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Certificates
Kinds of Certificates Terms modified by Certificates Selected AbstractsDental therapists' experience in the immediate management of traumatized teethDENTAL TRAUMATOLOGY, Issue 2 2006Teresa Loh Abstract,,, The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education ,Ordinary' (GCE ,O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases. [source] The readiness is all The degree level qualifications and preparedness of initial teacher trainees in EnglishENGLISH IN EDUCATION, Issue 2 2010Julie Blake Abstract This article is the first of two reporting research concerned with the profile of degree level qualifications of initial teacher trainees who start Postgraduate Certificate of Education (PGCE) Secondary English courses. In a context where there is no existing database of such information, the researchers sought to establish the patterns in this profile and collate a summary of Initial Teacher Education (ITE) tutors' perceptions about the level of subject knowledge preparedness of students with different degree level qualifications. Following from this, the enquiry was also interested in the ways that PGCE institutions support students with different subject knowledge development needs. The article that follows below treats the issue of degree qualifications and the PGCE selection process in the context of recent changes to subject English. The evidence suggests patterned but divergent practices with an overall trend of preference for prior qualifications in English Literature despite significant alterations in the study of English since 1980. PGCE courses surveyed attract many more applicants than there were places and tutors exercise considerable discretion in admissions practices which are not always made transparent by published policies and rationales, including those made available to prospective applicants. The review of the literature showed little published discourse on this topic to date. [source] Concept Acquisition within the Context of an AS Media Studies CourseENGLISH IN EDUCATION, Issue 2 2003Vivien Whelpton Abstract This article explores the means by which students' concept formation can be promoted and outlines findings from an action research project undertaken with a class of 17-year-old AS Media Studies students as a submission for the British Film Institute's MA Certificate in Media Education in 2001. It argues that academic concepts can neither be allowed to develop spontaneously nor be directly taught, but that indirect methods of teacher intervention can be found. It also examines the relationship between thought and language and argues that, while contact with academic discourse can be alienating, its features include a fluency which the handling of complex and abstract ideas requires, particularly in the written mode. The writer suggests that, while this discourse cannot be explicitly taught or learned, modelling techniques may offer a useful approach. [source] The development of an ePortfolio for life-long reflective learning and auditable professional certificationEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2009R. L. Kardos Abstract Recent legislative changes, that affect all healthcare practitioners in New Zealand, have resulted in mandatory audits of practitioners who are now required to provide evidence of competence and continued professional development in the form of a professional portfolio. These changes were the motivation for our development of an electronic portfolio (ePortfolio) suitable for both undergraduate and life-long learning. Bachelor of Oral Health (BOH) students, studying to qualify as Dental Hygienists and Dental Therapists, and BOH teaching staff (who held registrations in Dental Hygiene, Dental Therapy and Dentistry) trialled the use of a personal ePortfolio for advancing their academic and professional development. The ePortfolio enables BOH students to collect evidence of their achievements and personal reflections throughout their 3 years of undergraduate study, culminating in registration and the award of an Annual Practising Certificate (APC). The ePortfolio was designed to allow users to store information and then select appropriate material to be displayed or published, thus assisting health practitioners to present high-quality evidence of their participation and achievements, and to meet the professional requirements for their APC. [source] Dental school admissions in Ireland: can current selection criteria predict success?EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2006C. D. Lynch Introduction:, Entry into university education in Ireland, including dental school, is based solely on academic performance in the Leaving Certificate Examination, held at the end of formal school education. The aim of this investigation was to examine the suitability of this process for the selection of dental students in Ireland. Materials and methods:, Information for all dental students who entered the dental degree programme immediately following completion of the Leaving Certificate Examination at the National University of Ireland, Cork, during the years 1997,1999 was retrieved. Information was collected relating to gender, the number of times the student had attempted the Leaving Certificate Examination, their performance in this examination, the total number of marks awarded to each student at the end of the First and Final Dental Examinations, and their performance in individual modules. Results:, Whilst there was a significant relationship between performance in the Leaving Certificate Examination and the First Dental Examination (correlation coefficient = 0.22, P < 0.05), this relationship could only explain 12% of the variation within the performance of students in this examination. There was no relationship between performance in the Leaving Certificate and the Final Dental Examination (correlation coefficient = 0.09, P > 0.05). There was a significant correlation between performance in the Leaving Certificate Examination and performance in seven of the 55 programme modules, all of which were pre-clinical modules, and of which five were related to basic sciences. Conclusions:, Based on the limitations of this study, the current selection process for dental students in Ireland seems to be of limited value. [source] Strategies and students: beginning teachers' early encounters with national policyLITERACY, Issue 2 2006Andrey Rosowsky Abstract The 1-year Postgraduate Certificate in Education Secondary English method course at the University of Sheffield's School of Education has, since 2001, asked its students to write an essay of around 4000 words on their initial understanding and experience of the National Strategies promoted by the United Kingdom's Department for Education and Skills. The essay expects a critical, reflective and analytical piece of writing that records the student teacher's developing views on the place, role and value of the National Strategies in the classroom. Using grounded theory and content analysis techniques, this small-scale study of the 2005 cohort identifies common perceptions regarding the National Strategies among student teachers of English and seeks to categorise these to account for their developing identities as future English teachers. Drawing on Twiselton's identification of teacher types, Task Manager, Curriculum Deliverer and Concept/Skill Builder, and Shulman's classification of knowledges necessary for teaching, this article will argue that the National Strategies and their respective Frameworks, while successful in moving teachers on from the role of ,Task Managers', runs the risk of locking teachers into being ,Curriculum Deliverers', and not developing the pedagogical content knowledge necessary for teaching English expertly. [source] Survivorship in the US hospital services industryMANAGERIAL AND DECISION ECONOMICS, Issue 5 2000Rexford E. Santerre Over the last two decades, changing state and federal regulations and increased price competition have dramatically changed the environment in which hospitals compete. This paper uses observations drawn at 5-year intervals from 1973 to 1993 for each of the 50 states to examine the specific effect of these factors on the size distribution of hospitals. It finds that Certificate of Need (CON) laws and rate review regulations have tended to favor large hospitals. The paper also finds that hospitals have responded to increased payer price sensitivity by seeking a medium bed-size capacity. Copyright © 2000 John Wiley & Sons, Ltd. [source] Gestational age estimation on United States livebirth certificates: a historical overviewPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2007Megan L. Wier Summary Gestational age on the birth certificate is the most common source of population-based gestational age data that informs public health policy and practice in the US. Last menstrual period is one of the oldest methods of gestational age estimation and has been on the US Standard Certificate of Live Birth since 1968. The ,clinical estimate of gestation', added to the standard certificate in 1989 to address missing or erroneous last menstrual period data, was replaced by the ,obstetric estimate of gestation' on the 2003 revision, which specifically precludes neonatal assessments. We discuss the strengths and weaknesses of these measures, potential research implications and challenges accompanying the transition to the obstetric estimate. [source] Test substance characterization for the EPA: what you've always wanted to know but were afraid to ask,QUALITY ASSURANCE JOURNAL, Issue 3-4 2007William Barta Abstract The Society of Quality Assurance (SQA) GLP Specialty Section, a member of the SQA Regulatory Forum, is a group of participants from the regulated community which provides insight and guidance to our membership and the regulated community. The Specialty Section has encountered several participants who want to know what types of information and data are needed during an inspection by the US EPA's Office of Enforcement and Compliance Assurance (OECA). The OECA is responsible for monitoring studies submitted to the Office of Pesticide Programs in support of pesticide registrations as defined under the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA). All submitted studies are to be conducted according to the FIFRA US Good Laboratory Practice Standards (GLPS). The GLPS contain specific language concerning the characterization of test, control and reference substances used in these studies. This article clarifies those requirements and provides perspective on the EPA expectations on meeting those requirements. The topics of discussion include: regulatory requirements responsibilities of the testing facility management, study director, Quality Assurance Unit and the sponsor preparing for an inspection overview of data to be made available at the time of inspection composition of a Certificate of Analysis. Copyright © 2008 John Wiley & Sons, Ltd. [source] Using Medical Examiner/Coroner-Generated Death Certificates in Research: Advantages and LimitationsJOURNAL OF FORENSIC NURSING, Issue 3 2005Steven A. Koehler certificates (DC) are often used by researchers as a valuable! data source. While the information provides a broad overview of cause and manner of death, there are limitations to DC use in research studies. [source] The Reliability and Validity of Birth CertificatesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2006Sally Northam Objectives:, To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement. Data sources:, A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done. Study selection:, Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment. Data extraction:, Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable. Data synthesis:, The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery. Conclusions:, Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented. JOGNN, 35, 3-12; 2006. DOI: 10.1111/J.1552-6909.2006.00016.x [source] Type 2 Diabetes: Fueling the Surge of Cardiovascular Disease in WomenNURSING FOR WOMENS HEALTH, Issue 6 2008Emily J. Jones BSN Objectives Upon completion of this activity, the learner will be able to: 1Recognize and identify the interrelated risk factors that contribute to the development of type 2 diabetes and cardiovascular disease (CVD) in women. 2Formulate strategies that result in the early identification of women at risk for developing type 2 diabetes and CVD. 3Describe intervention strategies for the prevention and treatment of type 2 diabetes and CVD in women. Continuing Nursing Education (CNE) Credit A total of 2 contact hours may be earned as CNE credit for reading "Type 2 Diabetes: Fueling the Surge of Cardiovascular Disease in Women" and for completing an online post-test and participant feedback form. To take the test and complete the participant feedback form, please visit http://JournalsCNE.awhonn.org. Certificates of completion will be issued on receipt of the completed participant feedback form and processing fees. AWHONN is accredited as a provider of continuing nursing education by the American Credentialing Center's Commission on Accreditation. Accredited status does not imply endorsement by AWHONN or ANCC of any commercial products displayed or discussed in conjunction with an educational activity. AWHONN also holds California and Alabama BRN numbers: California CNE provider #CEP580 and Alabama #ABNP0058. [source] SMR Analysis of Historical Follow-Up Studies with Missing Death CertificatesBIOMETRICS, Issue 4 2000Werner Rittgen Summary. The evaluation of epidemiological follow-up studies is frequently based on a comparison of the number O of deaths observed in the cohort from a specified cause with the expected number E calculated from person years in the cohort and mortality rates from a reference population. The ratio SMR = 100 ×O/E is called the standardized mortality ratio (SMR). While person years can easily be calculated from the cohort and reference rates are generally available from the national statistical offices or the World Health Organization (WHO), problems can arise with the accessibility of the causes of death of the deceased study participants. However, the information that a person has died may be available, e.g., from population registers. In this paper, a statistical model for this situation is developed to derive a maximum likelihood (ML) estimator for the true (but unknown) number O* of deaths from a specified cause, which uses the known number O of deaths from this cause and the proportion p of all known causes of death among all deceased participants. It is shown that the standardized mortality ratio SMR * based on this estimated number is just SMR *= SMR/p. Easily computable confidence limits can be obtained by dividing the usual confidence limits of the SMR by the opposite limit of the proportion p. However, the confidence level , has to be adjusted appropriately. [source] THE EARNINGS EFFECT OF EDUCATION AT COMMUNITY COLLEGESCONTEMPORARY ECONOMIC POLICY, Issue 1 2010DAVE E. MARCOTTE In this paper, I make use of data from the 2000 follow-up of the National Education Longitudinal Survey postsecondary education transcript files to extend what is known about the value of education at community colleges. I examine the effects of enrollment in community colleges on students' subsequent earnings. I estimate the effects of credits earned separately from credentials because community colleges are often used as a means for students to engage in study not necessarily leading to a degree or certificate. I find consistent evidence of wage and salary effects of both credits and degrees, especially for women. There is no substantial evidence that enrollment in vocational rather than academic coursework has a particularly beneficial effect, however. (JEL I2, J24) [source] Reporting of diabetes on death certificates using data from the UK Prospective Diabetes StudyDIABETIC MEDICINE, Issue 8 2005M. J. Thomason Abstract Aims To study the effect of age at death, sex, ethnic group, date of death, underlying cause of death and social class on the frequency of reporting diabetes on death certificates in known cases of diabetes. Methods Data were extracted from certificates recording 981 deaths which occurred between 1985 and 1999 in people aged 45 years or more who participated in the UK Prospective Diabetes Study, to which 23 English, Scottish and Northern Ireland centres contributed. Diabetes (9th revision of the International Classification of Diseases; ICD-9 250) entered on parts 1A,1C or 2A,2C of the death certificate was considered as reporting diabetes. Logistic regression analyses were used to determine independent factors associated with the reporting of diabetes. Results Diabetes was reported on 42% (419/981) of all death certificates and on 46% (249/546) of those with underlying cardiovascular disease causes. Reporting of diabetes was independently associated on all death certificates with per year of age increase (OR 1.02; 95% CI 1.001,1.04, P = 0.037), underlying cause of death (non-cardiovascular causes OR 0.76; 95% CI 0.59,0.98, P = 0.035) and social class (classes I,II OR 1.00; class III OR 1.35; 95% CI 0.96,1.89, P = 0.084, classes IV,V OR 1.48; 95% CI 1.05,2.10, P = 0.027). Stratification by age, sex, and underlying cause of death also revealed significant differences in the frequency of reporting diabetes over time. Conclusions The rate of reporting of diabetes on cardiovascular disease death certificates remains poor. This may indicate a lack of awareness of the importance of diabetes as a risk factor for cardiovascular disease. [source] Towards an understanding of the high death rate among young people with diabetes in UkraineDIABETIC MEDICINE, Issue 1 2001M. Telishevka SUMMARY Aims Published rates of deaths attributed to diabetes mellitus among those aged under 50 have risen substantially in several former Soviet republics since the late 1980s. The reasons for this increase, and the situation facing patients with diabetes in these countries are poorly understood. The aim of this study was to describe the circumstances leading up to the death of individuals dying under the age of 50 years with mention of diabetes on their death certificate. Methods Interviews with surviving relatives or neighbours, combining elements of verbal autopsy and confidential enquiry. For those who had lived in the city of Lviv a random sample was taken. For those in rural areas a purposive sample was used to ensure coverage of more and less remote areas. Results Key informants were identified and agreed to be interviewed for 64 individuals out of a possible 79 with insulin-treated diabetes identified from their death certificates. The main immediate causes of death were renal failure (69%), ischaemic heart disease (9%), ketoacidosis (6%) and hypoglycaemia (3%). Over a third of men, but no women, were reported to have been heavy drinkers. Informants described many difficulties in obtaining regular supplies of insulin and related supplies since 1990. Although insulin is officially available free of charge, most had retained supplies for use in an emergency. More than half had, at some time, purchased supplies. The large number of deaths from renal failure reflects the effective absence of renal replacement therapy for patients with diabetes. Conclusions Individuals with diabetes in Ukraine face profound challenges involving access to necessary care. Their needs require significantly more attention from policy makers. [source] Chiral separation of cetirizine by capillary electrophoresisELECTROPHORESIS, Issue 12 2006Ann Van Eeckhaut Abstract Chiral separation of cetirizine, a second-generation H1 -antagonist, was studied by CD-mediated CE. Several parameters, including pH, CD type, buffer concentration, type of co-ion, applied voltage and temperature, were investigated. The best conditions for chiral separation were obtained using a 75,mM triethanolamine-phosphate buffer (pH,2.5) containing 0.4,mg/mL heptakis(2,3-diacetyl-6-sulfato)-,-CD and 10%,ACN. Online UV detection was performed at 214,nm, a voltage of 20,kV was applied and the capillary was temperature controlled at 25°C by liquid cooling. Hydrodynamic injection was performed for 1,s. The method was validated for the quantification of levocetirizine in tablets and for enantiomeric purity testing of the drug substance. Selectivity, linearity, LOD and LOQ, precision and accuracy were evaluated for both methods. The amount of levocetirizine dihydrochloride in the commercially available tablets was quantified and was found to be within the specification limits of the claimed amount (5,mg). The amount of distomer in levocetirizine drug substance was found to be 0.87 ± 0.09%,w/w, which is in agreement with the certificate of analysis supplied by the company. [source] The Impact of Medicaid Managed Care on Pregnant Women in Ohio: A Cohort AnalysisHEALTH SERVICES RESEARCH, Issue 4p1 2004Embry M. Howell Objective. To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. Data Sources/Study Setting. Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that implemented mandatory HMO enrollment, and 4 with low levels of voluntary enrollment (under 15 percent). Cuyahoga County (Cleveland) is analyzed separately; the other mandatory counties and the voluntary counties are grouped for analysis, due to small sample sizes. Study Design. Women serve as their own controls, which helps to overcome the bias from unmeasured variables such as health beliefs and behavior. Changes in key outcomes between the first and second birth are compared between women who reside in mandatory HMO enrollment counties and those in voluntary enrollment counties. County of residence is the primary indicator of managed care status, since, in Ohio, women are allowed to "opt out" of HMO enrollment in mandatory counties in certain circumstances, leading to selection. As a secondary analysis, we compare women according to their HMO enrollment status at the first and second birth. Data Collection/Extraction Methods. Linked birth certificate/enrollment data were used to identify 4,917 women with two deliveries covered by Medicaid, one prior to the implementation of mandatory HMO enrollment (mid-1996) and one following implementation. Data for individual births were linked over time using a scrambled maternal Medicaid identification number. Principal Findings. The effects of HMO enrollment on prenatal care use and smoking were confined to Cuyahoga County, Ohio's largest county. In Cuyahoga, the implementation of mandatory enrollment was related to a significant deterioration in the timing of initiation of care, but an improvement in the number of prenatal visits. In that county also, women who smoked in their first pregnancy were less likely to smoke during the second pregnancy, compared to women in voluntary counties. Women residing in all the mandatory counties were less likely to have a repeat C-section. There were no effects on infant birth weight. The effects of women's own managed care status were inconsistent depending on the outcome examined; an interpretation of these results is hampered by selection issues. Changes over time in outcomes, both positive and negative, were more pronounced for African American women. Conclusions. With careful implementation and attention to women's individual differences as in Ohio, outcomes for pregnant women may improve with Medicaid managed care implementation. Quality monitoring should continue as Medicaid managed care becomes more widespread. More research is needed to identify the types of health maintenance organization activities that lead to improved outcomes. [source] Utility of regular medical examinations of occupational diversINTERNAL MEDICINE JOURNAL, Issue 11 2009C. Sames Abstract The utility of regular medical fitness-for-diving examinations of occupational divers is unknown. The aim of this audit was to investigate the impact on the employment of occupational divers of a 5-yearly medical examination and an annual health surveillance questionnaire administered in intervening years. The medical records of all New Zealand occupational divers registered with the Department of Labour for at least 5 years were audited (n= 336). Each record included at least two full medical examinations (mean spacing of 5.6 years). An impact on career was defined as the diver being issued with either a conditional certificate of fitness or being graded as temporarily or permanently unfit for diving. The means by which the relevant medical issue was identified was recorded. Ten (3%) of 336 divers had an assessment outcome, which had a career impact. One was considered permanently unfit, four were temporarily unfit, and five were issued with conditional certification. Two were identified by respiratory function testing and eight by way of their responses to the questionnaire; none was found by the medical interview and examination process. The questionnaire system did not ,miss' any divers who developed a critically important health problem, and detected most of those with less important problems. Five yearly medical examinations have a low detection rate for important health problems, but remain useful for discussion of risk understanding, acceptance and mitigation. [source] Death of the first white resident of North QueenslandINTERNAL MEDICINE JOURNAL, Issue 10 2008D. Bossingham Abstract The first white resident of North Queensland's death certificate gives the final illness as ,arthritis'. This examination of contemporary records and more recent reports, together with the results of discussion with colleagues interested in medicine and history, attempts to suggest the reasons for his various symptoms and his final demise. This life story is reminiscent of a ,Boy's own' adventure with shipwrecks, survival at sea, coexistence with Aboriginal tribesmen before returning to ,white society', marriage and the start of a family. Are there lessons here for the twenty-first century physician and rheumatologist? Would the commonplace illnesses of mid nineteenth-century Queensland be very different to the problems seen in our outpatient clinics today? [source] Characteristics of anorexia nervosa-related deaths in Norway (1992,2000): Data from the National Patient Register and the Causes of Death RegisterINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2005Deborah L. Reas PhD Abstract Objective This study investigated demographic and diagnostic characteristics of individuals whose medical record or death certificate indicated the presence of anorexia nervosa at the time of death. Method Two national registers, the National Patient Register (NPR) and the Causes of Death Register (CODR), were examined in Norway for anorexia nervosa-related deaths occurring across a 9-year period (1992,2000). Results The medical record or death certificate listed anorexia nervosa as a diagnosis or cause of death for 66 individuals. Rates of death were 6.46 and 9.93 per 100,000 deaths for the NPR and the CODR, respectively. A substantial percentage of deaths (43.9%) in both registers occurred at or above the age of 65 years. For the NPR, the mean age at the time of death was 61 years and 31% of deaths occurred among men. For the CODR, the mean age at the time of death was 49 years and 18% of deaths occurred among men. Discussion Potential merits and shortcomings of assessing mortality rates using register-based data without linkage to a previously identified clinical sample are discussed. © 2005 by Wiley Periodicals, Inc. [source] A heterogeneous-network aided public-key management scheme for mobile ad hoc networksINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 1 2007Yuh-Min Tseng A mobile ad hoc network does not require fixed infrastructure to construct connections among nodes. Due to the particular characteristics of mobile ad hoc networks, most existing secure protocols in wired networks do not meet the security requirements for mobile ad hoc networks. Most secure protocols in mobile ad hoc networks, such as secure routing, key agreement and secure group communication protocols, assume that all nodes must have pre-shared a secret, or pre-obtained public-key certificates before joining the network. However, this assumption has a practical weakness for some emergency applications, because some nodes without pre-obtained certificates will be unable to join the network. In this paper, a heterogeneous-network aided public-key management scheme for mobile ad hoc networks is proposed to remedy this weakness. Several heterogeneous networks (such as satellite, unmanned aerial vehicle, or cellular networks) provide wider service areas and ubiquitous connectivity. We adopt these wide-covered heterogeneous networks to design a secure certificate distribution scheme that allows a mobile node without a pre-obtained certificate to instantly get a certificate using the communication channel constructed by these wide-covered heterogeneous networks. Therefore, this scheme enhances the security infrastructure of public key management for mobile ad hoc networks. Copyright © 2006 John Wiley & Sons, Ltd. [source] Avulsed permanent incisors: knowledge and attitudes of primary school teachers with regard to emergency managementINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2001C. Blakytny Summary. Objectives. This study was designed to examine the knowledge and attitudes of primary school teachers with regard to the emergency management of avulsed permanent incisors. Design. Data were collected by self-administered questionnaire. Setting. The study was conducted in primary schools lying within a 2-mile radius of the University Dental Hospital, Cardiff. Sample and methods. A total of 388 teachers in 31 participating schools were asked to complete a questionnaire, which was subsequently collected by two of the authors (CS and AT). Results. Two hundred and seventy-four teachers returned completed questionnaires, a response rate of 70·6%. One hundred and eighty-one respondents (60·1%) had received no advice about the emergency management of dental avulsion. Of the 133 teachers (48·5%) who possessed a first aid certificate, 39 (29·3%) had been given relevant advice as part of this training. Less than one-third of respondents (85 (31%)) cited an optimum extra-oral time of 30 min or less, with only 43 (15·7%) considering that this should be 10 min or less. However, 125 (45·6%) knew milk to be the best transport medium. Two hundred and four teachers (74·5%) stated that they would not be prepared to replant an avulsed tooth themselves, 133 (80%) basing this decision on lack of expertise and training. Two hundred and sixty-two teachers (95·6%) expressed a desire for further information. Conclusions. The majority of respondents possessed, at best, rudimentary knowledge of the emergency management of dental avulsion. Teachers, and other individuals who supervise children in schools, should receive simple instruction in dental first aid. [source] Robust stability of iterative learning control schemesINTERNATIONAL JOURNAL OF ROBUST AND NONLINEAR CONTROL, Issue 10 2008Mark French Abstract A notion of robust stability is developed for iterative learning control in the context of disturbance attenuation. The size of the unmodelled dynamics is captured via a gap distance, which in turn is related to the standard ,2 gap metric, and the resulting robustness certificate is qualitatively equivalent to that obtained in classical robust ,, theory. A bound on the robust stability margin for a specific adaptive ILC design is established. Copyright © 2007 John Wiley & Sons, Ltd. [source] Agreement Between Nosologist and Cardiovascular Health Study Review of Deaths: Implications of Coding DifferencesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2009Diane G. Ives MPH OBJECTIVES: To compare nosologist coding of underlying cause of death according to the death certificate with adjudicated cause of death for subjects aged 65 and older in the Cardiovascular Health Study (CHS). DESIGN: Observational. SETTING: Four communities: Forsyth County, North Carolina (Wake Forest University); Sacramento County, California (University of California at Davis); Washington County, Maryland (Johns Hopkins University); and Pittsburgh, Pennsylvania (University of Pittsburgh). PARTICIPANTS: Men and women aged 65 and older participating in CHS, a longitudinal study of coronary heart disease and stroke, who died through June 2004. MEASUREMENTS: The CHS centrally adjudicated underlying cause of death for 3,194 fatal events from June 1989 to June 2004 using medical records, death certificates, proxy interviews, and autopsies, and results were compared with underlying cause of death assigned by a trained nosologist based on death certificate only. RESULTS: Comparison of 3,194 CHS versus nosologist underlying cause of death revealed moderate agreement except for cancer (kappa=0.91, 95% confidence interval (CI)=0.89,0.93). kappas varied according to category (coronary heart disease, kappa=0.61, 95% CI=0.58,0.64; stroke, kappa=0.59, 95% CI=0.54,0.64; chronic obstructive pulmonary disease, kappa=0.58, 95% CI=0.51,0.65; dementia, kappa=0.40, 95% CI=0.34,0.45; and pneumonia, kappa=0.35, 95% CI=0.29,0.42). Differences between CHS and nosologist coding of dementia were found especially in older ages in the sex and race categories. CHS attributed 340 (10.6%) deaths due to dementia, whereas nosologist coding attributed only 113 (3.5%) to dementia as the underlying cause. CONCLUSION: Studies that use only death certificates to determine cause of death may result in misclassification and potential bias. Changing trends in cause-specific mortality in older individuals may be a function of classification process rather than incidence and case fatality. [source] Patterns of Presentation, Diagnosis, and Treatment in Older Patients with Colon Cancer and Comorbid DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Supriya K. Gupta MD Objectives: To estimate patterns of colon cancer presentation, diagnosis, and treatment according to history of dementia using National Cancer Institute (NCI) Surveillance, Epidemiology, and End-Result (SEER) Medicare data. Design: Population-level cohort study. Setting: NCI's SEER-Medicare database. Participants: A total of 17,507 individuals aged 67 and older with invasive colon cancer (Stage I-IV) were identified from the 1993,1996 SEER file. Medicare files were evaluated to determine which patients had an antecedent diagnosis of dementia. Measurements: Parameters relating to the cohort's patterns of presentation and care were estimated using logistic regressions. Results: The prevalence of dementia in the cohort of newly diagnosed colon cancer patients was 6.8% (1,184/17,507). Adjusting for possible confounders, dementia patients were twice as likely to have colon cancer reported after death (i.e., autopsy or death certificate) (adjusted odds ratio (AOR)=2.31, 95% confidence interval (CI)=1.79,3.00). Of those diagnosed before death (n=17,049), dementia patients were twice as likely to be diagnosed noninvasively than with tissue evaluation (i.e., positive histology) (AOR=2.02 95% CI=1.63,2.51). Of patients with Stage I -III disease (n=12,728), patients with dementia were half as likely to receive surgical resection (AOR=0.48, 95% CI=0.33,0.70). Furthermore, of those with resected Stage III colon cancer (n=3,386), dementia patients were 78% less likely to receive adjuvant 5-fluorouracil (AOR=0.22, 95% CI=0.13,0.36). Conclusion: Although the incidences of dementia and cancer rise with age, little is known about the effect of dementia on cancer presentation and treatment. Elderly colon cancer patients are less likely to receive invasive diagnostic methods or curative-intent therapies. The utility of anticancer therapies in patients with dementia merits further study. [source] Effects of Provider Practice on Functional Independence in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Elizabeth A. Phelan MD Objectives: To examine provider determinants of new-onset disability in basic activities of daily living (ADLs) in community-dwelling elderly. Design: Observational study. Setting: King County, Washington. Participants: A random sample of 800 health maintenance organization (HMO) enrollees aged 65 and older participating in a prospective longitudinal cohort study of dementia and normal aging and their 56 primary care providers formed the study population. Measurements: Incident ADL disability, defined as any new onset of difficulty performing any of the basic ADLs at follow-up assessments, was examined in relation to provider characteristics and practice style using logistic regression and adjusting for case-mix, patient and provider factors associated with ADL disability, and clustering by provider. Results: Neither provider experience taking care of large numbers of elderly patients nor having a certificate of added qualifications in geriatrics was associated with patient ADL disability at 2 or 4 years of follow-up (adjusted odds ratio (AOR) for experience=1.29, 95% confidence interval (CI)=0.81,2.05; AOR for added qualifications=0.72, 95% CI=0.38,1.39; results at 4 years analogous). A practice style embodying traditional geriatric principles of care was not associated with a reduced likelihood of ADL disability over 4 years of follow-up (AOR for prescribing no high-risk medications=0.56, 95% CI=0.16,1.94; AOR for managing geriatric syndromes=0.94, 95% CI=0.40,2.19; AOR for a team care approach=1.35, 95% CI=0.66,2.75). Conclusion: Taking care of a large number of elderly patients, obtaining a certificate of added qualifications in geriatrics, and practicing with a traditional geriatric orientation do not appear to influence the development of ADL disability in elder, community dwelling HMO enrollees. [source] Physician Recognition of Cognitive Impairment: Evaluating the Need for ImprovementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2004Joshua Chodosh MD Objectives: To assess physician recognition of dementia and cognitive impairment, compare recognition with documentation, and identify physician and patient factors associated with recognition. Design: Survey of physicians and review of medical records. Setting: Health maintenance organization in southern California. Participants: Seven hundred twenty-nine physicians who provided care for women participating in a cohort study of memory (Women's Memory Study). Measurements: Percentage of patients with dementia or cognitive impairment (using the Telephone Interview of Cognitive Status supplemented by the Telephone Dementia Questionnaire) recognized by physicians. Relationship between physician recognition and patient characteristics and physician demographics, practice characteristics, training, knowledge, and attitudes about dementia. Results: Physicians (n=365) correctly identified 81% of patients with dementia and 44% of patients with cognitive impairment without definite dementia. Medical records documented cognitive impairment in 83% of patients with dementia and 26% of patients with cognitive impairment without definite dementia. In a multivariable model, physicians with geriatric credentials (defined as geriatric fellowship experience and/or the certificate of added qualifications) recognized cognitive impairment more often than did those without (risk ratio (RR)=1.56, 95% confidence interval (CI)=1.04,1.66). Physicians were more likely to recognize cognitive impairment in patients with a history of depression treatment (RR=1.3, 95% CI=1.03,1.45) or stroke (RR=1.37, 95% CI=1.04,1.45) and less likely to recognize impairment in patients with cognitive impairment without definite dementia than in those with dementia (RR=0.46, 95% CI=0.23,0.72) and in patients with a prior hospitalization for myocardial infarction (RR=0.37, 95% CI=0.09,0.88) or cancer (RR=0.49, 95% CI=0.18,0.90). Conclusion: Medical record documentation reflects physician recognition of dementia, yet physicians are aware of, but have not documented, many patients with milder cognitive impairment. Physicians are unaware of cognitive impairment in more than 40% of their cognitively impaired patients. Additional geriatrics training may promote recognition, but systems solutions are needed to improve recognition critical to provision of emerging therapies for early dementia. [source] Personal imports of drugs to Japan in 2005 , an analysis of import certificatesJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2008K. Tsuji MS Summary Background:, Personal imports of unapproved drugs are made by physicians and patients in Japan. Such imports require submission of a request for an import certificate from the Regional Bureau of Health and Welfare (RBHW). So far, there have been few reports on personal imports of drugs in Japan. Objective:, To assess the extent and nature of personal imports of drugs in Japan. Methods:, The date, product name and amount of drug imported were provided by RBHW for each personal import made by physicians in 2005. All imports were classified into several groups including whether they were for ,prescription drugs for non-cosmetic use (PDNC)' or ,prescription drugs for cosmetic use (PDC)'. Identification of PDNC was made by International Non-proprietary Name (INN). All drugs were classified under therapeutic groups. For the most frequently imported unapproved drugs, the approval year in the US/EU and development status in Japan were recorded. Results:, A total of 12 196 personal imports were initiated by physicians in 2005. 5428 were for PDNCs corresponding to 242 drugs by INN. 55 PDNCs were each the subject of 10 or more imports. 11 drugs (252 imports) out of the top 55 PDNCs were available on the Japanese market during 2005 and 44 (4713 imports) were not approved. Of the 44 unapproved drugs, 11 (1019 imports) had been approved and 10 (2785 imports) were in the pre-registration phase as of December 31, 2006. Of the 44 unapproved drugs, 12 (1213 imports) were approved during 2000,2004, and 17 (3138 imports), during 1995,1999 in the US or EU. While the majority of imported drugs were antineoplastic drugs, drugs for various kinds of non-serious diseases were also imported. Conclusions:, A substantial number of unapproved drugs were being imported to Japan. A formal system for monitoring the use of those drugs should be established. [source] Forensic nursing education in North America: Social factors influencing educational developmentJOURNAL OF FORENSIC NURSING, Issue 2 2009Arlene E. Kent-Wilkinson RN Abstract In the mid 1990s, some of the first formal forensic nursing educational programs were established. Now more than a decade later, courses exist at educational levels from certificate to doctorate programs, with little educational research having been conducted. This recent study explored forensic nursing knowledge as a specialty area of study and factors influencing educational development. This paper reports on social factors that facilitated and impeded educational development in the forensic nursing specialty from the perspective of forensic nurse educators in North America. Changing attitudes to previously sanctioned professional roles in society provided discussion for implications for forensic nursing practice. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||