scholarly journals Is it possible to register the ideas, concerns and expectations behind the reason for encounter as a means of classifying patient preferences with ICPC-2?

2017 ◽  
Vol 19 (01) ◽  
pp. 1-6 ◽  
Author(s):  
Diego Schrans ◽  
Pauline Boeckxstaens ◽  
An De Sutter ◽  
Sara Willems ◽  
Dirk Avonts ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Preferences ◽  
Time Frame ◽  
Specific Procedure ◽  
Reason For Encounter ◽  
Related Information ◽  
Almost All ◽  
Danger To Others ◽  
Do So

BackgroundFamily practice aims to recognize the health problems and needs expressed by the person rather than only focusing on the disease. Documenting person-related information will facilitate both the understanding and delivery of person-focused care.AimTo explore if the patients’ ideas, concerns and expectations (ICE) behind the reason for encounter (RFE) can be coded with the International Classification of Primary Care, version 2 (ICPC-2) and what kinds of codes are missing to be able to do so.MethodsIn total, 613 consultations were observed, and patients’ expressions of ICE were narratively recorded. These descriptions were consequently translated to ICPC codes by two researchers. Descriptions that could not be translated were qualitatively analysed in order to identify gaps in ICPC-2.ResultsIn all, 613 consultations yielded 672 ICE expressions. Within the 123 that could not be coded with ICPC-2, eight categories could be defined: concern about the duration/time frame; concern about the evolution/severity; concern of being contagious or a danger to others; patient has no concern, but others do; expects a confirmation of something; expects a solution for the symptoms without specification of what it should be; expects a specific procedure; and expects that something is not done.DiscussionAlthough many ICE can be registered with ICPC-2, adding eight new categories would capture almost all ICE.

scholarly journals Reliability and validity of ICPC-2-R encoding by medical students

2018 ◽  
Vol 13 (40) ◽  
pp. 1-6
Author(s):  
Leonardo Ferreira Fontenelle ◽  
Álvaro Damiani Zamprogno ◽  
André Filipe Lucchi Rodrigues ◽  
Lorena Camillato Sirtoli ◽  
Natália Josiele Cerqueira Checon ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Reliability And Validity ◽  
International Classification ◽  
Free Text ◽  
Reason For Encounter ◽  
Community Physician ◽  
In The Beginning ◽  
Reasons For Encounter

Objective: To estimate how reliably and validly can medical students encode reasons for encounter and diagnoses using the International Classification of Primary Care, revised 2nd edition (ICPC-2-R). Methods: For every encounter they supervised during an entire semester, three family and community physician teachers entered the reasons for encounter and diagnoses in free text into a form. Two of four medical students and one teacher encoded each reason for encounter or diagnosis using the ICPC-2-R. In the beginning of the study, two three-hour workshops were held, until the teachers were confident the students were ready for the encoding. After all the reasons for encounter and the diagnoses had been independently encoded, the seven encoders resolved the definitive codes by consensus. We defined reliability as agreement between students and validity as their agreement with the definitive codes, and used Gwet’s AC1 to estimate this agreement. Results: After exclusion of encounters encoded before the last workshop, the sample consisted of 149 consecutive encounters, comprising 262 reasons for encounter and 226 diagnoses. The encoding had moderate to substantial reliability (AC1, 0.805; 95% CI, 0.767–0.843) and substantial validity (AC1, 0.864; 95% CI, 0.833–0.891). Conclusion: Medical students can encode reasons for encounter and diagnoses with the ICPC-2-R if they are adequately trained.

THE SEC PREEMPTS THE ACCOUNTING PRINCIPLES BOARD IN 1965: THE CLASSIFICATION OF THE DEFERRED TAX CREDIT RELATING TO INSTALLMENT SALES

2007 ◽  
Vol 34 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Stephen A. Zeff
Keyword(s):  
Securities And Exchange Commission ◽  
Accounting Practice ◽  
Slow Pace ◽  
Accounting Principles ◽  
Private And Public ◽  
Deferred Tax ◽  
Accounting Procedure ◽  
The U.S ◽  
Do So

In 1959, the Accounting Principles Board (APB) replaced the Committee on Accounting Procedure because the latter was unable to deal forthrightly with a series of important issues. But during the APB's first half-dozen years, its record of achievement was no more impressive than its predecessor's. The chairman of the Securities and Exchange Commission (SEC), Manuel F. Cohen, criticized the APB's slow pace and unwillingness to tackle difficult issues. This article discusses the circumstances attending the SEC's issuance of an Accounting Series Release in late 1965 to demonstrate forcefully to the APB that, when it is unable to carry out its responsibility to “narrow the areas of difference” in accounting practice, the SEC is prepared to step in and do so itself. In this sense, the article deals with the tensions between the private and public sectors in the establishment of accounting principles in the U.S. during the mid-1960s. The article makes extensive use of primary resource materials in the author's personal archive, which have not been used previously in published work.

scholarly journals CAD integrated automatic recognition of weld paths

2021 ◽  
Author(s):  
Tuan Anh Tran ◽  
Andrei Lobov ◽  
Tord Hansen Kaasa ◽  
Morten Bjelland ◽  
Ole Terje Midling
Keyword(s):  
Life Cycle ◽  
Spatial Analysis ◽  
Product Life Cycle ◽  
Real Life ◽  
Automatic Recognition ◽  
Integrated Method ◽  
Weld Joints ◽  
Related Information ◽  
Almost All ◽  
Sequential Assembly

AbstractIn this paper, a CAD integrated method is proposed for automatic recognition of potential weld locations in large assembly structures predominantly comprised of weld joints. The intention is to reduce the total man-hours spent on manually locating, assigning, and maintaining weld-related information throughout the product life cycle. The method utilizes spatial analysis of extracted stereolithographic data in combination with available CAD functions to determine whether the accessibility surrounding a given intersection edge is sufficient for welding. To demonstrate the method, a system is developed in Siemens NX using their NXOpen Python API. The paper presents the application of the method to real-life use cases in varying complexity in cooperation with industrial partners. The system is able to correctly recognize almost all weld lines for the parts considered within a few minutes. Some exceptions are known for particular intersection lines located deep within notched joints and geometries weldable through sequential assembly, which are left as a subject to further works.

scholarly journals Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Milena Bergmann ◽  
Jörg Haasenritter ◽  
Dominik Beidatsch ◽  
Sonja Schwarm ◽  
Kaja Hörner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Respiratory Tract ◽  
Chronic Cough ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Current Guideline ◽  
Acute Cough ◽  
Reason For Encounter ◽  
Tract Infections

Abstract Background Cough is a relevant reason for encounter in primary care. For evidence-based decision making, general practitioners need setting-specific knowledge about prevalences, pre-test probabilities, and prognosis. Accordingly, we performed a systematic review of symptom-evaluating studies evaluating cough as reason for encounter in primary care. Methods We conducted a search in MEDLINE and EMBASE. Eligibility criteria and methodological quality were assessed independently by two reviewers. We extracted data on prevalence, aetiologies and prognosis, and estimated the variation across studies. If justifiable in terms of heterogeneity, we performed a meta-analysis. Results We identified 21 eligible studies on prevalence, 12 on aetiology, and four on prognosis. Prevalence/incidence estimates were 3.8–4.2%/12.5% (Western primary care) and 10.3–13.8%/6.3–6.5% in Africa, Asia and South America. In Western countries the underlying diagnoses for acute cough or cough of all durations were respiratory tract infections (73–91.9%), influenza (6–15.2%), asthma (3.2–15%), laryngitis/tracheitis (3.6–9%), pneumonia (4.0–4.2%), COPD (0.5–3.3%), heart failure (0.3%), and suspected malignancy (0.2–1.8%). Median time for recovery was 9 to 11 days. Complete recovery was reported by 40.2- 67% of patients after two weeks, and by 79% after four weeks. About 21.1–35% of patients re-consulted; 0–1.3% of acute cough patients were hospitalized, none died. Evidence is missing concerning subacute and chronic cough. Conclusion Prevalences and incidences of cough are high and show regional variation. Acute cough, mainly caused by respiratory tract infections, is usually self-limiting (supporting a “wait-and-see” strategy). We have no setting-specific evidence to support current guideline recommendations concerning subacute or chronic cough in Western primary care. Our study presents epidemiological data under non non-pandemic conditions. It will be interesting to compare these data to future research results of the post-pandemic era.

Is Cauda Equina Syndrome Being Treated Within the Recommended Time Frame?

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1520-1526 ◽  
Author(s):  
Robert T. Arrigo ◽  
Paul Kalanithi ◽  
Maxwell Boakye
Keyword(s):  
Cauda Equina Syndrome ◽  
Medical Condition ◽  
Cauda Equina ◽  
Time Frame ◽  
Current Guideline ◽  
International Classification Of Disease ◽  
Lumbar Disk ◽  
Urgent Surgery ◽  
Spine Surgeon

Abstract BACKGROUND: Cauda equina syndrome (CES) is a rare but devastating medical condition requiring urgent surgery to halt or reverse neurological compromise. Controversy exists as to how soon surgery must be performed after diagnosis, and clinical and medicolegal factors make this question highly relevant to the spine surgeon. It is unclear from the literature how often CES patients are treated within the recommended time frame. OBJECTIVE: To determine whether CES patients are being treated in compliance with the current guideline of surgery within 48 hours and to assess incidence, demography, comorbidities, and outcome measures of CES patients. METHODS: We searched the 2003 to 2006 California State Inpatient Databases to identify degenerative lumbar disk disorder patients surgically treated for CES. An International Classification of Disease, ninth revision, clinical modification, diagnosis code was used to identify CES patients with advanced disease. RESULTS: The majority (88.74%) of California's CES patients received surgery within the recommended 48-hour window after diagnosis. The incidence of CES in surgically treated degenerative lumbar disk patients was 1.51% with an average of 397 cases per year in California. CES patients had worse outcomes and used more healthcare resources than other surgically treated degenerative lumbar disk patients; this disparity was more pronounced for patients with advanced CES. CES patients treated after 48 hours had 3 times the odds of a nonroutine discharge as patients treated within 48 hours (odds ratio = 3.082; P < .001). CONCLUSION: In California, patients are being treated within the recommended 48-hour time frame.

Somatoform disorders: A help or hindrance to good patient care?

2004 ◽  
Vol 184 (6) ◽  
pp. 465-467 ◽  
Author(s):  
Michael Sharpe ◽  
Richard Mayou
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
General Practitioners ◽  
Somatoform Disorders ◽  
Somatoform Disorder ◽  
Good Patient ◽  
Specific Category ◽  
Good Patient Care ◽  
Almost All ◽  
Issue Reports

The paper by de Waal and colleagues (2004, this issue) reports on the prevalence of somatoform disorders in Dutch primary care. They found that at least one out of six patients seen by general practitioners could be regarded as having a somatoform disorder, almost all in the non-specific category of undifferentiated somatoform disorder. The prevalence of the condition has major implications for medical services but what does this diagnosis mean? Is receiving a diagnosis of somatoform disorder of any benefit to the patient? Does it help the doctor to provide treatment?

On the Correct use of Host-Names. An Appeal to Parasitologists

Parasitology ◽  
1926 ◽  
Vol 18 (2) ◽  
pp. 203-205
Author(s):  
H. A. Baylis
Keyword(s):  
Complete Knowledge ◽  
Almost All ◽  
Special Studies ◽  
Large Groups ◽  
Host List

Parasitology has now become a vast subject, and it is impossible for any parasitologist to have a complete knowledge of the classification of all the groups of parasites with which he may be expected, from time to time, to deal. Almost all helminthologists, for example, are obliged to confine their special studies to one of the main groups—one dealing chiefly with Nematodes, another with Trematodes, another with Cestodes, and so on. Even within these large groups many findit impossible to keep in touch with the literature concerning more than one or two special families. But whether the field they attempt to cover be large or small, it is probable that most parasitologists find the name of the host a very valuable clue to the identity of the parasite which they are endeavouring to determine. For some groups more or less comprehensive host-lists have been published from time to time, and authors frequently include such lists even in short memoirs, presumably for the assistance of their fellow-workers. In all probability many workers find it useful to attempt to compile for their own use some kind of host-list.

scholarly journals eVITAL: A Preliminary Taxonomy and Electronic Toolkit of Health-Related Habits and Lifestyle

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Luis Salvador-Carulla ◽  
Carolyn Olson Walsh ◽  
Federico Alonso ◽  
Rafael Gómez ◽  
Carlos de Teresa ◽  
...  
Keyword(s):  
Primary Care ◽  
Models Of Care ◽  
International Classification Of Functioning ◽  
Evaluation Tool ◽  
Self Assessment ◽  
Evaluation Protocol ◽  
Health Related ◽  
Person Centered Approach ◽  
Adult Volunteers

Objectives. To create a preliminary taxonomy and related toolkit of health-related habits (HrH) following a person-centered approach with a focus on primary care.Methods. From 2003–2009, a working group (n=6physicians) defined the knowledge base, created a framing document, and selected evaluation tools using an iterative process. Multidisciplinary focus groups (n=29health professionals) revised the document and evaluation protocol and participated in a feasibility study and review of the model based on a demonstration study with 11 adult volunteers in Antequera, Spain.Results. The preliminary taxonomy contains 6 domains of HrH and 1 domain of additional health descriptors, 3 subdomains, 43 dimensions, and 141 subdimensions. The evaluation tool was completed by the 11 volunteers. The eVITAL toolkit contains history and examination items for 4 levels of engagement: self-assessment, basic primary care, extended primary care, and specialty care. There was positive feedback from the volunteers and experts, but concern about the length of the evaluation.Conclusions. We present the first taxonomy of HrH, which may aid the development of the new models of care such as the personal contextual factors of the International Classification of Functioning (ICF) and the positive and negative components of the multilevel person-centered integrative diagnosis model.

scholarly journals COVID-19 infection and subsequent psychiatric morbidity, sleep problems and fatigue: analysis of an English primary care cohort of 226,521 positive patients

2021 ◽  
Author(s):  
Kathryn M Abel ◽  
Matthew J Carr ◽  
Darren M Ashcroft ◽  
Trudie Chalder ◽  
Carolyn A Chew-Graham ◽  
...  
Keyword(s):  
Primary Care ◽  
Sleep Problems ◽  
Psychiatric Morbidity ◽  
Negative Control ◽  
Control Analysis ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Self Harm ◽  
Primary Hypothesis ◽  
Almost All

Objectives The primary hypothesis was that the risk of incident or repeat psychiatric illness, fatigue and sleep problems increased following COVID-19 infection. The analysis plan was pre-registered (https://osf.io/n2k34/). Design Matched cohorts were assembled using a UK primary care registry (the CPRD-Aurum database). Patients were followed-up for up to 10 months, from 1st February 2020 to 9th December 2020. Setting Primary care database of 11,923,499 adults (>16 years). Participants From 232,780 adults with a positive COVID-19 test (after excluding those with <2 years historical data or <1 week follow-up), 86,922 without prior mental illness, 19,020 with anxiety or depression, 1,036 with psychosis, 4,152 with fatigue and 4,539 with sleep problems were matched to up to four controls based on gender, general practice and year of birth. A negative control used patients who tested negative for COVID-19 and patients negative for COVID with an influenza diagnosis. Main Outcomes and Measures Cox proportional hazard models estimated the association between a COVID-19 positive test and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue or psychotropic prescribing. Models adjusted for comorbidities, ethnicity, smoking and BMI. Results After adjusting for observed confounders, there was an association between testing positive for COVID-19 and almost all markers of psychiatric morbidity, fatigue and sleep problems. The adjusted hazard ratio (aHR) for incident psychiatric morbidity was 1.75 (95% CI 1.56-1.96). However, there was a similar risk of incident psychiatric morbidity for those with a negative COVID-19 test (aHR 1.57, 95% CI 1.51-1.63) and a larger increase associated with influenza (aHR 2.97, 95% CI 1.36-6.48). Conclusions There is consistent evidence that COVID-19 infection elevates risk of fatigue and sleep problems, however the results from the negative control analysis suggests that residual confounding may be responsible for at least some of the association between COVID-19 and psychiatric morbidity.

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