Volume-checking tool

Tool, consisting of a graduated storage vessel and a control panel, can determine the amount of gas entrained by fluid in a closed system, the amount of fluid remaining in a dried system of known volume, or the volume of a container of unknown size

The Pattern of Odontogenic Referred Pain

Background: Referred odontogenic pain (RP) is a phenomenon that is seen regularly in dentistry and it is not extensively understood. It can make formulating a proper diagnosis difficult and its presence can lead to inappropriate treatment. Methods: 250 patients experiencing odontogenic pain within the dental clinics of West Virginia University were surveyed. The survey inquired about the patient’s biographical information, medical history, characteristics of the pain, the presence and location of RP, and the psychosocial effects of the pain. Additionally, the endodontic diagnosis of the offending tooth was determined by a member of the endodontic department. The collected data was then statistically analyzed via chi-square test, binary logistic regression, t-test, and ANOVA. Results: Statistically significant associations were developed with the presence of RP and a diagnosis of irreversible pulpitis (IP), as compared with pulp necrosis (PN), and the female gender, as compared with the male gender. Overall, 45.6% (114/250) of subjects experienced RP. Among those with RP, 68.4% had a pulpal diagnosis of IP and 30.7% had a pulpal diagnosis of PN. Subjects with RP reported an increased effect on their activity, sleep, mood, and stress on a DVPRS pain scale. Female subjects also reported an increased effect on activity, mood, and stress. Heat maps were generated for each tooth sextant. Conclusions: RP is more often associated with a diagnosis of IP and the female gender (as opposed to PN and the male gender, respectively). Increased psychosocial effects were found in subjects experiencing RP

Determining appropriateness for rehabilitation or other subacute care: is there a role for utilisation review?

BACKGROUND: Rehabilitation and other forms of subacute care play an important role in the Australian health care system, yet there is ambiguity around clinical definitions of subacute care, how it differs from acute care, where it is best done and what resources are required. This leads to inconsistent and often poorly defined patient selection criteria as well as a lack of research into efficient models of care. METHODS: A literature review on the potential role of utilisation review in defining levels of care and in facilitating appropriate care, with a focus on the interface between acute care and rehabilitation. RESULTS: In studies using standardised utilisation review tools there is consistent reporting of high levels of 'inappropriate' bed days in acute care settings. These inappropriate bed days include both inappropriate admissions to acute care and inappropriate continuing days of stay. While predominantly an instrument of payers in the United States, concurrent utilisation review programs have also been used outside of the US, where they help in the facilitation of appropriate care. Some utilisation review tools also have specific criteria for determining patient appropriateness for rehabilitation and other subacute care. CONCLUSION: The high levels of 'inappropriate' care demonstrated repeatedly in international studies using formal programs of utilisation review should not be ignored in Australia. Utilisation review tools, while predominantly developed in the US, may complement other Australian patient flow initiatives to improve efficiency while maintaining patient safety. They could also play a role in the identification of patients who may benefit from transfer from acute care to another type of care and thus be an adjunct to physician assessment. Testing of the available utilisation review tools in the Australian context is now required

Forecasting the Response of Earth’s Surface to Future Climatic and Land Use Changes: A Review of Methods and Research Needs

In the future, Earth will be warmer, precipitation events will be more extreme, global mean sea level will rise, and many arid and semiarid regions will be drier. Human modifications of landscapes will also occur at an accelerated rate as developed areas increase in size and population density. We now have gridded global forecasts, being continually improved, of the climatic and land use changes (C&LUC) that are likely to occur in the coming decades. However, besides a few exceptions, consensus forecasts do not exist for how these C&LUC will likely impact Earth-surface processes and hazards. In some cases, we have the tools to forecast the geomorphic responses to likely future C&LUC. Fully exploiting these models and utilizing these tools will require close collaboration among Earth-surface scientists and Earth-system modelers. This paper assesses the state-of-the-art tools and data that are being used or could be used to forecast changes in the state of Earth’s surface as a result of likely future C&LUC. We also propose strategies for filling key knowledge gaps, emphasizing where additional basic research and/or collaboration across disciplines are necessary. The main body of the paper addresses cross-cutting issues, including the importance of nonlinear/threshold-dominated interactions among topography, vegetation, and sediment transport, as well as the importance of alternate stable states and extreme, rare events for understanding and forecasting Earth-surface response to C&LUC. Five supplements delve into different scales or process zones (global-scale assessments and fluvial, aeolian, glacial/periglacial, and coastal process zones) in detail

Data gaps in electronic health record (EHR) systems: An audit of problem list completeness during the COVID-19 pandemic

OBJECTIVE: To evaluate the completeness of diagnosis recording in problem lists in a hospital electronic health record (EHR) system during the COVID-19 pandemic. DESIGN: Retrospective chart review with manual review of free text electronic case notes. SETTING: Major teaching hospital trust in London, one year after the launch of a comprehensive EHR system (Epic), during the first peak of the COVID-19 pandemic in the UK. PARTICIPANTS: 516 patients with suspected or confirmed COVID-19. MAIN OUTCOME MEASURES: Percentage of diagnoses already included in the structured problem list. RESULTS: Prior to review, these patients had a combined total of 2841 diagnoses recorded in their EHR problem lists. 1722 additional diagnoses were identified, increasing the mean number of recorded problems per patient from 5.51 to 8.84. The overall percentage of diagnoses originally included in the problem list was 62.3% (2841 / 4563, 95% confidence interval 60.8%, 63.7%). CONCLUSIONS: Diagnoses and other clinical information stored in a structured way in electronic health records is extremely useful for supporting clinical decisions, improving patient care and enabling better research. However, recording of medical diagnoses on the structured problem list for inpatients is incomplete, with almost 40% of important diagnoses mentioned only in the free text notes

Arts on prescription for community‐dwelling older people with a range of health and wellness needs

Published evidence for the role of participatory art in supporting health and well‐being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community‐dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8–10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre‐ and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. We found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick–Edinburgh Mental Well‐being Scale(WEMWBS) as well as a statistically significant increase in the level of self‐reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs

Cost Models for mHealth Intervention in Aged Care Diabetes Management

Governments across the globe are facing the challenges posed by ageing population. Diabetes is one of the leading causes of disease burden to the economies. A proactive management of diabetes for the elderly can offer benefits to all the stakeholders. Mobile Health (mHealth) can play a vital role to tackle the complexities associated with aged people who are living independently. While there have been several pilot studies of mHealth interventions in diabetes management, they have not made inroads into operational reality. The significant factors appear to be lack of comprehensive cost models and business case for mHealth interventions. The paper reviews some of the related research work and argues for the development of cost models for mHealth interventions in aged care diabetes management. It also presents the work-in-progress of creation of cost models and envisages that such a development will help the operational adoption of mHealth benefiting all the stakeholders

Rugby sevens match demands and measurement of performance: A review

© 2018, University of Zagreb - Faculty of Kinesiology. All rights reserved. The purpose of this review is to summarize the research that has examined the match demands of elite-level, men’s rugby sevens, and provide enhanced understanding of the elements contributing to successful physical and technical performance. Forty-one studies were sourced from the electronic database of PubMed, Google Scholar and SPORTDiscus. From these, twelve original investigations were included in this review. Positive match outcomes are the result of an interplay of successful physical, technical, and tactical performances. The physical performance of players (activity profile measurement from GPS) includes high relative total distance and high-speed distance values in comparison to other team sports. The technical performance of players (skill involvement measurement from match statistics) involves the execution of a range of specific offensive and defensive skills to score points or prevent the opponent from scoring. The factors influencing change in these performance constructs has not been investigated in rugby sevens. There is a paucity in the literature surrounding the situational and individual factors affecting physical and skill performance in elite rugby sevens competition. Future studies should investigate the factors likely to have the strongest influence on player performance in rugby sevens. This should include larger sample sizes and account for repeated measures within players. This will allow coaches and scientists to improve their interpretation of activity and skill profile data, and make more informed decisions on players’ athletic preparation program