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Cataletto M.,Winthrop University | Abramson S.,National Asthma Educator Certification Board | Meyerson K.,National Asthma Educator Certification Board | Arney T.,National Asthma Educator Certification Board | And 11 more authors.
Pediatric, Allergy, Immunology, and Pulmonology

Asthma is responsible for significant healthcare costs in the United States. Although advances in pharmacology and environmental science have provided many opportunities to improve asthma control, asthma remains a major cause of missed school days, acute care visits, and hospitalizations. Patient education is a key component of asthma care. The National Asthma Educator Certification Board was established in February 2000 and charged with the mission of "promoting optimal asthma management and quality of life for individuals with asthma, their families and communities by advancing excellence in asthma education through the certified asthma educator process." This study was performed to describe the workforce of certified asthma educators (AE-Cs®) by surveying a sample of educators who completed the recertification process. AE-Cs® who had completed the recertification process were invited to participate in an anonymous online survey. Sixty five of 135 (48%) recertificants completed the survey. The primary training of respondents was in respiratory therapy (51.6%) and nursing (42.2%). Respondents were primarily female (92.3%) and Caucasian (95.4%). The majority worked in specialty care outpatient (59.3%) or hospital inpatient (40.7%) settings. Twenty percent reported an increase in job responsibilities as a result of achieving their initial certification as an AE-C®. Most AE-Cs® have their basic training in either respiratory therapy or nursing. The workforce of AE-Cs® does not reflect the racial or ethnic percentages seen in the asthma population in the United States. More educators are needed to serve the growing numbers of individuals with asthma. Achievement of certification as an AE-C® resulted in additional job responsibilities in 20% of survey respondents. © 2011, Mary Ann Liebert, Inc. 2011. Source

Cui J.,University of Georgia | Chen Y.,Jilin University | Chou W.-C.,University of Georgia | Sun L.,Jilin University | And 18 more authors.
Nucleic Acids Research

This report describes an integrated study on identification of potential markers for gastric cancer in patients' cancer tissues and sera based on: (i) genome-scale transcriptomic analyses of 80 paired gastric cancer/reference tissues and (ii) computational prediction of blood-secretory proteins supported by experimental validation. Our findings show that: (i) 715 and 150 genes exhibit significantly differential expressions in all cancers and early-stage cancers versus reference tissues, respectively; and a substantial percentage of the alteration is found to be influenced by age and/or by gender; (ii) 21 co-expressed gene clusters have been identified, some of which are specific to certain subtypes or stages of the cancer; (iii) the top-ranked gene signatures give better than 94 classification accuracy between cancer and the reference tissues, some of which are gender-specific; and (iv) 136 of the differentially expressed genes were predicted to have their proteins secreted into blood, 81 of which were detected experimentally in the sera of 13 validation samples and 29 found to have differential abundances in the sera of cancer patients versus controls. Overall, the novel information obtained in this study has led to identification of promising diagnostic markers for gastric cancer and can benefit further analyses of the key (early) abnormalities during its development. The Author(s) 2010. Published by Oxford University Press.2010This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2. 5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © The Author(s) 2010. Source

A quality improvement intervention on central line-associated bloodstream infection prevention has been ongoing at a regional medical center since February 2004, and although improvements were noted between 2004 and 2007, the incidence rate of central line-associated bloodstream infections was still of concern. A comprehensive review of all infections from October 2005 through January 2007 indicated that these rates decreased when maximal barrier precaution compliance was tracked and increased when compliance tracking stopped; therefore, an ongoing compliance-tracking program for maximal barrier precautions was instituted, and caregivers were reeducated on the importance of central-line-bundle prevention efforts. A quality improvement intervention of daily CHG baths for all ICU patients was added in April 2008. The goal of this QI intervention was to decrease the incidence rate to 0 for a sustained period, and it was successful. Copyright © 2011 Lippincott Williams & Wilkins. Source

Dente C.J.,Emory University | Ashley D.W.,Mercer University | Dunne J.R.,Memorial Health | Henderson V.,Atlanta Medical Center | And 10 more authors.
Journal of the American College of Surgeons

Background Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Committee on Trauma instituted standardized audit filter analysis in all Level I and II trauma centers in the state. Study Design Audit filter reports were performed from July 2013 to September 2014. Records were reviewed to determine whether there was erroneous data abstraction. Percent yield was defined as number of errors divided by number of charts captured. Results Twelve centers submitted complete datasets. During 15 months, 21,115 patient records were subjected to analysis. Audit filter captured 2,901 (14%) records and review yielded 549 (2.5%) records with erroneous data. Audit filter 1 had the highest number of records identified and audit filter 3 had the highest percent yield. Individual center error rates ranged from 0.4% to 5.2%. When comparing quarters 1 and 2 with quarters 4 and 5, there were 7 of 12 centers with substantial decreases in error rates. The most common missed complications were pneumonia, urinary tract infection, and acute renal failure. The most common missed comorbidities were hypertension, diabetes, and substance abuse. Conclusions In Georgia, the prevalence of erroneous data in trauma registries varies among centers, leading to heterogeneity in data quality, and suggests that targeted educational opportunities exist at the institutional level. Standardized audit filter assessment improved data quality in the majority of participating centers. © 2016 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved. Source

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