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252. The value of data collection within a palliative care program

Author

Kamal, AH, Currow, DC, Ritchie, C, Bull, J, Wheeler, JL, Abernethy, AP, Kamal, AH, Currow, DC, Ritchie, C, Bull, J, Wheeler, JL, and Abernethy, AP

Abstract

Collecting reliable and valid data is an increasing expectation within palliative care. Data remain the crux for demonstrating value and quality of care, which are the critical steps to program sustainability. Parallel goals of conducting research and performing quality assessment and improvement can also ensure program growth, financial health, and viability in an increasingly competitive environment. Mounting expectations by patients, hospitals, and payers and inevitable pay-for-performance paradigms have transitioned data collection procedures from novel projects to expected standard operation within usual palliative care delivery. We present types of data to collect, published guides for data collection, and how data can inform quality, value, and research within a palliative care organization. Our experiences with the Quality Data Collection Tool (QDACT) in the Carolinas Palliative Care Consortium to collect data on quality have led to valuable lessons learned in creating a data collection system. Suggested steps in forming data-sharing collaborations and building data collection procedures are shared. © 2011 Springer Science+Business Media, LLC.

Published
2011

253. Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial

Author

Peters, R ; https://orcid.org/0000-0003-0148-3617, Beckett, N, Forette, F, Tuomilehto, J, Clarke, R, Ritchie, C, Waldman, A, Walton, I, Poulter, R, Ma, S, Comsa, M, Burch, L, Fletcher, A, Bulpitt, C, Peters, R ; https://orcid.org/0000-0003-0148-3617, Beckett, N, Forette, F, Tuomilehto, J, Clarke, R, Ritchie, C, Waldman, A, Walton, I, Poulter, R, Ma, S, Comsa, M, Burch, L, Fletcher, A, and Bulpitt, C

Abstract

Background: Observational epidemiological studies have shown a positive association between hypertension and risk of incident dementia; however, the effects of antihypertensive therapy on cognitive function in controlled trials have been conflicting, and meta-analyses of the trials have not provided clear evidence of whether antihypertensive treatment reduces dementia incidence. The Hypertension in the Very Elderly trial (HYVET) was designed to assess the risks and benefits of treatment of hypertension in elderly patients and included an assessment of cognitive function. Methods: Patients with hypertension (systolic pressure 160-200 mm Hg; diastolic pressure <110 mm Hg) who were aged 80 years or older were enrolled in this double-blind, placebo-controlled trial. Participants were randomly assigned to receive 1·5 mg slow release indapamide, with the option of 2-4 mg perindopril, or placebo. The target systolic blood pressure was 150 mm Hg; the target diastolic blood pressure was 80 mm Hg. Participants had no clinical diagnosis of dementia at baseline, and cognitive function was assessed at baseline and annually with the mini-mental state examination (MMSE). Possible cases of incident dementia (a fall in the MMSE score to <24 points or a drop of three points in 1 year) were assessed by standard diagnostic criteria and expert review. The trial was stopped in 2007 at the second interim analysis after treatment resulted in a reduction in stroke and total mortality. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00122811. Findings: 3336 HYVET participants had at least one follow-up assessment (mean 2·2 years) and were included: 1687 participants were randomly assigned to the treatment group and 1649 to the placebo group. Only five reports of adverse effects were attributed to the medication: three in the placebo group and two in the treatment group. The mean decrease in systolic blood pressure between the treatment and place

Published
2008

254. Effect of membrane character and solution chemistry on microfiltration performance

Author

Gray, S., Ritchie, C., Tran, Truyen, Bolto, B., Greenwood, Paul, Busetti, Francesco, Allpike, Bradley, Gray, S., Ritchie, C., Tran, Truyen, Bolto, B., Greenwood, Paul, Busetti, Francesco, and Allpike, Bradley

Abstract

To help understand and predict the role of natural organic matter (NOM) in the fouling oflow-pressure membranes, experiments were carried out with an apparatus that incorporates automatic backwashing and long filtration runs. Three hollow fibre membranes of varying character were included in the study, and the filtration of two different surface waters was compared. The hydrophilic membrane had greater flux recovery after backwashing than the hydrophobic membranes, but the efficiency of backwashing decreased at extended filtration times. NOM concentration of these waters (7.9 and 9.1 mg/L) had little effect on the flux of the membranes at extended filtration times, as backwashing of the membrane restored the flux to similar values regardless of the NOM concentration. The solution pH also had little effect at extended filtration times. The backwashing efficiency of the hydrophilic membrane was dramatically different for the two waters, and the presence of colloid NOM alone could not explain these differences. It isproposed that colloidal NOM forms a filter cake on the surface of the membranes and that small molecular weight organics that have an adsorption peak at 220 nm but not 254 nm were responsible for "gluing" the colloids to the membrane surface. Alum coagulation improved membrane performance in all instances, and this was suggested to be because coagulation reduced the concentration of "glue" that holds the organic colloids to the membrane surface.

Published
2008

257. A propensity-matched study of the effect of diabetes on the natural history of heart failure: variations by sex and age

Author

Ahmed, A, Aban, Ib, Vaccarino, V, Lloyd Jones, Dm, Goff, Dc, Zhao, J, Love, Te, Ritchie, C, Ovalle, F, Gambassi, Giovanni, Dell'Italia, Lj, Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Ahmed, A, Aban, Ib, Vaccarino, V, Lloyd Jones, Dm, Goff, Dc, Zhao, J, Love, Te, Ritchie, C, Ovalle, F, Gambassi, Giovanni, Dell'Italia, Lj, and Gambassi, Giovanni (ORCID:0000-0002-7030-9359)

Abstract

Poor prognosis in heart failure (HF) patients with diabetes is often attributed to increased co-morbidity and advanced disease. Further, this effect may be worse in women.

Published
2007

290. A comparison of the efficacy and safety of olanzapine and risperidone in the treatment of elderly patients with schizophrenia: an open study of six months duration

Author

Ritchie, C. W., primary, Chiu, E., additional, Harrigan, S., additional, Macfarlane, S., additional, Mastwyk, M., additional, Halliday, G., additional, Hustig, H., additional, Hall, K., additional, Hassett, A., additional, O'Connor, D. W., additional, Opie, J., additional, Nagalingam, V., additional, Snowdon, J., additional, and Ames, D., additional

Published
2006
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300. EXPLORATORY LEARNING THROUGH CRITICAL INQUIRY: SURVEY OF CRITICAL INQUIRY PROGRAMS AT MID-SIZED U.S. UNIVERSITIES.

Author

Foote, Stephanie M., Harrison, David S., Ritchie, C. Michael, and Dyer, Andrew

Subjects
LEARNING by discovery, EDUCATIONAL programs, CRITICAL thinking, GENERAL education, FACILITATED learning
Abstract

Many alternatives exist for setting the delivery, content, direction, tone, and priorities for a Critical Inquiry/Thinking general education program. Review of our university's overall general education program indicated the need, and overwhelming faculty approval, for a program to improve critical thinking skills, to specifically include exploratory learning and improved cognitive abilities. As we moved ahead we formed a Critical Inquiry Committee for in depth, and participative planning. One of the preliminary, investigative steps was to survey peer institution critical inquiry programs. The results of the study are reported below, along with our steps in developing our first year, one credit, general education critical inquiry program. Our paper includes details of our faculty development program and the results of our pilot program implementation. Our full program is scheduled for implementation during fall 2012. [ABSTRACT FROM AUTHOR]

Published
2012

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