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At least 577 records · Page 32Linked to original sources

PubMed1993

Objective evaluation of 3-D radiation treatment plans: a decision-analytic tool incorporating treatment preferences of radiation oncologists.

PURPOSE: Selecting the optimal radiation treatment plan from a set of competing plans involves making trade-offs among the doses delivered to the target volumes and normal tissues by the competing plans. Evaluation of 3-dimensional radiation treatment plans is difficult because it requires the review of vast amount of graphical and numerical data. We have developed an objective plan-ranking model based on the concepts of decision analysis. METHODS AND MATERIALS: Our model ranks a set of tentative radiation treatment plans from best to worst. A figure of merit is computed for each plan based on probabilities of possible clinical complications such as non-eradication of the tumor and radiation induced damage to the nearby healthy normal tissues, and weights which indicate their clinical relevance. This figure of merit is used to rank the plans. Key issues addressed by the model include the incorporation of individual treatment preferences of the radiation oncologist and clinical features of the patient. RESULTS: A methodology has been established for eliciting the treatment preferences of radiation oncologists. Results of this elicitation, and examples of several plan evaluations are presented. An interactive computer-based tool has been developed as one of a set of tools to assist in the evaluation of 3-dimensional radiation treatment plans. CONCLUSION: The paper presents a decision-analytic model incorporating radiation oncologists' treatment preferences and an interactive computer-based tool for objectively ranking competing radiation treatment plans. The tool can be used by radiation oncologists for the evaluation of competing plans, or as part of a system which tries to automatically generate optimal treatment plans using mathematical or symbolic techniques.

Decision Support Techniques↗

PubMed2006

Prepackaged hand hygiene educational tools facilitate implementation.

The Healthcare Infection Control Practices Advisory Committee released hand hygiene guidelines recommending that hospitals educate personnel to increase compliance with hand hygiene. However, few educational tools are available to assist hospitals in this effort. Eight hospitals were recruited to implement hand hygiene educational tools. Key informant interviews were conducted with infection control professionals (ICPs) at 5 participating hospitals. Lack of personnel time was the primary barrier to implementing the educational tools. Multimodal, prepackaged educational tools are needed to decrease barriers and facilitate implementation of interventions locally by ICPs.

Georgia↗

PubMed2004

Predicting vaginal birth after cesarean delivery: a review of prognostic factors and screening tools.

OBJECTIVE: Our purpose was to identify the factors associated with vaginal delivery after trial of labor in patients with a prior cesarean and to evaluate the effectiveness of existing screening tools. STUDY DESIGN: Studies were identified through MEDLINE and HealthSTAR (1980-2002), reference list reviews, and suggestions of national experts. RESULTS: Thirteen of the 100 eligible studies provided fair to good quality evidence for the predictive nature of 12 factors. Two of the six screening tools were considered promising and demonstrated reproducibility through validation studies. CONCLUSIONS: There is little high-quality data to guide clinical decisions regarding which women are likely to have a successful trial of labor. Although we identified two validated screening tools that may be reasonable for practitioners to use, further development is needed to deliver them in a user-friendly manner and further research is needed to determine the clinical setting in which they are most useful. Conducting high-quality research on the factors that delineate women who are at higher likelihood of vaginal delivery without complications and developing accurate user-friendly screening tools to integrate these data should be a national research priority.

Decision Making↗

PubMed2006

Assessment of medication management by community-living elderly persons with two standardized assessment tools: a cross-sectional study.

BACKGROUND: The ability of patients to adhere to a medication regimen is imperative for achieving optimal outcomes. Elderly patients, especially those with memory loss, should be evaluated for their ability to manage medications to prevent significant drug-related problems. Assessment tools to determine the ability to manage medication therapy have not been tested in elderly patients with cognitive impairment. OBJECTIVES: This study compared the Medication Management Ability Assessment (M1V1AA) and the Drug Regimen Unassisted Grading Scale (DRUGS) as standardized tools to assess medication management skills in elderly patients with a range of cognitive function and evaluated the association between the results obtained from these scales and self-reported drug-related problems. METHODS: This was a cross-sectional study of older individuals living in the community. At a scheduled study visit, the research assistant (RA) questioned participants with a structured interview to document demographic information, medical history, prescription use, over-the-counter drug and dietary supplement use, health care resource use, medication management practices, and adverse drug events. Cognitive status was assessed with the Mini-Mental State Examination (MMSE) and functional status with the instrumental activities of daily living rating scale. The MMAA, which uses a fictitious medication regimen with labeled prescription bottles, and the DRUGS, which uses the patient's own prescription bottles, were administered. Three months after the visit, the RA telephoned participants to determine recent changes in living situation and drug-related problems. RESULTS: The study group comprised 52 people with a mean (SD) MMSE score of 28.3 (2.5). The participants had a mean (SD) age of 75.8 (6.2) years; 69% (36/52) were women, and 96% (50/52) were white. Participants reported an average of 4.1 medical conditions, and 88% (46/52) reported good to excellent health. Skipping doses or cutting them in half was reported by 25% (13/52) of participants who adjusted doses themselves. Almost half (44%) reported medication problems and/or medication ineffectiveness during the past 3 months at both the study visit and the 3-month follow-up (23/52 for both). The 49 participants who took the MMAA had a mean (SD) score of 19.4 (6.1), with a range of 0 to 25. Of the 49 participants with scores, 34 took less than the correct number of tablets and 13 took more. The 46 participants who took the DRUGS had a mean (SD) score of 91.6 (24.7), with a range of 0 to 100. Forty of 46 participants attempting the test attained the maximum score. Higher scores for both tests indicate better accuracy. Analysis revealed that the MMAA and the DRUGS correlated with one another (P = 0.000). We found no significant associations between these medication management assessment tools and selfreported adherence or drug-related events. CONCLUSIONS: The MMAA and DRUGS tools correlated positively with cognitive function in this population of community-living elderly persons but need further evaluation of their ability to predict who is at greatest risk for drug related problems due to nonadherence to medication regimens.

Aged↗

PubMed2005

A multi-level systems approach for the development of tools, equipment and work processes for the construction industry.

Ergonomics is a key issue in the construction industry. Many work tasks and associated equipment and tools are not designed with ergonomics principles in mind. Often, in the development of power tools for construction, any attention to ergonomics is restricted to the human-machine interface and handle design. The need for ergonomics intervention in the development process originates from considerations of safety, health, physical work load, and productivity. It is argued that in each of these respects, the construction industry has lower standards than other industries and therefore has a need and opportunity for improvement. A multi-level ergonomics approach is proposed addressing these issues. The approach defines five levels of ergonomics intervention, from designing individual tools for safety, to designing wider aspects of construction and work flow for optimal productivity. This holistic approach is illustrated using case study examples of the development of power tools and work methods.

Equipment Design↗

PubMed2005

Cognitive aspects of tool use.

Tool use has traditionally been viewed as primarily a physical activity, with little consideration given to the cognitive aspects that might be involved. In this paper, a new approach to considering tool use in terms of Forms of Engagement is presented and discussed. This approach combines notions of schema from cognitive psychology with the idea of task-specific devices to explain psychomotor aspects of using tools. From the perspective of Forms of Engagement, various aspects of craftwork and skilled tool use are considered.

Biomechanical Phenomena↗

PubMed2004

On line biomonitors used as a tool for toxicity reduction evaluation of in situ groundwater remediation techniques.

Success of groundwater remediation is typically controlled via snapshot analysis of selected chemical substances or physical parameters. Biological parameters, i.e. ecotoxicological assays, are rarely employed. Hence the aim of the study was to develop a bioassay tool, which allows an on line monitoring of contaminated groundwater, as well as a toxicity reduction evaluation (TRE) of different remediation techniques in parallel and may furthermore be used as an additional tool for process control to supervise remediation techniques in a real time mode. Parallel testing of groundwater remediation techniques was accomplished for short and long time periods, by using the energy dependent luminescence of the bacterium Vibrio fischeri as biological monitoring parameter. One data point every hour for each remediation technique was generated by an automated biomonitor. The bacteria proved to be highly sensitive to the contaminated groundwater and the biomonitor showed a long standing time despite the highly corrosive groundwater present in Bitterfeld, Germany. The bacterial biomonitor is demonstrated to be a valuable tool for remediation success evaluation. Dose response relationships were generated for the six quantitatively dominant groundwater contaminants (2-chlortoluene, 1,2- and 1,4-dichlorobenzene, monochlorobenzene, ethylenbenzene and benzene). The concentrations of individual volatile organic chemicals (VOCs) could not explain the observed effects in the bacteria. An expected mixture toxicity was calculated for the six components using the concept of concentration addition. The calculated EC(50) for the mixture was still one order of magnitude lower than the observed EC(50) of the actual groundwater. The results pointed out that chemical analysis of the six most quantitative substances alone was not able to explain the effects observed with the bacteria. Thus chemical analysis alone may not be an adequate tool for remediation success evaluation in terms of toxicity reduction.

Aliivibrio fischeri↗

PubMed2005

Development of a risk assessment tool for women with a family history of breast cancer.

BACKGROUND: Innovative technologies that enable the collection of family history information and the assessment of breast cancer risk have a potential to enhance the quality of preventive care. We developed a computerized tool that supports stratification of breast cancer risk, genetic risk assessment in the clinical environment (GRACE). METHODS: In a preliminary evaluation of the tool's impact, we randomized women with a family history of breast cancer (n=72) to either use the GRACE tool or undergo risk counseling by a nurse specialist. RESULTS: There was no statistically significant differences between the GRACE and nurse counselling groups in risk perceptions (F=.03, P>.05) and cancer-related worries (F=.80, P>.05). However, patients reported more positive attitudes toward working with the nurse. CONCLUSION: It was feasible to use GRACE in a Clinic. Additional research is required to identify solutions for providing emotional support in conjunction with the tool.

Adolescent↗

PubMed2005

Comparison of tools for nutritional assessment and screening at hospital admission: a population study.

INTRODUCTION: This population study aimed to test the sensitivity and specificity of nutritional risk index (NRI), malnutrition universal screening tool (MUST) and nutritional risk screening tool 2002 (NRS-2002) compared to subjective global assessment (SGA) and to evaluate the association between nutritional risk determined by these screening tools and length of hospital stay (LOS). METHODS: Patients (n=995) were assessed at hospital admission by four screening tools (SGA, NRI, MUST and NRS-2002). Sensitivity, specificity and predictive values were calculated to evaluate NRI, MUST and NRS-2002 compared to SGA. Multiple logistic regressions, adjusted for age, were used to estimate odds ratios (OR) and confidence interval (CI) for medium and high, compared to low risk in patients hospitalized >11, compared to 1-10 days LOS. RESULTS: The sensitivity was 62%, 61% and 43% and specificity was 93%, 76% and 89% with the NRS-2002, MUST and NRI, respectively. NRS-2002 had higher positive (85%) and negative predictive values (79%) than the MUST (65% and 76%) or NRI (76% and 66%, respectively). Patients who were severely malnourished or at high nutritional risk by SGA (OR 2.4, CI 1.5-3.9), MUST (OR 3.1, CI 2.1-4.7) and NRS-2002 (OR 2.9, CI 1.7-4.9) were significantly more likely to be hospitalized >11 days, compared to 1-10 days, than patients assessed as low risk. CONCLUSION: NRS-2002 had higher sensitivity and specificity than the MUST and NRI, compared to SGA. There was a significant association between LOS and nutritional status and risk by SGA, NRS-2002, MUST and NRI. Nutritional status and risk can be assessed by SGA, NRS-2002 and MUST in patients at hospital admission.

Anthropometry↗

PubMed2004

OptiRNAi, an RNAi design tool.

RNA interference (RNAi), a recently developed reverse genetics tool, has many advantages compared to traditional gene knockout methods. Appropriate selection of double stranded RNAs identical to a specific region(s) of the target gene is critical for the successful implementation of this technology. Recently, Elbashir et al. [Methods 26 (2002) 199] has established empirical criteria for siRNA sequence selection that significantly improved the success rate for RNAi attempts. We have developed OptiRNAi, a computational tool, which uses the Elbashir et al. criteria to predict appropriate target sequences for siRNA production. Specificity of these siRNAs for the target of interest can then be assessed by the investigator using the embedded Blast search engine optimized for RNAi design. Thus, OptiRNAi is an efficient and user friendly tool for RNAi design based on criteria that are more stringent than other available tools.

Animals↗

PubMed2006

ProteinParser--a community based tool for the generation of a detailed protein consensus and FASTA output.

Comparison of bioinformatic data is a common application in the life sciences and beyond. In this communication, a novel Java based software tool, ProteinParser, is outlined. This software tool calculates a detailed consensus, or most common, amino acid at a given position in an aligned protein set, whilst also generating a full consensus protein FASTA output. A second application of this software tool, computing a consensus amino acid given a tolerance threshold, is also demonstrated. The phytase and the common bacterial beta-lactamase proteins are analysed as 'proof of concept' examples. Consensus proteins, as generated by ProteinParser, are regularly utilised in the selection of residues for protein stabilisation mutagenesis; however, this widely applicable software tool will find many alternative applications in areas such as protein homology modelling.

Amino Acid Sequence↗

PubMed2006

Applications of computational algorithm tools to identify functional SNPs in cytokine genes.

Understanding the functions of single nucleotide polymorphisms (SNPs) can greatly help to understand the genetics of the human phenotype variation and especially the genetic basis of human complex diseases. However, how to identify functional SNPs from a pool containing both functional and neutral SNPs is challenging. In this study, we analyzed the genetic variations that can alter the expression and function of a group of cytokine proteins using computational tools. As a result, we extracted 4552 SNPs from 45 cytokine proteins from SNPper database. Of particular interest, 828 SNPs were in the 5'UTR region, 961 SNPs were in the 3' UTR region, and 85 SNPs were non-synonymous SNPs (nsSNPs), which cause amino acid change. Evolutionary conservation analysis using the SIFT tool suggested that 8 nsSNPs may disrupt the protein function. Protein structure analysis using the PolyPhen tool suggested that 5 nsSNPs might alter protein structure. Binding motif analysis using the UTResource tool suggested that 27 SNPs in 5' or 3'UTR might change protein expression levels. Our study demonstrates the presence of naturally occurring genetic variations in the cytokine proteins that may affect their expressions and functions with possible roles in complex human disease, such as immune diseases.

Algorithms↗

PubMed2026

MAJIQ-CLIN: A novel tool to help identify Mendelian disease-causing variants from RNA-seq data.

PURPOSE: The current diagnostic rate for patients with suspected Mendelian genetic disorders is low, despite exome/genome sequencing being the standard of care. One reason for this low diagnostic rate is that traditional exome/genome sequencing analysis methods struggle to detect RNA splicing aberrations. Causative variants often involve splicing changes, with numerous splice-altering variants being responsible for known Mendelian disorders. Therefore, it is crucial to develop reliable tools to detect, quantify, prioritize, and visualize RNA splicing aberrations from patient RNA sequencing data. METHODS: We developed Modeling Alternative Junction Inclusion Quantification for Clinical Applications (MAJIQ-CLIN), a method to identify RNA splicing aberrations in patients' RNA sequencing data compared with a cohort of control samples. MAJIQ-CLIN can efficiently process large datasets, avoiding reprocessing when new data are added, while effectively detecting local splicing variations with deviations in a given patient, termed outlier local splicing variation, or unique to the patient, termed private local splicing variation. RESULTS: We performed a systematic evaluation of the accuracy of tools for detecting patients' RNA splicing aberrations from RNA sequence using synthetic data across several aberration types and transcript inclusion levels. Then, we used several real datasets to assess MAJIQ-CLINs ability to identify solved test cases and control for the effect of confounders such as batches. We showed that MAJIQ-CLIN compares favorably to existing tools in both accuracy and efficiency. We also used MAJIQ-CLIN to investigate several unsolved patient cases from the Undiagnosed Diseases Network. CONCLUSION: MAJIQ-CLIN offers an efficient, accurate, and user-friendly tool to aid in diagnosing Mendelian disease-causing variants from RNA sequence data.

Bioinformatics↗

PubMed2004

Asssessment of practice in intensive care: students' perceptions of a clinical competence assessment tool.

Part I of this paper (literature review) identified some of the challenges around the development of suitable assessment tools to measure clinical competence. The lack of research on competence assessment, especially within an intensive care environment was also high lighted. In this, part 2, findings from a qualitative study aimed at exploring student nurses' perceptions of a new clinical competence assessment tool, recently introduced into a postgraduate intensive care nursing course are presented. Semi- structured interviews and a focus group interview were used to collect the data. Eleven students were involved in the study. The findings are presented in narrative form and in the context of literature on assessment and competence. Although the clinical competence assessment tool was in its infancy at the time of this study, the findings suggest that students not only had difficulty interpreting the language of the tool, but considered that because of its generic nature, it failed to capture the specialist skills required for intensive care nursing.

Attitude of Health Personnel↗

PubMed2005

GInaFiT, a freeware tool to assess non-log-linear microbial survivor curves.

This contribution focuses on the presentation of GInaFiT (Geeraerd and Van Impe Inactivation Model Fitting Tool), a freeware Add-in for Microsoft Excel aiming at bridging the gap between people developing predictive modelling approaches and end-users in the food industry not familiar with or not disposing over advanced non-linear regression analysis tools. More precisely, the tool is useful for testing nine different types of microbial survival models on user-specific experimental data relating the evolution of the microbial population with time. As such, the authors believe to cover all known survivor curve shapes for vegetative bacterial cells. The nine model types are: (i) classical log-linear curves, (ii) curves displaying a so-called shoulder before a log-linear decrease is apparent, (iii) curves displaying a so-called tail after a log-linear decrease, (iv) survival curves displaying both shoulder and tailing behaviour, (v) concave curves, (vi) convex curves, (vii) convex/concave curves followed by tailing, (viii) biphasic inactivation kinetics, and (ix) biphasic inactivation kinetics preceded by a shoulder. Next to the obtained parameter values, the following statistical measures are automatically reported: standard errors of the parameter values, the Sum of Squared Errors, the Mean Sum of Squared Errors and its Root, the R(2) and the adjusted R(2). The tool can help the end-user to communicate the performance of food preservation processes in terms of the number of log cycles of reduction rather than the classical D-value and is downloadable via the KULeuven/BioTeC-homepage at the topic "Downloads" (Version 1.4, Release date April 2005).

Bacteria↗

PubMed2006

A software tool to aid long-term care budget planning at local authority level.

OBJECTIVE: Local authorities face real challenges when it comes to annual budget planning for funding the system of long-term care. Uncertainty about the long-term cost of caring for current residents in the system, in addition to unknown future admissions, have made the tasks of local authority budget managers very complex and demanding. In this paper, we present a software implementation of a novel forecasting framework developed by the authors to provide useful information to local authority budget planners involved in long-term care. METHODS: The tool is built upon a forecasting framework, which combines unit costs of care with an estimated underlying survival model for publicly funded residents in long-term care, to provide forecasts of the cost of maintaining the group of elderly people who are currently in long-term care (referred to as known commitments) for a period of time. A prototype version of the software tool, which was created and tested in collaboration with an English borough, allows user interaction via a friendly graphical interface that guides through a set of screens of options in a familiar wizard fashion. RESULTS AND DISCUSSION: Feedback from care planners and managers show that the tool helps them gain better understanding of the patterns of length-of-stay of residents under their care, and provides quantitative inputs into their decision making on budget planning for long-term care. The development of the software tool brings advanced modelling techniques out of research papers into the hands of decision makers in the public sector and contributes to improving the delivery of long-term care.

Activities of Daily Living↗

PubMed2006

The impact of the implementation of a rehabilitation tool on the contents of the communication during multidisciplinary team conferences in rheumatology.

OBJECTIVE: Problems with multidisciplinary team conferences in health care include the exchange of too much (discipline-specific) information. The aim of this study was to investigate the effect of the implementation of a rehabilitation tool on the contents of communication during multidisciplinary team conferences in a rheumatology setting. METHODS: All initial and follow-up team conferences of 25 consecutive patients with rheumatoid arthritis admitted to a day patient care ward were videotaped during a period before (period I) and after (period II) the introduction of a rehabilitation tool. The aims of the rehabilitation tool were to enhance discussions on the co-ordination of care rather than merely exchange of information. This was achieved by providing a framework for the setting and evaluation of common treatment goals and management strategies as well as accompanying electronic and printed records. For every team conference, the duration of time spent on three types of communication was recorded: (1) grounding regarding the patient's health status, (2) the making of practical arrangements by no more than two health professionals, and (3) the co-ordination of common treatment goals or management strategies. Comparisons of the proportions of time spent on the different types of communication between the two periods were done by means of the Mann-Whitney U-test. RESULTS: Apart from the 25 initial team conferences in both periods, 86 and 71 follow-up team conferences were available in periods I and II, respectively. Regarding the initial team conferences, the proportion of time spent on grounding and practical arrangements was significantly smaller in period II than in period I. In addition, the proportion of time spent on common goals or management strategies was significantly greater in period II than in period I. For the follow-up team conferences, the proportion of time spent on practical arrangements was significantly smaller in period II, than in period I. Moreover, the proportions of time spent on the other types of communication did not differ significantly between the two periods. CONCLUSION: The implementation of a rehabilitation tool including a computer application increased the proportion of time spent on the discussion of common treatment goals or management strategies during initial but not during follow-up team conferences in a day patient rheumatology clinic.

Cohort Studies↗

PubMed2005

Integration of tools and resources for display and analysis of genomic data for protozoan parasites.

Centralisation of tools for analysis of genomic data is paramount in ensuring that research is always carried out on the latest currently available data. As such, World Wide Web sites providing a range of online analyses and displays of data can play a crucial role in guaranteeing consistency of in silico work. In this respect, the protozoan parasite research community is served by several resources, either focussing on data and tools for one species or taking a broader view and providing tools for analysis of data from many species, thereby facilitating comparative studies. In this paper, we give a broad overview of the online resources available. We then focus on the GeneDB project, detailing the features and tools currently available through it. Finally, we discuss data curation and its importance in keeping genomic data 'relevant' to the research community.

Animals↗