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Field Testing (field + testing)
Kinds of Field Testing Selected AbstractsAscertaining Health-Related Information on Adults With Intellectual Disabilities: Development and Field Testing of the Rochester Health Status SurveyJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Philip W. Davidson Abstract, There is a growing need for researchers and service providers to ascertain and track health status and health care utilization among adults with intellectual disabilities as they pass through the lifespan. This paper reports the development and field testing of the Rochester Health Status Survey (RHSS), a survey instrument that identifies incidence, lifetime prevalence, and point prevalence of diseases common in adults, as well as functional abilities and medication usage. The instrument also provides information about health system access and utilization. The survey is designed to be completed from chart review. An initial version of the survey was developed in 1998, revised in 2003, and then validated on a cohort of adults ages 21 to 73 years living in supervised community residences in the U.S. The RHSS includes 51 questions and requires about 45 min to complete. In the present study, data were collected on each subject by 3 different respondents (a service coordinator, a nurse, and when available, a family member). Their responses were compared item by item with the responses of the second author, a developmental disabilities geriatrician, who also completed the survey on each subject. Correlations and Kappa statistics confirmed that the highest agreement scores occurred between nurses and the geriatrician. [source] Field testing of equilibrium passive samplers to determine freely dissolved native polycyclic aromatic hydrocarbon concentrationsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2008Gerard Cornelissen Abstract Equilibrium passive samplers are promising tools to determine freely dissolved aqueous concentrations (CW,free) of hydrophobic organic compounds. Their use in the field, however, remains a challenge. In the present study on native polycyclic aromatic hydrocarbons (PAHs) in Oslo Harbor, Norway, two different passive sampler materials, polyoxymethylene (POM; thickness, 55 ,m [POM-55] and 500 ,m [POM-500]) and polydimethylsiloxane (PDMS; thickness, 200 ,m), were used to determine in the laboratory CW,free in sediment pore water (CPW,free), and the suitability of five passive samplers for determination of CW,free in overlying surface water was tested under field conditions. For laboratory determinations of CPW,free, both POM-55 and PDMS turned out to be suitable. In the field, the shortest equilibrium times (approximately one month) were observed for POM-55 and PDMS (thickness, 28 ,m) coatings on solid-phase microextraction fibers, with PDMS tubing as a good alternative. Low-density polyethylene (thickness, 100 ,m) and POM-500 did not reach equilibrium within 119 d in the field. Realistic values were obtained for dissolved organic carbon,water partition coefficients in the field (approximately one log unit under log KOW), which strengthened the conclusion that equilibrium was established in field-exposed passive samplers. At all four stations, chemical activity ratios between pore water and overlying water were greater than one for all PAHs, indicating that the sediment was a PAH diffusion source and that sediment remediation may be an appropriate treatment for PAH contamination in Oslo Harbor. [source] Field testing of honeybee-dispersed Trichoderma spp. to manage sunflower head rot (Sclerotinia sclerotiorum)PLANT PATHOLOGY, Issue 3 2002A. R. Escande Efficacy of Trichoderma spp. to reduce sunflower head rot caused by Sclerotinia sclerotiorum was evaluated in the field. A mixture of six isolates, including Trichoderma koningii, T. aureoviride and T. longibrachiatum, was tested in five field trials at Balcarce, Argentina. Trichoderma formulation (TF) included Trichoderma conidia and viable hyphal fragments, industrial talc and milled corn kernels. Honeybees (Apis mellifera) were used to disperse TF for six weeks from the onset of flowering. Two days after the first TF delivery, sunflower heads were inoculated with S. sclerotiorum ascospores. When 100 g TF was taken by honeybees in a 10-h per day period, head rot incidence was significantly reduced. This approach was successful in reducing disease incidence until physiological maturity of the crop, in environments highly conducive to head-rot development. [source] The effects of selective breeding for differential rates of 50-kHz ultrasonic vocalizations on emotional behavior in ratsDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2009Jeffrey Burgdorf Abstract Fifty-kHz ultrasonic vocalizations have previously been shown to be positively correlated with reward and appetitive social behavior in rats, and to reflect a positive affective state. In this study, rats selectively bred for high and low rates of 50-kHz vocalizations as juveniles were tested as adults in a battery of behavioral tests for social/emotional behaviors. We found that animals selectively bred for high rates of 50-kHz vocalizations exhibited more crosses into the center area of the open field apparatus, were more likely to show a preference for a dilute sucrose solution (.8%) compared to tap water, and were less aggressive than randomly bred animals. Conversely, animals bred for low rates of 50-kHz calls produced more fecal boli during both open field testing and "tickling" stimulation, and made less contact with conspecifics in a social interaction test compared to randomly bred animals. We also observed that low line rats have elevated brain levels of cholecystokinin (CCK) in the cortex, which is consistent with literature showing that CCK content in the cortex is positively correlated with rates of aversive 22-kHz USVs. Conversely, high line animals had elevated levels of met-enkephalin in several brain regions, which is consistent with the role of endogenous-opioids in the generation 50-kHz USVs and positive affect. These results suggest that animals bred for high rates of 50-kHz may show a stress resilient phenotype, whereas low line rats may show a stress prone phenotype. As such these animals could provide novel insights into the neurobiology of emotion. © 2008 Wiley Periodicals, Inc. Dev Psychobiol 51: 34,46, 2009 [source] Long-term review of driving potential following bilateral panretinal photocoagulation for proliferative diabetic retinopathyDIABETIC MEDICINE, Issue 1 2009S. A. Vernon Abstract Aim To determine the necessity for repeated Driver and Vehicle Licensing Agency (DVLA) visual field testing in people with diabetes who have had bilateral panretinal photocoagulation (PRP) for proliferative diabetic retinopathy. Methods A questionnaire survey was conducted of driving history in a cohort of people with diabetes who had been treated with bilateral PRP for proliferative retinopathy between 1988 and 1990. In addition, all similarly eligible subjects attending the diabetic retinal review clinic over a 12-month period who had had laser between 1991 and 2000 were questioned as to their driving status. Results Forty-five surviving patients from the 1988,1990 cohort were eligible and 25 returned the questionnaire (55%). Eight had never driven and 15 (13 with Type 1 diabetes) still held a valid licence, having passed the DVLA field test on a number of occasions. Neither of the two patients who had stopped driving reported failing the DVLA field test as the reason for stopping. All 12 of the patients directly questioned in the clinic were still driving and had passed at least one repeat DVLA test. Conclusions People with Type 1 diabetes who have no further laser treatment for proliferative diabetic retinopathy can expect to retain their UK driving licence for at least 15 years following small-burn PRP, provided they maintain sufficient acuity. [source] A Simple Pore Water Hydrogen Diffusion Syringe SamplerGROUND WATER, Issue 6 2007Don A. Vroblesky Molecular hydrogen (H2) is an important intermediate product and electron donor in microbial metabolism. Concentrations of dissolved H2 are often diagnostic of the predominant terminal electron-accepting processes in ground water systems or aquatic sediments. H2 concentrations are routinely measured in ground water monitoring wells but are rarely measured in saturated aquatic sediments due to a lack of simple and practical sampling methods. This report describes the design and development (including laboratory and field testing) of a simple, syringe-based H2 sampler in (1) saturated, riparian sediments, (2) surface water bed sediments, and (3) packed intervals of a fractured bedrock borehole that are inaccessible by standard pumped methods. [source] The development of taiwan arterial traffic-adaptive signal control system and its field test: A taiwan experienceJOURNAL OF ADVANCED TRANSPORTATION, Issue 4 2009Yueh-Tzu Wu Abstract This Taiwan traffic-adaptive arterial signal control model borrowed its traffic flow framework mainly from a British traffic-adaptive control model with a cyclic traffic progression function, i.e. SCOOT (Split Cycle Office Optimisation Technique). The new arterial control model can take into account delays of both major and minor streets and make real-time signal timing decisions with optimal two-way signal offsets, so as to create the best arterial signal operation performance. It has been developed to be an online real-time software for both simulation testing and field validation. Through simulation, it was found that the performance when operating this newly developed real-time arterial traffic-adaptive model was significantly better than when using the optimal fixed-time arterial timing plan. On the aspect of field testing, three signalized intersections located in East District, Tainan City, Taiwan were selected to be the test sites. Fairly good traffic control performance has been demonstrated in that it can effectively reduce travel delays of the control arterial as a whole. Additional discussions about how to combine travel delay and the total number of vehicle stops into a new control performance index have also been included to make the new traffic-adaptive model more flexible and reasonable to meet the expectations of different driver groups in the arterial system. [source] Experimental validation and field performance metrics of a hybrid mobile robot mechanismJOURNAL OF FIELD ROBOTICS (FORMERLY JOURNAL OF ROBOTIC SYSTEMS), Issue 3 2010Pinhas Ben-Tzvi This paper presents the experimental validation and field testing of a novel hybrid mobile robot (HMR) system using a complete physical prototype. The mobile robot system consists of a hybrid mechanism whereby the locomotion platform and manipulator arm are designed as one entity to support both locomotion and manipulation symbiotically and interchangeably. The mechanical design is briefly described along with the related control hardware architecture based on an embedded onboard wireless communication network between the robot's subsystems, including distributed onboard power using Li-ion batteries. The paper focuses on demonstrating through extensive experimental results the qualitative and quantitative field performance improvements of the mechanical design and how it significantly enhances mobile robot functionality in terms of the new operative locomotion and manipulation capabilities that it provides. In terms of traversing challenging obstacles, the robot was able to surmount cylindrical obstacles up to 0.6-m diameter; cross ditches with at least 0.635-m width; climb and descend step obstacles up to 0.7-m height; and climb and descend stairs of different materials (wood, metal, concrete, plastic plaster, etc.), different stair riser and run sizes, and inclinations up to 60 deg. The robot also demonstrated the ability to manipulate objects up to 61 kg before and after flipping over, including pushing capacity of up to 61 kg when lifting objects from underneath. The above-mentioned functions are critical in various challenging applications, such as search and rescue missions, military and police operations, and hazardous site inspections. © 2010 Wiley Periodicals, Inc. [source] Ascertaining Health-Related Information on Adults With Intellectual Disabilities: Development and Field Testing of the Rochester Health Status SurveyJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Philip W. Davidson Abstract, There is a growing need for researchers and service providers to ascertain and track health status and health care utilization among adults with intellectual disabilities as they pass through the lifespan. This paper reports the development and field testing of the Rochester Health Status Survey (RHSS), a survey instrument that identifies incidence, lifetime prevalence, and point prevalence of diseases common in adults, as well as functional abilities and medication usage. The instrument also provides information about health system access and utilization. The survey is designed to be completed from chart review. An initial version of the survey was developed in 1998, revised in 2003, and then validated on a cohort of adults ages 21 to 73 years living in supervised community residences in the U.S. The RHSS includes 51 questions and requires about 45 min to complete. In the present study, data were collected on each subject by 3 different respondents (a service coordinator, a nurse, and when available, a family member). Their responses were compared item by item with the responses of the second author, a developmental disabilities geriatrician, who also completed the survey on each subject. Correlations and Kappa statistics confirmed that the highest agreement scores occurred between nurses and the geriatrician. [source] Characterization of First-Stage Silicon Nitride Components After Exposure to an Industrial Gas TurbineJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 1 2006H.-T. Lin This paper provides a summary of recent efforts undertaken to examine the mechanical properties and microstructural stability of first-stage silicon nitride blades and nozzles after field testing in an industrial gas turbine. Two commercially available silicon nitrides, i.e., Kyocera SN282 vanes and SN281 blades, were successfully evaluated in the 100 h final phase engine test at Solar Turbines Incorporated. The turbine rotor inlet temperature was increased from 1010° to 1121°C at 100% speed during the engine test with efficiency increasing from 28.8% to 30.1%. Results of scanning electron microscopy showed that apparent materials recession still occurred during the 100 h engine test, especially in the leading and trailing edge regions where the gas pressure or velocity was the highest. The apparent material recession of the airfoils resulted from the volatilization of the normally protective silica layer, evidenced by the increased surface roughness and porous Lu2Si2O7 surface layer features. On the other hand, mechanical results generated using a ball-on-ring test technique showed that little strength degradation was measured after the 100 h engine test. [source] Ineffectiveness of sun awareness posters in dermatology clinicsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2010GW Jung Abstract Background, Although sun awareness posters have been used in doctors' offices and clinics for decades to promote sun protective behaviour, there is no evidence of their usefulness. Objectives, To investigate whether sun awareness posters lead to inquiry of skin cancer and sun protection measures. Method, Patients considered at risk for skin cancer seen at a dermatology clinic were randomly asked to complete a questionnaire designed to assess the effectiveness of three different sun awareness posters placed in patient rooms. The posters were selected on the basis of their catchy slogan and eye-appealing images, and included those featuring parental interest, sex appeal and informative advice. Results, Only half of the patients noticed the posters (50.6%). The poster with sex appeal garnered the most attention (67.8%), followed by the informative poster (49.2%) and the parental interest poster (35.8%) (P < 0.001). Although patients who noticed the sun awareness poster inquired about cutaneous cancers and sun protection practices twice as often as those who did not notice the poster, only one-tenth of such inquiries were attributed to the poster (,5% of the target population). As reported in the questionnaire, the posters themselves were less effective than the advice of physicians in influencing patient attitudes towards sun protection measures. Conclusion, Organizations that produce and disseminate posters should consider beyond focus groups when they design their posters and should consider field testing their products to ensure that they are reaching the targeted audience and are having the expected beneficial effect, otherwise their posters are simply decorative. [source] Dose determination and confirmation of a long-acting formulation of ceftiofur (ceftiofur crystalline free acid) administered subcutaneously for the treatment of bovine respiratory diseaseJOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2002B. HIBBARD Hibbard, B., Robb, E. J., Chester Jr., S. T., Dame, K. J., Boucher, J. F., Alaniz, G. R. Dose determination and confirmation of a long-acting formulation of Ceftiofur (Ceftiofur crystalline free acid) administered subcutaneously for the treatment of bovine respiratory disease. J. vet. Pharmacol. Therap.25, 175,180. The objective of this work was to determine and confirm an effective dose of ceftiofur crystalline free acid sterile oil suspension (CCFA-SS, 100 mg ceftiofur equivalents (CE)/mL], a long-acting single-administration ceftiofur formulation, for the treatment of the bacterial component of bovine respiratory disease (BRD). Study 1 was a dose determination study that used an intratracheal Mannheimia haemolytica (Pasteurella haemolytica) challenge model to evaluate single-administration doses of CCFA-SS at 0.0, 1.1, 2.2, 3.3, 4.4 or 5.5 mg CE/kg body weight (BW) for the treatment of BRD. Data from this study were used to select doses for field testing in three multi-location clinical studies. In Study 2, the efficacy of a single administration dose of CCFA-SS at 4.4 mg CE/kg BW was compared with a negative control for the treatment of naturally occurring BRD in feedlot cattle. Treatments were administered when uniform clinical signs of BRD were present. Study 3 used a design similar to Study 2, and compared single-administration doses of CCFA-SS at 3.0 or 4.4 mg CE/kg BW with the positive-control tilmicosin (Micotil® 300 Injection, Elanco Animal Health) at 10 mg/kg BW. Study 4 compared the efficacy of single doses of CCFA-SS of 1.1,8.8 mg CE/kg BW with tilmicosin at 10 mg/kg BW. A total of 1176 cattle were included in these clinical studies. In Study 1, a dose of 4.55 mg CE/kg BW was determined to be effective. This was rounded to 4.4 mg CE/kg for field testing. In Study 2, a single dose of CCFA-SS at 4.4 mg CE/kg BW had a higher treatment success rate on day 14 (61%) than negative controls (26%, P < 0.01). However, in Study 3 this dose was judged to be at the beginning of an efficacious dose range for the treatment of BRD when compared with tilmicosin. In Study 4, day 28 treatment success rates were higher for CCFA-SS at 4.4,8.8 CE/kg BW than for tilmicosin (P=0.002) or the noneffective CCFA-SS dose of 1.1 mg CE/kg BW (P < 0.001). Based on decision criteria for Study 4, the effective dose was determined to be 4.4,5.5 mg CE/kg BW. These clinical studies demonstrated that a single dose of CCFA-SS (100 mg CE/mL) administered subcutaneously (s.c.) in the neck at 4.4,5.5 mg CE/kg BW is an effective treatment for BRD in feedlot cattle. However, this route of administration is no longer being considered for this formulation because of the ceftiofur residues that are present at the injection site for extended periods of time. [source] AN ADAPTIVE LEARNING FRAMEWORK FOR FORECASTING SEASONAL WATER ALLOCATIONS IN IRRIGATED CATCHMENTSNATURAL RESOURCE MODELING, Issue 3 2010SHAHBAZ KHAN Abstract This paper describes an adaptive learning framework for forecasting end-season water allocations using climate forecasts, historic allocation data, and results of other detailed hydrological models. The adaptive learning framework is based on artificial neural network (ANN) method, which can be trained using past data to predict future water allocations. Using this technique, it was possible to develop forecast models for end-irrigation-season water allocations from allocation data available from 1891 to 2005 based on the allocation level at the start of the irrigation season. The model forecasting skill was further improved by the incorporation of a set of correlating clusters of sea surface temperature (SST) and the Southern oscillation index (SOI) data. A key feature of the model is to include a risk factor for the end-season water allocations based on the start of the season water allocation. The interactive ANN model works in a risk-management context by providing probability of availability of water for allocation for the prediction month using historic data and/or with the incorporation of SST/SOI information from the previous months. All four developed ANN models (historic data only, SST incorporated, SOI incorporated, SST-SOI incorporated) demonstrated ANN capability of forecasting end-of-season water allocation provided sufficient data on historic allocation are available. SOI incorporated ANN model was the most promising forecasting tool that showed good performance during the field testing of the model. [source] Does the niqab (veil) wearer satisfy the minimal visual field for driving?OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2008E. Ian Pearce Abstract Visual field testing of subjects wearing a niqab was carried out using the approved (Esterman) test on a Humphrey perimeter to determine if visually normal subjects met the European driving standard. Measurement of aperture dimensions of the niqab when worn was recorded. When wearing the niqab, all subjects achieved a visual field adequate to satisfy UK/European driving standards. A measurement of the limiting aperture size was obtained and a self-test method for niqab wearers was determined. [source] How good are we at advising appropriate patients with glaucoma to inform the DVLA?OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2008A closed audit loop Abstract Purpose:, To establish how good we are as clinicians at advising glaucoma patients with bilateral visual field defects of their legal responsibility to inform the Driver and Vehicle Licensing Agency (DVLA). By using a sticker placed in the patients' notes to highlight driving status and visual fields, we sought to improve our success in providing and documenting this advice. Methods:, We interviewed and examined the notes of two groups of 100 consecutive glaucoma patients before and after the introduction of a ,driver sticker' placed into patients' notes at the time of visual field testing. We examined the documentation of driving status, and the provision and documentation of advice regarding the DVLA. Results:, In the first audit, we found only 9% of patients had driving status documented. Only 20% of drivers with bilateral field defects were advised to inform the DVLA with 11.4% documentation of this advice. After the introduction of the sticker, we succeeded in improving the documentation of driving status to 99%. We advised and documented the advice to inform the DVLA in 97% of drivers with bilateral field defects. Conclusions:, We found that as a unit we were poor at documenting driving status and advising glaucoma patients with bilateral field defects to inform the DVLA. By the simple measure of introducing a sticker into patients' notes, we were able to highlight this critical group and improve our provision and documentation of appropriate advice regarding informing the DVLA. [source] Vision screening of older peopleOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2007Zahra Jessa Abstract A recent systematic review found that between 20% and 50% of older people in the UK have undetected reduced vision and in most cases this is caused by refractive error or cataracts, and is correctable. Two approaches to improve the detection of these problems are to better publicise optometric services and to carry out community-based vision screening of older people. Screening programmes should pass the Wilson criteria and a consideration of these highlights three inter-related questions: ,Is vision screening effective at detecting correctable low vision in older people?'; ,Which tests should be included?' and ,Which venues are most appropriate?' We carried out a systematic review to investigate these questions. For the first question, only one study was found which met our selection criteria. The ,gold standard' eye examination in this study lacked several important components, and the vision screening method that was used was not found to be very effective. The review revealed other studies, which, although not meeting our selection criteria, included relevant information. The screening studies highlight the lack of agreement on the content of a gold standard eye examination and of the test(s) that should be used to screen vision. Visual function in older people is not adequately described by high contrast visual acuity (VA), nor by self-reports of visual difficulties. Other tests that may be relevant include visual field testing, low contrast VA, contrast sensitivity and stereo-acuity. The pinhole test has often been used in attempts to detect uncorrected refractive errors, but results from this test can be problematic and possible reasons for this are discussed. Appropriate venues for vision screening are contingent upon the format of the vision screening programme. There is still uncertainty over the battery of vision tests that are most appropriate. This, and optimum venues for screening, require further research before it can be fully determined whether vision screening of older people meets the Wilson criteria. If a vision screening programme using a battery of vision tests, perhaps computerised, can be established, then this should be tested to determine the sensitivity and specificity for detecting the target conditions. Ultimately, longitudinal studies are necessary to determine whether such a screening programme will lead to improved visual performance and quality of life in older people. [source] Sources of resistance to broomrape (Orobanche crenata Forsk.) in narbon vetchPLANT BREEDING, Issue 1 2007S. Nadal Abstract Little is known about the levels of resistance to Orobanche crenata available in narbon vetch. A germplasm collection of 200 accessions of narbon vetch (Vicia narbonensis L.) originating from different countries was screened for resistance to crenate broomrape under field conditions. Thirteen accessions were selected for more detailed screening under controlled conditions and for additional field testing. Resistance to O. crenata was manifested by lower germination of broomrape seeds, reduced emergence of Orobanche shoots and fewer root attachments per narbon vetch plant. Differences in pod yield among narbon vetch accessions were also found in response to Orobanche infestation. Finally, eight accessions were selected and identified as new sources of narbon vetch resistant to broomrape. [source] Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patientsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2009Ratana Saipanish md Aims:, Because of the high patient load in Thailand, we need a practical measurement to help primary physicians detect depression. This study aimed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index (WHO-5-T), which is short and easy to use as a screening tool for major depression in primary care patients. Methods:, The English version of the WHO-Five Well-Being Index was translated into Thai. Back-translations, cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly. The WHO-5-T was administered randomly to 300 patients in our primary care clinic. Then the patients were further assessed using the Mini International Neuropsychiatric Interview and the Hamilton Rating Scale for Depression as the gold standard of diagnosis and symptom severity, respectively. Results:, Completed data were obtained from 274 respondents. Their mean age was 44.6 years [standard deviation (SD) = 14.7] and 73.7% of them were female. The mean WHO-5-T score was 14.32 (SD = 5.26). The WHO-5-T had a satisfactory internal consistency (Cronbach's alpha = 0.87) and showed moderate convergent validity with the Hamilton Rating Scale for Depression (r = ,0.54; P < 0.001). The optimal cut-off score of the WHO-5-T <12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression. The area under the curve in this study was 0.86 (SD = 0.03, 95% confidence interval 0.81 to 0.89). Conclusions:, The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self-assessment to screen for major depression in primary care setting at a cut-off point of <12. [source] EARLY EXPERIENCE WITH CLINICAL INDICATORS IN SURGERYANZ JOURNAL OF SURGERY, Issue 6 2000B. T. Collopy Background: In 1997 a set of 53 clinical indicators developed by the Royal Australasian College of Surgeons (RACS) and the Australian Council on Healthcare Standards (ACHS) Care Evaluation Programme (CEP), was introduced into the ACHS Evaluation and Quality Improvement Programme (EQuIP). The clinical indicators covered 20 different conditions or procedures for eight specialty groups and were designed to act as flags to possible problems in surgical care. Methods: The development process took several years and included a literature review, field testing, and revision of the indicators prior to approval by the College council. In their first year 155 health-care organizations (HCO) addressed the indicators and this rose to 210 in 1998. Data were received from all states and both public and private facilities. Results: The collected data for 1997 and 1998 for some of the indicators revealed rates which were comparable with those reported in the international literature. For example, the rates of bile duct injury in laparoscopic cholecystectomy were 0.7 and 0.53%, respectively; the mortality rates for coronary artery graft surgery were 2.5 and 2.1%, respectively; the mortality rates after elective abdominal aortic aneurysm repair were 2.5 and 3.7%, respectively; and the post-tonsillectomy reactionary haemorrhage rates were 0.9 and 1.3%, respectively. Results for some indicators differed appreciably from other reports, flagging the need for further investigation; for example, the negative histology rates for appendectomy in children were 18.6 and 21.2%, respectively, and the rates for completeness of excision of malignant skin tumours were 90.7 and 90%, respectively. The significance of these figures, however, depends upon validation of the data and their reliability and reproducibility. Because reliability can be finally determined only at the hospital level they are of limited value for broader comparison. Conclusion: The process of review established for the indicator set has led to refinement of some indicators through improvement of definitions, and to a considerable reduction in the number of indicators to 29 (covering 18 procedures), for the second version of the indicators (which was introduced for use from January 1999). The clinical indicator programme, as it has with other disciplines, hopefully will provide a stimulus to the modification and improvement of surgical practice. Clinician ownership should enhance the collection of reliable data and hence their usefulness. [source] Assessing Effective Care in Normal Labor: The Bologna ScoreBIRTH, Issue 2 2001Beverley Chalmers DSc(Med) The intention of the "Bologna score" is to quantify, both in an individual labor and in a wider population, the extent to which labors have been managed as if they are normal as opposed to complicated. In this way it may be possible to assess both attitudes and practices within a maternity service toward the effective care of normal labor. A scoring system for normal labor was proposed at the World Health Organization (Regional Office for Europe) Task Force Meeting on Monitoring and Evaluation of Perinatal Care, held in Bologna in January 2000. This paper describes conceptual development of the scale. Recommendations for future evaluation of the Bologna score's validity and potential include field testing globally, comparison with the Apgar score, and evaluation of the relative weight contributed by each of the five measures comprising the Bologna score. [source] 4222: Potential retinal causes: when and how to investigateACTA OPHTHALMOLOGICA, Issue 2010BP LEROY Purpose To describe the retinal conditions that need to be excluded when non-organic visual loss is suspected, and the investigations required to either confirm or exclude them. Methods A case presentation format will be used to illustrate those conditions which can be discovered using psychophysical and electrophysiological tests as well as special imaging including autofluorescence, infrared and red free imaging and spectral-domain optical coherence tomography, in patients in whom a non-organic origin for visual loss is suspected. Results Inherited retinal diseases such as Stargardt macular dystrophy, X-linked retinoschisis and cone dystrophy as well as Batten disease in their early stages all need to be excluded when visual loss is thought to be non-organic. In addition, several acquired retinal conditions such as acute acular neuroretinopathy need to be taken into account. visual field testing, ISCEV-standard full-field flash electroretinography, pattern electroretinography and visual evoked potentials and specialised imaging techniques contribute significantly to making the correct diagnosis. Conclusion Visual loss in a list of organic conditions may mimic non-organic visual loss. Functional testing as well as specialised imaging techniques are essential in differentiating true organic from non-organic visual loss. [source] 4351: Using the OHTS-EGPS risk calculator with OctopusTM visual field testingACTA OPHTHALMOLOGICA, Issue 2010AM STEVENS Purpose Assessing risk in ocular hypertensive (OHT)patients is not only of clinical importance for the patients with regard to their possible glaucomatous field damage but has major repercussions on their quality of life when making decisions about the use of eye drops for longer periods. Clinicians are not that good in estimating the risk hence the need for instruments to help them make a more evidence-based decision. The EGPS group states that a methodological difference " of using in a quarter of the patients another type of perimeter could explain the Hasard Ratio for the Pattern Standard Deviation (PSD) of 1.66 in EGPS and 1.27 in OHTS . Hence our interest to recalculate a conversion of the Octopus G1 program ( mostly used for glaucoma ) to the Humphrey 30-2 in a Group of ocular hypertensives conform the inclusions of the OHTS thus providing a way to use the calculator more accurately. Methods 50 OHT patients recruited using the OHTS criteria were tested both with the Humphrey 30-2 program and the Octopus G1 program. The Humphrey PSD values were plotted against the square root of the Loss of Variance (sLV) and a conversion formula was calculated Results Our data generated the following conversion formula: Y = 0.4X + 1.1 Conclusion Our conversion permits a proper use of the risk calculator in OHT patients. There has been an attempt to convert the values from Humphrey 30-2 to Octopus 32 by Monhart based on the results of a study by Langerhorst. Another approach could be based on the algorithm described by Zeyen using HFA 24-2 and G1 Octopus but proves difficult to use in daily practice. EGPS simply used "converted" indices by taking the square root of LV for PSD. Our formula is based on the same population as OHTS but yields different results [source] Anatomical and functional outcome in brilliant blue G assisted chromovitrectomyACTA OPHTHALMOLOGICA, Issue 5 2010Paul B. Henrich Abstract. Purpose:, To evaluate the potential of brilliant blue G (BBG) for intraoperative staining of the inner limiting membrane (ILM) with respect to staining properties and surgical outcome. Methods:, In a retrospective, non-comparative clinical case series, we analysed 17 consecutive chromovitrectomy interventions for surgery of macular holes, ERMs, vitreoretinal traction syndromes and cystoid macular oedema. Following complete posterior vitreous detachment, BBG was injected into the vitreous cavity at a concentration of 0.25 mg/ml, followed by immediate washout. Main outcome measures were staining properties, visual acuity, central visual field testing and optical coherence tomography (OCT) measurements over a mean follow-up period of 3 months. Results:, ILM staining was somewhat less intensive for BBG than for average indocyanine green (ICG) chromovitrectomy. However, the ILM was removed successfully without additional ICG in 15/17 patients. Postoperative visual acuity was improved in 16/17 patients and remained unchanged in one patient. Central retinal OCT thickness showed a postoperative reduction, with values ranging from +7 to ,295 ,m (median ,89 ,m). Neither visual field defects nor any other adverse events were recorded. Conclusion:, BBG permits sufficient staining for safe ILM removal. In this short-term study, good anatomical and functional results were achieved and no adverse events were observed. [source] Combined intravitreal anti-vascular endothelial growth factor (Avastin®) and photodynamic therapy to treat retinal juxtapapillary capillary haemangiomaACTA OPHTHALMOLOGICA, Issue 5 2010Stefan Mennel Abstract. Objective:, Retinal capillary haemangioma complications are characterized by progressive exudation with consecutive intraretinal and subretinal leakage. A successful therapy without side-effects has not been found. We report a case of retinal juxtapapillary capillary haemangioma causing consecutive leakage with macular involvement. The tumour was treated with a combination of anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) and was followed for 1 year. Methods:, A 44-year-old woman with retinal juxtapapillary capillary haemangioma in the right eye experienced a decrease of visual acuity from 20/20 to 20/60 because of a severe leakage from the tumour involving the macula with lipid depositions. Two sessions of PDT (sparing the part of the haemangioma located within the optic disc) and five injections of bevacizumab were applied in a period of 5 months. Visual acuity, visual field testing, retinal thickness measurements, fundus photography and fluorescein angiography were performed to evaluate the treatment effect. Results:, One year after the last injection, visual acuity increased to 20/40. All lipid exudates at the posterior pole resolved. Retinal thickness decreased from 490 to 150 ,m with the restoration of normal central macular architecture. Leakage in fluorescence angiography reduced significantly, but hyperfluorescence of the tumour was still evident. Visual field testing and angiography did not show any treatment-related vaso-occlusive side-effects. Conclusion:, In this single case, the combination of anti-VEGF and PDT appeared to be an effective strategy for the treatment of retinal juxtapapillary capillary haemangioma without side-effects. Further studies with a greater number of eyes and adequate follow-up are necessary to support these first clinical results. [source] Temporal visual field defects are associated with monocular inattention in chiasmal pathologyACTA OPHTHALMOLOGICA, Issue 7 2009Hans C. FledeliusArticle first published online: 24 OCT 200 Abstract. Purpose:, Chiasmal lesions have been shown to give rise occasionally to uni-ocular temporal inattention, which cannot be compensated for by volitional eye movement. This article describes the assessments of 46 such patients with chiasmal pathology. It aims to determine the clinical spectrum of this disorder, including interference with reading. Methods:, Retrospective consecutive observational clinical case study over a 7-year period comprising 46 patients with chiasmal field loss of varying degrees. Observation of reading behaviour during monocular visual acuity testing ascertained from consecutive patients who appeared unable to read optotypes on the temporal side of the chart. Visual fields were evaluated by kinetic (Goldmann) and static (Octopus) techniques. Five patients who clearly manifested this condition are presented in more detail. The results of visual field testing were related to absence or presence of uni-ocular visual inattentive behaviour for distance visual acuity testing and/or reading printed text. Results:, Despite normal eye movements, the 46 patients making up the clinical series perceived only optotypes in the nasal part of the chart, in one eye or in both, when tested for each eye in turn. The temporal optotypes were ignored, and this behaviour persisted despite instruction to search for any additional letters temporal to those, which had been seen. This phenomenon of unilateral visual inattention held for both eyes in 18 and was unilateral in the remaining 28 patients. Partial or full reversibility after treatment was recorded in 21 of the 39 for whom reliable follow-up data were available. Reading a text was affected in 24 individuals, and permanently so in six. Conclusion:, A neglect-like spatial unawareness and a lack of cognitive compensation for varying degrees of temporal visual field loss were present in all the patients observed. Not only is visual field loss a feature of chiasmal pathology, but the higher visual function of affording attention within the temporal visual field by means of using conscious thought to invoke appropriate compensatory eye movement was also absent. This suggests the possibility of ,trans-synaptic dysfunction' caused by loss of visual input to higher visual centres. When inattention to the temporal side is manifest on monocular visual testing it should raise the suspicion of chiasmal pathology. [source] Fitness to drive in glaucoma patients- Preliminary study resultsACTA OPHTHALMOLOGICA, Issue 2009AM STEVENS Purpose To develop a useful binocular 30° visual field criterion to predict safe driving behaviour in glaucoma patients by comparing perimetric data with an actual driving test on the road. Methods The sample will consist of 200 driving glaucoma patients, recruited in 2 university based glaucoma clinics (Ghent and Leuven, Belgium). Inclusion criteria are glaucomatous optic disc damage and/or glaucomatous field defects. Exclusion criteria are concomitant ocular disease, cataract > LOCS 2, systemic disease or medication affecting the visual field. Data collection will include demographic and medical data, driving habits, and Mini Mental Status. A complete ophthalmic examination wil be done including Goldmann, SAP and Esterman visual field testing. In addition, UFOV test, stereopsis and contrast sensitivity testing will be performed. All subjects will perform an on the road driving test with a driving expert of the Belgian Institute for Traffic Safety. Subjects can pass, fail, or pass the test with limitations. An attempt will be made to develop an algorithm of visual field abnormalities that predict as accurately as possible the outcome of the practical driving test. Results Preliminary results of the first 50 included patients will be presented. [source] Retinal nerve fiber layer thickness and central corneal thickness in ocular hypertensive patients and healthy subjectsACTA OPHTHALMOLOGICA, Issue 2009AM BRON Purpose To establish the correlation between central corneal thickness (CCT) and retinal nerve fiber layer (RNFL) thickness in ocular hypertensive patients and healthy subjects. Methods We prospectively collected charts of healthy subjects and ocular hypertensive (OHT) patients in one academic center between 2007 and 2008. OHT patients were defined by two measurements of intraocular pressure superior to 21mmHg without treatment, open angle in gonioscopy, normal appearing optic nerve head and normal visual field test Standard Automated Perimetry (SAP SITA) and Frequency Doubling Technique (FDT). Every patient underwent a standard clinical examination including optic nerve head examination, intraocular pressure, CCT measurement by ultrasonic (US) and anterior segment OCT pachymetry, visual field testing (SAP and FDT), RNFL thickness by scanning laser polarimetry (GDX-VCC) and optical coherence tomography (OCT). Results Eighty healthy subjects and 60 OHT patients were included. A correlation between US CCT and OCT CCT was found in both groups (r2=0.85 and r2= 0.87, p<0.001). There was no significant difference (p>0.15) in GDX-VCC and OCT RNFL thickness in both groups. In controls there was no correlation of any RNFL thickness measurement with the CCT. In OHT patients, the US CCT was weakly correlated with the average TSNIT evaluated by GDX-VCC (r2= 0.04, p<0.02). Conclusion This study did not show any relevant correlation between the RNFL thickness evaluated by GDX-VCC and the US CCT in healthy individuals and in OHT patients with a normal FDT. [source] Visual field assessment and the Austroads driving standardCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2002Isabel M McLean MB BS Abstract Purpose:,To compare the conventional (Humphrey 24-2) automated visual field testing with the Goldmann standard visual field test for driving, and to predict how many patients with glaucoma may not meet the Australian driving standard with respect to visual fields. Methods: Four patients (retinitis pigmentosa, glaucoma or vigabatrin treatment) with marked visual field defects as determined by uniocular static computerized perimetry (conventional testing) were re-evaluated with binocular kinetic Goldmann IV4e target field test (Australian driving standard). A series of 48 consecutive patients seen by the Glaucoma Inheritance Study in Tasmania were assessed with both static computerized perimetry and the Goldmann IV4e target test. Results:,The four patients with severe visual field defects (on computerized perimetry) were found to meet the driving standard on the binocular Goldmann IV4e target test. On computerized perimetry, 15 of 48 patients from the Glaucoma Inheritance Study in Tasmania were found to have visual field defects of sufficient severity that they may not meet the driving standard. However, only five of these patients failed the driving standard for visual fields, two of whom were still driving. Conclusions:,Patients with severe field defects on conventional uniocular automated perimetry may still meet the Goldmann standard visual field test for driving. Approximately 30% of glaucoma patients would have visual field loss shown on Humphrey 24-2 test of a severity that requires further testing to determine if they meet the driving standard. Ten per cent of glaucoma patients tested did not meet the driving standard for visual fields. [source] CASE REPORT: Clinical application of mfERG/VEP in assessing superior altitudinal hemifield lossCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2005Dr Henry Ho-lung Chan PhD FAAO Multifocal ERG (mfERG) and multifocal VEP (mfVEP) have been used widely in the investigation of pathological changes or functional variations in the visual system. Altitudinal hemifield loss is a visual field defect that is usually found in patients with ischaemic optic neuropathy (ION). Anterior ischaemic optic neuropathy (AION) is a complex multi-factorial disease and it is difficult to diagnose according to clinical symptoms and signs alone. AION is believed to be caused by an infarction of the optic nerve due to the occlusion of the posterior ciliary arteries. The current report presents a patient diagnosed with non-arteritic AION. In this report, the mfERG findings did not match the results of the visual field test but those of the mfVEP did. After consideration of the visual electrophysiological and visual field results, the defect arises from neither the retina nor the visual pathway behind the optic chiasma. Hence, the optic nerve is the most likely location of the lesion, causing the superior altitudinal hemi-field loss. This report shows that the mfERG and mfVEP techniques can be used for objective visual field assessment to supplement the conventional visual field testing. [source] Implementing HoNOS: An eight stage approachCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 2 2001Derek Milne The Health of the Nation Outcome Scales (HoNOS) were developed as a brief way to quantify progress towards the national target of improving significantly the health and social functioning of mentally ill people (Wing et al., 1998). As an instrument, HoNOS was regarded as adequate for this purpose and so field testing was deemed to be the next task. However, the implementation of an outcome measure such as HoNOS under routine service conditions represents a significant implementation challenge. Therefore, we conducted an eight stage approach to implementation, with a sample of multi-disciplinary care managers from one county in the UK (N = 30). The results of shadowing and initial interviews indicated that significant barriers to implementation were insufficient staff and the high level of routine demands on staff for the completion of paperwork. These barriers outweighed the perceived boosters, including the favourable responses of colleagues and the benefits of data feedback from HoNOS. More staff, standardized training in the use of HoNOS, regular feedback and less paperwork were amongst ten suggestions for facilitating implementation. During a pilot period, staff received training, used HoNOS and were given graphical feedback of the HoNOS results. They were then re-interviewed, at which time they reported becoming fairly positive about the use of HoNOS and definitely valued the implementation approach. However, it is concluded that the routine use of HoNOS will require continued effort from staff and their managers (e.g. refresher training courses) and alternative or additional outcome measures may be necessary to provide useful clinical information. Copyright © 2001 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||