scholarly journals Preservation of Distemper Painting: Indoor Monitoring Tools for Risk Assessment and Decision Making in Kvernes Stave Church

Climate ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 33
Author(s):  
Tone Marie Olstad ◽  
Anne Apalnes Ørnhøi ◽  
Nina Kjølsen Jernæs ◽  
Lavinia de Ferri ◽  
Ashley Freeman ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Assessment Tool ◽  
Wall Paintings ◽  
Cultural Significance ◽  
Current State ◽  
Monitoring Tools ◽  
Heritage Buildings ◽  
Indoor Conditions ◽  
Indoor Monitoring

During the Medieval period, over 1000 stave churches were thought to have been constructed in Norway. However, currently, only 28 of these churches remain and only 19 still have distemper wall paintings. The cultural significance of these structures, and more specifically their elaborate distemper wall paintings, has changed over time, as have the means and methods for preserving these monuments. Deeper knowledge of the current state of these structures, along with environmental monitoring and modeling will open the way to a better understanding of preservation. This paper presents a case study for unheated Norwegian wooden churches based on data collected from Kvernes stave church. There are three aims for this paper: (i) to describe the typical indoor conditions similar to the historic climate of stave churches; (ii) determine the common characteristics of distemper paint found within stave churches; (iii) and develop a risk assessment tool to evaluate the climate-induced risk factors in stave churches. The outcome of this work will contribute to research performed within the Sustainable Management of Heritage Buildings in a Long-term Perspective (SyMBoL) project which aims to develop a better understanding of climate induced risks for stave churches, and ultimately to better manage environmental risk.

scholarly journals Thromboprophylaxis use in medical inpatients and the impact of electronic risk assessment tool

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3511-3511 ◽  
Author(s):  
Nikhil Mukhi ◽  
Gurinder Sidhu ◽  
Christopher Nabors ◽  
Chaitanya Iragavarapu
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Decision Support ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Hospital Death ◽  
Vte Prophylaxis ◽  
Electronic Assessment ◽  
The Impact

Abstract Introduction: VTE is the third most common cause of hospital related deaths and the most common preventable cause of hospital death. Population based studies have continually emphasized the rising prevalence of VTE. As per data from CDC, VTE complicated about 550,000 hospitalizations each year in adults >18yrs. The prevalence was much higher in adults >60yrs and female sex. Pulmonary embolism accounts for about 5-10% of hospital deaths and the case fatality rates of DVT ranges between 1-10% mainly due to fatal PE and is highest in those with malignancies. VTE is associated with long term risks of post thrombotic syndrome and chronic thromboembolic pulmonary hypertension which contributes significantly to patient morbidity and cost of management. The ENDORSE trial assessed the proportion of at-risk medical patients who received thromboprophylaxis and determined that 39.5% (6119 out of 15487 patients) received ACCP-recommended VTE prophylaxis. The most effective strategies to improve prophylaxis consist of a system for reminding clinicians to assess patients for VTE risk, either electronic decision-support systems or paper-based reminders. In a recent study electronic VTE risk assessment tool (elVis) on VTE prophylaxis in hospitalised patients improved the prophylaxis rates by 5.0% amongst all patients and by 10.7% amongst high risk patients. Materials and Methods: This was a retrospective study to assess the effectiveness of a VTE (Venous Thrombo Embolism) risk assessment tool as part of the in hospital quality control initiative. A total of 400 charts were reviewed; 200 prior to implementation of the risk assessment tool, and 200 after. Patients with incomplete or missing data were excluded. A total of 388 patients were included in the study (Fig 1). These patients were randomly picked in the pre and post implementation phases of the study (April 2011 and October 2011 respectively). The hospital committee designed the risk assessment tool based on the ACCP guidelines with few modifications individualized to our patient population. The tool was an automatic and mandatory pop op that would guide the admitting resident in making a decision about VTE prophylaxis. After the tool was implemented (July 2011), all house staff were educated on its use by a dedicated lecture during a noon conference session. Results: Demographics and results of the study are shown via the following table: Table 1.Pre-VTE toolPost-VTE toolNumber of patients189199Male47.9%49.7%Moderate –High Risk57.1%61.3%Individual Risk FactorsPrior VTE13.7%15.7%Chronic Pulm Disease17.9%19.1%Chronic Heart Failure14.4%16.9%Long term immobility11.7%17.4%Obesity37.2%34.3%Thrombophilia1.2%1.1%Malignancy4.6%4.7%Contraindications to anticoagulation19.04%19.06%Treatment Correctness56.3%80.3% Conclusions: This study gives us insight that VTE risk assessment tool accompanied with staff education improves VTE prophylaxis in at risk medicine inpatients. Study also confirms that incorporation of VTE prophylaxis guidelines in routine clinical practice can be assisted by electronic assessment and decision support tools. Disclosures No relevant conflicts of interest to declare.

scholarly journals A randomised controlled trial, cost-effectiveness and process evaluation of the implementation of self-management for chronic gastrointestinal disorders in primary care, and linked projects on identification and risk assessment

2018 ◽  
Vol 6 (1) ◽  
pp. 1-154 ◽  
Author(s):  
David G Thompson ◽  
Sarah O’Brien ◽  
Anne Kennedy ◽  
Anne Rogers ◽  
Peter Whorwell ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Self Management ◽  
Gastrointestinal Disorders ◽  
Management Support ◽  
Long Term Conditions

BackgroundChronic gastrointestinal disorders are major burdens in primary care. Although there is some evidence that enhancing self-management can improve outcomes, it is not known if such models of care can be implemented at scale in routine NHS settings and whether or not it is possible to develop effective risk assessment procedures to identify patients who are likely to become chronically ill.ObjectivesWhat is the clinical effectiveness and cost-effectiveness of an intervention to enhance self-management support for patients with chronic conditions when translated from research settings into routine care? What are the barriers and facilitators that affect the implementation of an intervention to enhance self-management support among patients, clinicians and organisations? Is it possible to develop methods to identify patients at risk of long-term problems with functional gastrointestinal disorders in primary care? Data sources included professional and patient interviews, patient self-report measures and data on service utilisation.DesignA pragmatic, two-arm, practice-level cluster Phase IV randomised controlled trial evaluating outcomes and costs associated with the intervention, with associated process evaluation using interviews and other methods. Four studies around identification and risk assessment: (1) a general practitioner (GP) database study to describe how clinicians in primary care record consultations with patients who experience functional lower gastrointestinal symptoms; (2) a validation of a risk assessment tool; (3) a qualitative study to explore GPs’ views and experiences; and (4) a second GP database study to investigate patient profiles in irritable bowel syndrome, inflammatory bowel disease and abdominal pain.SettingSalford, UK.ParticipantsPeople with long-term conditions and professionals in primary care.InterventionsA practice-level intervention to train practitioners to assess patient self-management capabilities and involve them in a choice of self-management options.Main outcome measuresPatient self-management, care experience and quality of life, health-care utilisation and costs.ResultsNo statistically significant differences were found between patients attending the trained practices and those attending control practices on any of the primary or secondary outcomes. The intervention had little impact on either costs or effects within the time period of the trial. In the practices, self-management tools failed to be normalised in routine care. Full assessment of the predictive tool was not possible because of variable case definitions used in practices. There was a lack of perceived clinical benefit among GPs.LimitationsThe intervention was not implemented fully in practice. Assessment of the risk assessment tool faced barriers in terms of the quality of codting in GP databases and poor recruitment of patients.ConclusionsThe Whole system Informing Self-management Engagement self-management (WISE) model did not add value to existing care for any of the long-term conditions studied.Future workThe active components required for effective self-management support need further study. The results highlight the challenge of delivering improvements to quality of care for long-term conditions. There is a need to develop interventions that are feasible to deliver at scale, yet demonstrably clinically effective and cost-effective. This may have implications for the piloting of interventions and linking implementation more clearly to local commissioning strategies.Trial registrationCurrent Controlled Trial ISRCTN90940049.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 6, No. 1. See the NIHR Journals Library website for further project information.

scholarly journals Cancer Risk Assessment Tool: A new general model to estimate cure-rate fraction in patients under tumor therapy

2020 ◽  
Author(s):  
Diego C. Nascimento ◽  
Pedro L. Ramos ◽  
Oilson A. Gonzatto ◽  
Gabriel G. Ferreira ◽  
Patricia P. M. de Castro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Assessment ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Medical Decision ◽  
Cancer Type ◽  
Cure Rate ◽  
Cure Fraction

Cure fraction is not an easy task to be calculated relating probabilistic estimations to an event. For instance, cancer patients may abandon treatment, be cured, or die due to another illness, causing limitations regarding the information about the odds of cancer cure (related to the patient follow-up) and may mislead the researcher's inference. In this paper, we overcame this limitation and proposed a risk assessment tool related to the lifetime of cancer patients to survival functions to help medical decision-making. Moreover, we proposed a new machine learning algorithm, so-called long-term generalized weighted Lindley (LGWL) distribution, solving the inferential limitation caused by the censored information. Regarding the robustness of this distribution, some mathematical properties are shown and inferential procedures discussed, under the maximum likelihood estimators' perspective. Empirical results used TCGA lung cancer data (but not limited to this cancer type) showing the competitiveness of the proposed distribution to the medical field. The cure-rate is dynamic but quantifiable. For instance, after 14 years of development/spread of lung cancer, the group of patients under the age of 70 had a cure fraction of 32%, while the group of elderly patients presented a cure fraction of 22%, whereas those estimations using the traditional (long-term) Weibull distribution is 31% and 17%. The LGWL returned closer curves to the empirical distribution, then were better adjusted to the adopted data, elucidating the importance of cure-rate fraction in survival models.

scholarly journals Derivation of a Risk Assessment Tool for Prediction of Long-Term Pain Intensity Reduction After Physical Therapy

2021 ◽  
Vol Volume 14 ◽  
pp. 1515-1524
Author(s):  
Maggie E Horn ◽  
Steven Z George ◽  
Cai Li ◽  
Sheng Luo ◽  
Trevor A Lentz
Keyword(s):  
Risk Assessment ◽  
Physical Therapy ◽  
Pain Intensity ◽  
Assessment Tool ◽  
Risk Assessment Tool
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