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At least 1,207 records · Page 67Linked to original sources
PubMed2004

Single high-dose rectal acetaminophen in children.

OBJECTIVE: To determine whether there is sufficient evidence to support the use of one-time high-dose (>30 mg/kg) rectally administered acetaminophen to control postoperative pain in children. DATA SOURCES: Literature was accessed through MEDLINE (1966-May 2004) and bibliographic searches. STUDY SELECTION AND DATA EXTRACTION: All articles identified from the data sources were evaluated and all studies regarding the use of greater than 30 mg/kg of acetaminophen in children were included for this review. DATA SYNTHESIS: A single high dose of rectally administered acetaminophen has been used in children to control postoperative pain. Ten randomized controlled trials and pharmacokinetic studies evaluating the use of greater than 30 mg/kg of rectally administered acetaminophen in children were identified and reviewed. Each study had a unique objective. The studies also differed substantially in regard to design, study population, dosing, rectal formulation used, and monitoring. CONCLUSIONS: Due to limited study data, wide study variability, and lack of standardization in terms of design, objectives, study population, dosing, rectal formulation, and monitoring, compounded by the fact that children often require additional doses of acetaminophen to control postoperative pain, the practice of using one-time, high-dose, rectally administered acetaminophen in children cannot be recommended at this time.

Acetaminophen↗
PubMed2006

From psychiatric ward to the streets and shelters.

The issue of discharge from hospital ward to the streets is seldom explored in the literature, but all too commonly experienced by individuals experiencing psychiatric disorders. The Community University Research Alliance on Housing and Mental Health sought to determine how frequently people were discharged from psychiatric wards to shelters or the street in London, Ontario, Canada. A number of data sources were accessed to determine instances of discharges to shelters or the street. Data were analysed to determine the number of moves occurring between hospital and shelter or no fixed address. All datasets revealed the problem of discharge to shelters or the street occurred regularly. All data sources used have the difficulty of likely underestimating the extent of the problem. This type of discharge occurred at least 194 times in 2002 in London, Ontario, Canada. Policies that contribute to this problem include income-support policies, the reduction in psychiatric hospital beds and the lack of community supports. Without recognition, this problem is at risk of remaining invisible with no further improvements to the situation.

Adult↗
PubMed2001

The limits of narratives in understanding teacher thinking.

Researchers have argued that narrative provides insight into teachers' thinking and a model for the storage of knowledge about teaching. Concurrently, however, there are numerous cautions about using narratives as data sources. The present study addresses two problems: the limits of narrative as a data source and the feasibility of productively analyzing narratives. It also addresses the question of whether teachers actually store information as narratives. For the study, 23 deaf or hearing teachers of the Deaf participating in a project on integrating technology into teaching were interviewed about their experiences as teachers in general and in using technology in the classroom in particular. They rarely generated stories spontaneously. Rather, responses were related to the nature of the stimulus question. For example, when asked about their "worst class," teachers did not provide complete narratives but instead gave responses containing problems without resolutions. The study results suggest that teachers do not store information about teaching as narratives, but nonetheless can expertly construct narratives when given the right opportunity.

Deafness↗
PubMed1994

Defining the generalist physician's training.

OBJECTIVE: To determine the extent to which various specialties prepare residents in the broad competencies required for primary care practice and to propose guidelines for improving generalist physician training. DATA SOURCES: Leading causes of morbidity and mortality, 1991 National Ambulatory Medical Care Survey data, expert reports, and the special requirements for residency training. DESIGN: From the data sources we identified the common presenting conditions and diagnoses that broadly trained generalist physicians could be expected to manage in primary care practice. We then compiled a list of 60 requisite residency training components grouped according to seven practice criteria for generalist physicians. Using the special requirements for residency training for family practice, internal medicine, pediatrics, obstetrics and gynecology, and emergency medicine, we determined the extent to which the requirements addressed the 60 components and continuity-of-care training. RESULTS: Almost all of the 60 generalist training components were required by family practice (95%), internal medicine (91%), and pediatrics (91%), compared with emergency medicine (42%) and obstetrics and gynecology (47%). Family practice, internal medicine, and pediatric residencies also require lengthy, well-defined continuity-of-care experiences. CONCLUSION: Family practice, internal medicine, and pediatric programs prepare residents in the broad competencies necessary for primary care practice. To train competent generalist physicians, we recommend that residency programs require training in 90% or more of the 60 components, 50% or more of the components in each of the seven categories, and a continuity-of-care experience for a panel of patients during at least 10% of the entire residency training period.

Clinical Competence↗
PubMed2026

SurvGRN: a multi-feature fusion framework for bladder cancer survival prediction.

Bladder cancer survival outcomes exhibit significant heterogeneity, influenced by multifaceted factors. While digital pathology-based survival models leveraging artificial intelligence show promise, they often overlook complementary data sources. Conversely, imaging lacks cellular detail, and genomics/proteomics entail complexity and cost. To integrate multidimensional data for enhanced survival prediction, we propose SurvGRN, a multi-feature fusion framework. SurvGRN synergistically combines clinical variables, transcriptomics, and digital pathology slides using a gated residual network architecture. Pathological features are extracted via multiple instance learning, while clinical and transcriptomic data are processed as static inputs. These features are dynamically fused using a long short-term memory (LSTM) network for comprehensive survival risk assessment. Evaluated on 400 bladder cancer patients, SurvGRN significantly outperformed existing methods: improving the C-index by 12.6% over DeepMISL; 20.6% and 7.1% over graph-based models (DeepGraphConv and Patch-GCN); and 5.4% and 4.0% over attention-based approaches (Surformer and HVTSurv). Ablation studies confirmed the contributions of pathology features (extracted via ResNet-50 pre-trained on bladder tissue), clinical/transcriptomic data, and the LSTM fusion. SurvGRN also enabled significant stratification of patients into distinct risk cohorts. This work demonstrates that holistic integration of multi-source data through tailored fusion architectures substantially improves bladder cancer survival prediction.

bladder cancer↗
PubMed1989

[[Mainland China's urban population and urbanization level]].

The author discusses urbanization in the People's Republic of China and problems in data analysis "due to the lack of standardized and well-defined terms for the urban settlements and urban population on the mainland. This paper clarifies the relationship between geographic units and demographic data, identifies the major types of urban population and their characteristics, explains the reasons for the differing levels of urbanization revealed in various data sources, and presents a comprehensive data series on mainland China's urbanization that best approximates reality." (SUMMARY IN ENG)

Asia↗
PubMed2004

A comparison of three sources of data on child homicide.

This study compared data from death certificates (DC), medical examiner (ME) reports, and Uniform Crime Reporting (UCR) Program for homicides among children age 5 years or younger in Jefferson County, Alabama between 1988 and 1998. Records from each source were matched independently to records from the other two sources. Kappa coefficients measured the chance-corrected agreement between sources. The strongest correlations were for victim's gender and race. Correlations were weakest for victim's relationship to the offender and offender's gender. DC and ME data demonstrated excellent agreement and provided a comprehensive count of homicides in Jefferson County, whereas UCR comparisons had lower correlations. However, the UCR is a valuable source of child homicide data in the United States that is underutilized in public health research.

Alabama↗
PubMedDate not supplied

Surveillance for nosocomial infections: can the sources of data be reduced?

With the goal of achieving economy in infection control surveillance we tested the relative efficiency of the various surveillance sources for detecting nosocomial infections (NIs). We reviewed the initial and final surveillance sources of 415 NIs at Hackensack Hospital during an 11-month period; cultures were taken on most of the patients with NIs. Positive microbiology cultures were the initial sources in 64.8% of NIs and secondary sources in 23.6%. Chart review of patients with positive cultures added another 2.9%. Therefore, 91.3% of NIs could have been detected by positive culture reports. The remainder were discoverable by notification from nurses, or by studying admission cards or temperature rounds. Although the NIs missed by lack of a positive culture report often were significant infections, these alternate methods of surveillance did not help to detect any clusters of infections that could be traced to a particular source among the staff or the environment.

Bacteria↗
PubMed2000

Why the government was right to change the 'Our Healthier Nation' accidental injury target.

We congratulate the current UK Government on their inclusion of accidental injury as one of the national targets in the White Paper: Saving Lives-Our Healthier Nation (OHN). We had concerns about the particular target that was proposed in the Green Paper: 'ellipsisto reduce the rate of accidents-here being defined as those which involve a hospital visit or consultation with a family doctor-by at least a fifthellipsis'. The limitations of this target were: firstly, it would focus attention on minor injury and so not reflect the main burden of injury; and secondly, that ascertainment of cases would be influenced by social factors as well as provision of service and access factors. The new target stated in Saving Lives also has its limitations since it will be influenced by service factors. This target is to reduce by 10% the rate of serious injury, defined as injury resulting in four or more days in hospital. We have proposed the use of an alternative indicator of unintentional injury occurrence, based on serious long bone fracture admitted to the hospital. This alternative indicator is based on the occurrence of serious rather than minor injury. It is likely that a high proportion of cases of these injuries can be identified from existing data sources. Ascertainment of cases is likely to be independent of social, service or access factors. Finally, these injuries are associated with significant long term outcomes including disablement, reduced functional capacity and reduced quality of life. It does have the limitation that it does not measure all serious injury. Such a measure is much more difficult to achieve. Further improvements to our proposed indicator could be made in a number of ways, through investigating an extended definition of the indicator to include a range of other serious injuries, improving the quality of existing data, making other data sources available, including outpatient data, and making serious injury a notifiable disease.

Accident Prevention↗
PubMed2005

Application of satellite remote-sensing data for source analysis of fine particulate matter transport events.

Satellite sensors have provided new datasets for monitoring regional and urban air quality. Satellite sensors provide comprehensive geospatial information on air quality with both qualitative imagery and quantitative data, such as aerosol optical depth. Yet there has been limited application of these new datasets in the study of air pollutant sources relevant to public policy. One promising approach to more directly link satellite sensor data to air quality policy is to integrate satellite sensor data with air quality parameters and models. This paper presents a visualization technique to integrate satellite sensor data, ground-based data, and back trajectory analysis relevant to a new rule concerning the transport of particulate matter across state boundaries. Overlaying satellite aerosol optical depth data and back trajectories in the days leading up to a known fine particulate matter with an aerodynamic diameter of <2.5 microm (PM2.5) event may indicate whether transport or local sources appear to be most responsible for high PM2.5 levels in a certain location at a certain time. Events in five cities in the United States are presented as case studies. This type of analysis can be used to help understand the source locations of pollutants during specific events and to support regulatory compliance decisions in cases of long distance transport.

Aerosols↗
PubMed1998

Recurrent facial neuromas.

OBJECTIVE: The study aimed to present clinical, radiographic, and operative findings in cases of recurrent facial neuromas and discuss changes in demographics of primary facial neuromas since 1986. DATA SOURCES: MEDLINE search of English language literature since 1966 and bibliographies of collected articles were the data sources. STUDY SELECTION: All available reports of recurrent facial neuromas (N = 8) and case reports of primary facial neuromas since 1986 (N = 238) were selected. DATA EXTRACTION: Cases of facial neuromas confirmed by histologic and/or clinical and radiographic criteria are included. DATA SYNTHESIS: Compilation of reported anatomic and clinical data is included. CONCLUSIONS: Improved imaging techniques have documented an increased incidence of primary facial neuromas medial to the geniculate ganglion. Clinical suspicion, histologic confirmation of tumor-free margins, interspecialty cooperation in tumor resection, and routine follow-up imaging with magnetic resonance imaging are suggested to minimize recurrent facial neuromas.

Adult↗
PubMedDate not supplied

Denominator effects on traumatic occupational fatality incidence rates.

Each year over 6,000 workers are killed while earning a living in the United States. From these deaths, how can researchers determine if employees in the manufacturing industry are at greater risk of a traumatic occupational fatality than those employed in agriculture or any other industry? Similarly, does the risk of traumatic occupational fatality differ among states? To answer such questions, two measurements are normally used: frequency of occurrence and incidence rate. These measures are used to identify worker groups at greatest risk of fatal injury, target research and prevention activities, and evaluate the impact of these activities. Developing the best methods to accurately identify worker groups at greatest risk of losing their life while at work is always important, but even more so in times of limited government resources. The accuracy of a traumatic occupational fatality incidence rate depends on how closely the denominator and numerator represent the same population. Selecting data from different employment programs for the denominator when calculating incidence rates using the National Traumatic Occupational Fatalities surveillance system for the numerator has shown dramatically different results. This analysis points out that researchers must carefully: choose the data they employ; evaluate the meaning of calculated incidence rates; and document the data sources to ensure proper interpretation by others. Additional research and evaluation are necessary to improve data sources, analytical methods and tools to ensure effective resource allocations for the occupational safety and health field.

Accidents, Occupational↗
PubMedDate not supplied

Methodological considerations for grounded theory research in critical care settings.

BACKGROUND: The context of critical care and human phenomena involved in critical illness offer rich opportunity for nursing research. Naturalistic investigation with grounded theory methods can uncover previously unexamined elements and interactions in the critical care setting. This article presents methodological considerations for conducting grounded theory research in fast-paced physiologically and technologically complex critical care settings. APPROACH: Critique and recommendations are based in review and analysis of grounded theory research in adult critical care settings and on the literature describing grounded theory methods. The authors' experiences in medical and surgical intensive care units provide added practical context for this article. RESULTS: Barriers to achieving grounded theory in critical care settings, such as communication impairments, participant attrition, and observational difficulties, are explored. Methodological strategies and data sources particular to critical care settings are also discussed. Critical care settings offer a variety of data sources that should be rigorously pursued in grounded theory research. DISCUSSION: Given current trends in healthcare treatments and demographics, future research must examine physiological and technological data as integral components of basic social psychological or social structural processes in critical care interactions and should include technology as a component of nurse-patient interaction.

Critical Care↗
PubMed1988

A proposal for more informative abstracts of review articles.

This proposal presents guidelines for preparing informative abstracts of review articles. Six guidelines are proposed: 1. The abstract should begin with a precise statement of the primary objective of the review. 2. The data sources for the review should be succinctly summarized. 3. The criteria used to select studies from the data sources and the method by which these criteria were applied should be specified. 4. The guidelines used for abstracting data and assessing data quality should be described. 5. The main results of the review and the methods used to obtain these results should be stated. 6. Conclusions and potential applications of the review's results should be clearly and succinctly stated. Application of these guidelines can lead to efficient identification of relevant, scientifically sound review articles, a greater awareness of the vital elements of a good review article, more precise computerized literature searches, and improved peer-review processes.

Abstracting and Indexing↗
PubMed1995

Approaches to community needs assessment: a literature review.

In the light of the growing awareness of professionals in the community of the need to undertake health needs assessments of the population, this literature review sets out to explore, delineate and critically analyse the various approaches to community needs assessment, to facilitate a greater understanding of their strengths and weaknesses. The review commences by highlighting its complex nature, and attempting to define what is meant by 'needs assessment' from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics. It continues by putting forward an argument for the use of the community health profile, being a multi-focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources. The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy. Throughout the review, issues are discussed with reference to the current political context in the United Kingdom. Equally important is the community nurse perspective, which is integrated into the arguments where appropriate.

Community Health Nursing↗
PubMed1992

Effect of histamine H2-receptor antagonists on vitamin B12 absorption.

OBJECTIVE: To discuss the potential of histamine H2-receptor antagonists (H2RAs) to cause malabsorption of vitamin B12 (cyanocobalamin). DATA SOURCES: Pertinent literature was identified via a MEDLINE search. Journals and references cited in published articles also were used as data sources. STUDY SELECTION: Studies evaluating the effect of H2RAs on vitamin B12 absorption were reviewed. DATA SYNTHESIS: H2RAs decrease acid secretion by the gastric parietal cells. Gastric acid and pepsin produced by these cells are required for the cleavage of vitamin B12 from dietary sources. Intrinsic factor (IF), also produced by gastric parietal cells, is required for vitamin B12 absorption from the gastrointestinal tract. Although H2RAs have not conclusively been shown to decrease IF secretion, studies have demonstrated a significant reduction in food-bound vitamin B12 absorption secondary to decreased acid secretion in patients taking these drugs. CONCLUSIONS: H2RAs have the potential to cause vitamin B12 deficiency. This may be important in patients with inadequate stores of vitamin B12 (e.g., poor diet), particularly those receiving H2RA therapy continuously for more than two years. Healthcare providers should be aware of this potential adverse effect.

Cimetidine↗
PubMed1995

Preschool teachers' theoretical and pedagogical stances on the language and literacy development of deaf and hard-of-hearing children. Implications for teacher preparation and in-service programs.

This study was an investigation into three preschool teachers' theoretical and pedagogical stances on the language and literacy development of deaf and hard-of-hearing children. Transcripts from formal, audiotaped interviews provided the primary data source for the investigation of the teachers' theoretical orientations toward language and literacy learning. The primary data sources used in examining the teachers' instructional practices were videotape recordings, handwritten field notes, and photographs of the teachers and their students participating in classroom language and literacy events over a six-month period. Data were analyzed inductively using the procedures and techniques related to grounded theory analysis. Results of the study indicated that the teachers held differing theories and that these theories influenced the teachers' instruction in significant ways. The study highlights the growth in one teacher's perspectives and the resulting changes in her classroom practice.

Child↗
PubMedDate not supplied

What clinicians should know about the QT interval.

CONTEXT: Of the several factors implicated in causing QT interval prolongation and torsades de pointes, errors in the use of medications that may prolong this interval deserve special attention. OBJECTIVE: To systematically summarize the available clinical data on the QT interval and to offer improved recommendations for the use of QT-prolonging medications. DATA SOURCES: We searched MEDLINE from 1966 through 2002 for all English-language articles related to the QT interval. Additional data sources included bibliographies of articles identified on MEDLINE, a survey of experts, and data presented at a meeting of experts on long QT syndrome. STUDY SELECTION: We selected for review registries and case series examining clinical outcomes of patients with prolonged QT interval and the effect of different methods of measurement of the QT interval on patient outcomes. Ten studies were identified, of which 6 were included in the analysis. DATA EXTRACTION: Data quality was determined by publication in the peer-reviewed literature. DATA SYNTHESIS: Optimal measurement of the QT interval is problematic because of lack of standardization and lack of data regarding the best way to adjust for heart rate. Reliable information on the proper use of QT-prolonging medications is scarce. Although a QT interval of at least 500 milliseconds generally has been shown to correlate with a higher risk of torsades de pointes, there is no established threshold below which prolongation of the QT interval is considered free of proarrhythmic risk. The risk of torsades de pointes should be assessed in patients who are about to begin taking a QT-prolonging medication. Although inadequate clinical studies preclude prediction of absolute risk for individual patients, particularly high-risk situations can be defined based on clinical variables. We propose recommendations on proper monitoring of the QT interval in patients receiving QT-prolonging medications. CONCLUSION: Although the use of QT-prolonging medications can predispose to torsades de pointes, there is a relative paucity of information that can help clinicians and patients make optimal informed decisions about how best to minimize the risk of this serious complication.

Drug Interactions↗