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PubMed1998

MicroVal: a European approach to the certification of new microbiological methods. MicroVal secretariat.

Reference methods, such as those published by ISO (International Standards Organisation), are often laborious, expensive, and time consuming. More convenient, cheaper and more rapid methods are therefore often preferred for daily use. However, results obtained with such methods should be accepted by official control laboratories and trade partners, MicroVal, a European project for the validation and approval of alternative methods for the microbiological analysis of food and beverages, was set up to achieve this. A description is given of MicroVal. The general rules and certification procedures are described, as well as how the certification is organised. MicroVal aims at certifying alternative methods, i.e. methods which perform as well as internationally standardised methods. Whenever possible, an ISO standard method is used as the reference. Certification of alternative methods should ensure their acceptance by governmental inspection laboratories and laboratories in the food trade, thus facilitating commerce within the European Union.

Certification↗

PubMed1999

Job analysis 1996: Infection control professional. Certification Board in Infection Control and Epidemiology, Inc, 1996 Job Analysis Committee.

The Certification Board in Infection Control and Epidemiology, Inc, directed its Test and Administrative Subcommittees to compose a Job Analysis Committee in 1995. This 16-member Job Analysis Committee, in collaboration with Applied Measurement Professionals, Inc, conducted a job analysis survey of infection control professionals in the United States and Canada during 1996. The reassessment of the previous Certification Board in Infection Control and Epidemiology, Inc, task analysis, formation of a job-analysis survey tool, the actual job-analysis process, and its results are described in this article. The previous and newly revised test specification outlines are compared. The Revised Certification Examination for Infection Control offered beginning in 1997 will reflect the efforts of this endeavor.

Canada↗

PubMed1997

Competing causes of death: a death certificate study.

BACKGROUND: Despite the widespread interest in competing causes of death, empirical information on interrelationships between causes of death is scarce. We have used death certificate information to estimate the prevalence of competing causes of death at the moment of dying from specific underlying causes of death. MATERIALS AND METHODS: In a stratified sample of 5975 deaths occurring in The Netherlands in 1990, information contained in the death certificate was used to determine the presence of diseases which, in the hypothetical case of elimination of the underlying cause of death, could develop into a new underlying cause of death. Poisson regression analysis was used to describe variation in age- and sex-adjusted prevalence of competing causes of death between different underlying causes. RESULTS: Per 100 deaths, 46.2 competing causes were identified (52.0 after reweighting to take away the effects of stratification). The most frequent competing causes, all occurring in more than 2% of deaths, were: senile dementia, diabetes mellitus, ischemic heart disease, cerebrovascular disease, chronic obstructive lung disease, hypertensive disease, and arteriosclerosis. The overall prevalence of competing causes is relatively high among deaths from respiratory diseases (relative risk for respiratory diseases as compared with all underlying causes (RR) = 1.42 (95% CI, 1.25-1.62)), relatively low among deaths from neoplasms (RR = 0.54 (95% CI, 0.47-0.62)), and in between among deaths from cardiovascular diseases (RR = 1.08 (95% CI, 0.95-1.22)). CONCLUSION: Although it cannot be excluded that some of the variation in prevalence of competing causes by underlying cause is due to selective underregistration of coexisting diseases on death certificates, the results of this study suggest that conventional estimates of gains in life expectancy after elimination of neoplasms are much less biased by the effect of competing causes than the corresponding estimates for cardiovascular diseases and particularly respiratory diseases.

Adolescent↗

PubMed2001

Validation of birth certificate data. A study of women in New Jersey's HealthStart program.

PURPOSE: This study assesses the accuracy of 1989-1992 birth certificate data from New Jersey for a group of high-risk women. METHODS: Birth records were linked to data on women who participated in HealthStart, a program of enriched prenatal care for pregnant women on Medicaid. Concordance was assessed for all variables common to the two data sets. RESULTS: The birth records had accurate reporting of birth-weight, demographic characteristics, and most methods of delivery. Prenatal care use was over-reported, and alcohol, tobacco, transfer status, medical risk factors, obstetric procedures, as well as complications of labor and delivery were underreported. CONCLUSIONS: While many variables are reported very accurately on birth certificates, other measures must be used cautiously. Analyses using birth certificate data, particularly those focusing on high-risk women, need to take the low levels of sensitivity for many risk factors into consideration.

Birth Certificates↗

PubMed2003

Survey of recently board-certified prosthodontists on the board certification process. Part 1: Demographics.

PURPOSE: A survey of recently board-certified prosthodontists was conducted in 2001. The purpose of this survey was to identify trends that assisted candidates in attaining diplomate status. MATERIALS AND METHODS: A questionnaire was mailed to 176 diplomates who had become board certified between the years 1993 and 2001. Of these, 131 board-certified prosthodontists returned the completed survey, resulting in a response rate of 74%. The mean, median, and range of responses were computed when applicable. RESULTS: Results from this survey show that the mean number of years from completion of a postdoctoral program to achieving board certification was 6 years, with a median of 4 years and a range of 1 to 23 years. The mean number of years from the time of completion of a postdoctoral program to board eligibility was 2.3 years, with a median of 1 year and a range of 0 to 22 years. The mean number of years from board eligibility to board certification was 3.9 years, with a median of 3 years and a range of 0 to 17 years. The military was the most frequently reported employment status at the time the respondents took Parts 1-4 of the boards. A total of 54% of the diplomates reported that they challenged Part 1 separately, and then challenged Parts 2, 3, and 4 together; 79% of the diplomates were encouraged by their graduate program director/faculty to challenge the board; and 48% of the diplomates reported that their patients received free dental treatment. CONCLUSIONS: Certain trends were observed regarding diplomates who succeeded in their efforts to challenge the board examination. The largest group who challenged the board certification examinations comprised members of the armed forces. Most prosthodontists challenged Part 1 before challenging the remaining 3 parts. In an effort to encourage more prosthodontists to challenge the board examination, numerous changes were made between 1992 and 1998; however, most of the diplomates did not take advantage of those changes.

Certification↗

PubMed1996

Benefits of certification for pharmacy specialists.

The objective of the study was to measure the tangible and intangible benefits of certification by the Board of Pharmaceutical Specialties (BPS). All BPS-certified pharmacists (n = .733) were mailed a survey in October 1933. The response rate was 65.5% (n = 480). Approximately 8% of respondents reported a promotion, 16% reported a bonus, and 10% reported a raise as a direct result of certification. Respondents were asked to indicate their level of agreement with statements concerning benefits they had experienced as a result of certification. The highest level of agreement about perceived benefits had to do with greater self-worth, improved competence, and greater marketability. The lowest agreement about perceived benefits was related to monetary compensation. This article compares responses by pharmacists in three specialties and who hold two types of degrees.

Certification↗

PubMed1996

Strategies for success: preparing for the certification examination.

Preparing for one of the certification examinations in perianesthesia nursing can be as challenging as taking them. For many, a certification examination will be the first test taken since graduation from a nursing education program. Identifying and practicing successful testing behaviors will assist the candidate in organizing an approach to learning and reviewing for examination. Developing a realistic time frame for a study strategy, along with objectives and completed goals, is imperative. Test anxiety often is a major obstacle to effective test performance. Strategies to deal with anxiety can be learned and used to successfully prepare for and take the examination. A confident approach to the certification examination is the candidate's greatest asset.

Certification↗

PubMed2003

Healthcare teams over the Internet: programming a certificate-based approach.

Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modern healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has, therefore, become a major concern. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security model is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control (HAC) security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

Certification↗

PubMed1997

Approaches for certification of electronic prescription software.

The proper management of drug treatment is essential, since adverse drug reactions are common reasons of hospitalisations. Expenditure on drug therapy has also been growing faster than any other aspect of health care in many countries. Savings and quality improvements in drug treatment could be achieved with computerised prescribing. In this paper, the architecture of an electronic prescription system is described in the light of software certification and registration. An electronic prescription system is an example of a system supporting shared care and therefore it should be person based, integrated, secure and confidential and data should be shared among health care institutions. The system architecture shares the idea of a virtual patient record and a smart card will be used as a key to prescription data located on the network. The certification and registration of medical software is a difficult and costly procedure. Ensuring the quality of software can be based on; certification of development process, voluntary evaluation, and post-market surveillance. Voluntary evaluation practice would be a precious tool for both the customers and software developers, and it would also be an invaluable source of information in terms of developing new software.

Certification↗

PubMedDate not supplied

Blended roles: preparing the advanced practice nurse educator/clinician with a Web-based nurse educator certificate program.

Changing demographics, a nursing shortage, and various societal changes underscore the need for nurse educators and new nurse educator programs. This article describes a Web-based nurse educator program designed to prepare advanced practice nurses for faculty roles while simultaneously preparing them as clinicians. Guided by adult education theory and self-directed learning theory, the Web-based Nurse Educator Certificate (four Web-based nurse educator courses including a teaching practicum) has been developed and offered to clinical master's and postmaster's students. This article also describes student work with mentors, interactive Web-based teaching strategies, portfolios, graduate competencies, and initial evaluative data. In the first two years of the program, 48 students have taken at least one course in the Nurse Educator Certificate program and eight students have completed it. A Web-based nurse educator certificate program, as part of a clinical master's or postmaster's program, has the potential to help meet the faculty shortage.

Attitude of Health Personnel↗

PubMed2001

The MCH Certificate Program: a new path to graduate education in public health.

OBJECTIVE: The purpose of the MCH Certificate Program was threefold: to develop a new educational initiative in response to national and local demands for increased MCH workforce capacity, to eliminate key financial and nonfinancial barriers to advanced MCH academic preparation, and to improve rates of recruitment and retention of students from minority communities, thus enhancing the quality of MCH services available to the region. METHODS: An MCH Certificate Program, designed for clinicians (e.g., nurses, occupational therapists and nutritionists) and public health practitioners as a bridge to graduate programs in public health, combined a competency based curriculum with skills workshops, leadership seminars, mentoring, small group activities, and an interactive teaching format. RESULSTS: Students from the first two cohorts (n = 45) report an expansion of core public health knowledge (issues, policies, and strategies), enhanced self-confidence, and efficacy. Half have experienced job changes that represent increased responsibility, leadership, and professional advancement. A third are enrolled in or have completed a formal program of graduate study in MCH. CONCLUSIONS: This innovative MCH Certificate Program, now in its fourth year, is a new approach to increasing workforce capacity and a successful model of instruction for adult learners. It has the potential for adaptation to a variety of educational settings and MCH populations, and helps to expand the continuum of MCH training experiences in schools of public health.

Boston↗

PubMed2000

Asthma mortality in Danish children and young adults, 1973-1994: epidemiology and validity of death certificates.

Several reports indicate that asthma mortality has increased during the last few decades. International comparisons reveal some striking differences in the pattern of asthma mortality. The authors investigated the asthma mortality rate in the Danish child and youth population 1973-1994 and studied the validity of death certificates. The authors reviewed all death certificates coded as asthma death in the International Classification of Diseases (ICD 8-ICD 10 (1994)) and adjacent respiratory code numbers for the age group 1-19 yrs. Hospital records and autopsy reports were assessed to validate the cause of death. Age-standardized and age-specific mortality rates were calculated. From 1973 to 1987 there was a significant upward trend in the mortality. On subdivision, this trend was limited to the age group 15-19 yrs. Generally the mortality rate decreased from 1988 to 1994. Four per cent coded as asthma were false positive. Twelve per cent were false negative asthma deaths, wrongly coded as due to other causes. Only 62% of all true positive death caused by asthma were appropriately coded. The number of false negative certifications increased with increasing autopsy frequency. Asthma mortality rates in Denmark increased in adolescents during 1973-1987 and decreased from 1988 to 1994. A possible explanation may be an increased awareness of asthma symptoms combined with a steadily improved treatment of asthma. Even in children and young adults under the age of 20 yrs, validity problems still make comparisons between countries difficult; even interpretation of national trends requires caution.

Adolescent↗

PubMed1994

The impact on colorectal cancer survival of cases registered by 'death certificate only': implications for national survival rates.

This paper describes the effect of including death certificate only (DCO) registrations on 5 year relative survival rates for colorectal cancer in four district health authorities (DHAs) in south-east England. A retrospective case note study was set up to examine all cases of colorectal cancer listed in the Thames Cancer Registry (TCR) as having been diagnosed in 1983 and 1988 and resident in one of four districts, A, B, C and D. A total of 673 sets of cases notes were requested from all hospitals within the four districts, including 150 sets on DCO cases. Of 465 (69%) sets of case notes retrieved, 378 (72.3%) were non-DCO cases. Of these, 14 were excluded from survival analysis because of missing dates of diagnosis or death in the notes. Eighty-seven (58.0%) sets of case notes were retrieved on DCO registrations, of which seven were excluded because no date of diagnosis was available in the notes. Retrieval rates on case note registrations varied by DHA of residence: 73.3% in DHA A, 96.6% in DHA B, 34.5% in DHA C and 79.2% in DHA D. The corresponding figures for DCO registrations were 63.5%, 69.0%, 7.4% and 76.2%. Cumulative relative 5 year survival rates by DHA of residence were calculated first for cases registered from case notes and then for all cases including those registered solely from a death certificate. The total number of cases used in the survival analysis was 444 (18% DCOs). In all four DHAs, 5 year survival decreased with the inclusion of DCO registrations: by 9.1% in district A (from 52.8 to 43.7), by 4.5% in district B (from 59.6 to 55.1), by 4.8% in district C (from 80.0 to 75.2) and by 7.6% in district D (from 31.4 to 23.8). The overall reduction in survival was 8.6%. The exclusion of death certificate only registrations from survival data is an important source of bias. Using TCR data, we compared DCO proportions for colorectal cancer with other sites. DCO proportions were shown to vary by tumour site and survival time. The DCO registration is an important quality measure of ascertainment and follow-up. OPCS should publish DCO proportions by registry area and cancer site. Registries should implement DCO monitoring as part of quality improvement programmes.

Colorectal Neoplasms↗

PubMed1995

Limitations of the death certificate only index as a measure of incompleteness of cancer registration.

The death certificate only (DCO) index, which quantifies the proportion of patients for whom the death certificate provides the only notification to the registry, is a widely used measure of incompleteness of population-based cancer registration. This paper provides an algebraic assessment and a quantitative illustration of the relationship between the DCO index and incompleteness of cancer registration. It is shown that the relationship between the DCO index and incompleteness of registration is strongly dependent on the case fatality rate and the misclassification rates of cancer deaths among unregistered patients. Therefore, the DCO index is a very poor indicator of incompleteness. Similar limitations apply to the DCN index (proportion of cases first notified by death certificate), which has been proposed as an alternative measure of incompleteness.

Death Certificates↗

PubMed2005

Feasibility study of preparation and certification of reference materials for nitrogen dioxide and sulfur dioxide in diffusive samplers.

This paper presents the results of a feasability study for the preparation and certification of reference materials (RMs) for nitrogen dioxide (NO(2)) and sulfur dioxide (SO(2)) in diffusive samplers. RMs for NO(2) were prepared by exposure to gas mixtures in a chamber while the RMs for SO(2) were prepared by liquid spiking. Certification of RMs for NO(2) was found feasible with a certified uncertainty of 5.8% and a proposed shelf life of 5 years. The uncertainty was calculated with contribution from the homogeneity of preparation, stability and transport of the CRMs and from an external verification of the certified value. To reach 5.8% of uncertainty, the contribution of the differences between the results of analysis by ion chromatography and colorimetry must be eliminated. It is proposed to solve this by pre-extracting the samplers with water before analysis. The results of this study indicate that the samplers are stable for at least two years before and after exposure when stored in a refrigerator. By contrast, the certification of RMs for SO(2) was found to not be feasible due to instability problems. This instability was attributed to reaction of sulfate on the walls of the samplers. Alternatively, the preparation of RMs by simultaneous exposure to SO(2) and NO(2) has been tested. Satisfying homogeneities has been reached both for NO(2) and SO(2).

Air Pollutants↗

PubMed2002

Are medical postgraduate certification processes valid? A systematic review of the published evidence.

OBJECTIVE: To collate the published works on validation of assessments used in postgraduate medical certification. DESIGN: Systematic review of original papers on reliability and validity of assessments used in medical postgraduate certification. SETTING: Medical and education research databases. RESULTS: Fifty-five papers were identified from 1985 to 2000. A wide range of approaches to validation were employed. Inter-rater reliability and internal consistency were the most reported foci for validation. There were just two papers on consequential validity, and only a few on construct validity. These two forms of validity are considered central in recent general education writing. The majority of papers were from general and family practice. There was a noticeable lack of papers from the UK Royal Colleges (except the Royal College of General Practitioners), despite 5 years of the new unified grade and the renewed emphasis on the role of the Royal Colleges in setting assessment criteria. CONCLUSIONS: There is a relative scarcity of published papers on validation of assessment for postgraduate medical certification considering the influence these high stakes processes have on doctors career progression and employment opportunities. General and family practice institutions in a number of English speaking countries have set an example to others, by showing that rigour and transparency in assessment development and implementation can be reflected in publication.

Certification↗

PubMed2006

Vascular surgery training after primary certification: where we go from here.

Program directors in vascular surgery have an increasingly complex set of responsibilities in the management of a vascular surgery residency, now that primary certification has been approved for vascular surgery and new training paradigms have been created in addition to the previous sequential training and certification in both general and vascular surgery. With the availability of new training paradigms, such as the 3+3 curriculum or entrance into a vascular residency program of 5 or 6 years directly out of medical school, the program director will become responsible for ensuring adequate training in basic surgical principals as well in the management of vascular pathology. Areas of added responsibility will include recruiting trainees, maintaining training case volumes, developing effective educational curricula and certifying the quality of the residents. This article discusses these tasks in detail, identifying special problem areas, such as changing lifestyle expectations, particularly in recruiting women, now approaching one half of medical students; expansion to meet the increasing need for vascular surgeons in the future as the population ages; funding vascular fellowship training; maintaining open surgical case loads while providing the facilities and supervision for adequate endovascular surgical training; providing a useful experience in both noninvasive vascular diagnosis and nonoperative management of vascular disease--in short, an experience that will result in Board certification and obtaining hospital privileges and a career that satisfies their choice of vascular surgery as a specialty.

Career Choice↗

PubMed2001

Death certification in patients whose primary treatment for oral and oropharyngeal carcinoma was operation: 1992-1997.

The aim of this study was to report the cause and place of death of patients with oral cancer as recorded by death certification and their survival with regard to comorbidity and age. From the departmental head and neck oncology database, 322 patients were identified with previously untreated oral and oropharyngeal squamous cell carcinoma diagnosed between 1992 and 1997 inclusive. Three-hundred were matched with the Office for National Statistics (ONS) and copies of death certificates generated on 6 March 1999. Of the 286 patients primarily treated by operation, 203 were alive and 83 had died. In 56 (68%), oral cancer was a contributory factor to the patient's death. Patients with a medical history recorded on their admission for operation had similar survival curves compared to those having no problems recorded. Although most patients (n= 46 55%) died in hospital, only 13 (16%) died in the Regional Maxillofacial Unit. Almost half of those patients who died were not recorded as dead on the departmental oncology database. This study shows that it is useful to link with the ONS to obtain accurate data on date and place of death. The death certificate also gives a useful indication of the cause of death and this seems unrelated to preoperative comorbidity.

Age Factors↗