Simple Data Entry Research Articles

Identifying barriers and enablers to participation in infection surveillance in Australian residential aged care facilities

BackgroundInfection surveillance is a vital part of infection prevention and control activities for the aged care sector. In Australia there are two currently available infection and antimicrobial use surveillance programs for residential aged care facilities. These programs are not mandated nor available to all facilities. Development of a new surveillance program will provide standardised surveillance for all facilities in Australia.MethodsThis study aimed to assess barriers and enablers to participation in the two existing infection and antimicrobial use surveillance programs, to improve development and implementation of a new program. A mixed-methods study was performed. Aged Care staff involved in infection surveillance were invited to participate in focus groups and complete an online survey comprising 17 items. Interviews were transcribed and analysed using the COM-B framework.ResultsTwenty-nine staff took part in the focus groups and two hundred took part in the survey. Barriers to participating in aged care infection surveillance programs were the time needed to collect and enter data, competing priority tasks, limited understanding of surveillance from some staff, difficulty engaging clinicians, and staff fatigue after the COVID-19 pandemic. Factors that enabled participation were previous experience with surveillance, and sharing responsibilities, educational materials and using data for benchmarking and to improve practice.ConclusionStreamlined and simple data entry methods will reduce the burden of surveillance on staff. Education materials will be vital for the implementation of a new surveillance program. These materials must be tailored to different aged care workers, specific to the aged care context and provide guidance on how to use surveillance results to improve practice.

Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

The prescribers need to memorize the dose and strength of thousands of drugs often with similar sounding names but differing actions, by their weight (strengths), which could lead to significant errors in medication. When prescribing, instead of using amounts in milligrams, a “standard unit” - a universal standard adult dose unit- concept can be employed to minimize such instances of erroneous recollection of dosages. Prescribers would not essentially need to know the composition and actual amount of active pharmaceutical ingredients in prescribed drugs if such a standardized unit prescribing system could be adopted. They could simply resort to prescribing the required number of units of medication instead. The standard adult dose of any drug could be referred to as one adult unit regardless of the amounts by weight. Only drug manufacturers and research scientists would need to know the actual strengths of the medications in milligrams of what would be referred to as a standard adult unit. Implementation of the unit system, along with the incorporation of electronic prescribing, could allow for simple data entry, and easier corrections for lean body weight/BMI, renal function, age, pregnancy, etc., leading to improvements in patient safety and optimal dosage achieved, eliminating difficult calculations. Moreover, a parallel paediatric unit could also be developed. The conceptual study to arouse an interest cannot address all issues and details relating to actual implementations.

MPA-FishMApp – A Citizen Science App That Simplifies Monitoring of Coral Reef Fish Density and Biomass in Marine Protected Areas

Monitoring changes in fish density and biomass inside marine protected areas (MPAs) through fish visual census (FVC) can determine if MPAs are achieving their goal of promoting fish population recovery. Simplified FVC methods have been developed for citizen scientists to enable them to monitor fish populations in MPAs. However, MPA monitoring programs led by local stakeholders remain rare and difficult to sustain due to technical barriers related to FVC data management. Here, we describe and evaluate a novel online app called MPA-FishMApp, which we developed to help stakeholders of MPAs that protect coral reefs in the Philippines efficiently store, analyze, and visualize FVC data. MPA-FishMApp is coupled to a simplified FVC method wherein the observer records only 21 reef fish species groups during surveys. The app provides a simple data entry interface, cloud storage, and algorithms to estimate fish density and biomass. Spatial and temporal trends in fish density and biomass can be instantaneously visualized in the app based on relative importance to fisheries. Field testing suggested that the MPA-FishMApp methodology (simplified FVC and app) is sensitive enough to detect qualitative patterns showing differences in density and biomass that may develop between MPAs and fished sites, especially in fishes that are highly important to fisheries. However, users must have sufficient training and experience in simplified FVC to produce reliable data. MPA-FishMApp may help reverse the lack of monitoring in MPAs across the Philippines and offers an accessible, transparent, and auditable venue for collaboration between citizen scientists and professional scientists.

Design and Application of the Tank Simulation Model (TSM): Assessing the Ability of Rainwater Harvesting to Meet Domestic Water Demand

Rainwater harvesting (RWH) is a necessary technology to supplement and/or replace insufficient ground and surface water resources for domestic water supplies, especially under changing climate conditions. An accessible and flexible Excel-based RWH simulation tool is developed and applied to investigate the utility of RWH in two regional case studies, under both present conditions and future climate scenarios, through examination of relationships between tank volumes, roof areas, rainfall patterns, and yield. The conversion of complex mathematical formula into a tool with a simple data entry form for infinite combinations of the critical variables enables non-experts to manipulate and optimize designs at the level of RWH implementation. The results clearly show that RWH can augment problematic or insufficient water supplies. Roof area and rainfall distribution have the greatest impact on the ability of a RWH system to meet demand; tank size has a minimal effect, providing a buffer during short dry periods within any given month. Demand met improves in both geographies under future scenarios. Thus, while RWH is insufficient as the sole source of domestic water now and in the future, it is a low-cost supply augmentation solution even in cold climates. RWH solutions are made more accessible through planning tools such as the Tank Simulation Model presented here, which is sufficiently flexible to incorporate climate change scenario planning.

The Determinants of User Satisfaction of Engineering Maintenance System (EMESYS) in the Malaysian Army

Engineering Maintenance System (EMESYS) is the online Management Information System (MIS) on equipment maintenance performed by the Royal Electrical and Mechanical Engineers (REME) Corps including maintenance on vehicle, weapon, electronic and miscellaneous equipment. This study attempts to identify the determinants of user satisfaction in adopting the EMESYS based on an information system success model by De Lone and Mc Lean (2003). This study is important as it is the first empirical study focusing on the user satisfaction of EMESYS in the context of the Malaysian Army. The data were collected using online surveys from 309 EMESYS users. Standard multiple regressions was used to analyse the data gathered. The results of this study indicate that three of the hypothesis are supported and users’ satisfaction of EMESYS is influenced by the three dimensions, namely, system quality, information quality and IT infrastructure. EMESYS has been proven successful in transforming the tedious procedures involving multiple parties and documents to the process of a simple data entry to EMESYS.

An Electronic Registry for Improving the Quality of Antenatal Care in Rural Bangladesh (eRegMat): Protocol for a Cluster Randomized Controlled Trial.

BackgroundDigital health interventions (DHIs) can alleviate several barriers to achieving better maternal and child health. The World Health Organization’s guideline recommendations for DHIs emphasize the need to integrate multiple DHIs for maximizing impact. The complex health system of Bangladesh provides a unique setting for evaluating and understanding the role of an electronic registry (eRegistry) for antenatal care, with multiple integrated DHIs for strengthening the health system as well as improving the quality and utilization of the public health care system.ObjectiveThe aim of this study is to assess the effect of an eRegistry with DHIs compared with a simple digital data entry tool without DHIs in the community and frontline health facilities.MethodsThe eRegMat is a cluster-randomized controlled trial conducted in the Matlab North and Matlab South subdistricts in the Chandpur district, Bangladesh, where health facilities are currently using the eRegistry for digital tracking of the health status of pregnant women longitudinally. The intervention arm received 3 superimposed data-driven DHIs: health worker clinical decision support, health worker feedback dashboards with action items, and targeted client communication to pregnant women. The primary outcomes are appropriate screening as well as management of hypertension during pregnancy and timely antenatal care attendance. The secondary outcomes include morbidity and mortality in the perinatal period as well as timely first antenatal care visit; successful referrals for anemia, diabetes, or hypertension during pregnancy; and facility delivery.ResultsThe eRegistry and DHIs were co-designed with end users between 2016 and 2018. The eRegistry was implemented in the study area in July 2018. Recruitment for the trial started in October 2018 and ended in June 2020, followed by an 8-month follow-up period to capture outcome data until February 2021. Trial results will be available for publication in June 2021.ConclusionsThis trial allows the simultaneous assessment of multiple integrated DHIs for strengthening the health system and aims to provide evidence for its implementation. The study design and outcomes are geared toward informing the living review process of the guidelines for implementing DHIs.Trial RegistrationISRCTN Registry ISRCTN69491836; https://www.isrctn.com/ISRCTN69491836International Registered Report Identifier (IRRID)DERR1-10.2196/26918

A Structured Maternity Case Record to Improve Quality of Documentation in a Tertiary Care Hospital, Delhi

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as “good and very good” for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum.

Spreadsheet Model for Determining Adequate Performance Indicators of Production Management

Research Question: This paper presents a simulation model aimed at improving total adequacy calculation for performance indicators of the first phase of production management. Motivation: Defining a set of adequate performance indicators that are specific and highly important for the observed planning phase has a significant impact on the effectiveness of the production process management. The result of the developed model is the value of selected performance indicators adequacy. Consequently, it can be concluded whether defined performance indicators are essential for the observed phase or other performance indicators should be selected. The monitoring of defined performance indicators should provide complete information about the observed phase and improvement of the planning phase management. Idea: The main idea of this paper is to develop a user-friendly simulation model, in accordance with the basic principles of spreadsheet engineering, for improving the selection of adequate performance indicators. This model is intended for use in Small and Medium Enterprises (SMEs) for the improvement of production management. Data: The data used in the paper are grounded on the scientific articles, reviews and empirical studies, related to the performance and performance indicators in production management. The set of most adequate performance indicators based on a relevant literature review and used in the model, represents performance indicators for the planning phase that are the most suitable for SMEs. Tools: The simulation model is developed in a spreadsheet environment. The use of spreadsheet applications enables simple data entry, processing, editing, analyzing and output reports compiling. Findings: Simulation results show the overall efficiency of the developed model in the determination of adequate performance indicators. They influence overall adequacy of performance indicators on the observed phase. Contribution: The main contribution of this paper lies in the model developed to maximize the adequacy of the performance indicators, suitable for use in the production management of SMEs.

Quick Calculation of Magnetic Flux Density in Electrical Facilities

The World Health Organization (WHO) warns that the presence of magnetic fields due to the circulation of industrial frequency electrical currents may have repercussions on the health of living beings. Hence, it is crucially important that we are able to quantify these fields under the normal operating conditions of the facilities, both in their premises and in their surroundings, in order to take the appropriate corrective measures and assure the safety conditions imposed, in force, by regulations. For this purpose, CRMag® software has been developed. Using the simplified Maxwell equations for low frequencies, CRMag® calculates and represents the magnetic flux density (MFD) that electrical currents produce in the environment. Users can easily model electrical facilities through a friendly and simple data entry. MFDs calculated by CRMag® have been validated in real facilities and laboratory tests. With this software, exposure levels can be studied in any hypothetical scenario, even in inaccessible zones. This allows designers to guarantee that legal limits (occupational, general population, or precautionary levels related to epidemiological studies) are fulfilled. A real case study has been described to show how the reconfiguration of conductors in a distribution transformer substation (DTS) allows significant reductions in MFD in some points outside the facility.

Iterative four-phase development of a theory-based digital behaviour change intervention to reduce occupational sedentary behaviour

IntroductionAs high amounts of occupational sitting have been associated with negative health consequences, designing workplace interventions to reduce sedentary behaviour (SB) is of public health interest. Digital technology may serve as a cost-effective and scalable platform to deliver such an intervention. This study describes the iterative development of a theory-based, digital behaviour change intervention to reduce occupational SB.MethodsThe behaviour change wheel and The Behaviour Change Technique Taxonomy were used to guide the intervention design process and form a basis for selecting the intervention components. The development process consisted of four phases: phase 1 – preliminary research, phase 2 – consensus workshops, phase 3 – white boarding and phase 4 – usability testing.ResultsThe process led to the development and refinement of a smartphone application – Worktivity. The core component was self-monitoring and feedback of SB at work, complemented by additional features focusing on goal setting, prompts and reminders to break up prolonged periods of sitting, and educational facts and tips. Key features of the app included simple data entry and personalisation based on each individual’s self-reported sitting time. Results from the ‘think-aloud’ interviews (n=5) suggest Worktivity was well accepted and that users were positive about its features.ConclusionThis study led to the development of Worktivity, a theory-based and user-informed mobile app intervention to reduce occupational SB. It is the first app of its kind developed with the primary aim of reducing occupational SB using digital self-monitoring. This paper provides a template to guide others in the development and evaluation of technology-supported behaviour change interventions.

Essential drug stock alert tracker in provincial department of Health Services Western Province

Introduction The health indices in Sri Lanka are well above the regional health indices, which can be partly attributed to the free health care system. However, lack of pharmacy supplies in government health institutions, especially in divisional hospitals, is a major complaint from the general public. Health care institutions under the purview of Provincial Director of Health Services (PDHS) receive pharmacy items from the Regional Medical Supplies Division (RMSD). Some of the reasons for shortage of pharmacy items are poor communication between RMSD and health institutions, mal-distribution of items at RMSD and actual drug shortage. Currently there is no manual or electronic mechanism to monitor the institution’s essential drugs at any level, resulting in difficulty to replenish stocks in a timely manner. Objective The objective of this system is to alert the health care institutional heads and regional/provincial administrators about essential drug status and to effectively mobilize the available drugs. Methods A Web based system was designed with a simple data entry format and color code system. A dashboard facilitates the visualization of the available stock with green (satisfactory), yellow (reorder), red (zero stock). User levels in the system include institution, RMSD, Regional and Provincial levels. Currently 26 essential drug items are monitored by the system. Results Before implementing the system, there were 38 occasions (11.73%) of zero stock level for any of the 26 essential drugs in Divisional hospitals. In 66(20.37%) occasions the drugs were at low stock level. This has improved to 1.54% and 8.02% respectively as at April 2016. Conclusion Both Knowledge and Practices for a preparedness of a chemical hazard were not adequate. Some key factors were significantly associated with service duration and teaching subject at school of study subjects. Policy guidelines to assess the disaster drills, training programmes ensuring attendance of all school population are recommended. Coordinated assistance from Disaster Management Centre and health sector should be arranged.

Development and validation of the Surgical Outcome Risk Tool (SORT).

BackgroundExisting risk stratification tools have limitations and clinical experience suggests they are not used routinely. The aim of this study was to develop and validate a preoperative risk stratification tool to predict 30-day mortality after non-cardiac surgery in adults by analysis of data from the observational National Confidential Enquiry into Patient Outcome and Death (NCEPOD) Knowing the Risk study.MethodsThe data set was split into derivation and validation cohorts. Logistic regression was used to construct a model in the derivation cohort to create the Surgical Outcome Risk Tool (SORT), which was tested in the validation cohort.ResultsProspective data for 19 097 cases in 326 hospitals were obtained from the NCEPOD study. Following exclusion of 2309, details of 16 788 patients were analysed (derivation cohort 11 219, validation cohort 5569). A model of 45 risk factors was refined on repeated regression analyses to develop a model comprising six variables: American Society of Anesthesiologists Physical Status (ASA-PS) grade, urgency of surgery (expedited, urgent, immediate), high-risk surgical specialty (gastrointestinal, thoracic, vascular), surgical severity (from minor to complex major), cancer and age 65 years or over. In the validation cohort, the SORT was well calibrated and demonstrated better discrimination than the ASA-PS and Surgical Risk Scale; areas under the receiver operating characteristic (ROC) curve were 0·91 (95 per cent c.i. 0·88 to 0·94), 0·87 (0·84 to 0·91) and 0·88 (0·84 to 0·92) respectively (P < 0·001).ConclusionThe SORT allows rapid and simple data entry of six preoperative variables, and provides a percentage mortality risk for individuals undergoing surgery.

Development of a tailored, computerized, breast cancer risk assessment and decision support tool: What do clinicians want?

e20660 Background: End user input into the design of decision support tools is critical to enhance integration and future routine use in clinical practice. As part of the development of an evidence-based, tailored, computerized breast cancer (BC) risk assessment and management tool, we examined clinicians’ requirements. Methods: Australian breast surgeons (BSs) and primary care clinicians (PCCs) were recruited through local professional networks. Facilitated focus group discussions about current practice of assessing and managing BC risk and perceptions of the proposed tool were audiotaped transcribed and managed using QSR NVivo. A coding framework was developed based on the transcripts, data were coded and each code further analyzed to identify key themes. Results: Four focus groups, involving 12 BSs, 17 PCCs (12 doctors, 5 practice nurses) were conducted. 55 % were male, mean age 45yrs (range 25-67), mean of 14yrs in practice (range1-25+). Clinicians identified difficulties assessing and managing BC risk and lack of available tools to standardise their current inconsistent approach to risk assessment and management. Most felt confident identifying high risk women, but found differentiating women at population risk from those at moderately increased risk more difficult. They felt a tool would help them reassure anxious low to moderate risk women and avoid unnecessary onward referral or investigations and better identify and refer or manage high risk women. Desirable features in a tool included: evidence-based, accessible (web-based), visual, simple data entry process, displays absolute risk (rather than relative) and mutable risk and risk reduction estimates in multiple formats (words, pictographs, graphs) to improve comprehension, printable summary sheets. Clinicians felt that women could input risk factors before the clinic visit but that joint consumer and clinician data entry was preferable and women should only receive a risk estimate with a clinician present. Conclusions: Development of tools for BC risk assessment and management should address these clearly identified needs of end users in order to optimise translation of current and future knowledge into clinical practice.

Abstract 241: Design and Clinical Outcomes of INSTOR (Interventional Stroke Therapy Outcomes Registry)

Background: In the United States there has been no national stroke registry that tracks emergency intra-hospital processes of care and 90-day clinical outcomes for both IV tPA and/or emergency endovascular (IA) stroke treatment. The Joint Commission and other regulatory agencies now mandate use of a national stroke registry based upon concurring recommendations from the Brain Attack Coalition, the American Stroke Association, and the international Multisociety Quality Improvement Guidelines. (online JVIR, Jan 29, 2013) Methods and Results: A custom software development company was employed to create a dedicated on-line national registry for tracking hospital processes and performance trends, and that could perform instant complex multifactorial analyses of clinical outcomes (90-day modified Rankin Score (mRS) based upon numerous patient-specific characteristics. Extensive physician interaction with the software company over a period of years allowed construction of a complex analytical machine with a built-in logic chain for numerous clinical process steps resulting in automatic error detection of out-of-range or impossible answers. The simple self-prompting point and click data entry system typically requires 10 minutes for each stroke alert, 20 minutes for each IV tPA case, and 45 minutes for all aspects of an IA stroke case. INSTOR is a HIPAA compliant, point-and-click national registry that tracks processes-of-care as well as clinical outcomes for both IV tPA and endovascular therapies. All major data points are presented as “site” vs. “All”, with “All” being an anonymous aggregate of data from all participating sites. Conclusions: INSTOR presents instant online graphical and numerical results including “door to CT”, “door to IV tPA”, “time for return of laboratory results” and “time to angiography”, etc. Process trends are presented with graphed monthly median data points overlain by a logistic regression trend line. The computerized multisite database also has the capability of automatically sending text massage or email reminders to designated recipients for follow-up events such as discharge information or 90-day mRS. INSTOR instantly performs complex multifactorial analyses of numerous measures of clinical outcomes for both IV tPA and endovascular stroke interventions and presents this data in standard stacked bar chart form. Outcomes data results include: all ASA Metrics for ischemic stroke, 90-day mRS for IV tPA, IV + IA, and IA treatment alone, and all data points mandated by the international Multisociety Quality Improvement Guidelines. 90-day clinical Outcomes are also analyzed based upon baseline clinical factors such as original NIHSS, vascular occlusion site, and comorbidities such as atrial fibrillation, diabetes, hypertension, and age.

Analysis on Stability Bar

Vehicle anti-roll bars are suspension components used for limiting body roll angle. They have a direct effect on the handling characteristics of the vehicle. Design changes of anti-roll bars are quite common at various steps of vehicle production, and a design analysis must be performed for each change. Finite Element Analysis (FEA) can be effectively used in design analysis of anti-roll bars. However, due to high number of repeated design analyses, the analysis time and cost problems associated with the use of general FEA package programs may create considerable. Disadvantages in using these package programs for performing anti-roll bar design analysis. In this study, an automated design program is developed for performing design analysis of vehicle antiroll bars. The program is composed of two parts, the user interface and the FEA macro. The FEA macro includes the codes for performing deformation, stress, fatigue, and modal analysis of anti-roll bars in ANSYS 10. The user interface, which is composed in Visual Basic 8.0, includes the forms for data input and result output procedures. By the developed software, the FEA of the anti roll bars is simplified to simple data entry via user interface. The flow of the analysis is controlled by the program and the finite element analysis is performed by ANSYS at the background. The developed software can perform design analysis for a wide range of anti-roll bars: The bar centerline can have any 3D shape, the cross section can be solid or hollow circular, the end connections can be of pin or spherical joint type, the bushings can be mounted at any position on the bar with a user defined bushing length. The effects of anti-roll bar design parameters on final anti-roll bar properties are also evaluated by performing sample analyses with the automated design program developed in this study. Ride comfort, handling and road holding are the three aspects that a vehicle suspension system has to provide compromise solutions. Ride comfort requires insulating the vehicle and its occupants from vibrations and shocks caused by the road surface. Handling requires providing safety in maneuvers and in ease in steering. For good road holding, the tires must be kept in contact with the road surface in order to ensure directional control and stability with adequate traction and braking capabilities. The anti-roll bar, as being a suspension component, is used to improve the vehicle performance with respect to these three aspects. The anti-roll bar is a rod or tube that connects the right and left suspension members. It can be used in front suspension, rear suspension or in both suspensions, no matter the suspensions are rigid axle type or independent type. The ends of the anti-roll bar are connected to the suspension links while the center of the bar is connected to the frame of the car such that it is free to rotate. The ends of the arms are attached to the suspension as close to the wheels as possible. If the both ends of the bar move equally, the bar rotates in its bushing and provides no tensional resistance. But it resists relative movement between the bar ends, such as shown in Figure1 Figure 1Antiroll/Sway Bar The bar's tensional stiffness-or resistance to twist-determines its ability to reduce such relative movement and it’s called as “roll stiffness”.

Preservative-free tafluprost 0.0015% in the treatment of patients with glaucoma and ocular hypertension

The objective of this study was to evaluate efficacy, local tolerability, and safety of this first-in-class preservative-free prostaglandin preparation in patients with ocular hypertension and glaucoma. Patients with glaucoma or ocular hypertension who required a change of medication or were naïve to treatment were included in this noninterventional and observational study. Noninterventional means that no influence was made upon the decision of the physicians to include specific patients and upon the treatment algorithm used. German law for observational studies does not allow any influence on the choice of drugs used, patient selection, masking, and comparator treatment regimens. The main aim of this observational study was to collect "real-life data" on the efficacy and safety of a new medical treatment after approval in a large patient population. Participating ophthalmologists were asked to provide anonymous patient data collected during regular visits by filling a simple data entry form. Intraocular pressure (IOP) readings were recorded at baseline (previous therapy or untreated) and 6-12 weeks after changing medical treatment to or initiating treatment with preservative-free tafluprost once daily. Changes in the IOP were evaluated over the study period for all patients as well as for specific pretreatment subgroups. Local comfort was determined using a five-point scale (very good, good, satisfactory, less satisfactory, not acceptable) before and after the change of medical treatment. All adverse events were recorded. Data from 2123 patients with glaucoma or ocular hypertension were considered for the final evaluation. Medication was changed in 41.1% of patients due to tolerability issues and in 25.6% of patients due to insufficient efficacy with prior medication. In all patients preservative-free tafluprost 0.0015% lowered IOP from 19.5 ± 4.4 mmHg (baseline) to 16.4 ± 2.9 mmHg after 6-12 weeks. Preservativefree tafluprost also significantly lowered the IOP in all monotherapy subgroups: treatment-naïve patients (n=440): 22.6 ± 3.9 mmHg (baseline) to 16.7 ± 2.7 mmHg (week 6-12); beta blockers (n=307): 20.3 ± 3.5 mmHg (baseline) to 16.7 ± 2.6 mmHg (week 6-12); carbonic anhydrase inhibitors (n=158): 19.0 ± 3.6 mmHg (baseline) to 16.0 ± 2.6 mmHg (week 6-12); prostaglandin analogs (PGAs; n=447): 16.8 ± 2.9 mmHg (baseline) to 15.8 ± 2.6 mmHg (week 6-12). Local comfort was rated as "very good" or "good" by 85.6% of patients at the final visit (P<0.001). Only few adverse events occurred during the treatment period: 18 patients (0.8%) discontinued medical treatment with preservative-free tafluprost due to local intolerance; six patients (0.3%) due to efficacy issues; four patients complained about systemic side effects (0.2%); and two patients preferred to use a multidose treatment regimen (0.2%). Although this study was limited by its observational design the results demonstrate that preservative-free tafluprost 0.0015% was effective, generally well tolerated, and safe in a broad and heterogeneous patient population.

OVERCOMING SPREADSHEET RISK IN SUPPLY CHAIN MODELING

Spreadsheet optimization modeling plays an important role in the management of today's sophisticated supply chains. However, despite the advantages of spreadsheets (or in some cases because of these advantages) there are significant risks associated with spreadsheet models. Spreadsheet risk is defined as the chance of adverse operational or financial consequences due to erroneous creation, maintenance, and/or use of spreadsheet models. Such errors arise because the intrinsic complexity of optimization models is beyond the expertise of many non‐technical managers. In this article we discuss procedures that we developed for managing the substantial risks associated with the use of spreadsheets for supply chain optimization. The issues we address go far beyond simple data entry mistakes, which are possible in virtually every aspect of business and can never be completely eliminated.

MRMaid-DB: A Repository of Published SRM Transitions

Selected reaction monitoring (SRM) is a technique that applies tandem mass spectrometry to quantify specific proteins of biological interest. The key to SRM is finding the best peptide-to-product ion transitions to monitor. The MRMaid database (MRMaid-DB) is a new online database for capturing SRM transitions from published research papers to save practitioners time when searching for transitions that have been previously validated. It contains all the information needed to reproduce the transitions, such as information on the sample matrix, HPLC, and MS instrumentation used, and also includes details of the manuscript of origin. Transitions are submitted using simple Web-based data entry forms, meaning researchers have a simple way to increase access to their transitions, and in turn, may increase the citations for their research papers. MRMaid-DB is free to use, via the Web at www.mrmaid-db.info .

Selecting a BRCA risk assessment model for use in a familial cancer clinic

BackgroundRisk models are used to calculate the likelihood of carrying a BRCA1 or BRCA2 mutation. We evaluated the performances of currently-used risk models among patients from a large familial program using the criteria of high sensitivity, simple data collection and entry and BRCA score reporting.MethodsRisk calculations were performed by applying the BRCAPRO, Manchester, Penn II, Myriad II, FHAT, IBIS and BOADICEA models to 200 non-BRCA carriers and 100 BRCA carriers, consecutively tested between August 1995 and March 2006. Areas under the receiver operating characteristic curves (AUCs) were determined and sensitivity and specificity were calculated at the conventional testing thresholds. In addition, subset analyses were performed for low and high risk probands.ResultsThe BRCAPRO, Penn II, Myriad II, FHAT and BOADICEA models all have similar AUCs of approximately 0.75 for BRCA status. The Manchester and IBIS models have lower AUCs (0. and 0.47 respectively). At the conventional testing thresholds, the sensitivities and specificities for a BRCA mutation were, respectively, as follows: BRCAPRO (0.75, 0.62), Manchester (0.58,0.71), Penn II (0.93,0.31), Myriad II (0.71,0.63), FHAT (0.70,0.63), IBIS (0.20,0.74), BOADICEA (0.70, 0.65).ConclusionThe Penn II model most closely met the criteria we established and this supports the use of this model for identifying individuals appropriate for genetic testing at our facility. These data are applicable to other familial clinics provided that variations in sample populations are taken into consideration.

On Getting More and Better Data Into the Classroom

The authors’ work to develop capabilities for getting data into the data analysis software Fathom™ is described. Heuristics of detecting data on a web page allow drag and drop of a URL into a document. A collaboration with the Minnesota Population Center makes possible sampling from census microdata from 1850 through 2000. With direct support for Vernier sensors, students can build a model during the process of realtime data collection. Finally, a survey capability makes it easy for teachers and students to create simple data entry forms hosted on a web site such that the collated data is instantly downloadable for data analysis in Fathom. By taking some of the drudgery out of gathering data, these capabilities carry implications for teaching and curriculum development; namely that students should have experience throughout their learning with data that they individually have chosen to explore. It is argued that the skills they gain by engaging in exploratory data analysis with self-chosen and self-generated data are critically important in our data-driven society and not yet adequately supported in K–14 learning.