Missing cases of injury death: use of quantitative methods and case reviews to inform future improvements in case definition

2021 ◽  
pp. injuryprev-2021-044371
Author(s):  
Colin Cryer ◽  
Pauline Gulliver ◽  
Gabrielle Davie ◽  
Ari Samaranayaka ◽  
Christine Fowler
Keyword(s):  
Quantitative Methods ◽  
Premature Death ◽  
Operational Definition ◽  
Case Definition ◽  
Injury Death ◽  
Detection Rates ◽  
Hospital Patients ◽  
Injury Event ◽  
Underlying Cause Of Death ◽  
Definition Of

BackgroundKnowledge of fatal injuries is required to inform prevention activities. Where hospital patients with an injury principal diagnosis (PDx) died and were certified to a medical underlying cause of death (UCoD), there is the potential to underestimate injury mortality. We sought to characterise injury/non-injury (NI) mismatches between PDx and UCoD by identifying which subgroups had small/large mismatches, and to understand why mismatches had occurred using informative examples.MethodHospital records (n=10 234) with a PDx of injury were linked to the mortality collection using a unique personal identifier. Percentages UCoD coded to a NI were tabulated, for three follow-up periods and by selected variables. Additionally, we reviewed a sample of 70 records for which there was a mismatch.Results%NIs were 39%, 66% and 77% for time from injury to death of <1 week, <90 days and <1 year, respectively. Variations in %NI were found for all variables. Illustrative examples of 70 medical UCoD deaths showed that for 12 cases the injury event was unequivocally judged to have resulted in premature death. A further 16 were judged as injury deaths using balance of probability arguments.ConclusionThere is variation in rates of mismatch between PDx of injury and UCoD of NI. While legitimate reasons exist for mismatches in certain groups, a material number of injury deaths are not captured using UCoD alone; a new operational definition of injury death is needed. Early solutions are proposed. Further work is needed to investigate operational definitions with acceptable false positive and negative detection rates.

scholarly journals 269 Early Identification of Frailty: Developing an International Delphi Consensus for a Definition of Pre-frailty

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Duygu Sezgin ◽  
Mark O’Donovan ◽  
Jean Woo Wong ◽  
Karen Bandeen-Roche ◽  
Giuseppe Liotta ◽  
...  
Keyword(s):  
Early Identification ◽  
Quantitative Methods ◽  
Operational Definition ◽  
Linear Process ◽  
Consensus Meeting ◽  
Physical Factors ◽  
Delphi Consensus ◽  
International Consensus ◽  
Targeted Interventions ◽  
Definition Of

Abstract Background Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent condition before frailty becomes established. Despite this, there is no widely accepted definition of pre-frailty to support its early identification and management. This study applied an international consensus approach to define and better understand pre-frailty. Methods A modified electronic two-round Delphi Consensus study was conducted. In all, 23 experts from 12 countries with different backgrounds participated. The questionnaire was developed following a systematic literature review. An online consensus meeting was conducted with eight Delphi participants and two external experts. Qualitative and quantitative methods were employed for data analysis. An agreement level of 70% was applied for accepting statements. Results A total of 71 statements were circulated in Round 1. Of these, 52.8% were accepted. Fifty-one statements were re-circulated in Round 2, of which 92.1% were accepted. The online consensus meeting produced a consensus statement describing the concept, multi-factorial nature, and mechanism of pre-frailty as well as assessment, prevention and management approaches. All experts agreed that physical and non-physical factors such as psychological and social capacity are involved in the development of pre-frailty, potentially adversely affecting health and health-related quality of life outcomes. Practitioners should regard pre-frailty as a multi-factorial, multi-dimensional, and non-linear process that does not inevitably lead to frailty. It might be reversed or attenuated by targeted interventions. Brief, feasible and validated tools are recommended for opportunistic screening or case-finding followed by confirmation with multi-dimensional assessment. Conclusion It is difficult to establish consensus on one compact definition of pre-frailty, which is a multi-dimensional concept not only associated with physical impairment, but also with cognitive, nutritional, socioeconomic and other aspects of frailty. However, it may be too early to agree on an operational definition of pre-frailty since none yet exists for frailty.

Understanding functional illiteracy from a policy, adult education, and cognition point of view: Towards a joint referent framework

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann
Keyword(s):  
Adult Education ◽  
Operational Definition ◽  
Literacy Skills ◽  
Point Of View ◽  
Industrialized Countries ◽  
Functional Illiteracy ◽  
Scale Levels ◽  
Components Of Reading ◽  
The One ◽  
Definition Of

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.

“The Unconscious” in Current Psychology

2010 ◽  
Vol 15 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Elisabeth Norman
Keyword(s):  
Cognitive Psychology ◽  
Verbal Report ◽  
Psychological Research ◽  
Operational Definition ◽  
The Unconscious ◽  
Apparent Lack ◽  
Unconscious Processing ◽  
Unconscious Processes ◽  
Intermediate States ◽  
Definition Of

A series of vignette examples taken from psychological research on motivation, emotion, decision making, and attitudes illustrates how the influence of unconscious processes is often measured in a range of different behaviors. However, the selected studies share an apparent lack of explicit operational definition of what is meant by consciousness, and there seems to be substantial disagreement about the properties of conscious versus unconscious processing: Consciousness is sometimes equated with attention, sometimes with verbal report ability, and sometimes operationalized in terms of behavioral dissociations between different performance measures. Moreover, the examples all seem to share a dichotomous view of conscious and unconscious processes as being qualitatively different. It is suggested that cognitive research on consciousness can help resolve the apparent disagreement about how to define and measure unconscious processing, as is illustrated by a selection of operational definitions and empirical findings from modern cognitive psychology. These empirical findings also point to the existence of intermediate states of conscious awareness, not easily classifiable as either purely conscious or purely unconscious. Recent hypotheses from cognitive psychology, supplemented with models from social, developmental, and clinical psychology, are then presented all of which are compatible with the view of consciousness as a graded rather than an all-or-none phenomenon. Such a view of consciousness would open up for explorations of intermediate states of awareness in addition to more purely conscious or purely unconscious states and thereby increase our understanding of the seemingly “unconscious” aspects of mental life.

An Analysis of the Demand for Reporting on Internal Control

2000 ◽  
Vol 14 (3) ◽  
pp. 325-341 ◽  
Author(s):  
Heather M. Hermanson
Keyword(s):  
Decision Making ◽  
Financial Reporting ◽  
Internal Control ◽  
Operational Definition ◽  
Financial Statement ◽  
Individual Investors ◽  
Internal Auditors ◽  
Additional Information ◽  
User Groups ◽  
Definition Of

The purpose of this study is to analyze the demand for reporting on internal control. Nine financial statement user groups were identified and surveyed to determine whether they agree that: (1) management reports on internal control (MRIC) are useful, (2) MRICs influence decisions, and (3) financial reporting is improved by adding MRICs. In addition, the paper examined whether responses varied based on: (1) the definition of internal control used (manipulated as broad, operational definition vs. narrow, financial-reporting definition) and (2) user group. The results indicate that financial statement users agree that internal controls are important. Respondents agreed that voluntary MRICs improved controls and provided additional information for decision making. Respondents also agreed that mandatory MRICs improved controls, but did not agree about their value for decision making. Using a broad definition of controls, respondents strongly agreed that MRICs improved controls and provided a better indicator of a company's long-term viability. Executive respondents were less likely to agree about the value of MRICs than individual investors and internal auditors.

Shape Dynamics and the Linking Theory

2018 ◽  
Author(s):  
Flavio Mercati
Keyword(s):  
Phase Space ◽  
Degrees Of Freedom ◽  
Line Element ◽  
Hamiltonian Formulation ◽  
Operational Definition ◽  
Extended Phase Space ◽  
Extended Phase ◽  
Problem Of Time ◽  
Definition Of ◽  
Matter Fields

This chapter explains in detail the current Hamiltonian formulation of SD, and the concept of Linking Theory of which (GR) and SD are two complementary gauge-fixings. The physical degrees of freedom of SD are identified, the simple way in which it solves the problem of time and the problem of observables in quantum gravity are explained, and the solution to the problem of constructing a spacetime slab from a solution of SD (and the related definition of physical rods and clocks) is described. Furthermore, the canonical way of coupling matter to SD is introduced, together with the operational definition of four-dimensional line element as an effective background for matter fields. The chapter concludes with two ‘structural’ results obtained in the attempt of finding a construction principle for SD: the concept of ‘symmetry doubling’, related to the BRST formulation of the theory, and the idea of ‘conformogeometrodynamics regained’, that is, to derive the theory as the unique one in the extended phase space of GR that realizes the symmetry doubling idea.

scholarly journals Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linghui Liang ◽  
Feng Qi ◽  
Yifei Cheng ◽  
Lei Zhang ◽  
Dongliang Cao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Efficiency ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Multivariable Logistic Regression Analysis ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Definition Of ◽  
Medical University

AbstractTo analyze the clinical characteristics of patients with negative biparametric magnetic resonance imaging (bpMRI) who didn’t need prostate biopsies (PBs). A total of 1,012 male patients who underwent PBs in the First Affiliated Hospital of Nanjing Medical University from March 2018 to November 2019, of 225 had prebiopsy negative bpMRI (defined as Prostate Imaging Reporting and Data System (PI-RADS 2.1) score less than 3). The detection efficiency of clinically significant prostate cancer (CSPCa) was assessed according to age, digital rectal examination (DRE), prostate volume (PV) on bpMRI, prostate-specific antigen (PSA) and PSA density (PSAD). The definition of CSPCa for Gleason score > 6. Univariate and multivariable logistic regression analysis were used to identify predictive factors of absent CSPCa on PBs. Moreover, absent CSPCa contained clinically insignificant prostate cancer (CIPCa) and benign result. The detection rates of present prostate cancer (PCa) and CSPCa were 27.11% and 16.44%, respectively. Patients who were diagnosed as CSPCa had an older age (P < 0.001), suspicious DRE (P < 0.001), a smaller PV (P < 0.001), higher PSA value (P = 0.008) and higher PSAD (P < 0.001) compared to the CIPCa group and benign result group. PSAD < 0.15 ng/ml/cm3 (P = 0.004) and suspicious DRE (P < 0.001) were independent predictors of absent CSPCa on BPs. The negative forecast value of bpMRI for BP detection of CSPCa increased with decreasing PSAD, mainly in patients with naive PB (P < 0.001) but not in prior negative PB patients. 25.33% of the men had the combination of negative bpMRI, PSAD < 0.15 ng/ml/cm3 and PB naive, and none had CSPCa on repeat PBs. The incidence of PB was determined, CSPCa was 1.59%, 0% and 16.67% in patients with negative bpMRI and PSAD < 0.15 ng/ml/cm3, patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and biopsy naive and patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and prior negative PB, separately. We found that a part of patients with negative bpMRI, a younger age, no suspicious DRE and PSAD < 0.15 ng/ml/cm3 may securely avoid PBs. Conversely PB should be considered in patients regardless of negative bpMRI, especially who with a greater age, obviously suspicious DRE, significantly increased PSA value, a significantly small PV on MRI and PSAD > 0.15 ng/ml/cm3.

scholarly journals The scale of effect depends on operational definition of forest cover—evidence from terrestrial mammals of the Brazilian savanna

2021 ◽  
Author(s):  
Christophe Amiot ◽  
Cyntia Cavalcante Santos ◽  
Damien Arvor ◽  
Beatriz Bellón ◽  
Hervé Fritz ◽  
...  
Keyword(s):  
Forest Cover ◽  
Operational Definition ◽  
Brazilian Savanna ◽  
Terrestrial Mammals ◽  
Scale Of Effect ◽  
Definition Of

scholarly journals Spiritual nursing care: A concept analysis

Curationis ◽  
2012 ◽  
Vol 35 (1) ◽  
Author(s):  
Lydia V. Monareng
Keyword(s):  
Nursing Care ◽  
Concept Analysis ◽  
Operational Definition ◽  
The Body ◽  
Empirical Literature ◽  
Spiritual Needs ◽  
Optimal Care ◽  
Health Crisis ◽  
Group Interviews ◽  
Definition Of

Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

scholarly journals What is professionalism in occupational therapy? A concept analysis

2021 ◽  
pp. 000841742199437
Author(s):  
Alexandra Lecours ◽  
Nancy Baril ◽  
Marie-Josée Drolet
Keyword(s):  
Occupational Therapy ◽  
Professional Identity ◽  
Cultural Influences ◽  
Occupational Therapists ◽  
Concept Analysis ◽  
Operational Definition ◽  
Analysis Design ◽  
Definition Of ◽  
Over Time ◽  
Extract Information

Background. Professionalism has been given different definitions over time. These are, commonly theoretical and difficult to operationalize. Purpose. This study aimed to provide an operational definition of the concept of professionalism in occupational therapy. Method. Based on a concept analysis design, a meta-narrative review was conducted to extract information from 30 occupational therapy manuscripts. Findings. Professionalism is a complex competence defined by the manifestation of distinct attitudes and behaviours that support excellence in the occupational therapy practice. In addition, professionalism is forged and evolves according to personal and environmental characteristics. The manifestation of professionalism can lead to positive consequences for occupational therapists, clients, and the discipline, notably contributing to a positive and strong professional identity. Moreover, professionalism is also subject to cultural influences, which leads to variations in its development, manifestations, and consequences. Implications. This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance.

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