practice requires further research.

Circulating Tumor DNA Analysis in Patients With Cancer: American Society of Clinical Oncology and College of American Pathologists Joint Review.

PubMed

Merker, Jason D; Oxnard, Geoffrey R; Compton, Carolyn; Diehn, Maximilian; Hurley, Patricia; Lazar, Alexander J; Lindeman, Neal; Lockwood, Christina M; Rai, Alex J; Schilsky, Richard L; Tsimberidou, Apostolia M; Vasalos, Patricia; Billman, Brooke L; Oliver, Thomas K; Bruinooge, Suanna S; Hayes, Daniel F; Turner, Nicholas C

2018-06-01

Purpose Clinical use of analytical tests to assess genomic variants in circulating tumor DNA (ctDNA) is increasing. This joint review from ASCO and the College of American Pathologists summarizes current information about clinical ctDNA assays and provides a framework for future research. Methods An Expert Panel conducted a literature review on the use of ctDNA assays for solid tumors, including pre-analytical variables, analytical validity, interpretation and reporting, and clinical validity and utility. Results The literature search identified 1,338 references. Of those, 390, plus 31 references supplied by the Expert Panel, were selected for full-text review. There were 77 articles selected for inclusion. Conclusion The evidence indicates that testing for ctDNA is optimally performed on plasma collected in cell stabilization or EDTA tubes, with EDTA tubes processed within 6 hours of collection. Some ctDNA assays have demonstrated clinical validity and utility with certain types of advanced cancer; however, there is insufficient evidence of clinical validity and utility for the majority of ctDNA assays in advanced cancer. Evidence shows discordance between the results of ctDNA assays and genotyping tumor specimens and supports tumor tissue genotyping to confirm undetected results from ctDNA tests. There is no evidence of clinical utility and little evidence of clinical validity of ctDNA assays in early-stage cancer, treatment monitoring, or residual disease detection. There is no evidence of clinical validity and clinical utility to suggest that ctDNA assays are useful for cancer screening, outside of a clinical trial. Given the rapid pace of research, re-evaluation of the literature will shortly be required, along with the development of tools and guidance for clinical practice.

Factors associated with institutional delivery service utilization in Ethiopia

PubMed Central

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Background Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. Objective The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. Methods The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I2 test. Results People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization. Conclusion and recommendation Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended. PMID:27672342

The Effect of Formulary Restrictions on Patient and Payer Outcomes: A Systematic Literature Review.

PubMed

Park, Yujin; Raza, Syed; George, Aneesh; Agrawal, Rumjhum; Ko, John

2017-08-01

Formulary restrictions are implemented to reduce pharmacy costs and ensure appropriate use of pharmaceutical products. As adoption of formulary restrictions increases with rising pharmacy costs, there is a need to better understand the potential effect of formulary restrictions on patient and payer outcomes. To conduct a systematic literature review that assesses the effect of formulary restrictions on the following outcomes: medication adherence, clinical outcomes, treatment satisfaction, drug utilization, health care resource utilization, and economic outcomes. Studies published in 2005 or later were identified from the MEDLINE, Embase, and Cochrane databases and the National Health Service Economic Evaluation Database, using 2 sets of search terms. A total of 17 formulary restriction terms (e.g., step therapy [ST] and prior authorization [PA]) and 55 outcome terms were included, resulting in 935 unique search term combinations. Two reviewers independently conducted analyses of the titles, abstracts, and full-text articles. The search was limited to English-language articles that evaluated the effect of ST and/or PA placed by U.S. third-party payers on the following outcomes: patient outcomes (medication adherence, clinical outcomes, and treatment satisfaction) and payer outcomes (drug utilization, health care resource utilization, and economic outcomes). Of 2,321 reviewed articles, 59 articles met the study inclusion criteria. The included studies assessed the effect of ST (n = 18), PA (n = 35), or both (n = 6) on medication adherence (n = 14), clinical outcomes (n = 12), treatment satisfaction (n = 2), drug utilization (n = 39), health care resource utilization (n = 18), and economic outcomes (n = 42). The 59 articles measured 164 outcomes across the patient, health care resource utilization, and economic outcome categories of interest. Of the total number of outcomes, 50.6% (n = 83) were negative in direction or were unfavorable, whereas 40.2% (n = 66) were positive in direction or were favorable, when the perspectives of patients and payers were considered. Of the total number of drug utilization outcomes reported (n = 46), the majority showed lower drug utilization (> 90%). However, in some of the articles, pharmacy cost savings resulting from lower drug utilization appeared to be offset by increased medical costs. Formulary coverage decisions may have unintended consequences on patient and payer outcomes despite lower drug utilization and pharmacy cost savings; therefore, careful evaluation of restrictions before policy implementation and continued reevaluation after implementation is warranted. This study was funded by Novartis Pharmaceuticals. Park and Ko are employed by Novartis Pharmaceuticals in East Hanover, New Jersey, and Ko holds stock in Novartis. Raza, George, and Agrawal are employed by Novartis Healthcare in Hyderabad, India. Study concept and design were contributed primarily by Park and Ko, along with the other authors. Raza, George, and Agrawal collected the data, along with Park and Ko. Data interpretation was performed by Agrawal, Raza, George, Park, and Ko. The manuscript was written and revised by Raza, George, and Park, along with Ko and Agrawal. Results from this systematic literature review were presented at the AMCP Annual Meeting 2016; San Francisco, California; April 19-22, 2016.

Synchronous and Asynchronous Text-Based CMC in Educational Contexts: A Review of Recent Research

ERIC Educational Resources Information Center

Johnson, Genevieve, Marie

2006-01-01

This paper presents a review of recent research that examines the relative instructional utility of text-based synchronous and asynchronous computer-mediated communication (CMC). As a mechanism for limiting the number of studies reviewed as well as controlling for emergent technologies, only research published since 2000 was reviewed. The goal was…

44 CFR 12.14 - Annual comprehensive review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... should be abolished. (b) Pertinent factors to be considered in the comprehensive review required by... programs or operations; (4) An evaluation of the utilization by the Agency of the committee's policy...

Enhancing rigor and practice of scoping reviews in social policy research: considerations from a worked example on the Americans with disabilities act.

PubMed

Harris, Sarah Parker; Gould, Robert; Fujiura, Glenn

2015-01-01

There is increasing theoretical consideration about the use of systematic and scoping reviews of evidence in informing disability and rehabilitation research and practice. Indicative of this trend, this journal published a piece by Rumrill, Fitzgerald and Merchant in 2010 explaining the utility and process for conducting reviews of intervention-based research. There is still need to consider how to apply such rigor when conducting more exploratory reviews of heterogeneous research. This article explores the challenges, benefits, and procedures for conducting rigorous exploratory scoping reviews of diverse evidence. The article expands upon Rumrill, Fitzgerald and Merchant's framework and considers its application to more heterogeneous evidence on the impact of social policy. A worked example of a scoping review of the Americans with Disabilities Act is provided with a procedural framework for conducting scoping reviews on the effects of a social policy. The need for more nuanced techniques for enhancing rigor became apparent during the review process. There are multiple methodological steps that can enhance the utility of exploratory scoping reviews. The potential of systematic consideration during the exploratory review process is shown as a viable method to enhance the rigor in reviewing diverse bodies of evidence.

An Integrative Review of Multicomponent Weight Management Interventions for Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Doherty, Alison J.; Jones, Stephanie P.; Chauhan, Umesh; Gibson, Josephine M. E.

2018-01-01

Background: Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. Methods: An integrative review utilizing systematic review methodology was conducted…

Integration of utility and environmental activities in the project development process.

DOT National Transportation Integrated Search

2010-01-01

Two sources of delay during the project development process are utility adjustments and the environmental : review and clearance process. There are several efforts underway at the Texas Department of Transportation : (TxDOT) to optimize these process...

Bibliography of Literature for Avian Issues in Solar and Wind Energy and Other Activities

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

Walston, Leroy J.; White, Ellen M.; Meyers, Stephanie A.

2015-04-01

Utility-scale solar energy has been a rapidly expanding energy sector in the United States in recent years and is expected to continue to grow. In 2014, concerns were raised over the risk of avian fatalities associated with utility-scale solar plants. With funding from the U.S. Department of Energy SunShot Program, Argonne National Laboratory and the National Renewable Energy Laboratory studied the issue and released A Review of Avian Monitoring and Mitigation Information at Existing Utility-Scale Solar Facilities (ANL/EVS-15/2, March 2015). A comprehensive literature review included peer-reviewed journal articles on avian fatalities from solar energy facilities and other sources (e.g., windmore » energy, building collisions, etc.), project-specific technical reports on avian monitoring and fatality at solar facilities, information on mitigation measures and best management practices, and literature pertaining to avian behavioral patterns and habitat use. The source citations are listed in this bibliography; they are current through December 2014.« less

Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

PubMed

Yoshizawa, R S

2013-01-01

Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

11 CFR 9036.4 - Commission review of submissions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., in conducting its review, may utilize statistical sampling techniques. Based on the results of its... nonmatchable and the reason that it is not matchable; or if statistical sampling is used, the estimated amount...

Frequency of Binge Eating Episodes in Bulimia Nervosa and Binge Eating Disorder: Diagnostic Considerations

PubMed Central

Wilson, G. Terence; Sysko, Robyn

2013-01-01

Objective In DSM-IV, to be diagnosed with Bulimia Nervosa (BN) or the provisional diagnosis of Binge Eating Disorder (BED), an individual must experience episodes of binge eating is “at least twice a week” on average, for three or six months respectively. The purpose of this review was to examine the validity and utility of the frequency criterion for BN and BED. Method Published studies evaluating the frequency criterion were reviewed. Results Our review found little evidence to support the validity or utility of the DSM-IV frequency criterion of twice a week binge eating; however, the number of studies available for our review was limited. Conclusion A number of options are available for the frequency criterion in DSM-V, and the optimal diagnostic threshold for binge eating remains to be determined. PMID:19610014

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... different geographical locations or for different types of providers. (B) For healthcare services provided... TRICARE/CHAMPUS Policy Manual, or until the approved transplant occurs. (D) For healthcare services.... (3) Outlier review. Claims which qualify for additional payment as a long-stay outlier or as a cost...

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... different geographical locations or for different types of providers. (B) For healthcare services provided... TRICARE/CHAMPUS Policy Manual, or until the approved transplant occurs. (D) For healthcare services.... (3) Outlier review. Claims which qualify for additional payment as a long-stay outlier or as a cost...

Review of Empirical Research That Utilized the Bell Object Relations Inventory.

ERIC Educational Resources Information Center

Hansen, Joseph Wm.

This literature review examines how the Bell Object Relations Inventory (BORI) (M. Bell and others, 1986) has been used in the literature. General domains of BORI use include interpersonal relatedness, the measurement of religious dimensions, and the diagnosis and prediction of psychopathology. Specific areas are reviewed regarding the…

Women and Minorities in Engineering: A Review of the Literature

ERIC Educational Resources Information Center

Mamaril, Natasha J. A; Royal, Kenneth D.

2008-01-01

This review of the literature investigates the various factors identified by researchers to explain women's underrepresentation in the engineering field. Because a great deal of research has been published through the years, a compilation summary of existing research was necessary. This literature review utilized searches from thousands of…

Universal Adolescent Depression Prevention Programs: A Review

ERIC Educational Resources Information Center

Carnevale, Teresa D.

2013-01-01

Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several…

Methods for Assessing Sleep in Children with Autism Spectrum Disorders: A Review

ERIC Educational Resources Information Center

Hodge, Danelle; Parnell, Andrea M. N.; Hoffman, Charles D.; Sweeney, Dwight P.

2012-01-01

A literature review completed by Bauer and Blunden (2008) determined that compared to objective measures, subjective assessments of sleep for typically developing children (e.g., parental reports) were of limited utility. No comparable literature review has been undertaken to determine whether subjective measures are appropriate for assessing…

A Systematic Review of Factors Utilized in Preconception Health Behavior Research

ERIC Educational Resources Information Center

Delissaint, Dieula; McKyer, E. Lisako J.

2011-01-01

This systematic review critically synthesizes the literature focusing on factors related to preconception health behaviors (PCHBs) among childbearing age women in the United States, developed countries, and developing countries. Ovid Medline and CINAHL databases were searched for peer-reviewed articles published between 1998 and 2008 relating to…

Evaluation of costs to process and manage utility and driveway permits.

DOT National Transportation Integrated Search

2014-10-01

Reviewing and processing utility and driveway permits at the Texas Department of Transportation (TxDOT) : requires a considerable amount of involvement and coordination by TxDOT personnel, both at the district : and division levels. Currently, TxDOT ...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

A review of screening mammography participation and utilization in Canada.

PubMed

Doyle, G P; Major, D; Chu, C; Stankiewicz, A; Harrison, M L; Pogany, L; Mai, V M; Onysko, J

2011-09-01

Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

Conceptual and empirical themes regarding the design of technology transfer programs : a review of wood utilization research in the United States

Treesearch

Paul V. Ellefson; Michael A. Kilgore; Kenneth E. Skog; Christopher D. Risbrudt

2011-01-01

Transfer of technologies produced by research is critical to innovation within all organizations. The intent of this paper is to take stock of the conceptual underpinnings of technology transfer processes as they relate to wood utilization research and to identify conditions that promote the successful transfer of research results. Conceptually, research utilization...

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

PubMed Central

2011-01-01

Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days). Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients) and 33% (other patients, from the time of referral). Most inappropriate days in acute care were due to delays in processes/scheduling (45%) or being more appropriate for rehabilitation or lower level of care (30%). On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively). From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including rehabilitation. The rehabilitation team was the most accurate in determining ongoing medical stability, but at the cost of a longer acute stay. To avoid inpatients remaining in acute care in a state of 'terra nullius', clinical models which provide rehabilitation within acute care, and more efficient movement to a rehabilitation setting, is required. Utilization review could have a decision support role in the determination of medical stability. PMID:22040281

Optical coherence tomography in gastroenterology: a review and future outlook

NASA Astrophysics Data System (ADS)

Tsai, Tsung-Han; Leggett, Cadman L.; Trindade, Arvind J.; Sethi, Amrita; Swager, Anne-Fré; Joshi, Virendra; Bergman, Jacques J.; Mashimo, Hiroshi; Nishioka, Norman S.; Namati, Eman

2017-12-01

Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

PubMed

Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

2016-01-01

We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics. Copyright © 2016 Elsevier Inc. All rights reserved.

42 CFR 456.436 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities... mentally retarded, the recipient's qualified mental retardation professional, within 1 working day of its... final decision on the need for the continued stay; (g) If the attending physician or qualified mental...

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions... granted by the Administrator to the Medicaid agency for a specific remote facility to use time periods...

Three Techniques for Task Analysis: Examples from the Nuclear Utilities.

ERIC Educational Resources Information Center

Carlisle, Kenneth E.

1984-01-01

Discusses three task analysis techniques utilized at the Palo Verde Nuclear Generating Station to review training programs: analysis of (1) job positions, (2) procedures, and (3) instructional presentations. All of these include task breakdown, relationship determination, and task restructuring. (MBR)

Cost-Utility and Cost-Effectiveness Studies of Telemedicine, Electronic, and Mobile Health Systems in the Literature: A Systematic Review

PubMed Central

López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

2015-01-01

Abstract Objective: A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Materials and Methods: Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as “cost-utility” OR “cost utility” AND “telemedicine,” “cost-effectiveness” OR “cost effectiveness” AND “mobile health,” etc. In the articles searched, there were no limitations in the publication date. Results: The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. Conclusions: There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures. PMID:25474190

Social determinants of bone densitometry uptake for osteoporosis risk in patients aged 50yr and older: a systematic review.

PubMed

Brennan, Sharon L; Wluka, Anita E; Gould, Haslinda; Nicholson, Geoffrey C; Leslie, William D; Ebeling, Peter R; Oldenburg, Brian; Kotowicz, Mark A; Pasco, Julie A

2012-01-01

The World Health Organization identifies that osteoporosis is one of the leading health problems in the Western world. An increased risk of fragility fracture is observed in more socially disadvantaged individuals in most Western countries. Dual-energy X-ray absorptiometry (DXA) is currently the procedure of choice to diagnose osteoporosis and assess fracture risk. We systematically reviewed the literature regarding social determinants of DXA utilization for osteoporosis detection in patients aged 50yr and older using a computer-aided search of MEDLINE, EMBASE, CINAHL, and PsychINFO from January 1994 to December 2010. Five cross-sectional studies, incorporating 16 separate analyses, were identified for inclusion in this review. The best evidence analysis identified limited evidence for a positive association between either income or education with DXA utilization; furthermore, the best evidence analysis found no evidence for an association between either marital status or working status and DXA utilization. Further research is required to identify whether a relationship exists and elucidate reasons for disparities in DXA utilization between different social groups, such as choice and referral processes, as a necessary precursor in identifying modifiable determinants and appropriate strategies to promote preventive screening to identify fracture risk. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Valorization of date palm (Phoenix dactylifera) fruit processing by-products and wastes using bioprocess technology - Review.

PubMed

Chandrasekaran, M; Bahkali, Ali H

2013-04-01

The date palm Phoenix dactylifera has played an important role in the day-to-day life of the people for the last 7000 years. Today worldwide production, utilization and industrialization of dates are continuously increasing since date fruits have earned great importance in human nutrition owing to their rich content of essential nutrients. Tons of date palm fruit wastes are discarded daily by the date processing industries leading to environmental problems. Wastes such as date pits represent an average of 10% of the date fruits. Thus, there is an urgent need to find suitable applications for this waste. In spite of several studies on date palm cultivation, their utilization and scope for utilizing date fruit in therapeutic applications, very few reviews are available and they are limited to the chemistry and pharmacology of the date fruits and phytochemical composition, nutritional significance and potential health benefits of date fruit consumption. In this context, in the present review the prospects of valorization of these date fruit processing by-products and wastes' employing fermentation and enzyme processing technologies towards total utilization of this valuable commodity for the production of biofuels, biopolymers, biosurfactants, organic acids, antibiotics, industrial enzymes and other possible industrial chemicals are discussed.

A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

PubMed

Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

2015-01-01

The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

Valorization of date palm (Phoenix dactylifera) fruit processing by-products and wastes using bioprocess technology – Review

PubMed Central

Chandrasekaran, M.; Bahkali, Ali H.

2013-01-01

The date palm Phoenix dactylifera has played an important role in the day-to-day life of the people for the last 7000 years. Today worldwide production, utilization and industrialization of dates are continuously increasing since date fruits have earned great importance in human nutrition owing to their rich content of essential nutrients. Tons of date palm fruit wastes are discarded daily by the date processing industries leading to environmental problems. Wastes such as date pits represent an average of 10% of the date fruits. Thus, there is an urgent need to find suitable applications for this waste. In spite of several studies on date palm cultivation, their utilization and scope for utilizing date fruit in therapeutic applications, very few reviews are available and they are limited to the chemistry and pharmacology of the date fruits and phytochemical composition, nutritional significance and potential health benefits of date fruit consumption. In this context, in the present review the prospects of valorization of these date fruit processing by-products and wastes’ employing fermentation and enzyme processing technologies towards total utilization of this valuable commodity for the production of biofuels, biopolymers, biosurfactants, organic acids, antibiotics, industrial enzymes and other possible industrial chemicals are discussed. PMID:23961227

Health Worker mHealth Utilization: A Systematic Review

PubMed Central

White, Alice; Thomas, Deborah S.K.; Ezeanochie, Nnamdi; Bull, Sheana

2016-01-01

This systematic review describes mHealth interventions directed at healthcare workers in low resource settings from the PubMed database from March, 2009 to May, 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits; communication between health workers and patients; communication between health workers; and public health surveillance. Most studies used a combination of quantitative and qualitative methods to assess acceptability of use, barriers to use, changes in healthcare delivery, and improved health outcomes. Few papers included theory explicitly to guide development and evaluation of their mHealth programs. Overall, evidence indicated that mobile technology tools, such as smartphones and tablets, substantially benefit healthcare workers, their patients, and health care delivery. Limitations to mHealth tools included insufficient program use and sustainability, unreliable Internet and electricity, and security issues. Despite these limitations, this systematic review demonstrates the utility of using mHealth in low-resource settings and the potential for widespread health system improvements using technology. PMID:26955009

The impact of transitional care programs on health services utilization in community-dwelling older adults: a systematic review.

PubMed

Weeks, Lori E; Macdonald, Marilyn; Martin-Misener, Ruth; Helwig, Melissa; Bishop, Andrea; Iduye, Damilola F; Moody, Elaine

2018-02-01

The objective was to identify and synthesize the best available evidence on the impact of transitional care programs on various forms of health services utilization in community-dwelling older adults. There is growing evidence that transitional care programs can help address important challenges facing health care systems and our increasing older adult population in many countries by reducing unnecessary health service utilization. There is a need for a systematic review of the research evaluating the impact of transitional care programs on hospital and other health service usage. The review included studies on community-dwelling adults age 60 and over with at least one medical diagnosis, and which evaluated the outcomes of transitional care programs on health system utilization of older adults. The outcomes for this review were hospital usage including admissions and readmissions, emergency department usage, primary care/physician usage, nursing home usage, and home health care usage. The review considered experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, and case-control studies. A three-step search was utilized to find published and unpublished studies conducted in any country but reported in English. Six electronic databases were searched from inception of the database to May, 2016. A search for unpublished studies was also conducted. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Quantitative data were extracted from included studies independently by the two reviewers using the standardized Joanna Briggs Institute data extraction tools. Due to the methodological heterogeneity of the included studies, a comprehensive meta-analysis for all outcomes was not possible. Meta-analysis was conducted for rehospitalization at 30, 90 and 180 days. A narrative summary of other quantitative findings was conducted. Twenty-three studies met the inclusion criteria and were included in the review. Nineteen of the studies were randomized controlled trials and four were case control studies, involving 20,997 participants in total with a mean age of 76. Meta-analysis found that transitional care significantly reduced hospital readmission rates at 30 days (odds ratio [OR] 0.75, 95% confidence intervals [CIs] 0.62-0.91, p < 0.01), 90 days (OR 0.77, 95% CIs 0.59-1.02, p = 0.04), and 180 days (OR 0.67, 95% CIs 0.46-0.99, p < 0.01). Narrative synthesis indicated little impact of transitional care on emergency department and nursing home usage, increased use of primary care/physician usage, and decreased home health care usage. Based on a review of 23 studies conducted in the USA, Hong Kong, Canada, Germany, the Netherlands, Sweden and Switzerland, we identified four major conclusions. First, transitional care reduces rehospitalization rates over time, with the largest effects seen at 30 days. Second, transitional care may increase the utilization of primary care services and thus have a favourable impact on preventative care. Third, transitional care may reduce home health usage. Fourth, transitional care interventions of one month or less appear to be as effective as longer interventions in reducing hospital usage.

Perspectives of The Interagency Nuclear Safety Review Panel (INSRP) on future nuclear powered space missions

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

Gray, L.B.; Pyatt, D.W.; Sholtis, J.A.

1993-01-10

The Interagency Nuclear Safety Review Panel (INSRP) has provided reviews of all nuclear powered spacecraft launched by the United States. The two most recent launches were Ulysses in 1990 and Galileo in 1989. One reactor was launched in 1965 (SNAP-10A). All other U.S. space missions have utilized radioisotopic thermoelectric generators (RTGs). There are several missions in the next few years that are to be nuclear powered, including one that would utilize the Topaz II reactor purchased from Russia. INSRP must realign itself to perform parallel safety assessments of a reactor powered space mission, which has not been done in aboutmore » thirty years, and RTG powered missions.« less

Responding to Community Needs through Community Follow-Up. Junior College Resource Review.

ERIC Educational Resources Information Center

Mehallis, Mantha Vlahos

This literature review examines the utilization of community needs assessment data in program planning and evaluation efforts at community colleges. The review first defines and looks at the purposes of community needs assessments, noting that while such studies are purported to facilitate the planning and evaluation of credit and non-credit…

"Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

ERIC Educational Resources Information Center

Stansfield, Claire; Thomas, James; Kavanagh, Josephine

2013-01-01

Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

A Systematic Review of Measures of Activity Limitation for Children with Cerebral Palsy

ERIC Educational Resources Information Center

Harvey, Adrienne; Robin, Jonathan; Morris, Meg E.; Graham, H. Kerr; Baker, Richard

2008-01-01

This systematic review critically appraises the literature on the psychometric properties and clinical utility of evaluative activity limitation outcome measures used for children with cerebral palsy (CP). The search strategy yielded 29 articles for eight outcome measures that met the inclusion criteria for the review. The Gross Motor Function…

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2012 CFR

2012-01-01

..., Certification Full cost. Amendment, Renewal, Other Approvals Full cost. C. Test Facility/Research Reactor... of components requiring Commission and Executive Branch review, for example, actions under 10 CFR 110... export of reactor and other components requiring Executive Branch review, for example, those actions...

Peer Review of Report Modeling the Relationship Between Lead in Drinking Water and Blood Lead Levels in Children

EPA Science Inventory

EPA is peer reviewing the Agency’s report modeling the relationship between lead in drinking water and blood lead levels in children utilizing the Integrated Exposure Uptake Biokinetic (IEUBK) model. The report being peer reviewed may be used to inform the derivation of a concent...

Technology-Supported Learning in Secondary and Undergraduate Biological Education: Observations from Literature Review

ERIC Educational Resources Information Center

Lee, Silvia Wen-Yu; Tsai, Chin-Chung

2013-01-01

We conducted a literature review of using educational technology in biology learning from 2001 to 2010. A total of 36 empirical articles were included for review. Based upon the content analyses of these studies, such as technologies utilized, student sample, biological topics involved, the research purpose, and methodology, the following…

7 CFR 1730.23 - Review rating summary, RUS Form 300.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Review rating summary, RUS Form 300. 1730.23 Section 1730.23 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... § 1730.23 Review rating summary, RUS Form 300. RUS Form 300 in Appendix A shall be used when required by...

75 FR 56540 - Office of Governmentwide Policy: Submission for OMB Review; Information Collection, Real Property...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... of Governmentwide Policy: Submission for OMB Review; Information Collection, Real Property Status... (GSA). ACTION: Submission for OMB Review; Comment Request and Final Notice of the Real Property Status... will be able to utilize a new standard form to collect information on the status of real property under...

78 FR 46373 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Domestic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... minimum wage an agricultural employer utilizing the H-2A program, allowing temporary employment of alien... for OMB Review; Comment Request; Domestic Agricultural In-Season Wage Report ACTION: Notice. SUMMARY...- Season Wage Report,'' to the Office of Management and Budget (OMB) for review and approval for use in...

Amyloid-β Positron Emission Tomography Imaging Probes: A Critical Review

PubMed Central

Kepe, Vladimir; Moghbel, Mateen C.; Långström, Bengt; Zaidi, Habib; Vinters, Harry V.; Huang, Sung-Cheng; Satyamurthy, Nagichettiar; Doudet, Doris; Mishani, Eyal; Cohen, Robert M.; Høilund-Carlsen, Poul F.; Alavi, Abass; Barrio, Jorge R.

2013-01-01

The rapidly rising prevalence and cost of Alzheimer’s disease (AD) in recent decades has made the imaging of amyloid-β (Aβ) deposits the focus of intense research. Several amyloid imaging probes with purported specificity for Aβ plaques are currently at various stages of FDA approval. However, a number of factors appear to preclude these probes from clinical utilization. As the available “amyloid specific” PET imaging probes have failed to demonstrate diagnostic value and have shown limited utility for monitoring therapeutic interventions in humans, a debate on their significance has emerged. The aim of this review is to identify and discuss critically the scientific issues contributing to the extensive inconsistencies reported in the literature on their purported in vivo amyloid specificity and potential utilization in patients. PMID:23648516

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... of the problem and follow-up. Quality review study information means all documentation related to the...

Applications of Desensitization Procedures for School-Related Problems; A Review.

ERIC Educational Resources Information Center

Prout, H. Thompson; Harvey, John R.

1978-01-01

A variety of desensitization and counterconditioning procedures have been utilized to deal with school-related problems. These procedures are reviewed with respect to applications for treating school phobia, test anxiety, and other academic anxieties. (Author)

7 CFR Exhibit F to Subpart I of... - Site Option Loan to Technical Assistance Grantees

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... decision reviewed following the procedure established in subpart B of part 1900 of this chapter. (2) Review...

ERISA preemption. Colleton Regional Hospital v. MRS Medical Review Systems Inc.

PubMed

1997-01-01

ERISA preempts state law claims brought by hospitals against medical utilization review firm including claims of tortious interference with contracts, defamation, unfair trade practices, bad faith refusal to pay claims and improper claims practices.

L-Area STS MTR/NRU/NRX Grapple Assembly Closure Mechanics Review

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

Huizenga, D. J.

2016-06-08

A review of the closure mechanics associated with the Shielded Transfer System (STS) MTR/NRU/NRX grapple assembly utilized at the Savannah River Site (SRS) was performed. This review was prompted by an operational event which occurred at the Canadian Nuclear Laboratories (CNL) utilizing a DTS-XL grapple assembly which is essentially identical to the STS MTR/NRU/NRX grapple assembly used at the SRS. The CNL operational event occurred when a NRU/NRX fuel basket containing spent nuclear fuel assemblies was inadvertently released by the DTS-XL grapple assembly during a transfer. The SM review of the STS MTR/NRU/NRX grapple assembly will examine the operational aspectsmore » of the STS and the engineered features of the STS which prevent such an event at the SRS. The design requirements for the STS NRU/NRX modifications and the overall layout of the STS are provided in other documents.« less

Health care economic analyses and value-based medicine.

PubMed

Brown, Melissa M; Brown, Gary C; Sharma, Sanjay; Landy, Jennifer

2003-01-01

Health care economic analyses are becoming increasingly important in the evaluation of health care interventions, including many within ophthalmology. Encompassed with the realm of health care economic studies are cost-benefit analysis, cost-effectiveness analysis, cost-minimization analysis, and cost-utility analysis. Cost-utility analysis is the most sophisticated form of economic analysis and typically incorporates utility values. Utility values measure the preference for a health state and range from 0.0 (death) to 1.0 (perfect health). When the change in utility measures conferred by a health care intervention is multiplied by the duration of the benefit, the number of quality-adjusted life-years (QALYs) gained from the intervention is ascertained. This methodology incorporates both the improvement in quality of life and/or length of life, or the value, occurring as a result of the intervention. This improvement in value can then be amalgamated with discounted costs to yield expenditures per quality-adjusted life-year ($/QALY) gained. $/QALY gained is a measure that allows a comparison of the patient-perceived value of virtually all health care interventions for the dollars expended. A review of the literature on health care economic analyses, with particular emphasis on cost-utility analysis, is included in the present review. It is anticipated that cost-utility analysis will play a major role in health care within the coming decade.

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time..., mental hospital, and ICF located within a 50-mile radius of the facility; (e) The distance and average...

42 CFR 456.508 - Withdrawal of waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.508 Withdrawal of waiver.... (b) If a waiver is withdrawn by the Administrator, each hospital or mental hospital covered by the...

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... travel time between the remote facility and each facility listed in paragraph (e) of this section; (f...

42 CFR 456.521 - Conditions for granting variance requests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... is unable to meet the time requirements for which the variance is requested; and (2) A revised UR...

Planetary science and resource utilization at a lunar outpost - Chemical analytical facility requirements

NASA Technical Reports Server (NTRS)

Taylor, Lawrence A.

1992-01-01

Unresolved issues of lunar geology are reviewed and the role of a lunar outpost in helping to address them is considered. Plans for in situ resource utilization of lunar materials are examined. Concepts for a lunar outpost are described.

ASSESSMENT OF CONTROL TECHNOLOGIES FOR REDUCING EMISSIONS OF SO2 AND NOX FROM EXISTING COAL-FIRED UTILITY BOILERS

EPA Science Inventory

The report reviews information and estimated costs on 15 emissioncontrol technology categories applicable to existing coal-fired electric utility boilers. he categories include passive controls such as least emission dispatching, conventional processes, and emerging technologies ...

23 CFR 230.409 - Contract compliance review procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., written corrective action plans, PR-1391 or Manpower Utilization Reports, training requirements, previous... result in increased utilization of minorities and women? (iv) Is there impartiality in treatment of...) Have the contractor's efforts produced results? (f) Exit conference (Action R-6). (1) During the exit...

23 CFR 230.409 - Contract compliance review procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., written corrective action plans, PR-1391 or Manpower Utilization Reports, training requirements, previous... result in increased utilization of minorities and women? (iv) Is there impartiality in treatment of...) Have the contractor's efforts produced results? (f) Exit conference (Action R-6). (1) During the exit...

23 CFR 230.409 - Contract compliance review procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., written corrective action plans, PR-1391 or Manpower Utilization Reports, training requirements, previous... result in increased utilization of minorities and women? (iv) Is there impartiality in treatment of...) Have the contractor's efforts produced results? (f) Exit conference (Action R-6). (1) During the exit...

23 CFR 230.409 - Contract compliance review procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., written corrective action plans, PR-1391 or Manpower Utilization Reports, training requirements, previous... result in increased utilization of minorities and women? (iv) Is there impartiality in treatment of...) Have the contractor's efforts produced results? (f) Exit conference (Action R-6). (1) During the exit...

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

NONE

This document containes reports from the proceedings of the 1995 U.S. DOE hydrogen program review. Reports are organized under the topics of systems analysis, utilization, storage, and production. This volume, Volume I, contains the reports concerned with systems analysis and utilization. Individual reports were processed separately for the DOE data bases.

Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity.

PubMed

Jansen, Marleen E; Rigter, T; Rodenburg, W; Fleur, T M C; Houwink, E J F; Weda, M; Cornel, Martina C

2017-01-01

Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

CO2 utilization: an enabling element to move to a resource- and energy-efficient chemical and fuel production.

PubMed

Ampelli, Claudio; Perathoner, Siglinda; Centi, Gabriele

2015-03-13

CO(2) conversion will be at the core of the future of low-carbon chemical and energy industry. This review gives a glimpse into the possibilities in this field by discussing (i) CO(2) circular economy and its impact on the chemical and energy value chain, (ii) the role of CO(2) in a future scenario of chemical industry, (iii) new routes for CO(2) utilization, including emerging biotechnology routes, (iv) the technology roadmap for CO(2) chemical utilization, (v) the introduction of renewable energy in the chemical production chain through CO(2) utilization, and (vi) CO(2) as a suitable C-source to move to a low-carbon chemical industry, discussing in particular syngas and light olefin production from CO(2). There are thus many stimulating possibilities offered by using CO(2) and this review shows this new perspective on CO(2) at the industrial, societal and scientific levels. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

PubMed

Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

2013-04-01

Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

Techniques of Force and Pressure Measurement in the Small Joints of the Wrist.

PubMed

Schreck, Michael J; Kelly, Meghan; Canham, Colin D; Elfar, John C

2018-01-01

The alteration of forces across joints can result in instability and subsequent disability. Previous methods of force measurements such as pressure-sensitive films, load cells, and pressure-sensing transducers have been utilized to estimate biomechanical forces across joints and more recent studies have utilized a nondestructive method that allows for assessment of joint forces under ligamentous restraints. A comprehensive review of the literature was performed to explore the numerous biomechanical methods utilized to estimate intra-articular forces. Methods of biomechanical force measurements in joints are reviewed. Methods such as pressure-sensitive films, load cells, and pressure-sensing transducers require significant intra-articular disruption and thus may result in inaccurate measurements, especially in small joints such as those within the wrist and hand. Non-destructive methods of joint force measurements either utilizing distraction-based joint reaction force methods or finite element analysis may offer a more accurate assessment; however, given their recent inception, further studies are needed to improve and validate their use.

Clinical and diagnostic utility of saliva as a non-invasive diagnostic fluid:
a systematic review

PubMed Central

Nunes, Lazaro Alessandro Soares; Mussavira, Sayeeda

2015-01-01

This systematic review presents the latest trends in salivary research and its applications in health and disease. Among the large number of analytes present in saliva, many are affected by diverse physiological and pathological conditions. Further, the non-invasive, easy and cost-effective collection methods prompt an interest in evaluating its diagnostic or prognostic utility. Accumulating data over the past two decades indicates towards the possible utility of saliva to monitor overall health, diagnose and treat various oral or systemic disorders and drug monitoring. Advances in saliva based systems biology has also contributed towards identification of several biomarkers, development of diverse salivary diagnostic kits and other sensitive analytical techniques. However, its utilization should be carefully evaluated in relation to standardization of pre-analytical and analytical variables, such as collection and storage methods, analyte circadian variation, sample recovery, prevention of sample contamination and analytical procedures. In spite of all these challenges, there is an escalating evolution of knowledge with the use of this biological matrix. PMID:26110030

Socioeconomic disparities in home health care service access and utilization: a scoping review.

PubMed

Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie

2012-10-01

Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage. Education, rurality and race were less frequently reported. In contrast to well-documented socioeconomic gradient seen with primary and acute care services, we found general agreement that persons of lower socioeconomic status are favored and not disadvantaged in terms of home health care services. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improving the utilization of research knowledge in agri-food public health: a mixed-method review of knowledge translation and transfer.

PubMed

Rajić, Andrijana; Young, Ian; McEwen, Scott A

2013-05-01

Knowledge translation and transfer (KTT) aims to increase research utilization and ensure that the best available knowledge is used to inform policy and practice. Many frameworks, methods, and terms are used to describe KTT, and the field has largely developed in the health sector over the past decade. There is a need to review key KTT principles and methods in different sectors and evaluate their potential application in agri-food public health. We conducted a structured mixed-method review of the KTT literature. From 827 citations identified in a comprehensive search, we characterized 160 relevant review articles, case studies, and reports. A thematic analysis was conducted on a prioritized and representative subset of 33 articles to identify key principles and characteristics for ensuring effective KTT. The review steps were conducted by two or more independent reviewers using structured and pretested forms. We identified five key principles for effective KTT that were described within two contexts: to improve research utilization in general and to inform policy-making. To ensure general research uptake, there is a need for the following: (1) relevant and credible research; (2) ongoing interactions between researchers and end-users; (3) organizational support and culture; and (4) monitoring and evaluation. To inform policy-making, (5) researchers must also address the multiple and competing contextual factors of the policy-making process. We also describe 23 recommended and promising KTT methods, including six synthesis (e.g., systematic reviews, mixed-method reviews, and rapid reviews); nine dissemination (e.g., evidence summaries, social media, and policy briefs); and eight exchange methods (e.g., communities of practice, knowledge brokering, and policy dialogues). A brief description, contextual example, and key references are provided for each method. We recommend a wider endorsement of KTT principles and methods in agri-food public health, but there are also important gaps and challenges that should be addressed in the future.

Utility interconnection issues for wind power generation

NASA Technical Reports Server (NTRS)

Herrera, J. I.; Lawler, J. S.; Reddoch, T. W.; Sullivan, R. L.

1986-01-01

This document organizes the total range of utility related issues, reviews wind turbine control and dynamic characteristics, identifies the interaction of wind turbines to electric utility systems, and identifies areas for future research. The material is organized at three levels: the wind turbine, its controls and characteristics; connection strategies as dispersed or WPSs; and the composite issue of planning and operating the electric power system with wind generated electricity.

Defense Infrastructure: Actions Needed to Strengthen Utility Resilience Planning

DTIC Science & Technology

2016-11-01

and design , historical architecture and materials, and overhead; and inflation adjustments. 6We obtained and analyzed records from DOD’s Real...the impacts of those disruptions, and the characteristics of the DOD-owned utility systems, among other things. To inform the design of our survey...managing and operating DOD-owned utility systems. Furthermore, the survey instrument was independently reviewed by a survey design expert within GAO. We

The Influence of Physical Therapy Guideline Adherence on Healthcare Utilization and Costs among Patients with Low Back Pain: A Systematic Review of the Literature

PubMed Central

Liu, Xinliang; Kolber, Morey J.

2016-01-01

Background Low back pain (LBP) is common and associated healthcare costs are significant. While clinical practice guidelines have been established in an attempt to reduce costs and healthcare utilization, it is unclear if adherence to physical therapy guidelines for those with LBP is efficacious. Therefore, the purpose of this study was to assess current evidence and evaluate the impact of physical therapy guideline adherence on subsequent healthcare costs and utilization for patients with LBP. Methods An electronic search was conducted in PubMed, CINAHL (EBSCO Host), AMED (Ovid), and PEDro. Studies included in this review were published in peer reviewed journals and the primary mode of treatment was administered by a physical therapist. Also, the definition of adherence was clearly defined based on claims data and at least one measure of cost or utilization reported. Quality assessment was evaluated via a modified Downs and Black checklist. Due to the conceptual heterogeneity in variable measurements, data were qualitatively synthesized and stratified by reported utilization and cost measures. Results A total of 256 results were identified and after omitting duplicates, 4 articles were retained, which were all retrospective in nature. Quality scores ranged between 19 and 21 points out of a possible 26 on the modified Downs and Black checklist. All identified studies used the same definition of guideline adherence, which focused on billing active codes and minimizing use of passive codes. The results demonstrated trends that, with a few exceptions, suggested those patients with LBP that were treated with an adherent guideline program demonstrated decreased healthcare utilization and an overall healthcare savings. Conclusion Preliminary evidence suggests that adherence to established clinical practice guidelines may assist with decreasing healthcare utilization and costs. Additional research based on prospective randomized controlled trials are needed to provide high quality evidence regarding the impact of guideline adherence among patients with LBP. PMID:27285608

A reference set of health utilities for long-term survivors of prostate cancer: population-based data from Ontario, Canada.

PubMed

Krahn, Murray D; Bremner, Karen E; Alibhai, Shabbir M H; Ni, Andy; Tomlinson, George; Laporte, Audrey; Naglie, Gary

2013-12-01

To measure quality of life (QOL) and utilities for prostate cancer (PC) patients and determine their predictors. A population-based, community-dwelling, geographically diverse sample of long-term PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physician. Consenting patients completed questionnaires by mail: Health Utilities Index (HUI 2/3), Patient Oriented Prostate Utility Scale PORPUS-U (utility), PORPUS-P (health profile), Functional Assessment of Cancer Therapy-Prostate (FACT-P), and Prostate Cancer Index (PCI). Clinical data were obtained from chart reviews. Regression models determined the effects of a series of variables on QOL and utility. We received questionnaires and reviewed charts for 585 patients (mean age 72.6, 2-13 years postdiagnosis). Mean utility scores were as follows: PORPUS-U = 0.92, HUI2 = 0.85, and HUI3 = 0.78. Mean health profile scores were as follows: PORPUS-P = 71.7, PCI sexual, urinary, and bowel function = 23.7, 79.1, and 84.6, respectively (0 = worst, 100 = best), and FACT-P = 125.1 (0 = worst, 156 = best). In multiple regression analyses, comorbidity and PCI urinary, sexual, and bowel function were significant predictors of other QOL measures. With all variables, 32-50 % of the variance in utilities was explained. Many variables affect global QOL of PC survivors; only prostate symptoms and comorbidity have independent effects. Our model allows estimation of the effects of multiple factors on utilities. These utilities for long-term outcomes of PC and its treatment are valuable for decision/cost-effectiveness models of PC treatment.

Developing a UAS Program for Electric Utilities

NASA Astrophysics Data System (ADS)

Keltgen, James

New innovations and technologies using unmanned aerial systems (UAS), or drones, have created unique opportunities for commercial applications. Electric utilities, likewise, realize the benefits of using UAS as a tool in electric utility operations. Although the opportunities exist, establishing a UAS program for electric utilities is largely an endeavor of trial and error or research and development with no clear path defined on how to establish a UAS program. By reviewing UAS use case examples and integrating lessons learned with Federal Aviation Administration (FAA) regulations, UAS best practices, unique electric utility values, legal and insurance perspectives, equipment selection, and thoughtful planning and preparation; a solution model is developed to establish a UAS program for electric utilities.

A Systematic Review and Meta-Analysis of Utility-Based Quality of Life in Chronic Kidney Disease Treatments

PubMed Central

Wyld, Melanie; Morton, Rachael Lisa; Hayen, Andrew; Howard, Kirsten; Webster, Angela Claire

2012-01-01

Background Chronic kidney disease (CKD) is a common and costly condition to treat. Economic evaluations of health care often incorporate patient preferences for health outcomes using utilities. The objective of this study was to determine pooled utility-based quality of life (the numerical value attached to the strength of an individual's preference for a specific health outcome) by CKD treatment modality. Methods and Findings We conducted a systematic review, meta-analysis, and meta-regression of peer-reviewed published articles and of PhD dissertations published through 1 December 2010 that reported utility-based quality of life (utility) for adults with late-stage CKD. Studies reporting utilities by proxy (e.g., reported by a patient's doctor or family member) were excluded. In total, 190 studies reporting 326 utilities from over 56,000 patients were analysed. There were 25 utilities from pre-treatment CKD patients, 226 from dialysis patients (haemodialysis, n = 163; peritoneal dialysis, n = 44), 66 from kidney transplant patients, and three from patients treated with non-dialytic conservative care. Using time tradeoff as a referent instrument, kidney transplant recipients had a mean utility of 0.82 (95% CI: 0.74, 0.90). The mean utility was comparable in pre-treatment CKD patients (difference = −0.02; 95% CI: −0.09, 0.04), 0.11 lower in dialysis patients (95% CI: −0.15, −0.08), and 0.2 lower in conservative care patients (95% CI: −0.38, −0.01). Patients treated with automated peritoneal dialysis had a significantly higher mean utility (0.80) than those on continuous ambulatory peritoneal dialysis (0.72; p = 0.02). The mean utility of transplant patients increased over time, from 0.66 in the 1980s to 0.85 in the 2000s, an increase of 0.19 (95% CI: 0.11, 0.26). Utility varied by elicitation instrument, with standard gamble producing the highest estimates, and the SF-6D by Brazier et al., University of Sheffield, producing the lowest estimates. The main limitations of this study were that treatment assignments were not random, that only transplant had longitudinal data available, and that we calculated EuroQol Group EQ-5D scores from SF-36 and SF-12 health survey data, and therefore the algorithms may not reflect EQ-5D scores measured directly. Conclusions For patients with late-stage CKD, treatment with dialysis is associated with a significant decrement in quality of life compared to treatment with kidney transplantation. These findings provide evidence-based utility estimates to inform economic evaluations of kidney therapies, useful for policy makers and in individual treatment discussions with CKD patients. PMID:22984353

Utility of proteomics in obstetric disorders: a review

PubMed Central

Hernández-Núñez, Jónathan; Valdés-Yong, Magel

2015-01-01

The study of proteomics could explain many aspects of obstetric disorders. We undertook this review with the aim of assessing the utility of proteomics in the specialty of obstetrics. We searched the electronic databases of MEDLINE, EBSCOhost, BVS Bireme, and SciELO, using various search terms with the assistance of a librarian. We considered cohort studies, case-control studies, case series, and systematic review articles published until October 2014 in the English or Spanish language, and evaluated their quality and the internal validity of the evidence provided. Two reviewers extracted the data independently, then both researchers simultaneously revised the data later, to arrive at a consensus. The search retrieved 1,158 papers, of which 965 were excluded for being duplicates, not relevant, or unrelated studies. A further 86 papers were excluded for being guidelines, protocols, or case reports, along with another 64 that did not contain relevant information, leaving 43 studies for inclusion. Many of these studies showed the utility of proteomic techniques for prediction, pathophysiology, diagnosis, management, monitoring, and prognosis of pre-eclampsia, perinatal infection, premature rupture of membranes, preterm birth, intrauterine growth restriction, and ectopic pregnancy. Proteomic techniques have enormous clinical significance and constitute an invaluable weapon in the management of obstetric disorders that increase maternal and perinatal morbidity and mortality. PMID:25926758

Green Care: A Review of the Benefits and Potential of Animal-Assisted Care Farming Globally and in Rural America.

PubMed

Artz, Brianna; Bitler Davis, Doris

2017-04-13

The term Green Care includes therapeutic, social or educational interventions involving farming; farm animals; gardening or general contact with nature. Although Green Care can occur in any setting in which there is interaction with plants or animals, this review focuses on therapeutic practices occurring on farms. The efficacy of care farming is discussed and the broad utilization of care farming and farm care communities in Europe is reviewed. Though evidence from care farms in the United States is included in this review, the empirical evidence which could determine its efficacy is lacking. For example, the empirical evidence supporting or refuting the efficacy of therapeutic horseback riding in adults is minimal, while there is little non-equine care farming literature with children. The health care systems in Europe are also much different than those in the United States. In order for insurance companies to cover Green Care techniques in the United States, extensive research is necessary. This paper proposes community-based ways that Green Care methods can be utilized without insurance in the United States. Though Green Care can certainly be provided in urban areas, this paper focuses on ways rural areas can utilize existing farms to benefit the mental and physical health of their communities.

Utilization of construction and agricultural waste in Malaysia for development of Green Concrete: A Review

NASA Astrophysics Data System (ADS)

Tambichik, M. A.; Mohamad, N.; Samad, A. A. A.; Bosro, M. Z. M.; Iman, M. A.

2018-04-01

Green Concrete (GC) is defined as a concrete that utilize a waste material for at least one of its component. The production of GC has been increasing due to the drawback of conventional concrete that create many environmental problems. In Malaysia, the amount of waste generates from agricultural and construction industries were increasing every year. Hence, one of the solutions to reduce the impact of conventional concrete and limited landfill spaces due to excessive waste is by utilizing it in concrete. This paper reviews the possible use of construction waste (Recycle Concrete Aggregate) and agricultural waste (Palm Oil Fuel Ash, Rice Husk Ash and Palm Oil Fibre) as partial replacement for the basic material in a concrete to produce an innovative Green Concrete. The optimum replacement level for each type of waste was also been review. Green Concrete also has the potential to reduce environmental pollution and solve the depletion of natural sources. The result from this review shows that the addition of agricultural waste or construction waste in concrete indicate positive and satisfactory strength when compared to normal concrete. Finally, a mass production of Green Concrete can fulfil the Construction Industry Transformation Plan (CITP) 2016-2020 made by CIDB that emphasizes on a construction system which is environmentally sustainable.

75 FR 19400 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-14

...: 3060-0895. Title: Numbering Resource Optimization. Form No.: FCC Form 502. Type of Review: Extension of... the NANPA to monitor numbering resource utilization by all carriers using the resource and to project...

Review of equine piroplasmosis

USDA-ARS?s Scientific Manuscript database

Equine piroplasmosis is caused by one of two erythrocytic parasites Babesia caballi or Theileria equi. Although the genus of the latter remains controversial the most recent designation, Theileria is utilized in this review. Shared pathogenesis includes tick-borne transmission and erythrolysis leadi...

42 CFR 480.136 - Disclosure to intermediaries and carriers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations... deliberations and quality review study information, a QIO must disclose to intermediaries and carriers QIO...

42 CFR 480.136 - Disclosure to intermediaries and carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations... deliberations and quality review study information, a QIO must disclose to intermediaries and carriers QIO...

Sludge Treatment, Utilization, and Disposal.

ERIC Educational Resources Information Center

Dick, Richard I.

1978-01-01

Presents the 1978 literature review of wastewater treatment. This review covers such areas: (1) industrial and hazardous sludges; (2) chemical sludges; (3) stabilization and combustion; (4) ocean disposal; and (5) land application. A list of 411 references is also presented. (HM)

42 CFR 456.653 - Acceptable reasons for not meeting requirements for annual on-site review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Program... will find an agency's showing satisfactory, even if it failed to meet the annual review requirements of...

77 FR 24701 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... Backwash Recycling Rule (FBRR), Long Term 1 Enhanced Surface Water Treatment Rule (LT1ESWTR), Long Term 2... review instructions; develop, acquire, install, and utilize technology and systems for the purposes of...

Nano-array based monolithic catalysts: Concept, rational materials design and tunable catalytic performance

DOE PAGES

Ren, Zheng; Guo, Yanbing; Gao, Pu-Xian

2015-03-20

Monolithic catalysts, also known as structured catalysts, represent an important catalyst configuration widely used in automotive, chemical, and energy industries. However, several issues associated with washcoat based monolithic catalyst preparation are ever present, such as compromised materials utilization efficiency due to a less-than-ideal wash coating process, difficulty in precise and optimum microstructure control and lack of structure-property correlation. Here, in this mini-review, we introduce the concept of nano-array catalyst, a new type of monolithic catalyst featuring high catalyst utilization efficiency, good thermal/mechanical robustness, and catalytic performance tunability. A comprehensive overview is presented with detailed discussion of the strategies for nano-arraymore » catalyst preparation and rational catalytic activity adjustment enabled by the well-defined nano-array geometry. Specifically their scalable fabrication processes are reviewed in conjunction with discussion of their various catalytic oxidation reaction performances at low temperature. Finally, we hope this review will serve as a timely and useful research guide for rational design and utilization of the new type of monolithic catalysts.« less

42 CFR 456.524 - Notification of Administrator's action and duration of variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.524 Notification of Administrator's action and duration of...

75 FR 45087 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... provide financial assistance to eligible entities that are proposing to deploy broadband transmission... assumptions used; (c) ways to enhance the quality, utility and clarity of the information to be collected; (d... Utilities Service Title: Broadband Grant Program. OMB Control Number: 0572-0127. Summary of Collection...

Impact of alternative energy forms on public utilities

NASA Technical Reports Server (NTRS)

Keith, F. W., Jr.

1977-01-01

The investigation of alternative energy sources by the electric utility industry is discussed. Research projects are reviewed in each of the following areas; solar energy, wind energy conversion, photosynthesis of biomass, ocean thermal energy conversion, geothermal energy, fusion, and the environmental impact of alternative energy sources.

75 FR 34970 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority... performance of the functions of the agency, including whether the information will have practical utility; (b... assumptions used; (c) ways to enhance the quality, utility and clarity of the information to be collected; (d...

75 FR 7438 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority... practical utility; (b) the accuracy of the agency's estimate of burden including the validity of the methodology and assumptions used; (c) ways to enhance the quality, utility and clarity of the information to...

Liquid-cooling technology for gas turbines review and status

NASA Technical Reports Server (NTRS)

Vanfossen, G. J., Jr.; Stepka, F. S.

1978-01-01

A review of research related to liquid cooling of gas turbines was conducted and an assessment of the state of the art was made. Various methods of liquid cooling turbines were reviewed. Examples and results with test and demonstrator turbines utilizing these methods along with the advantages and disadvantages of the various methods are discussed.

A Systematic Literature Review of Funding for Higher Education Institutions in Developed Countries

ERIC Educational Resources Information Center

Zhang, Qilong; Ning, Kang; Barnes, Ruth

2016-01-01

Resource allocation and funding in higher education is crucial to the success of reform and transformation of our higher education system. With a view to identifying trends and best practices in the area, utilizing a method of systematic literature review, we have critically reviewed relevant theories and practices from developed counties that are…

The Role of Servant Leadership in Faculty Development Programs: A Review of the Literature

ERIC Educational Resources Information Center

Russell, Eric James

2012-01-01

The following note is that a review of existing literature pertaining to servant leadership and faculty development. Specifically, this work discussed delivering servant leadership to online faculty through the utilization of a faculty development program. The idea for this literature review stemmed from the author asking how an online academic…

Virtual Learning Environments for Students with Disabilities: A Review and Analysis of the Empirical Literature and Two Case Studies

ERIC Educational Resources Information Center

Vasquez, Eleazar, III; Nagendran, Arjun; Welch, Gregory F.; Marino, Matthew T.; Hughes, Darin E.; Koch, Aaron; Delisio, Lauren

2015-01-01

Students with autism spectrum disorder (ASD) show varying levels of impairment in social skills situations. Interventions have been developed utilizing virtual environments (VEs) to teach and improve social skills. This article presents a systematic literature review of peer-reviewed journal articles focusing on social interventions in VEs…

The Self-Adapting Focused Review System. Probability sampling of medical records to monitor utilization and quality of care.

PubMed

Ash, A; Schwartz, M; Payne, S M; Restuccia, J D

1990-11-01

Medical record review is increasing in importance as the need to identify and monitor utilization and quality of care problems grow. To conserve resources, reviews are usually performed on a subset of cases. If judgment is used to identify subgroups for review, this raises the following questions: How should subgroups be determined, particularly since the locus of problems can change over time? What standard of comparison should be used in interpreting rates of problems found in subgroups? How can population problem rates be estimated from observed subgroup rates? How can the bias be avoided that arises because reviewers know that selected cases are suspected of having problems? How can changes in problem rates over time be interpreted when evaluating intervention programs? Simple random sampling, an alternative to subgroup review, overcomes the problems implied by these questions but is inefficient. The Self-Adapting Focused Review System (SAFRS), introduced and described here, provides an adaptive approach to record selection that is based upon model-weighted probability sampling. It retains the desirable inferential properties of random sampling while allowing reviews to be concentrated on cases currently thought most likely to be problematic. Model development and evaluation are illustrated using hospital data to predict inappropriate admissions.

Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

PubMed

Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

2017-01-01

Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or higher financial risk protection.

Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: A systematic review of peer-reviewed literature.

PubMed

Nelson, Kristin N; Wallace, Aaron S; Sodha, Samir V; Daniels, Danni; Dietz, Vance

2016-11-04

Immunization programs in developing countries increasingly face challenges to ensure equitable delivery of services within cities where rapid urban growth can result in informal settlements, poor living conditions, and heterogeneous populations. A number of strategies have been utilized in developing countries to ensure high community demand and equitable availability of urban immunization services; however, a synthesis of the literature on these strategies has not previously been undertaken. We reviewed articles published in English in peer-reviewed journals between 1990 and 2013 that assessed interventions for improving routine immunization coverage in urban areas in low- and middle-income countries. We categorized the intervention in each study into one of three groups: (1) interventions aiming to increase utilization of immunization services; (2) interventions aiming to improve availability of immunization services by healthcare providers, or (3) combined availability and utilization interventions. We summarized the main quantitative outcomes from each study and effective practices from each intervention category. Fifteen studies were identified; 87% from the African, Eastern Mediterranean and Southeast Asian regions of the World Health Organization (WHO). Six studies were randomized controlled trials, eight were pre- and post-intervention evaluations, and one was a cross-sectional study. Four described interventions designed to improve availability of routine immunization services, six studies described interventions that aimed to increase utilization, and five studies aiming to improve both availability and utilization of services. All studies reported positive change in their primary outcome indicator, although seven different primary outcomes indicators were used across studies. Studies varied considerably with respect to the type of intervention assessed, study design, and length of intervention assessment. Few studies have assessed interventions designed explicitly for the unique challenges facing immunization programs in urban areas. Further research on sustainability, scalability, and cost-effectiveness of interventions is needed to fill this gap. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: A systematic review of peer-reviewed literature

PubMed Central

Nelson, Kristin N.; Wallace, Aaron S.; Sodha, Samir V.; Daniels, Danni; Dietz, Vance

2016-01-01

Introduction Immunization programs in developing countries increasingly face challenges to ensure equitable delivery of services within cities where rapid urban growth can result in informal settlements, poor living conditions, and heterogeneous populations. A number of strategies have been utilized in developing countries to ensure high community demand and equitable availability of urban immunization services; however, a synthesis of the literature on these strategies has not previously been undertaken. Methods We reviewed articles published in English in peer-reviewed journals between 1990 and 2013 that assessed interventions for improving routine immunization coverage in urban areas in low- and middle-income countries. We categorized the intervention in each study into one of three groups: (1) interventions aiming to increase utilization of immunization services; (2) interventions aiming to improve availability of immunization services by healthcare providers, or (3) combined availability and utilization interventions. We summarized the main quantitative outcomes from each study and effective practices from each intervention category. Results Fifteen studies were identified; 87% from the African, Eastern Mediterranean and Southeast Asian regions of the World Health Organization (WHO). Six studies were randomized controlled trials, eight were pre- and post-intervention evaluations, and one was a cross-sectional study. Four described interventions designed to improve availability of routine immunization services, six studies described interventions that aimed to increase utilization, and five studies aiming to improve both availability and utilization of services. All studies reported positive change in their primary outcome indicator, although seven different primary outcomes indicators were used across studies. Studies varied considerably with respect to the type of intervention assessed, study design, and length of intervention assessment. Conclusion Few studies have assessed interventions designed explicitly for the unique challenges facing immunization programs in urban areas. Further research on sustainability, scalability, and cost-effectiveness of interventions is needed to fill this gap. PMID:27692772

Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review

PubMed Central

Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

2017-01-01

Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or higher financial risk protection. PMID:28151946

Environmental factors associated with disordered weight-control behaviours among youth: a systematic review.

PubMed

Wang, Monica L; Peterson, Karen E; McCormick, Marie C; Austin, S Bryn

2014-07-01

Environmental factors may be very important in the development of disordered weight-control behaviours (DWCB) among youth, yet no study to date has conducted a review that synthesizes these findings. The purpose of the present study was to systematically review existing literature on environmental influences on DWCB among youth and to identify conceptual and methodological gaps in the literature. Systematic review. Studies were identified through a systematic search using PubMed, PsycINFO, Google Scholar and secondary references. Inclusion criteria included observational studies published in peer-reviewed journals from 1994 to 2012 that examined environmental exposure(s) associated with DWCB among youth. Ninety-three studies, the majority of which utilized a cross-sectional design (75 %; n 70), were identified. Longitudinal studies' follow-up time ranged from 8 months to 10 years. Parental, peer and media influences have been extensively studied as factors associated with DWCB among youth. Fewer studies have examined behavioural settings (i.e. homes, schools, neighbourhoods) or sectors of influence other than the media on DWCB. No studies utilized multilevel methods to parse out environmental influences on DWCB. Most studies (69 %, n 64) did not explicitly utilize a theory or model to guide the research. Findings indicate that exploring a wider range of environmental influences on DWCB, specifically behavioural settings and sectors of influence, using diverse study samples and multilevel methodology is needed to advance the field and to inform the design of comprehensive prevention programmes that target DWCB and other weight-related behaviours.

Review of Prior Commercial Building Energy Efficiency Retrofit Evaluation: A Report to Snohomish Public Utilities District

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

Price, Phillip N.

2014-11-01

Snohomish County Public Utilities District (the District or Snohomish PUD) provides electricity to about 325,000 customers in Snohomish County, Washington. The District has an incentive programs to encourage commercial customers to improve energy efficiency: the District partially reimburses the cost of approved retrofits if they provide a level of energy performance improvement that is specified by contract. In 2013 the District contracted with Lawrence Berkeley National Laboratory to provide a third-party review of the Monitoring and Verification (M&V) practices the District uses to evaluate whether companies are meeting their contractual obligations. This work helps LBNL understand the challenges faced bymore » real-world practitioners of M&V of energy savings, and builds on a body of related work such as Price et al. (2013). The District selected a typical project for which they had already performed an evaluation. The present report includes the District's original evaluation as well as LBNL's review of their approach. The review is based on the document itself; on investigation of the load data and outdoor air temperature data from the building evaluated in the document; and on phone discussions with Bill Harris of the Snohomish County Public Utilities District. We will call the building studied in the document the subject building, the original Snohomish PUD report will be referred to as the Evaluation, and this discussion by LBNL is called the Review.« less

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

PubMed

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Estimating QALY gains in applied studies: a review of cost-utility analyses published in 2010.

PubMed

Wisløff, Torbjørn; Hagen, Gunhild; Hamidi, Vida; Movik, Espen; Klemp, Marianne; Olsen, Jan Abel

2014-04-01

Reimbursement agencies in several countries now require health outcomes to be measured in terms of quality-adjusted life-years (QALYs), leading to an immense increase in publications reporting QALY gains. However, there is a growing concern that the various 'multi-attribute utility' (MAU) instruments designed to measure the Q in the QALY yield disparate values, implying that results from different instruments are incommensurable. By reviewing cost-utility analyses published in 2010, we aim to contribute to improved knowledge on how QALYs are currently calculated in applied analyses; how transparently QALY measurement is presented; and how large the expected incremental QALY gains are. We searched Embase, MEDLINE and NHS EED for all cost-utility analyses published in 2010. All analyses that had estimated QALYs gained from health interventions were included. Of the 370 studies included in this review, 48% were pharmacoeconomic evaluations. Active comparators were used in 71% of studies. The median incremental QALY gain was 0.06, which translates to 3 weeks in best imaginable health. The EQ-5D-3L is the dominant instrument used. However, reporting of how QALY gains are estimated is generally inadequate. In 55% of the studies there was no reference to which MAU instrument or direct valuation method QALY data came from. The methods used for estimating expected QALY gains are not transparently reported in published papers. Given the wide variation in utility scores that different methodologies may assign to an identical health state, it is important for journal editors to require a more transparent way of reporting the estimation of incremental QALY gains.

Does convenience matter in health care delivery? A systematic review of convenience-based aspects of process utility.

PubMed

Higgins, A; Barnett, J; Meads, C; Singh, J; Longworth, L

2014-12-01

To systematically review the existing literature on the value associated with convenience in health care delivery, independent of health outcomes, and to try to estimate the likely magnitude of any value found. A systematic search was conducted for previously published studies that reported preferences for convenience-related aspects of health care delivery in a manner that was consistent with either cost-utility analysis or cost-benefit analysis. Data were analyzed in terms of the methodologies used, the aspects of convenience considered, and the values reported. Literature searches generated 4715 records. Following a review of abstracts or full-text articles, 27 were selected for inclusion. Twenty-six studies reported some evidence of convenience-related process utility, in the form of either a positive utility or a positive willingness to pay. The aspects of convenience valued most often were mode of administration (n = 11) and location of treatment (n = 6). The most common valuation methodology was a discrete-choice experiment containing a cost component (n = 15). A preference for convenience-related process utility exists, independent of health outcomes. Given the diverse methodologies used to calculate it, and the range of aspects being valued, however, it is difficult to assess how large such a preference might be, or how it may be effectively incorporated into an economic evaluation. Increased consistency in reporting these preferences is required to assess these issues more accurately. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Collegiate Aviation Review 1998.

ERIC Educational Resources Information Center

Carney, Thomas Q., Ed.; Luedtke, Jacqueline R., Ed.; Johnson, Jeffrey A., Ed.

1998-01-01

This document contains four peer-reviewed papers about university-level aviation education that were presented at the 1998 Fall Education Conference of the University Aviation Association. "Setting the Foundation for Effective Learning: Utilizing the Cognitive, Affective, and Psychomotor Domains to Establish Rigorous Performance Learning…

42 CFR 478.28 - Qualifications of a reconsideration reviewer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.28... initial denial determination. (c) A specialist in the type of services under review, except where meeting...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 480.116 Section 480.116 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... institutions under review with the following information— (a) The title and address of the person responsible...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... institutions under review with the following information— (a) The title and address of the person responsible...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... institutions under review with the following information— (a) The title and address of the person responsible...

Workplace Discrimination, Prejudice, and Diversity Measurement: A Review of Instrumentation.

ERIC Educational Resources Information Center

Burkard, Alan W.; Boticki, Michael A.; Madson, Michael B.

2002-01-01

Critically reviews diversity measures in terms of item development, psychometric evidence, and utility for counseling and development: Workplace Prejudice/Discrimination Inventory, Attitudes toward Diversity Scale; Organizational Diversity Inventory, Workforce Diversity Questionnaire, Perceived Occupational Opportunity Scale-Form B, and Perceived…

A REVIEW OF ENVIRONMENTAL APPLICATIONS OF BIOLUMINESCENCE MEASUREMENTS

EPA Science Inventory

This review of the recent literature on environmental applications of bioluminescence systems will focus on in vivo and in vitro bioluminescence methods that have been utilized to elucidate properties of chemicals, toxic and mutagenic effects, and to estimate biomass. The unifyin...

Sex offender polygraph examination: an evidence-based case management tool for social workers.

PubMed

Levenson, Jill S

2009-10-01

This article will review the use of polygraphy in the assessment and treatment of sexual perpetrators. Such information can be utilized by social workers who are involved in the treatment and case management of child sexual abuse cases. First, the controversial literature regarding the validity and reliability of polygraph examination in general will be reviewed. Next, an emerging body of evidence supporting the utility of polygraph testing with sex offenders will be discussed. Finally, ways that social workers can incorporate this knowledge into their case management and clinical roles will be offered.

Preschool ADHD: exploring uncertainties in diagnostic validity and utility, and treatment efficacy and safety.

PubMed

Sonuga-Barke, Edmund J S; Daley, David; Thompson, Margaret; Swanson, Jim

2003-07-01

The current scientific and clinical status of preschool attention deficit hyperactivity disorder and its management is reviewed. Recent clinical and neuropsychological research supporting the utility of the construct will be presented along with a critical analysis of diagnostic issues. The published literature on treatment efficacy (both pharmacological and nonpharmacological) will be reviewed with a special focus on the issue of the safety and side effects of psycho-stimulants. The need for early identification and preventative intervention is indicated but caution should be employed in the use of psychostimulants with this age group.

A systematic review of suggestive seizure induction for the diagnosis of psychogenic nonepileptic seizures.

PubMed

Popkirov, Stoyan; Grönheit, Wenke; Wellmer, Jörg

2015-09-01

Suggestive seizure induction is a widely used method for diagnosing psychogenic nonepileptic seizures (PNES). Despite seven decades of multidisciplinary research, however, there is still no unified protocol, no definitive agreement on the ethical framework and no consensus on diagnostic utility. This systematic review surveys the evidence at hand and addresses clinically relevant aspects of suggestive seizure induction. In addition to its use for facilitating the diagnostic process, its mechanism of action and utility in elucidating the psychopathology of PNES will be discussed. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Magnetic nanoparticle-based approaches to locally target therapy and enhance tissue regeneration in vivo.

PubMed

Sensenig, Richard; Sapir, Yulia; MacDonald, Cristin; Cohen, Smadar; Polyak, Boris

2012-09-01

Magnetic-based systems utilizing superparamagnetic nanoparticles and a magnetic field gradient to exert a force on these particles have been used in a wide range of biomedical applications. This review is focused on drug targeting applications that require penetration of a cellular barrier as well as strategies to improve the efficacy of targeting in these biomedical applications. Another focus of this review is regenerative applications utilizing tissue engineered scaffolds prepared with the aid of magnetic particles, the use of remote actuation for release of bioactive molecules and magneto-mechanical cell stimulation, cell seeding and cell patterning.

Defense Health Care: DOD Is Meeting Most Mental Health Care Access Standards, but It Needs a Standard for Follow-up Appointments

DTIC Science & Technology

2016-04-01

domestically and overseas. GAO analyzed recent, available data on MHS mental health utilization , staffing, and appointment access and compared... utilization of mental health treatment services in both the direct and purchased care systems by active duty servicemembers, including activated...reservists, from fiscal years 2009 to 2014.5 To determine the reliability of the utilization data, we reviewed relevant documentation, discussed this

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...; (2) In an ICF that cares primarily for mental patients, at least one individual knowledgeable in the...

42 CFR 456.438 - Time limits for notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for notification of adverse decision... AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Review of Need for Continued Stay § 456.438 Time limits for notification...

42 CFR 456.438 - Time limits for notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for notification of adverse decision... AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Review of Need for Continued Stay § 456.438 Time limits for notification...

77 FR 16214 - Commission Information Collection Activities (FERC-598); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... Generator or Foreign Utility Company Status, to the Office of Management and Budget (OMB) for review of the...., Washington, DC 20426. Instructions: All submissions must be formatted and filed in accordance with submission...: Title: FERC-598, Self Certification for Entities Seeking Exempt Wholesale Generator or Foreign Utility...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

42 CFR 456.380 - Individual written plan of care.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Plan of Care § 456.380 Individual written plan of care. (a) Before admission to an ICF or before... designed to meet the objectives of the plan of care; (5) Plans for continuing care, including review and...

Maximum propellant utilization in an electron bombardment thruster

NASA Technical Reports Server (NTRS)

Kaufman, H. R.; Cohen, A. J.

1971-01-01

Current theory and experimental data on propellant utilization in electron bombardment ion thrusters are reviewed. Because the majority of investigations have been conducted with mercury, the presentation emphasizes that propellant. The results are presented in as general a form as possible to facilitate use in areas other than space propulsion.

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2014 CFR

2014-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2012 CFR

2012-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

42 CFR 456.406 - Description of UR review function: Who performs UR; disqualification from performing UR.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; disqualification from performing UR. 456.406 Section 456.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities Ur Plan: Administrative Requirements § 456.406 Description...

A review on the complete utilization of the Sugarbeet

USDA-ARS?s Scientific Manuscript database

The Sugarbeet is one of the main sugar crops in the world. In the search for sustainability and economic value, the complete utilization of the crop is necessary. In addition to sugar and animal feed, Sugarbeets can provide many value-added co-products for biofuels, human nutrition, plastics, and ph...

STATE ACID RAIN RESEARCH AND SCREENING SYSTEM - VERSION 1.0 USER'S MANUAL

EPA Science Inventory

The report is a user's manual that describes Version 1.0 of EPA's STate Acid Rain Research and Screening System (STARRSS), developed to assist utility regulatory commissions in reviewing utility acid rain compliance plans. It is a screening tool that is based on scenario analysis...

77 FR 34003 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... performance of the functions of the agency, including whether the information will have practical utility; (b..., Office of Information and Regulatory Affairs, Office of Management and Budget (OMB), [email protected] Utilities Service Title: Advance of Loan Funds and Budgetary Control and Related Burdens. OMB Control Number...

77 FR 65532 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... information is vital for making prudent financial decisions. Need and Use of the Information: RBS will collect... agency, including whether the information will have practical utility; (b) the accuracy of the agency's... quality, utility and clarity of the information to be collected; (d) ways to minimize the burden of the...

78 FR 43848 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... agency, including whether the information will have practical utility; (b) the accuracy of the agency's... quality, utility and clarity of the information to be collected; (d) ways to minimize the burden of the... across the country. The data and information collected through EARS will inform management decisions...

78 FR 65606 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... and procedures will not have the value of this research in making their decisions on matters affecting... agency, including whether the information will have practical utility; (b) the accuracy of the agency's... quality, utility and clarity of the information to be collected; (d) ways to minimize the burden of the...

Scoping review of pediatric tonsillectomy quality of life assessment instruments.

PubMed

Kao, Stephen Shih-Teng; Peters, Micah D J; Dharmawardana, Nuwan; Stew, Benjamin; Ooi, Eng Hooi

2017-10-01

Sleep-disordered breathing or recurrent tonsillitis have detrimental effects on the child's physical health and quality of life. Tonsillectomy is commonly performed to treat these common conditions and improve the child's quality of life. This scoping review aims to present a comprehensive and descriptive analysis of quality of life questionnaires as a resource for clinicians and researchers when deciding which tool to use when assessing the quality of life effects after tonsillectomy. A comprehensive search strategy was undertaken across MEDLINE (PubMed), CINAHL, Embase, and Cochrane CENTRAL. Quality of life questionnaires utilized in studies investigating pediatric patients undergoing tonsillectomy for chronic tonsillitis or sleep-disordered breathing were included. Methodological quality and data extraction were conducted as per Joanna Briggs Institute methodology. Ten questionnaires were identified, consisting of six generic and four disease-specific instruments. The Pediatric Quality of Life Inventory was the most commonly utilized generic questionnaire. The Obstructive Sleep Apnea-18 was the most commonly utilized disease-specific questionnaire. This review identified a range of generic and disease-specific quality of life questionnaires utilized in pediatric patients who have undergone tonsillectomy with or without adenoidectomy for sleep-disordered breathing or chronic tonsillitis. Important aspects of each questionnaire have been summarized to aid researchers and clinicians in choosing the appropriate questionnaire when evaluating the quality of life effects of tonsillectomy. NA Laryngoscope, 127:2399-2406, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Impact of an Advanced Imaging Utilization Review Program on Downstream Health Care Utilization and Costs for Low Back Pain.

PubMed

Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

2018-06-01

Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. Interrupted time series. In total, 76,119 Washington State workers' compensation claimants with LBP between 2006 and 2014. Proportion of workers receiving imaging per month (MRI, computed tomography, radiographs) and lumbosacral injections and surgery; mean total health care costs per worker; mean duration of disability per worker. Measures were aggregated monthly and attributed to injury month. After accounting for secular trends, decreases in early MRI [level change: -5.27 (95% confidence interval, -4.22 to -6.31); trend change: -0.06 (-0.01 to -0.12)], any MRI [-4.34 (-3.01 to -5.67); -0.10 (-0.04 to -0.17)], and injection [trend change: -0.12 (-0.06 to -0.18)] utilization were associated with the policy. Radiograph utilization increased in parallel [level change: 2.46 (1.24-3.67)]. In addition, the policy resulted in significant decreasing changes in mean costs per claim, mean disability duration, and proportion of workers who received disability benefits. The policy had no effect on computed tomography or surgery utilization. The UR policy had discernable effects on health care utilization, costs, and disability. Integrating evidence-based guidelines with UR can improve quality of care and patient outcomes, while reducing use of low-value health services.

Financial statistics of major U.S. publicly owned electric utilities 1997

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

NONE

1998-12-01

The 1997 edition of the ``Financial Statistics of Major U.S. Publicly Owned Electric Utilities`` publication presents 5 years (1993 through 1997) of summary financial data and current year detailed financial data on the major publicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decisionmaking purposes related to publicly owned electric utility issues. Generator (Tables 3 through 11) and nongenerator (Tables 12 through 20) summaries are presented in this publication. Five years of summary financial data aremore » provided (Tables 5 through 11 and 14 through 20). Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided in Appendix C. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, operating revenue, and electric energy account data. The primary source of publicly owned financial data is the Form EIA-412, ``Annual Report of Public Electric Utilities.`` Public electric utilities file this survey on a fiscal year basis, in conformance with their recordkeeping practices. The EIA undertook a review of the Form EIA-412 submissions to determine if alternative classifications of publicly owned electric utilities would permit the inclusion of all respondents. The review indicated that financial indicators differ most according to whether or not a publicly owned electric utility generates electricity. Therefore, the main body of the report provides summary information in generator/nongenerator classifications. 2 figs., 101 tabs.« less

Utility-Based Instruments for People with Dementia: A Systematic Review and Meta-Regression Analysis.

PubMed

Li, Li; Nguyen, Kim-Huong; Comans, Tracy; Scuffham, Paul

2018-04-01

Several utility-based instruments have been applied in cost-utility analysis to assess health state values for people with dementia. Nevertheless, concerns and uncertainty regarding their performance for people with dementia have been raised. To assess the performance of available utility-based instruments for people with dementia by comparing their psychometric properties and to explore factors that cause variations in the reported health state values generated from those instruments by conducting meta-regression analyses. A literature search was conducted and psychometric properties were synthesized to demonstrate the overall performance of each instrument. When available, health state values and variables such as the type of instrument and cognitive impairment levels were extracted from each article. A meta-regression analysis was undertaken and available covariates were included in the models. A total of 64 studies providing preference-based values were identified and included. The EuroQol five-dimension questionnaire demonstrated the best combination of feasibility, reliability, and validity. Meta-regression analyses suggested that significant differences exist between instruments, type of respondents, and mode of administration and the variations in estimated utility values had influences on incremental quality-adjusted life-year calculation. This review finds that the EuroQol five-dimension questionnaire is the most valid utility-based instrument for people with dementia, but should be replaced by others under certain circumstances. Although no utility estimates were reported in the article, the meta-regression analyses that examined variations in utility estimates produced by different instruments impact on cost-utility analysis, potentially altering the decision-making process in some circumstances. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Effects of the West Africa Ebola Virus Disease on Health-Care Utilization – A Systematic Review

PubMed Central

Brolin Ribacke, Kim J.; Saulnier, Dell D.; Eriksson, Anneli; von Schreeb, Johan

2016-01-01

Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries, and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reviews. A total of 3354 articles were identified for screening, and while 117 articles were read in full, 22 studies were included in the final review. Utilization of maternal health services decreased during the outbreak. The number of cesarean sections and facility-based deliveries declined and followed a similar pattern in Guinea, Liberia, and Sierra Leone. A change in the utilization of antenatal and postnatal care and family planning services was also seen, as well as a drop in utilization of children’s health services, especially in terms of vaccination coverage. In addition, the uptake of HIV/AIDS and malaria services, general hospital admissions, and major surgeries decreased as well. Interestingly, it was the uptake of health service provision by the population that decreased, rather than the volume of health service provision. Estimates from the various studies suggest that non-Ebola morbidity and mortality have increased after the onset of the outbreak in Sierra Leone, Guinea, and Liberia. Reproductive, maternal, and child health services were especially affected, and the decrease in facility deliveries, cesarean sections, and volume of antenatal and postnatal care visits might have significant adverse effects on maternal and newborn health. The impact of Ebola stretches far beyond Ebola cases and deaths. This review indicates that indirect health service effects are substantial and both short and long term, and highlights the importance of support to maintain routine health service delivery and the maintenance of vaccination programs as well as preventative and curative malaria programs, both in general but especially in times of a disaster. PMID:27777926

Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

PubMed

Leib, M S; Larson, M M; Panciera, D L; Troy, G C; Monroe, W E; Rossmeisl, J H; Forrester, S D; Herring, E S

2010-01-01

Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. Eighty-nine pet dogs with chronic vomiting. Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.

42 CFR 475.104 - Requirements for demonstrating ability to perform review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... review. 475.104 Section 475.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.104 Requirements for demonstrating...

Program Evaluation: A Review and Synthesis.

ERIC Educational Resources Information Center

Webber, Charles F.

This paper reviews models of program evaluation. Major topics and issues found in the evaluation literature include quantitative versus qualitative approaches, identification and involvement of stakeholders, formulation of research questions, collection of data, analysis and interpretation of data, reporting of results, evaluation utilization, and…

18 CFR 301.3 - Filing procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER ACT § 301.3 Filing procedures. (a) Bonneville's ASC review procedures. The procedures established by Bonneville's Administrator... Bonneville's ASC review procedures. (b) Exchange Period. The Exchange Period will be equal to the term of...

A review of protocols for monitoring streams and juvenile fish in forested regions of the Pacific Northwest.

Treesearch

Scott A. Stolnack; Mason D. Bryant; Robert C. Wissmar

2005-01-01

This document reviews existing and proposed protocols used to monitor stream ecosystem conditions and responses to land management activities in the Pacific Northwest. Because of recent work aimed at improving the utility of habitat survey and fish abundance assessment methods, this review focuses on current (since 1993) monitoring efforts that assess stream habitat...

A Systematic Review of the Effectiveness of Physical Education and School Sport Interventions Targeting Physical Activity, Movement Skills and Enjoyment of Physical Activity

ERIC Educational Resources Information Center

Dudley, Dean; Okely, Anthony; Pearson, Philip; Cotton, Wayne

2011-01-01

This article presents a systematic review of published literature on the effectiveness of physical education in promoting participation in physical activity, enjoyment of physical activity and movement skill proficiency in children and adolescents. The review utilized a literature search, specifically publications listed in Ovid, A+ Education,…

Systematic Review of the Check-In, Check-Out Intervention for Students at Risk for Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Hawken, Leanne S.; Bundock, Kaitlin; Kladis, Kristin; O'Keeffe, Breda; Barret, Courtenay A.

2014-01-01

The purpose of this systematic literature review was to summarize outcomes of the Check-in Check-out (CICO) intervention across elementary and secondary settings. Twenty-eight studies utilizing both single subject and group (experimental and quasi-experimental) designs were included in this review. Median effect sizes across the eight group…

Status Tracking and Reporting the Quality Matters Process at the University of North Georgia

ERIC Educational Resources Information Center

Lamson, Nina; Babb, David; Schmidt, Robert

2016-01-01

The University of North Georgia utilizes the internal Quality Matters (QM) process to review all their online courses. As our online course offerings have increased, the need to devise a system to track the QM process, ensure timely reviews, and begin recertification of previously reviewed courses was necessary. As a result, several reports have…

10 CFR Appendix Q to Part 50 - Pre-Application Early Review of Site Suitability Issues

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Pre-Application Early Review of Site Suitability Issues Q Appendix Q to Part 50 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Pt. 50, App. Q Appendix Q to Part 50—Pre-Application Early Review of Site Suitability Issues This...

10 CFR Appendix Q to Part 50 - Pre-Application Early Review of Site Suitability Issues

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Pre-Application Early Review of Site Suitability Issues Q Appendix Q to Part 50 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Pt. 50, App. Q Appendix Q to Part 50—Pre-Application Early Review of Site Suitability Issues This...

10 CFR Appendix Q to Part 50 - Pre-Application Early Review of Site Suitability Issues

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Pre-Application Early Review of Site Suitability Issues Q Appendix Q to Part 50 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Pt. 50, App. Q Appendix Q to Part 50—Pre-Application Early Review of Site Suitability Issues This...

Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V.

PubMed

LeBeau, Richard T; Glenn, Daniel; Liao, Betty; Wittchen, Hans-Ulrich; Beesdo-Baum, Katja; Ollendick, Thomas; Craske, Michelle G

2010-02-01

The present review was conducted in order to evaluate the current diagnostic criteria for specific phobia (SP) in light of the empirical evidence gathered since DSM-IV and to propose changes to DSM-V where change is clearly and reliably indicated by the evidence. In response to questions put forth by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group, four primary areas were determined for this review: the accuracy and utility of the current SP type classification system, the validity of test anxiety as a type of SP, the boundary between agoraphobia and SP, and the reliability and utility of the diagnostic criteria for SP. Developmental issues are addressed within each area. Literature reviews examining academic findings published between 1994 and 2009 were carried out and the results are included herein. The review presents a number of options and preliminary recommendations to be considered for DSM-V. All of these recommendations should be considered tentative as they await the field trials and expert consensus necessary prior to their inclusion in the DSM-V. The present review also reveals a great need for future research in the area of SP and directions for such research is provided.

Impact of the residential conservation service program on natural gas and electric utilities. Appendix B

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

Not Available

An assessment of the RCS program is provided from the perspective of eleven case study utilities. First, an introduction to the role and value of conservation in utility strategic planning is presented. The interplay of various utility system characteristics is shown to be the primary determinant of the value of conservation efforts from the utility's point of view. Simplified typologies of utilities are developed to aid in the identification of those combinations of the utility characteristics that will favor the adoption of the utility sponsored strategic conservation efforts. The integration of the RCS program with other utility conservation and loadmore » management programs is explored for the eleven case study utilities. Reference is made to the simplified typologies in order to show, through actual program experience, how the strategic position of the utility company affects its adoption of this federal program. Evaluative studies done by the eleven case study utilities of the RCS program are reviewed. Results are presented and the methodologies are critiqued. Conclusions regarding the RCS program from the utility perspective are presented.« less

Transforming EQ-5D utilities for use in cost–value analysis of health programs.

PubMed

Nord, Erik; Johansen, Rune

2015-04-01

In a number of jurisdictions there is increasing interest in incorporating concerns for fairness in models for economic evaluation of health interventions. Cost–value analysis is a name for evaluations with such a broader aim. The most widely held concern for fairness is a concern for the worse off, i.e. the idea that severity of illness should count in determining priorities. In economic evaluations of improvements in health-related quality of life this concern may be taken into account by replacing conventional health state utilities with societal values for health states that are characterised by strong upper end compression and decreasing marginal value of utility gains. We review evidence on the strength of concerns for the worse off--measured at the cardinal level--in 15 articles published in peer-reviewed journals in the time period 1978–2010, with reports from altogether 20 individual studies in nine different countries. We report 116 individual observations of paired comparisons of utility improvements with different start levels. Concerns for severity show up quite strongly across countries, sample types and question framings. By means of regression analyses we fit a societal value function to the data that has the property of decreasing marginal value of utility gains. Using the central tendency in the data we present two plausible transformations of EQ-5D utilities into societal values that reflect concerns for the worse off.

Individual determinants of research utilization: a systematic review.

PubMed

Estabrooks, Carole A; Floyd, Judith A; Scott-Findlay, Shannon; O'Leary, Katherine A; Gushta, Matthew

2003-09-01

In order to design interventions that increase research use in nursing, it is necessary to have an understanding of what influences research use. To report findings on a systematic review of studies that examine individual characteristics of nurses and how they influence the utilization of research. A survey of published articles in English that examine the influence of individual factors on the research utilization behaviour of nurses, without restriction of the study design, from selected computerized databases and hand searches. Articles had to measure one or more individual determinants of research utilization, measure the dependent variable (research utilization), and evaluate the relationship between the dependent and independent variables. The studies also had to indicate the direction of the relationship between the independent and dependent variables, report a P-value and the statistic used, and indicate the magnitude of the relationship. Six categories of potential individual determinants were identified: beliefs and attitudes, involvement in research activities, information seeking, professional characteristics, education and other socio-economic factors. Research design, sampling, measurement, and statistical analysis were examined to evaluate methodological quality. Methodological problems surfaced in all of the studies and, apart from attitude to research, there was little to suggest that any potential individual determinant influences research use. Important conceptual and measurement issues with regard to research utilization could be better addressed if research in the area were undertaken longitudinally by multi-disciplinary teams of researchers.

78 FR 52528 - Information Collection(s) Being Reviewed by the Federal Communications Commission, Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... FEDERAL COMMUNICATIONS COMMISSION Information Collection(s) Being Reviewed by the Federal... information collection(s). Comments are requested concerning: whether the proposed collection of information... information shall have practical utility; the accuracy of the Commission's burden estimate; ways to enhance...

76 FR 72189 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review AGENCY: Department of Education... to the Office of Information and Regulatory Affairs, Attention: Education Desk Officer, Office of...; (3) Enhance the quality, utility, and clarity of the information to be collected; and (4) Minimize...

7 CFR 4288.103 - Review or appeal rights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Review or appeal rights. 4288.103 Section 4288.103 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program...

7 CFR 4288.103 - Review or appeal rights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Review or appeal rights. 4288.103 Section 4288.103 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program...

7 CFR 4288.103 - Review or appeal rights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Review or appeal rights. 4288.103 Section 4288.103 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program...

Aging and Nutrition Education

ERIC Educational Resources Information Center

Bazzarre, Terry L.

1978-01-01

Reviews nutrition education programs in relation to aging. A summary of nutritional information that constitutes different components of nutrition education programs for the elderly is discussed. A brief review of physiological changes affecting nutrient utilization and food selection and changes in dietary intake and requirements are presented.…

78 FR 60244 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... collections are best assured of having their full effect if received within 30 days of this notification.... Rural Utilities Service (RUS) announced the application window for funding Rural Libraries, Technical... three funding opportunities were reviewed and awards were made for Satellite and Technical Assistance...

42 CFR 478.30 - Evidence to be considered by the reconsideration reviewer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reviewer. 478.30 Section 478.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.30...

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations... institutions has been deleted; and (9) Information describing the characteristics of a quality review study... 42 Public Health 4 2011-10-01 2011-10-01 false Information subject to disclosure. 480.120 Section...

42 CFR 480.133 - Disclosure of information about practitioners, reviewers and institutions.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.133 Disclosure of... 42 Public Health 4 2011-10-01 2011-10-01 false Disclosure of information about practitioners...

42 CFR 476.150 - Abandoned complaints and reopening rights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Abandoned complaints and reopening rights. 476.150 Section 476.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review...

42 CFR 480.133 - Disclosure of information about practitioners, reviewers and institutions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Disclosure of information about practitioners..., AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.133 Disclosure of...

38 CFR 17.500 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of Healthcare Quality Assurance Review Records § 17.500 General. (a) Section 5705, title 38, United... §§ 17.500 through 17.511, the VA's medical quality assurance program consists of systematic healthcare... utilization of healthcare resources in VA medical facilities. These review activities may involve continuous...

38 CFR 17.500 - General.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of Healthcare Quality Assurance Review Records § 17.500 General. (a) Section 5705, title 38, United... §§ 17.500 through 17.511, the VA's medical quality assurance program consists of systematic healthcare... utilization of healthcare resources in VA medical facilities. These review activities may involve continuous...

38 CFR 17.500 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of Healthcare Quality Assurance Review Records § 17.500 General. (a) Section 5705, title 38, United... §§ 17.500 through 17.511, the VA's medical quality assurance program consists of systematic healthcare... utilization of healthcare resources in VA medical facilities. These review activities may involve continuous...

38 CFR 17.500 - General.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of Healthcare Quality Assurance Review Records § 17.500 General. (a) Section 5705, title 38, United... §§ 17.500 through 17.511, the VA's medical quality assurance program consists of systematic healthcare... utilization of healthcare resources in VA medical facilities. These review activities may involve continuous...

38 CFR 17.500 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Healthcare Quality Assurance Review Records § 17.500 General. (a) Section 5705, title 38, United... §§ 17.500 through 17.511, the VA's medical quality assurance program consists of systematic healthcare... utilization of healthcare resources in VA medical facilities. These review activities may involve continuous...

Use of Pathogen-Specific Antibody Biomarkers to Estimate Waterborne Infections in Population-Based Settings

EPA Science Inventory

Purpose of reviewThis review discusses the utility of pathogen-specific antibody biomarkers for improving estimates of the population burden of waterborne infections, assessing the fraction of infections that can be prevented by specific water treatments, and understanding transm...

75 FR 54877 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... enhance the quality, utility, and clarity of the information collected; (d) ways to minimize the burden of... Class A TV Broadcast Station, FCC Form 301-CA. Form Number: FCC 301-CA. Type of Review: Extension of a...

48 CFR 41.401 - Monthly and annual review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... values exceeding the simplified acquisition threshold, on an annual basis. Annual reviews of accounts with annual values at or below the simplified acquisition threshold shall be conducted when deemed... services to each facility under the utility's most economical, applicable rate and to examine competitive...

42 CFR 456.501 - UR plans as a condition for FFP.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.501 UR plans as a condition for FFP. (a) Except... services furnished by a hospital or mental hospital unless the facility has in effect a UR plan that meets...

42 CFR 456.126 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.126 Time limits for final... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.137 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Continued Stay § 456.137 Time limits for final... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.238 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Review of Need for Continued Stay § 456.238 Time limits for... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for final decision and notification of...

42 CFR 456.137 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Continued Stay § 456.137 Time limits for final... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for final decision and notification of...

42 CFR 456.126 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.126 Time limits for final... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for final decision and notification of...

A Comparison of Perceptual Strategies Utilized by Expert and Novice Performers.

ERIC Educational Resources Information Center

Moore, John O.

This paper reviews the literature comparing the perceptual strategies of expert and novice sport/skill performers in ball sports to specifically identify where differences exist. The following comparisons were made: (1) experts attend to fewer, somewhat different visual cues than beginners; (2) experts exhibit an ability to utilize advanced…

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Skie, EPA, dated May 18, 1989, Charles A. Collins, Administrator of the Air Quality Divisions stated: * * * The Division, will, as a matter of practice, utilize the “Guideline on Air Quality Models” as revised, including Supplement A, in all PSD permit application reviews. The Division will utilize any future...

77 FR 76302 - Notice Lodging of Proposed Consent Decree Under the Clean Air Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-27

... Utilities Company for violations of state and federal opacity, New Source Review, and Title V regulations at the company's electric generating station in Ghent, Kentucky. The proposed consent decree requires... Utilities Company, Civil Action No. 3:12-cv-00076-CFVT. The United States filed this lawsuit under the Clean...

Project demonstration of wind-turbine electricity: Interconnecting a northern Michigan fruit farm with a major utility

NASA Astrophysics Data System (ADS)

Amon, D. M.

Progress is reviewed in a project to test the economic feasibility of wind turbine technology for generating electricity. The use of wind generating electricity on a commercial fruit farm interconnecting a commercial fruit farm with a major utility to sell power are the find project goals.

Models of Evaluation Utilization: A Meta-Modeling Synthesis of the Literature.

ERIC Educational Resources Information Center

Johnson, R. Burke

An integrative causal process model of evaluation utilization variables is presented. The model was developed through a traditional approach to literature review that lists results from published studies and relates these to the research topic, and through an approach that tries to integrate the models found in the literature search. Meta-modeling…

76 FR 46267 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... assumptions used; (c) ways to enhance the quality, utility and clarity of the information to be collected; (d... Utility Service Title: 7 CFR Part 1780, Water and Waste Loan and Grant Program. OMB Control Number: 0572-0121. Summary of Collection: Section 306 of the Consolidated Farm and Rural Development Act (CONACT), 7...

JOB PERFORMANCE AIDS AND THEIR IMPACT ON MANPOWER UTILIZATION.

ERIC Educational Resources Information Center

CHALUPSKY, ALBERT B.; KOPF, THOMAS J.

THE PURPOSE OF THE STUDY WAS TO REVIEW AND SYNTHESIZE THE RESULTS OF RESEARCH ON JOB PERFORMANCE AIDS AND EXPLORE THEIR CURRENT AND POTENTIAL ON INDUSTRIAL MANPOWER UTILIZATION. JOB PERFORMANCE AIDS ARE AUXILIARY INFORMATION STORAGE DEVICES WHICH PRESENT JOB INSTRUCTIONS OR REFERENCE DATA FOR USE BY THE EMPLOYEE DURING THE COURSE OF HIS JOB…

Effective utilization of disadvantaged business enterprises (DBE) in alternative delivery projects: strategies and resources to support the achievement of DBE goals : Georgia DOT research project 14-42 : final report.

DOT National Transportation Integrated Search

2016-04-01

This synthesis is a comprehensive review of the best knowledge and practices for stimulating effective : utilization of Disadvantaged Business Enterprises (DBE) in the procurement and execution of : transportation projects, using design-build and oth...

75 FR 54871 - National Drinking Water Advisory Council's Climate Ready Water Utilities Working Group Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9198-8] National Drinking Water Advisory Council's Climate... final in-person meeting of the Climate Ready Water Utilities (CRWU) Working Group of the National Drinking Water Advisory Council (NDWAC). The purpose of this meeting is to review and discuss final changes...

LiDAR utility for natural resource managers

Treesearch

Andrew Thomas Hudak; Jeffrey Scott Evans; Alistair Mattthew Stuart Smith

2009-01-01

Applications of LiDAR remote sensing are exploding, while moving from the research to the operational realm. Increasingly, natural resource managers are recognizing the tremendous utility of LiDAR-derived information to make improved decisions. This review provides a cross-section of studies, many recent, that demonstrate the relevance of LiDAR across a suite of...

Kleinke's "Bleeding Edge" sees utility role for providers.

PubMed

Johnson, D E

1998-10-01

Hospitals will evolve into units of health care delivery systems that will eventually resemble utilities, like water and the telephone, according to a new book. Donald E.L. Johnson reviews Bleeding Edge: The Business View of Health Care in the New Century, by J.D. Kleinke, and discusses the strategic implications of Kleinke's predictions.

Role of Anti-Müllerian Hormone in pathophysiology, diagnosis and treatment of Polycystic Ovary Syndrome: a review.

PubMed

Dumont, Agathe; Robin, Geoffroy; Catteau-Jonard, Sophie; Dewailly, Didier

2015-12-21

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women. Excessive ovarian production of Anti-Müllerian Hormone, secreted by growing follicles in excess, is now considered as an important feature of PCOS. The aim of this review is first to update the current knowledge about the role of AMH in the pathophysiology of PCOS. Then, this review will discuss the improvement that serum AMH assay brings in the diagnosis of PCOS. Last, this review will explain the utility of serum AMH assay in the management of infertility in women with PCOS and its utility as a marker of treatment efficiency on PCOS symptoms. It must be emphasized however that the lack of an international standard for the serum AMH assay, mainly because of technical issues, makes it difficult to define consensual thresholds, and thus impairs the widespread use of this new ovarian marker. Hopefully, this should soon improve.

Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

PubMed

Shin, Y S; Yeom, Y K; Hwang, H

1993-02-01

This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

Information technology enters the doctor's office: Part II--Six lessons about intended ... and unintended ... results.

PubMed

Frankel, P; Chernow, R; Rosenberg, W

1994-02-01

Part I of this article ("Six Design and Implementation Lessons," Physician Executive, Sept.-Oct. 1993, pp. 46-50) described an ambulatory utilization review (AUR) program designed and implemented by Metropolitan Life Insurance Company and reviewed some of the lessons learned over the past five years. Those lessons pertained to the tasks of inventing a new information technology to measure and evaluate ambulatory care and some of the practical implementation issues associated with review of 30,000 small dollar value claims per day in 19 claim offices nationwide. This article turns to the basic purpose of AUR--to review the medical necessity and appropriateness of ambulatory utilization. One lesson learned about AUR in this context is that AUR works: savings from the program outweigh costs by almost 5:1. The more important lessons, however, stem from understanding how the savings are achieved, and what some of the other unintended benefits of the program are.

School-based prevention programs for depression and anxiety in adolescence: a systematic review.

PubMed

Corrieri, Sandro; Heider, Dirk; Conrad, Ines; Blume, Anne; König, Hans-Helmut; Riedel-Heller, Steffi G

2014-09-01

School-based interventions are considered a promising effort to prevent the occurrence of mental disorders in adolescents. This systematic review focuses on school-based prevention interventions on depression and anxiety disorders utilizing an RCT design, starting from the year 2000. Based on an online search (PubMed, Scirus, OVID, ISI) and bibliographic findings in the eligible articles, 28 studies providing information were reviewed. The search process ended on 2 May 2011. The majority of interventions turn out to be effective, both for depression (65%) and anxiety (73%). However, the obtained overall mean effect sizes calculated from the most utilized questionnaires can be considered rather small (CDI: -0.12; RCMAS: -0.29). The majority of the reviewed school-based interventions shows effectiveness in reducing or preventing mental disorders in adolescents. However, effect size computation revealed only small-scale effectiveness. Future studies have to consider the impact of program implementation variations. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exploring Nursing Students' Experiences of Learning Using Phenomenography: A Literature Review.

PubMed

Barry, Sinead; Ward, Louise; Walter, Ruby

2017-10-01

The purpose of this extensive international and national literature review was to explore how phenomenography identifies nursing students' experiences of learning within preregistration (or prelicensure) nursing education. Data were collected utilizing a comprehensive search of electronic databases. Full text, peer-reviewed, and scholarly articles published in English using the search terms phenomengraph*, nurs*, student, education, and learning were reviewed. Two discreet themes emerged exploring students' experiences of learning within preregistration nursing education: (a) Phenomenography was a beneficial method to expose variation in students' understandings of a challenging concept or topic and (b) phenomenography was beneficial to evaluate teaching methods in attempt to improve student learning of challenging and complex concepts. On the basis of these findings, future research utilizing phenomenography within nursing education has potential to uncover variation in students' understandings of mental health, with future consideration of implications to nursing curriculum design and development. [J Nurs Educ. 2017;56(10):591-598.]. Copyright 2017, SLACK Incorporated.

A systematic literature review of the economic implications of chemotherapy-induced diarrhea and its impact on quality of life.

PubMed

Tarricone, Rosanna; Abu Koush, Dana; Nyanzi-Wakholi, Barbara; Medina-Lara, Antonieta

2016-03-01

Chemotherapy-induced diarrhea (CID) diminishes physical performance, raises anxiety and depression levels, and increases healthcare resource utilization. To understand the impact that CID has on health-related quality of life (HRQoL) and on healthcare resource utilization. Systematic searches were conducted in MEDLINE, EMBASE, DARE, and the NHS EED databases. A total of 22 articles were retrieved for full review (n=17, HRQoL; n=5 healthcare resource utilization). Only 2 studies had assessed HRQoL in patients experiencing CID, while cost studies demonstrated that CID episodes are unnecessarily expensive and can be avoided if diagnosed and treated early. Better management of CID has the potential to reduce overall economic burden and improve patients' HRQoL. Available evidence also relays the need to conduct larger studies that assess HRQoL and consider cost beyond direct medical costs in order to understand the full impact of CID on HRQoL and healthcare resource utilization. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Utilizing Wisconsin Afterschool Programs to Increase Physical Activity in Youth.

PubMed

Cavanagh, Bradley D; Meinen, Amy

2015-10-01

Approximately 31.7% of children in the United States are overweight or obese. Interventions in the afterschool setting may help combat childhood obesity. Research exists on interventions in school settings, but a few data exist for interventions about afterschool programs. This study investigates increasing physical activity (PA) in Wisconsin afterschool programs. A literature review was used to develop key informant interviews. Utilizing a constant comparative method, interview data were coded and themes were identified. The themes, literature review, and expert opinions were used to formulate recommendations for improving PA in afterschool programs. Programs had success in utilizing different resources to improve PA. Key barriers to improving PA included grant-imposed academic restrictions, the need for provider education, fears of conflict and competitiveness, and a lack of understanding between health and sedentariness. There is a clear need for additional exploration into improving PA in Wisconsin afterschool programs. This study resulted in specific recommendations to increase PA in afterschool programming, including utilizing school wellness policies and staff professional development to improve PA in afterschool programs. © 2015, American School Health Association.

Neuroimaging of Human Balance Control: A Systematic Review

PubMed Central

Wittenberg, Ellen; Thompson, Jessica; Nam, Chang S.; Franz, Jason R.

2017-01-01

This review examined 83 articles using neuroimaging modalities to investigate the neural correlates underlying static and dynamic human balance control, with aims to support future mobile neuroimaging research in the balance control domain. Furthermore, this review analyzed the mobility of the neuroimaging hardware and research paradigms as well as the analytical methodology to identify and remove movement artifact in the acquired brain signal. We found that the majority of static balance control tasks utilized mechanical perturbations to invoke feet-in-place responses (27 out of 38 studies), while cognitive dual-task conditions were commonly used to challenge balance in dynamic balance control tasks (20 out of 32 studies). While frequency analysis and event related potential characteristics supported enhanced brain activation during static balance control, that in dynamic balance control studies was supported by spatial and frequency analysis. Twenty-three of the 50 studies utilizing EEG utilized independent component analysis to remove movement artifacts from the acquired brain signals. Lastly, only eight studies used truly mobile neuroimaging hardware systems. This review provides evidence to support an increase in brain activation in balance control tasks, regardless of mechanical, cognitive, or sensory challenges. Furthermore, the current body of literature demonstrates the use of advanced signal processing methodologies to analyze brain activity during movement. However, the static nature of neuroimaging hardware and conventional balance control paradigms prevent full mobility and limit our knowledge of neural mechanisms underlying balance control. PMID:28443007

Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

PubMed

Winkelman, Warren J; Leonard, Kevin J

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

Utilization of agricultural and forest industry waste and residues in natural fiber-polymer composites: A review.

PubMed

Väisänen, Taneli; Haapala, Antti; Lappalainen, Reijo; Tomppo, Laura

2016-08-01

Natural fiber-polymer composites (NFPCs) are becoming increasingly utilized in a wide variety of applications because they represent an ecological and inexpensive alternative to conventional petroleum-derived materials. On the other hand, considerable amounts of organic waste and residues from the industrial and agricultural processes are still underutilized as low-value energy sources. Organic materials are commonly disposed of or subjected to the traditional waste management methods, such as landfilling, composting or anaerobic digestion. The use of organic waste and residue materials in NFPCs represents an ecologically friendly and a substantially higher value alternative. This is a comprehensive review examining how organic waste and residues could be utilized in the future as reinforcements or additives for NFPCs from the perspective of the recently reported work in this field. Copyright © 2016 Elsevier Ltd. All rights reserved.

Review of Smartphone Applications for the Treatment of Eating Disorders

PubMed Central

Juarascio, Adrienne S.; Manasse, Stephanie M.; Goldstein, Stephanie P.; Forman, Evan M.; Butryn, Meghan L.

2016-01-01

mHealth tools may be a feasible modality for delivering evidence-based treatments and principles (EBPs), and may enhance treatment for eating disorders (EDs). However, research on the efficacy of mHealth tools for EDs and the extent to which they include EBPs is lacking. The current study sought to (i) review existing apps for EDs, (ii) determine the extent to which available treatment apps utilize EBPs, and (iii) assess the degree to which existing smartphone apps utilize recent advances in smartphone technology. Overall, existing ED intervention apps contained minimal EBPs and failed to incorporate smartphone capabilities. For smartphone apps to be a feasible and effective ED treatment modality, it may be useful for creators to begin taking utilizing the abilities that set smartphones apart from in-person treatment while incorporating EBPs. Before mHealth tools are incorporated into treatments for EDs, it is necessary that the feasibility, acceptability, and efficacy be evaluated. PMID:25303148

Droplet Microfluidics for Chip-Based Diagnostics

PubMed Central

Kaler, Karan V. I. S.; Prakash, Ravi

2014-01-01

Droplet microfluidics (DMF) is a fluidic handling technology that enables precision control over dispensing and subsequent manipulation of droplets in the volume range of microliters to picoliters, on a micro-fabricated device. There are several different droplet actuation methods, all of which can generate external stimuli, to either actively or passively control the shape and positioning of fluidic droplets over patterned substrates. In this review article, we focus on the operation and utility of electro-actuation-based DMF devices, which utilize one or more micro-/nano-patterned substrates to facilitate electric field-based handling of chemical and/or biological samples. The underlying theory of DMF actuations, device fabrication methods and integration of optical and opto-electronic detectors is discussed in this review. Example applications of such electro-actuation-based DMF devices have also been included, illustrating the various actuation methods and their utility in conducting chip-based laboratory and clinical diagnostic assays. PMID:25490590

The state of autotrophic ethanol production in Cyanobacteria.

PubMed

Dexter, J; Armshaw, P; Sheahan, C; Pembroke, J T

2015-07-01

Ethanol production directly from CO2 , utilizing genetically engineered photosynthetic cyanobacteria as a biocatalyst, offers significant potential as a renewable and sustainable source of biofuel. Despite the current absence of a commercially successful production system, significant resources have been deployed to realize this goal. Utilizing the pyruvate decarboxylase from Zymomonas species, metabolically derived pyruvate can be converted to ethanol. This review of both peer-reviewed and patent literature focuses on the genetic modifications utilized for metabolic engineering and the resultant effect on ethanol yield. Gene dosage, induced expression and cassette optimizat-ion have been analyzed to optimize production, with production rates of 0·1-0·5 g L(-1) day(-1) being achieved. The current 'toolbox' of molecular manipulations and future directions focusing on applicability, addressing the primary challenges facing commercialization of cyanobacterial technologies are discussed. © 2015 The Society for Applied Microbiology.

Consumer sleep tracking devices: a review of mechanisms, validity and utility.

PubMed

Kolla, Bhanu Prakash; Mansukhani, Subir; Mansukhani, Meghna P

2016-05-01

Consumer sleep tracking devices such as fitness trackers and smartphone apps have become increasingly popular. These devices claim to measure the sleep duration of their users and in some cases purport to measure sleep quality and awaken users from light sleep, potentially improving overall sleep. Most of these devices appear to utilize data generated from in-built accelerometers to determine sleep parameters but the exact mechanisms and algorithms are proprietary. The growing literature comparing these devices against polysomnography/actigraphy shows that they tend to underestimate sleep disruptions and overestimate total sleep times and sleep efficiency in normal subjects. In this review, we evaluate the current literature comparing the accuracy of consumer sleep tracking devices against more conventional methods used to measure sleep duration and quality. We discuss the current technology that these devices utilize as well as summarize the value of these devices in clinical evaluations and their potential limitations.

Circulating tumor cells: clinical validity and utility.

PubMed

Cabel, Luc; Proudhon, Charlotte; Gortais, Hugo; Loirat, Delphine; Coussy, Florence; Pierga, Jean-Yves; Bidard, François-Clément

2017-06-01

Circulating tumor cells (CTCs) are rare tumor cells and have been investigated as diagnostic, prognostic and predictive biomarkers in many types of cancer. Although CTCs are not currently used in clinical practice, CTC studies have accumulated a high level of clinical validity, especially in breast, lung, prostate and colorectal cancers. In this review, we present an overview of the current clinical validity of CTCs in metastatic and non-metastatic disease, and the main concepts and studies investigating the clinical utility of CTCs. In particular, this review will focus on breast, lung, colorectal and prostate cancer. Three major topics concerning the clinical utility of CTC are discussed-(1) treatment based on CTCs used as liquid biopsy, (2) treatment based on CTC count or CTC variations, and (3) treatment based on CTC biomarker expression. A summary of published or ongoing phase II and III trials is also presented.

Oil Palm Empty Fruit Bunches (OPEFB): Existing Utilization and Current Trends Bio Refinery in Indonesia

NASA Astrophysics Data System (ADS)

Rame

2018-02-01

In a future carbon-constrained global economy, the use of fossil fuels will be restricted. Biomass resources will be increased demand for renewable products. Oil Palm Empty Fruit Bunches (OPEFB) can be used as lignocellulose feedstock. The production of biofuels from lignocellulose feedstock can be achieved through biochemical or thermo-chemical routes. OPEFB contain chemical blocks of cellulose, hemicellulose and lignocellulose. Due to these substances, OPEFB can be converted into bio-products and chemical. Special attention to biorefinery approach that is present at relatively high potential in bio-products such as polymers, nutraceuticals, chemical building blocks, biofuels, and bioenergy. Different utilization types were considered and reviewed, and the most common and efficient process were discussed. In general, there is no single product which could be considered a solution to the utilization of managing OPEFB - in this review a number of product are more economic, effective and environmentally friendly.

The validity and clinical utility of purging disorder.

PubMed

Keel, Pamela K; Striegel-Moore, Ruth H

2009-12-01

To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

A review of sugarcane bagasse for second-generation bioethanol and biopower production

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

Bezerra, Tais Lacerda; Ragauskas, Art J.

Sugarcane bagasse is a large-volume agriculture residue that is generated on a ~540 million metric tons per year basis globally 1,2 with the top-three producing countries in Latin America being Brazil (~181 million metric ton yr –1), 3 Mexico 15 million metric ton yr –1), 4 and Colombia 7 million metric ton yr –1), 5 respectively. 6 Given sustainability concerns and the need to maximize the utilization of bioresources, the use of sugarcane bagasse is receiving significant attention in biorefining applications, as it is a promising resource for the conversion to biofuels and biopower. Lastly, this review provides a comprehensivemore » review of bagasse and its chemical constituents and on-going research into its utilization as a feedstock for cellulosic ethanol and electricity generation.« less

A review of sugarcane bagasse for second-generation bioethanol and biopower production

DOE PAGES

Bezerra, Tais Lacerda; Ragauskas, Art J.

2016-07-20

Sugarcane bagasse is a large-volume agriculture residue that is generated on a ~540 million metric tons per year basis globally 1,2 with the top-three producing countries in Latin America being Brazil (~181 million metric ton yr –1), 3 Mexico 15 million metric ton yr –1), 4 and Colombia 7 million metric ton yr –1), 5 respectively. 6 Given sustainability concerns and the need to maximize the utilization of bioresources, the use of sugarcane bagasse is receiving significant attention in biorefining applications, as it is a promising resource for the conversion to biofuels and biopower. Lastly, this review provides a comprehensivemore » review of bagasse and its chemical constituents and on-going research into its utilization as a feedstock for cellulosic ethanol and electricity generation.« less

Utilization of open source electronic health record around the world: A systematic review.

PubMed

Aminpour, Farzaneh; Sadoughi, Farahnaz; Ahamdi, Maryam

2014-01-01

Many projects on developing Electronic Health Record (EHR) systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems.

Dielectrophoresis for Biomedical Sciences Applications: A Review

PubMed Central

Abd Rahman, Nurhaslina; Ibrahim, Fatimah; Yafouz, Bashar

2017-01-01

Dielectrophoresis (DEP) is a label-free, accurate, fast, low-cost diagnostic technique that uses the principles of polarization and the motion of bioparticles in applied electric fields. This technique has been proven to be beneficial in various fields, including environmental research, polymer research, biosensors, microfluidics, medicine and diagnostics. Biomedical science research is one of the major research areas that could potentially benefit from DEP technology for diverse applications. Nevertheless, many medical science research investigations have yet to benefit from the possibilities offered by DEP. This paper critically reviews the fundamentals, recent progress, current challenges, future directions and potential applications of research investigations in the medical sciences utilizing DEP technique. This review will also act as a guide and reference for medical researchers and scientists to explore and utilize the DEP technique in their research fields. PMID:28245552

A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems.

PubMed

Simpao, Allan F; Tan, Jonathan M; Lingappan, Arul M; Gálvez, Jorge A; Morgan, Sherry E; Krall, Michael A

2017-10-01

Anesthesia information management systems (AIMS) are sophisticated hardware and software technology solutions that can provide electronic feedback to anesthesia providers. This feedback can be tailored to provide clinical decision support (CDS) to aid clinicians with patient care processes, documentation compliance, and resource utilization. We conducted a systematic review of peer-reviewed articles on near real-time and point-of-care CDS within AIMS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Studies were identified by searches of the electronic databases Medline and EMBASE. Two reviewers screened studies based on title, abstract, and full text. Studies that were similar in intervention and desired outcome were grouped into CDS categories. Three reviewers graded the evidence within each category. The final analysis included 25 articles on CDS as implemented within AIMS. CDS categories included perioperative antibiotic prophylaxis, post-operative nausea and vomiting prophylaxis, vital sign monitors and alarms, glucose management, blood pressure management, ventilator management, clinical documentation, and resource utilization. Of these categories, the reviewers graded perioperative antibiotic prophylaxis and clinical documentation as having strong evidence per the peer reviewed literature. There is strong evidence for the inclusion of near real-time and point-of-care CDS in AIMS to enhance compliance with perioperative antibiotic prophylaxis and clinical documentation. Additional research is needed in many other areas of AIMS-based CDS.

A review of health utilities using the EQ-5D in studies of cardiovascular disease

PubMed Central

2010-01-01

Background The EQ-5D has been extensively used to assess patient utility in trials of new treatments within the cardiovascular field. The aims of this study were to review evidence of the validity and reliability of the EQ-5D, and to summarise utility scores based on the use of the EQ-5D in clinical trials and in studies of patients with cardiovascular disease. Methods A structured literature search was conducted using keywords related to cardiovascular disease and EQ-5D. Original research studies of patients with cardiovascular disease that reported EQ-5D results and its measurement properties were included. Results Of 147 identified papers, 66 met the selection criteria, with 10 studies reporting evidence on validity or reliability and 60 reporting EQ-5D responses (VAS or self-classification). Mean EQ-5D index-based scores ranged from 0.24 (SD 0.39) to 0.90 (SD 0.16), while VAS scores ranged from 37 (SD 21) to 89 (no SD reported). Stratification of EQ-5D index scores by disease severity revealed that scores decreased from a mean of 0.78 (SD 0.18) to 0.51 (SD 0.21) for mild to severe disease in heart failure patients and from 0.80 (SD 0.05) to 0.45 (SD 0.22) for mild to severe disease in angina patients. Conclusions The published evidence generally supports the validity and reliability of the EQ-5D as an outcome measure within the cardiovascular area. This review provides utility estimates across a range of cardiovascular subgroups and treatments that may be useful for future modelling of utilities and QALYs in economic evaluations within the cardiovascular area. PMID:20109189

Impact of cost sharing on specialty drug utilization and outcomes: a review of the evidence and future directions.

PubMed

Doshi, Jalpa A; Li, Pengxiang; Ladage, Vrushabh P; Pettit, Amy R; Taylor, Erin A

2016-03-01

Specialty drugs often represent major medical advances for patients with few other effective options available, but high costs have attracted the attention of both payers and policy makers. We reviewed the evidence regarding the impact of cost sharing on utilization of specialty drugs indicated for rheumatoid arthritis (RA), multiple sclerosis (MS), and cancer, and on the use of nondrug medical services, health outcomes, and spending. Systematic review of Medline-indexed studies identified via an OVID search for articles published in English from 1995 to 2014, using combinations of terms for cost sharing and specialty drugs, and/or our 3 conditions of interest. We identified additional studies from reference lists. We identified 19 articles focusing on specialty drugs indicated for MS (n = 9), cancer (n = 8), and RA (n = 8). Studies examined prescription abandonment (n = 3), initiation or any utilization (n = 8), adherence (n = 9), persistence/discontinuation (n = 7), number of claims (n = 1), and drug spending (n = 1). Findings varied by disease, but generally indicated stronger effects for noninitiation or abandonment of a prescription at the pharmacy and somewhat smaller effects for refill behavior and drug spending once patients initiated therapy. Studies have not examined specialty tier cost sharing seen under Medicare Part D or health insurance exchanges, nor effects on medical utilization, spending, or health outcomes. Evidence to date generally indicates reductions in specialty drug utilization associated with higher cost sharing; effects have varied by type of disease and specialty drug use outcome. We draw upon our findings and the gaps in evidence to summarize future directions for research and policy.

Biodegradability of pentachlorophenol in the environment: A literature review

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

Nakles, D.

1993-04-01

Pentachlorophenol has been widely used as a wood preserving agent for over 50 years to treat millions of electrical utility poles and crossarms. Treatment of poles with pentachlorophenol has in some cases resulted in contamination of soils, groundwater, and surface water. Environmental releases are a concern because of the potential toxicity of pentachlorophenol and its stringent regulation. Microbiological degradation of pentachlorophenol in environmental media has been demonstrated in numerous cases. The potential for pentachlorophenol to be biologically degraded is of interest to the electrical utility industry for two reasons. First, it is a factor in understanding the probable fate ofmore » pentachlorophenol where it has been released into the environment, and second, its biodegradability can potentially result in effective and economical treatment strategies for soils, water, and subsurface environments. The objective of this literature review is to collect a baseline of information on the biodegradability of pentachlorophenol in soils, surface water, and groundwater for the electric utility industry. The focus of the electric utility industry's interest in the environmental management and control of pentachlorophenol is primarily in the management of environmental media, particularly soils, that may have become incidentally contaminated with pentachlorophenol in association with the treatment, storage, or use of utility poles and crossarms. The review of the literature has found that [open quotes]unassisted[close quotes] biodegradation of pentachlorophenol in aquatic, soil, and subsurface environments may occur, presumably if there is an acclimated microbial population of sufficient density. Aerobic conditions appear to be most conducive to biodegradation in these cases. Several studies have shown that with an acclimated, mixed culture and conventional wastewater treatment approaches, pentachlorophenol can be effectively treated in water.« less

Biodegradability of pentachlorophenol in the environment: A literature review. Final report

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

Nakles, D.

1993-04-01

Pentachlorophenol has been widely used as a wood preserving agent for over 50 years to treat millions of electrical utility poles and crossarms. Treatment of poles with pentachlorophenol has in some cases resulted in contamination of soils, groundwater, and surface water. Environmental releases are a concern because of the potential toxicity of pentachlorophenol and its stringent regulation. Microbiological degradation of pentachlorophenol in environmental media has been demonstrated in numerous cases. The potential for pentachlorophenol to be biologically degraded is of interest to the electrical utility industry for two reasons. First, it is a factor in understanding the probable fate ofmore » pentachlorophenol where it has been released into the environment, and second, its biodegradability can potentially result in effective and economical treatment strategies for soils, water, and subsurface environments. The objective of this literature review is to collect a baseline of information on the biodegradability of pentachlorophenol in soils, surface water, and groundwater for the electric utility industry. The focus of the electric utility industry`s interest in the environmental management and control of pentachlorophenol is primarily in the management of environmental media, particularly soils, that may have become incidentally contaminated with pentachlorophenol in association with the treatment, storage, or use of utility poles and crossarms. The review of the literature has found that {open_quotes}unassisted{close_quotes} biodegradation of pentachlorophenol in aquatic, soil, and subsurface environments may occur, presumably if there is an acclimated microbial population of sufficient density. Aerobic conditions appear to be most conducive to biodegradation in these cases. Several studies have shown that with an acclimated, mixed culture and conventional wastewater treatment approaches, pentachlorophenol can be effectively treated in water.« less

Use of social media across US hospitals: descriptive analysis of adoption and utilization.

PubMed

Griffis, Heather M; Kilaru, Austin S; Werner, Rachel M; Asch, David A; Hershey, John C; Hill, Shawndra; Ha, Yoonhee P; Sellers, Allison; Mahoney, Kevin; Merchant, Raina M

2014-11-27

Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services.

Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization

PubMed Central

Griffis, Heather M; Kilaru, Austin S; Werner, Rachel M; Asch, David A; Hershey, John C; Hill, Shawndra; Ha, Yoonhee P; Sellers, Allison; Mahoney, Kevin

2014-01-01

Background Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. Objective The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. Methods We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Results Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Conclusions Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the quality of hospital care and services. PMID:25431831

Applications of Telemedicine and Telecommunications to Disaster Medicine

PubMed Central

Garshnek, Victoria; Burkle, Frederick M.

1999-01-01

Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes, based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. This manuscript reviews the history of telemedicine activities in actual disasters and similar scenarios as well as ongoing telemedicine innovations that may be applicable to disaster situations. Emergency care providers must begin to plan effectively to utilize disaster-specific telemedicine applications to improve future outcomes. PMID:9925226

Application of microbial transglutaminase in meat foods: A review.

PubMed

Santhi, D; Kalaikannan, A; Malairaj, P; Arun Prabhu, S

2017-07-03

Microbial transglutaminase (MTG) is an enzyme isolated from a variant of Streptomyces mobaraensis that forms covalent cross-links between protein molecules. Studies are being conducted since last two decades on utilization of MTG in meat foods to improve their characteristics, such as gelation, water-binding, emulsion stability, purge loss, cooking loss, etc. MTG is one of the important topics of interest in meat processing industry due to its advantages in practical utilization and commercial exploitation. This review will discuss about the overall applications of MTG in manipulating the functional properties of meat and meat products by means of various processes such as restructuring, value addition, etc.

The Impact of the Photocopier on Peer Review and Nursing Theory.

PubMed

Nicoll, Leslie H

Two influential publications in nursing, Nursing Research and Perspectives on Nursing Theory, are used to illustrate how a specific technology change-the invention and marketing of the photocopier-influenced knowledge dissemination and information utilization in nursing, perhaps in ways not immediately apparent. Content analysis and historical comparison, using editorials from Nursing Research, historical reports on technology development, and personal reflections on the genesis of Perspectives on Nursing Theory are used to create an argument for the role of technology in peer review, information utilization, and knowledge development in nursing. Multiple forces influence nursing science. Scholars should be alert to data inputs from many sources and respond accordingly.

Solution of partial differential equations on vector and parallel computers

NASA Technical Reports Server (NTRS)

Ortega, J. M.; Voigt, R. G.

1985-01-01

The present status of numerical methods for partial differential equations on vector and parallel computers was reviewed. The relevant aspects of these computers are discussed and a brief review of their development is included, with particular attention paid to those characteristics that influence algorithm selection. Both direct and iterative methods are given for elliptic equations as well as explicit and implicit methods for initial boundary value problems. The intent is to point out attractive methods as well as areas where this class of computer architecture cannot be fully utilized because of either hardware restrictions or the lack of adequate algorithms. Application areas utilizing these computers are briefly discussed.

In-situ Resource Utilization (ISRU) and Lunar Surface Systems

NASA Technical Reports Server (NTRS)

Sanders, Jerry; Larson, Bill; Sacksteder, Kurt

2007-01-01

This viewgraph presentation reviews the benefits of In-Situ Resource Utilization (ISRU) on the surface of the moon. Included in this review is the commercialization of Lunar ISRU. ISRU will strongly influence architecture and critical technologies. ISRU is a critical capability and key implementation of the Vision for Space Exploration (VSE). ISRU will strongly effects lunar outpost logistics, design and crew safety. ISRU will strongly effect outpost critical technologies. ISRU mass investment is minimal compared to immediate and long-term architecture delivery mass and reuse capabilities provided. Therefore, investment in ISRU constitutes a commitment to the mid and long term future of human exploration.

Clinical and Insurance Perspectives on Intermediate Levels of Care in Psychiatry.

PubMed

Plakun, Eric M

2018-03-01

This column compares a clinical perspective on the continuum of care for mental health and substance use disorders with a different perspective derived from publicly available insurance company documents and experience dealing with managed care utilization reviewers. The latter perspective tends to determine the need for access to levels of care based on the need for crisis stabilization, whereas the generally accepted clinical standard is more nuanced than the need for crisis stabilization alone. The column proposes that this discrepancy in perspectives makes a substantial contribution to disagreements between treating clinicians, such as therapists, and insurance utilization reviewers concerning the medical necessity of various requested levels of care.

Magnetic nanoparticle-based approaches to locally target therapy and enhance tissue regeneration in vivo

PubMed Central

Sensenig, Richard; Sapir, Yulia; MacDonald, Cristin; Cohen, Smadar; Polyak, Boris

2013-01-01

Magnetic-based systems utilizing superparamagnetic nanoparticles and a magnetic field gradient to exert a force on these particles have been used in a wide range of biomedical applications. This review is focused on drug targeting applications that require penetration of a cellular barrier as well as strategies to improve the efficacy of targeting in these biomedical applications. Another focus of this review is regenerative applications utilizing tissue engineered scaffolds prepared with the aid of magnetic particles, the use of remote actuation for release of bioactive molecules and magneto–mechanical cell stimulation, cell seeding and cell patterning. PMID:22994959

Demand for Women's Health Services in Northern Nigeria: A Review of the Literature.

PubMed

Sinai, Irit; Anyanti, Jennifer; Khan, Mohsin; Daroda, Ramatu; Oguntunde, Olugbenga

2017-06-01

Demand for and utilization of women's health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women's health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region's population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women's health-seeking behaviors for themselves and for their children. Programs seeking to improve women's health outcomes in northern Nigeria should involve women's influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services.

Remote Antimicrobial Stewardship in Community Hospitals

PubMed Central

Wood, Zachary H.; Nicolsen, Nicole C.; Allen, Nichole; Cook, Paul P.

2015-01-01

Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to streamline, discontinue, or switch antimicrobial agents. Totals of charts reviewed, recommendations made, recommendations accepted, and categories of intervention were recorded. Linear regression was utilized to measure changes in antimicrobial use over time. For the four larger hospitals, recommendations for changes were made in an average of 45 charts per month per hospital and physician acceptance of the pharmacists’ recommendations varied between 83% and 88%. There was no significant decrease in total antimicrobial use, but much of the use was outside of the stewardship program’s review. Quinolone use decreased by more than 50% in two of the four larger hospitals. Remote antimicrobial stewardship utilizing an EMR is feasible in community hospitals and is generally received favorably by physicians. As more community hospitals adopt EMRs, there is an opportunity to expand antimicrobial stewardship beyond the academic medical center. PMID:27025642

Liquid metal actuation by electrical control of interfacial tension

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

Eaker, Collin B.; Dickey, Michael D., E-mail: michael-dickey@ncsu.edu

2016-09-15

By combining metallic electrical conductivity with low viscosity, liquid metals and liquid metal alloys offer new and exciting opportunities to serve as reconfigurable components of electronic, microfluidic, and electromagnetic devices. Here, we review the physics and applications of techniques that utilize voltage to manipulate the interfacial tension of liquid metals; such techniques include electrocapillarity, continuous electrowetting, electrowetting-on-dielectric, and electrochemistry. These techniques lower the interfacial tension between liquid metals and a surrounding electrolyte by driving charged species (or in the case of electrochemistry, chemical species) to the interface. The techniques are useful for manipulating and actuating liquid metals at sub-mm lengthmore » scales where interfacial forces dominate. We focus on metals and alloys that are liquid near or below room temperature (mercury, gallium, and gallium-based alloys). The review includes discussion of mercury—despite its toxicity—because it has been utilized in numerous applications and it offers a way of introducing several phenomena without the complications associated with the oxide layer that forms on gallium and its alloys. The review focuses on the advantages, applications, opportunities, challenges, and limitations of utilizing voltage to control interfacial tension as a method to manipulate liquid metals.« less

An ethernet/IP security review with intrusion detection applications

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

Laughter, S. A.; Williams, R. D.

2006-07-01

Supervisory Control and Data Acquisition (SCADA) and automation networks, used throughout utility and manufacturing applications, have their own specific set of operational and security requirements when compared to corporate networks. The modern climate of heightened national security and awareness of terrorist threats has made the security of these systems of prime concern. There is a need to understand the vulnerabilities of these systems and how to monitor and protect them. Ethernet/IP is a member of a family of protocols based on the Control and Information Protocol (CIP). Ethernet/IP allows automation systems to be utilized on and integrated with traditional TCP/IPmore » networks, facilitating integration of these networks with corporate systems and even the Internet. A review of the CIP protocol and the additions Ethernet/IP makes to it has been done to reveal the kind of attacks made possible through the protocol. A set of rules for the SNORT Intrusion Detection software is developed based on the results of the security review. These can be used to monitor, and possibly actively protect, a SCADA or automation network that utilizes Ethernet/IP in its infrastructure. (authors)« less

Review on Microwave-Matter Interaction Fundamentals and Efficient Microwave-Associated Heating Strategies

PubMed Central

Sun, Jing; Wang, Wenlong; Yue, Qinyan

2016-01-01

Microwave heating is rapidly emerging as an effective and efficient tool in various technological and scientific fields. A comprehensive understanding of the fundamentals of microwave–matter interactions is the precondition for better utilization of microwave technology. However, microwave heating is usually only known as dielectric heating, and the contribution of the magnetic field component of microwaves is often ignored, which, in fact, contributes greatly to microwave heating of some aqueous electrolyte solutions, magnetic dielectric materials and certain conductive powder materials, etc. This paper focuses on this point and presents a careful review of microwave heating mechanisms in a comprehensive manner. Moreover, in addition to the acknowledged conventional microwave heating mechanisms, the special interaction mechanisms between microwave and metal-based materials are attracting increasing interest for a variety of metallurgical, plasma and discharge applications, and therefore are reviewed particularly regarding the aspects of the reflection, heating and discharge effects. Finally, several distinct strategies to improve microwave energy utilization efficiencies are proposed and discussed with the aim of tackling the energy-efficiency-related issues arising from the application of microwave heating. This work can present a strategic guideline for the developed understanding and utilization of the microwave heating technology. PMID:28773355

Use of Bibliographic Systems and Concept Maps: Innovative Tools to Complete a Literature Review

ERIC Educational Resources Information Center

Martelo, Maira L.

2011-01-01

This article presents a process for utilizing a bibliographic system built with Microsoft Excel as well as concept maps to organize and to synthesize information that can be included in a literature review. A review of the conceptual framework behind these tools is included as well as a detailed description about how to build the system in Excel.…

Most Courses Are Not Born Digital: An Overview of the Quality Matters Peer Review Process for Online Course Design

ERIC Educational Resources Information Center

Varonis, Evageline Marlos

2014-01-01

Purpose: The purpose of this paper is to discuss benefits of and barriers to online learning and describe utilization of the Quality Matters (QM) peer review process as a method to assure the quality of online courses. It outlines the QM higher education rubric, explains how the collaborative QM peer review process facilitates online course design…

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.

PubMed

Geleto, Ayele; Chojenta, Catherine; Mussa, Abdulbasit; Loxton, Deborah

2018-04-16

Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care. However, different factors can hinder women's ability to access and use emergency obstetric services in sub-Saharan Africa. Therefore, the aim of this review is to synthesize current evidence on barriers to accessing and utilizing emergency obstetric care in sub-Saharan African. Decision-makers and policy formulators will use evidence generated from this review in improving maternal healthcare particularly the emergency obstetric care. Electronic databases including MEDLINE, CINAHL, Embase, and Maternity and Infant Care will be searched for studies using predefined search terms. Articles published in English language between 2010 and 2017 with quantitative and qualitative design will be included. The identified papers will be assessed for meeting eligibility criteria. First, the articles will be screened by examining their titles and abstracts. Then, two reviewers will review the full text of the selected articles independently. Two reviewers using a standard data extraction format will undertake data extraction from the retained studies. The quality of the included papers will be assessed using the mixed methods appraisal tool. Results from the eligible studies will be qualitatively synthesized using the narrative synthesis approach and reported using the three delays model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be employed to present the findings. This systematic review will present a detailed synthesis of the evidence for barriers to access and utilization of emergency obstetric care in sub-Saharan Africa over the last 7 years. This systematic review is expected to provide clear information that can help in designing maternal health policy and interventions particularly in emergency obstetric care in sub-Saharan Africa where maternal mortality remains high. PROSPERO CRD42017074102 .

PEL and Corridor Planning: State of the Practice Review of Planning and Environment Linkages Implementation in Corridor Planning

DOT National Transportation Integrated Search

2014-07-01

The Federal Highway Administration (FHWA) commissioned a review of transportation corridor plans to determine the extent to which these plans have utilized FHWA's Planning and Environment Linkages (PEL) approach, as described in the FHWA Guidance on ...

Evaluation and Development of Pavement Scores, Performance Models and Needs Estimates for the TXDOT Pavement Management Information System : Final Report

DOT National Transportation Integrated Search

2012-10-01

This project conducted a thorough review of the existing Pavement Management Information System (PMIS) database, : performance models, needs estimates, utility curves, and scores calculations, as well as a review of District practices : concerning th...

Higher Education for Sustainable Development: A Systematic Review

ERIC Educational Resources Information Center

Wu, Yen-Chun Jim; Shen, Ju-Peng

2016-01-01

Purpose: This study aims to provide a complete understanding of academic research into higher education for sustainable development (HESD). Design/methodology/approach: This study utilizes a systematic review of four scientific literature databases to outline topics of research during the UN's Decade of Education for Sustainable Development…

42 CFR 480.137 - Disclosure to Federal and State enforcement agencies responsible for the investigation or...

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... relating to disclosure of QIO deliberations and quality review study information, the QIO must disclose...

42 CFR 480.132 - Disclosure of information about patients.

Code of Federal Regulations, 2011 CFR

2011-10-01

... IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations... must disclose quality review study information only as specified in § 480.140. (c) Manner of disclosure... 42 Public Health 4 2011-10-01 2011-10-01 false Disclosure of information about patients. 480.132...

Stay-in-place bridge deck forms, a state of the art review. Prestressed panel subdecks.

DOT National Transportation Integrated Search

1973-01-01

The results of prior research conducted on precast prestressed panel subdecks for use in the construction of bridge decks are reviewed and summarized. This construction technique utilizes the precast panel subdecks as the forming for the cast-in-plac...

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2014 CFR

2014-01-01

..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2013 CFR

2013-01-01

..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2011 CFR

2011-01-01

..., review of standard referenced design approvals, special projects, inspections and import and export... standard referenced design approvals, special projects, inspections and import and export licenses..., approvals of facility standard reference designs, re-qualification and replacement examinations for reactor...

Note Taking and Recall

ERIC Educational Resources Information Center

Fisher, Judith L.; Harris, Mary B.

1974-01-01

To study the effect of note taking and opportunity for review on subsequent recall, 88 college students were randomly assigned to five treatment groups utilizing different note taking and review combinations. No treatment effects were found, although quality of notes was positively correlated with free recall an multiple-choice measures.…

78 FR 54444 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... Department of Agriculture has submitted the following information collection requirement(s) to OMB for review...) whether the collection of information is necessary for the proper performance of the functions of the agency, including whether the information will have practical utility; (b) the accuracy of the agency's...

42 CFR 403.746 - Condition of participation: Utilization review.

Code of Federal Regulations, 2010 CFR

2010-10-01

....746 Section 403.746 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care... admission, and at least every 30 days, the continued care review of each patient in the RHNCI home services...

Teenage Pregnancy and Motherhood: A Review of the Literature.

ERIC Educational Resources Information Center

Phipps-Yonas, Susan

1980-01-01

The literature is reviewed in terms of medical studies: who becomes pregnant, teenagers who choose to abort, psychological considerations, contraceptive utilization, attitudes of male adolescents, and the children of adolescents. The effectiveness of special programs for pregnant adolescents and their offspring and implications for policy and…

Psychometric properties of health related quality of life measures in acute coronary syndrome patients: a systematic review protocol.

PubMed

Brasil, Virginia; Oliveira, Gabriela; Moraes, Katarinne Lima

2018-02-01

The objective of this systematic review is to evaluate the psychometric properties and clinical utility of patient-reported outcome measures that assess health-related quality of life in patients with a clinical diagnosis of acute coronary syndrome.

Evidence-Based Practices for Students with Visual Disabilities

ERIC Educational Resources Information Center

Ferrell, Kay Alicyn

2006-01-01

Forty years of peer-reviewed research in literacy and 50 years of research in mathematics were systematically analyzed to determine the evidence supporting instructional pedagogy for students with visual disabilities. Review teams identified 30 intervention studies that utilized an appropriate comparison group. Although some studies had large…

Decrease in Statewide Antipsychotic Prescribing after Implementation of Child and Adolescent Psychiatry Consultation Services.

PubMed

Barclay, Rebecca P; Penfold, Robert B; Sullivan, Donna; Boydston, Lauren; Wignall, Julia; Hilt, Robert J

2017-04-01

To learn if a quality of care Medicaid child psychiatric consultation service implemented in three different steps was linked to changes in statewide child antipsychotic utilization. Washington State child psychiatry consultation program primary data and Medicaid pharmacy division antipsychotic utilization secondary data from July 1, 2006, through December 31, 2013. Observational study in which consult program data were analyzed with a time series analysis of statewide antipsychotic utilization. All consultation program database information involving antipsychotics was compared to Medicaid pharmacy division database information involving antipsychotic utilization. Washington State's total child Medicaid antipsychotic utilization fell from 0.51 to 0.25 percent. The monthly prevalence of use fell by a mean of 0.022 per thousand per month following the initiation of elective consults (p = .004), by 0.065 following the initiation of age/dose triggered mandatory reviews (p < .001), then by another 0.022 following the initiation of two or more concurrent antipsychotic mandatory reviews (p = .001). High-dose antipsychotic use fell by 57.8 percent in children 6- to 12-year old and fell by 52.1 percent in teens. Statewide antipsychotic prescribing for Medicaid clients fell significantly at different rates following each implementation step of a multilevel consultation and best-practice education service. © Health Research and Educational Trust.

WEB-BASED DATABASE ON RENEWAL TECHNOLOGIES ...

EPA Pesticide Factsheets

As U.S. utilities continue to shore up their aging infrastructure, renewal needs now represent over 43% of annual expenditures compared to new construction for drinking water distribution and wastewater collection systems (Underground Construction [UC], 2016). An increased understanding of renewal options will ultimately assist drinking water utilities in reducing water loss and help wastewater utilities to address infiltration and inflow issues in a cost-effective manner. It will also help to extend the service lives of both drinking water and wastewater mains. This research effort involved collecting case studies on the use of various trenchless pipeline renewal methods and providing the information in an online searchable database. The overall objective was to further support technology transfer and information sharing regarding emerging and innovative renewal technologies for water and wastewater mains. The result of this research is a Web-based, searchable database that utility personnel can use to obtain technology performance and cost data, as well as case study references. The renewal case studies include: technologies used; the conditions under which the technology was implemented; costs; lessons learned; and utility contact information. The online database also features a data mining tool for automated review of the technologies selected and cost data. Based on a review of the case study results and industry data, several findings are presented on tren

Chiropractic and CAM utilization: a descriptive review.

PubMed

Lawrence, Dana J; Meeker, William C

2007-01-22

To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

In Situ Estuarine and Marine Toxicity Testing: A Review, Including Recommendations for Future Use in Ecological Risk Assessment

DTIC Science & Technology

2009-09-01

testing may be a preferable or complementary strategy in certain situations utilizing a weight of evidence approach (Baird et al. 2007). One of the most...embryonic development, or post-exposure feeding rate are discussed. It is acknowledged that a plethora of additional endpoints have utility for use in situ...example, may have proven utility , it is generally preferable to evaluate toxicity using ecologically relevant species and life stages (i.e., those

PURPA and Photovoltaics: A Status Report

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

Flaim, T.

On May 16, 1983, the U.S. Supreme Court struck down the last major challenge to the Public Utility Regulatory Policies Act (PURPA) and its implementing regulations. In so doing, the Supreme Court upheld the right of photovoltaic and other qualifying investors to interconnect with electric utilities and to sell power at rates equal to the utility's full avoided cost. To appreciate the significance of this event, for U.S. markets, it is necessary to review the recent five-year history of PURPA-related events.

Can cost utility evaluations inform decision making about interventions for low back pain?

PubMed

Dagenais, Simon; Roffey, Darren M; Wai, Eugene K; Haldeman, Scott; Caro, Jaime

2009-11-01

Low back pain (LBP) is associated with high health-care utilization and lost productivity. Numerous interventions are routinely used, although few are supported by strong evidence. Cost utility analyses (CUAs) may be helpful to inform decision makers. To conduct a systematic review of CUAs of interventions for LBP. Systematic review. A search strategy combining medical subject headings and free text related to LBP and health economic evaluations was executed in MEDLINE. Cost utility analyses combined with randomized controlled trials for LBP were included. Studies that were published before 1998, non-English, decision analyses, and duplicate reports were excluded. Search results were evaluated by two reviewers, who extracted data independently related to clinical study design, economic study design, direct cost components, utility results, cost results, and CUA results. The search produced 319 citations, and of these 15 met eligibility criteria. Most were from the United Kingdom (n=8), published in the past 3 years (n=12), studied chronic LBP or radiculopathy (n=13), and had a follow-up >12 months (n=13). Combined, there were 33 study groups who received a mean 2.1 interventions, most commonly education (n=17), exercise therapy (n=13), spinal manipulation therapy (n=7), surgery (n=7), and usual care from a general practitioner (n=7). Mean baseline utility was 0.57, improving to 0.67 at follow-up; the mean difference in utility improvement between study groups was 0.04. Based on available data and converted to US dollars, the cost per quality-adjusted life year ranged from $304 to 579,527 dollars, with a median of 13,015 dollars. Few CUAs were identified for LBP, and there was heterogeneity in the interventions compared, direct cost components measured, indirect costs, other methods, and results. Reporting quality was mixed. Currently published CUAs do not provide sufficient information to assist decision makers. Future CUAs should attempt to measure all known direct cost components relevant to LBP, estimate indirect costs such as lost productivity, have a follow-up period sufficient to capture meaningful changes, and clearly report methods and results to facilitate interpretation and comparison.

Association of Inpatient Antimicrobial Utilization Measures with Antimicrobial Stewardship Activities and Facility Characteristics of Veterans Affairs Medical Centers.

PubMed

Graber, Christopher J; Jones, Makoto M; Chou, Ann F; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew H; Glassman, Peter A

2017-05-01

Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. To determine associations between ASPs and facility characteristics, and inpatient antimicrobial utilization measures in the Veterans Affairs (VA) system in 2012. In 2012, VA administered a survey on antimicrobial stewardship practices to designated ASP contacts at VA acute care hospitals. From the survey, we identified 34 variables across 3 domains (evidence, organizational context, and facilitation) that were assessed using multivariable least absolute shrinkage and selection operator regression against 4 antimicrobial utilization measures from 2012: aggregate acute care antimicrobial use, antimicrobial use in patients with non-infectious primary discharge diagnoses, missed opportunities to convert from parenteral to oral antimicrobial therapy, and double anaerobic coverage. All 130 VA facilities with acute care services. Variables associated with at least 3 favorable changes in antimicrobial utilization included presence of postgraduate physician/pharmacy training programs, number of antimicrobial-specific order sets, frequency of systematic de-escalation review, presence of pharmacists and/or infectious diseases (ID) attendings on acute care ward teams, and formal ID training of the lead ASP pharmacist. Variables associated with 2 unfavorable measures included bed size, the level of engagement with VA Antimicrobial Stewardship Task Force online resources, and utilization of antimicrobial stop orders. Formalization of ASP processes and presence of pharmacy and ID expertise are associated with favorable utilization. Systematic de-escalation review and order set establishment may be high-yield interventions. Journal of Hospital Medicine 2017;12:301-309. © 2017 Society of Hospital Medicine