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Personality research on the Internet: a comparison of Web-based and traditional instruments in take-home and in-class settings.

Students, faculty, and researchers have become increasingly comfortable with the Internet, and many of them are interested in using the Web to collect data. Few published studies have investigated the differences between Web-based data and data collected with more traditional methods. In order to investigate these potential differences, two important factors were crossed in this study: whether the data were collected on line or not and whether the data were collected in a group setting at a fixed time or individually at a time of the respondent's choosing. The Visions of Morality scale (Shelton & McAdams, 1990) was used, and the participants were assigned to one of four conditions: in-class Web survey, in-class paper-and-pencil survey; take-home Web survey, and take-home paper-and-pencil survey. No significant differences in scores were found for any condition; however, response rates were affected by the type of survey administered, with the take-home Web-based instrument having the lowest response rate. Therefore, researchers need to be aware that different modes of administration may affect subject attrition and may, therefore, confound investigations of other independent variables.

Data Collection↗

Comparison of 2-dimensional and 3-dimensional cardiac 82Rb PET studies.

UNLABELLED: Most new PET scanners have the capability to collect data in 3-dimensional (3D) (septa removed) mode. This allows many more detected events at the cost of increased random events and scatter. In the case of 82Rb imaging, the injected dose might have to be limited to avoid saturating the scanner. We present a comparison of 2-dimensional (2D) and 3D data collection for 82Rb cardiac studies using the ECAT EXACT scanner. METHODS: Resting 82Rb cardiac studies were collected in 2D and 3D modes for 33 consecutive patients. Four experienced physicians rated the images to determine if the different acquisition methods would lead to different patient care. A separate quantitative analysis was performed on data from multiple scans of a thoracic phantom filled to simulate cardiac and background radioactivity corresponding to 82Rb injections between 37 and 1740 MBQ: RESULTS: The 2D and 3D studies were significantly different, with the image quality being poorer in the 3D studies. The scanner collected data at near its maximal counting rate for either 1480-MBq 2D or 37-MBq 3D acquisitions. Because the data collection was counting rate limited in either mode, and there are more random and scatter events in 3D mode, the 2D acquisitions resulted in more detected true events and a better signal-to-noise ratio. CONCLUSION: Cardiac 82Rb studies should be performed in 2D mode when using the ECAT EXACT scanner.

Heart↗

Perspectives on epidemiologic surveillance in the 21st century.

This paper describes the importance of epidemiologic surveillance as a systematic, ongoing and population-based system for early warning and program development in the 21st century. Such a system routinely collects data on three classes of indicators (health outcomes, risk factors and intervention strategies) to set up both an early warning system (to identify associations and make predictions on health outcomes) and a program development system (to assess the need for intervention strategies, to plan and implement such strategies and to assess their effectiveness). A comprehensive surveillance system must be systematic (evidence-based selection of indicators, not hypothesis-driven), ongoing (continuous data collection, including repeated surveys) and population-based (whole population, or representative samples of the population). Such a system need not be developed from scratch, but can be based on linkage of existing databases and collection of additional information for identified data gaps. The initial steps for selecting indicators and creating a prototype framework for a comprehensive surveillance system are proposed to stimulate further discussion. It is suggested that surveillance systems should be more widely used in public health.

Community Health Planning↗

A standard data collection-package for medical follow-up studies.

A standard method of collecting identifying data for medical follow-up studies has been developed by Statistics Canada. By helping improve health record-keeping, this method has the potential to make it easier to track populations exposed to potentially hazardous agents through lifestyle, work, environmental factors, ecological disasters, or medical treatments. The data collection package, which has been reviewed by expert groups and pilot tested, can reduce costs, save time and result in more comparable data. The package guides the user in developing an easily maintained and accessed database using either the Data Collection Package handbook or the personal computer package option. Part I of this article gives an overview of the new data collection package and how it can be used. Part II gives the background and methodological notes on its development.

Canada↗

Videotaped focus groups: transforming a therapeutic strategy into a research tool.

Focus groups have become a popular method of collecting data for research projects. The addition of using a videotaped approach has broad implications for researchers, as it allows constant replay of the session. Although on the surface this approach seems straightforward and easy to use, the authors caution that this is not an approach for the novice. Investigators planning to use a focus group method must be well versed in group process. There is an unpredictable nature to the focus group process, and researchers need to prepare for the inevitable mishaps that lead to lost opportunities for data collection.

Data Collection↗

Implementing the British Columbia Nutrition Survey: perspectives of interviewers and facilitators.

The British Columbia Nutrition Survey was the last of ten provincial nutrition surveys completed between 1988 and 1999. A qualitative process evaluation was conducted to identify strengths and weaknesses of British Columbia Nutrition Survey procedures, as perceived by 27 public health nurses and dietitians directly involved in data collection. Data for the process evaluation were collected through in-depth telephone interviews, during which interviewers and facilitators described their experiences working for the survey. Qualitative analysis of interview transcripts identified codes that were then organized into eight categories, including issues arising from interviewer and facilitator training, challenges in recruiting survey participants, reflections on safety for survey personnel and participants, facilitators' key role, the flexibility required to implement the protocol, and communication within the survey research team. Two final categories related to rewarding aspects of the job: insights affecting professional practice, and meeting survey participants and personnel. Evaluation findings show the importance of establishing open communication between research planners and those conducting surveys. This communication is needed to ensure that workers' needs are met, the quality of the study is maximized, and evaluations of study protocols include the perspectives of those directly involved in data collection.

British Columbia↗

401(k) plan asset allocation, account balances, and loan activity.

The Employee Benefit Research Institute (EBRI) and the Investment Company Institute (ICI) have been collaborating for the past two years to collect data on participants in 401(k) plans. This effort, known as the EBRI/ICI Participant-Directed Retirement Plan Data Collection Project, has obtained data for 401(k) plan participants from certain of EBRI and ICI sponsors and members serving as plan recordkeepers and administrators. The report includes 1996 information on 6.6 million active participants in 27,762 plans holding nearly $246 billion in assets. The data include demographic information, annual contributions, plan balances, asset allocation, and loans, and are currently the most comprehensive source of information on individual plan participants. In 1996, the first year for which data are ready for analysis, the EBRI/ICI database appears to be broadly representative of the universe of 401(k) plans. Key findings include: for all participants, 44.0 percent of the total plan balance is invested in equity funds, 19.1 percent in employer stock, 15.1 percent in guaranteed investment contracts (GICs), 7.8 percent in balanced funds, 6.8 percent in bond funds, 5.4 percent in money funds, 0.8 percent in other stable value funds, and 1.0 percent in other or unidentified investments. This allocation implies that over two-thirds of plan balances are invested directly or indirectly in equity securities. Asset allocation varies with age. For instance, on average, individuals in their twenties invested 76.8 percent of assets in equities and only 22.1 percent in fixed-income investments. By comparison, individuals in their sixties invested 53.2 percent of their assets in equities and 45.9 percent of assets in fixed-income investments. Investment options offered by 401(k) plans appear to influence asset allocation. For example, the addition of company stock substantially reduces the allocation to equity funds and the addition of GICs lowers allocations to bond and money funds. Employer contributions in the form of company stock affect participant allocation behavior. Participants in plans in which employer contributions are made in company stock appear to decrease allocations to equity funds and to increase the allocation of company stock in self-directed balances. The average account balance (net of plan loans) for all participants is $37,323. The balances, however, represent only amounts with current employers and do not include amounts remaining in the plans of prior employers. Nor do the balances indicate what savings would be in a "mature" 401(k) plan program. The average balances of older workers with long tenure at one employer indicate that a mature 401(k) plan program will produce substantial account balances. For example, individuals in their sixties with at least 30 years of tenure have average account balances in excess of $156,000; those in their fifties have balances in excess of $117,000.

Data Collection↗

Managing and analysing data from a large-scale study on Framingham Offspring relating brain structure to cognitive function.

At the Framingham Heart Study under separate research grant funding from the National Institute of Aging, NIH, we are gathering brain structure and cognitive information on the Framingham Offspring, creating one of the largest known data sets to assess changes in brain structure associated with normative ageing and cognitive decline. Subject recruitment, data collection, data management and statistical analysis require a collaborative integrated effort on the part of the Framingham project team. Here we describe this effort, as well as the various brain structure and cognitive function parameters we are now collecting. We are currently performing analyses of data collected through 2002, and we discuss the statistical issues arising relating brain structure parameters to cognitive function.

Aged↗

Fit for practice? An exploration of the development of newly qualified nurses using focus groups.

UNLABELLED: Previous research in the newly qualified has primarily focused upon their levels of competence at the time of registration rather than upon the way that this continues to develop over time. Though newly qualified nurses are expected to be competent and able to practice independently without direct supervision the reality is that, for most, their training has not equipped them with the knowledge, skills or confidence necessary for independent practice. This belief provided the foundations for this study designed to gain an understanding of the way that competence develops amongst nurses themselves and how this is seen by their managers and those working with them. It focused neither on what competencies nurses possessed nor on the level of overall competence but rather on the factors influencing the development of competence over time. RESEARCH DESIGN: This qualitative exploratory study relied upon a combination of focus groups and individual interviews to access information and perceptions not readily accessible through more quantitative means. DATA COLLECTION: Data was collected using focus groups involving newly qualified staff, including both those on a development programme and those in substantive posts, experienced qualified nurses (preceptors) and practice development nurses. A total of twelve focus groups were conducted yielding a purposive sample of 105 volunteer participants; groups were continued until no new data emerged and saturation was achieved. Ward managers (5) were interviewed individually and their data was added to that obtained from the focus groups. ANALYSIS: Content analysis of the transcripts enabled the material to be explored systematically to identify relevant themes and categories within the data thus helping to clarify descriptions of the major issues identified; these were returned to the participants to ensure validity in data interpretation. FINDINGS: Ward managers appear to have low expectations of the newly qualified while 'new' nurses themselves believe that they are expected to be able to fulfil tasks that they feel ill-equipped to undertake. This emphasises the need for appropriate support to enable them to develop their knowledge, skills and confidence and enable independent practice. While staff development programmes benefit some, others gain equal value from supportive preceptorship in helping them to develop the clinical and managerial skills necessary in today's healthcare climate.

Attitude of Health Personnel↗

Developing lecturer practitioner roles using action research.

BACKGROUND: Lecturer Practitioner roles are well established in the United Kingdom. The national literature demonstrates that these staff are valuable to National Health Service trusts and universities however, their roles are busy and demanding, with conflicting expectations from the two employers. In addition, their role in addressing the theory-practice gap - a major reason for their establishment - is at best unclear. Although a number of qualitative studies have explored the topic, there have been no systematic attempts to develop the role or to quantify the effects on postholders. AIM: This paper reports a study that aimed to develop aspects of Lecturer Practitioners' work roles, examine the effects of this on individuals at one English university, and to quantify Lecturer Practitioners' occupational stress and burnout. METHODS: A flexible, 'spiral' action research framework and 'collaborative group approach' were used, with mixed methods of data collection. Data were collected through focus groups, meetings and participant feedback, and participants' reflective diaries. A questionnaire using previously validated psychological attitude rating scales was also used to measure occupational stress and burnout, the extent to which the project influenced these, and the influence of Lecturer Practitioners' experience and qualifications. Six null hypotheses were constructed to measure these ideas. Findings from qualitative and quantitative perspectives were triangulated to give depth to the analysis. FINDINGS: Five themes emerged from the focus groups: personal motivation, workload pressures, role clarity, preparation and support, and gains from the role. Specific policies and documentation were developed as a result of this initial project planning work. The findings from the questionnaire indicated that Lecturer Practitioners were no more stressed or burnt out than comparable workers. Synthesis of findings indicated, broadly speaking, that these LPs were 'thriving rather than just surviving'. CONCLUSION: Action research was an effective methodology for uncovering new knowledge, and bringing about organizational change in this project.

Burnout, Professional↗

Global Tobacco Surveillance System (GTSS): purpose, production, and potential.

The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Canadian Public Health Association (CPHA) developed the Global Tobacco Surveillance System (GTSS) to assist all 192 WHO Member States in collecting data on youth and adult tobacco use. The flexible GTSS system includes common data items but allows countries to include important unique information at their discretion. It uses a common survey methodology, similar field procedures for data collection, and similar data management and processing techniques. The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, and the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for adults. GTSS data potentially can be applied in four ways. First, countries and research partners can disseminate data through publications, presentations, and an active GTSS web site. Second, countries can use GTSS data to inform politicians about the tobacco problem in their country, leading to new policy decisions to prevent and control tobacco use. Third, GTSS can provide countries with valuable feedback to evaluate and improve Country National Action Plans or develop new plans. Fourth, in response to the WHO FCTC call for countries to use consistent methods and procedures in their surveillance efforts, GTSS offers such consistency in sampling procedures, core questionnaire items, training infield procedures, and analysis of data across all survey sites. The GTSS represents the most comprehensive tobacco surveillance system ever developed and implemented. As an example, this paper describes development of the GYTS and discusses potential uses of the data. Sample data were drawn from 38 sites in 24 countries in the African Region, 82 sites in 35 countries in the Americas Region, 20 sites in 17 countries and the Gaza Strip/West Bank region in the Eastern Mediterranean Region, 25 sites in 22 countries in the European Region, 34 sites in six countries in the Southeast Asia Region, and 25 sites in 14 countries in the Western Pacific Region.

Adolescent↗

Sources of variability in the reproducibility of food frequency questionnaires.

The reproducibility of food frequency questionnaires varies widely. Since reports of past intake are known to be biased toward the present and the forces of supply and demand affect what people eat at a given point in time, the questionnaire may capture an atypical snapshot of consumption rather than the intended view of unusual consumption. The consumption of regularly consumed foods is the same throughout the year. The consumption of these foods is likely to be highly reproducible at another point in time. The consumption of seasonally consumed foods, however, fluctuates throughout the year, and may have peaks in winter or summer or particular holidays. There may be no common denominator among these foods necessary for the purpose of assessing reproducibility. Therefore, questionnaires that contain a combination of regularly and seasonally consumed foods, will be likely to have problems with reproducibility, the variance depending upon the number of seasonally consumed foods in the questionnaire. This explanation for variability in reproducing food frequency questionnaires raises a question about the importance of assessing reproducibility as a way of evaluating the worth of questionnaires. Perhaps an improved method of collecting data for seasonal foods is what is really needed to improve the quality of data collected.

Analysis of Variance↗

Creating the web-based intensive care unit safety reporting system.

In an effort to improve patient safety, researchers at the Johns Hopkins University designed and implemented a comprehensive Web-based Intensive Care Unit Safety Reporting System (ICUSRS). The ICUSRS collects data about adverse events and near misses from all staff in the ICU. This report reflects data on 854 reports from 18 diverse ICUs across the United States. Reporting is voluntary, and data collected is confidential, with patient, provider, and reporter information deidentified. Preliminary data include system factors reported, degree of patient harm, reporting times, and evaluations of the system. Qualitative and quantitative data are reported back to the ICU site study teams and frontline staff through monthly reports, case discussions, and a quarterly newsletter.

Computer Communication Networks↗

Comparison of information: a way to improve the quality of health care.

Quality of care is a growing concern of health care providers, financers and consumers, as regards both the cost and the outcome. Uncertainty about what is appropriate health care has triggered interest in comparing the outcomes of different health care practices. This paper addresses the necessity to compare information on variations in practice, utilization and cost of health care delivery. However, for general improvements in the outcome of health care, a variety of partners, such as ministries of health, non-governmental organizations, professional societies, third party financers and consumer groups, must be actively involved. The Regional Office for Europe of the World Health Organization (WHO/EURO) regularly collects data from member states. Such data collection is part of the monitoring of the European regional strategy for Health for All by the year 2000. These data can and actually are being used for the purpose of comparison of achievements in accordance with the European Health for All policy in member states. In addition, other indicators, information systems and longitudinal databases are being developed in collaboration with different professions, and provider and community groups to serve as instruments for quality assurance in the European region primarily at the level of health care services. However, this approach, which has been promoted over the past decade by the Quality of Care and Technologies programme of the WHO/EURO, is gradually gaining momentum at all levels of health care as a useful tool for quality assessment and development.

Anti-Bacterial Agents↗

Evaluation of the appropriate use of albumin in adult and pediatric patients.

The appropriateness of albumin use and baseline albumin usage patterns were studied. Institutional practice patterns regarding the use of albumin were compared to criteria established by an independent expert panel. Fifty-three institutions, all of which were members of VHA or the University Health-System Consortium, participated in the evaluation. Investigators collected data over an eight-week period from the medical records, pharmacy records, and hospital billing data of adult (18 years of age or older) and pediatric (age 1-17 years) patients for whom albumin was prescribed. Data collected included patient-specific information, the prescribing physician's specialty area, patient location (level of care) when albumin was prescribed, primary reasons for prescribing albumin, and details of albumin use. Data were collected for 1649 adult and 23 pediatric patients. Albumin was prescribed inappropriately in 57.8% and appropriately in 28.2% of adults; appropriateness of use was unknown in 14% of the patients reviewed. The most common indication for albumin use was hypotension/hypovolemia (23.9%), followed by bypass-pump priming (16.3%), intradialytic blood pressure support (9.6%), and serum albumin values less than 2 g/dL (8.6%). Albumin was prescribed inappropriately 100% of the time when used for intradialytic blood pressure support, low serum albumin values, and acute respiratory distress syndrome. The most appropriate use of albumin occurred in patients with postsurgical hypotension and hypovolemia (67.8%), nephrotic syndrome (79.3%), non-hemorrhagic shock (44.3%), hemorrhagic shock (51.9%), and cirrhosis and paracentesis (31.3%). Albumin was inappropriately prescribed for 57.8% of adult patients and 52.2% of pediatric patients. The mean number of total grams used by patients receiving albumin appropriately was similar to those patients inappropriately receiving albumin.

Adolescent↗

Results of the ACSUS for pediatric AIDS patients: utilization of services, functional status, and social severity.

OBJECTIVE: This study describes demographic characteristics of pediatric AIDS patients, describes hospital and community-based service utilization patterns, and analyzes medical and social support service usage patterns with respect to patient demographic characteristics, clinical trial participation, functional/developmental status, and social environment. DATA SOURCES AND STUDY SETTING: Data reported in this study are from the AIDS Costs and Service Utilization Survey (ACSUS) and cover the six-month period beginning March 1991 (N = 135). Pediatric patients who sought care for HIV-related problems were sampled at seven different hospitals in five metropolitan regions of the United States. All of the participating hospitals had clinics specifically serving pediatric patients infected with HIV. The sample consists of HIV-positive patients who had had at least one HIV-related symptom or condition. STUDY DESIGN: A stratified probability sample design guided the sampling strategy, which included oversampling in two large hospitals from two of the five metropolitan areas. Survey data cover an 18-month time period of health care utilization, cost, and financing information from HIV-infected patients and their providers. Utilization measures are standardized to a six-month period. Per capita income, family structure, informal personal network, functional status, and clinical trial participation are tested for associations with patterns of utilization. In addition, a weighted ten-point social severity scale was developed to assess family/household stability. DATA COLLECTION: Data were collected through a screener instrument completed by the person accompanying the child to a hospital clinic visit (usually a a parent), and through two interviews conducted in person with the patients' primary caregivers. Data from the questionnaires were coded and assembled into computerized SAS analysis files by WESTAT: PRINCIPAL FINDINGS: Children in this sample are 62 percent African American, 25 percent Hispanic, and 10 percent White. Medicaid is the primary payer for 92 percent. Mean per capita income is $3,440. Fewer than one-half (41 percent) of the families of the children receive Aid to Families with Dependent Children (AFDC). (AFDC). Within the six-month period, approximately one-third of the sample (29.6 percent) was hospitalized. Mean length of stay was 16.0 days. Clinical trial participation was positively related to mean number of hospital clinic visits and receipt of formal (paid) home care. There were no differences in use of community clinic, mental health, and inpatient facilities by clinical trial status. Participation in clinical trials was positively related to income and negatively related to social severity. In four cities, emergency room use was consistently lower for clinical trial participants than for nonparticipants. CONCLUSIONS: Data from the first six months of the ACSUS pediatric sample suggest that participation in clinical trials may bring about access to social services that appear to reduce emergency room use. However, the findings reported here are descriptive and exploratory. Further multivariate, nonparametric analyses of the full 18-month provider-patient merged data set are necessary to confirm the simple correlations found in this study.

Acquired Immunodeficiency Syndrome↗

The lived experience of men and women with hepatitis C: implications for support needs and health information.

routinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic. Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.

Data Collection↗