Estimating regional bone mineral density-based T-scores using clinical information; tools validated for postmenopausal women in Sri Lanka

Objectives@#This study aims to develop and validate a country specific osteoporosis risk assessing tool for Sri Lankan postmenopausal women. @*Methods@#Community-dwelling postmenopausal women were enrolled to development (n ¼ 602) and validation (n ¼ 339) samples. Clinical risk factors (CRFs) of osteoporosis were assessed. Bone mineral densities (BMD) of femoral neck, total hip and lumbar spine were assessed by dual energy X-ray absorptiometry (DXA) scan. Radial ultrasound (US) bone scan was done. Linear regression analysis was performed in development sample considering regional BMDs as dependent and CRFs as independent variables. Regression equations were developed to estimate regional BMDs using best predictive CRFs.Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were assessed to validate the new tools. @*Results@#Age, body weight and US T-scores showed positive correlations with BMDs of all 3 sites. Two osteoporosis risk assessing tools (OPRATs) were developed as OPRAT-1 and OPRAT-2. Prevalence of osteoporosis, in the validation sample was 74.3%. Sensitivity were high in both tools (OPRAT-1 and OPRAT-2; 83.2% and 82.5%) while specificity were moderate (44.8% for both). PPV of OPRAT-1 and OPRAT-2 were 79.5% and 81.2%. Both tools showed moderate NPV (OPRAT-1 and OPRAT-2; 51% and 47%). @*Conclusions@#Both OPRAT-1 and OPRAT-2 have high performance in screening postmenopausal women in Sri Lanka for risk of osteoporosis. OPRAT-2 is more convenient and can be used in any healthcare setting with limited resources to identify women who will be benefitted by DXA. OPRAT-1 can be used if the radial US facility is available.

El registro y la medición de la criminalidad. El problema de los datos faltantes y el uso de la ciencia para producir estimaciones en relación con el homicidio en Colombia, demostrado a partir de un ejemplo: el departamento de Antioquia (2003-2011) / Criminality registration and measurement. The problem of missing data, and the use of science to produce estimations relating to homicide in Colombia, as demonstrated with an example from one of its administrative and political divisions: the Department of Antioquia (2003-2011) / O registro e a medição da criminalidade. O problema dos dado faltantes e o uso da ciência para produzir estimativas com relação ao homicídio na Colômbia, demonstrado a partir de um exemplo: o departamento de Antioquia (2003-2011)

La integridad del ciclo de políticas públicas depende de la calidad de la información disponible para tomar decisiones en cualquiera de las fases. De manera preocupante, este ciclo -especialmente en el campo de la política criminal- se aparta del análisis técnico, que debería basarse en prueba empírica y sustento teórico. Este artículo retoma ejes clásicos (pero olvidados) de la medición de la criminalidad, con el propósito de resaltar la función esencial de datos confiables en el ciclo de políticas públicas. Brinda un análisis del proceso de registro y medición del crimen, y destaca los problemas y límites de cualquier ejercicio de registro delictivo. Resalta la necesidad de examinar el universo de lo desconocido por los diversos proyectos de registro, y explica las herramientas que se utilizan para dar cuenta de datos faltantes. Con el fin de ilustrar el potencial de la aplicación de estas herramientas en Colombia, ilustra los resultados del registro integrado de homicidios en el departamento de Antioquia, en el período 2003-2011, según cinco proyectos de registro (incluyendo el de la Policía Nacional), y presenta una estimación probabilística de los homicidios, que incorpora el cálculo de los datos faltantes según un técnica que se denomina Estimación por Sistemas Múltiples (ESM).

The integrity of the public policy cycle depends upon the quality of information available to make decisions in any of the relevant phases. In a disturbing manner, this cycle -and particularly in the field of criminal policy- diverges from the technical analysis that should be based on empiric proof and theoretical justification and support. This article retakes classical -though forgotten- axes of criminality measurement, for the purpose of stressing the essential function of reliable data in the public policy cycle. It offers an analysis of the registration and measurement process, and highlights both problems and limits involved in any crime registration exercise. It points out the need to examine the universe of what has been ignored in the diverse registration projects, and explains the tools used to account for the missing data. In order to illustrate the potential involved in the application of these tools in Colombia, it exemplifies the results found in the integrated homicide record keeper in one of the Colombian 32 administrative and political divisions: the Department of Antioquia, in the 2003-2011 period, pursuant to five registration projects (including that of the National Police); and it offers a probabilistic estimation of homicides incorporating the calculation of missing data, according to a technique known as the Multiple Systems Estimation (MSE).

A integridade do ciclo de políticas públicas depende da qualidade da informação disponível para fazer decisões em qualquer uma das fases. De maneira preocupante, este ciclo - especialmente no campo da política criminal - afasta-se da análise técnica, que teria que ser baseada no teste empírico e no apoio teórico. Este artigo retoma eixos clássico (mas esquecidos) da medição da criminalidade, a fim de enfatizar a função essencial de dados fiáveis no ciclo de políticas públicas. Oferece uma análise do processo do registo e medição do crime, e destaca os problemas e os limites de todo o exercício do registo criminal. Resalta a necessidade para examinar o universo do desconhecido pelos diversos projetos de registo, e explica as ferramentas que são usadas para apresentar os dados faltantes. A fim de ilustrar o potencial da aplicação destas ferramentas na Colômbia, ilustra os resultados do registro integrado dos homicídios no departamento de Antioquia, no período 2003-2011, de acordo com cinco projetos de registro (incluindo aquele da Polícias Nacional), e apresenta uma estimativa probabilística dos homicídios, que incorpora o cálculo dos dados faltantes de acordo com uma técnica chamada estimativa por múltiplos sistemas.

Adherence to treatment guidelines in the pharmacological management of chronic heart failure in an Australian population / 老年心脏病学杂志（英文版）

Background To document the pharmacotherapy of chronic heart failure (CHF) and to evaluate the adherence to treatment guidelines in Australian population.Methods The pharmacological management of 677 patients (female 46.7%,75.5±11.6 years) with CHF was retrospectively analyzed.Results The use of angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and fl-blockers were 58.2%and 34.7%,respectively.Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatimne level.For patients who did not receive β-blockers,asthma and chronic obstructive pulmonary disease were the main contraindications.Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication (40.3% and 28.9%,respectively).Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population.Further studies are required to develop processes to improve the optimal use of heart failure medications.