227 research outputs found
Perceived-As Plaintiffs: Expanding Title VII Coverage to Discrimination Based on Erroneous Perception
Local Cinema History at Scale: Data and Methods for Comparative Exhibition Studies
34 pagesDigital tools and digitized sources have expanded our ability to research and present regional
film histories, along with the hope of conducting comparative work across both place and time.
Alongside these projects are increasing calls for more deliberate coordination of tools, methods,
and sources to create more meaningful comparisons. However, it remains difficult for
researchers to know what digital projects exist for comparative work, and the methods, points of
comparison, data structure, and sources used all considerably vary. Utilizing research data
management principles, we conducted an exploratory survey of local film exhibition digital
projects to document the current historiographic landscape, and to assess existing coverage of
geography, time, sources, data structures, metadata schema, data accessibility and
reproducibility. The dataset from the survey results can be shared by researchers to better
discover each other’s work, but also to serve as a guide to best practices going forward
Oregon Theater Project: A Dataset of Oregon Cinemas from the Silent Era
7 pagesThe Oregon Theater Project (OTP) dataset is part of an ongoing collaborative research
project by undergraduate students enrolled in successive iterations of “Exhibition &
Audiences,” a Cinema Studies course at the University of Oregon. It will be updated with
additional data each time the course is taught. The data set comprises geo/historical
data about movie theaters (cinemas) and exhibition in the state from approximately
1894 to 1929. The data is presented on a public website (https://oregontheaterproject.
uoregon.edu/) which includes maps and individual theater profiles produced by the
students. All profiles, and the underlying data, are reviewed by the course instructors
and edited as needed for clarification or accuracy. Profiles include, where available,
the theater name, address, city, state, latitude, longitude, number of seats, owner/
manager names, and a narrative description. The underlying data, shared as Excel
documents and tab-delimited spreadsheets, invites historical comparative analysis of
film exhibition practices across time and locale, both local and global
Strategies To Improve Control Of Blood A1C In Diabetics
A1c monitoring is an important aspect of controlling the health of a diabetic patient. An adult internal medicine clinic noted that the percentage of their diabetic patients who had an A1c higher than 9 or no reading within the past year exceeded the national average. As a result, operational excellence methods were implemented with the overall goal to reduce their percentage to 18% or less.
A root cause analysis identified several deficiencies to includelack of essential equipment, variations in
staff education and the absence of daily reminders.
Post KPI implementations, an overall decrease in the percentage of patients with poorly controlled diabetes was attained. Next steps include ongoing monthly reviews of patients with A1c \u3e9 or have not been seen in 12 month
Increasing Advanced Care Planning in an Ambulatory Care Setting
Maine is experiencing an increasing percentage of its population being over 65 years old. Advanced Care Planning (ACP) is an important part of this aging population medical care so those ends of life preferences are known well in advance. An adult internal medicine clinic in a large academic tertiary medical center decided to create a performance improvement project that addressed ACP with embedded workflows.
The goal of this project was to have a minimum of 40% of patients 65 or older have an Advanced Care Directive or Serious Illness Conversation documented in EPIC.
Baseline metrics demonstrated that ACP discussion rates were less than 12%. A root cause analysis demonstrated several reasons for this low percentage. Several countermeasures were instituted to include a KPI that addressed intern/resident education, daily reminders at morning huddles and email reminders that ACP should be included in pre-visit planning.
In the seven months since the start of this performance improvement project, the documented ACP discussion rate increased to 22.2%.
Next steps include continued compliance monitoring, teach providers to review ACP related reports and ongoing data vigilance
Survival Benefit for Individuals with Constitutional Mismatch Repair Deficiency Syndrome and Brain Tumors Who Undergo Surveillance Protocol. A Report from the International Replication Repair Consortium
BACKGROUND
Constitutional mismatch repair deficiency syndrome (CMMRD) is a severe cancer predisposition syndrome resulting in early onset central nervous system (CNS) and other cancers. International guidelines for surveillance exist but no study has systematically evaluated the efficacy of this protocol. METHODS
We surveyed all confirmed CMMRD patients in the International Replication Repair Deficiency Consortium. A surveillance protocol consisting of frequent biochemical, endoscopic and imaging (CNS and total body MRI) studies were employed. Survival analyses and efficacy of each method were assessed. RESULTS
Surveillance data were collected from 105 CMMRD individuals from 41 countries. Of the 193 malignant tumors, CNS malignancies were the most common (44%). The surveillance protocol uncovered 49 asymptomatic tumors including 16 glioblastomas and medulloblastomas. Five-year overall survival was 89% for tumors discovered by surveillance, and 61% for symptomatic tumors (p\u3c0.004). Similarly, 5-year survival was 82+/-11% and 24+/-6% for surveillance and non-surveillance of brain tumors (p=0.005). Yearly total body and q6 month brain MRI detected asymptomatic cancers in all but 3 symptomatic CNS gliomas. These were tumors uncovered when time between scans was \u3e6 months as per protocol. Finally, of the low grade tumors identified asymptomatically, 5 were low grade gliomas. All of the low grade gliomas, which were not resected transformed to high grade tumors at a median of 1.6 ± 0.9 years. CONCLUSION
These data support a survival benefit in CMMRD patients undergoing a surveillance protocol. Adherence to protocol and resection of lower grade lesions may improve survival for patients with CNS tumors
Preventable deaths involving opioids in England and Wales, 2013–2022: a systematic case series of coroners’ reports
Background
Opioid deaths have increased in England and Wales. Coroners’ Prevention of Future Deaths reports (PFDs) provide important insights that may enable safer use and avert harms, yet reports implicating opioids have not been synthesized. We aimed to identify opioid-related PFDs and explore coroners’ concerns to prevent future deaths.
Methods
In this systematic case series, we screened 3897 coronial PFDs dated between 01 July 2013 and 23 February 2022, obtained by web scraping the UK’s Courts and Tribunals Judiciary website. PFDs were included when an opioid was implicated in the death. Included PFDs were descriptively analysed, and content analysis was used to assess concerns reported by coroners.
Results
Opioids were involved in 219 deaths reported in PFDs (5·6% of PFDs), equating to 4418 years of life lost (median 33 years/person). Morphine (29%), methadone (23%) and diamorphine (16%) were the most common implicated opioids. Coroners most frequently raised concerns regarding systems and protocols (52%) or safety issues (15%). These concerns were most often addressed to National Health Service (NHS) organizations (51%), but response rates were low overall (47%).
Conclusions
Opioids could be used more safely if coroners’ concerns in PFDs were addressed by national organizations such as NHS bodies, government agencies and policymakers, as well as individual prescribing clinicians
Oral hormone pregnancy tests and the risks of congenital malformations: a systematic review and meta-analysis [version 2; referees: 3 approved]
Background: Oral hormone pregnancy tests (HPTs), such as Primodos, containing ethinylestradiol and high doses of norethisterone, were given to over a million women from 1958 to 1978, when Primodos was withdrawn from the market because of concerns about possible teratogenicity. We aimed to study the association between maternal exposure to oral HPTs and congenital malformations. Methods: We have performed a systematic review and meta-analysis of case-control and cohort studies that included data from pregnant women and were exposed to oral HPTs within the estimated first three months of pregnancy, if compared with a relevant control group. We used random-effects meta-analysis and assessed the quality of each study using the Newcastle–Ottawa Scale for non-randomized studies. Results: We found 16 case control studies and 10 prospective cohort studies, together including 71 330 women, of whom 4,209 were exposed to HPTs. Exposure to oral HPTs was associated with a 40% increased risk of all congenital malformations: pooled odds ratio (OR) = 1.40 (95% CI 1.18 to 1.66; P<0.0001; I2 = 0%). Exposure to HPTs was associated with an increased risk of congenital heart malformations: pooled OR = 1.89 (95% CI 1.32 to 2.72; P = 0.0006; I2=0%); nervous system malformations  OR = 2.98 (95% CI 1.32 to 6.76; P = 0.0109 I2 = 78%); gastrointestinal malformations, OR = 4.50 (95% CI 0.63 to 32.20; P = 0.13; I2 = 54%); musculoskeletal malformations, OR = 2.24 (95% CI 1.23 to 4.08; P= 0.009; I2 = 0%); the VACTERL syndrome (Vertebral defects, Anal atresia, Cardiovascular anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb defects), OR = 7.47 (95% CI 2.92 to 19.07; P < 0.0001; I2 = 0%). Conclusions: This systematic review and meta-analysis shows that use of oral HPTs in pregnancy is associated with increased risks of congenital malformations
Oral hormone pregnancy tests and the risks of congenital malformations: a systematic review and meta-analysis [version 1; referees: 2 approved]
Background: Oral hormone pregnancy tests (HPTs), such as Primodos, containing ethinylestradiol and high doses of norethisterone, were given to over a million women from 1958 to 1978, when Primodos was withdrawn from the market because of concerns about possible teratogenicity. We aimed to study the association between maternal exposure to oral HPTs and congenital malformations. Methods: We have performed a systematic review and meta-analysis of case-control and cohort studies that included data from pregnant women and were exposed to oral HPTs within the estimated first three months of pregnancy, if compared with a relevant control group. We used random-effects meta-analysis and assessed the quality of each study using the Newcastle–Ottawa Scale for non-randomized studies. Results: We found 16 case control studies and 10 prospective cohort studies, together including 71 330 women, of whom 4209 were exposed to HPTs. Exposure to oral HPTs was associated with a 40% increased risk of all congenital malformations: pooled odds ratio (OR) = 1.40 (95% CI 1.18 to 1.66; P<0.0001; I2 = 0%). Exposure to HPTs was associated with an increased risk of congenital heart malformations: pooled OR = 1.89 (95% CI 1.32 to 2.72; P = 0.0006; I2=0%); nervous system malformations  OR = 2.98 (95% CI 1.32 to 6.76; P = 0.0109 I2 = 78%); gastrointestinal malformations, OR = 4.50 (95% CI 0.63 to 32.20; P = 0.13; I2 = 54%); musculoskeletal malformations, OR = 2.24 (95% CI 1.23 to 4.08; P= 0.009; I2 = 0%); the VACTERL syndrome (Vertebral defects, Anal atresia, Cardiovascular anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb defects), OR = 7.47 (95% CI 2.92 to 19.07; P < 0.0001; I2 = 0%). Conclusions: This systematic review and meta-analysis shows that use of oral HPTs in pregnancy is associated with increased risks of congenital malformations
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