Estimating the completeness of births and deaths registration in Egypt through dual record systems.
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Africa↗
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Results for “Dual Data Collection”
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Age-related proximal femur bone mineral loss in South Indian women: a dual energy X-ray absorptiometry study.
OBJECTIVES: i) To collect normative data for proximal femur bone mineral density (BMD) in South Indian women using dual energy X-ray absorptiometry (DXA) and ii) to study the rate and significance of hip bone mineral loss with advancing age in this population. MATERIAL AND METHODS: Forty five women, whose age ranged from 16 to 84 years were studied. This sample was drawn randomly from general medical practice at KJ Hospital, Chennai, South India during November, 1997 to April, 1998. Of these 45 cases, 21 were pre-menopausal (mean +/- SD age = 30.9+/-8.8 years) and 24 post-menopausal (mean +/- SD age = 62.1+/-11.0 years). Subjects with secondary bone diseases were excluded. Also excluded were those taking any drugs known to affect calcium metabolism e.g., thiazide diuretics, oestrogen and calcium. Subjects were divided into seven decadal age groups from 15-24 years to 75-84 years. BMD of the right proximal femur was evaluated using a QDR-1000 DXA bone densitometer (Hologic Inc., Waltham, Massachusetts, USA). Data analysis was done with SPSS/PC statistical software package. RESULTS: Linear regression analysis showed significant (p < 0.001) negative correlations between all hip BMD variables at different regions of interest and patient's age. Relative to that at 30 years of age, rates of BMD loss in the neck of femur, trochanter, intertrochanter, total hip and Ward's triangle were 0.68%, 0.65%, 0.58%, 0.61% and 1.05% per annum respectively. Over the age of 65 years, the above mentioned regions BMD decreased by 0.91%, 0.84%, 0.72%, 0.78% and 1.66% per annum respectively. CONCLUSION: Normative data for proximal femur BMD in South India women have been evaluated and it may prove useful for diagnosing osteoporosis in the women of South India.
Adolescent↗
Total error in PES estimates of population.
"We describe a methodology for estimating the accuracy of dual systems estimates (DSE's) of population, census estimates of population, and estimates of undercount in the census. The DSE's are based on the census and a post-enumeration survey (PES). We apply the methodology to the 1988 dress rehearsal census of St. Louis and east-central Missouri and we discuss its applicability to the 1990 [U.S.] census and PES. The methodology is based on decompositions of the total (or net) error into components, such as sampling error, matching error, and other nonsampling errors. Limited information about the accuracy of certain components of error, notably failure of assumptions in the 'capture-recapture' model, but others as well, lead us to offer tentative estimates of the errors of the census, DSE, and undercount estimates for 1988. Improved estimates are anticipated for 1990." Comments are included by Eugene P. Ericksen and Joseph B. Kadane (pp. 855-7) and Kenneth W. Wachter and Terence P. Speed (pp. 858-61), as well as a rejoinder by Mulry and Spencer (pp. 861-3).
Americas↗
'Dual positivity' for neural tube defects and down syndrome at maternal serum screening: gestational outcome.
OBJECTIVE: To evaluate the gestational outcome of pregnancies screen-positive for both neural tube defects (NTD) and Down syndrome (DS) ('dual positivity'). METHODS: Among 10,667 mid-trimester women screened for DS and NTD with alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG), delivered up to July 1996, we have selected cases with both an unexplained AFP value > or = 2.5 multiples of median (MoM) and a DS risk > or = 1:250. All these pregnant women were managed with amniocentesis and/or CVS, ultrasound scans, and Doppler velocimetry. We have collected all data about the gestations with 'dual positivity' and no obvious explanation for these findings (cases with fetal malformations related to raised AFP). RESULTS: Twelve women (1.1:1,000) showed unexplained 'dual positivity'. Abnormal karyotypes were found in 3 fetuses, and pregnancies were terminated: there were 2 triploidies with partial hydatiform mola, and 1 DS. In 9 cases the fetal karyotype was normal, but a confined placental trisomy 16 was found in 4. Of the 9 continuing gestations, 8 displayed fetal growth retardation (FGR). One gestation ended with fetal death at 27 weeks. All 9 fetuses were morphologically normal, and 8 were small for gestational age. CONCLUSIONS: 'Dual positivity' at NTD/DS screening may anticipate pregnancy complications. The finding of trisomy 16 confined to the placenta and FGR in 4 cases suggests that at least some fetuses with growth restriction may suffer from a distinct placental disease. Maternal serum screening may have implications different from DS and NTD, as demonstrated by the 2 cases with triploidy and incomplete hydatiform mola, the 4 cases with placental trisomy 16, and the 4 cases of FGR of the 5 fetuses without chromosome abnormalities. As the pathologic outcome of these pregnancies is more important than the mere serum screening results, we feel that these cases need a strict work-up, including CVS, amniocentesis and ultrasound studies to better address the obstetrical management.
Adult↗
Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders.
OBJECTIVE: Persons with co-occurring severe mental illness and substance use disorders were followed for three years to better understand how they are involved with the legal system and to identify factors associated with different kinds of involvement. METHODS: Data came from a three-year study of 203 persons enrolled in specialized treatment for dual disorders. Cost and utilization data were collected from multiple data sources, including police, sheriffs and deputies, officers of the court, public defenders, prosecutors, private attorneys, local and county jails, state prisons, and paid legal guardians. RESULTS: Over three years 169 participants (83 percent) had contact with the legal system, and 90 (44 percent) were arrested at least once. Participants were four times more likely to have encounters with the legal system that did not result in arrest than they were to be arrested. Costs associated with nonarrest encounters were significantly less than costs associated with arrests. Mean costs per person associated with an arrest were $2,295, and mean costs associated with a nonarrest encounter were $385. Combined three-year costs averaged $2,680 per person. Arrests and incarcerations declined over time. Continued substance use and unstable housing were associated with a greater likelihood of arrest. Poor treatment engagement was associated with multiple arrests. Men were more likely to be arrested, and women were more likely to be the victims of crime. CONCLUSIONS: Effective treatment of substance use among persons with mental illness appears to reduce arrests and incarcerations but not the frequency of nonarrest encounters. Stable housing may also reduce the likelihood and number of arrests.
Adult↗
The effects of census undercount adjustment on congressional apportionment.
"This article shows that undercount adjustment [of the 1990 U.S. census] will probably reallocate one [in] three House seats across the states. The adjustment's impact may depend on the method used and the assumptions underlying undercount estimates. Using regression analysis to reduce sampling error in undercount estimates from dual-systems analysis, however, eliminates sensitivity to all but the most extreme changes in assumptions. Generally, adjustment will more likely affect large states than small ones, and large states with proportionately many urban Black and Hispanic residents will likely gain seats at the expense of large states with few such residents."
Americas↗
Respondent selection by mail: obtaining probability samples of health plan enrollees.
OBJECTIVES: This study was done to assess the feasibility of respondent selection by mail to obtain random samples of both child and adult enrollees of health plans when only subscriber contact information is available. METHODS: The subjects were enrollees of health plans covered under the policies of employees of the State of Washington. Subscribers were eligible for inclusion in the study samples if they had been enrolled for at least 6 months and, depending on the test, had at least one child and/or a spouse enrolled under their policy. Subjects were randomly assigned to six groups: three approaches for sampling children, two approaches for sampling adults, and one test of parents' willingness to return a questionnaire about themselves. Child selection protocols involved asking respondents to complete either a child-only or a dual questionnaire, asking them to follow a decision rule to choose a sample person, and collecting data in two phases, asking respondents to return material twice. RESULTS: Results indicated that asking subscribers to select an adult respondent by mail was not a success. At least given the procedures we used, adults did not demonstrate good compliance with the respondent selection process offered them. In contrast, parents proved willing to follow a more complicated child selection rule and to do it nearly perfectly. CONCLUSIONS: Parents will follow a decision rule to select an eligible child, but requiring this additional respondent selection step may be associated with a slightly decreased response rate. Asking parents to return materials twice is feasible, but it is too cumbersome a procedure to be practical. It is possible to collect data about both an adult and a child using a dual instrument; however, the increase in information is tempered by a decrease in response rates.
Adult↗
Decision support system for the analysis of hospital operation indicators.
The inauguration of national health insurance (NHI) in many countries and their worsening financial condition has increased the sensitivity to operational cost and efficiency in hospitals. For several years, hospitals have been monitoring their operations by analyzing the financial and operational reports that are provided. Because of the rapidly changing character of the medical industry, statistical data shown on paper are no longer sufficient for decision makers. This paper describes a decision support system (DSS) for hospital administrators to assist in analyzing their operations efficiently and precisely. In hospitals, operational data of outpatients and inpatients are now stored on computers, resulting in much easier and faster data acquisition for administrators. The proposed system makes suggestions to hospital administrators and is able to self-learn to improve its future usefulness. With the dual capabilities of integrating evaluations and data collecting, the system can assist administrators in discovering and resolving problems quickly. The system provides multidimensional and multilevel analyses, by using data warehousing techniques, and generates appropriate advice to users by employing decision-making methodology. The self-learning function of the system makes it work like an expert, continually modifying its content (knowledge) and generating advice that is promptly updated to accord with changes in the medical industry.
Age Distribution↗
Combining census, dual-system, and evaluation study data to estimate population shares.
"The 1990 [U.S.] census and Post-Enumeration Survey produced census and dual system estimates (DSE) of population by domain, together with an estimated sampling covariance matrix of the DSE. Estimates of the bias of the DSE were derived from various PES evaluation programs. Of the three sources, the unadjusted census is the least variable but is believed to be the most biased, the DSE is less biased but more variable, and the bias estimates may be regarded as unbiased but are the most variable. This article addresses methods for combining the census, the DSE, and bias estimates obtained from the evaluation programs to produce accurate estimates of population shares, as measured by weighted squared- or absolute-error loss functions applied to estimated population shares of domains."
Americas↗
A nonlinear numerical model of percutaneous drug absorption.
A nonlinear mathematical model developed by Chandrasekaran et al. is examined to monitor pharmacokinetic profiles in percutaneous drug absorption and is addressed to several associated problems that could occur in the data analysis of in vitro experiments. The formulation of the model gives rise to a nonlinear partial differential equation (PDE) of parabolic type, and a family of finite-difference methods is developed for the numerical solution of the associated initial/boundary-value problem. The value given to a parameter in this family determines the stability properties of the resulting method and whether the solution is obtained explicitly or implicitly. In the case of implicit members of the family it is seen that the solution of the nonlinear PDE is obtained by solving a linear algebraic system, the coefficient matrix of which is tridiagonal. The behaviors of two methods of the family are examined in a series of numerical experiments. Numerical differentiation and integration procedures are combined to monitor the cumulative amount of drug eliminated into the receptor cell per unit area as time increases. It is found that the use of the equation for the simple membrane model to estimate the permeability coefficient and lag time is warranted even if the system should be described by the dual-sorption model, provided cumulative amount versus time data collected for a sufficiently long time are used. However, being different from the behavior in the simple membrane model, the lag time, which can be estimated in this way, is dose-dependent and decreases with increasing donor cell concentration. On the other hand, the permeability coefficient in the dual-sorption model remains constant irrespective of the donor cell concentrations as in the simple membrane model.
Administration, Cutaneous↗
The dynamic responses of pro-inflammatory and anti-inflammatory cytokines of human mononuclear cells induced by uromodulin.
This study was undertaken to examine the dynamic response of human peripheral blood mononuclear cells (PBMC) in the secretion of proinflammatory and anti-inflammatory cytokines induced by uromodulin (URO). Levels of tumor necrosis factor-alpha (TNFalpha), TNF soluble receptor (sTNFRI and II), interleukin 1-beta (IL-1beta), and IL-1 receptor antagonist (IL-1Ra) in the supernatants of URO-stimulated PBMC were measured by ELISA. URO stimulated the secretion of all these cytokines in a dose dependent manner except sTNFRI. Peak levels of TNFalpha and IL-1beta were reached at 6-12 h, while 5-10 fold higher in sTNFR II and IL-1Ra levels were observed at 24-48 h after URO stimulation. URO-induced secretion of TNFalpha, IL-1beta, sTNFRII and IL-1Ra could be enhanced by human plasma. Specifically, serum proteins including C3, sCD14 and IgG not only bound to URO but also enhanced URO-induced TNFalpha secretion of PBMC. Collectively, our data suggest that URO might have dual immunomodulating effect through regulating the secretion of proinflammatory and anti-inflammatory cytokines, and that serum binding proteins might enhance this activity.
Adjuvants, Immunologic↗
Image-guided central venous catheters for apheresis.
Apheresis is an increasingly important procedure in the treatment of a variety of conditions, sometimes performed via peripheral access because of concern over major complications associated with central venous catheter (CVC) placement. This study sought to determine the safety and success for ultrasound and fluoroscopically guided, non-tunneled dual lumen CVCs placed for apheresis. Prospective data collection was made of 200 attempted CVC placements in the radiology department utilizing real time sonographic guidance. The complications relating to placement were noted in all and the number of passes required for venepuncture and whether a single wall puncture was achieved was recorded in 185 cases. Duration of catheterization and reason for line removal were recorded in all. Our study group included 71 donors providing peripheral blood stem cells for allogeneic transplant. CVCs were successfully placed in all patients, 191 lines in the internal jugular and seven in the femoral vein. 86.5% required only a single pass and 80.5% with only anterior wall puncture. Inadvertent but clinically insignificant arterial puncture occurred in six (3%) cases. In no case did this prevent line placement. There were no other procedure-related complications. 173 (87.4%) catheters were removed the same day. No catheters were removed prematurely. There was one case of prolonged venous bleeding. Our study demonstrates the safety of central venous catheters for apheresis provided that duration of catheterization is short and real-time sonographic guidance is used for the puncture, and guide wire and catheter placement are confirmed fluoroscopically.
Adolescent↗
Bone densitometry of the peripheral skeleton with a new photon counting and imaging device.
We present a new method for the assessment of bone mineral content of the peripheral skeleton. The method employs a new photon counting and imaging area device, the multi-wire proportional counter. The system can work as a single photon absorptiometer at the energies of both I-125 and Gd-153. It can work also as a dual photon absorptiometer using one of the two pairs of isotopes (I-125, Gd-153) or (I-125, Am-241). Both the calcaneus and the forearm can be imaged in a few minutes, with either single or dual photon absorptiometry. To test this new method in a clinical environment we compared it with the standard dual photon absorptiometry of the forearm. The data collected in a cross-sectional study of bone mineral content and bone mineral density in a group of 76 patients show a good correlation between the two measurement techniques (r = 0.931). The multi-wire proportional counter, due to its imaging capabilities, has a much lower repositioning error. This allows its use in regions with a large gradient of bone mineral density, such as the calcaneus or the very distal site of the forearm, which recent data have indicated to be superior to more proximal measurements in identifying osteoporosis.
Absorptiometry, Photon↗
Effects of a minimal intervention to increase physical activity in women: daily activity records.
BACKGROUND: Effective interventions to increase physical activity levels are critical in a nation where inactivity is a national public health problem. OBJECTIVE: This pilot study examined whether a minimal intervention (daily records of physical activity) increased activity levels in a community sample of working women. METHODS: In a longitudinal, pretest-posttest design, 49 working women were randomly assigned at the work site level to the control (n = 25) or intervention group (n = 24). At pretest and posttest, subjects completed self-report questionnaires that measured psychological, social-environmental, physical activity, and demographic variables. Subjects in the intervention group kept daily records of their physical activities during the 12-week study, while those in the control group kept no records. In order to compare activity in the two groups, all subjects wore pedometers daily that recorded number of steps. RESULTS: There was a significant difference between groups in the pedometer values (mean number of daily steps) at the end of the study period (mean difference +/- SE 2147 +/- 636, p = .022) (2000 steps = approximately 1 mile). Multiple regression analysis showed that only the intervention (p = .003) was a significant predictor of the pedometer values. Hierarchical data analysis was used to account for the intra-class correlation of 0.48 within work site. CONCLUSION: Results from this sample of 49 women indicated that mean activity was greater in the intervention group compared to the control group. Recording daily activity is a cost-effective and acceptable intervention that may increase activity levels in women. However, more research is recommended to study the dual role of activity records as a data collection method as well as a potential intervention to increase physical activity.
Adult↗
Development, implementation, and validation of the Canadian Intercollegiate Sport Injury Registry.
PURPOSE: To outline the development and implementation of the Canadian Intercollegiate Sport Injury Registry (CISIR), to examine its validity, including the data collection forms, the recording of athlete exposure, and the mechanism of injury, and to determine the ability of the CISIR to meet its stated objectives of assessing rates and risk of injury. DESIGN: Prospective cohort study. SETTING: Canadian intercollegiate athletics. SUBJECTS: 344 varsity football players from five western Canadian universities. ASSESSMENT OF RISK FACTORS AND OUTCOME MEASURES: Three data collection instruments were developed to capture the principle types of information forming the cornerstones of the CISIR: a medical form for preseason assessment of risk factors, a weekly exposure sheet (WES) for the documentation of daily individual athlete participation, and an individual injury report form (IIRF) for collection of injury-related information. Design and implementation input was provided by therapists and physicians through initial meetings, pilot testing, site visits, questionnaire, and final consensus meeting. The completeness of injury reporting was assessed through cross-referencing with participation time loss data. An item analysis was conducted on the principal elements of the IIRF. The categorization of participation itself was also examined, as was the diagnostic agreement between the therapists and physicians involved in data collection. The recorded mechanism of injury was compared with that noted through a video analysis for game-related injuries. Lastly, a test analysis was conducted to extract data and compute rates and risks of injury. RESULTS: This developmental phase was successful, with 99.7% subject enrollment, high therapist satisfaction, and good flow of data. A relational database, incorporating dual-entry data verification, was designed and functioned well. The collection process revealed that 100% of the WESs were submitted, and the data therein was 99.7% complete. The injuries resulting in participation time loss were recorded on an IIRF 97.9% of the time. The exposure (participation) codes were thought to be overly precise, and a simplification of these categories is suggested. The diagnostic agreement between physicians and therapists was 70%. It was possible to validate game exposures, but no standard was identified to permit validation of the categories of exposure. Likewise, the mechanism of injury as recorded by the therapists was thought to be more precise than the video analysis. After two modifications in the table structure of the relational database, it was possible to extract data relating to rates and risks of injury. CONCLUSIONS: This study demonstrated a high degree of validity for many elements of the CISIR. One limitation was that no reference standard existed for some components, limiting some aspects of validity assessment. With the suggested revisions, the CISIR represents the current standard in athletic injury reporting in terms of individual injury risk assessment. This system will be used in the future to explore the prediction and prevention of sport injuries.
Adult↗
Dual-function foot orthosis: effect on shock and control of rearfoot motion.
Orthoses have been designed that claim to both reduce shock and control rearfoot motion. It was hypothesized that the dual-purpose soft orthosis would reduce shock and control rearfoot motion greater than a no-orthotic condition. Three-dimensional kinematic and kinetic data were collected along with tibial acceleration while subjects ran in no-orthotic, the dual-purpose orthotic, and a rigid orthotic condition. Variables of interest were eversion excursion, peak eversion, eversion velocity, peak positive acceleration, loading rate, and leg stiffness. None of the evaluated variables were significantly different (p = .05) between the three conditions. These data suggest that shock attenuation and rearfoot motion cannot be controlled by the orthoses used in this study for a group of healthy runners.
Adolescent↗
Household tobacco smoke exposure is negatively associated with premenopausal bone mass.
Subjects exposed to environmental tobacco smoke have been found to be at increased risk for several health problems. Whether exposure to passive tobacco smoke is associated with reduced bone mineral density (BMD) is unknown. In order to examine this, we measured BMD in 154 healthy premenopausal women (age range 40-45 years). BMD of the total hip, femoral neck, lumbar spine and total body was measured by dual-energy X-ray absorptiometry (DXA). Data were collected on exposure to household tobacco smoke from age 10 years to the present as well as on other lifestyle factors related to bone mass. We found that 67.5% of the subjects had a history of household tobacco smoke exposure. Subjects exposed to household tobacco smoke had a mean adjusted BMD that was significantly lower at the total hip ( p = 0.021) and femoral neck ( p = 0.018) compared with subjects who were not exposed. In addition, duration of household tobacco smoke exposure was negatively associated with BMD at the total hip ( p = 0.010), femoral neck ( p = 0.004), lumbar spine ( p = 0.037) and total body ( p = 0.031). Subjects exposed to household tobacco smoke for 15 years or more had mean adjusted BMD that was 4% lower at the total body, and more than 8% lower at the total hip, femoral neck and lumbar spine, compared with subjects who were not exposed. In conclusion, household tobacco smoke exposure during adolescence and young adulthood was found to be negatively associated with BMD at the total hip and femoral neck, and duration of exposure was negatively associated with BMD at the total hip, femoral neck, lumbar spine and total body in premenopausal women.
Absorptiometry, Photon↗
Persistence of muscle catabolism after severe burn.
BACKGROUND: The hypermetabolic response to severe burn is characterized by muscle protein catabolism. Current opinion states that the hypermetabolic state resolves soon after complete wound closure. Clinically, we have witnessed that burned children appear to be hypermetabolic and catabolic long after full healing of their wounds. Our goal in this study was to determine scientifically if burn-associated hypermetabolism persists after full wound healing. METHODS: To determine the duration of muscle catabolism and systemic hypermetabolism after severe burn in children, patients with > 40% total body surface area burns were enrolled in a prospective, longitudinal study; resting energy expenditure was measured by indirect calorimetry, muscle protein kinetics were determined by using stable isotopic methodology, and body composition was measured by dual-energy x-ray absorptiometry imaging. Data were collected at 6, 9, and 12 months after injury. RESULTS: The mean total body surface area burned was 65% +/- 13%, and the mean age was 7.6 +/- 1. 5 years. Resting energy expenditure was elevated above the predicted age-matched levels from the Harris-Benedict equation and incrementally declined throughout the 12-month study. The net protein balance and lean mass reflected catabolic persistence at 6 and 9 months after severe burn. Between 9 and 12 months, protein breakdown decreased, net protein balance improved, and lean body mass increased. CONCLUSIONS: In severely burned children, hypermetabolism and catabolism remain exaggerated for at least 9 months after injury. This suggests that therapeutic attempts to manipulate the catabolic and hypermetabolic response to severe injury should be continued long after injury.
Absorptiometry, Photon↗