We have previously studied system failures involved in medication errors using a limited number of root cause analyses as source. The aim of this study was to describe a larger number of medication errors with respect to harm, involved medicines and involved system problems - thus providing information for the development of IT-based decision support. We evaluated 3,520 medication error reports derived from 12 months of consecutive reporting from 13 hospitals in the Capital Region of Denmark. We found 0.65% errors with serious harm and 16% with moderate harm. A small number of medicines were involved in the majority of the errors. The problems in the medication error process were heterogeneous. Some were related to specific medicines and others were related to the computerized order entry system. Accordingly decision support targeted at specific medicines and improved IT systems are part of the continuing work to reduce the frequency of medication errors.
A six-year prospective study of 3775 individuals, first examined in 1978, using an original mathematical program of myocardial infarction risk prognosis, is reported. The program is based on an integral assessment of 19 risk factors, each having 4 degrees of severity. The subjects were allocated to one of 3 groups, depending on the prognostic risk score. In the low coronary risk group (2068 people), there was 1 (0.048%) myocardial infarction over 6 years. There were 12 (0.76%) infarctions in the medium risk group (1569 people), and 62 (44.92%) infarctions in the high risk group (138 people). Therefore, the program is capable of identifying a limited (about 4%) population that is going to develop 80% of all myocardial infarctions within the next 5 or 6 years.
Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark; Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark; Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark; ITmedico, Aarhus, Denmark; Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark; and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
?? Spinal cord stimulation (SCS) is increasingly gaining widespread use as a treatment for chronic pain. A widely used electronic registry could play a pivotal role in improving this complex and cost-?intensive treatment. We aimed to construct a comprehensive, universally available data base for SCS.
?? The design considerations behind a new online data base for SCS are presented; basic structure, technical issues, research applications, and future perspectives are described.
?? The Aarhus Neuromodulation Database covers core SCS treatment parameters, including procedure-?related details and complications, and features recording of key success parameters such as pain intensity, work status, and quality of life. It combines easy access to patient information with exhaustive data extraction options, and it can readily be adapted and expanded to suit different needs, including other neuromodulation treatment modalities.
?? We believe that the data base described in this article offers a powerful and versatile data collection tool suited for both clinicians and researchers in the field. The basic data base structure is immediately available on a no?-cost basis, and we invite our colleagues to make use of the data base as part of the efforts to further the field of neuromodulation.
Six cereal/legume mixtures were developed with the aid of computer-assisted optimization software from cereal and legume staples indigenous to the West African sub-region. The mixtures had 45-50% maize, 35-40% decorticated cowpeas and either blanched peanuts or decorticated soybeans as a source of lipid and complementary amino acids. Three processing schemes involving roasting, amylase digestion and extrusion cooking were employed. The proportion of ingredients in each cereal/legume blend was based on meeting the nutrient requirement of the 0.5-0.9-year-old infant and cost considerations. Nutrient composition of the blends (proximate, amino acid, mineral and vitamin composition) indicated that these formulations were adequate nutritionally as weaning supplements (Mensa-Wilmot et al, 2000a,2000b). These formulations were evaluated by mothers of weanling children based on their preferences with respect to color, flavor, texture and willingness to purchase the product assessed. A total of 133 one-on-one interviews and 23 group discussions were conducted (involving 6-12 respondents) with selected Ghanaian women. The mothers found the convenience of a weaning food made from local staples that could be processed on village/market scale very attractive.
Assessment of image analysis methods and computer software used in (99m) Tc-MAG3 dynamic renography is important to ensure reliable study results and ultimately the best possible care for patients. In this work, we present a national multicentre study of the quantification accuracy in (99m) Tc-MAG3 renography, utilizing virtual dynamic scintigraphic data obtained by Monte Carlo-simulated scintillation camera imaging of digital phantoms with time-varying activity distributions. Three digital phantom studies were distributed to the participating departments, and quantitative evaluation was performed with standard clinical software according to local routines. The differential renal function (DRF) and time to maximum renal activity (Tmax ) were reported by 21 of the 28 Swedish departments performing (99m) Tc-MAG3 studies as of 2012. The reported DRF estimates showed a significantly lower precision for the phantom with impaired renal uptake than for the phantom with normal uptake. The Tmax estimates showed a similar trend, but the difference was only significant for the right kidney. There was a significant bias in the measured DRF for all phantoms caused by different positions of the left and right kidney in the anterior-posterior direction. In conclusion, this study shows that virtual scintigraphic studies are applicable for quality assurance and that there is a considerable uncertainty associated with standard quantitative parameters in dynamic (99m) Tc-MAG3 renography, especially for patients with impaired renal function.
Existing methods for estimating historical effective population size from genetic data have been unable to accurately estimate effective population size during the most recent past. We present a non-parametric method for accurately estimating recent effective population size by using inferred long segments of identity by descent (IBD). We found that inferred segments of IBD contain information about effective population size from around 4 generations to around 50 generations ago for SNP array data and to over 200 generations ago for sequence data. In human populations that we examined, the estimates of effective size were approximately one-third of the census size. We estimate the effective population size of European-ancestry individuals in the UK four generations ago to be eight million and the effective population size of Finland four generations ago to be 0.7 million. Our method is implemented in the open-source IBDNe software package.
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Cites: Proc Biol Sci. 2013 Oct 7;280(1768):2013133923926150
Cites: Am J Hum Genet. 2013 Nov 7;93(5):840-5124207118
[A computing laboratory-clinical system in the screening of malignant tumors: study of the state of the antioxidant system and level of cellular proliferation markers among the population from the Chernobyl AES accident area]
The author bases and describes the computing laboratory and clinical system for screening groups at a higher risk for malignant neoplasms whose incidence is likely to increase due to irradiation. Two years after the disaster the detected group at a higher risk was 2-2.4 times larger than the control group among persons who received the total irradiation dose 5 rem and over as well as among persons who are to be removed from the area polluted with radionuclides whatever the dose. As the time elapsed since the disaster increases, the number of subjects with a higher level of biomarkers also grows. It is advisable that this system be introduced in all fields of the practical health care in the polluted and control areas to carry out goal-oriented treatment and diagnostic measures in the selected population groups.
A non-sequential Bayesian program for diagnosing acute abdominal pain was developed using an Amdahl mainframe accessed by a Texas Instrument remote terminal. Transferring the program to a MacIntosh SE/30 using hypercard was attended by increased utilisation from 15 to 44%.
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The article substantiate the necessity to improve the automatization of the information process in the system of medical support in extreme situations and thus to liquidate the disproportion between the medico-diagnostical and information accumulation storage facilities. These facts clearly define the importance of work which is being carried out by Medical Service towards an elaboration of the "Disaster Medicine" automated information retrieval system (AIRS). The data obtained as a result of AIRS processing could be directly used for reference or prediction purposes.