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Journal articles on the topic 'Year 12 certificate'
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1
Hill, Peter W., Tim Brown, Kenneth J. Rowe, and Ross Turner. "Establishing Comparability of Year 12 School-Based Assessments." Australian Journal of Education 41, no. 1 (April 1997): 27–47. http://dx.doi.org/10.1177/000494419704100103.
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THIS paper briefly outlines the dilemma confronting assessment and certification authorities in ensuring comparability of end-of-school assessments and proceeds to outline approaches adopted in Victoria following the introduction of the Victorian Certificate of Education (VCE). In particular, a description is provided of a new system for maximising comparability of school-based assessments which was implemented for the first time in 1994. This system made use of a reference test (the General Achievement Test) to check on the reasonableness of schools' assessments and to identify those schools with unexpected results. If schools' assessments were within a specified tolerance band, the schools' assessments were automatically confirmed. If they fell outside the tolerance band, the schools' assessments were subject to re-marking by two external reviewers. This re-marking in turn led to a decision either to confirm or adjust schools' assessments. The paper concludes with some preliminary observations on the outcomes of implementing the new system.
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Alias, Abdul Hadi, Abdul Hadi Alias, Zamira Hasanah Zamzuri, Nur Riza Mohd Suradi, and Nur Riza Mohd Suradi. "The Profile of Female Labor Force Participation in Malaysia Based on Recursive Partitioning Analyses." Malaysian Journal of Fundamental and Applied Sciences 17, no. 3 (June 29, 2021): 226–41. http://dx.doi.org/10.11113/mjfas.v17n3.2041.
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In determining the level of the Malaysian economy, one of the factors contributing to the economic development of the country is the availability of labour. Studies on the availability of female labour force by identifying female profiles in labor force participation were made using data from Labour Force Survey (LFS), Malaysia for reference year 1990, 2000, 2010 and the latest 2018. Referring to the latest year 2018, the recursive partitioning (RP) technique showed that four subgroup profiles of working women have been created equal to 12%, 43%, 57% and 78%, respectively (percentage of working women at the four subgroups). Majority of the working women are identified in the group of aged 20-59 and the highest certificate obtain was tertiary education (Certificate, Diploma and Bachelor’s Degree) with 78%. Comparison between year 2018 with others reference year, there was a difference in the profile of working women whose working age had increased from 54 to 59 years. There is also a difference in the highest qualification obtained from obtaining only UPSR or SRP qualification in year 1990 to Diploma and Bachelor’s degree certificate in year 2018. Therefore, efforts need to be enhanced by providing initiatives for this group so that those who are in this group or will join this group later will be motivated to join labour market.
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Hewitt, Kelsey C., Meghan W. Cody, Craig D. Marker, and David W. Loring. "General Educational Development (GED) and Educational Attainment Equivalency for Demographically Adjusted Norms†." Archives of Clinical Neuropsychology 34, no. 8 (February 1, 2019): 1340–45. http://dx.doi.org/10.1093/arclin/acz003.
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Abstract Objective To investigate whether the General Educational Development (GED) certificate should be considered equivalent to a standard 12-year high school education when performing demographic corrections on neuropsychological performance levels. If the GED certificate and high school diploma reflect comparable levels of educational achievement, then performance on the Test of Premorbid Function (TOPF) and selected WAIS-IV indices should not differ between groups. Method Archival neuropsychology data were reviewed to identify patients who either (1) did not complete high school and did not subsequently obtain a GED, (2) did not complete high school but subsequently obtained a GED, or (3) completed high school and did not obtain any further formal education. Most patients were programmatic referrals for epilepsy surgery evaluation, although referrals from the general neurology clinic were also included. The primary dependent measures were the TOPF and WAIS-IV Full Scale IQ (FSIQ). Results High school graduates obtained higher scores on the TOPF (p < .01, partial η2 = 0.16) and FSIQ (p < .01, partial η2 = 0.14) as compared to both GED subjects and subjects withdrawing from high school with no GED. The non-GED group and the GED group did not differ from each other. Conclusions These findings demonstrate that the GED is not equivalent to a standard 12-year high school education when characterizing educational background. Although these data do not address what the appropriate year equivalent should be for the GED when adjusting performance for educational background, using 12 years will likely identify more areas of neuropsychological weakness simply by suggesting higher levels of premorbid ability.
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Faruque, MO, MP Choudhury, CH Ritchil, F. Tabassum, MA Hashem, and AKFH Bhuiyan. "Assessment of performance and livelihood generated through community based goat production in Bangladesh." SAARC Journal of Agriculture 14, no. 2 (January 23, 2017): 12–19. http://dx.doi.org/10.3329/sja.v14i2.31241.
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The study was undertaken to investigate the performance of Black Bengal goats and livelihood generated through goat rearing at 3 different villages namely Kaichapur, Salia and Shimulia at Phulpur Upazila (GPS: 24.9500°N and 90.3500°E) of Mymensingh district in Bangladesh. The average birth weight, body weight at 6 and 12 months of Black Bengal goat (BBG) were 1.03 ± 0.01 kg, 7.75 ± 0.09 and 12.77 ± 0.16 kg, respectively and daily body weight gain at 0-6 and 6-12 months of age were 34.38±0.54 and 24.62±0.57 g respectively. The average litter size of does was 1.51±0.05 and kid mortality rate was 12.58%. The study revealed that, most of the goat owners were housewives. The educational status and goat rearing system of the farmers were also observed. Most of the farmers were either Primary (55%) or illiterate (38.3%). About 3.33% were below Secondary School certificate and 1.67% Higher Secondary School certificate level. Few farmers have completed their graduation (1.67%). The average net profit from one goat in a year was Tk.754. The expenditure on food purchase, health care, education, clothing, housing condition and social status of the farmers were increased, respectively at a scale of 22.79%, 6.56%, 14.47%, 4.34%, 14.22% and 19.35% due to increase of their income from goat rearing.SAARC J. Agri., 14(2): 12-19 (2016)
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Kleinveldt, Lynn Tatum, and Mbali Zulu. "Integrating tablet technology into information literacy training at CPUT libraries: a pilot project." Library Hi Tech News 33, no. 4 (June 6, 2016): 10–14. http://dx.doi.org/10.1108/lhtn-12-2015-0083.
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Purpose The purpose of this study is to highlight the techniques and applications used to adapt information literacy (IL) modules in such a way that students acquired the IL skills through the use of tablet technology. The focus at higher education institutions has been placed on embracing the ever-changing Web technologies to enhance teaching and learning. This case study reports on a collaborative effort between faculty and librarians in 2014, where tablet technology was integrated into the Information Literacy Certificate Programme of Environmental Management Extended Curriculum Programme (ECP) students. Design/methodology/approach To support teaching with technology at the Cape Peninsula University of Technology (CPUT), a pilot project was conducted in 2014 using tablet technology to train IL to a group of 20 ECP Environmental Management students in the Applied Sciences Faculty. All modules were adapted for this purpose meaning that students used the tablet throughout the training sessions. Findings Good collaboration between librarians and faculty, as well as interaction between students increased. Some of the challenges faced were unstable internet connection; many Web applications identified by the trainers to use during the training were not compatible with the Nexus 7 Tablet. Overall, the training went well. In the end, the librarians were successful in achieving learning to take place among students. Originality/value Currently CPUT Libraries promotes the Information Literacy (IL) Certificate Programme to first year students, integrating IL into the curriculum of faculty. It is hoped that this paper will give insight for academic librarians wishing to incorporate mobile technologies into their IL training programmes.
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McLoughlin, Kevin, and Margaret Farren. "An Action Research Enquiry into the potential of SolidWorks in the teaching of rotation in Junior Certificate Technical Graphics." International Journal for Transformative Research 7, no. 1 (December 1, 2020): 26–35. http://dx.doi.org/10.2478/ijtr-2020-0004.
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AbstractTechnical Graphics is one of the technology subjects taught at Junior Certificate level in post- primary schools in Ireland. The Junior Certificate examination is held at the end of the Junior Cycle in post-primary schools, which caters for students aged from 12 to 15 years. As a teacher of Technical Graphics for the past seven years, I have gained a great understanding and insight into the different topics in the subject and how they are perceived by students. I concur with the State Examinations Commission report (2008) that students lack an understanding of the rotation element of transformation geometry, one of the six topics covered on the Junior Cycle Technical Graphics course. The purpose of this study is to implement a new teaching methodology through the use of SolidWorks in an effort to improve the students’ visualization, spatial awareness and understanding of transformation geometry.I engaged in an action research study of my own practice as I investigated if SolidWorks could actually be used at Junior Certificate level to improve student understanding of transformation geometry. The action research took place over a five-week period and included three cycles of research. The research was carried out with a third-year Junior Cycle group aged between fifteen and sixteen years of age and all students in the class took part in the study. The first stage of the research examined student progress as they worked through the topic following teacher instruction on SolidWorks. The second stage of the research examined the students’ progress as they used the software for themselves. I carried out an assessment task with students towards the end of the study, which showed that student learning had improved in comparison to previous years.
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McLoughlin, Kevin, and Margaret Farren. "An Action Research Enquiry into the potential of SolidWorks in the teaching of rotation in Junior Certificate Technical Graphics." International Journal for Transformative Research 7, no. 1 (December 1, 2020): 26–35. http://dx.doi.org/10.2478/ijtr-2020-0004.
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Abstract Technical Graphics is one of the technology subjects taught at Junior Certificate level in post- primary schools in Ireland. The Junior Certificate examination is held at the end of the Junior Cycle in post-primary schools, which caters for students aged from 12 to 15 years. As a teacher of Technical Graphics for the past seven years, I have gained a great understanding and insight into the different topics in the subject and how they are perceived by students. I concur with the State Examinations Commission report (2008) that students lack an understanding of the rotation element of transformation geometry, one of the six topics covered on the Junior Cycle Technical Graphics course. The purpose of this study is to implement a new teaching methodology through the use of SolidWorks in an effort to improve the students’ visualization, spatial awareness and understanding of transformation geometry. I engaged in an action research study of my own practice as I investigated if SolidWorks could actually be used at Junior Certificate level to improve student understanding of transformation geometry. The action research took place over a five-week period and included three cycles of research. The research was carried out with a third-year Junior Cycle group aged between fifteen and sixteen years of age and all students in the class took part in the study. The first stage of the research examined student progress as they worked through the topic following teacher instruction on SolidWorks. The second stage of the research examined the students’ progress as they used the software for themselves. I carried out an assessment task with students towards the end of the study, which showed that student learning had improved in comparison to previous years.
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Hesketh, Beryl, and Sonja Whiteley. "Students' Perceptions of Help Received during the Tertiary Admissions Process." Australian Journal of Career Development 4, no. 3 (October 1995): 64–69. http://dx.doi.org/10.1177/103841629500400319.
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Two cohorts of Year 12 students were surveyed three times following their completion of Higher School Certificate (HSC) examinations in December 1993 and 1994, after HSC results were received in January 1994 and 1995, and while the students were undertaking tertiary studies in May 1994 and 1995. This paper describes the students' decision approaches together with the outcomes of the approaches used and an evaluation of the help received during the tertiary education decision process. Recommendations arising from the research are relevant to careers advisers in schools and to tertiary education institutions in preparing information for prospective students. SUMMARY
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Facchinetti, Davide, Stefano Santoro, Lavinia Eleonora Galli, and Domenico Pessina. "Agricultural Tractor Roll-Over Related Fatalities in Italy: Results from a 12 Years Analysis." Sustainability 13, no. 8 (April 19, 2021): 4536. http://dx.doi.org/10.3390/su13084536.
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In Italy, about 160 fatal accidents per year have occurred recently in agriculture, most of them involving agricultural machinery. The most frequent cause of fatal events is the tractor overturning. One of the opportunities to monitor the trend of agricultural tractors fatal overturning is a meticulous search for information on the numerous web portals, at national and local level. In fact, in their information purposes are also included the recording, practically in real time, of significant details about each fatal event, such as the place of the accident, the year, the month and the day of the week of occurring, the victim’s age, gender and nationality, etc. This article is describing the results of the monitoring of fatal tractor overturning accidents in the period of 2008–2019 in Italy. In the 12 years of the survey, 1414 fatal accidents were recorded, most of them occurring in the spring and summer months. The region with the highest cumulative number of fatal events was Tuscany (143). The majority (58.8%) of the victims were over 60, while 71.4% of accidents occurred during field work. Most (57.6%) of the tractors involved in the fatal events did not have rollover protective structures (ROPS), while 19.4% were equipped with a two-post foldable front roll-bar, which, however, was in the lowered position at the time of the accident. In most cases, the tractors involved were obsolete and in poor maintenance conditions, and did not comply with general and specific laws on work safety. To improve the situation, the introduction of the tractor training certificate for the drivers and the periodical inspection for tractors, as well as the issuing of significant financial supports to encourage the replacement of the old models with modern more safe models, are the most effective actions to be put into practice.
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Marriott, Mary E., and Esther Care. "Fluid and crystallised intelligence and their relationship to school outcome." Australian Educational and Developmental Psychologist 19, no. 2 (2004): 97–108. http://dx.doi.org/10.1017/s081651220002931x.
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AbstractFew studies exist that address the relationship between the higher order factors of fluid (Go and crystallised (Gc) intelligence and Victorian Certificate of Education (VCE) outcomes. In this study, for each of five cohorts, longitudinal data have been collected over a six-year span, consisting of results from standardised achievement and ability tests and ending with achievement outcomes.Two factors, interpreted as Gf and Gc, are derived from the standardised measures. In Year 7, these measures were the Progressive Achievement Test Mathematics (PAT Moths), Progressive Achievement Test Reading Comprehension (PAT Comprehension), and the jenkins Test of Nonverbal Ability. In Year 10, the measures were the subtests of the Differential Aptitude Test (DAT).These factors are investigated in order to identify whether they are differentially important in regard to VCE Performance. The standardised measures and final VCE results were collected at a Melbourne independent girls' school from 414 exiting Year 12 students, in 1998, 1999, 2000, 2001, and 2002. Both Gf and Gc accounted for a significant amount of the variance in VCE performance, with Gc being the most significant indicator.
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Alhaj, Baharu Kemat, Elmi Baharuddin, and Saadiah Hj Mat Dahari. "The Relationship of the Antecedent Factors of Entrepreneurial Intention with Entrepreneurial Intention: A Case Study." Global Journal of Business and Social Science Review (GJBSSR) Volume 4 (2016: Issue-3) 4, no. 3 (August 21, 2016): 79–90. http://dx.doi.org/10.35609/gjbssr.2016.4.3(12).
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Objective - The objective of the study is to investigate the relationship between the antecedent factors of entrepreneurial intention with entrepreneurial intention among students of National Craft Institute Malaysia. Methodology/Technique - A study was designed to determine the relationship of an antecedent factor which is attitudinal factors, behavioral factors and educational support with entrepreneurial intention. Data were collected through questionnaires obtained from 119 final year students of certificate and diploma offered in national Craft Institute. Data collected have been analyzed by statistical technique such as descriptive statistic, reliability, correlations and regression analysis. Findings - In general, the findings of the study support the hypotheses. Attitudinal factors, educational support and behavioral factors have a positive significant relationship with entrepreneurial intention. The findings of the study offer useful contribution to the field of entrepreneurship both in terms of theory and practice. Novelty - Theoretically, the study presents a relationship model that depicts the significance and role of the antecedent factors in explaining the entrepreneurial intention among the students. In practice, the results of the study will benefit to the teachers and policy maker in order to improve the entrepreneurial program and training which can increase the level of entrepreneurial intention among National Craft Institute Students. Type of Paper - Empirical Keywords: Entrepreneurial Intention, Entrepreneurship And Entrepreneurial Antecedent.
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Hoffman, LaVae M., Marie Ireland, Shannon Hall-Mills, and Perry Flynn. "Evidence-Based Speech-Language Pathology Practices in Schools: Findings From a National Survey." Language, Speech, and Hearing Services in Schools 44, no. 3 (July 2013): 266–80. http://dx.doi.org/10.1044/0161-1461(2013/12-0041).
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Purpose This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010–2011. Method Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP activities, as well as their resource needs and future training format preferences. Results A total of 2,762 SLPs in 28 states participated in the online survey, 85% of whom reported holding the Certificate of Clinical Competence in Speech-Language Pathology credential. Results revealed that one quarter of survey respondents had no formal training in EBP, 11% of SLPs worked in school districts with official EBP procedural guidelines, and 91% had no scheduled time to support EBP activities. The majority of SLPs posed and researched 0 to 2 EBP questions per year and read 0 to 4 American Speech-Language-Hearing Association (ASHA) journal articles per year on either assessment or intervention topics. Conclusion Use of ASHA online resources and engagement in EBP activities were documented to be low. However, results also revealed that school-based SLPs have high interest in additional training and resources to support scientifically based practices. Suggestions for enhancing EBP support in public schools and augmenting knowledge transfer are provided.
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Hollow, Robert P., W. B. McAdam, J. O’Byrne, Graeme L. White, R. Holmes, J. K. Webb, L. R. Allen, W. J. Zealey, and R. Hafner. "The Cosmology Distinction Course in NSW." Publications of the Astronomical Society of Australia 11, no. 1 (April 1994): 39–43. http://dx.doi.org/10.1017/s1323358000019640.
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AbstractThe Cosmology Distinction Course is a new one-year course to be introduced for Year 12 candidates in the 1994 Higher School Certificate examinations in NSW. It is one of three challenging courses of study that will enrich the HSC for talented students who accelerate and complete part of the HSC one year early. The courses will be taught through distance learning and will include residential seminars. They will be implemented on behalf of the Board of Studies by Charles Sturt University and the University of New England.The Cosmology Course is organised into nine modules of course work covering historical and social aspects of cosmology, observational techniques, key observations and the various models developed—Newtonian, de Sitter, Friedmann, Lemaitre, steady-state, quasi-steady-state and big bang. Assessment will be through assignments, exams and a major project.As the first Distinction Course in a scientific area, the Cosmology Course represents an exciting and important educational initiative that needs the cooperation of NSW astronomers and, in return, promises to benefit the astronomical and general scientific community in Australia.
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Biernbaum, John A., Mathieu Ngouajio, and Laurie Thorp. "Development of a Year-round Student Organic Farm and Organic Farming Curriculum at Michigan State University." HortTechnology 16, no. 3 (January 2006): 432–36. http://dx.doi.org/10.21273/horttech.16.3.0432.
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How do you teach community supported agriculture (CSA) principles, small-scale organic farming, and local food issues at a major land grant university and develop related small-scale farming research and outreach? You create a place and opportunities for students, staff, and faculty to work together with the soil and plants to raise food in a non-classroom farm setting. After several years of discussion and obtaining funding, the Michigan State University (MSU) Student Organic Farm (SOF) CSA started in May 2003 with 25 memberships and increased to 50 after 1 year. The farm allows experiential learning of CSA management, crop selection, scheduling, maintenance, harvest, and organic farming methods. The CSA helps many MSU students and faculty see the value of supporting local organic food systems. With more than 3 years of experience working with students to run the SOF and the CSA, we are in the process of developing an organic farming certificate program. A total of 40 credits will include 12 months on campus plus a 16-week on-farm internship. The program has three major components: 1) organic farming courses with seven one-credit courses; 2) horticultural crop production courses with eight courses for a total of 15 credits; and 3) approximately 20 credits of experiential course work combined with classroom and independent learning.
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Harrison, Helen C. "146 The Master Gardener Program in Wisconsin." HortScience 34, no. 3 (June 1999): 467A—467. http://dx.doi.org/10.21273/hortsci.34.3.467a.
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The Master Gardener Program in the state of Wisconsin is growing rapidly and has been in existence since the late 1970s. There are several aspects of our program(s) that make us unique. First, we are one of the very few states to service all counties within the state, not just our heavily metropolitan areas. Second, we have two major program types along with some unique county programming. We have the basic Master Gardener Program, which covers the major aspects of horticulture—this gives the learner 36 h of training with an expectation of 36 h of volunteer work in return. We now offer the general program in districts (extension has six clusters of counties in Wisconsin)—such that the counties within a district (usually around 16) will have the chance to offer the course at least once every 3 years. That is because the general course is offered once a week (3 h in the evening) for 12 weeks; and thus the basic course is offer spring and fall. If some of the counties within a particular district do not choose to participate, then other counties around the state can take part. Most of the 12 programs are high quality 2-h video productions followed by a 1-h ETN program, which is like a big conference call—everyone has an interactive session with the specialist who developed the video. The specialized program is a series of four 36-h (six 6-h days) training over a 4-year period, which covers flowers, fruit, vegetables, and turf, along with trees and shrubs. This program is offered in our four largest metropolitan areas and is still done all by live lecture. Finally, we require update training for our MGs if they want to continue to be members in good standing (wallet-size cards are issued). This involves 10 h of specified educational opportunities and 10 volunteer hours per year. We also have a day-long educational conference each spring as well as cooperating with Iowa and Minnesota to offer a 2-1/2 day workshop on the alternating years of the international conference. This is hands-on training, held usually the end of June, and rotates among the three states. We now have a stong MG association which has nonprofit status and is an integral partner with us here at the university. Not only do MGs receive members in good standing cards annually, they also receive certificates for 150, 250, 500, 750, and 1000 h of service as well as a 10-year certificate.
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Mitritskaya, Anna. "Additional social leave for single mothers: the practice of applying and improving legislation." Legal Ukraine, no. 12 (December 19, 2019): 31–37. http://dx.doi.org/10.37749/2308-9636-2019-12(204)-4.
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The article is devoted to the study of the procedure for providing additional social leave to single mothers. The legislation of Ukraine, judicial practice on the provision of additional social leave are analyzed. Applied mainly hermeneutic research method. It is concluded that the absence of a legislative settlement, the concept of “single mother” and a clear list of documents confirming this fact, especially in the case when the mother brings up a child without a father (divorced woman) leads to the ambiguous application of Art. 19 of the Law of Ukraine “On Vacations” in practice. In order to support motherhood and childhood and the effective exercise of the right to additional social leave, it is necessary to improve the legislation of Ukraine in this area. On the feasibility of improving the legal regulation of the status of “single mother” and fixing the list of documents confirming the status of “single mother” to provide additional social leave. When granting additional social leave to single mother (divorced woman), the employer is entitled to require, in addition to the application for granting this leave, copies of the birth certificate and the marriage dissolution, a document (s) confirming with sufficient certainty the absence of the father in the upbringing of the child, : certificate of registration of residence or residence; an act drawn up by a social and community commission established by a primary trade union organization or by any other commission formed at an enterprise, institution, organization. In controversial matters – the court’s decision on deprivation of parental rights; about establishing the fact of “single mother”; a court order or an investigator’s decision to search his father in a claim for alimony. A woman who has remarried but has not adopted a new husband from her first marriage has to produce a document confirming that the child’s father is not taking part in her upbringing, and a certificate from the civil registration authority, that the baby was not adopted by the new husband. If a widow or divorced child raising a child without a father (in the event of his or her parental rights being deprived), has remarried to another man and has not been adopted by his or her child from the first marriage, she is entitled to an additional social leave as a single mother. A woman who has children from a person with whom she has not been and who is not married, but with whom she co-operates, cohabitates and raises children, does not have the right to receive additional social leave as a single mother. The legislative level does not provide for the periodicity with which an employee must re-submit documents (renew them) to confirm the right to additional social leave. However, the Ministry of Social Policy regarding documents to confirm the right to such leave on the basis of “single mother” indicates: the employer has the right to request the renewal of these documents once a year. Key words: single mother, additional social leave.
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SHEVCHUK, Oleksandr. "PROGNOSTIC VALIDITY OF THE COMPETITION SELECTION OF GRADUATES OF ECONOMIC COLLEGES." "EСONOMY. FINANСES. MANAGEMENT: Topical issues of science and practical activity", no. 2 (42) (February 2019): 140–50. http://dx.doi.org/10.37128/2411-4413-2019-2-12.
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One of the topical challenges facing higher educational establishments (HEE) is to build the most optimal model for competitive selection of entrants. Based on the results of the external independent assessment (EIA) and the average score of the entry certificate, the institution of higher education, by varying weights, tries to build such a rating list, which places in the first place exactly those applicants who are able to study better in the relevant specialty. Evaluation of the applied model of competitive selection is investigated by the indicator of the predictive validity of the competitive score. Predictive validity is the correlation coefficient between the indicator by which competitive selection is made and the student's performance during the first year of study. Therefore, by assessing the value of predictive validity, it is possible to examine the statistical relationships of EIA results in different subjects or their respective weights with student performance and to build optimal competitive selection models based on them. In this case, the effectiveness of the HEE entry system based on EIA is recognized as high, if the correlation coefficient (R) is greater than 0.5; sufficient, if the correlation coefficient is in the range [0,3, 0,5] and low, if the correlation coefficient is less than 0,3. Since 2018, analytical procedures for EIA have begun to be introduced gradually for college graduates, but only as a state final certification. Subsequently, the results of the EIA will be taken into account in the admission of junior specialists to the bachelor's degree. But now, enrollment in the HEE is based on the grade point average of the school certificate and the results of the university entrance examination. Therefore, the study of the prognostic validity index of competitive selection of college graduates is relevant both in terms of evaluating the existing model of admission to the HEE, and for the search of directions for its improvement. In order to evaluate the predictive value of competitive selection and its components, the results of the calculation of correlation indicators between the students' grades and the students' success in the subjects studied in the HEE during the first semester of the third year are presented. The data obtained indicate a sufficiently high prognostic validity (R>0,5) of the competition score. At the same time, a significant level of correlation was observed both with the average rates of students' education in the first semester and with success in almost every discipline (only for the discipline "Information Systems and Technologies of Accounting and Audit" the correlation coefficient is slightly less than 0.5). It should also be noted that the competition score is better correlated with the results of the current academic performance of students in the 1st semester (before the test session), than with the results of the overall success after the 1st session. As it turns out, this tendency to decrease correlation is due to the fact that several students did not participate in the exam and therefore their average learning outcomes are very different from the main group of observations. Also indicative for predicting student learning outcomes in the HEE are the data from the average score of the school certificate. This indicator, as shown by the correlation coefficient calculations, has high predictive validity to the average results of the first semester (R = 0.73 and R = 0.67) and to each individual discipline (R>0.5). Therefore, when introducing external independent assessment for college graduates, it is also advisable to enter the average score of the education document into the formula for calculating the competition score. On the other hand, a proficiency test of university applicants is a weak predictor of student performance during the first semester (R<0.5 for all HEE subjects without exception). The slight correlation between these criteria is related to the introduced professional test evaluation methodology and therefore requires further improvement. By analyzing the standardized values of deviations between the competition grade and the average success rate of a student in the first semester, the presence of abnormal levels of evaluation within the sample was investigated. It is shown that the Spirman rank correlation coefficient is less dependent on the presence of such anomalies and is more rational when estimating the prognostic validity of small samples.
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Mok, Magdalena, and Marcellin Flynn. "Quality of School Life and Students' Achievement in the HSC: A Multilevel Analysis." Australian Journal of Education 41, no. 2 (August 1997): 169–88. http://dx.doi.org/10.1177/000494419704100206.
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THIS study examines the relationship between Year 12 students' perceptions of life in Catholic schools and their achievement in the Higher School Certificate (HSC) examination. It investigates whether the quality of school life which students experience differs across Catholic schools and whether it still affects students' achievement in the HSC when school and student background variables are controlled. The study was conducted by surveying 4949 students from 44 Catholic high schools in New South Wales, in May 1990 regarding their perceptions of the quality of school life. Student achievement was measured by their Tertiary Entrance Score at the HSC examination in November 1990. The clear picture which emerges suggests that Catholic schools differ considerably in terms of students' HSC achievement and that the quality of school life which students experience in these schools has a significant impact on their academic achievement over and above student characteristics and background characteristics of the schools.
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Tellis, Glen M., Lisa Bressler, and Katrina Emerick. "An Exploration of Clinicians Views About Assessment and Treatment of Stuttering." Perspectives on Fluency and Fluency Disorders 18, no. 1 (March 2008): 16–23. http://dx.doi.org/10.1044/ffd18.1.16.
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Abstract The purpose of this study was to examine school speech-language pathologists’ knowledge of and skill levels with assessing and treating stuttering. This paper provides information on 255 school speech-language pathologists who responded to a 49-question survey about stuttering. The instrument contained questions that addressed specific aspects of assessment and treatment as well as general questions about stuttering. Results indicate that on average, the speech-language pathologists had only treated 12 children who stuttered throughout their careers and averaged 2 children who stuttered on their caseloads per year. Data indicate that regardless of whether the speech-language pathologists took graduate course work in fluency disorders, had their Certificate of Clinical Competence, or attended continuing education workshops in fluency disorders, they lacked basic knowledge and skills in assessing and treating stuttering. Systematic training in specific aspects of assessment and treatment for people who stutter is urgently needed for speech-language pathology students and practicing clinicians.
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Rykov, M. Yu. "Medical care for children with cancer in the Siberian Federal District." Siberian journal of oncology 18, no. 1 (February 28, 2019): 5–12. http://dx.doi.org/10.21294/1814-4861-2019-18-1-5-12.
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background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results obtained is also the basis of the strategy for the development of medical care for this category of patients. aim: analysis of the main parameters characterizing medical care for children with cancer in the Siberian Federal District. material and methods. The reports for 2017 on the health protection of 11/12 (91.6 %) constituent entities of the Russian Federation belonging to the Siberian Federal District were analyzed (Irkutsk Region did not provide data). results. In 2017 the number of children aged 0–17 years was 3 722 470, the number of pediatric hospital beds for children with cancer (ages 0–17 years) was 260 (0,7 per 10,000), and the average number of bed-days per year was 342.2. In 3 (25 %) constituent entities of the Russian Federation, there were no departments of pediatric oncology and in 1 (8,3 %) there were no hospital beds for children with cancer. The number of physicians, who specialized in children’s cancer was 49, of them 32 (65,3 %, 0,08 per 10,000, ages 0–17 years) had a certificate of a pediatric oncologist. In 1 (8,3 %) constituent entity of the Russian Federation, there were no pediatric oncologists. For children aged 0–17 years, the cancer incidence rate was 11.7 per 100,000 children, the cancer mortality rate was 2,2 per 100,000, and one-year mortality rate was 7,4 %. 188 (43,2 %) primary cancer patients were referred to medical institutions of the Federal District, and 17 (3,9 %) primary patients left the territory of the Russian Federation. conclusion. The low incidence and mortality rates can be explained by the lost of reliable follow-up data. It is advisable to introduce electronic health record systems. For reliable estimation of hospital bed supply for children with cancer and percent of patients referred to medical centers for treatment, it is necessary to carry out a clinical audit. Deficiency of pediatric oncologists should be eliminated by reforming the training of medical personnel.
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Cedzyńska, M., P. Koczkodaj, M. Manczuk, and I. Przepiorka. "Cancer Vigilance in Primary Healthcare: Nationwide Series of Courses on Primary Prevention, Screening and Dealing With Anticancer Treatment Complications and Cancer Pain." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 183s. http://dx.doi.org/10.1200/jgo.18.65800.
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Amount raised: 1 542 720 PLN Background and context: Cancer is the second leading cause of deaths in Poland. In 2015, the malignant cancer registries in Poland received information on over 163,000 new incidence cases and more than 100,000 deaths due to cancer. In 2015, an increase in cancer incidence was observed (by over 4000 new cases). The idea of the program is to enhance skills of primary health care providers (family doctors) to provide primary prevention interventions, encouraging their patients to do screening, and to deal with cancer treatment complications and pain. Aim: The aim of the project is to increase motivation and competence of primary healthcare providers in following areas of cancer control: primary prevention, screening and early detection, taking medical care of patients during and after cancer treatment (i.e., dealing with cancer pain, complications connected with cancer itself, chemotherapy, radiotherapy, surgical treatment). Strategy/Tactics: The course is divided into three stages (theoretical lectures, practical workshops in small groups and e-learning). Course finishes finished with an exam. The target group are physicians (except for oncologists and dentists) from all over Poland, in particular doctors used in primary health care facilities (minimum 40% of participants), used in medical entities. Content of the course consists of following parts: I. cancer epidemiology, II. primary prevention (European code against cancer, obesity, smoking), III. genetics factors, IV. screening and early detection, V. cancer treatment complications. After completing the courses, participants gets educational points and receive two certificates - certificate of completion for course and certificate of completion for course of treatment of tobacco dependence syndrome, which is required for contracting such treatment with the National Health Fund in Poland. Educational materials for patients were provided to all doctors: 200 brochures (12 Ways to Health. European Code Against Cancer), 200 leaflets on early detection on skin cancer, 150 nicotine dependence tests, 150 motivation to quit smoking tests. Program process: The first phase was conducted through year 2017 and it consisted of 5 trainings (100 participants each), the second phase - small group workshops (up to 16 participants) through year 2018. The third phase e-learning. Costs and returns: Participation in the course is free. All costs combined with organization and participation are covered by EU from the European Social Fund. What was learned: There is a huge need to educate primary health care doctors in providing care to cancer patients during and after oncological treatment. The first part of course (lectures) obtained high evaluation notes from participants. As per their declaration especially important for them was anti-pain treatment and dealing with complications of cancer itself, as well as tobacco dependence treatment and deal with overweight and obesity.
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Rykov, Maxim Yu. "Analysis of Medical Care for Children with Cancer in the Central Federal District in 2017: Ecological Study." Oncopediatrics 5, no. 2 (July 19, 2018): 81–90. http://dx.doi.org/10.15690/onco.v5i2.1910.
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Background. Planning the management for medical care delivery for children with cancer, as well as analysis of the effectiveness of medical care delivery is based on the statistical indicators analysis.Objective. Our aim was to analyze the main indicators characterizing medical care delivery for children with cancer in the Central Federal District.Methods. The operative reports for 2017 provided by the executive health protection authorities of 18 subjects of the Russian Federation that are part of the Central Federal District have been analyzed.Results. The study enrolled the following data: number of children was 6 824 049 (0–17 years), pediatric oncological departments — 9, pediatric oncological beds — 464, days of berth employment per year — 319.3. The number of practitioners providing medical care to children with cancer was 91, 64 (70.3%) of them had a certificate of training as a pediatric oncologist. In 11 subjects, the department of pediatric oncology was not available; one of the districts did not provide any pediatric oncological beds. The number of primary patients with malignant neoplasms was 821. The number of deceased patients was 156 including 66 identified in 2017. The incidence of malignant tumors was 12 (per 100 000 for the 0–17 age group), the mortality rate was 2.3 (per 100 thousand for the age group 0–17 years), one-year mortality rate — 8%. We failed to reveal the average time from diagnosis establishing till its validation before the treatment onset since the reports did not provide precise information on the point. 12 (1.5%) primary patients left for treatment abroad.Conclusion. Most reports included indicators which lack congruity with one another. The incidence rates were significantly lower than those in countries with high statistical reliability. The percentage of patients identified actively remained extremely low. To improve the revealed defects a single database of children with oncological diseases should be implemented in the Russian Federation.
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Kurniasari, Dieka Armanda, Rahayu Sri Pujiati, and Prehatin Trirahayu Ningrum. "Higiene sanitasi makanan dan analisis nomor P-IRT pada kerupuk berwarna merah (Studi pasar Kepanjen Kabupaten Malang)." Pustaka Kesehatan 9, no. 1 (January 16, 2021): 1. http://dx.doi.org/10.19184/pk.v9i1.21063.
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Food sanitation hygiene has been done to control food factor, people, place and tools in order to prevent cross contamination between food and eater. Household food industry must possess household food industry certificate or SPP-IRT to aid supervision by involved parties. The aim of this research was to discover food sanitation hygiene and analysis P-IRT number on red-coloring crackers at Kepanjen Market in Malang. Thisresearch is descriptive research with observation and interview methods to cracker industry workers and there were 12 kinds of red-coloring crackers distributed around Kepanjen Market. The research used univariant analysis to describe variable of those which were observed. This research it was found that there were three stages in cracker making process, Food sanitation hygiene, and P-IRT number on red-coloring crackers. From this research there were 3 of respondents around < 40 years old, all respondents in secondary education, and 2respondents had < 3 years of working period. The application of food hygiene and sanitation of cracker industry in Malang Regency was categorized as relatively good. There were 7 red-coloring crackers traded at Kepanjen Market were qualified as what had been standardized by BPOM number 22 year 2020. Meanwhile, there were 4 products were not updated and 1 product was not qualified.
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van der Eijk, Yvette, Lisa A. Bero, and Ruth E. Malone. "Philip Morris International-funded ‘Foundation for a Smoke-Free World’: analysing its claims of independence." Tobacco Control 28, no. 6 (September 21, 2018): 712–18. http://dx.doi.org/10.1136/tobaccocontrol-2018-054278.
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The Foundation for a Smoke-Free World was launched in September 2017 with an announced 12-year funding commitment of $1 billion from Philip Morris International (PMI). The Foundation claims that its governing documents (certificate of incorporation, bylaws and a pledge agreement) ensure that it has an independent research agenda and stringent protections from conflicts of interest. We analysed the text of these governing documents. Their provisions have multiple loopholes, particularly regarding conflicts of interest. Further, these documents cannot substitute for other important documentation such as information about PMI’s internal business case for investing $1 billion in the Foundation, an unwaivable conflict of interest policy, annual disclosure statements, copies of pre-Foundation establishment correspondence between key individuals, all signed contracts or salary information, none of which, as of July 2018, the Foundation has made publicly available. Even if these were released, however, it is problematic that the Foundation’s fundamental purpose was decided on and its leader selected following a tobacco company-paid, privately negotiated arrangement with the Foundation’s president. It cannot be regarded as independent.
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Tran, Krystel, John Benjamin, Katrina Woodford, Louise Nardone, Catherine Martin, and Sashendra Senthi. "Time trends in the use of surgery for stage I non-small cell lung cancer (NSCLC) and the impact on population survival: Analysis from the Surveillance, Epidemiology, and End Results (SEER) Program." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18013-e18013. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18013.
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e18013 Background: Surgery is the standard of care treatment for stage I NSCLC. Improvements in surgical techiques and perioperative care over time are developed to facilitate surgery for more patients. We assessed the factors influencing the use of surgery, the interaction of these with time and the impact on population survival. Methods: Patients enrolled into SEER between 2004 and 2012, aged at least 18 years with a first malignant primary stage I NSCLC were retrospectively assessed. Patients diagnosed on the basis of autopsy or death certificate only were excluded.Time was catergorized into three periods; 2004-6, 2007-9 and 2010-12. Age, gender, marital status, race, geographic location and time were all considered exposure variables influencing surgical use and were adjusted for using logistic regression. Impact of variables with time was assessed using interaction terms between them. The impact of time on population survival was assessed using cox regression. Results: Sex, age, marital status, race, location and time all significantly influenced whether surgery was performed (all p < 0.001). The proportion undergoing sugery declined from 68.0% during 2004-6 to 62.7% during 2010-12 (adjusted HR 0.88, p < 0.001 between subsequent periods). Patients were less likely to have surgery with increasing age (adjusted HR 0.94 per year, p < 0.001) and if they were Black or Hispanic (adjusted HR 0.58, p < 0.001 and 0.87, p = 0.008 repectively) relative to Non-Hispanic Whites. There were significant differences with location. Relative to San-Fransisco-Oakland, the greatest adjusted differences were between Louisiana (HR 0.51, p < 0.001) and New Jersey (HR 1.57, p < 0.001). Age significantly interacted with time (p = 0.007). Surgical use declined from 75.5% during 2004-6 to 71.5% during 2010-12 when less than 75 years. For those older, the decline was greater, 55.3% to 46.5%. The risk of death declined with time (adjusted HR 0.94, p < 0.001 between periods). Conclusions: Since 2004, the use of surgery for stage I NSCLC has declined and done more so with increasing age. Despite this overall population survival has improved.
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Siau, Keith, A. John Morris, Aravinth Murugananthan, Brian McKaig, and Paul Dunckley. "Variation in exposure to endoscopic haemostasis for acute upper gastrointestinal bleeding during UK gastroenterology training." Frontline Gastroenterology 11, no. 6 (December 18, 2019): 436–40. http://dx.doi.org/10.1136/flgastro-2019-101351.
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IntroductionGastroenterologists are typically expected to be competent in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB), with the Certificate of Completion of Training (CCT) often heralding the onset of participation in on-call AUGIB rotas. We analysed the volume of haemostasis experience recorded by gastroenterology CCT holders on the Joint Advisory Group on Gastrointestinal Endoscopy Training System (JETS) e-portfolio, the UK electronic portfolio for endoscopy, and assessed for variations in exposure to haemostasis.MethodsUK gastroenterologists awarded CCT between April 2014 and April 2017 were retrospectively identified from the specialist register. Credentials were cross-referenced with JETS to retrieve AUGIB haemostasis procedures prior to CCT. Procedures were collated according to variceal versus non-variceal therapies and compared across training deaneries.ResultsOver the 3-year study period, 241 gastroenterologists were awarded CCT. 232 JETS e-portfolio users were included for analysis. In total, 12 932 haemostasis procedures were recorded, corresponding to a median of 42 (IQR 21–71) per gastroenterologist. Exposure to non-variceal modalities (median 28, IQR 15–52) was more frequent than variceal therapies (median 11, IQR 5–22; p<0.001). By procedure, adrenaline injection (median 12, IQR 6–23) and variceal band ligation (median 10, IQR 5–20) were most commonly recorded, whereas sclerotherapy experience was rare (median 0, IQR 0–1). Exposure to haemostasis did not differ by year of CCT (p=0.130) but varied significantly by deanery (p<0.001), with median procedures ranging from 20–126.ConclusionExposure to AUGIB haemostasis during UK gastroenterology training varied across deaneries and procedural modalities which should prompt urgent locoregional review of access and delivery of training. Endoscopy departments should ensure the availability of supportive provisions in haemostasis (i.e. training/upskilling, supervision, mentorship) during the early post-CCT period.
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Brown, Ph.D, Troy T., and Enid F. McLymont, Ph.D. "Teacher Qualification Characteristics and Secondary School Students’ Mathematics Achievement: A Quantitative Study." Journal of Education and Culture Studies 3, no. 3 (September 1, 2019): p339. http://dx.doi.org/10.22158/jecs.v3n3p339.
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Many Grade 12 Caribbean Secondary Education Certificate (CSEC) Mathematics examination registrants are consistently underperforming due to their inability to grasp basic mathematical concepts (Caribbean Examinations Council, 2006-2016). The purpose of this research was to examine the relation and association between five Teacher Qualification Characteristics (TQCs) and students’ 2016 CSEC Mathematics achievement at two secondary schools in the British Virgin Islands (BVI). A sample size of 113 participants were incorporated in this research (N=105 students and N=8 teachers). These teachers taught these students CSEC Mathematics during the year of examination, 2015-2016. The Spearman’s rho correlation revealed that there was a statistically significant positive relationship between teacher qualification, teacher certification, and teacher Mathematics teaching experience and students’ ordinal grades at [r=.416; p=.000 < ?=.001], [r=.235; p=.016 < ?=.05], and [r=.20; p=.041 < ?=.05] respectively. Similarly, the chi-square output showed a statistically significant association between teacher qualification, teacher certification, and teacher Mathematics teaching experience and students’ ordinal grades at [p=.000 < ? =.001], [p=.010< ? =.05], and [p=.003< ? =.05] respectively. On two occasions, the Bonferroni adjustment was used. For both tests, professional development and academic coaching were not statistically significant.
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Rykov, M. Yu. "Organization of medical care for children with cancer in the central federal district." Siberian journal of oncology 18, no. 2 (April 26, 2019): 5–14. http://dx.doi.org/10.21294/1814-4861-2019-18-2-5-14.
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Background. Planning the organization of medical care for children diagnosed with cancer as well as assessing the quality of care is based on the statistical data analysis.The purpose of the study was to analyze the main parameters characterizing medical care for children with cancer in the central Federal district.Material and methods. The reports of the executive authorities in the sphere of health protection of 18 subjects of the Russian Federation included into the central Federal district were analyzed for 2017.Results. The number of children aged 0–17 years was 6 824 049, the number of pediatric oncology departments was 9, the number of hospital beds for children with cancer was 464, the number of bed-days per year was 319.3. the number of physicians providing pediatric cancer care was 91, of them 64 (70.3 %) had a certificate of a pediatric oncologist. in 11 subjects of the Russian Federation, there were no departments of pediatric oncology, and in 1of them, there were no hospital beds for children with cancer. the number of patients newly diagnosed with cancer was 821. the number of patients who died of cancer was 156, of them 66 were diagnosed with cancer in 2017. the cancer incidence rate was 12 per 100,000 children aged 017 years; the mortality rate was 2.3 per 100,000 children aged 017 years. the one-year mortality rate was 8 %. the mean time taken to establish the diagnosis and the time interval between diagnosis and initiation of treatment was unknown, since the reports did not contain precise information. twelve (1.5 %) patients left the territory of the Russian Federation for receiving treatment outside the Russian Federation.Conclusion. The information provided in most reports was not statistically reliable. the cancer incidence rates were significantly lower than those in countries with high statistical reliability. For reliable estimation of the number of inpatient beds for children with cancer and the percentage of children referred for the treatment to the federal medical centers, it is necessary to implement a unified database for pediatric oncology in the Russian Federation.
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Rykov, M. Yu. "Medical care for children with cancer in the Central Federal District." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 63, no. 6 (December 29, 2018): 75–82. http://dx.doi.org/10.21508/1027-4065-2018-63-5-75-82.
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Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per yearis 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.
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Rykov, Maxim Yu. "Medical Care for Children with Cancer in the Russian Federation: Current Situation and Development Prospects." Oncopediatrics 6, no. 1 (April 15, 2019): 5–15. http://dx.doi.org/10.15690/onco.v6i1/1993.
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Background. The social significance of pediatric oncology and attention to the problems of treating children, both representatives of the authorities and the community, a small number of primary patients detected annually, a shortage of pediatric oncologists and pediatric oncological beds explain problems in organizing medical care for this category of patients. This requires a search for new approaches to the organization of medical care, based on scientific calculations. Objective. Our aim was to improve the organization of medical care for children with cancer in the Russian Federation. Methods: The operative reports for 2017 of executive bodies in the sphere of health care 81/85 (95.3%) of the subjects of the Russian Federation were analyzed. Results. The number of children was 28 132 685 people. (0–17 years), the number of child oncology departments — 47, children›s oncological beds — 1925 (0.7 for 10,000), the average number of days of berth employment in the year — 315.3 days. In 30 (35.3%) subjects of the department of pediatric oncology are absent, in 12 (14.1%) — there are no children›s oncological beds. The number of physicians that provide medical care to children with cancer — 392, of which 259 (66%, 0.09 for 10 thousand) have a certificate, a pediatrician oncologist. In 12 (14.1%) subjects, there are no doctors-children oncologists, 6 (7%) did not provide these data. In 6 (7%) subjects there are no children›s oncological beds and doctors-children›s oncologists. The incidence of malignant tumors was 13.2 (100,000 thousand) prevalence — 91.3, death rate — 2.5, a one-year lethality — 6.5%. Actually revealed 8.3% of patients. 1385 (37.4%) of primary patients were sent to medical organizations of federal subordination, 61 (1.6%) primary patients left the territory of the Russian Federation. Conclusion. It is necessary to take measures aimed at modernizing the system of rendering medical care to children with cancer, namely: to increase the reliability of statistical data, to analyze the needs of subjects in the number of children’s oncological beds and pediatric oncologists, to introduce criteria for selecting patients for children’s oncological beds as part of medical organizations of various levels, to minimize the deficit of doctors and children’s oncologists, to systematically increase the number of children’s cancer beds simultaneously dividing existing in accordance with the needs of the population and the level of congestion, as well as ensure the routing of patients in accordance with a three-tier model.
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Barnes, Jacqueline, Jane Stuart, Elizabeth Allen, Stavros Petrou, Joanna Sturgess, Jane Barlow, Geraldine Macdonald, et al. "Results of the First Steps study: a randomised controlled trial and economic evaluation of the Group Family Nurse Partnership (gFNP) programme compared with usual care in improving outcomes for high-risk mothers and their children and preventing abuse." Public Health Research 5, no. 9 (November 2017): 1–152. http://dx.doi.org/10.3310/phr05090.
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BackgroundFamily Nurse Partnership (FNP) is a home-based nurse home-visiting programme to support vulnerable parents. Group Family Nurse Partnership (gFNP) has similar aims and materials and was demonstrated to be feasible in implementation evaluations.ObjectivesTo determine whether or not gFNP, compared with usual care, could reduce risk factors for maltreatment in a vulnerable group and be cost-effective.DesignA multisite randomised controlled parallel-group trial and prospective economic evaluation, with eligible women allocated (minimised by site and maternal age group) to gFNP or usual care.SettingCommunity locations in the UK.ParticipantsExpectant mothers aged < 20 years with one or more previous live births, or expectant mothers aged 20–24 years with no previous live births and with low educational qualifications (defined as General Certificate of Education at grade C or higher in neither mathematics nor English language or, if they had both, no more than four General Certificates of Education at grade C or higher).InterventionForty-four sessions of gFNP (14 during pregnancy and 30 in the first 12 months after birth) were offered to groups of between 8 and 12 women with similar expected delivery dates (the difference between the earliest and latest expected delivery date ranged from 8 to 10 weeks depending on the group) by two family nurses (FNs), one of whom had notified her intention to practise as a midwife.Main outcome measuresParenting was assessed by a self-report measure of parenting opinions, the Adult Adolescent Parenting Inventory Version 2 (AAPI-2), and an objective measure of maternal sensitivity, the CARE-Index. Cost-effectiveness was primarily expressed in terms of incremental cost per quality-adjusted life-year (QALY) gained.Data sourcesInterviews with participants at baseline and when infants were aged 2, 6 and 12 months. Cost information from nurse weekly logs and other service delivery data.ResultsIn total, 166 women were enrolled (99 to the intervention group and 67 to the control group). Adjusting for site and maternal age group, the intention-to-treat analysis found no effect of gFNP on either of the primary outcomes. AAPI-2 total was 7.5/10 [standard error (SE) 0.1] in both arms [difference also adjusted for baseline 0.08, 95% confidence interval (CI) –0.15 to 0.28;p = 0.50]. CARE-Index maternal sensitivity mean: intervention 4.0 (SE 0.3); control 4.7 (SE 0.4) (difference –0.76, 95% CI –1.67 to 0.13;p = 0.21). The sensitivity analyses supported the primary analyses. The probability that the gFNP intervention was cost-effective based on the QALY measure did not exceed 3%. However, in terms ofchangein AAPI-2 score (baseline to 12 months), the probability that gFNP was cost-effective reached 25.1%. A separate discrete choice experiment highlighted the value placed by both pregnant women and members of the general population on non-health outcomes that were not included in the QALY metric.LimitationsSlow recruitment resulted in smaller than ideal group sizes. In some cases, few or no sessions took place owing to low initial group size, and small groups may have contributed to attrition from the intervention. Exposure to gFNP sessions was below maximum for most group members, with only 58 of the 97 intervention participants receiving any sessions; FNs were experienced with FNP but were mainly new to delivering gFNP.ConclusionsThe trial does not support the delivery of gFNP as a means of reducing the risk of child abuse or neglect in this population.Future workA randomised controlled trial with modified eligibility to enable first-time mothers aged < 20 years to be included, and a modified recruitment strategy to enable faster identification of potential participants from antenatal medical records.Trial registrationCurrent Controlled Trials ISRCTN78814904.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 9. See the NIHR Journals Library website for further project information.
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Čapla, Jozef, Peter Zajác, Jozef Čurlej, Ľubomír Belej, Miroslav Kročko, Marek Bobko, Lucia Benešová, Silvia Jakabová, and Tomáš Vlčko. "Procedures for the identification and detection of adulteration of fish and meat products." Potravinarstvo Slovak Journal of Food Sciences 14 (October 28, 2020): 978–94. http://dx.doi.org/10.5219/1474.
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The addition or exchange of cheaper fish species instead of more expensive fish species is a known form of fraud in the food industry. This can take place accidentally due to the lack of expertise or act as a fraud. The interest in detecting animal species in meat products is based on religious demands (halal and kosher) as well as on product adulterations. Authentication of fish and meat products is critical in the food industry. Meat and fish adulteration, mainly for economic pursuit, is widespread and leads to serious public health risks, religious violations, and moral loss. Economically motivated adulteration of food is estimated to create damage of around € 8 to 12 billion per year. Rapid, effective, accurate, and reliable detection technologies are keys to effectively supervising meat and fish adulteration. Various analytical methods often based on protein or DNA measurements are utilized to identify fish and meat species. Although many strategies have been adopted to assure the authenticity of fish and meat and meat a fish products, such as the protected designation of origin, protected geographical indication, certificate of specific characteristics, and so on, the coverage is too small, and it is unrealistic to certify all meat products for protection from adulteration. Therefore, effective supervision is very important for ensuring the suitable development of the meat industry, and rapid, effective, accurate, and reliable detection technologies are fundamental technical support for this goal. Recently, several methods, including DNA analysis, protein analysis, and fat-based analysis, have been effectively employed for the identification of meat and fish species.
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Saha, Arup Kumar, Most Shahana Afroge Khan, Shaik Abdullah Al Mamun, Diti Rani Das, Helal Uddin, and Md Mustafa Kamal. "Factors Affecting Oral Health in Non-Commissioned Soldiers of Bangladesh Army attended the Dhaka Combined Military Hospital." City Dental College Journal 10, no. 1 (February 5, 2018): 26–31. http://dx.doi.org/10.3329/cdcj.v10i1.13737.
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Aims: A descriptive type of cross-sectional study was conducted comprising 100 non-commissioned soldiers of Bangladesh Army attended Dhaka combined military hospital (CMH) during January to July 2012, to find out the factors affecting their oral health. Materials and Methods: Data were collected by structured questionnaire. Collected data were compiled, tabulated, analyzed by computer using SPSS version 16.0. Results: Mean age of the respondents was 30.16±5.09 (range 20- 41) years where about 60% were married.Most (91%) of themcompleted secondary school certificate. Eightypercent (80%) lived in barracks and 97% had idea about dental diseases and 3% had not.Of all, 73% respondents brushed their teeth once daily and 27%, twice daily.Majority(76%)respondents brushed their teeth at morning and the lowest 11% after breakfast and the rest (13%) brushed their teeth at bed time.Ninety nine percent(99%) respondents used tooth paste as cleaning materials and only 1% respondents used something else.In this study, 40.0% visited dentist once in a year, 17% twice in a year and 43% did never visit dentist without dental problem. Usually48% visited dental chamber for gum bleeding and only 1%visited for regular dental checkups. Among the respondents, 36% visited dental chamber for pain and 15% visited dental chamber for detection of dental caries by themselves. The notable bad habits were not observed among 84.0% of the respondents. A few respondents had smoking (6.0%), betel nut chewing (4.0%) and snuff dipping (3.0%)habits. Of all,63% of the respondents had swelling of gum and 37% had no swelling of gum. Presence and absence of calculus on the gingival margin were found 47% and 53%, respectively. In view of individual perspective,2DMFT had among 40.0% respondents, followed by 1DMFT, 29%, 4DMFT,12%, 3DMFT, 3.0% and 16% respondents had no DMFT. Conclusions: Overall findings suggest that the factors that affect the oral health were smoking, frequency of tooth brushing, having some bat habits and visit to dentist when dental symptoms such as bleeding gums or toothache occurred. Clinical factors included bleeding and swollen gums, toothache and caries. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13737 City Dent. Coll. J Volume-10, Number-1, January-2013
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Mouton, N., G. P. Louw, and G. L. Strydom. "Present-Day Dillemas And Challenges Of The South African Tertiary System." International Business & Economics Research Journal (IBER) 12, no. 3 (February 19, 2013): 285. http://dx.doi.org/10.19030/iber.v12i3.7672.
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The Education White Paper 3 on Higher Education aimed to transform the higher education system. Change within tertiary education included adjusting the size and shape of institutions, the meaning of autonomy and accountability, the nature of higher education, the character of student demographic distribution, management and governance, roles of student politics, models of delivery, the notion of higher education in terms of the relationship between free trade and public good, programme changes and the nature of the academic workplace. At this stage, transformation in higher education is leaping outwards to fulfil the criteria set by international competitiveness and related efficiency criteria that can be attributed to globalisation pressures and to deeper factors inherent in the nature of higher education, especially in terms of its resistance to change and modernization. In this regard, the tertiary higher education system in South Africa is faced with many multi-dimensional challenges that need to be addressed in this article. This includes stating whether Grade 12 results as the outcome of this exit point at school level are, internationally speaking, a reasonable predictor of first-year academic success at university. In South Africa, there is no benchmarking of the National Senior Certificate (NSC) examination; therefore, first-year students have difficulty in adapting to the university environment as they find themselves devoid of indispensable bases for the pursuit of their studies and the weakness of the level of education given at school level in a large number of instances. Furthermore, five universities were placed under administration in the 2011-2012 period because of appallingly poor levels of management, which adds extra layers of suspicion to the notion of the impact of higher education in South Africa. Many other challenges are facing the South African tertiary education system, which will be analysed and recommendations arrived at that will attempt to contribute to an enhancement of tertiary education in South Africa.
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Amarullah, Adinugraha, Didik Hasmono, IGD Ugrasena, and Yulistiani Yulistiani. "Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase." Folia Medica Indonesiana 54, no. 1 (April 5, 2018): 59. http://dx.doi.org/10.20473/fmi.v54i1.8054.
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Prednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression could reduce immune system in children with ALL and increase infection risk because reduction of cortisol level. In Indonesia, we did not find study about the incident of adrenal suppression after high dose prednisone therapy, especially in induction to consolidation phase ALL patient. The aim of this study was to analyze adrenal suppression after high dose prednisone therapy on children with standard risk acute lymphoblastic leukemia in induction and consolidation phase. This study has received a certificate of Ethical Clearance No. 588/Panke.KKE/X/2016, a longitudinal observational, prospective, non-randomized trial involving children with ALL who received prednisone for 49 days during the induction phase. We collected and compared laboratory result of cortisol level in children with ALL and received prednisone therapy during induction to consolidation phase. Sample was taken at week 0,4,5,6,7,8,10,12 in the course of ALL chemotheraphy Indonesian protocol year 2013. Serum was examined using methods CLIA ADVIA Centaur® XP. Between June 2016 – January 2017, 13 patients (8 males, 5 females) were included in this study. Decrease of cortisol level after prednisone therapy occured in week-10 as much as 53% compared with week-0 (p=0.027). Cortisol level increased 64% of week-12 compared with week-10 (p=0.003). In conclusion, high dose prednisone is not significant to causing adrenal suppression in induction phase of ALL patients, and the reducing cortisol level is reversible.
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Yang, Dongyun, Josh Usher, Jordan LoCoco, Chaudhari Pritesh, Heinz-Josef Lenz, and Anthony B. El-Khoueiry. "Impact of gender on survival of patients (pts) with hepatocellular carcinoma (HCC): A SEER analysis." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 4128. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.4128.
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4128 Background: The incidence of HCC is significantly higher in males (M) than females (F). Preclinical models suggest a role for estrogen in attenuating progression of HCC by various mechanisms such Il-6 suppression or estrogen receptor α-mediated inhibition of NF-κB activity. We investigated the impact of age and gender on survival in patients with HCC using the SEER data. Methods: We identified all patients diagnosed with HCC (ICD-O-3 Site code C22.0 and Histology Code 8170-8175) from 1988 to 2009 from the SEER registry. Pts with information on gender, age, ethnic background, and staging were included in the analysis. Exclusion criteria included fibrolamellar histology, diagnosis at autopsy or by death certificate, and absence of survival data. Hazard ratios (HR) for survival were derived using Cox regression model adjusted for race, year of diagnosis, marital status, treatment, birthplace, differentiation and tumor size. Results: A total of 38,250 pts were identified; 76% males; 50% White, 12% African American, 21% Asian, 16% Hispanic, and 1% Native American. 45% had liver limited disease (44%M, 50%F), 37% had macrovascular invasion (37%M, 35%F), 18% had metastatic disease (19%M, 15%F). Treatment information was available for pts diagnosed after 1998 (n=32,938): 11% received liver directed therapy, 11% had surgical resection, and 7% underwent liver transplantation. Median age at diagnosis was 61 years for M versus 68 years for F. HR for OS of F versus M was 0.83 (95%CI:0.78-0.89) for pts < 55 years old. In contrast, the OS HR of F versus M was 0.95 (95%CI:0.92-0.98) for pts ≥ 55 years old and 0.98 (95%CI: 0.94-1.01) for pts ≥ 65 years old. The F vs. M (<55 yrs old) HR for OS by stage of disease was: liver limited disease: HR 0.90, CI: 0.81-1.01; macrovascular invasion: HR 0.81, CI: 0.73-0.89; metastatic disease, HR 0.80, CI: 0.70-0.92. Conclusions: Females under the age of 55 appear to have superior survival compared to males with HCC based on a SEER data analysis. This finding is in line with preclinical reports of estrogen attenuation of HCC development and progression.
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Giri, Smith, Weiwei Zhu, Rong Wang, Amer M. Zeidan, Nikolai A. Podoltsev, Steven D. Gore, Xiaomei Ma, Amy J. Davidoff, and Scott F. Huntington. "Racial Disparities in the Utilization of Recommended Supportive Care Among Patients with Multiple Myeloma in the United States." Blood 132, Supplement 1 (November 29, 2018): 978. http://dx.doi.org/10.1182/blood-2018-99-119791.
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Abstract Introduction: Patients with Multiple Myeloma (MM) are living longer due to therapeutic advancements. With improving MM outcomes, supportive care measures focused on optimizing quality of life and minimizing treatment-related toxicities have become more relevant. Patients with MM report high rates of bone pain, skeletal-related events and infections for which bisphosphonates, influenza vaccination, and antiviral prophylaxis have been recommended. The extent to which these supportive care measures are used during routine clinical practice and the factors predicting utilization remain unknown. Methods: We selected older adults (age >65 years) diagnosed with MM between 2008-13 from the Surveillance Epidemiology and End Results-Medicare linked database. We excluded patients diagnosed at autopsy or by death certificate, those without continuous Medicare Parts A and B coverage from 12 months prior to diagnosis through death or end of study (12/31/2014). Additionally, we required continuous Part D claims from 12 months prior to diagnosis to 2 years after diagnosis. We required patients to receive anti-myeloma therapy and survive the first full flu season after diagnosis. Outcomes of interest included proportion of patients receiving guideline concordant supportive care therapy defined as 1) bisphosphonate therapy (zoledronic acid or pamidronic acid) within first 12 months after diagnosis, 2) influenza vaccination in the first flu season after diagnosis, and 3) receipt of antivirals (acyclovir, valacyclovir) among patients receiving bortezomib therapy. We estimated a multivariable logistic regression model for each outcome to evaluate potential predictors of supportive care use including patient characteristics (age, gender, race/ethnicity, comorbidity, disability status, diagnosis of CKD, socio-economic status, year of diagnosis), provider volume/experience (number of MM patients treated during a 12 month look back), and facility type (hospital outpatient vs community). Results: A total of 1,569 Medicare beneficiaries met our eligibility criteria. The median age was 74 years with 47% male and 73% non-Hispanic whites. Only 66% of Medicare beneficiaries on active MM therapy received bisphosphonates within 1 year of diagnosis. 53% of patients received influenza vaccination in the first flu season following diagnosis, and 44% received antiviral prophylaxis while receiving bortezomib therapy. Sensitivity analysis with and without pre-existing chronic kidney disease showed that 48% and 72% received bisphosphonates respectively. In the multivariate analysis, predictors of bisphosphonate non-usage included increasing age, (odds ratio [OR] for 85+ years 0.37; 95% confidence interval [CI] 0.23-0.58 compared to 66-69 years), non-Hispanic black and Hispanic ethnicity (OR 0.51; 95% CI 0.34-0.76 and OR 0.56; 95% CI 0.35-0.91 respectively compared to whites), and higher comorbidity index (for Elixhauser index of 3+ OR 0.41, 95% CI 0.29-0.57 compared to 0). Significant predictors of flu shot non-usage included non-Hispanic black ethnicity (OR 0.49; 95% CI 0.34-0.70 compared to whites), living in West (OR 0.53; 95% CI 0.38-0.75 compared to Midwest), having Medicaid dual coverage (OR 0.66; 95% CI 0.49-0.89) and lower comorbidity burden (For Elixhauser index of 3+ OR 1.44; 95% CI 1.07-1.93 compared to 0). Meanwhile, predictors of antiviral prophylaxis non usage included earlier years of diagnosis (global P<0.01, with increasing OR for more recent years), and higher comorbidity burden (For Elixhauser index of 3+ OR 0.40; 95% CI 0.24-0.67 compared to 0). Conclusion: We found significant under-utilization of supportive care measures focused at bone health and infection prevention among elderly adults with MM in the US. Similar to prior work evaluating utilization of novel MM therapies and transplantation, we found significant racial disparities in receipt of MM supportive care. Future studies should seek to identify reasons for such under-utilization of supportive care during MM therapy so that appropriate interventions may be implemented. Disclosures Zeidan: Agios: Consultancy; Celgene: Consultancy; Novartis: Consultancy; Incyte: Employment; Gilead: Consultancy; Ariad: Consultancy, Speakers Bureau; Abbvie: Consultancy; Pfizer: Consultancy. Podoltsev:Sunesis Pharmaceuticals: Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees; Boehringer Ingelheim: Research Funding; Astex Pharmaceuticals: Research Funding; Astellas Pharma: Research Funding; LAM Therapeutics: Research Funding; Celgene: Research Funding; Pfizer: Research Funding; Genentech: Research Funding; Daiichi Snakyo: Research Funding; Celator: Research Funding. Gore:Celgene: Consultancy, Research Funding. Ma:Celgene: Consultancy, Research Funding; Incyte: Consultancy. Davidoff:Celgene: Research Funding. Huntington:Celgene: Consultancy; Bayer: Consultancy; Janssen: Consultancy.
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Roestamy, Martin. "KONSEP KEPEMILIKAN RUMAH BAGI WARGA NEGARA ASING DALAM RANGKA PERCEPATAN PENINGKATAN INVESTASI DI INDONESIA." DE RECHTSSTAAT 2, no. 2 (September 1, 2016): 127–40. http://dx.doi.org/10.30997/jhd.v2i2.681.
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ABSTRACTIndonesia is known to have a good resource potential. Nevertheless, it has turned out it is not enough to attract investors. All that should be coupled with the ease of the procedure, the availability of law and good services to investors. This study attempted to correlate between the government's policies of home ownership for foreign with efforts to increase investment. It is expected to be answered on how the residential home ownership for foreigners in Indonesia? and how the concept of home ownership for foreigners in order to accelerate the increase in investment in Indonesia ?. using scientific principles the results of this study explained that the application of positive law pertaining to houses and buildings have ignored the principle of horizontal separation adopted in BAL and customary law, in practice the ownership of homes and buildings tend to use the principle of sticking always attach rights to land with the house or building that is on it, this has resulted in WNA difficult to get home because the houses built over the right to use is limited. To overcome this problem needs to be realized registration of houses and buildings by awarding certificate proof of right to a home or building or property that can be transferred, charged to a right of material, to realize the ideals Article 8 UUBG by Presidential Decree as mandated in Article 12 paragraph 4 of the Indonesian Government Regulation No. 36 Year 2005 concerning the Implementing Regulations of Law BG. Thus the application of the principle of horizontal separation adopted in BAL and customary law, in practice the ownership of homes and buildings will allow foreigners have a house to attract foreign investment to invest in Indonesia. Finally with the ease is expected to have an impact on increased investment in Indonesia until this is less good, especially when compared with neighboring countries.
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Veiga, Oscar Luis, Manel Valcarce-Torrente, and Miguel Ángel De la Cámara. "Encuesta Nacional de Tendencias de Fitness en España para 2021 (National Survey of Fitness Trends in Spain for 2021)." Retos, no. 39 (November 18, 2020): 780–89. http://dx.doi.org/10.47197/retos.v1i40.83008.
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Desde 2017 se realizan anualmente las Encuestas Nacionales de Tendencias de Fitness en España, reproduciendo la metodología de las encuestas internacionales promovidas por el Colegio Americano de Medicina del Deporte (ACSM). El objetivo del presente estudio es presentar los resultados de la quinta encuesta española e identificar las principales tendencias en el sector del fitness español para el año 2021, así como comparar sus resultados con los obtenidos en las encuestas nacional e internacional para el año 2020. Dado que la presente edición se realiza en una situación sanitaria excepcional debido a la COVID-19, se trató de identificar su posible influencia en los resultados. La encuesta fue enviada a 6230 profesionales del sector del fitness recogiéndose un total de 503 respuestas (tasa de respuesta de 8.1%). Las tendencias más relevantes para 2021 fueron: “ejercicio y pérdida de peso”, “contratación de profesionales certificados”, “entrenamiento personal”, “entrenamiento personal en pequeños grupos" y “entrenamiento funcional”. Las tendencias en el top-20 en España para el año 2021 resultaron muy similares a las obtenidas para el año 2020 (17 coincidencias), si bien con algunos cambios reseñables en cuanto a su posición que podrían ser explicables por los efectos de la COVID-19. Las diferencias son mayores cuando se comparan con la encuesta internacional (solo 12 coincidencias) con relevantes diferencias en las posiciones ocupadas. Estos hallazgos confirman los encontrados en ediciones anteriores, mostrando bastante estabilidad de las tendencias en el sector del fitness español y una progresiva divergencia con las tendencias internacionales.
Abstract. Since 2017 the National Surveys of Fitness Trends in Spain are yearly carried out, reproducing the methodology of the worldwide surveys endorsed by the American College of Sport Medicine (ACSM). The objective of the current study is to show the findings of the fifth Spanish survey of fitness trends and identified the main trends in Spanish fitness sector for year 2021, as well as to compare its results with those got in the national and international surveys for 2020. Because of the current edition of the survey was carried out in an exceptional health situation by COVID-19, it was tried to identify its possible influence in its results. The survey was sent to 6230 professionals of the fitness sector and a total of 503 responses were collected (response rate 8.1 %). The more relevant trends for 2021year were: “exercise and weight loss”, “employing certificate fitness professional”, “personal training”, “personal training in small groups” and “functional training”. The top-20 trends in Spain for year 2021were very similar to those for year 2020 (17 coinciding trends), however with some remarkable changes in their positions, that could be explained by the COVID-19 effect. Differences are greater when trends are compared with worldwide survey (just 12 coinciding trends) with relevant differences in their positions. These findings confirm those ones found in previous editions showing rather stability in the trends in Spanish fitness sector and a progressive divergency with worldwide trends.
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Kinsella, Anna. "P24 Does an interdisciplinary approach to tablet/capsule swallowing increase the uptake of or transition to solid oral dosage forms in paediatric patients with ALL acute lymphoblastic leukaemia?" Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e18.2-e19. http://dx.doi.org/10.1136/archdischild-2020-nppg.33.
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AimMost paediatric formulations produced for children are generally liquids or powders for reconstitution. Palatability of liquid formulations is often cited as a barrier to medication adherence.1 An alternative to liquid formulations is the conventional solid oral dosage forms, such as tablets or capsules. However, another barrier faced by paediatric patients is the inability to swallow tablets.2 This presents a number of challenges for children with ALL, as treatment contains a phase of extended ‘maintenance’ therapy to prevent relapse. This involves taking oral chemotherapy daily, ± monthly chemotherapy injections, over 2 years for girls and 3 years for boys. Prior to 2014, paediatric oncology pharmacists would work with children refusing to take or struggling with their liquid medicines. It was a simple approach, where ‘tic-tacs®’ were used and swallowinSg these was practiced together. Through education sessions and informal discussions with nursing, medical and play therapists, a culture evolved in 2014 whereby medicine taking was not just the responsibility of pharmacy but of the wider team. Nursing and medical staff were actively involved identifying families that needed support with their medicines. Display boards were created advertising the option of tablets for different medicines and highlighting the different swallowing techniques. The play specialists became ‘Medicine Champions’ using novel approaches to provide children with the tools, confidence and ability to take tablets. Children who successfully mastered swallowing tablets were presented a ‘star award’ certificate for their achievement. Photographs of children with their certificates were displayed in the outpatient clinic.MethodPaediatric patients diagnosed with ALL between 2012 and 2017 were retrospectively identified using chemotherapy prescriptions, patient’s medical notes and electronic patient medical records. Data collected included age at diagnosis, formulation choice initiated on and whether patients switched formulations during the course of their treatment. Children were excluded for the following reasons: if they had a history of swallowing difficulties/choking, if the child had learning difficulties or if the child was deceased.Results172 patients were diagnosed with ALL between 1st January 2012 and 31st December 2017; 14 patients were excluded (13 deceased,1 learning difficulties). The percentage of children aged 3–12 years taking tablets in 2012 and 2013 was 41% (n=7) and 20% (n=2) respectively. This increased to 69% (n=11) in 2014, remained consistently above 60% in 2015/2016 and increased again to 76% (n=14) in 2017. Between 2014 and 2017, 100% of patient’s ≥ 6 years took their oral chemotherapy as tablets. Over 65% of all patients 0 – 18 years were taking liquids in 2012/2013. From 2014 to 2017 less than 50% of all patients each year were taking liquids. No patients were identified as switching back from tablets to liquid.ConclusionThis study supports an interdisciplinary approach to tablet taking. By bringing together different members of staff with the necessary knowledge, skills and experiences, we were able to provide families with the tools and confidence to support their child in mastering the technique of swallowing tablets, increasing the number of patients initiating on or transitioning to solid oral dosage forms by approximately 50%.ReferencesBaguley D, et al. Prescribing for children – taste and palatability affect adherence to antibiotics: a review. Arch Dis Childhood, 2012;97:293–7.Polaha J. Dalton WT III, Lancaster BM. Parental report of medication acceptance among youth: implications for everyday practice. South Med J. 2008;101:1106–1112.
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Fiala, Mark A., Jesse Keller, Keith E. Stockerl-Goldstein, Michael H. Tomasson, Ravi Vij, and Tanya M. Wildes. "Treatment Advances for Multiple Myeloma Have Disproportionally Benefited Patients Who Are Young, White, and Have Higher Socioeconomic Status." Blood 124, no. 21 (December 6, 2014): 555. http://dx.doi.org/10.1182/blood.v124.21.555.555.
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Abstract Background: The use of autologous stem cell transplants (ASCT) for multiple myeloma (MM) has greatly improved overall survival (OS), however, not all patients have benefited equally. Several studies have indicated that patients over the age of 65 or 70 at diagnosis had no immediate improvement in OS following the use of ASCT for MM, which is intuitive as ASCT was not covered by Medicare until 2001 and today is still often reserved for patients under 70. In addition, Waxman, et al (Blood, 2010) reported that ASCT for MM, resulted in nearly a two-fold improvement in OS in white patients compared to black patients. This suggests that white patients had better access to ASCT as retrospective studies of MM patients who undergo ASCT have failed to show an OS difference between the two races. Disparities in the OS benefit of ASCT among patients of different socioeconomic groups have not been reported on to date. It is also unclear if these disproportional improvements in outcomes have continued following the approvals of bortezomib and lenalidomide. Methods: Using the SEERStat software, we extracted the case listings of 85,115 patients diagnosed with MM from 1973 through 2010 in Surveillance Epidemiology and End Results (SEER)-18 registries database based on the November 2012 submission. Children (under 18 years old) were excluded. Autopsy or death certificate only cases were excluded. Patients identified as any race other than white or black were excluded. Patients were followed for OS through December 2011. Patients were divided into three cohorts based on the year of diagnosis, era 1 those diagnosed from 1973 to 1994, era 2 those diagnosed from 1995-2002 (to coincide with ASCT), and era 3 those diagnosed from 2003-2010 (to coincide with bortezomib’s approval). Socioeconomic status (SES) was approximated by median household income (MHI) of each patient’s county of residence from the 1990 US census; patients were divided into tertiles within their era of diagnosis based on MHI and classified as low-SES, middle-SES, or high-SES. Results: 78,681 patients were eligible for analysis. The median age at diagnosis was 70 years (range 18-85+); 54% were male; 18% were black. The median follow-up was 22 months (range 0-441). The OS of white patients increased from 23 months in the era 1 to 27 months in era 2, to 36 months in the era 3 (p <0.001), representing improvements 15% and 25%, respectively; the OS of black patients increased from 27 months to 28 months to 36 months (p <0.001), representing only improvements of 4% and 22% respectively. In patients under 65 years old at diagnosis, those most likely to be candidates for ASCT, the OS of white patients increased from 35 months in era 1 to 52 months in era 2, to 69 months in era 3 (p <0.001), representing improvements 33% and 25%, respectively; the OS of black patients increased from 36 months to 41 months to 58 months (p <0.001), representing improvements of 12% and 29% respectively. During era 1 being younger and/or being black were both independently associated with improved OS while SES was not associated with OS. In era 2 and era 3 being younger, being white, and/or being higher SES were all independently associated with improved OS. Table 1 summarizes the results from the multivariate cox regression analysis. Table 1- Multivariate Overall Survival Analysis Era 1 (1973-1994) Era 2 (1995-2002) Era 3 (2003-2010) Age HR1 (95% CI) p value HR1 (95% CI) p value HR1 (95% CI) p value <65 12 12 12 65-69 1.32 (1.27-1.38) < 0.001 1.48 (1.41-1.55) < 0.001 1.37 (1.31-1.45) < 0.001 70+ 1.85 (1.80-1.91) < 0.001 2.26 (2.19-2.34) < 0.001 2.56 (2.47-2.64) < 0.001 Race White 12 12 12 Black 0.95 (0.91-0.98) 0.005 1.05 (1.01-1.09) 0.008 1.04 (1.01-1.08) 0.025 SES High 12 12 12 Middle 0.98 (0.95-1.01) 0.230 1.08 (1.04-1.12) < 0.001 1.14 (1.10-1.18) < 0.001 Low 1.01 (0.98-1.04) 0.662 1.13 (1.09-1.17) < 0.001 1.22 (1.17-1.26) < 0.001 1- Hazard Ratio is adjusted for all other variables within the model 2- Used as the Reference level Conclusions: As previously reported, the improvements in OS following the use of ASCT for MM disproportionally benefited patients who were a younger age at diagnosis and/or were white. In addition, higher SES patients benefited more than lower SES, a novel finding. Bortezomib and lenalidomide have equally benefited both black and white patients, but has worsened the outcome disparities for patients over 70 years of age at diagnosis and/or those with lower SES. Disclosures No relevant conflicts of interest to declare.
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Olszewski, Adam J., and Amrita Desai. "Radiotherapy in Stage I and II Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT): Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database." Blood 120, no. 21 (November 16, 2012): 2053. http://dx.doi.org/10.1182/blood.v120.21.2053.2053.
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Abstract Abstract 2053 Background: External beam radiotherapy (RT) is the treatment of choice for many patients with localized (stage IE-IIE) MALT lymphoma, primarily based on single-institution case series. There are no specific factors favoring surgical management or addition of systemic therapy in these cases. The purpose of this study was to evaluate the association of RT used as the initial treatment strategy with survival outcomes in a population-based cohort. Methods: We analyzed 6,111 cases of st I/IIE MALT lymphoma of the most common anatomical locations included in the SEER database, diagnosed between 1998 and 2009. Cases identified through autopsy or death certificate only, as well as those with unknown stage or RT status were excluded. RT was recorded only if administered as part of the initial treatment strategy within 12 months of diagnosis. 5-year relative survival was summarized for treated and untreated patients. For multivariate regression, flexible parametric Royston-Parmar models for overall survival were fitted for each site, adjusting for clinical and socioeconomic confounders. Age and surgical excision of the primary site were always included as variables. No records of progression-free survival, alternative or subsequent systemic treatments or watchful waiting strategy were available. Results: There were significant differences in the rates of RT utilization, baseline clinical characteristics and survival outcomes. Median age varied from 57 years (cutaneous lymphoma) to 69 years (breast). In multivariate models, RT was associated with improved survival in patients with ocular, cutaneous or gastric localization with no significant association for the pulmonary, intestinal, salivary, mammary and thyroid sites. The hazard ratio in gastric MALT was non-proportional and increased from 0.45 at 6 months to 0.97 at 24 months form diagnosis. Long-term prognosis for ocular, salivary and cutaneous thyroid lymphomas was excellent, but was less favorable for the gastrointestinal or pulmonary locations. Conclusions: The survival benefits of RT in early-stage MALT lymphoma are most evident for ocular and cutaneous sites of origin, and this modality can be advocated for treatment. The relative survival of 99–100% in those anatomical subtypes may indicate curative potential in patients who receive RT. In gastric MALT lymphoma the benefit is limited to the early period of two years of follow up. Inferior survival despite local radiotherapy in pulmonary and intestinal locations may suggest higher rates of occult disseminated disease and potential value of systemic therapy. Disclosures: No relevant conflicts of interest to declare.
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CAMPBELL, I., E. Brownson, and E. Robertson. "P210 Clostridium difficile infection in pre-existing inflammatory bowel disease: Management and outcomes." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S244—S245. http://dx.doi.org/10.1093/ecco-jcc/jjz203.339.
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Abstract Background Inflammatory bowel disease (IBD) is a recognised risk factor for clostridium difficile infection (CDI), and CDI in an IBD patient is associated with higher morbidity and mortality. It is thought that factors including alterations in the gut microbiome, mucosal disruption and immunosuppression provide a synergistic environment for CDI to complicate an IBD flare. Despite this, there is conflicting evidence available on management. Our aim was to examine a series of recent cases to assess our own practice and subsequent outcomes. Methods A retrospective analysis was carried out of hospitalised cases of CDI in IBD patients in Greater Glasgow and Clyde from 2017 to 2018. Patients were identified via the CDI database held by the microbiology department; those with co-existing IBD were extrapolated. Data collected included demographics, IBD subtype and presence of other CDI risk factors. Severity of symptoms was assessed using Truelove and Witts Criteria. Initial management and changes following the diagnosis of CDI were noted. Outcomes were measured by the length of stay, survival to discharge, and requirement for surgical intervention. One year outcomes were assessed by recording mortality, treatment escalation and re-admission to hospital. Results 29 patients in total were identified (61% female, 39% male). Twenty-one had a diagnosis of ulcerative colitis, 7 Crohn’s disease, and 1 IBD unclassified. Twenty-four were on immunosuppressive therapy at the time of CDI, 11 were on dual or triple immunosuppression. This was continued during admission in all but three cases. Once the diagnosis of CDI was established, metronidazole was given in 16 cases and vancomycin in 13. Steroid treatment varied - 13 received oral steroids, 5 IV steroids and 11 no steroids. There was no clear correlation between steroid management and outcome. Assessment with the Travis criteria on day 3 indicated a high chance of colectomy in 12 patients, however only one required surgical intervention. No patients received a faecal transplant. The median length of stay was 15 days (range 3–169). One patient did not survive to discharge. In those surviving to discharge, a further 6 had died at one year, bringing the one-year mortality to 24%. Three had CDI as a contributory factor listed on the death certificate. 31% of surviving patients had their IBD treatment escalated in the year following admission, 17% were treated for CDI relapse, and 28% had readmission to hospital. Conclusion Managing CDI in patients with co-existing IBD is challenging. This case series highlights the lack of consensus on how this should be approached, even within a single health board. Morbidity and mortality are high. This suggests that a wider body of work is required to establish guidelines and provide better outcomes.
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Raider, Faith S., Susan Paulukonis, Ward Hagar, Marsha J. Treadwell, and Mary Hulihan. "Mortality Among Women with Sickle Cell Disease Admitted for Delivery, California 2004-2014." Blood 128, no. 22 (December 2, 2016): 2332. http://dx.doi.org/10.1182/blood.v128.22.2332.2332.
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Abstract Maternal mortality results among women with sickle cell disease (SCD) from recent population-based studies using US hospital discharge data range from 72 (Villers, 2008) to 160 per 100,000 (Alayed, 2014). Researchers use hospital discharge or death certificate data to examine maternal death, as no national SCD surveillance system exists. We analyze California's surveillance data to describe the in-hospital maternal mortality rate among women meeting a stringent case definition for SCD, compare that rate to rates for all women and for Black women, and describe cases of SCD maternal demise. The CDC has developed the Sickle Cell Data Collection (SCDC) program to conduct state level surveillance in this disease. SCDC uses a validated case definition: confirmed SCD with known genotype (via newborn screening or clinical case reports) or three or more healthcare encounters in administrative or claims data with SCD ICD-9 codes. California SCDC collected hospitalization data for years 2004-2014 on 1,829 women with SCD. We queried hospitalization data for women ages 15-45 at time of admission for ICD-9 codes for delivery (V27.X) with disposition codes indicating death during the same admission. We used the same query for all women and for Black women to calculate comparable in-hospital maternal mortality rates. We reviewed death records for ICD-10-CM underlying cause of death (COD) codes, and prior ED and inpatient records, and describe the history of the women with SCD who died. We found 636 delivery hospitalizations among 441 of the 1,829 eligible women with SCD during the 11-year period. The maternal death rate for SCD was 629 per 100,000 (n = 4 of 636 deliveries), compared to 6 per 100,000 deliveries in the general population and 12 per 100,000 among Black women. There was an additional death (#5) among the women with SCD that occurred shortly after discharge; we include this death in the case descriptions, but not in the mortality rates. All of the women with SCD who died were Black. All births were live, singleton deliveries by cesarean surgery. Case #1: 29 years old at death with no prior pregnancies in nine years of utilization data. She had a history of eight hospitalizations for septicemia, pneumonia and Hb SS with crisis, but none during her pregnancy. There were 16 ED visits, most related to SCD crisis and pain, but none in the prior three years. COD was 'O96.0, Death from direct obstetric cause.' Case #2 was 34 years old and had seven prior years of medical history. She had no record of previous pregnancies, but had 44 prior hospital admissions and 95 ED encounters, including 12 in the year prior to her death. She had a history of venous thromboembolism, and deep phlebothrombosis was the primary diagnostic code for her final hospital admission. COD was 'D57.1 Sickle cell disease without crisis.' Case #3 was 28, with four years of prior data. There was one previous cesarean birth 2.5 years prior to her death, and a record indicating that there were one or more prior cesarean deliveries before that. She had 11 prior ED encounters, most for pain, with one in the year prior to her death; there were 46 prior hospitalizations, most for SCD crisis. Primary diagnosis was severe pre-eclampsia. COD was 'D57.1 Sickle cell disease without crisis.' Case #4 was 27, and had eight years of prior data and no prior births. She had 11 admissions, three in the months prior to her death for antepartum anemia. There were 12 prior ED encounters, three for antepartum anemia. Her death included codes for heart, liver, kidney and respiratory failure after delivery. COD was 'O96.0,' as described in Case #1. She died 11 days after delivery. Case #5 was 20, and had five years of utilization data with no prior births. Her labor was induced due to fetal distress, and she was hospitalized for six days. Records included a code for infection of the amniotic cavity. Four days after release, she was re-admitted for puerperal sepsis, suffered multi-organ failure, and died. There were 10 prior ED encounters, including four during and related to the pregnancy. COD was 'O23.5, Infections of the genital tract in pregnancy.' We found maternal mortality among women with SCD to be significantly higher than previous estimates. Statewide surveillance based on multiple data sources, and that follows individual patients over time whether or not they are seen in sickle cell disease clinics, can provide less biased information on health outcomes than analyses of single data sources or clinical sites. Disclosures Raider: Pfizer: Research Funding; Biogen: Research Funding. Paulukonis:Pfizer: Research Funding; Biogen: Research Funding.
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Lenfant, Claude. "Fifty Years of Death Certificates: The Framingham Heart Study." Annals of Internal Medicine 129, no. 12 (December 15, 1998): 1066. http://dx.doi.org/10.7326/0003-4819-129-12-199812150-00013.
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Siahaan, Juanda. "Kompetensi SDM Bidang Kebandarudaraan." Warta Penelitian Perhubungan 24, no. 6 (May 14, 2019): 551. http://dx.doi.org/10.25104/warlit.v24i6.1039.
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Recently, there is increasing growth in passenger numbers every year that are passengers, aircraft, routes, airports will have implications for increasing the number of competent human resources based on competency standards in each of the functions and duties in airport services. This implementation was carried out at the Tjilik Riwut Palangkarya Airport. Primary data were collected by interview with airport managers and direct observation, whereas secondary data obtained from reports, articles and standards of airportscompetence. Problems for some personnel do not have a certificate/ license and most of the airtime is depleted and workload that owned for each airport personnel is high. Data were analyzed using qualitative descriptive analysis towards aviation human resources competency. Overview of the results obtained for the basis technician license are 56% of licensed skilled personnel and 44% do not yet have, personnel who have SKP 46% have a basic license Avsec, 7% Avsec junior license and basic absec 20%, 13% aviation security personnel who have Avsec junior license, 40% senior Avsec licensing and 47% basic Avsec license, 29% flight engineer education had educatilln D III PLLU, 35% DIV Allu, 12% D III PPA and the other below 10%, personnel licensing PKP-PK 43 % do not have a license, 34% have a basic license, 3% junior license and 20% of senior license.Keywords: Human Resources, Competency Standards.Pada tahun terakhir ini terns terjadi peningkatan pertumbuhan jumlah penumpang setiap tahun baik jumlah penumpang, pesawat, rute penerbangan, bandar udara akan berimplikasi pada penambahan jumlah sumber daya manusia yang berkompetensi sesuai standar kompetensi pada bidang masing-masing fungsi dan tugasnya dalam pelayanan jasa kebandarudaraan. Pelaksanaan ini dilaksanakan di bandar udara Tjilik Riwut Palangkarya. Data primer dikumpulkan, dengan teknik wawancara pengelola bandar udara serta observasi langsung, sedangkan data sekunder diperoleh dari laporan, artikel dan standar kompetensi bandar udara. Permasalahan sebagian personel belum memiliki sertifikat/lisensi dan sebagian besar masa berlakunya sudah habis serta beban kerja yang dimiliki setiap personel bandar udara cukup tinggi. Data dianalisis dengan menggunakan analisis deskriptif kualitatif terhadap kompetensi sumber daya manusia kebandarudaraan. Diperoleh gambaran hasil untuk lisensi teknisi landasan 56 % personel yang memiliki lisensi terampil dan 44 % belum memiliki, personel yang memiliki SKP 46% memiliki lisensi basic avsec, 7% lisensi junior avsec dan basic avsec 20%, personel keamanan penerbangan 13% yang memiliki lisensi junior avsec, 40% lisensi senior avsec dan 47% lisensi basic avsec, pendidikan teknisi penerbangan 29% memiliki pendidikan D III PLLU, 35% DIV ALLU, 12% D III PPA dan yang lainnya dibawah 10%, lisensi personel PKP-PK 43% belum memiliki lisensi, 34% memiliki lisensi basic, 3% lisensi junior dan 20% lisensi senior. Kata kunci : SDM bandara, Standar Kompetensi
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Chino, Fumiko Ladd, Arif Kamal, and Junzo P. Chino. "Opioid-associated deaths in patients with cancer: A population study of the opioid epidemic over the past 10 years." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 230. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.230.
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230 Background: Over 40,000 Americans died due to opioid overdose in 2016; the epidemic is a top public health concern. Opioids are commonly used for cancer associated pain but it is unknown what risks for overdose exist in this vulnerable population. Methods: De-identified death certificate data was obtained via the National Center for Health Statistics. Death certificates contain 1 underlying cause of death and up to 20 contributing causes, as well as demographic data. All deaths due to opioids were included from 2006-2016; if present, cancer was noted as a contributing cause. Opioid death incidence was calculated from both the US and estimated cancer survivor population. Chi and R squared tests assessed for differences. Results: From 2006-2016, there were 895 deaths due to opioids in cancer patients compared to 193,500 in the non-cancer population. Opioid deaths increased from 5.33 to 8.97 per 100,000 people in the general population (significant time trend, p < 0.001, polynomial fit, R2 0.99). Opioid deaths increased in the cancer population from 0.52 to 0.66 per 100,000 (significant time trend, p < 0.001, linear fit, R2 0.24, slope = 0.018). Cancer patients who died due to opioid use were different from those who died due to opioids in the general population including: higher education (12.7 vs 6.9% at least a college degree), more women (38.5 vs 29.2%), fewer whites (82.3 vs 84.2%), more Hispanics (94.5 vs 91.3%), and fewer single patients (24.2 vs 48.1%) [all p < 0.001, except race p = 0.027]. Cancer patients also had older median age (57 years, IQR 50-65 vs median 42 years, IQR 31-51). 22% of opioid deaths were in lung cancer patients, followed by GI (21%), head & neck (12%), hematological (11%), and GU cancers (10%). Conclusions: Death from opioids as the primary cause noted on death certificates are 10 times less likely to occur in cancer patients versus the general population. There was a slight increase in opioid deaths in cancer patients; however, overall, there was not the sharp growth seen in the general population. Cancer patients at risk for opioid overdose are different than those at risk in the general population and care should be taken when planning effective treatment of cancer-related pain.
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Rodday, Angie Mae, Theresa Hahn, Peter Lindenauer, and Susan Parsons. "3014 Identification of a Cohort to Study Treatment Patterns in Elderly Patients with Incident Hodgkin Lymphoma (HL) using Surveillance, Epidemiology and End Results (SEER)-Medicare Data." Journal of Clinical and Translational Science 3, s1 (March 2019): 122–23. http://dx.doi.org/10.1017/cts.2019.278.
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OBJECTIVES/SPECIFIC AIMS: (1) To define and describe a cohort of patients aged ≥65 years with incident HL from SEER-Medicare data. (2) To identify patient, disease, and system-level factors associated with initial treatment for HL. METHODS/STUDY POPULATION: This retrospective cohort study utilized SEER-Medicare data from 1999-2014. Patients with incident classical HL were identified using SEER registry histology groupings. The cohort was restricted to those with Medicare Part A and B fee-for-service for 3 months prior to and 1 year after diagnosis (or until date of death) in order to fully capture claims for outpatient chemotherapy. Patients were excluded for the following reasons: missing month of HL diagnosis; unknown diagnostic confirmation; reporting from autopsy or death certificate; or another cancer diagnosis +/− 2 years of the HL diagnosis. Demographic and disease characteristics were defined based on SEER registry data. Broad treatment categories were defined using SEER data, while detailed treatment categories will be defined based on Medicare claims. Length of follow-up was defined as the number of months until the earliest of the following: death; end of continuous Medicare Part A and B fee-for-service enrollment; or the end of the available data (12/31/2014). Demographic, disease, and preliminary treatment characteristics were described for the cohort. Future analyses will explore patient and disease factors, including comorbidities and an estimate of frailty, as well as system-level factors associated with initial treatment of HL. RESULTS/ANTICIPATED RESULTS: We identified 2909 patients meeting eligibility for the cohort. The median length of follow-up was 22 months (Q1=5, Q3=62). Median age was 75.9 years (Q1=70, Q3=81), 49.6% were female, and 82.6% were non-Hispanic/White. Only 11.5% of patients were in rural or non-urban areas. 13.8% of patients were dual eligible for both Medicare and Medicaid. Nodular sclerosis was the most common histology (35.2%), followed by mixed cellularity (21.1%); 36.5% had histology that was not otherwise specified. Patients were evenly distributed across Ann Arbor Stage (21.8% with I; 22.3% with II; 25.8% with III; 24.2% with IV; 6% unknown). B symptoms were present in 35.2% of patients, absent in 39.6%, and unknown in 25.2%. Neither tumor bulk nor international prognostic score were available via SEER registry data. According to SEER registry data, most patients received some treatment for their HL (81.9%) and 75% of those patients initiated treatment within one month of diagnosis. 72% of patients died with median time to death of 9 months (Q1=3, Q3=43). DISCUSSION/SIGNIFICANCE OF IMPACT: We successfully identified and described a cohort of 2909 older patients with incident HL from the SEER-Medicare data. This provides a unique opportunity to study this cohort in a large, representative dataset with nearly 15 years of follow up. Future analysis will help us to better understand treatment patterns of HL in older patients and factors associated with treatment. These results can then be used to help improve care decisions and clinical outcomes.
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Anderson, David L., and William C. Cunningham. "Revalidation and Long-Term Stability of National Institute of Standards and Technology Standard Reference Materials 1566, 1567, 1568, and 1570." Journal of AOAC INTERNATIONAL 83, no. 5 (September 1, 2000): 1121–34. http://dx.doi.org/10.1093/jaoac/83.5.1121.
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Abstract Multiple units of Standard Reference Materials (SRMs) 1566 Oyster Tissue, 1567 Wheat Flour, 1568 Rice Flour, and 1570 Trace Elements in Spinach, produced by the National Institute of Standards and Technology (NIST, then the National Bureau of Standards), were analyzed 17–20 years after the original certification dates and 12–15 years after the certificates became invalid. Instrumental neutron activation analysis and thermal neutron prompt (γ-ray activation analysis were used to measure mass fractions for 27 elements in these SRMs to revalidate them for use in quality assurance (QA) programs required for food analysis programs within the U.S. Food and Drug Administration. With the exception of Se in SRM 1567, all element mass fractions were in agreement with certified values and literature data. Some evidence of B loss from SRM 1568 was observed. These materials were judged to be suitable for continued use in QA programs. Findings showed that these matrixes exhibited stability of moisture, mass fraction, and weight basis for far longer (≥15 years) than was indicated by the 5-year validity statement on the NIST Certificates of Analysis.
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Go, Ronald S., Jacob D. Gundrum, and Joan M. Neuner. "Natural History Of Smoldering Monoclonal Gammopathy-Associated Malignancies: A Population-Based Study." Blood 122, no. 21 (November 15, 2013): 5318. http://dx.doi.org/10.1182/blood.v122.21.5318.5318.
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Abstract Background We performed a population-based study to determine the natural history of monoclonal gammopathy-associated malignancies (MGAM) including multiple myeloma, lymphoplasmacytic lymphoma, and Waldenstrom's macroglobulinemia that were considered smoldering at the time of cancer diagnosis. We compared the clinical outcomes among those with and without a prior monoclonal gammopathy of undetermined significance (MGUS) follow-up. Methods Data were obtained from the Surveillance Epidemiology and End Results (SEER) database linked to Medicare claims. We considered patients age ≥ 67 years with MGAM diagnosed from 1994-2005. We excluded those who were diagnosed by autopsy or death certificate only, had invasive cancers within 5 years prior to MGAM diagnosis, prior diagnosis of MGAM, lacked date of either diagnosis or death, lacked complete Medicare parts A/B coverage 15 months prior to or 3 months after MGAM diagnosis (or to date of death, if death was within 3 months), and receiving dialysis more than 3 months before MGAM diagnosis. Major complications including acute kidney injury, cord compression, dialysis-requirement, fracture, and hypercalcemia at time of disease progression were obtained from diagnosis and procedure claims. MGUS follow-up was defined as having a diagnosis claim 4-15 months prior to smoldering MGAM diagnosis. Smoldering MGAM was defined as absence of all of the following criteria: any major complication claims, any treatment claims, and death because of MGAM within 12 months of MGAM diagnosis, while progression to active MGAM was defined by the presence of any of these criteria. Results At the time of MGAM diagnosis 2,189 had smoldering disease. Of these, 1,753 (80.1%) progressed to active MGAM with a median time-to-progression of 17 months. Progression to active MGAM were identified by claims reflecting the development of major cancer complications (34.9%), administration of cancer therapy (59.5%), both (0.7%), or report of death from MGAM without major complication or treatment claims (4.9%). The cumulative probability of progression by Kaplan-Meier analysis was 40.2%, 72.9%, 85.7%, and 96.1%, at years 1, 3, 5, and 10, respectively. Among those who progressed, 35.6% developed one or more major complications including acute kidney injury (13.0%), cord compression (1.8%), dialysis-requirement (2.0%), fracture (15.6%), and hypercalcemia (5.6%). A prior MGUS follow-up occurred in 199 (9.1%) smoldering MGAM patients. The time to progression for smoldering MGAM patients with a prior MGUS follow-up was similar to those without MGUS follow-up (P = 0.52). Multivariable analysis factoring in year of smoldering MGAM diagnosis, type of cancer, age, sex, race, place of residence, SEER site, median annual household income, Charlson co-morbidity index, and prior MGUS follow-up showed that older age, higher Charlson co-morbidity scores, and diagnosis of multiple myeloma as independent predictors of progression (Table). Conclusions Our population-based study shows that most patients with smoldering MGAM diagnosed at age ≥ 67 years progress to active disease within the first three years. Those with a prior history of MGUS follow-up progress at a similar rate compared to those without such a history. The determinants of progression at diagnosis are age, number of co-morbidities, and type of MGAM. Disclosures: No relevant conflicts of interest to declare.