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At least 1,351 records · Page 75Linked to original sources

PubMed2003

A scoring system as a tool for antenatal care audit in family medicine.

OBJECTIVE: To propose the antenatal assessment score (AAS) as a tool for auditing the process of antenatal care in family medicine, and to highlight its accessibility by applying it at 2 family health care centers. METHODS: A descriptive study of an audit process was conducted in 2 primary health care centers (non commissioned officers' [NCO] and officers' health centers [OC]) belonging to the Department of Family Medicine, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia from February 2001 to June 2002. A systematic random sample of patients registered at the maternal registers of both centers was selected. A score system of 100 points was developed containing items regarding history taking, examination, investigations, treatment, referral, health education, number of visits and record keeping. The information was gathered retrospectively from patients' files at both centers. RESULTS: The total assessment score approached 67 out of 100 for NCO and 71 out of 100 for OC with a statistically significant difference (p<0.05). History taking in general was achieved to 77% in NCO and 86% in OC. Examination whether general (8% and 76%) or obstetric (67% and 72%) was achieved at a lesser level. All investigations were recorded equally in both centers (77%). Referrals, whether routine or emergency, were much less recorded 35-28%. The majority of antenatal records at both centers were partially completed (84.5% and 81%). Indications to any given medications (73% and 91%) and the total number of visits were higher among NCO records with statistically significant difference (p<0.05). CONCLUSION: Antenatal assessment score is an accessible tool for the audit process of antenatal care in family medicine. In depth analysis and interpretation of the results could be of high importance to total antenatal care. Nationwide use of this audit tool is recommended.

Family Practice↗

PubMedDate not supplied

[The "grasping tie". I. Introduction to and technical notes of an innovative mechanical tool aimed at formation of "purse string" in digestive surgery].

The grasping tie is an original and mechanical tool, conceived and planned to be used in digestive surgery, to temporary grasp and fasten at the axis of the head or the anvil of a circular stapler the tract of the gut chosen for anastomosis. Its use permit to fix the lower oesophageal stump in total gastrectomy, or that of the rectal stump in the lower rectal resection, respectively to the axis of the circular stapler component for the time necessary to perform the mechanical anastomosis. That is performed by the employment of a thin nylon ribbon, which will be progressively tightened as requested like a one way running knot about the tract of the gut and at the axis of the part of the stapler. The device will be repeatedly activated by an handle located at one of its ends, tightening progressively at the other end a thin nylon ribbon preventively put and laced around the chosen point of the digestive tract to grasp firmly and irreversibly the gut to the axis of the stapler, and then cut away by a trigger of the device in the same end of the handle. The nylon ring will be extracted together with the muscle-mucosal rings once completed the stapler suture, so that nothing of the ribbon remains in the patient. Its function is alternative to the classical tool used to prepare a purse-string suture on a segment of the digestive tract. Its advantages in front of that tool is the minimal space it requires for its use, therefore with operative advantages in fixing the head of the circular stapler in the oesophagus during the reconstructive steps after a total gastrectomy, and in fixing the lower rectum to the axis of anvil of a circular stapler preventively introduced in the anus and extruded. Moreover its employment is advantageous in closing from the outside the two ends of a tract of the gut where a tumour is located, so allowing a safe subsequent manipulation of the gut without oncologic prejudice.

Anastomosis, Surgical↗

PubMed1992

Self-care assessment tool for spinal cord injured persons.

The purpose of this study was to develop a reliable and valid tool that assesses the cognitive and functional skills needed for self-care in persons with spinal cord injury (SCI). The Self-Care Assessment Tool (SCAT) assesses cognitive and functional skills in eight self-care areas: bathing/grooming, nutritional management, taking medications, mobility/transfers/safety, skin management, bladder management, bowel management and dressing. The tool was carefully developed and has demonstrated content validity. Interrater reliabilities for the cognitive, functional and total scores ranged from .69 to .94 (n = 10). Test-retest reliabilities for the cognitive, functional and total scores ranged from -.06 to .86 (n = 14, 16). Regarding predictive validity, R2 ranged from .61 to .90 for the cognitive, functional and total scores (n = 18). Although continued reliability and validity studies are needed, the SCAT has potential to measure patient rehabilitation outcomes, to evaluate nursing care approaches and to serve as a quality assurance indicator for nursing care.

Activities of Daily Living↗

PubMed1992

Work-related electrocutions involving portable power tools and appliances.

Portable power tools and appliances can be identified as the source of injury in approximately 9% of occupational electrocutions. A search of fatality records for 1984 through 1986 in National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) data bases identified 102 electrocutions involving portable appliances and tools that used 110-volt AC and 33 deaths involving welding equipment, which usually operates on 220-volt AC or higher. Of these 102 deaths, 51 occurred in the construction industry, 13 in services, 13 in manufacturing, and 25 in other industries. Plumbing contractors (Standard Industrial Classification [SIC] 1711) had the largest number of deaths (15) in construction. Powered hand-tools were involved in 58 deaths, with electric drills (23) and saws (13) the two largest classes. Proper provision of ground-fault circuit interrupter protection, particularly at temporary work sites, could have prevented most of the deaths from 110-volt AC. Engineering controls for preventing electrocution from portable arc-welding equipment should be evaluated.

Accidents, Occupational↗

PubMed2003

Mentor relationship as a tool of professional development of student nurses in clinical practice.

This is a condensed version of a research project relating to the design and the development of a research instrument concerning 'Mentor Relationship as a Tool of Professional Development of Student Nurses in Clinical Practice'. This short research paper is taken from and reproduces the research work undertaken by Saarikoski (2002). The main themes refer to: (1) Evaluation scale to assess the quality of clinical learning environment and (2) Supervision of student nurses during their clinical placements. Parts one and two are taken from the main research study and include the following (i) developing and testing an evaluation tool (ii) describing how nursing students experience their clinical learning environment and (iii) the supervision given by qualified staff nurses working in a hospital setting. This abridged report discusses the methodology approaches undertaken by the author and includes: (a) comparative phased twin centred study (b) a pilot scheme and (c) a primary research instrument that was developed into an extensively validated assessment-measuring tool. This report strongly suggests that there is clear evidence in this research report that the supervisory relationship is the most important single element of pedagogical activities of staff nurses. The total satisfaction of students correlated most clearly with the method of supervision and that those satisfied students had a successful mentor relationship and frequently enough access to private supervision sessions with mentor. In the sample of this empirical study (n = 279 student nurses in Finland) individualized supervision system was most common on psychiatric wards. All nurse educators and clinical practitioners working across Europe and around the World in clinical learning environments will find this paper very useful in helping them to improve and quantify the supervisory process. This study starts bridging the gap between using and integrating both at a National and European level qualitative assessment systems that relate to the learning and supervisory process. The study encourages the need for professionals to test these new instruments in other nursing cultures and reflects upon the need for further research work in this area.

Attitude of Health Personnel↗

PubMed2003

The water jet as a new tool for endoprosthesis revision surgery--an in vitro study on human bone and bone cement.

In revision surgeries of endoprostheses, the interface between implant and bone cement or bone must be loosened. Conventional tools have many disadvantages because of their size and limited range. Taking advantage of the selective and athermic cutting process, a plain water jet is already used in order to cut soft tissues. This study investigates the possibilities of both a plain and an abrasive water jet as cutting tools for revision surgery. Samples of the mid-diaphysis of human femora and bone cement (CMW3) were cut with a plain water jet (PWJ) and an abrasive water jet (AWJ) at two different jet-to-surface angles (30 degrees,90 degrees ) and at five different pressure levels (30, 40, 50, 60, 70 MPa). For a PWJ a selective pressure range was identified, where only bone cement was cut. Injecting a bio-compatible abrasive (lactose) to the jet stream resulted in significantly higher cut depths in both materials. Material removal in bone was significantly less at the smaller jet-to-surface angle for both techniques. No clear selectivity between bone and bone cement was observed for application of the AWJ. However, the material removal rate was significantly higher for bone cement than for bone at all pressure levels. The results indicate that an AWJ might be an alternative tool for cement removal. The possibility for localised cutting at interfaces could be an advantage for revision of a non-cemented prosthesis.

Aged↗

PubMed2003

Children's handwriting evaluation tools and their psychometric properties.

Handwriting is an important area of evaluation for pediatric therapists. In selecting a handwriting instrument, therapists must not only consider a child's area of handwriting difficulty, but also the psychometric properties of the instrument chosen. This paper reviews five commonly used children's handwriting evaluation tools: (a) Diagnosis and Remediation of Handwriting Problems; (b) Minnesota Handwriting Test; (c) Children's Handwriting Evaluation Scale-Manuscript; (d) Evaluation Tool of Children' s Handwriting-Manuscript; and (e) Test of Legible Handwriting. Each assessment is described including how it is administered, the scoring system, the reliability and validity of each instrument, and purchase information. The strengths and weaknesses of each tool are discussed along with factors affecting handwriting evaluation.

Adolescent↗

PubMedDate not supplied

An assessment tool for developing healthcare managerial skills and roles.

This article is based on a study to identify, and by doing so help develop, the skills and roles of senior-level healthcare managers related to the needs of the current healthcare environment. To classify these roles and skills, a qualitative study was conducted to examine the literature on forces in the healthcare environment and their impact on managers. Ten senior managers were interviewed, revealing six roles as the most crucial to their positions along with the skills necessary to perform those roles. A pilot study was conducted with these senior managers to produce a final assessment tool. This assessment tool helps managers to identify strengths and weaknesses, develop in deficient areas, and promote competence in all areas as demanded by the market and organization. This tool can be used by organizations in the recruitment process and in the training process.

Health Facility Administrators↗

PubMed2003

Analysis of the frequency distribution of tuberculin skin test readings: a tool for the assessment of group contact investigations.

SETTING: The public health tuberculosis control program covering Seattle, Washington, and its surrounding suburban areas. OBJECTIVE: To describe a tool of potential usefulness in the assessment of transmission of tuberculosis in contact investigations of groups, such as co-workers or schoolmates of an infectious case, with a low prior probability of latent tuberculosis infection (LTBI). DESIGN: Tuberculin skin test (TST) readings in mm of the group being tested were graphed and compared with the known frequency distributions of TST readings of populations with and without LTBI, the latter including a fraction with non-specific tuberculin reactivity. RESULTS: Four group contact investigations were analyzed retrospectively with this tool. In two the graphed TST readings of contacts fell within the distribution of a population with LTBI, and suggested that transmission had occurred. In the other two, the graphed readings better fit the distribution of a population with non-specific tuberculin reactivity and suggested that transmission had not occurred. CONCLUSION: This simple tool to facilitate the determination of whether transmission of tuberculosis has occurred, and who should be offered treatment for LTBI in contact investigations of groups of people, deserves further study.

Adolescent↗

PubMed1992

Identifying substance use: an assessment tool for the school nurse.

A nursing assessment tool was developed to identify students who may be using drugs or alcohol. The three-part tool enables the school nurse to identify those students who require immediate medical care, as well as those who are impaired by substance use but medically stable. The use of the tool and implications for school nurses are discussed.

Adolescent↗

PubMed2003

A "systematics" tool for medical terminologies.

Finding the hierarchical relations amongst multiple terms within medical terminologies that support multiple parents to a term is a common task, especially for trainees and knowledge engineers implementing or maintaining medical logic modules or guidelines. Examples of such terminologies include the UMLS and the Medical Entity Dictionary (MED). In addition, the task of identifying and discriminating amongst some common ancestors to a list of terms is a recurrent theme. This is also a common concern in the science of classification (systematics). Some nearest common ancestors have distinct valuable properties for classification and simplification of lists. Although there exist some visualized navigating and editing tools for the UMLS and the MED, they are browsers that show a large number of unrelated and irrelevant relationships to the task at hand. While algorithms have been well studied in computer science to solve such a problem over semantic networks and trees, to our knowledge, they have not been used with a visualization tool in biomedicine. We developed a visualized tool that graphically displays the hierarchical relations of multiple terms, and helps identifying the nearest common ancestors of these terms.

Classification↗

PubMed1992

Validity and reliability of the Pressure Sore Status Tool.

There is not yet a universal system for describing the status of pressure sores. The purpose of this study was to assess the validity and reliability of an instrument developed by the researchers for evaluation of pressure sores, the Pressure Sore Status Tool (PSST). This study was part of a larger study, which included development of a theoretical model for creation of items for the PSST. A nine-member expert judge panel established content validity of items on the instrument. Data were analyzed using a content of validity index (average index for tool = .91) and judges' comments were used to modify two items on the PSST. Two Enterostomal Therapy (ET) nurses independently used the revised tool to rate 20 pressure sores on ten adult medical-surgical patients, at two observation times. Interrater reliability was established at r = .91 for first observation and r = .92 for the second observation (p < .001). Intrarater reliability was r = .99 for rater one and r = .96 for rater two (p < .001). Future research will focus on refinement and further reliability testing of the instrument.

Adult↗

PubMed2003

Cost-benefit analysis of electron beam CT as a life insurance coronary disease risk assessment tool.

Electron beam CT (EBCT) or ultrafast CT is a diagnostic imaging technique that can identify calcium deposits within coronary arteries. Intra-coronary calcium is associated with coronary artery atherosclerosis. EBCT imaging has been advocated as a "better" way to screen for coronary artery disease. By producing a measure of the amount of calcium present, it may provide a non-invasive risk assessment tool that can predict the risk of future coronary events and death. Medical literature concerning identification and assessment of coronary risk using EBCT in the clinical setting is reviewed. The primary purpose is to illustrate one approach to a simple "back of the envelope" cost-benefit analysis (protective value) comparing EBCT with exercise electrocardiography as a life insurance coronary disease risk assessment tool. The performance and results of this analysis are contingent on a number of critical assumptions that are outlined in the text. The analysis limitations, and the future research required to refine the results are reviewed. With optimum levels of EBCT test performance, favorable thresholds of test costs, and long-term mortality data useful for assessment of value preservation, EBCT might prove to be a valuable risk assessment tool from a cost-benefit perspective under certain circumstances. Answers to key clinical research questions from prospective studies in asymptomatic cohorts are essential for refinement of a cost-benefit estimate.

Coronary Disease↗

PubMed2004

Correlation of osteoporosis screening by quantitative ultrasound of calcaneus and Osteoporosis Self-Assessment Tool for Asians in Taiwanese.

BACKGROUND AND PURPOSE: The Osteoporosis Self-Assessment Tool for Asians (OSTA) index, originally developed for use in postmenopausal Asian populations, is an inexpensive, simple tool based on age and body weight. Calcaneal quantitative ultrasound (QUS) is another simple and low-cost instrument used to prescreen osteoporotic subjects. This study investigated the correlation between these 2 screening methods. METHODS: OSTA indices were calculated in a total of 3,456 women aged 40 to 95 years (mean, 59.5 +/- 11.7 years) selected from a national epidemiological survey of calcaneal QUS in Taiwan. Age was multiplied by -0.2 and body weight by 0.2. Both values were truncated to yield integers, which were then added together, and compared to the QUS results. RESULTS: When the risk category was defined as OSTA index < or = -1, and low QUS value as t-score < or = -2.5, the sensitivity and the specificity of the index were 84.0% and 61.0%, respectively, and the area under the curve was 0.81. According to the OSTA research group's classification, the high-risk subgroup (index < -4) represented 10.7% of the women 40 years or older, the intermediate-risk subgroup (index -1 to -4) 35.0%, and the low-risk subgroup (index > -1) 54.3%. The prevalence of low QUS values was high among the high-risk category (48.5%), and significantly trended downwards among the moderate- and low-risk categories (21.1% vs 4.4%). As the age of the population increased, there was an increasing false-negative rate (p < 0.001) when using OSTA > -1 to predict the normal QUS value. CONCLUSIONS: The OSTA index, a simple and free risk assessment tool, can be used to estimate the prevalence of low QUS values in Asian women and may help to increase awareness and prevention of low bone mineral density.

Adult↗

PubMed2004

Approaches and informatics tools to assist in the integration of similar clinical research questionnaires.

OBJECTIVE: The integration of similar clinical research questionnaires is a complex process that can benefit from informatics approaches and tools that provide a systematic structure for performing mapping and integration. This systematic approach is necessary to address complex issues in integration such as data heterogeneity, differing levels of granularity of questions and responses, and other issues involving semantic differences. Informatics tools and approaches have been successfully applied to various standard clinical vocabulary integration processes but not for questionnaire integration or mapping. METHODS: A systematic approach to questionnaire integration was developed in the context of a collaboration of researchers using Trial/DB, a database designed to support clinical research. This approach was applied to the integration of questionnaires involving breast cancer risk factors from each of three research sites. RESULTS: From 375 questions on the three original questionnaires, we identified 65 concepts that were measured by two or three of the sites. An algorithm was developed and used to formalize the process of mapping questions and answers across the questionnaires. The approach was applied to previously collected data and prospective data in disparate data-base systems to import and merge the data from these three sites into Trial/DB. CONCLUSION: Informatics tools that support a systematic approach to mapping questionnaires can be used throughout the research process from questionnaire integration and creation, legacy data integration to data library maintenance and curation.

Biomedical Research↗

PubMed2003

RIONET: a water quality management tool for river basins.

The water quality management tool RIONET for river basins has been developed with regard to the EU Water Framework Directive. The management tool can simulate the water quality in catchment basins not only in the dimension of a single river but in whole river networks. A submodel of the IWA River Water Quality Model No. 1 is used in RIONET. The river model is based on the assumption that self purification processes in the river takes place both in the benthic biofilm and the bulk water phase. Laboratory experiments with sediment cores underline the major role of the benthic biofilm. The input parameters of the management tool such as volumetric flow rates from waste water treatment plants and flow velocities and discharge in the main river and its tributaries can be loaded directly from geographic information systems (GIS). The subcatchment basin of the river Bode in Saxon Anhalt was used for test runs of RIONET.

Biofilms↗

PubMed2003

[Variability in neurology care. Tools for quality improvement].

Medical practice variability is a common problem that can reduce the quality of health assistance. We can introduce several tools, like protocols (P), clinical practice guidelines (CPG) and clinical pathways (CP) that allow us to reduce it. CPG must be based in a review of medical evidence and it is the main difference with P. Also it will be more expensive to develop, and its final implementation is more difficult. On the other hand, P are born from simple consensus and its application are easier and widely in medicine. CP have recently appeared in the medical world to try to resolve the problems of the applications of P and CPG in clinical daily practice. They describe in detail medical attention in a systematic, temporal way. They are very similar to a process management and facilitate the interaction of all medical picture actors (manager, health personal and patients). One of the limitations of this tool is that it has not widely application. It is more useful in complex, frequent, very expensive medical process, with known predictable clinical evolution. Once developed, the control and the temporal improvement of these processes. It is very probable that the development of these tools can increase the quality of neurological assistance in Spain in the next future.

Critical Pathways↗

PubMedDate not supplied

A questionnaire on sleep and mental disorders in Parkinson's disease (QSMDPD): development and application of a new screening tool.

Psychiatric, cognitive and sleep disorders are the most frequent and disabling non-motor complications of Parkinson's disease (PD). To improve the description of sleep and mental disorders in PD patients, we set out to develop a simple and reliable data collection tool (questionnaire) for the screening of large samples of PD patients. The first draft of the questionnaire was administered to a consecutive series of 120 PD patients from the outpatient department of our unit, who were instructed to fill it in with the help of their caregivers. Subsequent drafts of the questionnaire were evaluated together with the patients and their caregivers, until a final, satisfactory version was obtained. This final version was named the Questionnaire on Sleep and Mental Disorders in PD (QSMDPD). This questionnaire--we used the Italian version, named Questionario sui Disturbi del Sonno e Mentali nella Malattia di Parkinson, ODSMMP--consists of 119 questions with multiple-choice answers. The QSMDPD was mailed or handed to 400 PD patients followed at our unit's outpatient department. Three hundred and twenty (80%) were returned to us. A review of these completed questionnaires, conducted by a neurologist together with the patients, showed 90% of them (289) to be complete and to provide reliable data. This high compliance suggests that the QSMDPD is a promising tool for collecting data on sleep and mental disorders in large samples of PD patients. A short version will be administered as a follow-up tool.

Aged↗