Measuring maternal mortality : an overview of opportunities and options for developing countries

Background:There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015. Methods: Since the launch of the Safe Motherhood Initiative in 1987, new opportunities for data capture have arisen and new methods have been developed, tested and used. This paper provides a pragmatic overview of these methods and the optimal measurement strategies for different developing country contexts. Results: There are significant recent advances in the measurement of maternal mortality, yet also room for further improvement, particularly in assessing the magnitude and direction of biases and their implications for different data uses. Some of the innovations in measurement provide efficient mechanisms for gathering the requisite primary data at a reasonably low cost. No method, however, has zero costs. Investment is needed in measurement strategies for maternal mortality suited to the needs and resources of a country, and which also strengthen the technical capacity to generate and use credible estimates. Conclusion: Ownership of information is necessary for it to be acted upon: what you count is what you do. Difficulties with measurement must not be allowed to discourage efforts to reduce maternal mortality. Countries must be encouraged and enabled to count maternal deaths and act.WJG is funded partially by the University of Aberdeen. OMRC is partially funded by the London School of Hygiene and Tropical Medicine. CS and SA are partially funded by Johns Hopkins University. CAZ is funded by the Health Metrics Network at the World Health Organization. WJG, OMRC, CS and SA are also partially supported through an international research program, Immpact, funded by the Bill & Melinda Gates Foundation, the Department for International Development, the European Commission and USAID

Using Biomedical Technologies to Inform Economic Modeling: Challenges and Opportunities for Improving Analysis of Environmental Policies

Advances in biomedical technology have irrevocably jarred open the black box of human decision making, offering social scientists the potential to validate, reject, refine and redefine the individual models of resource allocation that form the foundation of modern economics. In this paper we (1) provide a comprehensive overview of the biomedical methods that may be harnessed by economists and other social scientists to better understand the economic decision making process; (2) review research that utilizes these biomedical methods to illuminate fundamental aspects of the decision making process; and (3) summarize evidence from this literature concerning the basic tenants of neoclassical utility that are often invoked for positive welfare analysis of environmental policies. We conclude by raising questions about the future path of policy related research and the role biomedical technologies will play in defining that path.neuroeconomics, neuroscience, brain imaging, genetics, welfare economics, utility theory, biology, decision making, preferences, Institutional and Behavioral Economics, Research Methods/ Statistical Methods, D01, D03, D6, D87,

Data quality in European primary care research databases. Report of a workshop held in London September 2013

Primary care research databases provide a significant resource for health services and epidemiological research. However since data are recorded primarily for clinical care their suitability for research may vary widely according to the research application or recording practices of individual general practitioners. A methodological approach for characterising data quality is required. We describe a one-day workshop entitled “Towards a common protocol for measuring and monitoring data quality in European primary care research databases”. Researchers, database experts and clinicians were invited to give their perspectives on data quality and to exchange ideas on what data quality metrics should be made available to researchers. We report the main outcomes of this workshop, including a summary of the presentations and discussions and suggested way forward

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 217, March 1981

Approximately 130 reports, articles, and other documents introduced into the NASA scientific and technical information system in February 1981 are included in this bibliography. Topics include aerospace medicine and biology

Proposed methods for reviewing the outcomes of health research: the impact of funding by the UK's Arthritis Research Campaign

Background: External and internal factors are increasingly encouraging research funding bodies to demonstrate the outcomes of their research. Traditional methods of assessing research are still important, but can be merged into broader multi-dimensional categorisations of research benefits. The onus has hitherto been on public sector funding bodies, but in the UK the role of medical charities in funding research is particularly important and the Arthritis Research Campaign, the leading medical charity in its field in the UK, commissioned a study to identify the outcomes from research that it funds. This article describes the methods to be used. Methods: A case study approach will enable narratives to be told, illuminating how research funded in the early 1990s was (or was not) translated into practice. Each study will be organised using a common structure, which, with careful selection of cases, should enable cross-case analysis to illustrate the strengths of different modes and categories of research. Three main interdependent methods will be used: documentary and literature review; semi-structured interviews; and bibliometric analysis. The evaluative framework for organising the studies was previously used for assessing the benefits from health services research. Here, it has been specifically amended for a medical charity that funds a wide range of research and is concerned to develop the careers of researchers. It was further refined in three pilot studies. The framework has two main elements. First, a multi-dimensional categorisation of benefits going from the knowledge produced in peer reviewed journal articles through to the health and potential economic gain. The second element is a logic model, which, with various stages, should provide a way of organising the studies. The stock of knowledge is important: much research, especially basic, will feed into it and influence further research rather than directly lead to health gains. The cross-case analysis will look for factors associated with outcomes. Conclusions: The pilots confirmed the applicability of the methods for a full study which should assist the Arthritis Research Campaign to demonstrate the outcomes from its funding, and provide it with evidence to inform its own policies

Fiber-optic breath sensors: A comparison study

The paper presents a comparative study of three fiber optic sensors based on the fiber Bragg grating (FBG). The basic monitored parameter is the respiratory rate of the human body. Fiber-optic sensors are immune to electromagnetic interference (EMI). This fact singles them out as ideal for use in magnetic resonance environments (typically in MRI -magnetic resonance imaging) as a prediction of hyperventilation states in patients. These patient conditions arise as a result of the closed tunnel environment in MR scanners. The results (10 volunteers with written consent) were compared with the results using the conventional respiratory belt (RB) in a laboratory environment and processed using the objective Bland-Altman (B-A) method.Web of Science40635

Reliability of measuring thoracic kyphosis angle, lumbar lordosis angle and straight leg raise with an inclinometer

Licensed under the terms of the Creative Commons Attribution non-commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly citedPurpose: Several non-invasive measurement methods have been described in the literature for recording thoracic kyphosis, lumbar lordosis and straight leg raise (SLR). However, attempts to quantify the reliability of the inclinometer in these measurements are scarce. In addition, existing reliability studies within the literature were found to use small sample sizes. The aim of this investigation was to examine the intra-rater reliability of the chief investigator (SM), in order to provide clinicians with data that will allow them to better measure sagittal spinal posture and SLR. A blinded test-retest design was performed to determine the intra-rater reliability of thoracic kyphosis, lumbar lordosis and SLR when assessed using an Isomed inclinometer in normals. Methods. Thirty asymptomatic subjects were assessed on two occasions separated by a time interval of 1 hour to reduce investigator memory bias. Thoracic and lumbar measurements were recorded in a relaxed standing position using an inclinometer; SLR of the dominant leg was assessed with subjects in the supine position. Intraclass correlation coefficients (ICC), 95% confidence intervals (CI), and standard errors of measurement (SEM) were analysed to determine measurement reliability. Results. The chief investigator demonstrated excellent intra-rater reliability in the measurements of thoracic kyphosis, lumbar lordosis and SLR. ICC (2,3) values for all three variables exceeded the 0.90 threshold suggesting that the reliability of these measures are acceptable for clinical application. Conclusions. The inclinometer technique employed in this study to record thoracic kyphosis, lumbar lordosis and SLR is a reliable measurement method.Peer reviewe

Wellbeing and reproductive freedoms: assessing progress, setting agendas

Wellbeing, Rights and Reproduction Research Paper II

Impact of EHR Usability on Provider Efficiency and Patient Safety in Non-Hospital Settings

Healthcare organizations may reap benefits transitioning to electronic health records (EHRs), such as decreased healthcare costs and better care. However, severe unintended consequences from implementation and design of these systems have emerged. Poorly implemented EHR systems may endanger the integrity of clinical or administrative data. That, in turn, can lead to errors jeopardizing patient safety or quality of care. A literature review of 40 sources identified how EHR implementation and design can impact provider centric, patient centric, and outcomes. These categories provided the basis for a comprehensive EHR impact model that was evaluated in non-hospital settings through focus groups interviews