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PubMed1997

The path to a clinical pathway: collaborative care for the patient with an ostomy.

A colostomy and ileostomy clinical pathway was developed at a southeastern teaching hospital in 1990 in response to excessive lengths of stay and costs at our hospital compared with national data for this patient group. A multidisciplinary clinical pathway team was formed and charged with the development, implementation, and ongoing monitoring of the clinical pathway tool and its effect on the outcomes of the population of patients with colostomies and ileostomies. Through this multidisciplinary collaboration, length of stay and cost have been reduced while quality care indicators have been maintained. This article presents the sample pathway we developed and describes the pathway development process, documentation, the variance analysis process, and the outcomes achieved with implementation. A urostomy/urinary diversion pathway that was developed after variance analysis review of the colostomy and ileostomy clinical pathway is also presented.

Analysis of Variance↗
PubMed2005

[Relationship between the polymorphism of carboxylic esterases and genetic susceptibility to organophosphates pesticides exposure].

OBJECTIVE: To study the relationship between the polymorphism of butyrylcholinesterase (BChE, EC 3.1.1.8) and paraoxonase (PonE, EC 3.1.8.1), and the individuals' genetic susceptibility to organophosphates pesticides (OPs) exposure. METHODS: 75 OPs exposure workers were selected to determine their BChE-K, PON-192 and PON-55 genotypes using PCR-RFLP. The accumulative symptom scores and the whole blood acetylcholinesterase activity (mmol x h(-1) x ml(-1)) were used as health index. Firstly, the health condition related to single gene site of the three gene loci was analyzed to determine which kinds of genotype were susceptible. Then, used the multiple variance analysis was to see if there existed interactions among these three gene loci. Finally, established the multi-factor linear regression equation, in which considered some other factors that might influence the health situation such as age, gender and the exposure time. According to the equation, could get the accumulative symptom scores of each kind of subpopulation of different genotypes. RESULTS: The mean AChE activities of the exposed workers with BChE-K genotype UU (61 cases), genotype UK (12 cases) and genotype KK (2 cases) were 105.0 +/- 23.0, 84.4 +/- 16.4, 79.0 +/- 9.9, respectively; The accumulative symptom scores were 3.7 +/- 3.8, 9.2 +/- 3.0, 12.5 +/- 0.7, respectively. The AChE activities of the exposed workers with PON-192 genotype BB (37 cases), genotype AB (27 cases) and genotype AA (11 cases) were 116.8 +/- 15.1, 91.2 +/- 15.6, 72.3 +/- 21.4, respectively; The accumulative symptom scores were 2.0 +/- 3.2, 6.7 +/- 3.3, 9.7 +/- 1.8, respectively. Similarly, the AChE activities of the exposed workers with PON-55 genotype LL (70 cases) and genotype LM (5 cases) were 102.4 +/- 23.0, 82.8 +/- 22.0; The accumulative symptom scores were 4.5 +/- 4.2, 9.2 +/- 3.6, respectively. Single variance analysis showed that the accumulative symptom scores of the individuals with abnormal homozygote of these three gene loci were the highest, which indicated that they were most susceptible to OPs. Multiple variance analysis showed there were no interactions among the three gene loci. Age, gender and exposure time had no statistical significance, while genotypes of the three gene loci had statistical significance to health situation. CONCLUSION: Genotypes of BChE-K, PON-192 and PON-55 are related to susceptibility to OPs exposure.

Adult↗
PubMed2006

Comparing tongue shapes from ultrasound imaging using smoothing spline analysis of variance.

Ultrasound imaging of the tongue is increasingly common in speech production research. However, there has been little standardization regarding the quantification and statistical analysis of ultrasound data. In linguistic studies, researchers may want to determine whether the tongue shape for an articulation under two different conditions (e.g., consonants in word-final versus word-medial position) is the same or different. This paper demonstrates how the smoothing spline ANOVA (SS ANOVA) can be applied to the comparison of tongue curves [Gu, Smoothing Spline ANOVA Models (Springer, New York, 2002)]. The SS ANOVA is a technique for determining whether or not there are significant differences between the smoothing splines that are the best fits for two data sets being compared. If the interaction term of the SS ANOVA model is statistically significant, then the groups have different shapes. Since the interaction may be significant even if only a small section of the curves are different (i.e., the tongue root is the same, but the tip of one group is raised), Bayesian confidence intervals are used to determine which sections of the curves are statistically different. SS ANOVAs are illustrated with some data comparing obstruents produced in word-final and word-medial coda position.

Analysis of Variance↗