SEARCH · PubMed Health

Results for “Tools”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2001

Developing and implementing clinical practice tools: the legal and ethical implications.

The complexity of health care is ever increasing, as is the volume of research and literature available. In response there has been a corresponding emphasis on basing clinical decisions on the best available research evidence. The development and implementation of clinical practice tools is cited as a means of ensuring research utilisation as well as moderating variations in clinical practice. It is important that nurses contribute to the development of these clinical tools in order to actively shape their own practice. Nurses therefore need to have an understanding of the terminology and processes involved, and the implications for practice. This paper outlines definitions of the various clinical tools, the development process, and the legal and ethical implications of clinical practice tools.

Clinical Protocols↗

PubMed2001

Healthcare narratives from diverse communities--a self-assessment tool for healthcare providers.

Research examining cultural diversity in the healthcare context has produced general themes about particular patient populations, and tools based on this research vary in their approach to improving cultural sensitivity and competency. Some tools pose questions that providers may ask patients to help them become better informed about their culture; others name areas of sensitivity that providers ought to be aware of in caring for culturally diverse patients. This tool is different. It focuses on the provider and its goal is to raise the provider's consciousness through self-reflection and examination. It consists of three parts: stories from interviews with actual patients followed by thought-provoking questions; commentaries on four of the narratives to help you measure your assessment of the ethical issues contained in each one; and a decision-making analysis grid to help you use the tool more effectively. It concludes with a bibliography for additional reading.

Black or African American↗

PubMed2002

Building an asynchronous web-based tool for machine learning classification.

Various unsupervised and supervised learning methods including support vector machines, classification trees, linear discriminant analysis and nearest neighbor classifiers have been used to classify high-throughput gene expression data. Simpler and more widely accepted statistical tools have not yet been used for this purpose, hence proper comparisons between classification methods have not been conducted. We developed free software that implements logistic regression with stepwise variable selection as a quick and simple method for initial exploration of important genetic markers in disease classification. To implement the algorithm and allow our collaborators in remote locations to evaluate and compare its results against those of other methods, we developed a user-friendly asynchronous web-based application with a minimal amount of programming using free, downloadable software tools. With this program, we show that classification using logistic regression can perform as well as other more sophisticated algorithms, and it has the advantages of being easy to interpret and reproduce. By making the tool freely and easily available, we hope to promote the comparison of classification methods. In addition, we believe our web application can be used as a model for other bioinformatics laboratories that need to develop web-based analysis tools in a short amount of time and on a limited budget.

Algorithms↗

PubMed2002

MMT--a pathway modeling tool for data from rapid sampling experiments.

The identification of metabolic regulation is a major concern in metabolic engineering. Metabolic regulation phenomena depend on intracellular compounds such as enzymes, metabolites and cofactors. A complete understanding of metabolic regulation requires quantitative information about these compounds under in vivo conditions. This quantitative knowledge in combination with the known network of metabolic pathways allows the construction of mathematical models that describe the dynamic changes in metabolite concentrations over time. Rapid sampling combined with pulse experiments is a useful tool for the identification of metabolic regulation owing to the transient data they provide. Enzymatic tests in combination with ESI-LC-MS (Electrospray Ionization Liquid Chromatographic Tandem Mass Spectrometry) and HPLC measurements have been used to identify up to 30 metabolites and nucleotides from rapid sampling experiments. A metabolic modeling tool (MMT) that is built on a relational database was developed specifically for analysis of rapid sampling experiments. The tool allows to construct complex pathway models with information stored in the relational database. Parameter fitting and simulation algorithms for the resulting system of Ordinary Differential Equations (ODEs) are part of MMT. Additionally explicit sensitivity functions are calculated. The integration of all necessary algorithms in one tool allows fast model analysis and comparison. Complex models have been developed to describe the central metabolic pathways of Escherichia coli during a glucose pulse experiment.

Algorithms↗

PubMedDate not supplied

[Thoracic stab wound caused by a grilling scewer with defomration of the tool].

Injuries by meat- or barbecue-skewers are rarely relevant as cause of death. Besides accidental injuries they are used as coincidental tools in capital crimes. Skewers are non-typical stabbing tools of pointed-squared structure, which need considerable force to penetrate the skin. The authors report on a 42-year-old man's fatal thorax stab injury, which he sustained during a barbecue and which stretched from the left mamilla into the back right shoulder tissue. Death was caused by exanguination following stabbing through the superior vena cava. At issue was the question what amount of force was necessary to inflict the wound. Based on the deformation of the stabbing tool, as a result of a material-technical expertise, compressive load application in longitudinal direction and a stabbing force of between 120 to 665 N were to be assumed. Furthermore, in addition to the features of a non-typical tool, the autopsy findings allowed to conclude a powerful stabbing.

Adult↗

PubMed2003

UMLS language and vocabulary tools.

A variety of resources developed for use with the Unified Medical Language System are presented. These resources include the UMLS Knowledge Source Server, the SPECIALIST lexicon, a set of lexical tools that work with the SPECIALIST lexicon, and a variety of other NLP document processing tools. These tools manage lexical variation, tokenize and parse text strings, suggest spelling variants, and provide text-to-concept mapping capabilities. The UMLS Knowledge Source Server is available under a license agreement. The other tools are freely downloadable.

Abstracting and Indexing↗

PubMed2003

Productivity and acuity tool for wound care and hyperbaric medicine centers.

The unique workload and patient acuity in wound care and hyperbaric centers leaves staffing to subjective interpretation; lack of objective data makes it difficult to determine department budgets and appropriate staffing patterns. To address these problems, an objective tool was developed to assess acuity and productivity in hyperbaric and wound care departments. Patient classifications were created to define acuity based on disease and associated procedures. A total of 38 distinct indicators were identified for wound care and 22 for hyperbaric oxygen therapy. Time studies were performed on identified tasks. All patients were scored and placed in acuity classes. The number of hours per patient day was calculated and multiplied by direct care hours to find number of full-time-equivalents (FTEs). The tool was tested for content validity and clinical applicability. The tool was found to accurately reflect patient-care work and suitable as a benchmarking tool for use in monoplace hyperbaric and wound care centers.

Benchmarking↗

PubMed2003

Quality of life and HIV: current assessment tools and future directions for clinical practice.

Routine clinical assessment of health-related quality of life in persons with HIV infection has the potential to improve care by assessing and monitoring treatment effects, enhancing communication between patient and provider, and tracking changes in functional status over time. Currently available research-based assessment tools may be inadequate for routine clinical use because of the lack of inclusion of HIV-relevant aspects of quality of life and the impracticality of the use of such tools in the clinical setting. There may be a need for a new, clinically relevant, HIV-specific assessment tool that would be easy to incorporate into clinical practice to briefly, yet comprehensively, assess characteristics frequently found in HIV-infected persons, such as fatigue, pain, nausea and vomiting, sleep disturbances, sexual dysfunction, and body image issues. Until such a tool is developed, the Linear Analogue Self-Assessment questionnaire and the Medical Outcomes Study Short Form-12 (MOS SF-12) are short enough for routine use in a clinical setting. Slightly longer measures, such as the MOS-HIV Health Survey (MOS-HIV), can provide information in a greater number of domains.

Activities of Daily Living↗

PubMed2004

A comparison of nutritional screening tools in the prediction of post-operative infectious and wound complications in the elderly patients undergoing abdominal operations.

OBJECTIVE: To compare four nutritional screening tools--the Short Form Mini Nutritional Assessment (MNA-SF), the Nutrition Risk Classification (NRC), the Malnutrition Screening Tool (MST), and the Nutrition Risk Score (NRS)--in the prediction of post-operative infectious and wound complications in elderly patients undergoing abdominal surgery. PATIENTS AND METHOD: During the nine-month period from April 2002 to December 2002 nutritional screening was performed on 190 patients aged 60 years or over who underwent major abdominal surgery. Each patient was classified as either at risk or not at risk of malnutrition. This classification, for each screening tool, was tested for association with the occurrence of post-operative infectious and wound complications. Each screening tool was calculated and compared under the area of Receiver Operating Characteristic (ROC) curve. RESULT AND CONCLUSION: The NRC classification was the best prediction for the occurrence of post-operative infectious and wound complications in elderly surgical patients.

Abdomen↗

PubMed2004

Evaluation of air pollution modelling tools as environmental engineering courseware.

The study of phenomena related to the dispersion of pollutants usually takes advantage of the use of mathematical models based on the description of the different processes involved. This educational approach is especially important in air pollution dispersion, when the processes follow a non-linear behaviour so it is difficult to understand the relationships between inputs and outputs, and in a 3D context where it becomes hard to analyze alphanumeric results. In this work, three different software tools, as computer solvers for typical air pollution dispersion phenomena, are presented. Each software tool developed to be implemented on PCs, follows approaches that represent three generations of programming languages (Fortran 77, VisualBasic and Java), applied over three different environments: MS-DOS, MS-Windows and the world wide web. The software tools were tested by students of environmental engineering (undergraduate) and chemical engineering (postgraduate), in order to evaluate the ability of these software tools to improve both theoretical and practical knowledge of the air pollution dispersion problem, and the impact of the different environment in the learning process in terms of content, ease of use and visualization of results.

Air Pollution↗

PubMed2004

Assessing and managing breast cancer risk: clinical tools for advising patients.

Using breast cancer risk assessment tools and going through the process of assessing breast cancer risk can answer many women's questions about what puts them at relatively higher or lower risk. This effectively engages both the clinician and the patient in a discussion about breast cancer, the chances of getting it, and the family's involvement--making the process as important as the actual tools. Examples of selected case histories demonstrate risk assessment using available tools such as the Gail-NCI and the Claus models. For some women, such as those considering tamoxifen or prophylactic surgeries, it may be desirable to prescreen for the inheritance of hereditary mutations and to follow with genetic testing, if indicated. Testing for mutations of breast cancer susceptibility genes or for their diminished expression adds to our ability to assess breast cancer risk at an individual level. The literature contains general interventions that are widely accepted to reduce the severity and the burden of breast cancer, and these are brought together here. The risk assessment process is an important part of a risk reduction program and can help motivate women to engage in prevention activities. This paper uses 2 hypothetical but fact-based and typical case histories to discuss the utility of risk assessment tools for informing women about their options.

Adult↗

PubMed2004

Electronic implementation of national nursing standards--NANDA, NOC and NIC as an effective teaching tool.

With the increased interest in evidence-based medicine, Internet access and the growing emphasis on national standards, there is an increased challenge for teaching institutions and nursing services to teach and implement standards. At the same time, electronic clinical documentation tools have started to become a common format for recording nursing notes. The major aim of this paper is to ascertain and assess the availability of clinical nursing tools based on the NANDA, NOC and NIC standards. Faculty at 20 large nursing schools and directors of nursing at 20 hospitals were interviewed regarding the use of nursing standards in clinical documentation packages, not only for teaching purposes but also for use in hospital-based systems to ensure patient safety. A survey tool was utilized that covered questions regarding what nursing standards are being taught in the nursing schools, what standards are encouraged by the hospitals, and teaching initiatives that include clinical documentation tools. Information was collected on how utilizing these standards in a clinical or hospital setting can improve the overall quality of care. Analysis included univariate and bivariate analysis. The consensus between both groups was that the NANDA, NOC and NIC national standards are the most widely taught and utilized. In addition, a training initiative was identified within a large university where a clinical documentation system based on these standards was developed utilizing handheld devices.

Interviews as Topic↗

PubMed2005

Development of an evidence-based specialty support surface decision tool.

Advancing technology, an aging population, increasing attention to appropriate resource use, and growing concerns about patient safety and professional liability combine to complicate support surface choice. Cognizant of these factors, staff in a 600-bed tertiary care hospital in a large urban center in western Canada decided to evaluate an existing specialty support surface decision tool and update the instrument based on current published literature (no older than 3 years), expert opinion, and results of pilot testing. Elements included in the existing tool were the patient's Braden Score, mobility/activity indicators, and identification of existing skin breakdown. The tool allowed considerable latitude in decision-making based on other clinical factors and established professional practices and had not been formally evaluated. The revised tool addressed relevant assessment criteria such as risk category, patient weight, presence of existing skin breakdown/number of ulcers, flap surgery, pulmonary complications, palliative care, positioning, and Braden score, as well as oversight of support service choice. Although the incidence of nosocomial pressure ulcers did not change significantly during the trial period, costs incurred for support surface use decreased 26% overall, underscoring the need for improved guidelines for support surface selection.

Beds↗

PubMedDate not supplied

Development of an integrative patient history intake tool: a Delphi study.

OBJECTIVE: To identify patient history intake questions common to four fields of medicine--allopathic, naturopathic, chiropractic, and Traditional Chinese Medicine for potential development of an Integrative Patient History Intake Tool. DESIGN: A two-round modified Delphi technique was utilized to generate expert consensus among Oregon healthcare practitioners on the importance of specific patient history intake questions. A panel of faculty members from Oregon Health & Sciences University (OHSU), the National College of Naturopathic Medicine (NCNM), the Oregon College of Oriental Medicine (OCOM), and Western States Chiropractic College (WSCC) identified 321 patient history intake questions, which then were distributed to 106 Oregon healthcare practitioners. The healthcare practitioners were asked to rate the importance of each question through a series of two surveys over the period of 11 weeks. Suggestions for additional intake questions also were invited. RESULTS: The Delphi process resulted in the original 321 initial questions plus 150 additional suggested questions being reduced to 52 intake questions (11% total similarity) for the potential development of the Integrative Patient History Intake Tool. There was a 63% response rate to SURVEY I, and a 73% response rate for SURVEY II. CONCLUSION: The concept of attempting to develop an integrative patient history intake tool is important to improve communication between practitioners of allopathic, naturopathic, chiropractic, and Traditional Chinese Medicine. This study revealed insight into the difficulties faced with such a tool due to the lack of similarity in priorities of questions between these different disciplines. This may also reveal a component of why communication remains difficult between these fields, but should not deter efforts to increase communication in the interest of optimal patient care.

Attitude of Health Personnel↗

PubMed2005

State Plan Index: a tool for assessing the quality of state public health plans.

INTRODUCTION: The State Plan Index is an evaluation instrument that uses a Likert scale to assess 60 indicators of the quality of state public health plans. The State Plan Index was needed to enable evaluation of plans that were developed using a variety of public health planning models. METHODS: Federal, state, and academic partners participated in developing and testing the instrument. The authors conducted a literature review, interviews with experts, and several rounds of formative evaluation to assess item inclusion, coverage, weighting, organization of items, and content validity. In two rounds of field testing, public health practitioners at the federal and state levels rated 10 state public health plans for obesity prevention. RESULTS: Field-test raters took an average of two hours to rate a plan and indicated that the State Plan Index was "easy to use," "comprehensive," and "fair." Mean Cronbach alpha for components of the State Plan Index was 0.88 (median 0.93). Component scores among the 10 plans rated ranged from 0.2 to 4.8, indicating that raters made distinctions in quality among the components and the plans they rated. Correlations between component scores and overall scores were statistically significant (P < .001), except for one component. CONCLUSION: Public health professionals at the federal and state levels found the State Plan Index to be a useful tool for evaluating public health plans that were developed by states using various planning approaches. After the field tests, state staff reported adapting the State Plan Index for use as a planning tool, an evaluation tool for local plans, and a self-assessment tool for drafts of state plans. In addition, the State Plan Index can be revised easily for use in other chronic disease areas.

Centers for Disease Control and Prevention, U.S.↗

PubMed2005

Genomics and public health: development of Web-based training tools for increasing genomic awareness.

In 2001, the Centers for Disease Control and Prevention funded three Centers for Genomics and Public Health to develop training tools for increasing genomic awareness. Over the past three years, the centers, working together with the Centers for Disease Control and Prevention's Office of Genomics and Disease Prevention, have developed tools to increase awareness of the impact genomics will have on public health practice, to provide a foundation for understanding basic genomic advances, and to translate the relevance of that information to public health practitioners' own work. These training tools serve to communicate genomic advances and their potential for integration into public heath practice. This paper highlights two of these training tools: 1) Genomics for Public Health Practitioners: The Practical Application of Genomics in Public Health Practice, a Web-based introduction to genomics, and 2) Six Weeks to Genomic Awareness, an in-depth training module on public health genomics. This paper focuses on the processes and collaborative efforts by which these live presentations were developed and delivered as Web-based training sessions.

Costs and Cost Analysis↗

PubMed2005

Use of the PUSH tool to measure venous ulcer healing.

Currently, no instrument is available to provide an accurate and simple method of monitoring venous ulcer healing in clinical practice. The Pressure Ulcer Scale for Healing (PUSH) tool was developed and validated to monitor the healing of pressure ulcers. During a 2-month study involving 27 venous ulcer patients visiting a chronic wound clinic of a major university, the feasibility of using the PUSH tool to monitor healing was evaluated. The patients were assessed by two Wound Ostomy Continence Nurses using the PUSH tool, where 0 = healed and 17 = worst possible score. The mean score at the initial clinic visit was 12. One month and 2 months later, the mean scores were 9 and 8, respectively. Of the 27 participating patients, 23 had a decrease in their PUSH score over the 2-month period of the study; four of the 23 patients had PUSH scores of zero after 2 months because their venous ulcers had healed. One ulcer did not change and three ulcers worsened and their PUSH scores increased. Based on this study, the PUSH tool appears to be an effective way to monitor healing trends in venous ulcers as well as pressure ulcers.

Adult↗

PubMed2005

[Development of fracture risk assessment tool (FRAT) by WHO study group and its proposed application].

Risk factors for fragility fracture include BMD and other factors independent from BMD. WHO-study group has proposed a new strategy to establish international tool to estimate absolute risk values for the occurrence of femoral neck fracture at the individual levels, named as fracture risk assessment tool (FRAT). The tool issued from the group is basically derived from the integration of the data of various risk factors obtained in Sweden. It may be useful to identify cases for pharmacological intervention. However, the differences in the kinds and the relative values of fracture risks in other countries or districts have not yet been clarified. Utility of the tool may depend on the results of calibration and validation based on their own data in other districts.

Aged↗