Skip header and navigation

Refine By

26 records – page 1 of 3.

The analysis of risks and potential benefits in research.

https://arctichealth.org/en/permalink/ahliterature177439
Source
NCEHR Commun. 1999 Spring-Fall;9(2):16-20
Publication Type
Article
Author
C. Weijer
Author Affiliation
Dalhousie University, Canada.
Source
NCEHR Commun. 1999 Spring-Fall;9(2):16-20
Language
English
Publication Type
Article
Keywords
Canada
Guidelines as Topic
Human Experimentation - ethics - standards
Humans
Risk Assessment - standards
PubMed ID
15540383 View in PubMed
Less detail
Source
Can Nurse. 2005 Oct;101(8):25-9
Publication Type
Article
Date
Oct-2005
Author
Susan Bisaillon
Linda Kelloway
Kathryn LeBlanc
Nicole Pageau
Nadia Woloshyn
Author Affiliation
Neuroscience/Musculoskeletal Health System, Trillium Health Centre, Mississauga, Ontario.
Source
Can Nurse. 2005 Oct;101(8):25-9
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Benchmarking - organization & administration
Continuity of Patient Care - organization & administration
Deglutition Disorders - diagnosis - etiology
Emergency Treatment - nursing - standards
Focus Groups
Health Services Accessibility - standards
Hospitals, Community - organization & administration
Humans
Mass Screening - standards
Nursing Assessment - standards
Nursing Audit
Nursing Evaluation Research
Ontario
Organizational Objectives
Outcome and Process Assessment (Health Care) - organization & administration
Program Evaluation
Regional Medical Programs - organization & administration
Risk Assessment - standards
Stroke - complications - diagnosis - therapy
Time Factors
Tissue Plasminogen Activator - therapeutic use
Total Quality Management - organization & administration
Triage - standards
Abstract
In 2001, the Ontario Ministry of Health and Long-Term Care introduced the Ontario Stroke Strategy by designating regional stroke centres across the province. The primary role of these centres is to coordinate stroke care within the region and across the care continuum in keeping with best practices. Concurrently, Trillium Health Centre was identifying best practice projects to support its ongoing quest for excellence. With Trillium designated as a regional stroke centre, acute ischemic stroke care was an obvious choice for a best practice project. The aim of the project was to improve access to care and quality of care for stroke patients from emergency through acute care to in-patient rehabilitation. The team chose the rapid cycle change methodology. This approach to quality improvement advocates the testing of a series of small changes (i.e., process improvement ideas) in tandem with measurements to assess the impact of the change to drive further process improvements. The project was deemed a success, resulting in significant improvements in the timeliness and quality of care.
PubMed ID
16295364 View in PubMed
Less detail

Community-dwelling seniors who present to the emergency department with a fall do not receive Guideline care and their fall risk profile worsens significantly: a 6-month prospective study.

https://arctichealth.org/en/permalink/ahliterature170626
Source
Osteoporos Int. 2006;17(5):672-83
Publication Type
Article
Date
2006
Author
A E Salter
K M Khan
M G Donaldson
J C Davis
J. Buchanan
R B Abu-Laban
W L Cook
S R Lord
H A McKay
Author Affiliation
UBC Bone Health Research Group, Centre for Hip Health, Department of Orthopaedics, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, B.C., Canada.
Source
Osteoporos Int. 2006;17(5):672-83
Date
2006
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control - statistics & numerical data
Aged
Algorithms
British Columbia - epidemiology
Female
Geriatric Assessment
Guidelines as Topic
Humans
Male
Prospective Studies
Risk Assessment - standards
Risk factors
Abstract
Fall risk is a major contributor to fracture risk; implementing fall reduction programmes remains a challenge for health professionals and policy-makers.
We aimed to (1) ascertain whether the care received by 54 older adults after an emergency department (ED) fall presentation met internationally recommended 'Guideline Care', and (2) prospectively evaluate this cohort's 6-month change in fall risk profile. Participants were men and women aged 70 years or older who were discharged back into the community after presenting to an urban university tertiary-care hospital emergency department with a fall-related complaint. American Geriatric Society (AGS) guideline care was documented by post-presentation emergency department chart examination, daily patient diary of falls submitted monthly, patient interview and physician reconciliation where needed. Both at study entry and at a 6-month followup, we measured participants physiological characteristics by Lord's Physiological Profile Assessment (PPA), functional status, balance confidence, depression, physical activity and other factors.
We found that only 2 of 54 (3.7%) of the fallers who presented to the ED received care consistent with AGS Guidelines. Baseline physiological fall risk scores classified the study population at a 1.7 SD higher risk than a 65-year-old comparison group, and during the 6-month followup period the mean fall-risk score increased significantly (i.e. greater risk of falls) (1.7+/-1.6 versus 2.2+/-1.6, p=0.000; 29.5% greater risk of falls). Also, functional ability [100 (15) versus 95 (25), p=0.002], balance confidence [82.5 (44.4) versus 71.3 (58.7), p=0.000] and depression [0 (2) versus 0 (3), p=0.000] all worsened over 6 months. Within 6 months of the index ED visit, five participants had suffered six fall-related fractures.
We conclude that this group of community-dwelling fallers, who presented for ED care with a clinical profile suggesting a high risk of further falls and fracture, did not receive Guideline care and worsened in their fall risk profile by 29.5%. This gap in care, at least in one centre, suggests further investigation into alternative approaches to delivering Guideline standard health service.
PubMed ID
16491323 View in PubMed
Less detail

Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis.

https://arctichealth.org/en/permalink/ahliterature156689
Source
BMC Med Imaging. 2008;8:12
Publication Type
Article
Date
2008
Author
Ulfin Rethnam
Rajam Yesupalan
Giri Gandham
Author Affiliation
Department of Orthopaedics, Glan Clwyd Hospital, Bodelwyddan, UK. ulfinr@yahoo.com
Source
BMC Med Imaging. 2008;8:12
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada - epidemiology
Cervical Vertebrae - radiography
Comorbidity
Critical Care - statistics & numerical data
Decision Support Techniques
Female
Humans
Male
Neck Injuries - epidemiology - radiography
Patient Selection
Reproducibility of Results
Retrospective Studies
Risk Assessment - standards - statistics & numerical data
Risk factors
Sensitivity and specificity
Spinal Injuries - epidemiology - radiography
Wounds, Nonpenetrating - epidemiology - radiography
Abstract
A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries.
This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed.
28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4%) would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied.
Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.
Notes
Cites: JAMA. 2001 Oct 17;286(15):1841-811597285
Cites: N Engl J Med. 2003 Dec 25;349(26):2510-814695411
Cites: Emerg Med Clin North Am. 1985 Aug;3(3):437-463926451
Cites: Ann Emerg Med. 1986 Jan;15(1):44-93942356
Cites: J Emerg Med. 1990 Mar-Apr;8(2):177-822362120
Cites: J Trauma. 1993 Mar;34(3):342-68483172
Cites: J Emerg Med. 2005 Feb;28(2):127-3115707805
Cites: J Trauma. 1988 Jun;28(6):784-83385821
Cites: Radiology. 1989 Mar;170(3 Pt 1):831-42492671
Cites: Am J Surg. 1986 Dec;152(6):643-83789288
PubMed ID
18557998 View in PubMed
Less detail

[Guidelines for the assessment of regional factors of the urban populations' exposure]

https://arctichealth.org/en/permalink/ahliterature84973
Source
Gig Sanit. 2007 Sep-Oct;(5):20-4
Publication Type
Article
Author
Shashina T A
Novikov S M
Matsiuk A V
Lando N G
Source
Gig Sanit. 2007 Sep-Oct;(5):20-4
Language
Russian
Publication Type
Article
Keywords
Environmental Exposure - adverse effects
Environmental Health - organization & administration
Guidelines as Topic
Humans
Risk Assessment - standards
Risk factors
Russia
Urban Health - standards
Urban Population
Abstract
The paper presents guidelines for assessing regional exposure factors (EFs) according to the results of a questionnaire survey of about two thousand persons, including urban workers and/or adult students of the Central Federal District (CFD) and Siberian Federal District (SFD) of Russia. It has been ascertained that in CFD, annual exposure (324 days/year) is less than the standard value defaulted in Guidelines P 2.1.10.1920-04 (350 days/year), which causes a reduction in the chronic average daily dose. Town-dwellers spend the bulk of a day indoors (86 and 87% in CFD and SFD, respectively); 8 and 3% of a day on transport in CFD and SFD, and 7 and 10% indoors in these districts. The findings are in agreement with the data obtained by Russian and foreign investigators and suggest that the daily distribution of a microenvironmental load should be taken into account when health exposures and risks are estimated. The average daily tap water consumption in CFD (2.2 l/day) and SFD (1.7 l/day) is close to 90% percentile of the values recommended by the U.S. EPA (2.4 l/day) and the WHO or less than the value used in the calculation of the Russian maximum permissible concentrations for water (3.0 l/day). The time spent on water procedures by town-dwellers is 36.4 min/day in CFD and 37.6 min/day in SFD (while 29.2 min/day in rural dwellers in SFD) with the standard value of 30 min/day. The findings suggest that the use of the regional values of water-associated EFs increases the chronic average daily dose and therefore a risk upon oral, dermal, and inhalational exposure. The regional features of FEs have been kept in mind on assessing the risk upon multienvironmental exposures to the characteristic components of emission caused by aluminum works in CFD.
PubMed ID
18062010 View in PubMed
Less detail

Implementing the European Renal Best Practice Guidelines suggests that prediction equations work well to differentiate risk of end-stage renal disease vs. death in older patients with low estimated glomerular filtration rate.

https://arctichealth.org/en/permalink/ahliterature310293
Source
Kidney Int. 2019 09; 96(3):728-737
Publication Type
Journal Article
Date
09-2019
Author
Stein I Hallan
Dena E Rifkin
O Alison Potok
Ronit Katz
Knut A Langlo
Nisha Bansal
Joachim H Ix
Author Affiliation
Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Nephrology, St. Olav Hospital, Trondheim, Norway. Electronic address: stein.hallan@ntnu.no.
Source
Kidney Int. 2019 09; 96(3):728-737
Date
09-2019
Language
English
Publication Type
Journal Article
Keywords
Age Factors
Aged
Aged, 80 and over
Clinical Decision-Making
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Kidney Failure, Chronic - epidemiology - physiopathology - prevention & control
Male
Models, Biological
Norway - epidemiology
Patient Selection
Practice Guidelines as Topic
Renal Insufficiency, Chronic - mortality - pathology - physiopathology - therapy
Renal Replacement Therapy - standards
Risk Assessment - standards
Risk factors
Abstract
Recent European guidelines suggest using the kidney failure risk equation (KFRE) and mortality risk equation for kidney disease (MREK) to guide decisions on whether elderly patients with chronic kidney disease should be referred early for dialysis preparation. However, the concurrent use of the two risk equations has not been validated. To do so we evaluated 1,188 individuals over five years with estimated glomerular filtration rate (eGFR) under 45ml/min/1.73m2 and age over 65 years from the Norwegian population based HUNT study. Forty-two patients started renal replacement therapy and 462 died as their first clinical event. The KFRE was well calibrated (mean risk estimate 4.9% vs observed 3.5%) with high diagnostic accuracy (C-statistics 0.93). The MREK underestimated death risk in those with lower risk (mean risk estimate 30.1% vs observed 38.9%) and had moderate diagnostic accuracy (C-statistics 0.71). Only 31 individuals had estimated end stage kidney disease (ESRD) risk greater than death risk, and most experienced ESRD before death. Only two of 598 patients over 80 years old, and ten of 1,063 with eGFR 25-45ml/min/1.73m2 at baseline experienced ESRD. Decision curve analysis demonstrated that for risk adverse patients, deferring ESRD preparation may be appropriate until predicted ESRD risk exceeds predicted death risk. For those preferring a more aggressive approach, referral when eGFR is under 25 ml/min/1.73m2 may be beneficial if age remains under 80 years. Thus, the risk of ESRD is low compared to the risk of death in many older patients with chronic kidney disease stage 3b or worse, and combination of predicted ESRD and death risks, eGFR levels, age, and the patient`s valuations of harm and benefit can be helpful for deciding when to start dialysis preparations.
PubMed ID
31301887 View in PubMed
Less detail

Metal uptake by homegrown vegetables - the relative importance in human health risk assessments at contaminated sites.

https://arctichealth.org/en/permalink/ahliterature263763
Source
Environ Res. 2015 Apr;138:181-90
Publication Type
Article
Date
Apr-2015
Author
Anna L M Augustsson
Terese E Uddh-Söderberg
K Johan Hogmalm
Monika E M Filipsson
Source
Environ Res. 2015 Apr;138:181-90
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Cadmium - analysis - metabolism
Environmental Exposure
Environmental monitoring
Food contamination - analysis
Humans
Lead - analysis - metabolism
Lettuce - metabolism
Risk Assessment - standards
Soil Pollutants - analysis - metabolism
Solanum tuberosum - metabolism
Spectrophotometry, Atomic
Sweden
Abstract
Risk assessments of contaminated land often involve the use of generic bioconcentration factors (BCFs), which express contaminant concentrations in edible plant parts as a function of the concentration in soil, in order to assess the risks associated with consumption of homegrown vegetables. This study aimed to quantify variability in BCFs and evaluate the implications of this variability for human exposure assessments, focusing on cadmium (Cd) and lead (Pb) in lettuce and potatoes sampled around 22 contaminated glassworks sites. In addition, risks associated with measured Cd and Pb concentrations in soil and vegetable samples were characterized and a probabilistic exposure assessment was conducted to estimate the likelihood of local residents exceeding tolerable daily intakes. The results show that concentrations in vegetables were only moderately elevated despite high concentrations in soil, and most samples complied with applicable foodstuff legislation. Still, the daily intake of Cd (but not Pb) was assessed to exceed toxicological thresholds for about a fifth of the study population. Bioconcentration factors were found to vary more than indicated by previous studies, but decreasing BCFs with increasing metal concentrations in the soil can explain why the calculated exposure is only moderately affected by the choice of BCF value when generic soil guideline values are exceeded and the risk may be unacceptable.
PubMed ID
25723126 View in PubMed
Less detail

Minimal risk and its implications. Proceedings of the NCEHR National Workshop on Minimal Risk, March 31-April 1, 2000 held in Ottawa, Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature177437
Source
NCEHR Commun. 2001 Sep;11(1):15-26
Publication Type
Article
Date
Sep-2001

New approaches in human health risk assessment.

https://arctichealth.org/en/permalink/ahliterature289268
Source
Int J Circumpolar Health. 2016; 75:33845
Publication Type
Journal Article
Date
2016
Author
Khaled Abass
Anders Carlsen
Arja Rautio
Author Affiliation
Centre for Arctic Medicine, Thule Institute, University of Oulu, Oulu, Finland.
Source
Int J Circumpolar Health. 2016; 75:33845
Date
2016
Language
English
Publication Type
Journal Article
Keywords
Arctic Regions
Climate change
Environmental Exposure - prevention & control
Environmental Health - standards
Environmental Illness - prevention & control
Environmental Pollutants - adverse effects
European Union
Health status
Humans
Organic Chemicals - adverse effects
Risk Assessment - standards
Abstract
Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).
Notes
Cites: Environ Health Perspect. 2014 Feb;122(2):178-86 PMID 24345328
Cites: Environ Sci Pollut Res Int. 2014 Mar;21(6):4081-94 PMID 23990255
Cites: Environ Res. 2013 Jan;120:7-17 PMID 22999706
Cites: J Hazard Mater. 2013 Oct 15;261:1-10 PMID 23911823
Cites: Biomed Environ Sci. 2015 Sep;28(9):666-73 PMID 26464254
Cites: Environ Health Perspect. 2013 Nov-Dec;121(11-12):1292-8 PMID 24007675
Cites: Int J Hyg Environ Health. 2015 Mar;218(2):254-64 PMID 25556042
Cites: Toxicol Lett. 2014 Jan 13;224(2):300-9 PMID 24016712
Cites: J Expo Anal Environ Epidemiol. 2000 Mar-Apr;10(2):103-14 PMID 10791592
Cites: Environ Toxicol Chem. 2014 Jun;33(6):1259-70 PMID 24375779
Cites: J Toxicol Environ Health A. 2014;77(9-11):616-27 PMID 24754396
Cites: PLoS One. 2014 May 15;9(5):e97172 PMID 24831289
Cites: Environ Health Perspect. 2013 Jul;121(7):774-83 PMID 23651634
Cites: J Biochem Mol Toxicol. 2008 Sep-Oct;22(5):337-44 PMID 18972398
Cites: Environ Int. 2014 Apr;65:107-15 PMID 24486968
Cites: Environ Int. 2010 Jan;36(1):85-91 PMID 19913301
Cites: Risk Anal. 2003 Feb;23(1):107-15 PMID 12635727
Cites: Int J Circumpolar Health. 2014 Dec 05;73:25808 PMID 25491153
Cites: Environ Health Perspect. 2012 Feb;120(2):162-70 PMID 21997443
Cites: J Epidemiol. 2013 Sep 5;23(5):360-70 PMID 23933621
Cites: Can J Public Health. 2010 Jan-Feb;101(1):28-31 PMID 20364534
Cites: Int J Environ Res Public Health. 2013 Feb 07;10 (2):699-711 PMID 23435591
Cites: Am J Hum Biol. 2012 Mar-Apr;24(2):165-9 PMID 22287096
Cites: Toxicol Appl Pharmacol. 2005 May 1;204(3):216-37 PMID 15845415
Cites: Placenta. 2012 Oct;33(10 ):859-65 PMID 22892056
Cites: Br J Pharmacol. 2009 Oct;158(3):665-78 PMID 19788499
Cites: Toxicol Lett. 2014 Jan 13;224(2):290-9 PMID 23958702
Cites: Chemosphere. 2013 Apr;91(2):131-8 PMID 23260246
Cites: Food Chem Toxicol. 2013 Jul;57:161-9 PMID 23537601
PubMed ID
27974141 View in PubMed
Less detail

26 records – page 1 of 3.