Adaptation au codage CIM-10 de 15 indicateurs de la sécurité des patients proposés par l'Agence étasunienne pour la recherche et la qualité des soins de santé (AHRQ) [ICD-10 adaptation of 15 Agency for Healthcare Research and Quality patient safety indicators].

BACKGROUND: In the United States, the Agency for Healthcare Research and Quality (AHRQ) has developed 20 Patient Safety Indicators (PSIs) to measure the occurrence of hospital adverse events from medico-administrative data coded according to the ninth revision of the international classification of disease (ICD-9-CM). The adaptation of these PSIs to the WHO version of ICD-10 was carried out by an international consortium. METHODS: Two independent teams transcoded ICD-9-CM diagnosis codes proposed by the AHRQ into ICD-10-WHO. Using a Delphi process, experts from six countries evaluated each code independently, stating whether it was "included", "excluded" or "uncertain". During a two-day meeting, the experts then discussed the codes that had not obtained a consensus, and the additional codes proposed. RESULTS: Fifteen PSIs were adapted. Among the 2569 proposed diagnosis codes, 1775 were unanimously adopted straightaway. The 794 remaining codes and 2541 additional codes were discussed. Three documents were prepared: (1) a list of ICD-10-WHO codes for the 15 adapted PSIs; (2) recommendations to the AHRQ for the improvement of the nosological frame and the coding of PSI with ICD-9-CM; (3) recommendations to the WHO to improve ICD-10. CONCLUSIONS: This work allows international comparisons of PSIs among the countries using ICD-10. Nevertheless, these PSIs must still be evaluated further before being broadly used.

Networks of PhD Students and Academic Performance: A Comparison across Countries

In this article we compare regression models obtained to predict PhD students’ academic performance in the universities of Girona (Spain) and Slovenia. Explanatory variables are characteristics of PhD student’s research group understood as an egocentered social network, background and attitudinal characteristics of the PhD students and some characteristics of the supervisors. Academic performance was measured by the weighted number of publications. Two web questionnaires were designed, one for PhD students and one for their supervisors and other research group members. Most of the variables were easily comparable across universities due to the careful translation procedure and pre-tests. When direct comparison was notpossible we created comparable indicators. We used a regression model in which the country was introduced as a dummy coded variable including all possible interaction effects. The optimal transformations of the main and interaction variables are discussed. Some differences between Slovenian and Girona universities emerge. Some variables like supervisor’s performance and motivation for autonomy prior to starting the PhD have the same positive effect on the PhD student’s performance in both countries. On the other hand, variables like too close supervision by the supervisor and having children have a negative influence in both countries. However, we find differences between countries when we observe the motivation for research prior to starting the PhD which increases performance in Slovenia but not in Girona. As regards network variables, frequency of supervisor advice increases performance in Slovenia and decreases it in Girona. The negative effect in Girona could be explained by the fact that additional contacts of the PhD student with his/her supervisor might indicate a higher workload in addition to or instead of a better advice about the dissertation. The number of external student’s advice relationships and social support mean contact intensity are not significant in Girona, but they have a negative effect in Slovenia. We might explain the negative effect of external advice relationships in Slovenia by saying that a lot of external advice may actually result from a lack of the more relevant internal advice

Place marketing performance: benchmarking european cities as business destinations

The aim of this study is to develop a model measuring the performance of cities' marketing efforts. The model and the benchmarking methodology presented can be used by local authorities to position their marketing efforts and achievements against other (competing) cities and to identify best practices that can assist place marketers in learning how to be more efficient obtaining desired place marketing results, e.g., improved city brand image, with the available resources/budgets. The major implication for practitioners is that place marketing should be managed as a process, taking into account both the resource flows and the outputs, as well as the efficiency of this process.

What process research tells us about brief intervention efficacy.

ISSUE: This article explores mechanisms of the efficacy of brief intervention (BI). APPROACH: We conducted a BI trial at the emergency department of the Lausanne University Hospital, of whom 987 at-risk drinkers were randomised into BI and control groups. The overall results demonstrated a general decrease in alcohol use with no differences across groups. The intention to change was explored among 367 patients who completed BI. Analyses of 97 consecutive tape-recorded sessions explored patient and counsellor talks during BI, and their relationship to alcohol use outcome. KEY FINDINGS: Evaluation of the articulation between counsellor behaviours and patient language revealed a robust relationship between counsellor motivational interviewing (MI) skills and patient change talk during the intervention. Further exploration suggested that communication characteristics of patients during BI predicted changes in alcohol consumption 12 months later. Moreover, despite systematic training, important differences in counsellor performance were highlighted. Counsellors who had superior MI skills achieved better outcomes overall, and maintained efficacy across all levels of patient ability to change, whereas counsellors with inferior MI skills were effective mostly with patients who had higher levels of ability to change. Finally, the descriptions of change talk trajectories within BI and their association with drinking 12 months later showed that final states differed from initial states, suggesting an impact resulting from the progression of change talk during the course of the intervention. IMPLICATION: These findings suggest that BI should focus on the general MI attitude of counsellors who are capable of eliciting beneficial change talk from patients. [Daeppen J-B, Bertholet N, Gaume J. What process research tells us about brief intervention efficacy.

Clinical indicators for the initiation of endotracheal suction in children: An integrative review.

BACKGROUND: Critical decisions and interpretation of observations by the nurse caring for the paediatric intensive care (PIC) patient can have dramatic and potential adverse impact on the clinical stability of the patient. A common PIC procedure is endotracheal tube (ETT) suction, however there is inconsistent evidence regarding the clinical indicators to guide and support nursing action. Justification for performing this procedure is not clearly defined within the literature. Further, a review of the literature has failed to establish clear standards for determining if the procedure is warranted, especially for paediatric patients. OBJECTIVE: The objective of the review is to identify current clinical indicators used in practice to determine why ETT suction should be performed. METHOD: An integrative review using a systematic approach to summarise the empirical and theoretical evidence within the literature as it relates to clinical practice was used. RESULTS: Consensus of opinion indicates that ETT suctioning should only be performed when clinically indicated. There is no general consensus regarding which clinical indicators should be measured and used to guide the decision to perform ETT suctioning. CONCLUSION: Research is required to identify the clinical indicators that could be used to design a valid and clinically appropriate tool to use to assist in the decision making process to perform ETT suction.

Process and results of the development of an ICNP® Catalogue for Cancer Pain

This was a methodological study conducted to describe the process and results of the development of an International Classification for Nursing Practice (ICNP®) Catalogue for Cancer Pain. According to the International Council of Nurses (ICN), this catalogue contains a subset of nursing diagnoses, outcomes, and interventions to document the implementation of the nursing process in cancer patients. This catalogue was developed in several steps according to the guidelines recommended by the ICN. As a result, 68 statements on nursing diagnoses/outcomes were obtained, which were classified according to the theoretical model for nursing care related to cancer pain into physical (28), psychological (29), and sociocultural and spiritual (11) aspects. A total of 116 corresponding nursing interventions were obtained. The proposed ICNP® Catalogue for Cancer Pain aims to provide safe and systematic orientation to nurses who work in this field, thus improving the quality of patient care and facilitating the performance of the nursing process.

Warning systems in a computerized nursing process for Intensive Care Units

A hybrid study combining technological production and methodological research aiming to establish associations between the data and information that are part of a Computerized Nursing Process according to the ICNP® Version 1.0, indicators of patient safety and quality of care. Based on the guidelines of the Agency for Healthcare Research and Quality and the American Association of Critical Care Nurses for the expansion of warning systems, five warning systems were developed: potential for iatrogenic pneumothorax, potential for care-related infections, potential for suture dehiscence in patients after abdominal or pelvic surgery, potential for loss of vascular access, and potential for endotracheal extubation. The warning systems are a continuous computerized resource of essential situations that promote patient safety and enable the construction of a way to stimulate clinical reasoning and support clinical decision making of nurses in intensive care.

Análise Económica e Financeira como Instrumento de Apoio ao Processo Decisório

O foco central deste relatório consiste em mostrar a total importância da Análise Económica e Financeira como instrumento de apoio ao processo decisório. No contexto actual onde a concorrência é cada vez mais forte e a busca pela competitividade é uma necessidade constante, as empresas necessitam de informações precisas e oportunas para apoiar o processo decisório. A escassez de recursos financeiros e o elevado custo, aliado com a falta de planeamento e controle, têm contribuído para que muitas empresas encerrem suas actividades. A tomada de boas decisões torna-se, então, um factor crucial para assegurar a sobrevivência, crescimento e permanência da empresa no mercado. Neste sentido, buscamos trazer para todos os interessados alguns conceitos e técnicas fundamentais de análise e medição da performance económica e financeira das empresas que será igualmente útil, quer a nível académica, como também a nível profissional. Procuramos evidenciar a importância de se conhecer os indicadores que podem ser vistos como alertas de possíveis falências de empresas e com base nisso, tomar decisões que determinam que estratégias utilizar para enfrentar a concorrência. A finalizar este relatório procedemos a uma pesquisa Estudo de Caso que engloba uma análise económica e financeira, baseada na análise das Demonstrações Financeiras e demais informações complementares da TRANSCOR-SV, S.A. Foram explorados alguns conceitos relacionados com o tema, mostrando de forma simples e objectiva a situação de como a empresa vem actuando no mercado. Constámos algumas deficiências, pois, foram verificados alguns pontos fracos. Diante dos problemas, sugerimos formas de mudanças e de viabilidade dos mesmos. Esperamos, então, que este relatório contribua para a empresa analisar melhor a forma de administrar a parte económica e financeira e demais sectores.The central focus of this report consists of showing to total importance of the Analysis Economic and Financial as support instrument to the ruling process. In the context actual where the competition is more and more strong and the search for the competitiveness is a constant need, the companies need necessary and opportune information to support the ruling process. The shortage of financial resources and the high cost, ally with the planning lack and control, they have been contributing so that a lot of companies contain their activities. The socket of good decisions becomes, then, a crucial factor to assure the survival, growth and permanence of the company in the market. In this sense, we looked for to bring for all the interested parties, some concepts and fundamental techniques of analysis and measurement of the performance economic and financial of the companies, which will be equally useful, he/she wants to academic level, as well as at professional level. We tried to evidence, the importance of knowing the indicators that you/they can be seen as alerts of possible bankruptcies of companies and with base in that, to make decisions that determine which strategies to use to face the competition. To conclude this report we proceeded to a research Study of Case that includes an analysis economic and financial, based on the analysis of the Financial Demonstrations and other complementary information of TRANSCOR-S.V., S.A. Some concepts related with the theme were explored, showing the situation of simple form and objective of as the company is acting in the market. It was verified some deficiencies, because, some weak points were verified. Before the problems, we suggested forms of changes and of viability of the same ones.We waited, then, which this report contributes to company to analyze the form better of administering the part economic and financial and other sectors.

Validation of the New Mix Design Process for Cold In-Place Rehabilitation Using Foamed Asphalt, 2007

Asphalt pavement recycling has grown dramatically over the last few years as a viable technology to rehabilitate existing asphalt pavements. Iowa's current Cold In-place Recycling (CIR) practice utilizes a generic recipe specification to define the characteristics of the CIR mixture. As CIR continues to evolve, the desire to place CIR mixture with specific engineering properties requires the use of a mix design process. A new mix design procedure was developed for Cold In-place Recycling using foamed asphalt (CIR-foam) in consideration of its predicted field performance. The new laboratory mix design process was validated against various Reclaimed Asphalt Pavement (RAP) materials to determine its consistency over a wide range of RAP materials available throughout Iowa. The performance tests, which include dynamic modulus test, dynamic creep test and raveling test, were conducted to evaluate the consistency of a new CIR-foam mix design process to ensure reliable mixture performance over a wide range of traffic and climatic conditions. The “lab designed” CIR will allow the pavement designer to take the properties of the CIR into account when determining the overlay thickness.

Position statement--altitude training for improving team-sport players' performance: current knowledge and unresolved issues.

Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports.

Proving the performance of a new revenue management system

Revenue management (RM) is a complicated business process that can best be described ascontrol of sales (using prices, restrictions, or capacity), usually using software as a tool to aiddecisions. RM software can play a mere informative role, supplying analysts with formatted andsummarized data who use it to make control decisions (setting a price or allocating capacity fora price point), or, play a deeper role, automating the decisions process completely, at the otherextreme. The RM models and algorithms in the academic literature by and large concentrateon the latter, completely automated, level of functionality.A firm considering using a new RM model or RM system needs to evaluate its performance.Academic papers justify the performance of their models using simulations, where customerbooking requests are simulated according to some process and model, and the revenue perfor-mance of the algorithm compared to an alternate set of algorithms. Such simulations, whilean accepted part of the academic literature, and indeed providing research insight, often lackcredibility with management. Even methodologically, they are usually awed, as the simula-tions only test \within-model" performance, and say nothing as to the appropriateness of themodel in the first place. Even simulations that test against alternate models or competition arelimited by their inherent necessity on fixing some model as the universe for their testing. Theseproblems are exacerbated with RM models that attempt to model customer purchase behav-ior or competition, as the right models for competitive actions or customer purchases remainsomewhat of a mystery, or at least with no consensus on their validity.How then to validate a model? Putting it another way, we want to show that a particularmodel or algorithm is the cause of a certain improvement to the RM process compared to theexisting process. We take care to emphasize that we want to prove the said model as the causeof performance, and to compare against a (incumbent) process rather than against an alternatemodel.In this paper we describe a \live" testing experiment that we conducted at Iberia Airlineson a set of flights. A set of competing algorithms control a set of flights during adjacentweeks, and their behavior and results are observed over a relatively long period of time (9months). In parallel, a group of control flights were managed using the traditional mix of manualand algorithmic control (incumbent system). Such \sandbox" testing, while common at manylarge internet search and e-commerce companies is relatively rare in the revenue managementarea. Sandbox testing has an undisputable model of customer behavior but the experimentaldesign and analysis of results is less clear. In this paper we describe the philosophy behind theexperiment, the organizational challenges, the design and setup of the experiment, and outlinethe analysis of the results. This paper is a complement to a (more technical) related paper thatdescribes the econometrics and statistical analysis of the results.

Nonlinear models and small sample performance of the generalized method of moments

In this paper I explore the issue of nonlinearity (both in the datageneration process and in the functional form that establishes therelationship between the parameters and the data) regarding the poorperformance of the Generalized Method of Moments (GMM) in small samples.To this purpose I build a sequence of models starting with a simple linearmodel and enlarging it progressively until I approximate a standard (nonlinear)neoclassical growth model. I then use simulation techniques to find the smallsample distribution of the GMM estimators in each of the models.

Performance Report for Fiscal Year, 2005

I am pleased to present the performance report for the Iowa Department for the Blind for fiscal year 2005. This report is provided in compliance with sections 8E.210 and 216B.7 of the Code of Iowa. It contains valuable information about the services the Department and its partners provided for Iowans during the past fiscal year in the areas of vocational rehabilitation, library services, and resource management. Major accomplishments of the year included new food service opportunities in the Randolph-Sheppard program, extensive remodeling of the Adult Orientation and Adjustment Center, and continued national prominence in vocational rehabilitation as measured by the U.S. Rehabilitation Services Administration, which on June 13, 2005 released data on federal standards and indicators for the year ended September 30, 2004. Earnings ratios and the percentage of employment for vocational rehabilitation clients of the Department remain among the best in the nation. This is corroborated by a report released in September, 2005 by the U.S. Government Accountability Office, which tested and summarized datasets compiled by the U.S. Department of Education for the nation’s 80 vocational rehabilitation agencies. Overall, we met or exceeded 26 of 32 results targets included in this report. Key strategic challenges, developments, and trends are also discussed in the "Department Overview" that follows. Sincerely, Allen C. Harris Director, Iowa Department for the Blind

Performance Report for Fiscal Year, 2006

I am pleased to present the performance report for the Iowa Department for the Blind for fiscal year 2006. This report is provided in compliance with sections 8E.210 and 216B.7 of the Code of Iowa. It contains valuable information about the services the Department and its partners provided for Iowans during the past fiscal year in the areas of vocational rehabilitation, library services, and resource management. Major accomplishments of the year included successful administration of a federally-funded mentoring program (Pathfinders) that matches young adults ages 16-26 who are blind or visually impaired with mentors who also have vision loss, installed a state-of-the art digital recording studio in the library, and continued national prominence in vocational rehabilitation. Earnings ratios and the percentage of employment for vocational rehabilitation clients of the Department remain among the best in the nation, as measured by the U.S. Rehabilitation Services Administration, which on July 3, 2006 released data on federal standards and indicators for the year ended September 30, 2005. Overall, we met or exceeded 15 of 20 results targets included in this report. Key strategic challenges, developments, and trends are also discussed in the "Department Overview" that follows. Sincerely, Allen C. Harris Director, Iowa Department for the Blind

Performance Report for Fiscal Year, 2007

I am pleased to present the performance report for the Iowa Department for the Blind for fiscal year 2007. This report is provided in compliance with sections 8E.210 and 216B.7 of the Code of Iowa. It contains valuable information about the services the Department and its partners provided for Iowans during the past fiscal year in the areas of Vocational Rehabilitation, Independent Living, Library Services, and Resource Management. The Department determines its competitive success in a number of ways. We look at the federal standards and indicators to learn our ranking in relation to the performance of other public rehabilitation agencies. We compare our library's production and circulation figures with those from previous years to determine trends. We set our own standards for success by looking at such factors as the number of successful case closures, average hourly wage at case closure, skills training provided, and compliance with regulations. Results show that the Department is working positively toward achieving its strategic goals of increasing the independence and productivity of blind Iowans and improving access to information for blind Iowans. Major accomplishments of the year included the selection of our Library as the only agency authorized to distribute educational materials using the National Instructional Materials Accessibility Standard (NIMAS) to students in Iowa. Our Independent Living program received the Shining Star award at the Governor's Conference on Aging for its work with and outreach to older blind Iowans. The Department, the Iowa Braille School, and the Department of Education implemented new cooperative efforts to improve the coordination and delivery of services to blind and visually impaired students in Iowa. Finally, earnings ratios and the percentage of employment for vocational rehabilitation clients of the Department remain among the best in the nation, as measured by the U.S. Rehabilitation Services Administration, which on June 27, 2007 released data on federal standards and indicators for the year ended September 30, 2006. Overall, we met or exceeded 11 of 16 results targets included in this report. A discussion of the Department's services, customers, organizational structure, and budget appears in the "Department Overview" that follows. The success of the Department's programs is evident in the success achieved by blind Iowans. It is reflected in the many blind persons who can be seen traveling about independently, going to their jobs and to the community and family activities in which they participate. Sincerely, Allen C. Harris Director, Iowa Department for the Blind