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Specific Standards (specific + standards)
Selected AbstractsEmergency Department Information System Adoption in the United StatesACADEMIC EMERGENCY MEDICINE, Issue 5 2010Adam B. Landman MD Abstract Objectives:, The American Recovery and Reinvestment Act of 2009 incentivizes adoption of health care information technology (HIT) based on support for specific standards, policies, and features. Limited data have been published on national emergency department information systems (EDIS) adoption, and to our knowledge, no prior studies have considered functionality measures. This study determined current national estimates of EDIS adoption using both single-response rates of EDIS adoption and a novel feature-based definition and also identified emergency department (ED) characteristics associated with EDIS use. Methods:, The 2006 National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED visits that also surveyed participating EDs on EDIS, was used to estimate EDIS adoption. EDIS adoption rates were calculated using two definitions: 1) single-response,response to a single survey question as to whether the EDIS was complete, partial, or none; and 2) feature-based,based on the reported features supported by the EDIS, systems were categorized as fully functional, basic, other, or none. The relationship of EDIS adoption to specific ED characteristics such as facility type and location was also examined. Results:, Using the single-response classification, 16.1% of EDs had a complete EDIS, while 30.4% had a partial EDIS, and 53.5% had none. In contrast, using a feature-based categorization, 1.7% EDs had a fully functional EDIS, 12.3% had basic, 32.1% had other, and 53.9% had none. In multivariable analysis, urban EDs were significantly more likely to have a fully functional or basic EDIS than were rural EDs. Pediatric EDs were significantly more likely than general EDs to have other EDIS. Conclusions:, Despite more optimistic single-response estimates, fewer than 2% of our nation's EDs have a fully functional EDIS. EDs in urban areas and those specializing in the care of pediatric patients are more likely to support EDIS. Accurate and consistent EDIS adoption estimates are dependent on whether there are standardized EDIS definitions and classifications of features. To realize the potential value of EDIS for improved emergency care, we need to better understand the extent and correlates of the diffusion of this technology and increase emergency medicine engagement in national HIT policy-making. Academic Emergency Medicine 2010; 17:536,544 © 2010 by the Society for Academic Emergency Medicine [source] Factors Associated with the Use of and Compliance with the IIA Standards: A Study of Anglo-culture CAEsINTERNATIONAL JOURNAL OF AUDITING, Issue 1 2009Mohammad J. Abdolmohammadi Chief audit executives (CAEs) are required to use and comply with The International Standards for the Professional Practice of Internal Auditing (Standards). However, this study finds that 13.5 percent of CAEs in Anglo-culture countries do not use the Standards. Furthermore, of those who use the Standards a significant number fail to comply with specific standards. Multivariate tests of data from CAEs in this study show that ,Length of IIA membership' and ,Internal auditing certification' are positively associated with use. Other significant variables are ,Superseded by local/government regulations or standards,',Not perceived as value added by management/board' and ,Compliance not expected in the country' that are inversely related to use. The length of training is also positively associated with compliance, while other significant variables are internal audit certification, ,Standards are too costly,',Not perceived as value added by management/board' and ,Inadequate internal audit staff' that are negatively associated with compliance. The paper ends with a discussion of the implications of these results for practice and research. [source] Use of real-time gene-specific polymerase chain reaction to measure RNA expression of three family members of rat cytochrome P450 4AJOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY, Issue 3 2001Kimberly B. Bleicher Abstract Exposure of rats to peroxisome proliferators induces members of the cytochrome P450 4A (CYP4A) family. In rats, the CYP4A family consists of four related genes, CYP4A1, CYP4A2, CYP4A3, and CYP4A8. We are specifically interested in examining CYP4A1, CYP4A2, and CYP4A3, each of which is expressed in a tissue-dependent and sex-dependent manner. While CYP4A1 is sufficiently different from the other two members to enable relatively easy specific quantitation, the close similarity between CYP4A2 and CYP4A3 makes quantitative discrimination difficult. We have combined a fluorescent real-time PCR assay (TaqMan®) with the sequence-specific mismatch amplification mutation assay (MAMA) to allow us to carry out specific quantitation of all three members of this family. The assay is designed such that a single fluorescent TaqMan® probe binds to all three gene products, while specificity is conferred by sequence-specific primers. This specific MAMA technique takes advantage of the ability of Taq polymerase to distinguish between the two cDNAs based on mismatches at the 3, end of a PCR primer. In the 84-base PCR product used for this assay, there is only a single-base difference between CYP4A2 and CYP4A3. Despite this similarity, there is at least a 1000-fold discrimination between the two sequences, using CYP4A2 or CYP4A3 specific standards. Analysis of rat liver RNA from both sexes demonstrates that this discrimination is also achieved in complex RNA mixtures. This technique should be broadly applicable to other areas of research such as allelic discrimination, detecting mutational hotspots in tumors, and discrimination among closely related members of other gene families. © 2001 John Wiley & Sons, Inc. J Biochem Mol Toxicol 15:133,142, 2001 [source] In-vitro release of bupivacaine from injectable lipid formulations investigated by a single drop technique , relation to duration of action in-vivoJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 6 2002Lars Söderberg The aim of this study was to develop an in-vitro release method suitable for injectable slow-release lipid formulations of local anaesthetics (or other drugs). We also aimed that the results of the in-vitro measurements should have a clear relationship to duration of action in-vivo. Six formulations of bupivacaine base in medium-chain triglyceride-glyceryl dilaurate mixtures were developed. A new apparatus was constructed for determination of their in-vitro release profiles. A bulbous glass tube was fixed inside a standard glass bottle, which was then filled with release medium. A stirring magnet was enclosed in the perforated polypropylene cylinder holding the glass tube. The stirring created a continuous, rotating downward flow of medium inside the tube, which kept the lipid phase, introduced by means of a syringe, suspended as a single, free drop. Release profiles were obtained by sampling of the release medium for up to 72 h and analysis by gas-liquid chromatography. The duration of action in-vivo of the respective formulations was tested by the hot-plate method in rats. The release profiles of bupivacaine in-vitro were mono-exponential for four formulations and bi-exponential for the other two. There was a positive correlation between the proportion of glyceryl dilaurate in the formulation and the slow half-life of release of bupivacaine. All formulations showed prolonged duration of action in-vivo, median values within the range 4.5,12 h, as compared with a 2-h effect of bupivacaine hydrochloride solution. A comparison of in-vitro release curves and durations of action in-vivo suggested that to maintain nerve blockade in-vivo the formulations must release bupivacaine at a rate of approximately 350 ,g h,1 under the in-vitro conditions. To conclude, we designed and tested a novel apparatus for measuring release of a local anaesthetic (or other drug) from a fluid or semi-solid formulation in-vitro. Release rates obtained in-vitro by means of this technique may be used to guide the development of formulations with suitable durations of action in-vivo. The apparatus is, however, as yet a prototype. Rigorous evaluation of performance should be carried out on devices built to specific standards according to their intended application. [source] Anwendung der neuen Stahlbetonnormen für die Bemessung von TunnelinnenschalenBETON- UND STAHLBETONBAU, Issue 2 2004Bruno Mattle Dipl.-Ing. Abstract Die in den letzten Jahren in der Bundesrepublik Deutschland und in Österreich errichteten Verkehrstunnel wurden i. a. zweischalig, d. h. mit einer Spritzbetonaußenschale und einer Innenschale aus unbewehrtem Beton oder Stahlbeton hergestellt. Die Bemessung der Innenschalen erfolgte unter Anwendung der Normen DIN 1045 [1] und ÖN B 4200 [2]. Während die neuen Normen wie EC 2 [3], DIN 1045-1 [4] und ÖN B 4700 [5] im Hochbau schon seit längerem Anwendung finden, ist deren Anwendung für die Bemessung von Tunnelschalen im wesentlichen noch Neuland. Dies betrifft insbesondere die Anwendung des Teilsicherheitskonzeptes und die Möglichkeit, die Schnittgrößen unter Anwendung nichtlinearer Stoffgesetze zu ermitteln. Im vorliegenden Beitrag wird die Problematik dargestellt und anhand von Beispielen der Einfluß unterschiedlicher Annahmen aufgezeigt. Design of Final Tunnel Linings according to the new Codes for Reinforced Concrete The traffic tunnels which have been constructed during the last few years in Germany and Austria in general have an initial shotcrete lining and a final, cast in place reinforced or unreinforced concrete lining. The structural design of the final linings has been based on specific standards from the clients and on the national codes DIN 1045 [1] and ÖN B 4200 [2]. While the new codes EC 2 [3], DIN 1045-1 [4] and ÖN B 4200 [5] have been widely used for the structural design of buildings for a while, their application for the design of tunnel linings is more or less a new field. In particular this is valid for using nonlinear material laws and the partial safety factor concept. In the presented paper this topic is discussed and the consequences of different assumptions are shown on specific examples. [source] Nutritional state of Polish prepubertal children assessed by population-specific and international standardsACTA PAEDIATRICA, Issue 2 2007P. Matusik Abstract Objective: To assess the frequency of obesity, overweight and underweight (thinness) in Polish 7,9-year-old children using a population specific definition as compared to the French, US and IOTF references based on body mass index (BMI). Design: Height and weight were measured and BMI was calculated in a randomly selected representative sample of 7,9-year-old Polish children (N = 2916; 1445 girls; 1471 boys) to define their nutritional status. Overweight (including obesity) was estimated according to four and underweight (thinness) according to three definitions Polish national references; French references; United States references and International Obesity Task Force references. Results: According to Polish, French, U.S. and IOTF references overweight (including obesity) was found in 12.1, 14.3, 20.7 and 15.4% of children, respectively; 3.5, 9.4 and 3.6% of children were obese according to national, U.S. and IOTF references, respectively while underweight (thinness) was present in 6.9, 2.6 and 4.2% of children according to Polish, French and U.S. references, respectively. A trend of decreasing overweight and increasing underweight through age classes was observed. Conclusion: The rates of underweight (thinness), overweight and obesity in Polish 7,9-year-old children calculated according to the national, French, U.S. and IOTF references were significantly different. Therefore even if the IOTF reference is considered superior for international epidemiological studies, population specific standards should probably coexist for clinical practice. [source] | ||||||||||