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Chi-square
Kinds of Chi-square Terms modified by Chi-square Selected AbstractsA Hybrid SPC Method with the Chi-Square Distance Monitoring Procedure for Large-scale, Complex Process DataQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 4 2006Nong Ye Abstract Standard multivariate statistical process control (SPC) techniques, such as Hotelling's T2, cannot easily handle large-scale, complex process data and often fail to detect out-of-control anomalies for such data. We develop a computationally efficient and scalable Chi-Square () Distance Monitoring (CSDM) procedure for monitoring large-scale, complex process data to detect out-of-control anomalies, and test the performance of the CSDM procedure using various kinds of process data involving uncorrelated, correlated, auto-correlated, normally distributed, and non-normally distributed data variables. Based on advantages and disadvantages of the CSDM procedure in comparison with Hotelling's T2 for various kinds of process data, we design a hybrid SPC method with the CSDM procedure for monitoring large-scale, complex process data. Copyright © 2005 John Wiley & Sons, Ltd. [source] Functional consistency across two behavioural modalities: fire-setting and self-harm in female special hospital patientsCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2007Sarah Miller Background,Fire-setting and self-harm behaviours among women in high security special hospitals may be understood using Shye's Action System Theory (AST) in which four functional modes are recognized: ,adaptive', ,expressive', ,integrative', and ,conservative'. Aims,To test for relationships between different forms of fire-setting and self-harm behaviours and AST modes among women in special hospital, and for consistency within modes across the two behaviours. Method,Clinical case files evidencing both fire-setting and self-harm behaviours (n = 50) were analysed for content, focusing on incident characteristics. A total of 29 fire-setting and 22 self-harm variables were analysed using Smallest Space Analysis (SSA). Chi-square and Spearman's rho (,) analyses were used to determine functional consistency across behavioural modes. Results,Most women showed one predominant AST mode in fire-setting (n = 39) and self-harm (n = 35). Significant positive correlations were found between integrative and adaptive modes of functioning. The lack of correlation between conservative and expressive modes reflects the differing behaviours used in each activity. Despite this, significant cross-tabulations revealed that each woman had parallel fire-setting and self-harm styles. Discussion,Findings suggest that, for some women, setting fires and self harm fulfil a similar underlying function. Support is given to AST as a way of furthering understanding of damaging behaviours, whether self- or other-inflicted. Copyright © 2007 John Wiley & Sons, Ltd. [source] Orofacial trauma and rugby in France: epidemiological surveyDENTAL TRAUMATOLOGY, Issue 4 2003Michèle Muller-Bolla Abstract ,,,A stratified epidemiological survey was carried out among the best French rugby players to assess the prevalence of trauma to the lower or middle part of the face (TLMPF) and the frequency at which the mouthguards (MGs) were worn. The 1140 randomized players (elite 1, elite 2 and national 1 clubs) filled in the same form anonymously. The variables were first subjected to univariate analysis (Chi-square, anova). Secondly, they were included in a multivariate model (logistic regression). Some 29.57% of players had already been affected by a TLMPF. The risk increased for the oldest forward players. It also increased with the number of yearly competitions and number of hours of weekly training. Some 64.3% of players used a MG. The frequency at which it was worn increased with the number of yearly competitions, for those who had experinced a previous trauma and for the pack players who had been playing for a long time. [source] The Impact of a Concurrent Trauma Alert Evaluation on Time to Head Computed Tomography in Patients with Suspected StrokeACADEMIC EMERGENCY MEDICINE, Issue 3 2006Esther H. Chen MD Background: Emergency department (ED) overcrowding threatens quality of care by delaying the time to diagnosis and treatment of patients with time-sensitive diseases, such as acute stroke. Objective: The authors hypothesized that the presence of a trauma alert evaluation would impede the time to head computed tomography (hCT) in patients with stroke-like symptoms. Methods: This was a secondary analysis of prospectively collected data on patients with potential stroke who received an hCT in an urban trauma center ED from January 1, 2004, to November 30, 2004. Structured data collection included historical and examination items, National Institutes of Health (NIH) stroke scale score, laboratory and radiographic results, and final diagnosis. Admitted patients were followed in hospital. Patients who presented within one hour following a trauma evaluation were compared with patients who presented without concurrent trauma for triage time until completion of hCT. Chi-square, t-tests, and 95% confidence intervals (95% CIs) were used for comparisons. Results: The 171 patients enrolled had a mean (± standard deviation) age of 60.7 (± 7) years; 60% were female; and 58% were African American. Of these, 72 patients had a significant cerebrovascular event (38 [22%] ischemic stroke, 25 [15%] transient ischemic attack, seven [4%] intracranial hemorrhage, one [0.6%] subarachnoid hemorrhage, and one [0.6%] subdural hematoma). The remaining diagnoses included 4.6% migraine, 2.3% seizure, 2.9% syncope, 2.3% Bell's palsy, and 2.9% vertigo. There was no significant difference in time to hCT in patients who presented during a trauma activation and those who did not (99 minutes [interquartile range (IQR) = 24,156] vs. 101 minutes [IQR = 43,151.5]; p = 0.537). In subgroup analysis of patients with a significant cerebrovascular event, times to hCT were also similar (24 minutes [IQR = 12,99] vs. 61 minutes [IQR = 15,126]; p = 0.26). Conclusions: In the authors' institution, the presence of concurrent trauma evaluation does not delay CT imaging of patients with potential stroke. [source] Cultural Variability in the Manifestation of Expressed EmotionFAMILY PROCESS, Issue 2 2009STEVEN R. LÓPEZ PH.D. We examined the distribution of expressed emotion (EE) and its indices in a sample of 224 family caregivers of individuals with schizophrenia pooled from 5 studies, 3 reflecting a contemporary sample of Mexican Americans (MA 2000, N=126), 1 of an earlier study of Mexican Americans (MA 1980, N=44), and the other of an earlier study of Anglo Americans (AA, N=54). Chi-square and path analyses revealed no significant differences between the 2 MA samples in rates of high EE, critical comments, hostility, and emotional over-involvement (EOI). Only caregiver warmth differed for the 2 MA samples; MA 1980 had higher warmth than MA 2000. Significant differences were consistently found between the combined MA samples and the AA sample; AAs had higher rates of high EE, more critical comments, less warmth, less EOI, and a high EE profile comprised more of criticism/hostility. We also examined the relationship of proxy measures of acculturation among the MA 2000 sample. The findings support and extend Jenkins' earlier observations regarding the cultural variability of EE for Mexican Americans. Implications are discussed regarding the cross-cultural measurement of EE and the focus of family interventions. RESUMEN Examinamos la distribución de emoción expresada y sus índices en una muestra de 224 cuidadores parientes de personas con esquizofrenia tomadas de 5 estudios, tres que reflejaban una muestra contemporánea de personas méxico-estadounidenses (ME 2000, N=126), una de un estudio anterior de méxico-estadounidenses (ME 1980, N=44, Karno et al., 1987) y la otra de un estudio anterior de angloamericanos (AA, N=54, Vaughn et al., 1984). La distribución ji-cuadrado y los análisis de pautas no revelaron diferencias significativas entre las dos muestras de méxico-estadounidenses en cuanto a los índices de alta emoción expresada, comentarios críticos, hostilidad y sobreimplicación emocional. Solo la calidez de los cuidadores fue distinta en las dos muestras de méxico-estadounidenses; el grupo ME 1980 demostró mayor calidez que el grupo ME 2000. Se encontraron sistemáticamente diferencias considerables entre las dos muestras de méxico-estadounidenses y la muestra de angloamericanos; los angloamericanos demostraron índices más altos de alta emoción expresada, más comentarios críticos, menos calidez, menos sobreimplicación emocional y un perfil de alta emoción expresada compuesto mayormente por crítica y hostilidad. También examinamos la relación de los cálculos aproximados de aculturación entre la muestra ME 2000. Los resultados respaldan y amplían las observaciones anteriores de Jenkins (1991) con respecto a la variabilidad cultural de emoción expresada en los méxico-estadounidenses. Se comentan las implicaciones con respecto a la evaluación intercultural de emoción expresada y al enfoque de las intervenciones familiares. Palabras clave: Emoción expresada, cultura, méxico-estadounidenses, sobreimplicación emocional, esquizofrenia, cuidadores parientes [source] Personal and social determinants of health services utilization by Mexican older peopleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2010Maria Isabel Peñarrieta De Córdova PhD de córdova m.i.p., mier n., curi e.j.m., gómez t.g., quirarte n.h.g. & barrios f.f. (2009) Personal and social determinants of health services utilization by Mexican older people. International Journal of Older People Nursing 5, 193,201 doi: 10.1111/j.1748-3743.2009.00193.x Background., Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. Objective., To examine personal and social correlates to health services utilization among Mexican older persons. Design and methods., This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson's chi-squared tests and logistic regression were used for data analyses. Results., Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. Conclusions., Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands. [source] "Where Are They Going?": Immigrant Inclusion in the Czech Republic (A Case Study on Ukrainians, Vietnamese, and Armenians in Prague),INTERNATIONAL MIGRATION, Issue 2 2007an Drbohlav ABSTRACT This paper is based on research conducted by the International Organization for Migration (IOM) Office in Prague and the Faculty of Science, Charles University in Prague in the fall and winter of 2003-2004. Within the questionnaire survey, 126 first-generation immigrants in Prague (51 Ukrainians, 45 Vietnamese, and 30 Armenians) were successfully contacted via a non-probability sampling method. The main goals of the research were to ascertain what mode of inclusion into Czech society the immigrant groups practiced and to determine their satisfaction level with their new lives. Special attention was paid to finding out important factors that stand behind both the common features and particular patterns of behaviour. Our approach is an attempt to analyse the issue via quantitative statistics (Chi-square Test, the AnswerTree Method). Berry's (1992) acculturation strategies model and Portes and Zhou's (e.g. 2000) segmented assimilation model serve as reference points while discussing conceptual matters. The results indicate that the immigrants' inclusion in Czech society in Prague has developed into specific modes: Ukrainians are typical of their specific transnationalization patterns, Vietnamese represent a "well-off" but separated and segregated community, and Armenians practice a clear assimilation strategy, while approaching the mainstream in terms of socio-economic status. Based on various indications, it seems that successful inclusion in Czech society is connected to the assimilation mode. In sum, the immigrants most satisfied with their quality of life are those for whom it is not important to live close to their compatriots and those whose knowledge of the spoken Czech language is above average. The lowest satisfaction score is tied to those immigrants who prefer to live close to their compatriots, those with university education, and those with a low income. Good knowledge of the Czech language seems to be a gateway to immigrants' satisfaction. Cette étude s'appuie sur un travail de recherche mené par le bureau de Prague de l'Organisation internationale pour les migrations (OIM) et la faculté des sciences de l'Université Charles à Prague, au cours de l'automne et de l'hiver 2003-2004. Dans le cadre de l'enquête-questionnaire, 126 immigrants de la première génération se trouvant à Prague (51 Ukrainiens, 45 Vietnamiens et 30 Arméniens) ont répondu grâce à une méthode procédant par sondage non aléatoire. Les buts principaux de cette recherche consistaient à vérifier à quels moyens avaient eu recours les groupes d'immigrants pour s'insérer dans la société tchèque et à déterminer dans quelle mesure ils s'estimaient satisfaits de leur nouvelle vie. Une attention particulière a été accordée à la recherche des facteurs importants ayant contribuéà fixer à la fois les caractéristiques communes et les particularités en matière de comportement. L'auteur s'est efforcé d'analy-ser la question à l'aide des statistiques quantitatives (test Chi carré, méthode AnswerTree). Le modèle des stratégies d'acculturation de Berry (1992) et le modèle d'assimilation segmentée de Portes et Zhou (par exemple 2000) servent de points de référence dans l'examen de questions conceptuelles. Les résultats montrent que l'incorporation des immigrants dans la société tchèque, a Prague, s'est traduite de différentes façons. Les Ukrainiens correspondent aux schémas spécifiques de transnationalisation qui leur sontpropres; les Vietnamiens constituent une communauté« prospère » mais se tenant à l'écart des autres; et les Arméniens pratiquent une stratégie évidente d'assimilation, tout en se rapprochant du courant central sur le plan du statut socio-économique. Sur la base de différentes indications, il semble que l'incorporation réussie dans la société tchèque soit liée au mode d'assimilation. Pour résumer, les immigrés les plus satisfaits de leur qualité de vie sont ceux pour qui il n'est pas important de vivre auprès de leurs compatriotes et ceux dont les connaissances de la langue tchèque parlée sont audessus de la moyenne. Le niveau de satisfaction le plus bas est celui des immigrés qui préfèrent rester en contact étroit avec leur compatriotes, ceux quijouissent d'une éducation de niveau universitaire et ceux dont le revenu se situe dans une tranche basse. Une bonne connaissance de la langue tchèque semble être la clé de la satisfaction des immigrés. Este artículo se basa en un estudio realizado por la Oficina de la Organización Internacional para las Migraciones (OIM) en Praga y la Facultad de Ciencias de la Universidad Charles de Praga, durante el último trimestre de 2003 y el primer trimestre de 2004. Recurriendo al cuestionario y al método de muestreo improbable se encuestó a 126 inmigrantes de primera generación en Praga (51 ucranios, 45 vietnamitas y 30 armenios). Los objetivos principales del estudio fueron determinar los modos de inserción de los grupos de inmigrantes en la sociedad checa y su nivel de satisfacción con relación a sus nuevas vidas. Se concedió particular atención a otros importantes factores subyacentes, a saber, las características comunes y los patrones particulares de comportamiento. En este artículo se analiza la cuestión mediante: estadísticas cuantitativas (la prueba de Chi-square, el método del Árbol de Respuestas); el modelo de estrategias de aculturación de Berry (1992); y el modelo de asimilación segmentada de Portes y Zhou (2000) que sirvieron de referencia a la hora de debatir cuestiones conceptuales. Los resultados apuntan a que la inserción de los inmigrantes en la sociedad checa, concretamente en Praga, se ha desarrollado según patrones específicos: los ucranios recurren a patrones típicos de transnacionalización, los vietnamitas son unacomunidad "acomodada" pero que se halla separaday segregada, mientras que los armenios utilizan un patrón claro de inserción, al tiempo que intentan incorporarse a la corriente principal en lo que atañe a su estatus socioeconómico. Sobre la base de diversas indicaciones, parece que una asimilación acertada en la sociedad checa depende del modo de inserción. En otras palabras, los inmigrantes más satisfechos con su calidad de vida son aquellos que no consideran importante vivir cerca de sus compatriotas y cuyos conocimientos del checo hablado superan la media. El índice más bajo de satisfacción se observa en los inmigrantes que prefieren vivir cerca de sus compatriotas, realizaron estudios universitarios y perciben bajos ingresos. Por lo visto, el buen conocimiento del idioma checo es la clave en la satisfacción de los inmigrantes. [source] An evaluation of the hand and nasal flora of Turkish nursing students after clinical practiceJOURNAL OF CLINICAL NURSING, Issue 3 2009Reva Balc Aim., The purpose of this study was to evaluate and compare the hand and nasal flora of nursing students before and after the clinical practice. Background., Hospitals are places where infective agents abound. Healthcare workers, relatives of patients and students practising in the hospital medium are often exposed to these infective agents. Although the role of the hand and nasal flora of healthcare workers in the development of nosocomial infections has been emphasised by earlier studies, there are a limited number of studies which investigate the hand and nasal flora of nursing students. Design., Descriptive. Methods., This descriptive study involved 66 volunteer nursing students. Two samples of flora from both hands and nose of each student were obtained. The inoculated samples were then evaluated through routine bacteriological study methods. Chi-square and percentage calculations were used in comparisons. Results., None of the students had methicillin-resistant Staphylococcus aureus or methicillin-resistant coagulase-negative Staphylococcus colonisation in the hand samples before clinical practice, 6·1% of the students had methicillin-resistant Staphylococcus aureus and 4·5% had methicillin-resistant coagulase-negative Staphylococcus colonisation after the practice. Although the differences between the rates of contamination with pathogen micro-organisms in the hand and nasal flora of the student nurses before and after clinical practice were not significant, the rate of colonisation after clinical practice was higher. Conclusions., In this study, the rate of colonisation after clinical practice was higher. These findings indicate that students might have been contaminated with bacteria during clinical practice. Relevance to clinical practice., The results of this study have practical importance in clinical practice. The role of the hand and nasal flora of nursing students in the development of nosocomial infections is significant. For this reason, some precautions, such as using gloves and handwashing with special solutions when needed, should be taken to prevent nosocomial infections and protect students against associated risks. [source] Recurrence rates associated with incompletely excised low-risk nonmelanoma skin cancerJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2010Kerri E. Rieger Background: Reported recurrence rates for transected nonmelanoma skin cancer (NMSC) vary widely, and few studies have addressed recurrence of tumors followed clinically or treated with nonsurgical modalities. Methods: Retrospective review of dermatopathology records from January 1999 to January 2005 was conducted to identify biopsies or excision specimens with histologically transected basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) which were not subsequently excised. Patient and tumor characteristics associated with recurrence were analyzed in a subgroup of patients with predominantly ,low-risk' and/or minimally transected NMSCs. Prospective follow up was performed through March 31, 2008. Data was analyzed with Chi-square and Fishers exact tests and multivariate logistic regression. Results: Of 376 transected NMSCs, 27 (7.2%) recurred, including 20 (9%) of 223 BCCs and 7 (4.6%) SCCs in situ of 153 SCCs. The overall recurrence rate of the 124 minimally transected NMSCs was even lower (5.6%). Multivariate logistic regression identified three significant predictors of recurrence: tumor location on the head and neck (p = 0.041), tumor size (p = 0.00741) and superficial subtype of BCC (p = .035). Conclusions: Although surgical excision of NMSC remains the standard of care, observation or nonsurgical treatment may be acceptable in many cases of incompletely excised low-risk or minimally transected NMSCs. [source] THERMAL PROCESS EVALUATION OF RETORTABLE POUCHES FILLED WITH CONDUCTION HEATED FOODJOURNAL OF FOOD PROCESS ENGINEERING, Issue 5 2002MARCELO CRISTIANINI ABSTRACT Two models using the finite element technique (FE) and another using an analytical solution to solve the 3-dimensional heat conduction equation for a finite plate were built. FE models were built considering the actual pouch shape and retort temperature profile. Chi-square and regression lines were obtained for each set of temperatures generated by the models against experimental data. A mass average sterilizing value of 9.9 min was estimated when a critical point sterilizing value was at 8.7 min using the 3-Dimensional FE model. Close agreement was found among the three models for heating phase. Using actual retort temperature profile made FE models more accurate than the one using analytical solution, especially for cooling phase. [source] Impact of Label Information on Consumer Assessment of Soy-enhanced Tomato JuiceJOURNAL OF FOOD SCIENCE, Issue 9 2004C.D. Goerlitz ABSTRACT: The impact of label information on the liking and closeness to ideal of tomato juice beverages was examined by having 100 judges assess 3 tomato juice beverages (Campbell's tomato juice, V8 juice, and an experimental tomato juice enhanced with soy) either with or without labeling information. Judges rated overall liking of each product and then rated appropriateness of various attributes (saltiness, tomato flavor, thickness, texture, red color, orange color, and brown color) on 5-point just-right scales. Only half of the judges were presented with product-related label information during evaluation. Overall liking scores were analyzed using repeated-measures ANOVA, whereas different attribute ratings were analyzed using Thurstonian Ideal Point modeling and Chi-square. Product-associated label information did not significantly alter overall liking ratings (P > 0.05), although a significant difference in liking was found between products (P < 0.05). Similarly, the label information did not impact comparison of product attribute levels to ideal attribute levels. Both V8 and Campbell's were significantly different from the ideal for 3 of the attributes (P < 0.05). For the soy-enhanced tomato juice, all 7 attributes were significantly different from the ideal (P < 0.05). In this instance, labeling information had no notable impact on assessments. [source] Advanced Education in Prosthodontics: Residents' Perspectives on Their Current Training and Future GoalsJOURNAL OF PROSTHODONTICS, Issue 2 2010DMSc, Zeyad H. Al-Sowygh BDS Abstract Purpose: The purposes of this study were to identify current prosthodontic residents' demographics and to document prosthodontic residents' perspectives on their clinical training and future goals. Materials and Methods: A 52-item survey was created and distributed to prosthodontic residents in the United States on February 8, 2007. The data collected were analyzed; the means and standard deviations were calculated and ranked. Statistical analysis was conducted using Chi-square and Mann-Whitney analysis (p= 0.05). Results: A 43% response rate was achieved, representing approximately 48% of the total population of prosthodontic residents in the United States. The majority of residents ranked clinical education as the most important factor in selecting their programs, were satisfied with their training, and planned to pursue the certification of the American Board of Prosthodontics. When asked how often they planned to work, 4 days a week was the most common answer. Conclusion: This is the first report identifying current prosthodontic residents' demographics and their perspectives on their clinical training and future goals. Several trends were identified, indicating a bright future for the specialty. By knowing the students' perceptions regarding their training and future goals, the American College of Prosthodontists and/or program directors will be able to use this information to improve residency programs and the specialty. [source] Computed Tomography of Temporal Bone Fractures and Temporal Region Anatomy in HorsesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 2 2010S. Pownder Background: In people, specific classifications of temporal bone fractures are associated with clinical signs and prognosis. In horses, similar classifications have not been evaluated and might be useful establishing prognosis or understanding pathogenesis of certain types of trauma. Hypothesis/Objectives: We hypothesized associations between temporal bone fracture location and orientation in horses detected during computed tomography (CT) and frequency of facial nerve (CN7) deficit, vestibulocochlear nerve (CN8) deficit, or temporohyoid osteoarthropathy (THO). Complex temporal region anatomy may confound fracture identification, and consequently a description of normal anatomy was included. Animals: All horses undergoing temporal region CT at our hospital between July 1998 and May 2008. Methods: Data were collected retrospectively, examiners were blinded, and relationships were investigated among temporal bone fractures, ipsilateral THO, ipsilateral CN7, or ipsilateral CN8 deficits by Chi-square or Fischer's exact tests. Seventy-nine horses had CT examinations of the temporal region (158 temporal bones). Results: Sixteen temporal bone fractures were detected in 14 horses. Cranial nerve deficits were seen with fractures in all parts of the temporal bone (petrosal, squamous, and temporal) and, temporal bone fractures were associated with CN7 and CN8 deficits and THO. No investigated fracture classification scheme, however, was associated with specific cranial nerve deficits. Conclusions and Clinical Importance: Without knowledge of the regional anatomy, normal structures may be mistaken for a temporal bone fracture or vice versa. Although no fracture classification scheme was associated with the assessed clinical signs, simple descriptive terminology (location and orientation) is recommended for reporting and facilitating future comparisons. [source] Gene,gene and gene,environment interactions on IgE production in prenatal stageALLERGY, Issue 6 2010K. D. Yang To cite this article: Yang KD, Chang J-C, Chuang H, Liang H-M, Kuo H-C, Lee Y-S, Hsu T-Y, Ou C-Y. Gene,gene and gene,environment interactions on IgE production in prenatal stage. Allergy 2010; 65: 731,739. Abstract Background:, Prevalence of allergic diseases in children has increased worldwide over the past decades. Allergy sensitization may occur in fetal life. This study investigated whether gene,gene and gene,environment interactions affected cord blood IgE (CBIgE) levels. Methods:, A total of 575 cord blood DNA samples were subjected to a multiplex microarray for 384 single nucleotide polymorphisms (SNPs) in 159 allergy candidate genes. Genetic association was initially assessed by univariate and multivariate analyses. Multifactor dimensionality reduction (MDR) was used to identify gene,gene and gene,environment interactions. Environmental factors for analysis included maternal atopy, paternal atopy, parental smoking, gender, and prematurity. Results:, Twenty-one SNPs in 14 genes were associated with CBIgE elevation (,0.5 KU/l) in univariate analysis. Multivariate analysis identified eleven genes (IL13, IL17A, IL2RA, CCL17, CXCL1, PDGFRA, FGF1, HAVCR1, GNAQ, C11orf72, and ADAM33) which were significantly associated with CBIgE elevation. MDR analyses of gene,gene interactions identified IL13 interacted with IL17A and/or redox genes on CBIgE elevation with the prediction accuracy of 62.52%. Analyses of gene,environment interactions identified that maternal atopy combined with IL13, rs1800925 and CCL22, rs170359 SNPs had the highest prediction accuracy of 67.15%. All the high and low risk classifications on gene,gene and gene,environment interactions by MDR analyses could be validated by Chi-square test. Conclusions:, Gene,gene (e.g. immune and redox genes) and gene,environment (e.g. maternal atopy and FGF1or redox genes) interactions on IgE production begin in prenatal stage, suggesting that prevention of IgE-mediated diseases may be made possible by control of maternal atopy and redox responses in prenatal stage. [source] Over- and underreporting of energy intake by patients with metabolic syndrome using an automated dietary assessment websiteNUTRITION & DIETETICS, Issue 4 2007Yasmine PROBST Abstract Under- and overreporting of dietary intake in a face-to-face context is related to age, gender and body mass index. The use of computer technology in dietetic practice is restricted to analysis of nutrient data rather than assessment of the diet. DietAdvice, a website developed to allow patients with metabolic syndrome to self-report their dietary intake, has been developed in the Illawarra region of New South Wales, Australia. Patients are recruited by their general practitioner, and use the website, and the data are electronically fed to a dietitian for an individualised dietary prescription. The aim of the present study is to describe the reporting status of patients using a pilot test of the website from November 2004 to October 2005, and determine relationships to body mass index, gender and age. Reported energy intake (EI) was compared with predicted basal metabolic rate (BMR). Patients were classified as underreporting if EI : BMR <1.35 and overreporting if EI : BMR >2.4. Chi-square and ordinal regression analyses were used to determine relationships to patient characteristics. Two hundred patients were recruited, of whom 57 had missing data or did not complete the assessment. Of the remaining 143 patients, 32.3% underreported their intakes, 21.7% overreported their intakes, and 46.2% were on target with their reporting. No relationships were found for age, gender or body mass index. Findings suggest that computerised dietary assessment may encourage patients to report with less bias than in a verbal dietary assessment when compared with the literature. [source] Actual asthma control in a paediatric outpatient clinic population: Do patients perceive their actual level of control?PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 7 2008Sanne C Hammer Several epidemiological studies described poor asthma control in children. However, the diagnosis of childhood asthma in these studies is uncertain, and asthma control in children of an outpatient clinic population during treatment by a paediatrician is unknown. (1) to investigate the hypothesis that asthma control in a paediatric outpatient clinic population is better than epidemiological surveys suggest; (2) to find possible explanations for suboptimal asthma control. Asthmatic children aged 6,16 years, known for at least 6 months by a paediatrician at the outpatient clinic, were selected. During a normal visit, both the responsible physicians and parent/children completed a standardised questionnaire about asthma symptoms, limitation of daily activities, treatment, asthma attacks and emergency visits. Overall, excellent asthma control of 8.0% in this study was not significantly better than of 5.8% in the European AIR study (Chi-square, p = 0.24). Separate GINA goals like minimal chronic symptoms and no limitation of activities were better met in our study. Good to excellent controlled asthma was perceived by most children/parents (83%), but was less frequently indicated by the paediatrician (73%), or by objective criteria of control (45%) (chi-square, p = 0.0001). The agreement between patient-perceived and doctor assessed control was low, but improved in poorly controlled children. Patients were not able to perceive the difference between ,excellent asthma control' and ,good control' (p = 0.881). Too little children with uncontrolled disease got step-up of their asthma treatment. Although separate GINA goals like ,minimal chronic symptoms' and ,no limitation of activities' were significantly better in our study, overall, asthma control in this outpatient clinic population, treated by a paediatrician, was not significantly better than in the European AIR study. Poorly controlled disease was related to several aspects of asthma management, which are potentially accessible for improvements. [source] Adverse reactions of anti-tuberculosis drugs in hospitalized patients: incidence, severity and risk factors,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 10 2007Mohammad Reza Javadi Abstract Background Tuberculosis (TB) has been a common chronic infectious disease in human communities. Besides disease-related complications, there could be serious adverse reactions due to anti-tuberculosis (anti-TB) drug therapy. Objectives To assess the incidence and severity of adverse drug reactions (ADRs) induced by anti-TB drugs. To determine possible covariates associated with detected ADRs. Methods All patients with respiratory TB admitted to a teaching hospital who received anti-TB drugs during the research period entered the study and were monitored for ADRs. Socio-demographic and medical history of patients were used as independent covariates. The relationship between independent covariates with frequency and severity of ADRs was analysed using multivariate logistic regression. Preliminary analyses of the Mann,Whitney, Chi-square, Kruskal,Wallis and the Fisher's exact tests were applied to determine factors unlikely associated with the independent variables. Results Among 204 patients admitted, there were 92 patients (45.1%) with ADRs induced by anti-TB drugs. Patients with a previous history of anti-TB drugs usage (OR,=,5.81, 95% confidence interval [95%CI]: 1.31,25.2), patients with a history of drug allergy (OR,=,6.68, CI: 1.28,36.2), those from Afghani ethnic (OR,=,4.91, 95%CI: 1.28,18.30) as well as smoker patients with concurrent diseases (OR,=,19.67, CI: 1.24,341.51) had a higher rate of ADR incidence. Being female (OR,=,1.63, 95%CI: 1.96,36.40) and having previous history of ADR (OR,=,17.46, 95%CI: 1.96,20.42) were identified as risk factors. Conclusion Anti-TB drugs could cause severe and frequent adverse effects. Females, those with a previous history of ADRs to anti-TB drugs and Afghani patients, should be considered as high-risk groups. Copyright © 2007 John Wiley & Sons, Ltd. [source] The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2007Marion Gillen RN Abstract Background The combined effect of socioeconomic, organizational, psychosocial, and physical factors on work-related musculoskeletal disorders (WRMSDs) were studied in a heterogeneous, socioeconomically diverse sample (cases and their matched referents) of hospital workers. Methods Cases were defined by a new acute or cumulative work-related musculoskeletal injury; referents were matched by job group, shift length, or at random. Information was obtained through telephone interviews and on-site ergonomics observation. Questionnaire items included sociodemographic variables, lost work time, work effectiveness, health status, pain/disability, and psychosocial working conditions using Effort Reward Imbalance (ERI) and Demand-Control (DC) models. Two multivariate models were tested: Model 1 included occupation as a predictor; Model 2 included education,income as a predictor. Results Cases reported greater pain, disability, lost time, and decreased work effectiveness than the referents. Model 1 was statistically significant for neck/upper extremity injury (Chi-square,=,19.3, P,=,0.01), back/lower extremity injury (Chi-square,=,14.0, P,=,0.05), and all injuries combined (Chi-square,=,25.4, P,=,0.001). "Other Clinical" occupations (34% mental health workers) had the highest risk of injury (OR 4.5: 95%CI, 1.7,12.1) for all injuries. The ERI ratio was a significant predictor for neck and upper extremity (OR 1.5: 95%CI, 1.1,1.9) and all injuries (OR 1.3; 95%CI, 1.04,1.5), per SD change in score. Conclusions In this study, the risk of WRMSDs was more strongly influenced by specific psychosocial and physical job-related exposures than by broad socioeconomic factors such as education and income. Am. J. Ind. Med. 2007. © 2007 Wiley-Liss, Inc. [source] Robustness of Chi-square and Canberra distance metrics for computer intrusion detectionQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 1 2002Syed Masum Emran Abstract Intrusion detection complements intrusion prevention mechanisms, such as firewalls, cryptography, and authentication, to capture intrusions into an information system while they are acting on the information system. We develop two multivariate quality control techniques based on chi-square and Canberra distance metrics, respectively, to detect intrusions by building a long-term profile of normal activities in the information system (norm profile) and using the norm profile to detect anomalies. We investigate the robustness of these two distance metrics by comparing their performance on a number of data sets involving different noise levels in data. The performance results indicate that the Chi-square distance metric is much more robust to noises than the Canberra distance metric. Copyright © 2002 John Wiley & Sons, Ltd. [source] Comparison of Quantitative T-Wave Alternans Profiles of Healthy Subjects and ICD PatientsANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2009B.Eng., Euler De Vilhena Garcia Ph.D., M.Sc. Background: Current relevance of T-wave alternans is based on its association with electrical disorder and elevated cardiac risk. Quantitative reports would improve understanding on TWA augmentation mechanisms during mental stress or prior to tachyarrhythmias. However, little information is available about quantitative TWA values in clinical populations. This study aims to create and compare TWA profiles of healthy subjects and ICD patients, evaluated on treadmill stress protocols. Methods: Apparently healthy subjects, not in use of any medication were recruited. All eligible ICD patients were capable of performing an attenuated stress test. TWA analysis was performed during a 15-lead treadmill test. The derived comparative profile consisted of TWA amplitude and its associated heart rate, at rest (baseline) and at peak TWA value. Chi-square or Mann-Whitney tests were used with p values , 0.05. Discriminatory performance was evaluated by a binary logistic regression model. Results: 31 healthy subjects (8F, 23M) and 32 ICD patients (10F, 22M) were different on baseline TWA (1 ± 2 ,V; 8 ± 9 ,V; p < 0.001) and peak TWA values (26 ± 13 ,V; 37 ± 20 ,V; p = 0,009) as well as on baseline TWA heart rate (79 ± 10 bpm; 67 ± 15 bpm; p < 0.001) and peak TWA heart rate (118 ± 8 bpm; 90 ± 17 bpm; p < 0.001). The logistic model yielded sensitivity and specificity values of 88.9% and 92.9%, respectively. Conclusions: Healthy subjects and ICD patients have distinct TWA profiles. The new TWA profile representation (in amplitude-heart rate pairs) may help comparison among different research protocols. [source] Microleakage of composite resin restorations in cervical cavities prepared by Er,Cr:YSGG laser radiationAUSTRALIAN DENTAL JOURNAL, Issue 2 2008S Shahabi Abstract Background:, Evaluation of microleakage is important for assessing the success of new methods for surface preparation and new adhesive restorative materials. The aim of this laboratory study was to assess microleakage at the margins of composite restorations in Er,Cr:YSGG laser prepared cavities on the cervical aspects of teeth by means of dye penetration, and compare this with conventionally prepared and conditioned cavities. Methods:, Class V cavities were produced on sound extracted human teeth, which had been assigned randomly to one of three groups (N = 10 each), as follows: Group 1 , prepared using a diamond cylindrical bur and then treated with 37% phosphoric acid; Group 2 , irradiated with an Er,Cr:YSGG laser (Biolase Waterlase) and then treated with 37% phosphoric acid; Group 3 , irradiated only with the laser. After application of bonding agent (Excite, Ivoclar Vivadent), all cavities were restored with composite resin (Heliomolar). After polishing the restorations, the teeth were thermocycled from 5,50°C for 500 cycles. Dye leakage was assessed after immersion in methylene blue, by examining longitudinal sections in a stereomicroscope at ×30 magnification. Results:, The extent of dye penetration was lowest in the laser only group (Group 3). Penetration of dye to dentine and axial walls occurred in 80 per cent of conventionally prepared (bur + acid) specimens, but in the laser group, dye penetration to the axial wall occurred in only 30 per cent of cases. There was a strong statistical association between treatment group and the distribution of microleakage scores (Chi-square, P = 0.0023). Conclusions:, For Class V cavities, with the adhesive materials employed, higher microleakage occurs with phosphoric acid etching of bur- or laser-cut surfaces, than with the surface created by use of the laser alone without additional conditioning. [source] Subjective daytime sleepiness and its predictors in Finnish adolescents in an interview studyACTA PAEDIATRICA, Issue 5 2001O Saarenpää-Heikkilä The purpose of this study is to evaluate the predictors of subjective daytime sleepiness (SDS) and its chronicity in adolescents. Two groups of adolescents (107 with SDS and 107 without SDS) from our first questionnaire study were invited to an interview after 3 y. A follow-up questionnaire had been sent to them one year earlier. The interview included questions about sleep, daytime sleepiness, living habits, physical and mental health, and progress at school. The adolescents were also examined clinically. Interviews were conducted with 66 out of 107 subjects with SDS and 64 out of 107 without SDS (age range 12 to 19 y). In this interview 42 out of the 130 adolescents had SDS. A total of 20 adolescents reported SDS in both questionnaire studies and in the interview (chronic SDS). In a multivariate analysis (logistic regression) sleep disorders, frequent medication and depressive emotions were significantly associated with SDS. Chronic SDS was connected in a bivariate analysis (Pearson's chi-square) with excessive night waking, difficulty in falling asleep, dreaming, frequent medication, frequent alcohol drinking, and irregular breakfast eating, and in our previous studies also with delayed sleep rhythm. Conclusion: Sleep disorders and health problems were more common causes of SDS than undesirable living habits. However, alcohol drinking and delayed sleep rhythm were associated with chronic SDS in addition to sleep disorders and medication. [source] A multicentre investigation into the role of structured histories for patients with tooth avulsion at their initial visit to a dental hospitalDENTAL TRAUMATOLOGY, Issue 5 2003Peter F. Day Abstract ,,,A paper structured history (SH) is a sheet, which prompts or reminds the clinician to ask various important questions. The aim of this study was to examine avulsion cases with respect to the quality of clinical records. Hospitals studied used either a paper SH or had no specific structure in their recording of avulsion details, e.g. unstructured histories (USH). The most important prognostic items that should be recorded for avulsion cases at their first visit were identified by reviewing the literature. Clinical case records meeting strict inclusion criteria were retrospectively analyzed against 10 important prognostic items. Forty-seven patient records were identified in the SH group compared to 43 patient records in the USH group. Using chi-square and Fisher's exact tests, the SH group were significantly better at recording the following: accident details (P < 0.001), loss of consciousness (P < 0.001), other teeth or tooth injuries (P < 0.05), extra-alveolar mediums (P < 0.01), total extra-alveolar time (P < 0.001), antibiotics given at time of injury (P < 0.05) and apical maturity (P < 0.001). In all the dental hospitals selected, two-thirds of the case records were completed by junior dentists not in specialist training and the improvement in history when using an SH form was most pronounced in these groups. It is concluded, therefore, that an SH should be taken for cases of avulsion as it was significantly better at collecting essential prognostic information. [source] Risk Stratification and Prognosis in Octogenarians Undergoing Stress Echocardiographic StudyECHOCARDIOGRAPHY, Issue 8 2007F. A. C. C., Farooq A. Chaudhry M.D. Background: The prognostic value of stress echocardiography (SE) for the diagnosis and risk stratification of coronary artery disease in octogenarians is not well defined. Methods: Follow-up of 5 years (mean 2.9 ± 1.0 years) for confirmed nonfatal myocardial infarction (n = 17) and cardiac death (n = 37) was obtained in 335 patients, age ,80 years (mean age 84 ± 3 years, 44% male), undergoing SE (33% treadmill, 67% dobutamine). Left ventricular (LV) regional wall motion was assessed by a consensus of two echocardiographers and scored as per standard five-point scale, 16-segment model of wall motion analysis. Ischemic LV wall segment was defined as deterioration in the thickening and excursion during stress (increase in wall-motion score index (WMSI) ,1). Results: By univariate analysis, inducible ischemia (chi-square = 38.4, P < 0.001), left ventricular ejection fraction (chi-square = 41.2, P < 0.001), a history of previous myocardial infarction (chi-square = 22.3, P < 0.01), hypertension (chi-square = 33, P < 0.01), and age (chi-square = 27.7, P < 0.01) were significant predictors of future cardiac events. WMSI, an index of inducible ischemia, provided incremental prognostic information when forced into a multivariable model where clinical and rest echocardiography variables were entered first. WMSI effectively stratified octogenarians into low- and high-risk groups (annualized event rates of 1.2 versus 5.8%/year, P < 0.001). Conclusions: Stress echocardiography yields incremental prognostic information in octogenarians and effectively stratifies them into low- and high-risk groups. Precise therapeutic decision making in very elderly patients should incorporate combined clinical and stress echocardiography data. [source] Emergency Medicine Residency Selection: Factors Influencing Candidate DecisionsACADEMIC EMERGENCY MEDICINE, Issue 6 2005Melissa DeSantis MD Abstract Background: Published information is limited regarding factors considered by emergency medicine resident candidates when selecting a residency program. Objective: To identify factors considered important by applicants when making decisions about residency programs. Methods: A self-administered survey questionnaire was mailed to all applicants who interviewed at the authors' emergency medicine residency program for the 2003,2004 match year. Results: Surveys were completed by 105 respondents (53% response rate). Factors were rank-ordered by the proportion of respondents who indicated that the factor was "very important" or "important" when selecting residency programs. The five most important factors were friendliness (95%), environment (87%), interview day (81%), academics (76%), and location (74%). Male applicants were more likely to consider the existence of a flight program important or very important (55%), compared with female applicants (33%, p < 0.05, chi-square). Older respondents (over the age of 30 years) were more likely to consider gender issues (16%, compared with 13%) and research (32%, compared with 20%) as important factors (p < 0.05, chi-square). Conclusions: Residency applicants indicated that the most important factors when selecting residency program(s) were friendliness, environment, interview day, academics, and location. [source] Survey of major chronic iIlnesses and hospital admissions via the emergency department in a randomized older population in Randwick, AustraliaEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2002Daniel KY Chan Abstract Objective: To find out if patients with chronic illnesses living in the community are at risk of unplanned hospital admissions through emergency departments; what types of chronic illnesses may be putative risk factors; and if an increase in the number of chronic illnesses may be associated with increased risk. Methods: The survey included the completion of a standardized questionnaire for medical illnesses in a random sample of older people dwelling in the community and analysis of admission records to our hospital. The principal diagnoses for admissions were recorded. The risk factors for admissions were analysed. Results: Five hundred and twenty-six (239 men and 287 women) people aged 55 years and over were interviewed. Musculoskeletal disorders, hypertension, gastrointestinal disorders and ischaemic heart disease were the most frequently reported of the chronic illnesses surveyed. A total number of 70 people from the survey group with a total of 115 admissions through emergency departments were recorded. Using logistic regression model, hypertension, ischaemic heart disease and age were found to be risk factors for emergency admissions amongst this group of community-dwelling residents. The ratios were 2.03 (95% confidence interval (CI): 1.2,3.44), 2.02 (95% CI: 1.16,3.49) and 1.05 (95% CI: 1.02,1.09), respectively. Furthermore, multiple (three or more) chronic illnesses were found to be a strong predictor of hospital admission via emergency department (chi-square = 16.647, DF = 1, P -value < 0.001). Conclusion: We conclude that there was significant association between multiple chronic diseases and emergency admissions for older people. Of these, hypertension and ischaemic heart disease were found to be significant predictors. Age per se was found to be of borderline significance. [source] Utility of an Initial D-dimer Assay in Screening for Traumatic or Spontaneous Intracranial HemorrhageACADEMIC EMERGENCY MEDICINE, Issue 9 2001Mark E. Hoffmann MD Abstract Objective: To evaluate the sensitivity of a D-dimer assay as a screening tool for possible traumatic or spontaneous intracranial hemorrhage. If adequately sensitive, the D-dimer assay may potentially permit omission of a more expensive computed tomography (CT) scan of the head when such hemorrhage is clinically suspected. Methods: Prospective, consecutive, blinded study of patients (age > 16 years) requiring a CT scan of the head for suspected intracranial hemorrhage over a five-month period at a university, Level I trauma center. All study patients had a serum D-dimer assay obtained prior to their CT scans. Sensitivity and specificity, with 95% confidence intervals (95% CIs), of the enzyme-linked immunosorbent assay (ELISA) D-dimer assay for the detection of intracranial hemorrhage were calculated. Results: Of the 319 patients entered in the study, 25 (7.8%) had a CT scan positive for intracranial hemorrhage. Patients with intracranial hemorrhage were more likely to have a positive D-dimer assay (chi-square ? 13.075, p < 0.001). The D-dimer assay had 21 true-positive and four false-negative tests, resulting in a sensitivity of 84.0% (95% CI ? 63.7% to 95.5%) and a specificity of 55.8% (95% CI ? 55.5% to 55.9%). The four false-negative cases included one small intraparenchymal hemorrhage, one small subarachnoid hemorrhage, one moderate-sized intraparenchymal hemorrhage with mid-line shift, and one large subdural hematoma requiring emergent surgery. Conclusions: Due to the catastrophic nature of missing an intracranial hemorrhage in the emergency department, the D-dimer assay is not adequately sensitive or predictive to use as a screening tool to allow routine omission of head CT scanning. [source] Emergency Department Utilization by Noninstitutionalized EldersACADEMIC EMERGENCY MEDICINE, Issue 3 2001Manish N. Shah MD Abstract. Objectives: To the best of the authors knowledge, no nationally representative, population-based study has characterized the proportion of elders using the emergency department (ED) and factors associated with ED use by elders. This article describes the proportion of elder Medicare beneficiaries using the ED and identifies attributes associated with elder ED users as compared with nonusers. Methods: The 1993 Medicare Current Beneficiary Survey was used, a national, population-based, cross-sectional survey of Medicare beneficiaries linked with Medicare claims data. The study population was limited to 9,784 noninstitutionalized individuals aged 66 years or older. The Andersen model of health service utilization was used, which explains variation in ED use through a combination of predisposing (demographic and social), enabling (access to care), and need (comorbidity and health status) characteristics. Results: Eighteen percent of the sample used the ED at least once during 1993. Univariate analysis showed ED users were older; were less educated and lived alone; had lower income and higher Charlson Comorbidity Index scores; and were less satisfied with their ability to access care than nonusers (p < 0.01, chi-square). Logistic regression identified older age, less education, living alone, higher comorbidity scores, worse reported health, and increased difficulties with activities of daily living as factors associated with ED use (p < 0.05). Need characteristics predicted ED use with the greatest accuracy. Conclusions: The proportion of elder ED users is slightly higher than previously reported among Medicare beneficiaries. Need (comorbidity and health status) characteristics predict ED utilization with the greatest accuracy. [source] Emergency Medicine Resident Documentation: Results of the 1999 American Board of Emergency Medicine In-Training Examination SurveyACADEMIC EMERGENCY MEDICINE, Issue 10 2000John Howell MD Abstract. Objectives: To assess how emergency medicine (EM) residents perform medical record documentation, and how well they comply with Health Care Financing Administration (HCFA) Medicare charting guidelines. In addition, the study investigated their abilities and confidence with billing and coding of patient care visits and procedures performed in the emergency department (ED). Finally, the study assessed their exposure to both online faculty instruction and formal didactic experience with this component of their curriculum. Methods: A survey was conducted consisting of closed-ended questions investigating medical record documentation in the ED. The survey was distributed to all EM residents, EM,internal medicine, and EM,pediatrics residents taking the 1999 American Board of Emergency Medicine (ABEM) In-Training examination. Five EM residents and the Society for Academic Emergency Medicine (SAEM) board of directors prevalidated the survey. Summary statistics were calculated and resident levels were compared for each question using either chi-square or Fisher's exact test. Alpha was 0.05 for all comparisons. Results: Completed surveys were returned from 88.5% of the respondents. A small minority of the residents code their own charts (6%). Patient encounters are most frequently documented on free-form handwritten charts (38%), and a total of 76% of the respondents reported using handwritten forms as a portion of the patient's final chart. Twenty-nine percent reported delays of more than 30 minutes to access medical record information for a patient evaluated in their ED within the previous 72 hours. Twenty-five percent "never" record their supervising faculty's involvement in patient care, and another 25% record that information "1-25%" of the time. Seventy-nine percent are "never" or "rarely" requested by their faculty to clarify or add to medical records for billing purposes. Only 4% of the EM residents were "extremely confident" in their ability to perform billing and coding, and more than 80% reported not knowing the physician charges for services or procedures performed in the ED. Conclusions: The handwritten chart is the most widely used method of patient care documentation, either entirely or as a component of a templated chart. Most EM residents do not document their faculty's participation in the care of patients. This could lead to overestimation of faculty noncompliance with HCFA billing guidelines. Emergency medicine residents are not confident in their knowledge of medical record documentation and coding procedures, nor of charges for services rendered in the ED. [source] Clinical Characteristics as Predictors of Recurrent Alcohol-related SeizuresACADEMIC EMERGENCY MEDICINE, Issue 8 2000Niels K. Rathlev MD Abstract. Objective: To determine whether clinical data available in the emergency department can accurately predict a subset of patients at low risk of developing recurrent seizures following one or more initial alcohol-related seizures in the out-of-hospital arena. Methods: This was a retrospective secondary analysis of data obtained from the placebo arms of two prospective, randomized trials of drug treatments for the prevention of recurrent alcohol-related seizures. Subjects with and without one or more recurrent alcohol-related seizures during the study period were compared according to the following characteristics: 1) age, 2) gender, 3) daily ethanol consumption, 4) years of ethanol abuse, 5) previous alcohol-related seizure, 6) previous seizure of other etiology, 7) temperature, 8) heart rate, 9) systolic blood pressure, 10) diastolic blood pressure, 11) respiratory rate, and 12) ethanol level. Data were analyzed with t-tests and chi-square where appropriate. Results: One hundred five placebo-treated patients were analyzed and 31 (30%) developed recurrent alcohol-related seizures. None of the listed characteristics were statistically different between the two groups except for the initial ethanol level. Subjects with an ethanol level higher than 100 mg/dL were less likely (0%) to develop recurrent seizures than patients with a level equal to or below 100 mg/dL (36%) (p < 0.01). Conclusions: An initial ethanol level higher than 100 mg/dL was significantly associated with a low risk for recurrent alcohol-related seizures during the observation period. No other low-risk clinical characteristics could be identified. [source] | ||||||||||||||||||||||||||||||||||||||||