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Severity Classification (severity + classification)
Selected AbstractsThe BreathmobileÔ: A Novel Comprehensive School-Based Mobile Asthma Care Clinic for Urban Underprivileged ChildrenJOURNAL OF SCHOOL HEALTH, Issue 6 2006Otto Liao Many school-based programs have been funded to improve asthma management, especially for these "high-risk" inner-city children with asthma. Here we report the outcomes of the Children's Hospital of Orange County Breathmobile program, which is a school-based asthma program that combines the use of a mobile clinic and a pediatric asthma specialist. Baseline evaluations included a detailed history and physical, skin prick test to common allergens, spirometry measurements, and asthma severity classification based on the current National Asthma Education and Prevention Program guidelines. From April 2002 to September 2005, a total of 1321 children were evaluated for asthma. Analysis of the 1112 (84%) children diagnosed with asthma showed a population mean age of 7.8 years, 81% Latino ethnicity, and 73% with persistent disease. At baseline, only 24% of children with persistent asthma were on daily anti-inflammatory medications, which increased to 78% by the first follow-up visit. In the year prior to entry into the program, 64% had school absenteeism related to asthma (38% >10 days), 45% had emergency room (ER) visits (28% >1), and 19% had hospitalizations (9% >1). There was a significant reduction (p < .001) in the annual rates of ER visits, hospitalizations, and school absenteeism when comparing pre- and postentry into the program. These data suggest that a mobile asthma van clinic at the school site with an asthma specialist could be an effective model in reducing morbidity in the underserved child with asthma. Further studies are necessary to determine whether this model is applicable to other inner-city settings. (J Sch Health. 2006;76(6):313-319) [source] Revision of the severity rating and classification of hospital-acquired pneumonia in the Japanese Respiratory Society guidelinesRESPIROLOGY, Issue 6 2008Masafumi SEKI Background and objective: Based on the results of a multicentre collaborative survey of hospital-acquired pneumonia (HAP) conducted in Japan, the severity rating and classification of pneumonia in the Japanese Respiratory Society guidelines for management of HAP were examined. Methods: Parameters for the severity classification were selected from the factors associated with prognosis in the HAP survey and in other previous reports. Depending on the presence of the parameters listed below, patients with HAP were stratified into those with high, moderate or low-risk. The high-risk group was defined as patients with three or more of the following risk factors: ,malignant tumour or immunocompromised status', ,impaired consciousness', ,requiring fraction of inspired oxygen (FiO2) >35% to maintain SaO2 >90%', ,man aged 70 years or older, or woman aged 75 years or older' and ,oliguria or dehydration.' The moderate-risk group was defined as patients with any of the secondary risk factors as follows: ,CRP , 200 mg/L' and ,extent of infiltration on CXR covers at least 2/3 of one lung'. The low-risk group was defined as all other patients. Results: Application of this classification scheme to the patients enrolled in the HAP survey revealed a mortality rate of 40.8% (98/240) in the high-risk group, which was significantly higher than the mortality rates in the moderate and low-risk groups: 24.9% (69/277) and 12.1% (101/834), respectively. Conclusion: These results indicate that it is possible to classify patients using these parameters as prognostic indicators. [source] Evaluation of the newly established acne severity classification among Japanese and Korean dermatologistsTHE JOURNAL OF DERMATOLOGY, Issue 5 2008Nobukazu HAYASHI ABSTRACT Recently, we established an acne severity classification that is based on scientific evidence. Our classification allows three different methods for grading, which include general impression of consulted dermatologist, photograph-based estimation by independent experts, and grading by lesion counting. In our classification, we proposed standard photographs for the estimation of general severity to adjust the basis of judgments. In this study, we evaluated the validity of our classification. We made questionnaires of acne severity using acne patients' photographs, which were selected from the collection of representative photographs of our classification. Participants answered these questionnaires before and after our presentations about our classification of acne severity. We identified the conformity rate with our consensus decision. The results revealed that average conformity rates were raised from 67.0% to 88.9% among Japanese dermatologists and from 68.0% to 79.8% among Korean ones. These data show the adequacy of both our grading system itself and its presentation. We believe our classification will be one of the most effective and reasonable grading systems to classify acne severity. [source] Assessing burn severity and comparing soil water repellency, Hayman Fire, ColoradoHYDROLOGICAL PROCESSES, Issue 1 2006Sarah A. Lewis Abstract An important element of evaluating a large wildfire is to assess its effects on the soil in order to predict the potential watershed response. After the 55 000 ha Hayman Fire on the Colorado Front Range, 24 soil and vegetation variables were measured to determine the key variables that could be used for a rapid field assessment of burn severity. The percentage of exposed mineral soil and litter cover proved to be the best predictors of burn severity in this environment. Two burn severity classifications, one from a statistical classification tree and the other a Burned Area Emergency Response (BAER) burn severity map, were compared with measured ,ground truth' burn severity at 183 plots and were 56% and 69% accurate, respectively. This study also compared water repellency measurements made with the water drop penetration time (WDPT) test and a mini-disk infiltrometer (MDI) test. At the soil surface, the moderate and highly burned sites had the strongest water repellency, yet were not significantly different from each other. Areas burned at moderate severity had 1·5 times more plots that were strongly water repellent at the surface than the areas burned at high severity. However, the high severity plots most likely had a deeper water repellent layer that was not detected with our surface tests. The WDPT and MDI values had an overall correlation of r = ,0·64(p < 0·0001) and appeared to be compatible methods for assessing soil water repellency in the field. Both tests represent point measurements of a soil characteristic that has large spatial variability; hence, results from both tests reflect that variability, accounting for much of the remaining variance. The MDI is easier to use, takes about 1 min to assess a strongly water repellent soil and provides two indicators of water repellency: the time to start of infiltration and a relative infiltration rate. Copyright © 2005 John Wiley & Sons, Ltd. [source] | ||||||||||