Comparison of two methods of collecting healthcare usage data in chiropractic clinics: patient-report versus documentation in patient files

The use of patient-reported questionnaires to collect information on costs associated with routine healthcare services, such as chiropractic, represents a less labour intensive alternative to retrieving these data from patient files. The aim of this paper was to compare patient-report versus patient files for the collection of data describing healthcare usage in chiropractic clinics.As part of a prospective single cohort multi-centre study, data on the number of visits made to chiropractic clinics determined using patient-reported questionnaires or as recorded in patient files were compared three months following the start of treatment. These data were analysed for agreement using the Intraclass Correlation Coefficient (ICC) and the 95% Limits of Agreement.Eighty-nine patients that had undergone chiropractic care were included in the present study. The two methods yielded an ICC of 0.83 (95% CI = 0.75 to 0.88). However, there was a significant difference between the data collection methods, with an average of 0.6 (95% CI = 0.25 to 1.01) additional visits reported in patient files. The 95% Limits of Agreement ranged from 3 fewer visits to 4 additional visits in patient files relative to the number of visits recalled by patients.There was some discrepancy between the number of visits made to the clinic recalled by patients compared to the number recorded in patient files. This should be taken into account in future evaluations of costs of treatments

Houses of stories: the whale rider at the American Museum of Natural History

In April 2013, fifteen members of the Māori tribal arts group Toi Hauiti travelled to New York to reconnect with their carved wooden ancestor figure, Paikea, at the American Museum of Natural History (AMNH). They gave educational presentations  to school groups, museum staff and members of the public about Paikea and the whare kōrero , or house of stories, which Paikea had adorned as a gable figure.Through a discussion anchored in the importance of taonga (ancestral treasures), this paper describes embodied forms of knowledge used by Paikea’s descendants to know him in his absence, and introduce him to diverse audiences. Its foci are: museum education in multicultural contexts; learning by doing through the use of interactive activities; and community outreach and museum education. In addition, it discusses the challenges to protocols and opportunities for learning offered to AMNH staff through this engagement, and examines the impact it had son Toi Hauiti members themselves

Sage-grouse (Centrocercus urophasianus) Habitat in Central Montana

Greater sage-grouse (Centrocercus urophasianus) habitat was studied in central Montana primarily on Wyoming big sagebrush (Artemisia tridentata Nutt. ssp. wyomingensis Beetle and Young) dominated rangeland. The primary objective was to compare shrub and herbaceous parameters within (use, random or non-use) and between seasonal habitats (nest, brood, winter). Two study sites (Musselshell and Golden Valley counties), and 2 years (2004 and 2005) were compared. Nest, brood, and random sites were compared for herbaceous cover, and grass height. Nest, brood, random, winter use and winter non-use sites were evaluated for shrub cover, density, and height. All differences were considered significant at P ≤ 0.05. Sage-grouse nested in areas with greater total shrub cover and height, and taller live and residual grass than was randomly available. No differences were found between brood and paired random sites for any of the herbaceous or shrub parameters measured. Shrub cover and density were greater at winter use sites than non-use sites. Winter use sites had less shrub cover than nest sites. The nest and brood habitat had similar shrub cover, density, and height on the study area. Sage-grouse habitats should be managed to include sagebrush, forbs, and grass. Herbaceous vegetation was more important during nesting and brood rearing than during the winter. Therefore, some portions of grouse habitat may benefit from management for greater herbaceous cover, but never at the sake of less sagebrush. Sagebrush cover from 10 percent to 30 percent was the most consistent component of sage-grouse habita

A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D

Background: It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods: Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results: There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion: The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions

A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D

Background: It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods: Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results: There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion: The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions

Interactive versus Passive Distraction and Parent Psychoeducation as pain management techniques during pediatric venepuncture: A Randomized Controlled Trial

Objectives The aim of this research was twofold: to explore 1) the efficacy of active vs. passive distraction on self-reported pain and distress of children during a venepuncture; and 2) the impact ofparental psychoeducation on child and parent outcomes, parental knowledge of distraction procedures and parental engagement in effective pain management strategies.  Methods This cross-sectional study included 213 children scheduled for a venepuncture, and one of their parents, who were randomly allocated to one of four conditions; interactive distraction, passive distraction, interactive distraction with parent psychoeducation and passive distraction with parent psychoeducation. ANCOVA’s were used to investigate the impact of distraction type and the use of parent psychoeducation on child and parent pain related outcome variables.  Results Statistical analyses revealed no significant differences between groups for child-reported pain and distress. Parents who received parent psychoeducation had a significantly higher level of knowledge than parents who did not receive psychoeducation, but did not engage in more effective pain management behaviour.  Conclusions The results indicated that passive vs. active distraction does not have a significantly different influence on child pain-related outcome variables. In addition, while psychoeducation was demonstrated to be effective in increasing parental knowledge, it was not sufficient to change parental behaviour

Crossing State Lines For Collaborative Newspaper Digitization: The Gateway to Oklahoma History

This presentation discusses a collaborative project between the Oklahoma Historical Society and the University of North Texas (UNT) to digitize all of the pre-1923 newspapers in the Oklahoma Historical Society's collection. The project involved building The Gateway to Oklahoma History, which allows easy access to newspapers for students, researchers, and journalists

Mapping pneumonia research: a systematic analysis of UK investments and published outputs 1997–2013

BackgroundThe burden of pneumonia continues to be substantial, particularly among the poorest in global society. We describe here the trends for UK pneumonia R&D investment and published outputs, and correlate with 2013 global mortality.MethodsData related to awards to UK institutions for pneumonia research from 1997 to 2013 were systematically sourced and categorised by disease area and type of science. Investment was compared to mortality figures in 2010 and 2013 for pneumonia, tuberculosis and influenza. Investment was also compared to publication data.ResultsOf all infectious disease research between 2011 and 2013 (£917.0 million), £28.8 million (3.1%) was for pneumonia. This was an absolute and proportionate increase from previous time periods. Translational pneumonia research (33.3%) received increased funding compared with 1997–2010 where funding was almost entirely preclinical (87.5%, here 30.9%), but high-burden areas such as paediatrics, elderly care and antimicrobial resistance received little investment. Annual investment remains volatile; publication temporal trends show a consistent increase. When comparing investment to global burden with a novel ‘investment by mortality observed’ metric, tuberculosis (£48.36) and influenza (£484.21) receive relatively more funding than pneumonia (£43.08), despite investment for pneumonia greatly increasing in 2013 compared to 2010 (£7.39). Limitations include a lack of private sector data and the need for careful interpretation of the comparisons with burden, plus categorisation is subjective.ConclusionsThere has been a welcome increase for pneumonia funding awarded to UK institutions in 2011–2013 compared with 1997–2010, along with increases for more translational research. Published outputs relating to pneumonia rose steadily from 1997 to 2013. Investment relative to mortality for pneumonia has increased, but it remains low compared to other respiratory infections and clear inequities remain. Analyses that measure investments in pneumonia can provide an insight into funding trends and research gaps.Research in contextPneumonia continues to be a high-burden illness around the globe. This paper shows that although research funding is increasing in the UK (between 1997 and 2013), it remains poorly funded compared to other important respiratory infectious diseases such as tuberculosis and influenza. Publications about pneumonia have been steadily increasing over time, indicating continuing academic and clinical interest in the topic. Though global mortality of pneumonia is declining, it should still be an area of high priority for funders, policymakers and researchers

Developing a Culturally Proficient Intervention for Young African American Men in Drug Court: Examining Feasibility and Estimating an Effect Size for Habilitation Empowerment Accountability Therapy (HEAT)

African American males between 18 and 29 years of age are substantially less likely than many other participants to graduate successfully from drug court. Unsuccessful termination from drug court can have serious repercussions for these young men, including possible incarceration and negative collateral consequences associated with having a criminal record. This article reports preliminary results from two pilot studies that examined the feasibility of implementing a culturally proficient intervention for young African American men in drug court, and estimated an effect size for the intervention in improving treatment retention and reducing termination rates. Results confirmed that participants with serious criminal and substance use histories were willing and able to complete the lengthy 9-month curriculum, were satisfied with the intervention, and graduated from drug court at substantially higher rates than are commonly observed in this at-risk population. A sufficient basis has been established to justify the effort and expense of examining this intervention — Habilitation Empowerment Accountability Therapy (HEAT) — in fully powered randomized controlled trials