The Relationship Between Fall Rates and Fall Risk Inducing Drugs in Older Adult Patients in the Hospital Setting

The aim of this study was to analyze the risk of falls relative to the use of fall risk inducing drugs (FRIDs) among older adult patients admitted to the hospital setting. Quality improvement of nursing fall risk assessment was of special interest. To analyze this a retroactive review of fall incident reports was conducted in collaboration with the study hospital’s risk manager. Medications were correlated with injuries sustained to identify high risk FRIDs. The selected study population consisted of 166 patients over the age of 65 who fell on the acute care campus of a hospital in the mid-south region of the United States. The results demonstrated no correlation between drug classes and injury sustained from a fall. Anti-hypertensive and cardiovascular medications were found to be involved in the highest number of falls. The study was limited however by a small sample size of nurses who adequately reported fall incidents. Further studies are needed to identify relationships between medications and fall risk. Further studies are also needed to evaluate nurse compliance with incident reporting

Predicting Auditor Changes Using Financial Distress Variables And The Multiple Criteria Linear Programming (MCLP) And Other Data Mining Approaches

Our study evaluates a multiple criteria linear programming (MCLP) and other data mining approaches to predict auditor changes using a portfolio of financial statement measures to capture financial distress. The results of the MCLP approach and the other data mining approaches show that these methods perform reasonably well to predict auditor changes using financial distress variables. Overall accuracy rates are more than 60 percent, and true positive rates exceed 80 percent. Our study is designed to establish a starting point for auditor-change prediction using financial distress variables. Further research should incorporate additional explanatory variables and a longer study period to improve prediction rates

Predicting Material Weaknesses In Internal Control Systems After The Sarbanes-Oxley Act Using Multiple Criteria Linear Programming And Other Data Mining Approaches

Our study proposes a multiple criteria linear programming (MCLP) and other data mining methods to predict material weaknesses in a firm’s internal control system after the Sarbanes-Oxley Act (SOX) using 2003-2004 U.S. data.  The results of the MCLP and other data mining approaches in our prediction study show that the MCLP method performs better overall than the other data mining approaches using financial and other data from the Form 10-K report.  Consistent with prior research, firms that disclosed material weaknesses in their SOX Section 302 disclosures were more complex (based on the existence of foreign currency translations), more often used Big 4 auditors, and had lower operating cash flows-to-total assets ratios than the non-material weakness control firms.  Because of mixed results on several profitability measures and marginal predictive ability for the MCLP and other methods used, more research is needed to identify firm characteristics that help investors, auditors, and others predict material weaknesses

Predicting Auditor Changes With Financial Distress Variables: Discriminant Analysis And Problems With Data Mining Approaches

Our study extends previous research that uses financial distress factors in predicting auditor changes by evaluating the effectiveness of the traditional discriminant analysis model, not used in previous auditor change studies, and by highlighting the importance of evaluating the likelihood that data mining approach classification results occurred by chance. Significance of individual predictor variables, as well as of the full set of 13 financial variables, can be tested using discriminant analysis. Kwak et al. (2011) document overall classification accuracy rates ranging from 61 to 63.5 percent for the four data mining models they compared but did not address whether these rates occurred by chance. Using Kwak et al.’s (2011) data set of firms changing auditors in 2007 or 2008 and matching non-auditor change firms, our discriminant analysis test results show overall accuracy rates of less than 56 percent and true positive rates over 85 percent, but these rates are influenced by a disproportionate number of non-auditor change firms being classified as auditor change firms. Individual predictor variables that are important in the discriminant equation based on standardized canonical coefficients include losses (LOSS) and no payment of dividends (DIV) in the year prior to the auditor change, retained earnings as a percent of total assets (RE/TA), and earnings before interest and taxes as a percent of total assets (EBIT/TA). The Kappa statistic and AUC metrics for all 13 data mining algorithms we used indicate that classifications using these algorithms are no better than random classifications

Editorial: Advances in ecoacoustics

Presentation of a Special Issue on ecoacoustics with analysis of the contributions and of the current knowledge gaps

Developing and evaluating complex interventions: the new Medical Research Council guidance

<p><i>Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance</i></p> <p>Complex interventions are widely used in the health service, in public health practice, and in areas of social policy that have important health consequences, such as education, transport, and housing. They present various problems for evaluators, in addition to the practical and methodological difficulties that any successful evaluation must overcome. In 2000, the Medical Research Council (MRC) published a framework<sup>1</sup> to help researchers and research funders to recognise and adopt appropriate methods. The framework has been highly influential, and the accompanying BMJ paper is widely cited.<sup>2</sup> However, much valuable experience has since accumulated of both conventional and more innovative methods. This has now been incorporated in comprehensively revised and updated guidance recently released by the MRC (<a href="www.mrc.ac.uk/complexinterventionsguidance">www.mrc.ac.uk/complexinterventionsguidance</a>). In this article we summarise the issues that prompted the revision and the key messages of the new guidance. </p&gt

Treating to target in psoriatic arthritis: assessing real-world outcomes and optimising therapeutic strategy for adults with psoriatic arthritis-study protocol for the MONITOR-PsA study, a trials within cohorts study design.

BACKGROUND: The Tight Control of psoriatic arthritis (TICOPA) trial confirmed improved clinical outcomes with a treat to target (T2T) strategy in psoriatic arthritis (PsA). This consisted of 4-weekly review and escalation of 'step up' therapy (single disease modifying therapy (DMARD), combination DMARDs and then biologics) based on remission criteria. Based on this, a T2T approach is supported by European PsA treatment recommendations. However, it is not commonly implemented in routine care primarily due to feasibility and cost concerns. In the TICOPA trial, the same treatment regime was used for all participants regardless of their disease profile. Despite the recognition of PsA as a highly heterogeneous condition, no studies have tailored which drugs are used depending on disease severity. The cohort will establish real world outcomes for the T2T approach in PsA and also form the basis of a trials within cohorts (TWiCs) design to test alternative therapeutic approaches within embedded clinical trials providing an evidence base for treatment strategy in PsA. METHODS: The Multicentre Observational Initiative in Treat to target Outcomes in Psoriatic Arthritis (MONITOR-PsA) cohort will apply a T2T approach within routine care. It will recruit newly diagnosed adult patients with PsA starting systemic therapies. The cohort is observational allowing routine therapeutic care within NHS clinics but a T2T approach will be supported when monitoring treatment within the cohort. Eligible participants will be adults (≥18 years) with active PsA with ≥ 1 tender or swollen joints or enthesis who have not previously had treatment with DMARDs for articular disease. DISCUSSION: This study is the first TWiC designed to support a fully powered randomised drug trial. The results from the observational cohort will be compared with those observed in the TICOPA trial investigating the clinical effectiveness and health care costs of the pragmatic T2T approach. Nested trials will provide definitive RCT evidence establishing the optimal management of PsA within the T2T approach. The TWiCs design allows robust generalizability to routine healthcare, avoids disappointment bias, aids recruitment and in future will allow assessment of longer-term outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT03531073 . Retrospectively registered on 21 May 2018

Early-Season Avian Deaths from West Nile Virus as Warnings of Human Infection

An analysis of 2001 and 2002 West Nile virus (WNV) surveillance data shows that counties that report WNV-infected dead birds early in the transmission season are more likely to report subsequent WNV disease cases in humans than are counties that do not report early WNV-infected dead birds

The translation research in a dental setting (TRiaDS) programme protocol

Background: It is well documented that the translation of knowledge into clinical practice is a slow and haphazard process. This is no less true for dental healthcare than other types of healthcare. One common policy strategy to help promote knowledge translation is the production of clinical guidance, but it has been demonstrated that the simple publication of guidance is unlikely to optimise practice. Additional knowledge translation interventions have been shown to be effective, but effectiveness varies and much of this variation is unexplained. The need for researchers to move beyond single studies to develop a generalisable, theory based, knowledge translation framework has been identified.For dentistry in Scotland, the production of clinical guidance is the responsibility of the Scottish Dental Clinical Effectiveness Programme (SDCEP). TRiaDS (Translation Research in a Dental Setting) is a multidisciplinary research collaboration, embedded within the SDCEP guidance development process, which aims to establish a practical evaluative framework for the translation of guidance and to conduct and evaluate a programme of integrated, multi-disciplinary research to enhance the science of knowledge translation.Methods: Set in General Dental Practice the TRiaDS programmatic evaluation employs a standardised process using optimal methods and theory. For each SDCEP guidance document a diagnostic analysis is undertaken alongside the guidance development process. Information is gathered about current dental care activities. Key recommendations and their required behaviours are identified and prioritised. Stakeholder questionnaires and interviews are used to identify and elicit salient beliefs regarding potential barriers and enablers towards the key recommendations and behaviours. Where possible routinely collected data are used to measure compliance with the guidance and to inform decisions about whether a knowledge translation intervention is required. Interventions are theory based and informed by evidence gathered during the diagnostic phase and by prior published evidence. They are evaluated using a range of experimental and quasi-experimental study designs, and data collection continues beyond the end of the intervention to investigate the sustainability of an intervention effect.Discussion: The TRiaDS programmatic approach is a significant step forward towards the development of a practical, generalisable framework for knowledge translation research. The multidisciplinary composition of the TRiaDS team enables consideration of the individual, organisational and system determinants of professional behaviour change. In addition the embedding of TRiaDS within a national programme of guidance development offers a unique opportunity to inform and influence the guidance development process, and enables TRiaDS to inform dental services practitioners, policy makers and patients on how best to translate national recommendations into routine clinical activities