SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Board certification in any health care-related area is one mechanism that promotes high standards of practice and assures public confidence. Certification eligibility and requirements for dental technicians and laboratories are reviewed. Issues affecting the future of dental technology are discussed.
Accidental events such as fires, explosions, and leaks often result in large-scale contaminations of buildings with toxic chemicals. After decontamination, the certification for original use requires testing for residual contamination. The two basic kinds of sampling plans in use up to recently both fall short of the required performance. Their deficiencies are analyzed in terms of the scientific questions implicit in both the sampling plan and the subsequent statistical evaluation. A sampling strategy of a new kind is proposed and discussed in the same context. It is motivated by concern for the long-term safety of the building's occupants and is, therefore, based on factors important in risk assessment. Three different sampling plans are derived in the framework of this methodology, two of which have already been used in actual certification proceedings.
Certification is an attainable goal for all nurses within a variety of practice settings. Certification brings a special meaning to the profession. It allows nurses to take control and assume full responsibility for their competency, accountability, and professional identity.
Undergraduate nursing students, graduate nurses and practicing school nurses may enter a program of study at the University of Wisconsin-Madison leading to eligibility for certification as a school nurse. The option of attaining a minor in health education and certification eligibility as a teacher of health is available in conjunction with the school nurse program. The program and potentials are described and discussed.
OBJECTIVES: A survey was conducted to better understand the training needs of faculty members without dental public health (DPH) specialty board certification who teach DPH to dental students. METHODS: An 11-item questionnaire was sent to 193 non-DPH diplomate faculty members at US dental schools who were dentists and at least one of the following: a member of the American Association of Dental Schools Community and Preventive Dentistry Section, a referral from an academic American Board of Dental Public Health diplomate, a DPH faculty listed on the school's Web pages, a DPH contact from the AADS Institutional Directory, or the school's dean if no other contact. RESULTS: A 70 percent response rate was obtained. Seventy-nine percent of the respondents taught at least one national board-related DPH topic. Among these faculty members, 67 percent have or are in training for the master of public health, 26 percent have completed or are in a DPH residency, and 63 percent desire training in one or more of the DPH topics. The majority (64%) does not plan to take the specialty exam, while 28 percent plan to take the exam within five years. About half reported no personal incentives to take the exam and 39 percent perceived no institutional incentives. CONCLUSIONS: These nondiplomate teachers of predoctoral DPH desire training, but appear to have barriers and perceive few benefits to achieving DPH board certification.
The cause of death entered on the death certificates of 193 patients originally diagnosed as having cancer of the breast was compared with information obtained from clinical records, cancer registry records, and necropsy findings to determine the accuracy of death certification and the proportion of patients who, though dying from another cause, still had overt signs of cancer of the breast. It was found that the overall error in certifying cause of death as breast cancer was small, being an underestimate of about 4%. About a third of patients with breast cancer dying from other causes had overt signs of breast cancer at the time of death.
A comparison has been made between the coding of the cause of death by (a) the Royal College of General Practitioners (RCGP) during the Oral Contraception Study and (b) the Office of Population Censuses and Surveys (OPCS) or the General Register Office for Scotland (GRO) on death certificates for the same subjects. Broad grouping of the International Classification of Diseases (ICD) showed close agreement between RCGP and OPCS or GRO coding for all deaths which occurred from the start of the Oral Contraception Study in 1968 up to December 1978. Moreover, where discrepancies occurred there were no systematic differences between ever-users of oral contraceptive and non-users. Detailed examinations of discrepancies in the coding of the causes of those deaths included in the RCGP publication of October 1977 shows that our previous estimate of mortality risk associated with oral contraceptives would not be materially altered by the use of death certificate information.
STUDY OBJECTIVE: The aim was to determine the reliability of official mortality statistics in estimating long term trends of amyotrophic lateral sclerosis (ALS) in Italy. DESIGN: The study was a mortality follow up of cases of ALS. SETTING: Piedmond Region, northern Italy. SUBJECTS: Cases of ALS were identified from multiple sources between 1966 and 1985. MAIN RESULTS: Cause of death was determined for the cases who died between 1970 and 1985. Death certificates were obtained in 488 out of 510 cases (95.7%). ALS was mentioned in 365 (74.8%) of cases. The most frequent erroneous diagnoses were multiple sclerosis and malignant tumours. Demographic variables, such as sex, age at death, province of death, and calendar year of death, did not influence the percentage of true positive cases significantly. CONCLUSIONS: The death certificate diagnosis of ALS appears to be adequate for use in descriptive and analytical epidemiology.
OBJECTIVE: To investigate the risk of gastric cancer associated with 12 workplace exposures suspected or discussed as aetiological agents in previous reports. METHODS: A case-control study was conducted based on the death certificates of several million deaths in 24 states of the United States in 1984-96. Overall, the data base included 41,957 deaths from stomach cancer among subjects aged > or = 25 years. These were 20,878 white men, 14,125 white women, 4215 African American men, and 2739 African American women. Two controls for each case were selected from among subjects who died from non-malignant diseases, frequency matched to cases by geographic region, race, sex and 5 year age group. Each three digit occupation and industry code listed in the 1980 United States census was classified for probability and intensity of exposure to asbestos, inorganic dust, metals, lead, polycyclic aromatic hydrocarbons (PAHs), nitrogen oxides, nitrosamines, sulphuric acid, fertilisers, herbicides, other pesticides (including insecticides and fungicides), and wood dust. These job exposure matrices were subsequently applied to the occupation-industry combinations in the death certificates of study subjects, separately by sex and race. RESULTS: Risk of stomach cancer showed a modest association with occupational exposure to inorganic dust (odds ratio (OR) = 1.06; 95% confidence interval (95% CI) 1.03 to 1.11) with significant increasing trends by probability and intensity of exposure overall and by cross classification of the two exposure matrices. Workplace exposure to nitrosamines also showed a modest association (OR = 1.06; 95% CI 1.01 to 1.11), but the excess risk was even smaller after adjusting for inorganic dust exposure. Risk of gastric cancer was not associated with any of the other workplace exposures considered in this study. CONCLUSIONS: Non-differential misclassification of exposure may have caused negative findings in this study, and inorganic dust may be a partial surrogate for exposure to other unknown risk factors. Alternatively, our results suggest that occupational factors contribute little to the aetiology of gastric cancer. Inorganic dust might act through non-specific mechanisms, similar to those proposed for salt, aspirin, and heat by other authors.
Pulmonary barotrauma (PBT) is a recognised risk of compressed gas diving. Any reason that causes air trapping in the lung during ascent may cause PBT by increasing intrapulmonary pressure. Chest x ray examination is mandatory for medical certification of the professional divers in many countries, but pulmonary air trapping lesions such as an air cyst in the lungs cannot always be detected by plain chest x ray examination. Computed tomography (CT) is a reliable, but expensive measure for detecting pulmonary abnormalities in divers. Three cases with pulmonary air cysts are reported in which air cysts were invisible on the x ray pictures, but well defined by CT. It is impractical and not cost effective to perform CT for medical certification of all divers, but it can be an option to recommend CT once during the initial examination of the candidates for professional diving, especially if there is a history of predisposing factors, such as smoking or pulmonary infections.
Specialty certification is not a static process but is developing and changing. The author reviews traditional and current patterns of examinations given in English-speaking countries and reports recent concerns and criticisms of the certification process. New developments in the United States include the audiovisual examination, changes in the neurology examination, and institution of examiner training. In Canada there is a heavy emphasis on improving multiple-choice questions and using examiner training. The United Kingdom is experimenting with audiovisual techniques. Australasia is increasing the length of its training programs. Recent research by the American Board of Psychiatry and Neurology includes concordance studies, the relationship between residency training and Board performance, and feedback techniques.
OBJECTIVE: The purpose of this study was to track the progress of a cohort of graduates of psychiatry residency training programs in achieving certification by the American Board of Psychiatry and Neurology (ABPN). These data provide a detailed picture of how recent graduates perform on the ABPN's examinations. METHOD: The subjects for this study were the 739 new candidates who sat for the part I examination in fall 1994. The cohort's performance on the part I and part II examinations was analyzed, as was the relationship between performance on the two examinations. RESULTS: Approximately 8 years after their first attempt at the part I examination, 85% of the cohort were certified, and 15% were not. The majority passed both the part I and part II examinations on the first attempt. Those who passed part I on the first attempt were more likely than those who failed to pass part II on the first attempt. Of the 627 who were certified at follow-up, 199 (32%) were also certified in one subspecialty, and 29 (5%) were certified in two, for a total of 257 subspecialty certificates. CONCLUSIONS: The results of this study suggest that most recent graduates of residency training programs who attempt the ABPN process are likely to become board certified, and the majority will do so by passing both components on the first attempt.
In 1988 New York State imposed a moratorium on the development of new psychiatric beds for children because the state's certificate-of-need law lacked objective criteria for evaluating applications. The following year the department introduced revised certificate-of-need regulations that incorporated more specific program criteria, based on the department's policies, as well as a quantitative methodology for estimating the number of children's beds needed in general hospitals and private specialty hospitals. The methodology led to a planning figure of 10,000 admissions of children to acute care for 1995. It disaggregated the expected admissions to each of the state's 15 children's service areas and also established expected average lengths of stay for each service area. The authors outline the program criteria, the bed-need methodology, and results of the calculations.
The Canadian Association of Occupational Therapists (CAOT) has, for over 30 years, been committed to the development and implementation of a national certification examination. While the likelihood of this becoming a reality has waxed and waned over the years, the goal has remained. As the achievement of this goal nears completion, it is an important task of the Certification Examination Committee, the CAOT Executive, and the Board of Directors to ensure that the significance of the examination is fully understood and supported by the general membership. To this end, this presentation has been prepared.
OBJECTIVE: Data from death certificates are often used in research; however, little has been published on the processing of vague or incomplete information reported on certificates. The goal of this study was to examine the querying efforts in the United States used to clarify such records. METHODS: The authors obtained data on the querying efforts of the 50 states, New York City, and the District of Columbia. Descriptive statistics are presented for two units of analysis: registration area and death record. Using data from a single registration area, Washington State, the authors compared the percent change in age-adjusted death rates for data from before and after querying to analyze the effect of querying on selected causes of death. RESULTS: Fifty-one of the 52 registration areas queried either demographic or cause-of-death information. Almost 90% of queries were returned; the underlying cause of death changed in approximately 68% of these records. This data translates into about 3% of total U.S. death records, given that 4% of total U.S. death records were queried about cause of death. The impact of queries on age-adjusted death rates varied by cause of death. Generally, the effect is most obvious for cause-of-death categories that are specific and relatively homogenous. CONCLUSION: Querying continues to be widely practiced. In the case of cause-of-death queries, this method refines the assigned underlying cause of death for records reported with vague or incomplete information.
Nutrition Support Nurse Clinicians at a Central Texas tertiary care facility have developed a research-based nasoenteric feeding tube insertion procedure that minimizes the potential for inadvertent passage of a feeding tube containing a stylet into the respiratory tract and maximizes placement of the feeding tube in the desired gastric or duodenal location. The first 79 staff nurses to be certified to use the technique had a 90% duodenal placement success rate under supervision. No bedside feeding tube insertion complications have been noted since the initiation of the certification program 6 years ago. This article describes the feeding tube insertion technique used in the certification process and the research on which it is based.
To determine the thoroughness and accuracy with which medical certificates for cremation are completed, a record was made, during normal processing of the documents, of the number of questions that were not answered or answered wrongly, or in which clarification was required. Of 835 sets of forms only 346 (41%) were completed sufficiently accurately for the cremation to proceed without further enquiry. Junior doctors contributed the most errors but general practitioners and consultants also contributed large numbers of errors. Doctors ought to be far more accurate and thorough in completing cremation certificates than were those audited here. The results cast doubt on the reliability of information supplied on other forms. In view of the high frequency of poorly completed forms, review by a medical referee remains essential.
The set of articles appearing in this issue of Evaluation & the Health Professions provides an in-depth examination of the validation process for licensing and certification test score decisions. The winter 1990 issue of Educational Measurement: Issues and Practice also contains an excellent set of articles about licensing and certification tests. These special editions are much needed because these kinds of testing programs are increasing in numbers and aim to ensure public safety, promote growth of professions, and positively affect the careers of persons dedicated to serving in these professions. This article will comment on issues raised by the authors of these articles. But before doing this, a context is described that affects these issues.