Communication and Coordination: The Keys to Quality

Journal of Clinical Oncology (Impact Factor: 18.43). 10/2005; 23(27):6452-5. DOI: 10.1200/JCO.2005.05.026
Source: PubMed
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    ABSTRACT: The Central Queensland University (CQU) Regional Seismic Network is made up of an array of six short-period seismometer and two strong motion accelerometer stations. The array has an aperture of about 50 km. CQU is able to resolve epicentral co-ordinates to about 2 kilometres, with a sample rate of 100 per second, and an absolute time accuracy of 100 milliseconds. This resolution is achieved by using triaxial seismometers which allow better secondary phase identification of shear, converted and depth phases.The network covers an area of above average seismic risk in continental Australia. The area has been affected in 1918 by one of the largest earthquakes ever recorded along the eastern seaboard of Australia. The network also monitors a large number of blasts carried out by the coal mines and hard rock, quarries in the region, and these are being used in a long-term study to determine the structure of the Crust and Upper Mantle in Central Queensland.Techniques for monitoring rockbursts and longwall caving in mines are similar, to those used for monitoring local earthquakes. CQU has successfully used a single triaxial seismometer to record seismic events produced by the strata failure and roof falls of a longwall coal mine. The case history presented shows that the initial fall under massive roof conditions appears to be predicted by a simple trend plot of microseismic event magnitude and longwall production rate. Extension of this technique to a closely spaced array of both surface and in-seam triaxial seismometers is required for a more detailed appraisal to be undertaken. Adequate resolution of event location requires a higher, sample rate (up to 1000 Hz) and more accurate timing (about 1 millisecond) than for earthquake monitoring. An appropriate stratigraphic model is also required, as is the case for earthquake location.
    Pure and Applied Geophysics 01/1995; 145(1):39-57. DOI:10.1007/BF00879482 · 1.62 Impact Factor
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    ABSTRACT: There is debate about the value of measuring health-related quality of life (HRQL) in clinical trials in oncology because of evidence suggesting that HRQL does not influence clinical decisions. Analysis of HRQL in surgical trials, however, may inform decision making because it provides detailed assessment of the immediate detrimental short-term impact of surgery on HRQL that needs to be considered against the long-term survival benefits and functional outcomes of surgery. This study evaluated whether HRQL in randomized trials in surgical oncology contributes to clinical decision making. A systematic review identified randomized trials in surgical oncology with HRQL. Trials were evaluated independently by two reviewers and the value of HRQL in clinical decision making was categorized in three ways: whether trial investigators reported that HRQL influenced final treatment recommendations, whether trial investigators reported that HRQL would be useful for informed consent, and whether HRQL was assessed robustly according to predefined criteria. Thirty-three randomized trials with valid HRQL questionnaires were identified; 22 (67%) concluded that HRQL outcomes influenced treatment decisions or provided valuable data for informed consent, and seven of these trials had robust HRQL design. Another five trials had robust HRQL design but investigators reported that HRQL outcomes were not clinically important enough to influence treatment recommendations. In surgical trials in oncology, HRQL informed clinical decision making. It is recommended that HRQL be included in relevant surgical trials, and that information be used to inform clinicians and patients about the impact of surgery on short- and long-term HRQL.
    Journal of Clinical Oncology 08/2006; 24(19):3178-86. DOI:10.1200/JCO.2005.05.2951 · 18.43 Impact Factor
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    ABSTRACT: To explore the effect of race on primary care quality and satisfaction among women in the Department of Veterans Affairs (VA). We used a mail survey to measure primary care quality and satisfaction. We focused on 4 primary care domains: patient preference for provider, interpersonal communication, accumulated knowledge, and coordination. We performed univariate analyses to compare variables by race and multiple logistic regression analysis to examine the effect of race on the probability of reporting a perfect score on each domain, while adjusting for patient characteristics and site. Black women were younger, unmarried, educated, of higher income, and reported female providers and gynecological care in VA more often. In regression analysis, race was not significantly associated with any primary care domain or satisfaction. Gynecological care from VA provider was associated with perfect ratings on patient preference for provider (odds ratio [OR] 2.0, 95% confidence intervals [CI] 1.3, 3.1), and satisfaction (OR 1.6, 95% CI 1.2, 2.3), while female provider was associated with interpersonal communication (OR 1.9, 95% CI 1.4, 2.6). While demographics and health experiences vary by race among veterans, race had no effect on primary care ratings. Future studies need to determine whether this racial equity persists in health outcomes among women veterans.
    Journal of General Internal Medicine 11/2006; 21(10):1105-8. DOI:10.1111/j.1525-1497.2006.00517.x · 3.42 Impact Factor
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