The UK Renal Registry Advanced CKD Study: frequency of incorrect reporting of date of start of RRT

Background: A preliminary review of the UK Renal Registry (UKRR) pre-RRT study data revealed results suggesting that, for some patients, the date of start of renal replacement therapy (RRT), as reported to the UKRR, was incorrect and often significantly later than the true date of start. A more detailed study then aimed to validate a set of criteria to identify patients with an incorrect start date. Methods: Pre-RRT laboratory data were electronically extracted from 8,810 incident RRT patients from 9 UK renal centres. Any patient with a low urea (<15 mmol/L) at the start of RRT or with a substantial improvement in kidney function (either a fall in urea >10 mmol/L or rise in eGFR >2 ml/min/1.73 m) within the two months prior to RRT were considered to potentially have an incorrect date of start. In 4
selected centres, the electronic patient records of all patients flagged were reviewed to validate these criteria.
Results: Of 8,810 patients, 1,616 (18.3%) were flagged by the identification criteria as having a potentially incorrect date of start of RRT, although a single centre accounted for 41% of the total flagged cohort. Of these flagged patients, 61.7% had been assigned an incorrect date of start of haemodialysis (HD), 5.7% had evidence of acute RRT being given before the reported date of start of HD
and 9.2% had evidence of starting peritoneal dialysis exchanges prior to the reported date of start. Of
those flagged, 10.7% had a correct date of start of RRT.
Conclusions: Accurate reporting of RRT episodes is vital for the analysis of time dependent studies such as survival or time to transplantation. A proportion of patients starting RRT were assigned an incorrect start date. In order to improve the accuracy of this reporting the UK Renal Registry
must work with renal centres and clinical staff on improving data input for the start of RRT.

REporting and calibration of post-bomb C-14 data

The definitive paper by Stuiver and Polach (1977) established the conventions for reporting of 14C data for chronological and geophysical studies based on the radioactive decay of 14C in the sample since the year of sample death or formation. Several ways of reporting 14C activity levels relative to a standard were also established, but no specific instructions were given for reporting nuclear weapons testing (post-bomb) 14C levels in samples. Because the use of post-bomb 14C is becoming more prevalent in forensics, biology, and geosciences, a convention needs to be adopted. We advocate the use of fraction modern with a new symbol F14C to prevent confusion with the previously used Fm, which may or may not have been fractionation corrected. We also discuss the calibration of post-bomb 14C samples and the available datasets and compilations, but do not give a recommendation for a particular dataset.

Transfer ionization process p+He -> H-0+He2++e(-) with the ejected electron detected in the plane perpendicular to the incident beam direction

A joint experimental and theoretical study of the transfer ionization process p+He&RARR; H-0+He2++e(-) is presented for 630-keV proton impact energy, where the electron is detected in a plane perpendicular to the proton beam direction. With this choice of kinematics we find the triple-differential cross section to be particularly sensitive to angular correlation in the helium target. There is a good agreement between the experimental data and theoretical calculations.

Recognizing and reporting child physical abuse: a cross sectional survey of primary health care professionals

Objectives: To assess primary health care professionalsâ?? ability to recognise child physical abuse within their everyday practice. Design: Cross-sectional survey Participants: A stratified random sample of 979 nurses, doctors, and dentists working in primary care in NI. Results: Four hundred and thirty one primary health care professionals responded [44% response rate]. Thirty two per cent were doctors, 35% were dentists and 33% were nurse professionals. The mean age was 41.63 years. Fifty-nine percent (251) stated that they had seen a suspicious case of child physical abuse and 47% (201) said they had reported it. Seventy-two per cent (310) of participants were aware of the mechanisms for reporting child physical abuse. Ability and willingness to recognise and report abuse discriminated the three professions. Conclusions: The findings suggest a professional reluctance to engage in recognising and reporting abuse. Barriers could be reduced by providing training and professional support for the primary care professionals.