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At least 1,351 records · Page 75Linked to original sources
PubMed2002

Limited impact of sustained simple feedback based on soap and paper towel consumption on the frequency of hand washing in an adult intensive care unit.

OBJECTIVE: To determine whether hand washing would increase with sustained feedback based on measurements of soap and paper towel consumption. DESIGN: Prospective trial with a nonequivalent control group. SETTING: Open multibed rooms in the Omaha Veterans Affairs Medical Center's Surgical Intensive Care Unit (SICU) and Medical Intensive Care Unit (MICU). SUBJECTS: Unit staff. INTERVENTION: Every weekday from May 26 through December 8, 1998, we recorded daytime soap and paper towel consumption, nurse staffing, and occupied beds in the SICU (intervention unit) and the MICU (control unit) and used these data to calculate estimated hand washing episodes (EHWEs), EHWEs per occupied bed per hour, and patient-to-nurse ratios. In addition, from May 26 through June 26 (baseline period) and from November 2 through December 8 (follow-up period), live observers stationed daily for random 4-hour intervals in the MICU and the SICU counted actual hand washing episodes (CHWEs). The intervention consisted of posting in the SICU, but not in the MICU, a graph showing the weekly EHWEs per occupied bed per hour for the preceding 5 weeks. RESULTS: Directly counted hand washing fell in the SICU from a baseline of 2.68+/-0.72 (mean +/- standard deviation) episodes per occupied bed per hour to 1.92+/-1.35 in the follow-up period. In the MICU, episodes fell from 2.58+/-0.95 (baseline) to 1.74+/-0.69. In the MICU, the withdrawal of live observers was associated with a decrease in estimated episodes from 1.36+/-0.49 at baseline to 1.01+/-0.36, with a return to 1.16+/-0.50 when the observers returned. In the SICU, a similar decrease did not persist throughout a period of feedback. Estimated hand washing correlated negatively with the patient-to-nurse ratio (r = -0.35 for the MICU, r = -0.46 for the SICU). CONCLUSIONS: Sustained feedback on hand washing failed to produce a sustained improvement. Live observers were associated with increased hand washing, even when they did not offer feedback. Hand washing decreased when the patient-to-nurse ratio increased.

Adult↗
PubMed2006

Virtual reality pencil and paper tests for neglect: a protocol.

Hemispatial neglect is a common disorder that can occur after a lesion in the right hemisphere. Its main characterization is the difficulty in processing visual stimuli emanating from the space contralateral to the lesion. Pencil and paper tests (such as target cancellation, line bisection, or drawing copy) are used to diagnose neglect. We propose using virtual reality technology and haptic force feedback to enhance pencil and paper tests. Our system can track the patients' eye-gaze and their hand movements. Also, the efficiency of several techniques used to decrease the neglect in different sensory spaces are investigated.

Computer Simulation↗
PubMedDate not supplied

Alcohol-Use Disorders Identification Test: a comparison between paper and pencil and computerized versions.

The use of screening questionnaires to detect early problem drinking has been stimulated by the development of the AUDIT (Alcohol-Use Disorders Identification Test). A comparison of a computerized version of the test and its paper and pencil original was conducted on 110 consecutive attenders at an alcoholism day-treatment facility. The findings suggest that the computer version is as acceptable as the paper and pencil one and that scores on the two formats are comparable.

Adolescent↗
PubMed2026

Genetic testing and reporting: What the endocrinologists should know and can expect (Joint position paper of the ENDO-ERN).

Over the last decade, next generation sequencing (NGS) has become an essential tool for diagnostic DNA testing in human genetics. To improve the understanding of available genetic testing strategies and to facilitate the request of genetic testing in daily endocrine practice, clinical and laboratory experts in the field have summarized the major issues which should be known and considered. In this joint position paper of the ENDO-ERN, the roles and responsibilities of the health care professionals involved in the diagnostic workflow are described, and the major issues concerning genetic testing workflows are overviewed. These issues encompass all relevant steps, including test request and pre-analytical procedures, laboratory and data processing workflows, quality assurance, and reporting. As NGS procedures result in an increasing number of variants of unknown significance and incidental findings, these aspects are addressed as well. Accompanied by illustrations of the genetic diagnostic workflow and of concise reports for a fast orientation about the major aspects of genetic testing, this joint paper should support the health care professionals during a request for genetic testing.

VUS↗
PubMed2001

Use of filter paper for the collection and analysis of human whole blood specimens.

The Centers for Disease Control and Prevention and its partners have been operating the Newborn Screening Quality Assurance Program for >20 y. The program helps participating laboratories to evaluate and improve the quality of their newborn-screening testing efforts by providing quality control dried blood spot materials and proficiency-testing materials for the external evaluation of screening programs. The Newborn Screening Quality Assurance Program provides an independent evaluation of filter papers approved by the Food and Drug Administration for the collection of blood for clinical tests. These activities have created a mechanism for the validation of the filter paper blood collection device and the standardization of materials and methods for the analysis of dried blood spots.

Antibodies↗
PubMed2002

Whole blood collected on filter paper provides a minimally invasive method for assessing human transferrin receptor level.

Iron deficiency is the most common micronutrient deficiency worldwide, and transferrin receptor (TfR) level has been identified as an important measure of iron status that is not confounded by inflammation. However, logistical constraints associated with sample collection and processing have limited efforts to measure TfR, particularly at the community level. Standardized filter paper provides a relatively convenient and minimally invasive means for collecting and transporting samples of whole blood from simple finger pricks, and we present results of our validation of an improved method for quantifying TfR in dried blood spots. The method is based on commercially available reagents and uses capillary blood that is applied directly from the finger to filter paper, eliminating the need for premeasurement at the collection site. The blood spot TfR assay is precise and reliable, agrees well with plasma TfR, and can be performed at any facility with a microplate reader and basic laboratory equipment. Concentrations of TfR remain stable for at least 4 wk when blood spots are stored at room temperature, but begin to deteriorate after 3 d of exposure to higher temperatures. The advantages and disadvantages of the blood spot TfR method are discussed, as well as its potential contribution to future field-based studies of iron deficiency.

Blood↗
PubMed1982

Blotting of RNA onto ion exchange paper allowing subsequent characterization by in situ translation in addition to blot hybridization.

We present the preparation of an ion exchange paper which can be used as a solid carrier in the transfer of RNA from gels. In addition to detection by blot hybridization to specific probes, transferred RNA can be characterized by cell-free translation in situ. Preparation of the paper is simple, inexpensive and reproducible. Examples of applications are shown and possible other applications are discussed.

Animals↗
PubMed2001

The classification, genetics and neuropathology of frontotemporal dementia. Introduction to the special topic papers: Part I.

Interest in the neuropsychology and neuropsychiatry of frontotemporal dementia (FTD) has escalated in the past decade, as evidenced by the accompanying 10 special topic papers from research groups in the UK, France, North America and Australia addressing a wide range of theoretical and clinical issues. The first part of this review deals with the confusing terminologies that have been used in the area and argues for the retention of the term FTD as the general clinical label, with further subcategorization into the three principal clinical syndromes seen at presentation: frontal variant FTD (often called dementia of frontal type), semantic dementia and progressive non-fluent aphasia. Each of these syndromes has a characteristic profile of presenting clinical features, but may be accompanied by any one of five types of non-Alzheimer pathological change. There have also been significant advances in the genetics of FTD with the identification of tau gene mutations on chromosome 17 in some familial cases. The remarkable story of the discovery of these, the tau gene mutations, is briefly described. Part II of this review (Hodges and Miller, 2001) sets the special issue papers within the context of advances in the neuropsychology of frontal variant FTD and semantic dementia.

Dementia↗
PubMed1989

NHS resource allocation after the 1989 white paper: a critique of the research for the RAWP review.

The Government White Paper on the NHS, 'Working for Patients', abolished the Resource Allocation Working Party (RAWP) formula in name, but retained its general approach of ensuring geographical equity through funding health authorities by a system of weighted capitation. As a result, the longstanding debate about the appropriate need indicators to include in RAWP, which was tackled afresh in the recent NHS Management Board review of RAWP, will remain highly pertinent to NHS resource allocation in the 1990s. Yet, the research carried out for the RAWP review, on which its principal proposals for change to the need indicators were based, is inadequate for developing a new method of resource allocation after RAWP. The paper describes the research and sets out its main conceptual limitations and problems of method.

Catchment Area, Health↗
PubMed2006

Second-hand smoke levels in UK pubs and bars: do the English Public Health White Paper proposals go far enough?

BACKGROUND: The English Public Health White Paper proposes introducing smoke-free workplaces except in pubs and bars that do not prepare and serve food. The bar area will be non-smoking in exempted pubs. OBJECTIVE: To explore the likely impact of these proposals in UK pubs and bars. METHODS: A total of 59 pubs and bars within Greater Manchester in 2001 were chosen. Thirteen were mechanically ventilated, 12 were naturally ventilated and 34 had extractor fans; 23 provided non-smoking areas. We measured time-weighted average concentrations of respirable suspended particles (RSP), solanesol tobacco-specific particles and vapour-phase nicotine (VPN) over a 4-h sampling period on a Tuesday or Saturday night. RESULTS: Second-hand smoke (SHS) levels in smoking areas were high (mean RSP 114.5 microg/m3, VPN 88.2 microg/m3, solanesol 101.7 microg/m3). There were only small (5-13 per cent) reductions in bar areas. Mean levels were lower in non-smoking areas: by 33 per cent for RSPs, 52 per cent for solanesol particles and 69 per cent for VPN. Compared with other settings (homes and other workplaces) with unrestricted smoking, mean SHS levels were high throughout all areas of the pubs regardless of ventilation strategy. CONCLUSION: Partial measures, like those in the English Public Health White Paper, will leave bar staff in exempted pubs unprotected from the occupational hazard of SHS.

Air Pollution, Indoor↗
PubMed1993

Neutralization and buffering capacity of leaves of sugar maple, largetooth aspen, paper birch and balsam fir.

We compared the acidity, the external acid neutralizing capacity and the buffering capacity of leaves of four commercially important tree species, largetooth aspen (Populus grandidentata Michx.), sugar maple (Acer saccharum Marsh.), paper birch (Betula papyrifera Marsh.) and balsam fir (Abies balsamea (L.) Mill), at two sites of contrasting soil fertility in southern Quebec. External acid neutralizing capacity (ENC) of leaves was determined by measuring the change in pH induced by soaking fresh leaves in an acidic solution (pH 4.0) for two hours. The ENC was highest for largetooth aspen (14.3 micro equiv H(+) g(-1)), and lowest for sugar maple and balsam fir (< 5 micro equiv H(+) g(-1)). The buffering capacity index (BCI) was determined by measuring the amount of acid necessary to produce a change of 5 micro equiv H(+) in the leaf homogenate. The BCI ranged from 883 micro equiv H(+) g(-1) for largetooth aspen to less than 105 micro equiv H(+) g(-1) for sugar maple and balsam fir. Leaves of sugar maple and balsam fir had a lower internal pH and a higher percentage of ENC over BCI than paper birch and largetooth aspen. Overall, ENC was correlated with the concentration of all leaf nutrients except Ca, and BCI was correlated with Mg, N and Ca. The site effect was relatively unimportant for all variables.

Journal Article↗
PubMed1997

Pilot studies of in-course assessment for a revised medical curriculum: I. Paper-based, whole class.

PURPOSE: To test a paper-based method of in-course assessment for a modular, systems-oriented medical curriculum at the University of Otago Medical School. METHOD: In 1996, 193 students took paper-based quizzes on the first four topics of a course in clinical biochemistry. A score of 75% was required for passing, but students could retake quizzes. The subsequent test on these four topics was constructed from questions used in previous years. The next four topics were taught without quizzes. The test on these topics was again constructed from questions used in past years. The authors examined the performances on the quizzes and tests and sought the students' opinions about the program. RESULTS: 72.0-95.3% of the students passed the quizzes the first time and 94.8-99.5% passed by the second version. Performance on the subsequent test items was higher than [corrected] when the items had been used previously; so was performance on three of the four questions for the next four topics, none of which had been accompanied by quizzes. Students valued the quizzes as a stimulus to study and as feedback. They preferred the segment of the course with the quizzes to the segment without them. CONCLUSION: This method of in-course assessment was easy to administer and highly acceptable to the students. Performance on the quizzes was more than satisfactory and a passing score of 75% was reasonable. Such quizzes appeared to be able to replace a test that required explanation of answers while increasing the numbers of questions that could be asked and decreasing the marking time.

Biochemistry↗
PubMed1999

Medical students' education in the ambulatory care setting: background paper 1 of the Medical School Objectives Project.

The present article is the first MSOP Background Paper. In planning the Medical School Objectives Project (MSOP), the Association recognized that certain changes in medical students' education were occurring already in some schools, and that it would be important to gain insight into and monitor these changes to provide ideas and information to help schools design curricular changes to foster students' achievements of the objectives and recommendations set forth in the MSOP Reports published in 1998 and reprinted in Academic Medicine. This background paper provides an overview of the strategies being developed by medical schools to carry out education in the ambulatory care setting. This report is based on site visits in 1997 to 26 U.S. medical schools conducted by two of the authors (CEH and GAK), who also used information from 12 additional schools that were not visited and consulted individuals responsible for the evaluation of five grant programs dedicated to national curriculum reform. The authors define and discuss in detail the use of the three main strategies that their research uncovered: (1) longitudinal preceptorships, (2) multispecialty clerkships, and (3) activities that are community oriented and population based to provide medical students the kinds of educational experiences they need to understand and practice in the ambulatory care setting. The authors then discuss issues and challenges related to the implementation of these curricular changes: curricular management issues; developing and maintaining a network of practicing physicians willing to serve as preceptors; evaluating curricular innovations; and assessing students' performances. The authors conclude with general observations about the need for ambulatory care education, the difficulties that have been--and continue to be--met and overcome to implement it, and the recommendation that relevant learning experiences should be incorporated into existing course work or clinical experiences.

Ambulatory Care↗
PubMed1997

Digital conversion of paper electroencephalograms using a hand scanner.

We report a method of quantifying the analog signal of paper-recorded EEGs that involves readily available technology, including a standard personal computer and a compatible hand scanner. Simulations assessed the effects of erroneously scanning the paper at a slight angle and estimating pen arc distortion; these effects were demonstrated to be insignificant. The method allows application of several quantitative techniques, including power spectral analysis and determination of the squared coherence between homologous regions. In a companion study, we applied this technique to compare the coherence in patients with alpha pattern coma to coherence in normal subjects.

Analog-Digital Conversion↗
PubMedDate not supplied

Measles seroconfirmation using dried capillary blood specimens in filter paper.

Because the incidence of measles has declined in recent years, the potential for confusion of measles with other morbilliform rashes has increased. Routine serologic testing of suspected cases of measles is recommended but it has been hampered, particularly in young infants and children, by the requirement of performing venipuncture. We have compared measles hemagglutination inhibition antibody testing performed on dried capillary whole blood collected on filter paper strips with testing of serum specimens obtained simultaneously by venipuncture. We assessed overall comparability, diagnostic sensitivity and specificity and acceptability and practicality for field use. Of the 125 capillary-venous sets compared, there was a 4-fold difference in hemagglutination inhibition titer between the two types of specimens in only one set (0.8%). Diagnostic sensitivity using capillary blood was 100% and specificity was 96%. Immunoglobulin M assessments on six capillary-venous sets were in complete agreement (three positive in both, three negative in both). In a pilot program of field use, filter paper blood collection was associated with a 97% (36 of 37) success rate in obtaining specimens from individuals with suspected cases of measles. This method of blood collection and testing is an accurate, feasible and acceptable means for seroconfirmation of measles.

Antibodies, Viral↗
PubMedDate not supplied

Survival of cytomegalovirus in paper diapers and saliva.

We studied the survival of human cytomegalovirus inoculated experimentally into saliva and urine-soaked paper diapers. Infectious virus could be recovered from saliva maintained at room temperature or 37 degrees C for up to 2 hours after inoculation. Cytomegalovirus survived in paper diapers for periods as long as 48 hours, with the quantity of virus in urine remaining relatively constant for the initial 12 hours. These observations provide further support for the concept that fomites may have a role in the transmission of cytomegalovirus infections.

Adult↗
PubMed1989

Determination of caffeine in saliva by high-performance liquid chromatography: new sampling method for saliva using filter paper.

We report an assay method for the determination of salivary caffeine concentrations by high-performance liquid chromatography. A simple, new method for collecting mixed saliva using a piece of filter paper has been developed. An arbitrary amount of saliva is absorbed and a fixed amount of internal standard is added. The mean coefficient of variation of measurements repeated by changing both volumes absorbed and caffeine concentrations of saliva was 5.6% with this method. The detection limit was determined to be 0.5 microgram/ml. Precision of measurements and recoveries did not depend upon the volume of saliva absorbed. Four volunteers were given a capsule of 230 mg caffeine, and saliva was collected by the ordinary method using chemical stimulation with citric acid and by our filter paper absorption methods; the methods were compared. Salivary caffeine concentrations were always lower than plasma concentrations, and there were no big differences between two methods, although salivary concentrations measured by our method was higher, with a significant difference at 1.5 h after dosing. From the practical viewpoint this method would be convenient and sufficiently accurate.

Adult↗