A protocol improves GP recording of long-term sickness absence risk factors

Background If general practitioners (GPs) were better informed about patients' risks of long-term sickness absence (LTSA), they could incorporate these risk assessments into their patient management plans and cooperate more with occupational physicians to prevent LTSA. Aim To evaluate the effectiveness of a protocol helping GPs in recording risks of LTSA and in co-operating with occupational physicians (OPs). Methods Twenty-six GPs (co-operating in four groups) in Amsterdam, The Netherlands, participated in a controlled intervention study. Fourteen GPs were the protocol-supported intervention group and twelve GPs were the reference group. Outcome measures were consultations containing work-related information, information about two risk factors for LTSA, referrals to OPs and contacts of OPs with GPs and patients. Outcomes were identified through an electronic search in the GPs' information systems. Entries containing information were independently scored by two investigators. The proportions of patients with consultations documenting LTSA-pertinent items were compared between the groups, accounting for differences at baseline. Results There was no increase in consultations containing work-related information. Recording of risk factor information increased in the intervention group; the difference was 4.5% [95% CI 1.5-7.6] and 1.8% (95% CI −0.8 to 4.4) for the two risk factors. The referral rate to the OP increased by 2.9% (95% CI 1.2-4.5). There was no effect on contacts of OPs with GPs or with patients. Conclusion Protocol-supported consultations may lead to a modest increase in information regarding two risk factors for LTSA in GPs' electronic records and to more referrals to OP

Clinical history in management of suspected syncope: A powerful diagnostic tool

In this paper, the role of history taking as a diagnostic tool in patients with transient loss of consciousness (TLOC) is addressed. From a literature review it can be demonstrated that, if properly performed, the history is a powerful diagnostic tool, which in the majority of cases proves to be the only ‘test’ necessary to establish a diagnosis other than physical examination and electrocardiogram in patients with TLOC. In order to substantiate this conclusion, we examine the different levels of history taking according to the skills and training of the physician involved, the diagnostic yield of each level, the methodology, and the influence of the venue and urgency of the case

Quantified Self: Groningen zet stappen

Of het nu gaat om het kwantitatief in kaart brengen van het beweeggedrag van een groep kinderen, het overbrengen van kennis over lichaamsbeweging of het creëren van bewustwording over gezond beweeggedrag, er liggen tal van kansen om met nieuwe technologie het vak bewegingsonderwijs te verrijken. In dit artikel is beschreven op welke wijze het project 'Groningen zet stappen' dit in de praktijk heeft toegepast

Quantification of the influence of external vibrations on the measurement error of a coriolis mass-flow meter

In this paper the influence of external vibrations on the measurement value of a Coriolis mass-flow meter (CMFM) for low flows is investigated and quantified. Model results are compared with experimental results to improve the knowledge on how external vibrations affect the mass-flow measurement value. A flexible multi-body model is built and the working principle of a CMFM is explained. Some special properties of the model are evaluated to get insight into the dynamic behaviour of the CMFM. Using the model, the transfer functions between external vibrations (e.g. floor vibrations) and the flow error are derived. The external vibrations are characterised with a PSD. Integrating the squared transfer function times the PSD over the whole frequency range results in an RMS flow error estimate. In an experiment predefined vibrations are applied on the casing of the CMFM and the error is determined. The experimental results show that the transfer functions and the estimated measurement error correspond with the model results. The agreement between model and measurements implies that the influence of external vibrations on the measurement is fully understood. This result can be applied in two ways; firstly that the influence of any external vibration spectrum on the flow error can be estimated and secondly that the performance of different CMFM designs can be compared and optimised by shaping their respective transfer function