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At least 505 records · Page 28Linked to original sources

PubMed2005

[Self-evaluation of the quality of life of children aged 6 to 12 years old: construction and first steps in the validation of kidlQol, a generic computer-based tool].

The KidlQol is a self-evaluation computer-based instrument to assess the quality of life of children aged 6 to 12 years old. This self-evaluation comprises three areas of their subjective quality of life: physical, psychological and social. A computer-assisted tool, composed of 62 items, was developed and set up based upon the results from the evaluation of the initial prototype tool which underwent a series validation steps, tested among children with and without psychological problems. This evaluation lead to the production of a final tool called KidlQuol, which is composed of 44 items. This tool, which utilises computer images to represent real-life situations, is adapted for and accessible to children with a French cultural background aged between 6 and 12 years old. As a generic tool, it could be used among a population of children with various types of handicaps, chronic diseases or psycho-social difficulties.

Child↗

PubMed2001

Using student-collected practice data as a teaching tool.

Research is an intimidating prospect for many students. This brief and fairly simple foray into data collection and analysis did not convince all students to embrace research. It did, however, entice many to consider how to incorporate data collection into their own beginning practices. Students who had stated their aversion to research found themselves arguing for the necessity of data collection to provide evidence for practice changes. There were also students who found the experience yet another busywork paper trail invented by the faculty. They resented the time and effort required for completion of another form during their busy clinical experiences. Other students remained adamantly opposed to considering any changes in what they saw as "appropriate" practice despite evidence to the contrary. An ongoing goal of education is to facilitate lifelong learning and investigation into clinical questions. The faculty plan to survey the graduates to ascertain what data collection efforts, if any, they are currently using. The educational program described in this project closed in December 1998 because of funding restrictions. One of the faculty in this project (Carr) and current colleagues are continuing to use the NMCDS to encourage students to examine and analyze their own practices. An additional use of the data set is for student-initiated research projects that focus on specific clinical questions. One faculty member was part of an effort to institute a similar project in a master's-based nurse-midwifery education program. That database has currently provided data for two master's degree projects. The uses of the NMCDS are not limited to graduate students or advanced practice clinicians. The tool is being used in an undergraduate maternity nursing clinical course to assist students in seeing differences in practice and the possible reasons for those differences. The Division of Research of the ACNM has sponsored the development of similar data collection tools for both ambulatory prenatal and well-woman care. The wellwoman tool is currently in the pilot stage (1999), and will be refined and further tested this year. The use of these data collection tools by advanced practice nurses would provide a wealth of data for both policy setting and clinical research. Educational programs frequently combine coursework for various advanced practice nursing pathways, and nurse-midwifery and nurse practitioner students would benefit from jointly focusing on practice patterns and participating in the analysis of student-collected data. The standardized tools for intrapartum, well-woman care, and antepartum care will be available to all of the 50 ACNM education programs as well as to practicing clinicians.

California↗

PubMed1987

The effects of tool scarcity on group climate and affective meaning within the context of a stenciling activity.

Occupational therapists conducting activity analyses often consider the effects of supplies and tools on group process. This study compared three levels of tool supply within the context of a stenciling activity: high scarcity (one essential tool per three subjects), moderate scarcity (two essential tools per three subjects), and no scarcity (three essential tools per three subjects). Thirty-six female subjects rated the activity using Osgood's short-form semantic differential and MacKenzie's Group Climate Questionnaire-Short Form. The data supported the hypothesis of higher group engagement scores in the moderate level of supply than in the high-scarcity or no-scarcity conditions. Though low in all conditions, conflict scores were especially low in the moderate scarcity condition. An unexpected result was found: Subjects experiencing high scarcity had the shortest completion time. No differences between the three supply levels in terms of affective meaning were found. The findings are discussed in terms of the literature of small groups and occupational therapy theory.

Adolescent↗

PubMed1991

Perceptions of role assessment tools in the physical disability setting.

Various role assessment tools in occupational therapy have been developed to help the clinician understand role performance and role adjustment and guide the structure of intervention. This study was designed to examine the clinician's perceptions of standardized role assessment tools in physical disability settings. A random sample of 450 occupational therapists was surveyed to learn about therapists' knowledge of four published role assessment tools. The study also examined the frequency of tool use in the acute care hospital, the rehabilitation center, and the long-term care facility. The results from 236 questionnaires (a 52% response rate) indicated that more than half of the respondents reported that their current initial evaluation did not effectively address role performance. Additionally, most of the therapists surveyed had a poor understanding of the four standardized role assessment tools, and only 5% were using an assessment instrument in their practice. The respondents reported a desire to learn more about these instruments and how they affect treatment planning. Training implications, educational opportunities, and recommendations for future research are discussed.

Attitude to Health↗

PubMed1993

Tool box-based cardiac volumes: visualization and quantitation by computed tomography.

Volumetric image display and analysis techniques have been under development to support x-ray computed tomographic (CT) imaging of the heart and lungs since the mid 1970s when investigators began to understand the image analysis requirements for the Dynamic Spatial Reconstructor. With the spread of Imatron's C-100 scanners (Imatron, South San Francisco, CA) around the world along with the development of slower helical scanners that generate volumetric information, there is an increased interest in the use of volume visualization and analysis tools to study the cardiopulmonary system. An historic overview of the development of such volume visualization for x-ray CT scanning is given along with a discussion of techniques for data acquisition, volumetric display, and image quantitation. We further show throughout the discussion how the integration of tools into a comprehensive image display and analysis software package (the tool box) enhances the utility of the individual tools. An example of such a tool box is given in a discussion of an X Windows-based package dubbed VIDA.

Cardiac Volume↗

PubMedDate not supplied

Tools used to help community pharmacists implement comprehensive pharmaceutical care.

OBJECTIVE: To describe the tools and processes used in the practice enhancement program (PEP) of the Pharmaceutical Care Research and Education Project to enable community pharmacists to acquire the necessary skills, knowledge, and attitudes to deliver comprehensive pharmaceutical care to elderly ambulatory patients. SETTING: Independent community pharmacies in Alberta. PRACTICE DESCRIPTION: The PEP was designed to allow self-directed learning in a problem-based environment. The intent was for pharmacists to apply the knowledge they gained to improve drug therapy outcomes. PRACTICE INNOVATION: As a systematic approach to providing care, several tools were adapted to help pharmacists execute tasks required by the nine steps of the pharmaceutical care process proposed by Helper and Strand. These tools and processes facilitated (1) self-directed learning about diseases and drugs, (2) acquisition of relevant patient data, (3) a consistent and stepwise approach to the identification and resolution of drug-related problems, (4) documentation of care provided, and (5) continuity of care. RESULTS: To help pharmacists in the PEP acquire the necessary competency to provide pharmaceutical care, they were required to use the tools and processes described herein to work up and resolve patient problems. Initially, patient problems were presented as paper cases covering a range of acute and chronic problems, including topics applicable to geriatric patients. This was followed by a practicum phase wherein patient problems represented individuals from among their clientele. CONCLUSION: The tools and processes used in the project increased community pharmacists' competency for providing pharmaceutical care, by helping them develop the needed skills, knowledge, and attitudes.

Aged↗

PubMed2000

Modeling and modification of medical 3D objects. The benefit of using a haptic modeling tool.

The Computer Laboratory of the medical faculty in Goteborg (Mednet) has since the end of 1998 been one of a limited numbers of participants in the development of a new modeling tool together with SensAble Technologies Inc [http:¿www.sensable.com/]. The software called SensAble FreeForm was officially released at Siggraph September 1999. Briefly, the software mimics the modeling techniques traditionally used by clay artists. An imported model or a user defined block of "clay" can be modified using different tools such as a ball, square block, scrape etc via the use of a SensAble Technologies PHANToM haptic arm. The model will deform in 3D as a result of touching the "clay" with any selected tool and the amount of deformation is linear to the force applied. By getting instantaneous haptic as well as visual feedback, precise and intuitive changes are easily made. While SensAble FreeForm lacks several of the features normally associated with a 3D modeling program (such as text handling, application of surface and bumpmaps, high-end rendering engines, etc) it's strength lies in the ability to rapidly create non-geometric 3D models. For medical use, very few anatomically correct models are created from scratch. However, FreeForm features tools enable advanced modification of reconstructed or 3D scanned models. One of the main problems with 3D laserscanning of medical specimens is that the technique usually leaves holes or gaps in the dataset corresponding to areas in shadows such as orifices, deep grooves etc. By using FreeForms different tools, these defects are easily corrected and gaps are filled out. Similarly, traditional 3D reconstruction (based on serial sections etc) often shows artifacts as a result of the triangulation and/or tessellation processes. These artifacts usually manifest as unnatural ridges or uneven areas ("the accordion effect"). FreeForm contains a smoothing algorithm that enables the user to select an area to be modified and subsequently apply any given amount of smoothing to the object. While the final objects need to be exported for further 3D graphic manipulation, FreeForm addresses one of the most time consuming problems of 3D modeling: modification and creation of non-geometric 3D objects.

Computer Simulation↗

PubMed2001

Assessment of clinical partner violence screening tools.

OBJECTIVE: To compare the Women's Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV). METHODS: We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range of mental and physical health indicators known to be associated with IPV. RESULTS: 18% of 1152 eligible women surveyed had experienced IPV in a current or most recent intimate relationship with a male partner; 17% had been battered (WEB+), and 10% had been physically assaulted (ISA-P+). Had we used the ISA-P alone to assess IPV, we would have missed almost 45% of IPV. As anticipated, the ISA-P was more strongly associated with IPV-associated injuries and number of physician visits in the last year. The WEB was more strongly associated with self-perceived mental health, anxiety, depression, drug abuse, and low social support. CONCLUSION: Clinicians need validated screening tools to rapidly and reliably screen patients for IPV. Most screening tools assess physical violence and injury without considering the more chronic experience of battering and the psychological terror associated with this violence. The WEB may identify more abused women than tools measuring physical assaults.

Adult↗

PubMedDate not supplied

[A new decision support tool in the campaign against maternal mortality: the Dystocia Risk Score].

At Ziguinchor Regional Hospital (ZRH) in Senegal, 80% of maternal deaths are associated with late referral of dystocia cases. The gynecology and obstetrics team of the ZRH, in collaboration with the teaching staff of the Institute of Health and Development (ISED), tried to find ways to combat maternal mortality and stillbirth, based on double-entry contigency tables and a logical framework. We developed a tool more elaborate than a simple decision tree: the dystocial risk score. This tool has three components: A column provides a list of eight characteristics to check for in the woman: history of cesarean section, limping, less than 150 cm in height, no living child, less than 18 years old, more than 35 years old, other risk factors, no risk factors. A horizontal section provides a checklist of possible outcomes of the pregnancy itself: obstacle praevia, precedence, noncephalic presentation, uterine length of over 35 cm, loss of amniotic fluid over 12 hours or more, other abnormalities, no abnormalities. A rectangular grid indicates the prognosis. This grid consists of three zones: a large blue zone (dangerous), a medium-sized grey zone (doubtful) and a small blue zone (hopeful). A positive DRS is obtained if there is at least one cross in the dangerous zone and/or at least two crosses in the doubtful zone. If these conditions are not fulfilled, the DRS is negative. A positive DRS indicates that the woman should be referred to a center specialized in obstetric emergency care. This tool was validated in a study of 376 pregnant women carried out over a period of six months. It was found to have a sensitivity of 83.6%, a specificity of 90.1%, a positive predictive value of 72.3% and a negative predictive value of 94.1%. The DRS is a simple, easy-to-use decision-making tool. The large-scale use of this tool (by midwives, chief nurses and health workers) would accelerate the identification of pregnant women with a high risk of dystocia. The timely referral of these women to specialized emergency obstetrics centers would increase the efficacy of care and would reduce the levels of maternal mortality and stillbirth.

Decision Support Techniques↗

PubMed2001

[Aid tool for the assessment of health measures performance: the example of the program for alcoholism prevention in Lorraine].

From "alcohol primary prevention program in Lorraine", the authors developed a tool for an evaluation of performance: a card index to assess each action of the program. This tool can be applied to various programs, in particular health regional ones. Before presenting the tool, the authors specify conceptual frameworks to which they refer and present the evaluation of performance step which is declined in "evaluation of the results" and "evaluation of the processes". This assessment combine an understanding and a data based approaches. They show how those two kinds of assessment meet different and complementary aims. The tool presented includes 9 cards. The first 8 cards joined together in a booklet make possible a description and evaluation of each contributive action to the program. A ninth card gives a synthesis view to follow and assess the entire program in comparison with the starting reference frame. The publication of this perfectible tool is a call to practices exchanges between professionals in load of health programs.

Alcoholism↗

PubMed2001

[Evaluation of medical web sites. Interobserver and intraobserver reliability of an evaluation tool].

OBJECTIVE: To develop and test the reliability of a tool for rating websites that provide information on evidence-based medicine. DESIGN: For each site, 60% of the score was given for content (eight criteria) and 40% was given for organization and presentation (nine criteria). Five of 10 randomly selected sites met the inclusion criteria and were used by three observers to test the accuracy of the tool. Each site was rated twice by each observer, with a 3-week interval between ratings. SETTING: Laval University, Quebec city. PARTICIPANTS: Three observers. MAIN OUTCOME MEASURES: The intraclass correlation coefficient (ICC) was used to rate the reliability of the tool. RESULTS: Average overall scores for the five sites were 40%, 79%, 83%, 88%, and 89%. All three observers rated the same two sites in fourth and fifth place and gave the top three ratings to the other three sites. The overall rating of the five sites by the three observers yielded an ICC of 0.93 to 0.97. An ICC of 0.87 was obtained for the two overall ratings conducted 3 weeks apart. CONCLUSION: This new tool offers excellent intraobserver and interobserver measurement reliability and is an excellent means of distinguishing between medical websites of varying quality. For best results, we recommend that the tool be used simultaneously by two observers and that differences be resolved by consensus.

Evaluation Studies as Topic↗

PubMedDate not supplied

The estimate of cardiovascular risk. Theory, tools and problems.

The present article reviews the epidemiological and statistical bases of the multivariate prediction of cardiovascular events and its transformation into practical tools for primary prediction. The problems with the use of tools derived from studies conducted in populations that are different from those in which the estimate is being made are documented. A description is made of a number of predictive tools produced in the past and recently included in risk manuals, charts and computer programs and their main characteristics are outlined. The problems in the origin, structure and use of the chart suggested by the Task Force of three European Scientific Societies, including the marked overestimate of the risk when this tool is applied to Italian data, are reviewed in detail. The need to use predictive tools derived from Italian population studies is stressed. Comments are made on the difficult choice between the use of the absolute and relative risks for the identification of high-risk subjects to be treated on an individual basis for primary prevention of major cardiovascular diseases.

Adult↗

PubMed2003

Enhancing compliance at Department of Defense facilities: comparison of three environmental audit tools.

To enhance environmental compliance, the U.S. Department of Defense (DOD) recently developed and implemented a standardized environmental audit tool called The Environmental Assessment and Management (TEAM) Guide. Utilization of a common audit tool (TEAM Guide) throughout DOD agencies could be an effective agent of positive change. If, however, the audit tool is inappropriate, environmental compliance at DOD facilities could worsen. Furthermore, existing audit systems such as the U.S. Environmental Protection Agency's (U.S. EPA's) Generic Protocol for Conducting Environmental Audits of Federal Facilities and the International Organization for Standardization's (ISO's) Standard 14001, "Environmental Management System Audits," may be abandoned even if they offer significant advantages over TEAM Guide audit tool. Widespread use of TEAM Guide should not take place until thorough and independent evaluation has been performed. The purpose of this paper is to compare DOD's TEAM Guide audit tool with U.S. EPA's Generic Protocol for Conducting Environmental Audits of Federal Facilities and ISO 14001, in order to assess which is most appropriate and effective for DOD facilities, and in particular those operated by the U.S. Army Corps of Engineers (USACE). USACE was selected as a result of one author's recent experience as a district environmental compliance coordinator responsible for the audit mission at this agency. Specific recommendations for enhancing the quality of environmental audits at all DOD facilities also are given.

Environmental Pollutants↗

PubMed2002

A 3-Dimensional Analysis of Face-Mask Removal Tools in Inducing Helmet Movement.

OBJECTIVE: To evaluate the performance of specific face-mask removal tools during football helmet face-mask retraction using 3-dimensional (3-D) video. DESIGN AND SETTING: Four different tools were used: the anvil pruner (AP), polyvinyl chloride pipe cutters (PVC), Face Mask (FM) Extractor (FME), and Trainer's Angel (TA). Subjects retracted a face mask once with each tool. SUBJECTS: Eleven certified athletic trainers served as subjects and were recruited from among local sports medicine professionals. MEASUREMENTS: We analyzed a sample of movement by 3-D techniques during the retraction process. Movement of the head in 3 planes and time to retract the face mask were also assessed. All results were analyzed with a simple repeated-measures one-way multivariate analysis of variance. An overall efficiency score was calculated for each tool. RESULTS: The AP allowed subjects to perform the face-mask removal task the fastest. Face mask removal with the AP was significantly faster than with the PVC and TA and significantly faster with the TA than the PVC. The PVC and AP created significantly more movement than the FME and TA when planes were combined. No significant differences were noted among tools for flexion-extension, rotation, or lateral flexion. The AP had an efficiency score of 14; FME, 15; TA, 18; and PVC, 35. CONCLUSIONS: The subjects performed the face-mask removal task in the least amount of time with the AP. They completed the task with the least amount of combined movement using the FME. The AP and FME had nearly identical overall efficiency scores for movement and time.

Journal Article↗

PubMed2003

Comparison of a malnutrition screening tool with subjective global assessment in hospitalised patients with cancer--sensitivity and specificity.

Malnutrition is common in hospitals and it is important to implement an appropriate nutrition screening tool to identify patients at risk. The aim of the study was to assess the sensitivity and specificity of the malnutrition screening tool developed by the Malnutrition Advisory Group of the British Association of Parenteral and Enteral Nutrition against subjective global assessment in hospitalised patients with cancer. A cross-sectional study assessing the risk of malnutrition and nutritional status of sixty-five hospitalised patients with cancer, aged 56 +/- 15 years. According to subjective global assessment, 25 % of patients were well nourished and 75% were malnourished (63% were moderately or suspected of being malnourished and 12% severely malnourished). The malnutrition screening tool had a low sensitivity of 59% and a specificity of 75%. The positive predictive value was 88% and the negative predictive value 38%. There were significant linear trends between subjective global assessment classification and percentage weight loss in the previous six months (P < 0.001) and body mass index (P = 0.007). The malnutrition screening tool developed by the Malnutrition Advisory Group of the British Association of Parenteral and Enteral Nutrition is not a suitable screening tool for detecting risk of malnutrition in hospitalised patients with cancer.

Australia↗

PubMed2003

Implementing the push tool in clinical practice: revisions and results.

The ability to measure outcomes is increasingly important in the practice of medicine. For wound care, the Pressure Ulcer Scale for Healing tool was developed to assess and standardize wound healing progress. However, for a variety of reasons, use of the tool to monitor an individual patient's wounds is not widespread. Following revisions to the tool for the purpose of capturing system-wide wound outcomes data, a prospective study in two long-term, acute care hospitals was conducted. Admission and discharge wound scores from 374 patients (989 wounds), representing 13,737 patient-days of care were obtained and recorded to document overall progress of healing and to calculate healing as a function of time. The results obtained are now used as a benchmark in the participating facilities and can be used by others to gauge the effectiveness of care. Although these tools cannot provide information about the effectiveness of specific interventions, and the data will always require careful interpretation by thoughtful wound providers, results of this study show that, at this time, the revised Pressure Ulcer Scale for Healing may be the best tool available for comparing healing outcomes.

Humans↗

PubMed2003

A comparison of pain-assessment tools for use with elderly long-term-care residents.

The purpose of this study was to examine the psychometric properties (test-retest and interrater reliability, criterion concurrent validity) of 3 verbal pain-assessment tools (Faces Pain Scale, Numerical Rating Scale, Present Pain Intensity Scale) and a behavioural pain-assessment scale for use with an elderly population. The study used a repeated-measures design to examine the reliability and validity of the tools across 4 groups of participants with varying levels of cognitive impairment using a non-random stratified sample of 130 elderly long-term-care residents. The findings support the test-retest and interrater reliability of the behavioural pain-assessment tool across all levels of cognitive impairment, whereas the same measures of reliability for the verbal-report tools decreased with increasing cognitive impairment; however, the majority of elderly with mild to moderate cognitive impairment were able to complete at least 1 of these tools. The findings are discussed in relation to their clinical and research implications.

Aged↗

PubMed2003

A software tool for the graphical visualization of large and complex populations.

Pedigree drawing is an essential tool in genetic and genealogical studies. A genetic analysis of a disease often starts with drawing a pedigree to show the overall population structure, the relationship among individuals, and gene flows from generation to generation. Such a graphical presentation of a pedigree is valuable for understanding the nature of the disease such as inheritance mode and familial trends and of the disease, for tracing the source of a detrimental gene, and for identifying the founders of the population. A genealogy study typically requires a pedigree drawing to show relationships among individuals. However, as the size and complexity of a pedigree increase, drawing a clear pedigree becomes a challenge. Pedigraph has been created to solve this problem. We developed a software tool named Pedigraph capable of creating artistic graphical pedigree drawings of large and complex populations with flexible options for pedigree analysis. Preliminary tests show that this software tool has great potential to be a useful tool for research in breeding, genetics and genomics in plants, animals, and zoo species, as well as a useful tool for studying history and human populations.

Computer Graphics↗