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Sample records for baseline treatment preference

  1. Baseline brain activity predicts response to neuromodulatory pain treatment.

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    Jensen, Mark P; Sherlin, Leslie H; Fregni, Felipe; Gianas, Ann; Howe, Jon D; Hakimian, Shahin

    2014-12-01

    The objective of this study was to examine the associations between baseline electroencephalogram (EEG)-assessed brain oscillations and subsequent response to four neuromodulatory treatments. Based on available research, we hypothesized that baseline theta oscillations would prospectively predict response to hypnotic analgesia. Analyses involving other oscillations and the other treatments (meditation, neurofeedback, and both active and sham transcranial direct current stimulation) were viewed as exploratory, given the lack of previous research examining brain oscillations as predictors of response to these other treatments. Randomized controlled study of single sessions of four neuromodulatory pain treatments and a control procedure. Thirty individuals with spinal cord injury and chronic pain had their EEG recorded before each session of four active treatments (hypnosis, meditation, EEG biofeedback, transcranial direct current stimulation) and a control procedure (sham transcranial direct stimulation). As hypothesized, more presession theta power was associated with greater response to hypnotic analgesia. In exploratory analyses, we found that less baseline alpha power predicted pain reduction with meditation. The findings support the idea that different patients respond to different pain treatments and that between-person treatment response differences are related to brain states as measured by EEG. The results have implications for the possibility of enhancing pain treatment response by either 1) better patient/treatment matching or 2) influencing brain activity before treatment is initiated in order to prepare patients to respond. Research is needed to replicate and confirm the findings in additional samples of individuals with chronic pain. Wiley Periodicals, Inc.

  2. Treatment decisions based on scalar and functional baseline covariates.

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    Ciarleglio, Adam; Petkova, Eva; Ogden, R Todd; Tarpey, Thaddeus

    2015-12-01

    The amount and complexity of patient-level data being collected in randomized-controlled trials offer both opportunities and challenges for developing personalized rules for assigning treatment for a given disease or ailment. For example, trials examining treatments for major depressive disorder are not only collecting typical baseline data such as age, gender, or scores on various tests, but also data that measure the structure and function of the brain such as images from magnetic resonance imaging (MRI), functional MRI (fMRI), or electroencephalography (EEG). These latter types of data have an inherent structure and may be considered as functional data. We propose an approach that uses baseline covariates, both scalars and functions, to aid in the selection of an optimal treatment. In addition to providing information on which treatment should be selected for a new patient, the estimated regime has the potential to provide insight into the relationship between treatment response and the set of baseline covariates. Our approach can be viewed as an extension of "advantage learning" to include both scalar and functional covariates. We describe our method and how to implement it using existing software. Empirical performance of our method is evaluated with simulated data in a variety of settings and also applied to data arising from a study of patients with major depressive disorder from whom baseline scalar covariates as well as functional data from EEG are available.

  3. Hepatitis C treatment response kinetics and impact of baseline predictors

    DEFF Research Database (Denmark)

    Lindh, M; Arnholm, B; Eilard, A

    2011-01-01

    Summary. The optimal duration of treatment for hepatitis C virus (HCV) infections is highly variable but critical for achieving cure (sustained virological response, SVR). We prospectively investigated the impact of age, fibrosis, baseline viraemia and genotype on the early viral kinetics...... above 400 000 IU/mL were strongly associated with slower second phase declines of HCV RNA. Genotype 2/3 infections responded more rapidly than genotype 1, reaching week 4 negativity (RVR) in 59%vs 22%. We conclude that baseline response predictors such as age, fibrosis and viral load were well reflected...... by the early viral kinetics as assessed by repeated HCV RNA quantifications. The kinetic patterns and the high relapse rate in genotype 2/3 patients without RVR suggest that this group might benefit from treatment durations longer than 24 weeks....

  4. Predictors of treatment preference for mandibular fracture.

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    Der-Martirosian, Claudia; Gironda, Melanie W; Black, Edward E; Belin, Thomas R; Atchison, Kathryn A

    2010-01-01

    Patient treatment preferences do not necessarily remain stable over time. This study focuses on predictors of patient treatment choice and on the extent to which patients are willing to take risks by choosing surgical versus nonsurgical treatment for mandibular fracture. Surveys of African-American and Hispanic adults receiving treatment at King/Drew Medical Center for either a mandibular fracture (n = 98) or third-molar removal (n = 105) were used to investigate patterns of patient preference over the course of a 4-month study period using generalized estimating equations controlling for age, gender, income, and fracture versus third-molar patient. The study examined the effects of symptom rating and a"standard gamble" measure reflecting a patient's willingness to accept scarring or nerve damage. This analysis is based on 169 patients who participated in four waves of data collection. The most salient predictor of patient treatment was the standard gamble measure at 1-month follow-up. Subjects with higher risk tolerance were more likely to select surgery versus jaw wiring. A higher likelihood of choosing surgery was associated with higher income and greater symptom severity. Fracture patients were more likely to select surgery compared with third-molar patients. The significance of symptom severity 1-month post-surgery raises an important issue regarding the healing process. Moreover, the significance of standard gamble as a predictor of treatment choice for mandibular fracture should encourage other researchers to use this measure of willingness to accept risk when studying acute conditions such as jaw fracture.

  5. Depression Treatment Preferences in Older Primary Care Patients

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    Gum, Amber M.; Arean, Patricia A.; Hunkeler, Enid; Tang, Lingqi; Katon, Wayne; Hitchcock, Polly; Steffens, David C.; Dickens, Jeanne; Unutzer, Jurgen

    2006-01-01

    Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older…

  6. Depression Treatment Preferences in Older Primary Care Patients

    Science.gov (United States)

    Gum, Amber M.; Arean, Patricia A.; Hunkeler, Enid; Tang, Lingqi; Katon, Wayne; Hitchcock, Polly; Steffens, David C.; Dickens, Jeanne; Unutzer, Jurgen

    2006-01-01

    Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older…

  7. Clinician preferences and the estimation of causal treatment differences

    OpenAIRE

    Korn, Edward L.; Baumrind, Sheldon

    1998-01-01

    Clinician treatment preferences affect the ability to perform randomized clinical trials and the ability to analyze observational data for treatment effects. In clinical trials, clinician preferences that are based on a subjective analysis of the patient can make it difficult to define eligibility criteria for which clinicians would agree to randomize all patients who satisfy the criteria. In addition, since each clinician typically has some preference for the choice of treatment for a given ...

  8. Preference for rizatriptan 10-mg wafer vs. eletriptan 40-mg tablet for acute treatment of migraine.

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    Láinez, M J A; Evers, S; Kinge, E; Allais, G; Allen, C; Rao, N A; Massaad, R; Lis, K

    2006-03-01

    Preference is a composite, patient-oriented endpoint incorporating efficacy, tolerability, formulation, and convenience of medications. The objective of this study was to compare patient preference for rizatriptan 10-mg wafer vs. eletriptan 40-mg tablet for acute treatment of migraine. In this multicentre, open-label, two-period, crossover study, out-patients were randomly assigned to treat the first of two moderate to severe migraines with rizatriptan or eletriptan and the second with the alternate therapy. Patients completed diary assessments at baseline and up to 24 h after taking study medication. At the last visit, patients completed a psychometrically validated preference questionnaire. A total of 372 patients (mean age 38 years, 85% female) treated two migraine attacks, and 342 patients (92%) expressed a preference for treatment. Significantly more (P rizatriptan 10-mg wafer [61.1%; 95% confidence interval (CI) 55.7, 66.3] to eletriptan 40-mg tablet (38.9%; 95% CI 33.7, 44.3). The most common reason given for preference of either treatment was speed of headache relief. At 2 h, 80% and 69% of patients reported that rizatriptan and eletriptan, respectively, was convenient or very convenient to take (mean convenience score 1.99 vs. 2.31, respectively; P rizatriptan 10-mg wafer to the eletriptan 40-mg tablet for acute treatment of migraine. The single most important reason for preference was speed of relief, consistent with results from previous preference studies.

  9. Preclinical models for neuroblastoma: establishing a baseline for treatment.

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    Tal Teitz

    Full Text Available BACKGROUND: Preclinical models of pediatric cancers are essential for testing new chemotherapeutic combinations for clinical trials. The most widely used genetic model for preclinical testing of neuroblastoma is the TH-MYCN mouse. This neuroblastoma-prone mouse recapitulates many of the features of human neuroblastoma. Limitations of this model include the low frequency of bone marrow metastasis, the lack of information on whether the gene expression patterns in this system parallels human neuroblastomas, the relatively slow rate of tumor formation and variability in tumor penetrance on different genetic backgrounds. As an alternative, preclinical studies are frequently performed using human cell lines xenografted into immunocompromised mice, either as flank implant or orthtotopically. Drawbacks of this system include the use of cell lines that have been in culture for years, the inappropriate microenvironment of the flank or difficult, time consuming surgery for orthotopic transplants and the absence of an intact immune system. PRINCIPAL FINDINGS: Here we characterize and optimize both systems to increase their utility for preclinical studies. We show that TH-MYCN mice develop tumors in the paraspinal ganglia, but not in the adrenal, with cellular and gene expression patterns similar to human NB. In addition, we present a new ultrasound guided, minimally invasive orthotopic xenograft method. This injection technique is rapid, provides accurate targeting of the injected cells and leads to efficient engraftment. We also demonstrate that tumors can be detected, monitored and quantified prior to visualization using ultrasound, MRI and bioluminescence. Finally we develop and test a "standard of care" chemotherapy regimen. This protocol, which is based on current treatments for neuroblastoma, provides a baseline for comparison of new therapeutic agents. SIGNIFICANCE: The studies suggest that use of both the TH-NMYC model of neuroblastoma and the

  10. Autonomous and controlled motivation for eating disorders treatment: baseline predictors and relationship to treatment outcome.

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    Carter, Jacqueline C; Kelly, Allison C

    2015-03-01

    This study aimed to identify baseline predictors of autonomous and controlled motivation for treatment (ACMT) in a transdiagnostic eating disorder sample, and to examine whether ACMT at baseline predicted change in eating disorder psychopathology during treatment. Participants were 97 individuals who met DSM-IV-TR criteria for an eating disorder and were admitted to a specialized intensive treatment programme. Self-report measures of eating disorder psychopathology, ACMT, and various psychosocial variables were completed at the start of treatment. A subset of these measures was completed again after 3, 6, 9, and 12 weeks of treatment. Multiple regression analyses showed that baseline autonomous motivation was higher among patients who reported more self-compassion and more received social support, whereas the only baseline predictor of controlled motivation was shame. Multilevel modelling revealed that higher baseline autonomous motivation predicted faster decreases in global eating disorder psychopathology, whereas the level of controlled motivation at baseline did not. The current findings suggest that developing interventions designed to foster autonomous motivation specifically and employing autonomy supportive strategies may be important to improving eating disorders treatment outcome. The findings of this study suggest that developing motivational interventions that focus specifically on enhancing autonomous motivation for change may be important for promoting eating disorder recovery. Our results lend support for the use of autonomy supportive strategies to strengthen personally meaningful reasons to achieve freely chosen change goals in order to enhance treatment for eating disorders. One study limitation is that there were no follow-up assessments beyond the 12-week study and we therefore do not know whether the relationships that we observed persisted after treatment. Another limitation is that this was a correlational study and it is therefore important

  11. Patient preferences in the treatment of diabetic retinopathy

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    Wirostko B

    2011-05-01

    Full Text Available Barbara Wirostko1, Kathleen Beusterien2, Jessica Grinspan2, Thomas Ciulla3, John Gonder4, Alexandra Barsdorf1, Andreas Pleil51Pfizer, New York, NY, USA; 2Oxford Outcomes, Bethesda, MD, USA; 3Midwest Eye Institute, Indianapolis, IN, USA; 4Ivey Eye Institute, London, Ontario, Canada; 5Pfizer Inc, San Diego, CA, USAObjective: Accounting for patient preferences may be especially important in diabetes mellitus, given the challenge in identifying factors associated with treatment adherence. Although preference studies have been performed in diabetes, none have examined treatments used in diabetic retinopathy (DR. The objective of this study was to elicit patient preferences for attributes associated with antivascular endothelial growth factor, focal and panretinal laser, and steroid therapy used in DR management.Methods: A cross-sectional conjoint survey was administered to DR patients at three Canadian eye centers. The survey involved making tradeoffs among 11 DR treatment attributes, including the chance of improving vision and risks of adverse events over a 1-year treatment period. Attribute utilities were summed for each product profile to determine the most preferred treatment.Results: Based on the results from 161 patients, attributes affecting visual functioning, including improving visual acuity and reducing adverse events (eg, chance of cataracts, were more important than those not directly affecting vision (eg, administration. Overall, 52%, 20%, 17%, and 11% preferred the product profiles matching to the antivascular endothelial growth factor, steroid, focal laser, and panretinal laser therapies. Preferences did not vary substantially by previous treatment experience, age, or type of DR (macular edema, proliferative DR, both or neither, with the exception that more macular edema only patients preferred focal laser over steroid treatment (19% versus 14%, respectively.Conclusions: When considering the potential effects of treatment over a 1

  12. Motivations, concerns and preferences of personal genome sequencing research participants: Baseline findings from the HealthSeq project.

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    Sanderson, Saskia C; Linderman, Michael D; Suckiel, Sabrina A; Diaz, George A; Zinberg, Randi E; Ferryman, Kadija; Wasserstein, Melissa; Kasarskis, Andrew; Schadt, Eric E

    2016-01-01

    Whole exome/genome sequencing (WES/WGS) is increasingly offered to ostensibly healthy individuals. Understanding the motivations and concerns of research participants seeking out personal WGS and their preferences regarding return-of-results and data sharing will help optimize protocols for WES/WGS. Baseline interviews including both qualitative and quantitative components were conducted with research participants (n=35) in the HealthSeq project, a longitudinal cohort study of individuals receiving personal WGS results. Data sharing preferences were recorded during informed consent. In the qualitative interview component, the dominant motivations that emerged were obtaining personal disease risk information, satisfying curiosity, contributing to research, self-exploration and interest in ancestry, and the dominant concern was the potential psychological impact of the results. In the quantitative component, 57% endorsed concerns about privacy. Most wanted to receive all personal WGS results (94%) and their raw data (89%); a third (37%) consented to having their data shared to the Database of Genotypes and Phenotypes (dbGaP). Early adopters of personal WGS in the HealthSeq project express a variety of health- and non-health-related motivations. Almost all want all available findings, while also expressing concerns about the psychological impact and privacy of their results.

  13. Estimating the Causal Effect of Randomization versus Treatment Preference in a Doubly Randomized Preference Trial

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    Marcus, Sue M.; Stuart, Elizabeth A.; Wang, Pei; Shadish, William R.; Steiner, Peter M.

    2012-01-01

    Although randomized studies have high internal validity, generalizability of the estimated causal effect from randomized clinical trials to real-world clinical or educational practice may be limited. We consider the implication of randomized assignment to treatment, as compared with choice of preferred treatment as it occurs in real-world…

  14. Preferences for 'New' Treatments Diminish in the Face of Ambiguity.

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    Harrison, Mark; Marra, Carlo A; Bansback, Nick

    2016-05-12

    New products usually offer advantages over existing products, but in health care, most new drugs are 'me-too', comparable in effectiveness and side effects to existing drugs, but with a more ambiguous evidence base around adverse effects. Despite this, new treatments drive increased health care spending, suggesting a preference for 'newness' in this setting. We explore (1) whether preferences for treatments labeled 'new' exist and (2) persist once the ambiguity in the evidence base reflecting newness is described. We use a Canadian general population sample (n = 2837) characterized by their innovativeness in adopting new products in normal markets. We found that innovators/early adopters (n = 173) had significant preferences for 'newer' treatments (B = 0.162, p = 0.038) irrespective of comparable benefits and side effects and all respondents had significant preferences for less ambiguity in benefit/side effect estimates. Notably, when 'newness' was combined with ambiguity, no significant preferences for new treatments were observed regardless of respondent innovativeness. We conclude that preferences for new products exist for some people in health care markets but disappear when the implication of ambiguity in the evidence base for new treatments is communicated. Physicians should avoid describing treatments as 'new' or be mindful to qualify the implications of 'new' treatments in terms of evidence ambiguity. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Preference for pharmaceutical formulation and treatment process attributes

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    Stewart KD

    2016-07-01

    Full Text Available Katie D Stewart,1 Joseph A Johnston,2 Louis S Matza,1 Sarah E Curtis,2 Henry A Havel,3 Stephanie A Sweetana,3 Heather L Gelhorn1 1Outcomes Research, Evidera, Bethesda, MD, USA; 2Global Patient Outcomes & Real World Evidence, 3Small Molecule Design and Development, Eli Lilly & Company, Indianapolis, IN, USA Purpose: Pharmaceutical formulation and treatment process attributes, such as dose frequency and route of administration, can have an impact on quality of life, treatment adherence, and disease outcomes. The aim of this literature review was to examine studies on preferences for pharmaceutical treatment process attributes, focusing on research in diabetes, oncology, osteoporosis, and autoimmune disorders.Methods: The literature search focused on identifying studies reporting preferences for attributes of the pharmaceutical treatment process. Studies were required to use formal quantitative preference assessment methods, such as utility valuation, conjoint analysis, or contingent valuation. Searches were conducted using Medline, EMBASE, Cochrane Library, Health Economic Evaluation Database, and National Health Service Economic Evaluation Database (January 1993–October 2013.Results: A total of 42 studies met inclusion criteria: 19 diabetes, nine oncology, five osteoporosis, and nine autoimmune. Across these conditions, treatments associated with shorter treatment duration, less frequent administration, greater flexibility, and less invasive routes of administration were preferred over more burdensome or complex treatments. While efficacy and safety often had greater relative importance than treatment process, treatment process also had a quantifiable impact on preference. In some instances, particularly in diabetes and autoimmune disorders, treatment process attributes had greater relative importance than some or all efficacy and safety attributes. Some studies suggested that relative importance of treatment process depends on disease (eg

  16. Should Studies of Diabetes Treatment Stratification Correct for Baseline HbA1c?

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    Angus G Jones

    Full Text Available Baseline HbA1c is a major predictor of response to glucose lowering therapy and therefore a potential confounder in studies aiming to identify other predictors. However, baseline adjustment may introduce error if the association between baseline HbA1c and response is substantially due to measurement error and regression to the mean. We aimed to determine whether studies of predictors of response should adjust for baseline HbA1c.We assessed the relationship between baseline HbA1c and glycaemic response in 257 participants treated with GLP-1R agonists and assessed whether it reflected measurement error and regression to the mean using duplicate 'pre-baseline' HbA1c measurements not included in the response variable. In this cohort and an additional 2659 participants treated with sulfonylureas we assessed the relationship between covariates associated with baseline HbA1c and treatment response with and without baseline adjustment, and with a bias correction using pre-baseline HbA1c to adjust for the effects of error in baseline HbA1c.Baseline HbA1c was a major predictor of response (R2 = 0.19,β = -0.44,p<0.001.The association between pre-baseline and response was similar suggesting the greater response at higher baseline HbA1cs is not mainly due to measurement error and subsequent regression to the mean. In unadjusted analysis in both cohorts, factors associated with baseline HbA1c were associated with response, however these associations were weak or absent after adjustment for baseline HbA1c. Bias correction did not substantially alter associations.Adjustment for the baseline HbA1c measurement is a simple and effective way to reduce bias in studies of predictors of response to glucose lowering therapy.

  17. Estimating Preferences for Treatments in Patients With Localized Prostate Cancer

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    Ávila, Mónica [Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona (Spain); CIBER en Epidemiología y Salud Pública (CIBERESP) (Spain); Universitat Pompeu Fabra, Barcelona (Spain); Becerra, Virginia [Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona (Spain); Guedea, Ferran [Servicio de Oncología Radioterápica, Institut Català d' Oncologia, L' Hospitalet de Llobregat (Spain); Suárez, José Francisco [Servicio de Urología, Hospital Universitari de Bellvitge, L' Hospitalet de Llobregat (Spain); Fernandez, Pablo [Servicio de Oncología Radioterápica, Instituto Oncológico de Guipúzcoa, San Sebastián (Spain); Macías, Víctor [Servicio de Oncología Radioterápica, Hospital Clínico Universitario de Salamanca, Salamanca (Spain); Servicio de Oncología Radioterápica, Institut Oncologic del Valles-Hospital General de Catalunya, Sant Cugat del Vallès (Spain); Mariño, Alfonso [Servicio de Oncología Radioterápica, Centro Oncológico de Galicia, A Coruña (Spain); and others

    2015-02-01

    Purpose: Studies of patients' preferences for localized prostate cancer treatments have assessed radical prostatectomy and external radiation therapy, but none of them has evaluated brachytherapy. The aim of our study was to assess the preferences and willingness to pay of patients with localized prostate cancer who had been treated with radical prostatectomy, external radiation therapy, or brachytherapy, and their related urinary, sexual, and bowel side effects. Methods and Materials: This was an observational, prospective cohort study with follow-up until 5 years after treatment. A total of 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited from 2003 to 2005. The estimation of preferences was conducted using time trade-off, standard gamble, and willingness-to-pay methods. Side effects were measured with the Expanded Prostate Index Composite (EPIC), a prostate cancer-specific questionnaire. Tobit models were constructed to assess the impact of treatment and side effects on patients' preferences. Propensity score was applied to adjust for treatment selection bias. Results: Of the 580 patients reporting preferences, 165 were treated with radical prostatectomy, 152 with external radiation therapy, and 263 with brachytherapy. Both time trade-off and standard gamble results indicated that the preferences of patients treated with brachytherapy were 0.06 utilities higher than those treated with radical prostatectomy (P=.01). Similarly, willingness-to-pay responses showed a difference of €57/month (P=.004) between these 2 treatments. Severe urinary incontinence presented an independent impact on the preferences elicited (P<.05), whereas no significant differences were found by bowel and sexual side effects. Conclusions: Our findings indicate that urinary incontinence is the side effect with the highest impact on preferences and that brachytherapy and external radiation therapy are more valued than radical

  18. Light transmission and preference of eye patches for occlusion treatment.

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    Hwan Heo

    Full Text Available PURPOSE: To investigate light transmission and preference for six eye patches for occlusion therapy. METHODS: Six patches were examined, including; Ortopad Fun Pack, Ortopad Flesh, Kawamoto A-1, Kawamoto A-2, 3M Opticlude, and Everade Eye Guard. The size and the presence of a light blocking pad of patches were investigated. The amount of light transmitted through the patches was evaluated, using a digital light meter and a model eye, in three different environments; indoors with fluorescent light, outdoors on a sunny day, and strong light from illuminator. After patching the normal eye, the flash visual evoked potential (VEP was measured. Thirty patients with amblyopia or horizontal strabismus, who received occlusion therapy as initial treatment, were included. After using all six patches, patients completed a 7-item questionnaire regarding the patch preference for size, color and shape, adhesive power, pain with removal, skin irritation after removing patch, parent's preference and overall opinion. RESULTS: All patches had a light-blocking pad, except the 3M Nexcare. Ortopad had the strongest light blocking power in the three environments, and the 3M Nexcare had the weakest power. In flash VEP, Ortopad and Kawamoto patches showed flat, but 3M Nexcare and Everade Eye Guard showed normal response. There were significant preferential differences among the patches in all the items of the questionnaire (P<0.05. In comparison between the patches respectively, 3M Nexcare received the lowest satisfaction in pain when removing a patch and skin irritation after removing a patch. Kawamoto A-2 received the lowest score in the overall satisfaction. CONCLUSIONS: We found differences in the light-blocking power and in the preference of the various patches for the occlusion treatment. This is a pilot study regarding only characteristics and preferences of patches. Further clinical studies regarding the relationship between characteristics or preferences of

  19. Randomised clinical trials with clinician-preferred treatment.

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    Korn, E L; Baumrind, S

    1991-01-19

    The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient.

  20. The effect of patients’ preference on outcome in the EVerT cryotherapy versus salicylic acid for the treatment of plantar warts (verruca trial

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    Cockayne Sarah

    2012-11-01

    Full Text Available Abstract Background Randomised controlled trials are widely accepted as the gold standard method to evaluate medical interventions, but they are still open to bias. One such bias is the effect of patient’s preference on outcome measures. The aims of this study were to examine whether patients’ treatment preference affected clearance of plantar warts and explore whether there were any associations between patients’ treatment preference and baseline variables in the EverT trial. Methods Two hundred and forty patients were recruited from University podiatry schools, NHS podiatry clinics and primary care. Patients were aged 12 years and over and had at least one plantar wart which was suitable for treatment with salicylic acid and cryotherapy. Patients were asked their treatment preference prior to randomisation. The Kruskal-Wallis test was performed to test the association between preference group and continuous baseline variables. The Fisher’s exact test was performed to test the association between preference group and categorical baseline variables. A logistic regression analysis was undertaken with verruca clearance (yes or no as the dependent variable and treatment, age, type of verruca, previous treatment, treatment preference as independent variables. Two analyses were undertaken, one using the health professional reported outcome and one using the patient’s self reported outcomes. Data on whether the patient found it necessary to stop the treatment to which they had been allocated and whether they started another treatment were summarised by treatment group. Results Pre-randomisation preferences were: 10% for salicylic acid; 42% for cryotherapy and 48% no treatment preference. There was no evidence of an association between treatment preference group and either patient (p=0.95 or healthcare professional (p=0.46 reported verruca clearance rates. There was no evidence of an association between preference group and any of the

  1. Treatment Preferences for CAM in Children with Chronic Pain

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    Jennie C. I. Tsao

    2007-01-01

    Full Text Available CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls (mean age = 14.5 years ± 2.4; range = 8–18 years presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80% were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy, pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  2. Treatment Preferences for CAM in children with chronic pain.

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    Tsao, Jennie C I; Meldrum, Marcia; Kim, Su C; Jacob, Margaret C; Zeltzer, Lonnie K

    2007-09-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  3. Preference and Expectation for Treatment Assignment in a Randomized Controlled Trial of Once- vs Twice-weekly Yoga for Chronic Low Back Pain

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    Tran, Huong H.; Weinberg, Janice; Sherman, Karen J.; Saper, Robert B

    2015-01-01

    Background: In studies involving nonpharmacological complementary and alternative medicine interventions, participant blinding is very difficult. Participant expectations may affect perceived benefit of therapy. In studies of yoga as treatment for chronic low back pain, little is known about the relationship between patient expectations and preferences on outcomes. This study was designed to identify baseline predictors of preference and to determine if expectations and preferences for differ...

  4. Treatment modality preferences and adherence to group treatment for panic disorder with agoraphobia.

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    Perreault, Michel; Julien, Dominic; White, Noé Djawn; Bélanger, Claude; Marchand, André; Katerelos, Theodora; Milton, Diana

    2014-06-01

    To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

  5. Vicarious experience affects patients' treatment preferences for depression.

    Directory of Open Access Journals (Sweden)

    Seth A Berkowitz

    Full Text Available PURPOSE: Depression is common in primary care but often under-treated. Personal experiences with depression can affect adherence to therapy, but the effect of vicarious experience is unstudied. We sought to evaluate the association between a patient's vicarious experiences with depression (those of friends or family and treatment preferences for depressive symptoms. METHODS: We sampled 1054 English and/or Spanish speaking adult subjects from July through December 2008, randomly selected from the 2008 California Behavioral Risk Factor Survey System, regarding depressive symptoms and treatment preferences. We then constructed a unidimensional scale using item analysis that reflects attitudes about antidepressant pharmacotherapy. This became the dependent variable in linear regression analyses to examine the association between vicarious experiences and treatment preferences for depressive symptoms. RESULTS: Our sample was 68% female, 91% white, and 13% Hispanic. Age ranged from 18-94 years. Mean PHQ-9 score was 4.3; 14.5% of respondents had a PHQ-9 score >9.0, consistent with active depressive symptoms. Analyses controlling for current depression symptoms and socio-demographic factors found that in patients both with (coefficient 1.08, p = 0.03 and without (coefficient 0.77, p = 0.03 a personal history of depression, having a vicarious experience (family and friend, respectively with depression is associated with a more favorable attitude towards antidepressant medications. CONCLUSIONS: Patients with vicarious experiences of depression express more acceptance of pharmacotherapy. Conversely, patients lacking vicarious experiences of depression have more negative attitudes towards antidepressants. When discussing treatment with patients, clinicians should inquire about vicarious experiences of depression. This information may identify patients at greater risk for non-adherence and lead to more tailored patient-specific education about

  6. Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale.

    Science.gov (United States)

    Singh, Jasvinder A; Sloan, Jeff A; Atherton, Pamela J; Smith, Tenbroeck; Hack, Thomas F; Huschka, Mashele M; Rummans, Teresa A; Clark, Matthew M; Diekmann, Brent; Degner, Lesley F

    2010-09-01

    To collect normative data, assess differences between demographic groups, and indirectly compare US and Canadian medical systems relative to patient expectations of involvement in cancer treatment decision making. Meta-analysis. Individual patient data were compiled across 6 clinical studies among 3491 patients with cancer who completed the 2-item Control Preferences Scale indicating the roles they preferred versus actually experienced in treatment decision making. The roles in treatment decision making that patients preferred were 26% active, 49% collaborative, and 25% passive. The roles that patients reported actually experiencing were 30% active, 34% collaborative, and 36% passive. Roughly 61% of patients reported having their preferred role; only 6% experienced extreme discordance between their preferred versus actual roles. More men than women (66% vs 60%, P = .001) and more US patients than Canadian patients (84% vs 54%, P roles. More Canadian patients than US patients preferred and actually experienced (42% vs 18%, P roles. More women than men reported taking a passive role (40% vs 24%, P role. Roughly half of the studied patients with cancer indicated that they preferred to have a collaborative relationship with physicians. Although most patients had the decision-making role they preferred, about 40% experienced discordance. This highlights the need for incorporation of individualized patient communication styles into treatment plans.

  7. Treatment planning for children with attention-deficit/hyperactivity disorder: treatment utilization and family preferences

    Directory of Open Access Journals (Sweden)

    William B Brinkman

    2011-01-01

    Full Text Available William B Brinkman, Jeffery N EpsteinDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USABackground: Attention-deficit/hyperactivity disorder (ADHD is a common condition that often results in child and family functional impairments. Although there are evidence-based treatment modalities available, implementation of and persistence with treatment plans vary with patients. Family preferences also vary and may contribute to variability in treatment utilization.Objective: The objective of this study is to describe the evidence-based treatments available for ADHD, identify patterns of use for each modality, and examine patient and parent treatment preferences.Method: Literature review.Results: Treatment options differ on benefits and risks/costs. Therefore, treatment decisions are preference sensitive and depend on how an informed patient/parent values the tradeoffs between options. Literature on patient and parent ADHD treatment preferences is based on quantitative research assessing the construct of treatment acceptability and qualitative and quantitative research that assesses preferences from a broader perspective. After a child is diagnosed with ADHD, a variety of factors influence the initial selection of treatment modalities that are utilized. Initial parent and child preferences are shaped by their beliefs about the nature of the child's problems and by information (and misinformation received from a variety of sources, including social networks, the media, and health care providers. Subsequently, preferences become further informed by personal experience with various treatment modalities. Over time, treatment plans are revisited and revised as families work with their health care team to establish a treatment plan that helps their child achieve goals while minimizing harms and costs.Conclusions: Studies have not been able to determine the extent to which

  8. Preferences for treatment setting by substance users in India

    Directory of Open Access Journals (Sweden)

    Anju Dhawan

    2016-01-01

    Full Text Available Background: Drug and alcohol use is a growing public health concern for India. Treatment services delivery for substance use disorders is available through three sectors viz. Government (GO centres under Ministry of Health and FW, Non-Government (NGO under Ministry of Social Justice and Empowerment and the private sector. Information on ttreatment utilisation and preferences of treatment settings by substance users are not available for India. Methods: A performa was filled up prospectively for each consecutive new patient seeking treatment for drug/alcohol use (excluding tobacco at De-addiction centres funded by MOH&FW; NGOs under MoSJE and private psychiatrists between 15 th July to 15 th October, 2011. All data available for 182 drug using persons from private, 1228 persons from 35 NGOs and 1700 persons from GO organizations were entered into SPSS-21.0, data quality checks performed and analysed. Results: There was a variance in the population profile in the three sectors providing treatment delivery for substance users in India. Treatment seeking for illicit drugs (heroin, opiates and cannabis was higher in GO sector; injection drug use was higher in NGO sector while alcohol was higher in private sector. Conclusions: Strengthening linkages between GO and NGO sector is important for an improved coverage and quality of treatment services in the country. The Andersen′s Behavioural Model as theoretical background to clarify some issues in analyzing with larger datasets is warranted.

  9. Psychiatric treatments for children and adolescents preferred by spanish psychiatrists

    Directory of Open Access Journals (Sweden)

    Josep Toro

    2006-12-01

    Full Text Available Objectives: To study the prescription criteria of Spanish psychiatrists treating children and adolescents. Methods: a survey was designed to record their first choice and complementary preferences for pharmacological, psychotherapeutic and psychoeducational interventions in five disorders: autism, depression, separation anxiety, obsessive compulsive and attention-deficit/hyperactivity disorders. Results: One hundred and nine psychiatrists responded. No distinction was made between children and adolescents. Around 90% recommended all three types of intervention in the five disorders. Only 2-10% would use only one treatment. Antidepressants were the most frequently prescribed drugs (recommended by 58%, followed by anxiolytics (33%, antipsychotics (24%, stimulants (20%, beta-blockers (19%, mood stabilizers (10% and alpha-adrenergics (4%. Cognitive-behavioral therapy was the most popular approach, recommended by 66%; a third of the interviewees recommended family, support, interpersonal and dynamic psychotherapy. Interestingly, respondents quite frequently prescribe drugs, drug combinations and psychotherapies whose efficacy has not been demonstrated in the disorders in question. Conclusions: The majority of Spanish psychiatrists preferred the combined treatments in all disorders. There seems to be a tendency towards excessive generalization of therapeutic results obtained in adults.

  10. Bayesian inference of baseline fertility and treatment effects via a crop yield-fertility model.

    Directory of Open Access Journals (Sweden)

    Hungyen Chen

    Full Text Available To effectively manage soil fertility, knowledge is needed of how a crop uses nutrients from fertilizer applied to the soil. Soil quality is a combination of biological, chemical and physical properties and is hard to assess directly because of collective and multiple functional effects. In this paper, we focus on the application of these concepts to agriculture. We define the baseline fertility of soil as the level of fertility that a crop can acquire for growth from the soil. With this strict definition, we propose a new crop yield-fertility model that enables quantification of the process of improving baseline fertility and the effects of treatments solely from the time series of crop yields. The model was modified from Michaelis-Menten kinetics and measured the additional effects of the treatments given the baseline fertility. Using more than 30 years of experimental data, we used the Bayesian framework to estimate the improvements in baseline fertility and the effects of fertilizer and farmyard manure (FYM on maize (Zea mays, barley (Hordeum vulgare, and soybean (Glycine max yields. Fertilizer contributed the most to the barley yield and FYM contributed the most to the soybean yield among the three crops. The baseline fertility of the subsurface soil was very low for maize and barley prior to fertilization. In contrast, the baseline fertility in this soil approximated half-saturated fertility for the soybean crop. The long-term soil fertility was increased by adding FYM, but the effect of FYM addition was reduced by the addition of fertilizer. Our results provide evidence that long-term soil fertility under continuous farming was maintained, or increased, by the application of natural nutrients compared with the application of synthetic fertilizer.

  11. Relationship Between Family Economic Resources, Psychosocial Well-being, and Educational Preferences of AIDS-Orphaned Children in Southern Uganda: Baseline Findings.

    Science.gov (United States)

    Ssewamala, Fred M; Nabunya, Proscovia; Ilic, Vilma; Mukasa, Miriam N; Ddamulira, Christopher

    2015-06-01

    This study examines the relationship between economic resources, psychosocial well-being, and educational preferences of AIDS-orphaned children in southern Uganda. We use baseline data from a sample of 1410 AIDS-orphaned children (defined as children who have lost one or both biological parents to AIDS) enrolled in the Bridges to the Future study, a National Institute of Child Health and Human Development (NICHD) funded study. Analyses from both bivariate and multiple regression analyses indicate the following: 1) despite the well-documented economic and psychosocial challenges AIDS-orphaned children face, many of these children have high educational plans and aspirations; 2) educational aspirations differ by orphanhood status (double orphan vs. single orphan); 3) regardless of orphanhood status, children report similar levels of psychosocial well-being; 4) high levels of family cohesion, positive perceptions of the future, school satisfaction, and lower levels of hopelessness (hopefulness) are associated with high educational aspirations; and 5) reported family economic resources at baseline, all seem to play a role in predicting children's educational preferences and psychosocial well-being. These findings suggest that the focus for care and support of orphaned children should not be limited to addressing their psychosocial needs. Addressing the economic needs of the households in which orphaned children live is equally important. Indeed, in the context of extreme poverty-in which most of the children represented in this study live-addressing structural factors, including poverty, may be a key driver in addressing their psychosocial functioning.

  12. [Paraphilia, sexual preference disorders. Diagnosis, etiology, epidemiology, treatment and prevention].

    Science.gov (United States)

    Berner, Wolfgang; Briken, P

    2007-01-01

    Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders. Actual relationship- and self-confidence problems often trigger the severity of disturbance, especially in the episodic forms of paraphilia. For patients who are in conflict with the law, cognitive-behavioral therapeutic approaches with the aim to minimize self-deception regarding the effects of the paraphilic behavior have become more and more relevant. Regarding the medical treatment, anti-hormonal therapy plays an important role, but also treatment with serotonergic agents and naltrexone are used. Only little can be advised in terms of prevention; general psycho-hygiene (regarding the parent-child relationship) is recommended. Beside these general measures, institutions which offer special treatment for people in danger to become delinquents may be able to prevent serious harm for possible victims of abuse.

  13. Patient satisfaction and preferences of lanreotide Autogel treatment in acromegaly.

    Science.gov (United States)

    Witek, Przemysław; Mucha, Sławomir; Ruchała, Marek

    2016-01-01

    Despite the known importance of somatostatin analogues (SSAs) in the treatment of acromegaly, patient satisfaction leading to preferences for specific SSAs have received little attention so far. This open, prospective, observational, multicentre patient-reported outcome study included adult patients with acromegaly, who switched from another SSA to lanreotide Autogel (new and previous devices) at least two months prior to enrolment. The observation period was around 12 months. The primary outcome assessed was overall treatment satisfaction, measured using the five-point Likert scale. The secondary outcomes were: 1) treatment effectiveness, in terms of symptom control; 2) technical problems related to treatment administration, measured by the Visual Analog Scale (VAS); and 3) ease and safety of lanreotide Autogel delivery (new device vs. previous device). Of the 102 patients who completed the study, 97 (95.1%) were "completely or rather satisfied" with lanreotide Autogel therapy, four (3.9%) were "neither satisfied nor dissatisfied", and one (1%) was "rather dissatisfied". Symptom control was reported as "excellent" or "good" by 88-89% of patients throughout the study. Patients reported fewer technical problems related to administration of lanreotide Autogel (final mean VAS: 5.3) compared to previous SSAs (mean VAS: 37.6). Of the 31 patients treated with lanreotide Autogel using the previous device followed by the new device, 64.5% reported the new device as improved. Lanreotide Autogel therapy resulted in greater patient satisfaction with overall acromegaly management, when compared to previous SSAs. The new lanreotide Autogel device was found to be easier to use than the previous one. (Endokrynol Pol 2016; 67 (6): 572-579).

  14. Likelihood of Attending Treatment for Anxiety Among Veteran Primary Care Patients: Patient Preferences for Treatment Attributes.

    Science.gov (United States)

    Shepardson, Robyn L; Funderburk, Jennifer S

    2016-09-01

    Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed.

  15. Depression beliefs, treatment preference, and outcomes in a randomized trial for major depressive disorder.

    Science.gov (United States)

    Dunlop, Boadie W; Kelley, Mary E; Mletzko, Tanja C; Velasquez, Cristina M; Craighead, W Edward; Mayberg, Helen S

    2012-03-01

    Previous studies suggest that individual preferences for medication- or psychotherapy-based treatments for depression may affect outcomes in clinical trials that compare these two forms of treatment. We assessed patients' beliefs about the causes of their depression, their preferred treatment, and strength of that preference in 80 patients participating in a 12-week clinical trial evaluating neuroimaging predictors of response to cognitive behavior therapy (CBT) or escitalopram. Forty-five patients expressed a preference for one of the 2 treatments, but being matched to preference did not influence remission or completion rates. Medication-preferring patients were more likely to terminate the trial early, regardless of treatment received. CBT-preferring patients rarely endorsed unknown causes for their depression, and medication-preferring patients were highly unlikely to identify pessimistic attitudes as a source of their depression. Among patients willing to be randomized to treatment, preference does not appear to strongly influence outcome. Specific preferences for CBT or medication may reflect differing conceptualizations about depressive illness, knowledge of which may enhance treatment retention and efficacy.

  16. Low-dose budesonide treatment improves lung function in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren;

    2015-01-01

    in patients with less frequent symptoms at presentation. This was investigated in a post-hoc analysis of the multinational inhaled Steroid Treatment As Regular Therapy in early asthma (START) study.2 METHODS: Patients aged 4-66 years (median 21 years) with a history of recent-onset mild asthma (11 years......RATIONALE: Inhaled corticosteroids (ICS) are highly effective in low doses for improving asthma outcomes, including lung function. In the past, ICS treatment was recommended for patients with 'persistent' asthma, defined by symptoms >2 days/week.1 However, evidence is lacking for the benefit of ICS...... symptom frequency groups (Figure). CONCLUSIONS: Long-term, once-daily, low-dose budesonide treatment plus usual asthma medication improves lung function in patients with mild, recent-onset asthma. These beneficial effects were seen even in patients with the lowest baseline asthma symptom frequency (0...

  17. Colour preference between adults and children during a dental treatment session.

    Science.gov (United States)

    Oner Ozdas, Didem; Kazak, Magrur

    2017-02-01

    It is evidently shown that colour has physical, psychological and sociological effects on human beings. There are many studies showing the effects of colours on brain activity. Colour preferences may change from childhood to adulthood and are significantly different in various age groups. The aim of this study was to evaluate the adults and children in their preference for mouthrinses in various colours under stress condition during a dental treatment session. 240 adults and 263 children were included in the study. Three transparent cups were filled with water, two of which were coloured green/pink rinsing by dissolving a tablet in the water. Cups were placed near the dental unit. During dental treatment sessions, patients were told to rinse their mouth with whichever cup they preferred. Preferred colour of cup, gender and age of patient, number of sessions were recorded. Data were statistically analysed by SPSS 15.0 programme and chi-square tests. Half of all cases preferred water. In adults, while females statistically significantly preferred water, males chose cups with coloured contents (padults preferred more than one rinsing solution in a dental treatment session. Children mostly preferred water. Even if adults preferred cups with coloured contents in multi-dental treatment sessions, children regularly preferred water (padults and children. Female adults and children were not interested in trying colourful mouthrinses, while male adults were curious about trying colourful mouthrinses during dental treatment sessions under stress condition. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer

    NARCIS (Netherlands)

    Knuttel, Floor; van den Bosch, Maurice A A J; Young-Afat, Danny A.; Emaus, Marleen J.; van den Bongard, Desirée H J G; Witkamp, Arjen J.; Verkooijen, Helena M.

    Background: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. Objectives: To assess preferences of patients with breast cancer

  19. Baseline Psychological Treatment Reduces the Effect of Coaching in a Randomised Trial of a Depression Self-Care Intervention

    National Research Council Canada - National Science Library

    McCusker, Jane; Cole, Martin; Lambert, Sylvie; Yaffe, Mark; Ciampi, Antonio; Belzile, Eric

    2017-01-01

    Objective: To explore the effects of baseline psychological and antidepressant medication treatment in a trial of lay telephone coaching in a low-intensity, supported depression self-care intervention. Method...

  20. Client Preferences Affect Treatment Satisfaction, Completion, and Clinical Outcome: A Meta-Analysis

    Science.gov (United States)

    Lindhiem, Oliver; Bennett, Charles B.; Trentacosta, Christopher J.; McLear, Caitlin

    2014-01-01

    We conducted a meta-analysis on the effects of client preferences on treatment satisfaction, completion, and clinical outcome. Our search of the literature resulted in 34 empirical articles describing 32 unique clinical trials that either randomized some clients to an active choice condition (shared decision making condition or choice of treatment) or assessed client preferences. Clients who were involved in shared decision making, chose a treatment condition, or otherwise received their preferred treatment evidenced higher treatment satisfaction (ESd = .34; p < .001), increased completion rates (ESOR = 1.37; ESd = .17; p < .001), and superior clinical outcome (ESd = .15; p < .0001), compared to clients who were not involved in shared decision making, did not choose a treatment condition, or otherwise did not receive their preferred treatment. Although the effect sizes are modest in magnitude, they were generally consistent across several potential moderating variables including study design (preference versus active choice), psychoeducation (informed versus uninformed), setting (inpatient versus outpatient), client diagnosis (mental health versus other), and unit of randomization (client versus provider). Our findings highlight the clinical benefit of assessing client preferences, providing treatment choices when two or more efficacious options are available, and involving clients in treatment-related decisions when treatment options are not available. PMID:25189522

  1. The development of PubMed search strategies for patient preferences for treatment outcomes

    NARCIS (Netherlands)

    Hoorn, R.A. van; Kievit, W.; Booth, A.; Mozygemba, K.; Lysdahl, K.B.; Refolo, P.; Sacchini, D.; Gerhardus, A.; Wilt, G.J. van der; Tummers, M.J.G.M.

    2016-01-01

    BACKGROUND: The importance of respecting patients' preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study

  2. The impact of cancer treatment on the diets and food preferences of patients receiving outpatient treatment.

    Science.gov (United States)

    Coa, Kisha I; Epstein, Joel B; Ettinger, David; Jatoi, Aminah; McManus, Kathy; Platek, Mary E; Price, Wendy; Stewart, Meghan; Teknos, Theodoros N; Moskowitz, Bruce

    2015-01-01

    Patients undergoing cancer treatment experience a multitude of symptoms that can influence their ability to complete treatment as well as their quality of life during and after treatment. This cross-sectional study sought to describe the dietary changes experienced by cancer patients and to identify associations between these changes and common treatment symptoms. A convenience sample of 1199 cancer patients aged 18 yr and older undergoing active treatment were recruited from 7 cancer centers to complete a self-administered paper-and-pencil survey. Descriptive analyses were conducted to estimate prevalence of dietary changes and chi-squared tests were used to examine associations between dietary changes and health outcomes. Approximately 40% of patients reported a decreased appetite since beginning treatment, and 67.2% of patients reported at least 1 chemosensory alteration. Increased taste sensitivities were more common than decreased taste sensitivities, with increased sensitivity to metallic being the most common taste sensitivity (18.6%). Patients also had increased sensitivities to certain smells including cleaning solutions (23.4%), perfume (22.4%), and food cooking (11.4%). Patients reported a wide range of food preferences and aversions. Patients who had less energy or lost weight since beginning treatment were more likely than others to report treatment-related dietary changes.

  3. The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

    Science.gov (United States)

    Coa, Kisha I.; Epstein, Joel B.; Ettinger, David; Jatoi, Aminah; McManus, Kathy; Platek, Mary E.; Price, Wendy; Stewart, Meghan; Teknos, Theodoros N.; Moskowitz, Bruce

    2015-01-01

    Patients undergoing cancer treatment experience a multitude of symptoms that can influence their ability to complete treatment as well as their quality of life during and after treatment. This cross-sectional study sought to describe the dietary changes experienced by cancer patients and to identify associations between these changes and common treatment symptoms. A convenience sample of 1199 cancer patients aged 18 yr and older undergoing active treatment were recruited from 7 cancer centers to complete a self-administered paper-and-pencil survey. Descriptive analyses were conducted to estimate prevalence of dietary changes and chi-squared tests were used to examine associations between dietary changes and health outcomes. Approximately 40% of patients reported a decreased appetite since beginning treatment, and 67.2% of patients reported at least 1 chemosensory alteration. Increased taste sensitivities were more common than decreased taste sensitivities, with increased sensitivity to metallic being the most common taste sensitivity (18.6%). Patients also had increased sensitivities to certain smells including cleaning solutions (23.4%), perfume (22.4%), and food cooking (11.4%). Patients reported a wide range of food preferences and aversions. Patients who had less energy or lost weight since beginning treatment were more likely than others to report treatment-related dietary changes. PMID:25664980

  4. Veteran satisfaction and treatment preferences in response to a posttraumatic stress disorder specialty clinic orientation group.

    Science.gov (United States)

    Schumm, Jeremiah A; Walter, Kristen H; Bartone, Anne S; Chard, Kathleen M

    2015-06-01

    To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options.

  5. Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway.

    Science.gov (United States)

    Stangvaltaite, Lina; Kundzina, Rita; Eriksen, Harald M; Kerosuo, Eero

    2013-11-01

    To investigate preferred treatment methods of deep carious lesions in mature permanent teeth among dentists in Northern Norway. The survey included all 437 general dental practitioners in Northern Norway working in the private or the public dental health service. The participants received an invitation with a radiograph and a clinical picture of a deep carious lesion in a mature permanent tooth and a questionnaire asking about demographic characteristics and their preferred treatment methods related to different clinical deep caries diagnoses. The response rate was 56%. There was an over-representation of publicly employed dentists among the respondents; otherwise no systematic bias related to non-responders was detected. In the absence of carious exposure and no symptoms, total caries excavation was the preferred treatment method (49%) followed by stepwise excavation (45%). In cases of deep caries and no exposure with symptoms, the preferences were equally distributed between root canal treatment (39%) and stepwise excavation (38%). In the presence of carious exposure but no symptoms, the preferred treatment method was direct pulp capping (51%) and in carious exposure with symptoms root canal treatment was the preferred treatment method (91%). There is no uniform treatment method of deep carious lesions among dentists in Northern Norway.

  6. Minimal sufficient balance-a new strategy to balance baseline covariates and preserve randomness of treatment allocation.

    Science.gov (United States)

    Zhao, Wenle; Hill, Michael D; Palesch, Yuko

    2015-12-01

    In many clinical trials, baseline covariates could affect the primary outcome. Commonly used strategies to balance baseline covariates include stratified constrained randomization and minimization. Stratification is limited to few categorical covariates. Minimization lacks the randomness of treatment allocation. Both apply only to categorical covariates. As a result, serious imbalances could occur in important baseline covariates not included in the randomization algorithm. Furthermore, randomness of treatment allocation could be significantly compromised because of the high proportion of deterministic assignments associated with stratified block randomization and minimization, potentially resulting in selection bias. Serious baseline covariate imbalances and selection biases often contribute to controversial interpretation of the trial results. The National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator Stroke Trial and the Captopril Prevention Project are two examples. In this article, we propose a new randomization strategy, termed the minimal sufficient balance randomization, which will dually prevent serious imbalances in all important baseline covariates, including both categorical and continuous types, and preserve the randomness of treatment allocation. Computer simulations are conducted using the data from the National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator Stroke Trial. Serious imbalances in four continuous and one categorical covariate are prevented with a small cost in treatment allocation randomness. A scenario of simultaneously balancing 11 baseline covariates is explored with similar promising results. The proposed minimal sufficient balance randomization algorithm can be easily implemented in computerized central randomization systems for large multicenter trials.

  7. Insomnia treatment acceptability and preferences of male Iraq and Afghanistan combat veterans and their healthcare providers.

    Science.gov (United States)

    Epstein, Dana R; Babcock-Parziale, Judith L; Haynes, Patricia L; Herb, Christine A

    2012-01-01

    Sleep difficulty is a prevalent problem among returning Veterans. Although there is strong evidence for the efficacy and durability of cognitive-behavioral treatment for insomnia (CBT-I) in the general population, the interventions require motivation, attention, and adherence from patients to achieve successful outcomes. Given the unique characteristics of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who have experienced blast-related injuries and other trauma, CBT-I for these patients may require modification, including alternative delivery methods, to ensure effective implementation and positive outcomes. We interviewed 18 OIF/OEF Veterans who screened positive for mild traumatic brain injury and 19 healthcare providers to determine the acceptability of insomnia treatments and preferences for the interventions and treatment delivery. Veterans and providers had distinct preferences for insomnia treatment and its delivery. The treatments the Veterans found most acceptable were also the ones they preferred: relaxation treatment and pharmacotherapy. The providers identified relaxation therapy as the most acceptable treatment. Veterans preferred the individual treatment format as well as electronic methods of treatment delivery. Despite some differences between patients and providers, a compromise through modification of empirically supported behavioral treatments is feasible, and implications for preference-based insomnia intervention development and testing are discussed.

  8. Racial and Ethnic Differences in Preferences for End-of-Life Treatment

    National Research Council Canada - National Science Library

    Barnato, Amber E; Anthony, Denise L; Skinner, Jonathan; Gallagher, Patricia M; Fisher, Elliott S

    2009-01-01

    ... covariables.To explore racial and ethnic differences in concerns and preferences for medical treatment at the end of life in a national sample, adjusting for sociocultural covariables.Dual-language (English/Spanish), mixed-mode (telephone/mail...

  9. Preference and usage of intracanal medications during endodontic treatment

    Science.gov (United States)

    Madarati, Ahmad A.; Zafar, Muhammad S.; Sammani, Aya M.N.; Mandorah, Ayman O.; Bani-Younes, Hamzah A.

    2017-01-01

    Objectives: To investigate the preferences of general dental practitioners (GDPs) and endodontists in using endodontic intra-canal medications (ICMs). Methods: This observational and descriptive study was conducted in 2014 in the western province of Saudi Arabia. Following ethical clearance and 2 pilot studies, a web-based questionnaire was electronically sent to 375 randomly and systematically selected GDPs and all endodontists in the western province (n=49). An accompanying e-mail explained the study’s aims and confirmed that the data yielded would remain confidential. The responses were collected, and the data was analyzed using the Chi-square test at p=0.05. Results: Significantly, the highest proportion of respondents (53.7%) reported disinfection of the root canals as the main function of ICMs. Calcium hydroxide (CH) was the preferred material of the majority of those who used the same ICM in all cases (85.7%). While the vast majority of all endodontists (87.5%) used CH after pulp extirpation, 48.5% of GDPs used formocresol (p<0.001). Almost 30% of those who used ICMs after pulp extirpation did not do so after cleaning and shaping of vital cases. Most endodontists used CH (62.5%) and antibiotics (37.5%) in necrotic pulp cases without apical lesions, which were significantly greater than those of GDPs who did the same (43.8% and 17.2%). Conclusions: Participants were aware that the main function of ICMs is disinfection of the root canal system. However, it is clear that GDPs should reduce their reliance on phenol- and formaldehyde-based medications. There was a distinct trend toward the use of ICMs, especially CH, in necrotic pulp cases. PMID:28674723

  10. Antipsychotic drug treatment for patients with schizophrenia: theoretical background, clinical considerations and patients preferences

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Nielsen, Jimmi

    2009-01-01

      The cornerstone in treatment of psychosis is antipsychotic drugs. Treatment options have increased over the years; newer antipsychotic drugs with a proposed efficacy regarding negative and cognitive symptoms, but also a shift in side-effects from neurological side-effects to metabolic side-effe...... treatment. The clinically relevant aspects of antipsychotic drug treatment are reviewed; mechanism of antipsychotic drug action, clinical considerations in treatment, switching antipsychotic drugs, polypharmacy, safety and patient preference.  ...

  11. Dolutegravir treatment response by baseline viral load and NRTI backbone in treatment-naïve HIV-infected individuals

    Directory of Open Access Journals (Sweden)

    C Small

    2012-11-01

    Full Text Available Background: In two 48-week studies in naïve subjects, dolutegravir with NRTI of choice has shown non-inferiority to raltegravir and, with ABC/3TC, superiority to Atripla. Factors that influenced choice of NRTIs included viral load, resistance and safety. Methods: We analysed response rates and time to virologic failure by NRTI backbone and baseline viral load in the pivotal DTG-naïve studies. SPRING-2 randomized participants to DTG 50 mg QD or RAL 400 mg BID, each in combination with investigator-selected NRTIs (TDF/FTC or ABC/3TC. SINGLE randomised participants to DTG 50 mg+ABC/3TC QD or TDF/FTC/EFV (Atripla QD. In SPRING-2, changes in serum creatinine were examined by INI and NRTI backbone. Results: The two studies randomized and treated 1655 subjects, of whom 249 (15% were female, 388 (23% non-white, 495 (30% had HIV-1 RNA >100,000 c/ml, and 224 (14% had CD4+ count <200 cells/mm3. Primary analyses demonstrated non-inferiority of DTG to RAL in SPRING-2 (Δ=2.5%; 95% CI:−2.2% to +7.1%, excluding −10%, and superiority of the DTG regimen in SINGLE (7.4%; +2.5% to +12.3%. In SPRING-2, response rates by NRTI backbone were comparable in each viral load stratum. In SINGLE, a 7% difference in response (favoring DTG+ABC/3TC was observed in each viral load stratum. Exploratory analyses examining time-to-virologic failure showed no difference in response rates between the NRTIs irrespective of baseline viral load or study. Resistance to INIs or NRTIs was not demonstrated in any subject on DTG-based therapy through 48 weeks. Withdrawals due to AEs on DTG-based regimen were few (2% in both studies. In SPRING-2, no significant differences were observed in serum creatinine change from baseline to Week 48 by NRTI backbones. Conclusions: In SPRING-2 and SINGLE, DTG was effective with both ABC/3TC and TDF/FTC, and in subjects with high and low viral load. DTG was well tolerated in both studies. Renal safety also was similar by NRTI backbone. DTG is a once

  12. Patients' preferences for osteoporosis drug treatment: A discrete choice experiment

    NARCIS (Netherlands)

    E.W. de Bekker-Grob (Esther); M.L.E. Essink-Bot (Marie-Louise); W.J. Meerding (Willem Jan); H.A.P. Pols (Huib); B.W. Koes (Bart); E.W. Steyerberg (Ewout)

    2008-01-01

    textabstractSummary: Active case finding for osteoporosis is used to identify patients at high fracture risk who may benefit from preventive drug treatment. We investigated the relative weight that women place on various aspects of preventive drugs in a discrete choice experiment. Our patients said

  13. Epidemiological and Clinical Baseline Characteristics as Predictive Biomarkers of Response to Anti-VEGF Treatment in Patients with Neovascular AMD

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    Miltiadis K. Tsilimbaris

    2016-01-01

    Full Text Available Purpose. To review the current literature investigating patient response to antivascular endothelial growth factor-A (VEGF therapy in the treatment of neovascular age-related macular degeneration (nAMD and to identify baseline characteristics that might predict response. Method. A literature search of the PubMed database was performed, using the keywords: AMD, anti-VEGF, biomarker, optical coherence tomography, treatment outcome, and predictor. The search was limited to articles published from 2006 to date. Exclusion criteria included phase 1 trials, case reports, studies focusing on indications other than nAMD, and oncology. Results. A total of 1467 articles were identified, of which 845 were excluded. Of the 622 remaining references, 47 met all the search criteria and were included in this review. Conclusion. Several baseline characteristics correlated with anti-VEGF treatment response, including best-corrected visual acuity, age, lesion size, and retinal thickness. The majority of factors were associated with disease duration, suggesting that longer disease duration before treatment results in worse treatment outcomes. This highlights the need for early treatment for patients with nAMD to gain optimal treatment outcomes. Many of the identified baseline characteristics are interconnected and cannot be evaluated in isolation; therefore multivariate analyses will be required to determine any specific relationship with treatment response.

  14. Changes in the incentive value of food after naltrexone treatment depend on a differential preference for a palatable food in male rats.

    Science.gov (United States)

    Alvarado-Bañuelos, Mariana; Barrios De Tomasi, Eliana; Juárez, Jorge

    2017-09-01

    Opioid antagonist treatments such as naltrexone (NTX) and naloxone reduce consummatory behavior of palatable food (PF) and other incentives. Meanwhile, a significant increase in alcohol consumption has been observed when it is offered immediately after ending NTX treatment, an effect apparently produced by increased opioidergic activity caused by up-regulation of opioid receptors. On this basis we assessed changes in the consumption of PF after opioid antagonist treatment in rats with different preferences for that food. The preference of male Wistar rats for a PF was classified as low, medium, or high in a baseline period, after which the animals in each preference level were sub-divided into control and experimental groups that received injections of either NTX (2 mg/kg twice per day/6 days) or a saline solution with a space of 8 hours between doses. At the end of pharmacological treatment (PT), subjects were re-exposed to the PF. Increased PF intake was found only in the low-preference group, but the increase was observed in both the experimental and control animals. Also, a decrease in chow intake during PT was observed in all preference groups, while recovery after treatment was noted only in the low-preference rats. The increased intake observed in the low-preference rats after treatment phase suggests that the hypothalamic-pituitary-adrenal axis activation during PT could have enhanced the rewarding characteristics of the sweet food and so facilitated and increased its consumption in the re-exposure period.

  15. What determines providers' stated preference for the treatment of uncomplicated malaria?

    Science.gov (United States)

    Mangham-Jefferies, Lindsay; Hanson, Kara; Mbacham, Wilfred; Onwujekwe, Obinna; Wiseman, Virginia

    2014-03-01

    As agents for their patients, providers often make treatment decisions on behalf of patients, and their choices can affect health outcomes. However, providers operate within a network of relationships and are agents not only for their patients, but also other health sector actors, such as their employer, the Ministry of Health, and pharmaceutical suppliers. Providers' stated preferences for the treatment of uncomplicated malaria were examined to determine what factors predict their choice of treatment in the absence of information and institutional constraints, such as the stock of medicines or the patient's ability to pay. 518 providers working at non-profit health facilities and for-profit pharmacies and drug stores in Yaoundé and Bamenda in Cameroon and in Enugu State in Nigeria were surveyed between July and December 2009 to elicit the antimalarial they prefer to supply for uncomplicated malaria. Multilevel modelling was used to determine the effect of financial and non-financial incentives on their preference, while controlling for information and institutional constraints, and accounting for the clustering of providers within facilities and geographic areas. 69% of providers stated a preference for artemisinin-combination therapy (ACT), which is the recommended treatment for uncomplicated malaria in Cameroon and Nigeria. A preference for ACT was significantly associated with working at a for-profit facility, reporting that patients prefer ACT, and working at facilities that obtain antimalarials from drug company representatives. Preferences were similar among colleagues within a facility, and among providers working in the same locality. Knowing the government recommends ACT was a significant predictor, though having access to clinical guidelines was not sufficient. Providers are agents serving multiple principals and their preferences over alternative antimalarials were influenced by patients, drug company representatives, and other providers working at the

  16. Preferred treatment frequency in patients receiving androgen deprivation therapy for advanced prostate cancer

    DEFF Research Database (Denmark)

    Fode, Mikkel; Nielsen, Torben K; Al-Hamadani, Muhammad;

    2014-01-01

    for analysis. A total of 38.1% of participants preferred frequent treatment ("Every month", "Every third month"), 32.4% preferred infrequent treatment ("Every sixth month", "Every twelfth month") and 29.6% stated that length of the treatment intervals made no difference (p = 0.37). Patients with disease......OBJECTIVE: The aim of this study was to assess patient preference regarding the length of treatment intervals of androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonists for prostate cancer. MATERIAL AND METHODS: The study was conducted as a questionnaire-based, cross...... satisfaction and side-effects. Overall, 238 men receiving ADT for prostate cancer were presented with the questionnaire between September 2011 and May 2012. Descriptive statistics, the chi-squared test and multiple regression were used for analyses. RESULTS: In total, 176 questionnaires (74%) were available...

  17. The influence of baseline marijuana use on treatment of cocaine dependence: application of an informative-priors Bayesian approach.

    Directory of Open Access Journals (Sweden)

    Charles eGreen

    2012-10-01

    Full Text Available Background: Marijuana use is prevalent among patients with cocaine dependence and often non-exclusionary in clinical trials of potential cocaine medications. The dual-focus of this study was to (1 examine the moderating effect of baseline marijuana use on response to treatment with levodopa/carbidopa for cocaine dependence; and (2 apply an informative-priors, Bayesian approach for estimating the probability of a subgroup-by-treatment interaction effect.Method: A secondary data analysis of two previously published, double-blind, randomized controlled trials provided samples for the historical dataset (Study 1: N = 64 complete observations and current dataset (Study 2: N = 113 complete observations. Negative binomial regression evaluated Treatment Effectiveness Scores (TES as a function of medication condition (levodopa/carbidopa, placebo, baseline marijuana use (days in past 30, and their interaction. Results: Bayesian analysis indicated that there was a 96% chance that baseline marijuana use predicts differential response to treatment with levodopa/carbidopa. Simple effects indicated that among participants receiving levodopa/carbidopa the probability that baseline marijuana confers harm in terms of reducing TES was 0.981; whereas the probability that marijuana confers harm within the placebo condition was 0.163. For every additional day of marijuana use reported at baseline, participants in the levodopa/carbidopa condition demonstrated a 5.4% decrease in TES; while participants in the placebo condition demonstrated a 4.9% increase in TES.Conclusion: The potential moderating effect of marijuana on cocaine treatment response should be considered in future trial designs. Applying Bayesian subgroup analysis proved informative in characterizing this patient-treatment interaction effect.

  18. Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Anxiety in Children : A Multiple Baseline Design Analysis

    Science.gov (United States)

    Jarrett, Matthew A.; Ollendick, Thomas H.

    2012-01-01

    Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety…

  19. Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Anxiety in Children : A Multiple Baseline Design Analysis

    Science.gov (United States)

    Jarrett, Matthew A.; Ollendick, Thomas H.

    2012-01-01

    Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety…

  20. The development of PubMed search strategies for patient preferences for treatment outcomes

    Directory of Open Access Journals (Sweden)

    Ralph van Hoorn

    2016-07-01

    Full Text Available Abstract Background The importance of respecting patients’ preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. Methods A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se and specificity (Sp. Results Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94–95 %] and Sp of 97 % [97–98 %] with 75 % Se [74–76 %]. In the validation set these queries reached values of Se of 90 % [89–91 %] with Sp 94 % [93–95 %] and Se of 80 % [79–81 %] with Sp of 97 % [96–96 %], respectively. Conclusions Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

  1. Clinical preference for factors in treatment of geriatric depression

    Directory of Open Access Journals (Sweden)

    Riepe MW

    2014-12-01

    Full Text Available Matthias W Riepe Mental Health and Geriatric Psychiatry, Psychiatry II, Ulm University, Ulm, Germany Abstract: Little is known about symptom preferences of clinical psychiatrists in the treatment of geriatric depression and preferences for avoiding adverse drug effects. Participants (board-certified psychiatrists were recruited prior to a lecture on geriatric depression during a continuing education program. An analytic hierarchy process was performed and participants were asked for pairwise comparison of criteria guiding them in appraising therapeutic efficacy, and in avoiding toxicity and adverse events. Of the 61 participants from the continuing education program, 42 (69% returned their data sheet. Avoidance of cardiotoxicity was regarded as more important than avoidance of hepatotoxicity or hematotoxicity. Concerning adverse events, highest preference was given to avoidance of falls and drug interactions, followed by avoidance of sedation, weight change, and impairment of sexual function. The most important preferences for appraisal of therapeutic efficacy were suicidality over ability to concentrate and sleep. Clinical psychiatrists have a hierarchy of preferences for treatment goals and avoidance of adverse events and toxicity. This raises the question for future research whether these preferences cause differences in prescription patterns in clinical practice even though a multitude of antidepressants are similarly effective when judged with instruments used in clinical trials. Keywords: depressive disorder, symptoms, analytic hierarchy process, toxicity, adverse events, symptoms

  2. Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

    Directory of Open Access Journals (Sweden)

    Hernández Susana

    2011-01-01

    Full Text Available Abstract Background Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial. Methods/Design This work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid. The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression.. The dependent variable being the type of treatment chosen (oral or topical and the independent, the variables that after bivariant analysis, have been associated to the treatment preference. Discussion Clinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.

  3. Patient preferences for treatment of multiple sclerosis with disease-modifying therapies: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Garcia-Dominguez JM

    2016-09-01

    Full Text Available José Manuel Garcia-Dominguez,1 Delicias Muñoz,2 Marta Comellas,3 Irmina Gonzalbo,3 Luis Lizán,3 Carlos Polanco Sánchez4 1Multiple Sclerosis Unit, Hospital General Universitario Gregorio Marañon, Madrid, 2Neurology Department, Hospital Universitario Alvaro Cunqueiro, Vigo, 3Outcomes’10, Jaime I University, Castellón, 4Health Economics & Outcomes Research, Merck, Madrid, Spain Objectives: To assess disease-modifying therapy (DMT preferences in a population of patients with multiple sclerosis (MS and to estimate the association between sociodemographic and clinical factors and these preferences. Methods: Preferences for DMTs attributes were measured using a discrete choice experiment. Analysis of preferences was assessed using mixed-logit hierarchical Bayes regression. A multilinear regression was used to evaluate the association between the preferences for each attribute and patients’ demographic and clinical characteristics. A Student’s t-test or Welch’s t-test was used for subgroup comparisons. Results: A total of 125 patients were included in the final analysis (62.9% female, mean age 44.5 years, 71.5% with relapsing-remitting MS diagnosis. The most important factor for patients was the possibility of suffering from the side effects of the treatment (relative importance [RI] =50%, followed by a delay in disease progression (RI =19.4%, and route and frequency of administration (RI =14.3%. According to maximum acceptable risk, patients were willing to accept an increase of 3.8% in severity of side effects, for a delay of 1 year in disease progression. Treatment duration was the most prevalent factor affecting preferences, followed by the age of patients, type of MS, level of education, and the type of current treatment. Patients treated orally were significantly more concerned about the route and frequency of administration (P=0.026 than patients on injectable therapy. Naïve patients stated significantly less importance to

  4. Initial evaluation of an integrated treatment for comorbid PTSD and smoking using a nonconcurrent, multiple-baseline design.

    Science.gov (United States)

    Feldner, Matthew T; Smith, Rose C; Monson, Candice M; Zvolensky, Michael J

    2013-09-01

    The present study examined an integrated treatment for comorbid posttraumatic stress disorder (PTSD) and smoking entitled "Smoke-Free to Overcome PTSD: An Integrated Treatment" (STOP IT program). A nonconcurrent multiple-baseline design was used with six community-recruited adult smokers with PTSD to investigate both patient acceptance of the treatment and its initial efficacy on both PTSD and smoking. Potential order effects of exposure-based and affect management components were also examined. A gold-standard assessment strategy that included the Clinician Administered PTSD Scale (Blake et al., 1995) and biochemical verification of self-reported smoking status was employed to measure primary targets of treatment. Results suggested that the STOP IT program was well tolerated. There were clinically significant improvements in PTSD outcomes, but only temporary reductions in smoking. Participants' relatively low posttreatment smoking levels increased by the follow-up assessment, although not to baseline levels. Treatment component order did not appear to affect treatment outcomes, but those who were assigned to the exposure-focused writing prior to affect management training condition appeared more likely to discontinue treatment before beginning exposure. These preliminary data support the safety, acceptability, and potential efficacy of the STOP IT program. Future investigation of the STOP IT program should include testing the incremental efficacy of increasing the dose of smoking-focused intervention, as well as randomized controlled tests of the treatment that employ gold standards for treatment outcome research.

  5. Low-dose budesonide treatment reduces severe asthma-related events in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren

    2015-01-01

    RATIONALE: Inhaled corticosteroids (ICS) are highly effective in low doses for reducing asthma-related exacerbation risk and mortality. Previously, ICS treatment was recommended for patients with 'persistent' asthma, defined by symptoms >2 days/week.1 However, for patients with less frequent...... symptoms, evidence is lacking for the benefit of ICS and safety of bronchodilator-only treatment. We investigated asthma outcomes by baseline symptom frequency in a post-hoc analysis of the multinational inhaled Steroid Treatment As Regular Therapy in early asthma (START) study.2 METHODS: Patients aged 4...

  6. Depression Treatment Among Rural Older Adults: Preferences and Factors Influencing Future Service Use.

    Science.gov (United States)

    Kitchen, Katherine A; McKibbin, Christine L; Wykes, Thomas L; Lee, Aaron A; Carrico, Catherine P; McConnell, Katelynn A

    2013-01-01

    The purpose of this study was to investigate depression treatment preferences and anticipated service use in a sample of adults aged 55 years or older who reside in rural Wyoming. Sixteen participants (mean age = 59) completed 30- to 60-minute, semi-structured interviews. Qualitative methods were used to characterize common themes. Social/provider support and community gatekeepers were perceived by participants as important potential facilitators for seeking depression treatment. In contrast, perceived stigma and the value placed on self-sufficiency emerged as key barriers to seeking treatment for depression in this rural, young-old sample. Participants anticipated presenting for treatment in the primary care sector and preferred a combination of medication and psychotherapy for treatment. Participants were, however, more willing to see mental health professionals if they were first referred by a clergy member or primary care physician.

  7. Does Preference for Type of Treatment Matter? A Study of Exposure In Vivo With or Without Hypnosis in the Treatment of Panic Disorder With Agoraphobia.

    Science.gov (United States)

    Dyck, Richard Van; Spinhoven, Philip

    1997-01-01

    Explores whether a client's preference for a certain therapy effects treatment efficacy. Treatment of 64 agoraphobic patients with either exposure in vivo or exposure combined with hypnosis show that, although patients' preference clearly shifted in favor of a combined therapy approach, no effect of preference on outcome was evident. (RJM)

  8. Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy.

    Science.gov (United States)

    Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W; Rothbaum, Barbara O

    2016-07-01

    Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either d-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p therapy, in particular in the presence of enhancement (e.g., DCS). Published by Elsevier Ltd.

  9. Rizatriptan for the acute treatment of migraine: Consistency, preference, satisfaction, and quality of life.

    Science.gov (United States)

    Amoozegar, Farnaz; Pringsheim, Tamara

    2009-11-03

    Rizatriptan is a 5HT (IB/ID) agonist with proven efficacy in the acute treatment of migraine headache. We performed a systematic review of the literature for clinical trials of rizatriptan incorporating important patient outcomes including consistency of response, preference, satisfaction, and quality of life. We found evidence that rizatriptan provides consistent relief of migraine attacks and that patients prefer rizatriptan over other treatments because of its speed of relief. Patient satisfaction with rizatriptan is significantly higher than placebo, but appears equivalent to most other triptans. Migraine-specific quality of life at 24 hours is significantly better in patients treated with rizatriptan compared to placebo, while overall long-term quality of life is less affected. The published clinical trials included in this systematic review are subject to bias due to the open-label nature of preference trials and the doses chosen for comparison in head-to-head trials.

  10. Patient preferences for treatment of multiple sclerosis with disease-modifying therapies: a discrete choice experiment

    Science.gov (United States)

    Garcia-Dominguez, José Manuel; Muñoz, Delicias; Comellas, Marta; Gonzalbo, Irmina; Lizán, Luis; Polanco Sánchez, Carlos

    2016-01-01

    Objectives To assess disease-modifying therapy (DMT) preferences in a population of patients with multiple sclerosis (MS) and to estimate the association between sociodemographic and clinical factors and these preferences. Methods Preferences for DMTs attributes were measured using a discrete choice experiment. Analysis of preferences was assessed using mixed-logit hierarchical Bayes regression. A multilinear regression was used to evaluate the association between the preferences for each attribute and patients’ demographic and clinical characteristics. A Student’s t-test or Welch’s t-test was used for subgroup comparisons. Results A total of 125 patients were included in the final analysis (62.9% female, mean age 44.5 years, 71.5% with relapsing-remitting MS diagnosis). The most important factor for patients was the possibility of suffering from the side effects of the treatment (relative importance [RI] =50%), followed by a delay in disease progression (RI =19.4%), and route and frequency of administration (RI =14.3%). According to maximum acceptable risk, patients were willing to accept an increase of 3.8% in severity of side effects, for a delay of 1 year in disease progression. Treatment duration was the most prevalent factor affecting preferences, followed by the age of patients, type of MS, level of education, and the type of current treatment. Patients treated orally were significantly more concerned about the route and frequency of administration (P=0.026) than patients on injectable therapy. Naïve patients stated significantly less importance to prevention of relapses (P=0.021) and deterioration of the capacity for performing usual daily life activities (P=0.015). Finally, patients with >5 years since diagnosis were significantly less concerned about preventing disease progression (P=0.021), and more concerned about treatment side effects (P=0.052) than compared with patients with <5 years of MS history. Conclusion The most important attribute for

  11. Real-world evaluation of compliance and preference in Alzheimer’s disease treatment

    Directory of Open Access Journals (Sweden)

    Pai MC

    2015-11-01

    Full Text Available Ming-Chyi Pai,1,2 Hany Aref,3 Nazem Bassil,4 Nagaendran Kandiah,5 Jae-Hong Lee,6 AV Srinivasan,7 Shelley diTommaso,8 Ozgur Yuksel81Division of Behavioral Neurology, Department of Neurology, 2Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; 3Department of Neurology, Ain Shams University, Cairo, Egypt; 4Saint Georges Hospital Medical Center, Balamand University, Beirut, Lebanon; 5Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore; 6Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea; 7The Tamil Nadu Dr MGR Medical University, Chennai, Tamil Nadu, India; 8Novartis Pharma AG, Postfach, Basel, SwitzerlandPurpose: Rivastigmine transdermal patch has shown higher caregiver satisfaction and greater preference than oral formulation in patients with Alzheimer’s disease. However, there is limited literature available related to caregiver preference or treatment compliance in real-world clinical settings. To date, no such data are available from Asia and the Middle East, which account for a sizeable proportion of patients with Alzheimer’s disease. The objective of this study was to evaluate treatment preference and compliance with oral and transdermal medications in daily clinical practice in an ethnically diverse patient population from Asia and the Middle East with mild-to-moderate Alzheimer’s disease.Patients and methods: RECAP (Real-world Evaluation of Compliance And Preference in the treatment of Alzheimer’s disease was a 24-week, multicenter, prospective, noninterventional study. Two treatment cohorts were observed during the study: oral (cholinesterase inhibitors or memantine and transdermal (rivastigmine patch. Caregiver preference, physician preference, and patient compliance were evaluated at week 24.Results: A total of 978 of 1

  12. Preference weights for cost-outcome analyses of schizophrenia treatments: comparison of four stakeholder groups.

    Science.gov (United States)

    Shumway, Martha

    2003-01-01

    This study quantified preferences for schizophrenia outcomes in four stakeholder groups, tested the hypotheses that outcomes differ in importance and stakeholder groups have different preferences, and produced preference weights for seven outcomes for cost-outcome analysis. Fifty patients with schizophrenia, 50 clinicians, 41 family members of patients, and 50 members of the general public rated 16 schizophrenia-related health states, yielding preference weights for seven outcomes: positive symptoms, negative symptoms, extrapyramidal symptoms, tardive dyskinesia, social function, independent living, and vocational function. Outcomes differed in importance (F = 23.4, p stakeholders rated positive symptoms and social functioning as more important than negative and extrapyramidal symptoms. Stakeholder groups had different preferences (F = 1.9, p = 0.01). Patients rated extrapyramidal symptoms as more important than did other groups (p important than did patients or family members (p important than did patients and the general public (p important and that stakeholder groups value outcomes differently, demonstrating the importance of incorporating stakeholder preferences in cost-outcome analyses and other treatment comparisons.

  13. Attitudes and preferences in patients with acromegaly on long-term treatment with somatostatin analogues

    Directory of Open Access Journals (Sweden)

    Cecilia Follin

    2016-08-01

    Full Text Available Introduction: Patients with acromegaly can be treated with surgery, medical therapy and/or radiation therapy. For the patients not being cured with surgery, treatment with somatostatin analogues (SSAs is the primary therapy. SSA can be taken by self- or partner-administered injections in addition to being given by a nurse at a clinic. The aim was to assess if patients with acromegaly prefer self-injections and to investigate their attitudes towards long-term medical therapy. Method: All patients in the southern medical region of Sweden with a diagnosis of acromegaly and treated with SSA were eligible for the study (n = 24. The study is based on a questionnaire asking about the patients’ attitudes and preferences for injections with SSA, including their attitudes towards self-injection with SSA. Results: The patients’ (23 included median age was 68.5 years and the patients had been treated with SSA for 13 (1–38 years. One patient was currently self-injecting. All of the other patients were receiving injections from a nurse at a clinic. Three patients preferred self-injections, one preferred partner injections and 19 patients did not prefer self- or partner injections. The most frequent arguments to not preferring self-injections were ‘feeling more secure with an educated nurse’ and ‘preferring regular contact with a specialised nurse’. Conclusion: Patients with acromegaly prefer regular contact with the endocrine team to the independence offered by self-injections. These findings might mirror the patients’ desires for continuity and safety. We need to address patients’ concerns regarding injections with SSA and support them in their choices.

  14. Rorschach Inkblot Method data at baseline and after 2 years treatment of consecutively admitted patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Andersen, Palle Bent; Knudsen, Per Bjerregaard;

    2012-01-01

    Background: The Rorschach Inkblot Method is regarded as an important clinical instrument for detailed diagnostic description of the integrative capacities of individuals in psychotic states and as an instrument for measuring progression in the course of treatment. Aims: To describe relevant...... Rorschach variables at baseline in a group of consecutively admitted patients with first-episode schizophrenia. Furthermore, to describe the changes in these variables from baseline to year 2 for the group of patients given psychiatric standard treatment, and to compare these changes with changes in other......'s Rorschach Comprehensive System at inclusion and after 2 years. Results: Core variables of the Rorschach, assumed to show changes (e.g. reality testing, perceptual and thought disorders) in patients with a first episode of schizophrenia, all improved but revealed no significant changes after 2 years...

  15. Religion and End-of-Life Treatment Preferences: Assessing the Effects of Religious Denomination and Beliefs

    Science.gov (United States)

    Sharp, Shane; Carr, Deborah; Macdonald, Cameron

    2012-01-01

    We use Wisconsin Longitudinal Study data (n = 2,678) to assess the effects of religious denomination and ideology on end-of-life treatment preferences in two hypothetical terminal illness scenarios: physical pain and severe cognitive impairment. We found no statistically significant differences when comparing traditionally defined religious…

  16. Accounting for Patient Preferences Regarding Life-Sustaining Treatment in Evaluations of Medical Effectiveness and Quality.

    Science.gov (United States)

    Walkey, Allan J; Barnato, Amber E; Wiener, Renda Soylemez; Nallamothu, Brahmajee K

    2017-04-05

    The importance of understanding patient preferences for life-sustaining treatment is well-described for individual clinical decisions; however, its role in evaluations of healthcare outcomes and quality has received little attention. Decisions to limit life-sustaining therapies are strongly associated with high risks of death in ways that are unaccounted for by routine measures of illness severity. Yet, this essential information is generally unavailable to researchers, with the potential for spurious inferences. This may lead to "confounding by unmeasured patient preferences" (a type of confounding by indication) and has implications for assessments of treatment effectiveness and healthcare quality, especially in acute and critical care settings where risk of death and adverse events are high. Through a collection of case studies we explore the effect of unmeasured patient resuscitation preferences on issues critical for researchers and research consumers to understand. We then propose strategies to more consistently elicit, record and harmonize documentation of patient preferences that can be used to attenuate confounding by unmeasured patient preferences and provide novel opportunities to improve patient-centeredness of medical care for serious illness.

  17. Influence of medication risks and benefits on treatment preferences in older patients with multimorbidity

    Science.gov (United States)

    Caughey, Gillian E; Tait, Kirsty; Vitry, Agnes I; Shakib, Sepehr

    2017-01-01

    Multimorbidity is associated with use of multiple medicines, increased risk of adverse events and treatment conflicts. This study aimed to examine how older patients with multimorbidity and clinicians balance the benefits and harms associated with a medication and in the presence of competing health outcomes. Interviews were conducted with 15 participants aged ≥65 years with 2 or more chronic conditions. Three clinical scenarios were presented to understand patient preference to take a medicine according to i) degree of benefit, ii) type of adverse event and impact on daily living and iii) influence of comorbid conditions as competing health outcomes. Semi-structured interviews were also conducted with participants (n=15) and clinicians (n=5) to understand patient preferences and treatment decisions, in the setting of multimorbidity. The median age of participants was 79 years, 55% had 5 or more conditions and 47% took 8 or more medicines daily. When the level of benefit of the medicine ranged from 14% to 70%, 80% of participants chose to take the medicine, but when adverse effects were present, this was reduced to 0–33% depending upon impact on daily activities. In the presence of competing health outcomes, 13%–26% of patients chose to take the medicine. Two-thirds of patients reported that their doctor respects and considers their preferences and discussed medication benefits and harms. Interviews with clinicians showed that their overall approach to treatment decision-making for older individuals with multimorbidity was based upon 2 main factors, the patients’ prognosis and their preferences. The degree of benefit gained was not the driver of patients’ preference to take a medicine; rather, this decision was influenced by type and severity of adverse effects. Inclusion of patient preferences in the setting of risks and benefits of medicines with consideration and prioritization of competing health outcomes may result in improved health outcomes for

  18. Variability in orthopedic surgeon treatment preferences for nondisplaced scaphoid fractures: A cross-sectional survey.

    Science.gov (United States)

    Paulus, Megan Carroll; Braunstein, Jake; Merenstein, Daniel; Neufeld, Steven; Narvaez, Michael; Friedland, Robert; Bruce, Katherine; Pfaff, Ashley

    2016-12-01

    The absence of a best practice treatment standard contributes to clinical variation in medicine. Often in the absence of evidence, a standard of care is developed and treatment protocols are implemented. The purpose of this study was to examine whether the standard of care for the treatment of nondisplaced scaphoid fractures is uniform among orthopedic surgeons. A survey of orthopedic surgeons actively practicing in the US or abroad was conducted to elicit preferred treatment strategies for nondisplaced scaphoid fractures. The surgeons were recruited at orthopedic conferences, clinical visits, and via email. The survey included demographic questions along with a short clinical vignette. The option for fracture management included surgical versus nonsurgical treatment. For those who chose nonsurgical treatment, type/duration of immobilization was recorded. Cost analysis was performed to estimate direct and indirect costs of various treatment options. A total of 494 orthopedic surgeons completed the survey. The preference for surgical treatment was preferred in 13% of respondents. Hand/upper extremity specialists were significantly more likely to operate compared with generalists (p = 0.0002). Surgeons younger than forty-five were nearly twice as likely to choose surgery (p = 0.01). There was no clear consensus on duration of immobilization as 30% of surgeons chose 6 weeks, 33% selected 8 weeks, and 27% opted for 12 weeks. Total cost of surgery was 49% greater than that of nonoperative treatment. With each additional week of immobilization for nonoperative treatment, the total costs of surgical treatment near that of nonoperative treatment. There exist clear trends in how specific demographic groups choose to treat the nondisplaced scaphoid fracture. Whether these trends are the result of generational gaps or additional subspecialty training remains difficult to determine, but there is need to pursue a more consistent approach that benefits the patients and the

  19. The effect of support on internet-delivered treatment for Insomnia : Does baseline depression severity matter?

    NARCIS (Netherlands)

    Lancee, Jaap; Sorbi, Marjolijn J.; Eisma, Maarten C.; van Straten, Annemieke; van den Bout, Jan

    2014-01-01

    Internet-delivered cognitive-behavioral treatment is effective for insomnia. However, little is known about the beneficial effects of support. Recently we demonstrated that motivational support moderately improved the effects of Internet-delivered treatment for insomnia. In the present study, we tes

  20. The effect of support on Internet-delivered treatment for insomnia: Does baseline depression severity matter?

    NARCIS (Netherlands)

    Lancee, J.; Sorbi, M.J.; Eisma, M.C.; van Straten, A.; van den Bout, J.

    2014-01-01

    Internet-delivered cognitive-behavioral treatment is effective for insomnia. However, little is known about the beneficial effects of support. Recently we demonstrated that motivational support moderately improved the effects of Internet-delivered treatment for insomnia. In the present study, we tes

  1. The effect of support on internet-delivered treatment for Insomnia : Does baseline depression severity matter?

    NARCIS (Netherlands)

    Lancee, Jaap; Sorbi, Marjolijn J.; Eisma, Maarten C.; van Straten, Annemieke; van den Bout, Jan

    2014-01-01

    Internet-delivered cognitive-behavioral treatment is effective for insomnia. However, little is known about the beneficial effects of support. Recently we demonstrated that motivational support moderately improved the effects of Internet-delivered treatment for insomnia. In the present study, we tes

  2. Quality of life after prostate cancer treatments in patients comparable at baseline

    NARCIS (Netherlands)

    Tol-Geerdink, J.J. van; Leer, J.W.H.; Oort, I.M. van; Lin, E.J. van; Weijerman, P.C.; Vergunst, H.; Witjes, J.A.; Stalmeier, P.F.M.

    2013-01-01

    Background:Previous studies on the effects of different prostate cancer treatments on quality of life, were confounded because patients were not comparable. This study examined treatment effects in more comparable groups.Methods:From 2008-2011, 240 patients with localised prostate cancer were select

  3. Color Preference in Danio rerio: Effects of Age and Anxiolytic Treatments.

    Science.gov (United States)

    Peeters, Bernardus W M M; Moeskops, Max; Veenvliet, Anne R J

    2016-08-01

    Zebrafish are increasingly used in neurobiological and behavioral studies. Possible stimuli to manipulate zebrafish behavior are being investigated. The presentation of colors appears to be one of the most used approaches, but there is much debate about the exact color preference. Here we have investigated the color preference in both larvae and adult zebrafish. We have studied the effects of wavelength, contrast, intensity, and location. Furthermore, we have tried to manipulate the preference with anxiolytic drugs (ethanol and buspirone). Our results show that both adults and larvae have a clear preference for blue zones while they avoid yellow-colored zones. Red and green zones have an intermediate preference. Part of the yellow aversion is caused by a fear for this color and can be diminished by the treatment with anxiolytic drugs. The location of the color appears to be of critical importance. Presentation of the color on the walls induces an approach response whereas presentation on the bottom induces an aversion. In conclusion, colors are important stimuli to manipulate zebrafish behavior and can be used in behavioral models. Standardization of the procedures and a clear description of the used methodologies are, however, essential.

  4. Risk preferences: consequences for test and treatment thresholds and optimal cutoffs.

    Science.gov (United States)

    Felder, Stefan; Mayrhofer, Thomas

    2014-01-01

    Risk attitudes include risk aversion as well as higher-order risk preferences such as prudence and temperance. This article analyzes the effects of such preferences on medical test and treatment decisions, represented either by test and treatment thresholds or-when the test result is not given-by optimal cutoff values for diagnostic tests. For a risk-averse decision maker, effective treatment is a risk-reducing strategy since it prevents the low health outcome of forgoing treatment in the sick state. Compared with risk neutrality, risk aversion thus lowers both the test and the treatment threshold and decreases the optimal test cutoff value. Risk vulnerability, which combines risk aversion, prudence, and temperance, is relevant if there is a comorbidity risk: thresholds and optimal cutoff values decrease even more. Since common utility functions imply risk vulnerability, our findings suggest that diagnostics in low prevalence settings (e.g., screening) may be considered more beneficial when risk preferences are taken into account.

  5. Rizatriptan for the acute treatment of migraine: Consistency, preference, satisfaction, and quality of life

    Directory of Open Access Journals (Sweden)

    Farnaz Amoozegar

    2009-08-01

    Full Text Available Farnaz Amoozegar, Tamara PringsheimCalgary Headache Assessment and Management Program, Department of Clinical Neurosciences, University of Calgary, Calgary, AB, CanadaAbstract: Rizatriptan is a 5HT (IB/ID agonist with proven efficacy in the acute treatment of migraine headache. We performed a systematic review of the literature for clinical trials of rizatriptan incorporating important patient outcomes including consistency of response, preference, satisfaction, and quality of life. We found evidence that rizatriptan provides consistent relief of migraine attacks and that patients prefer rizatriptan over other treatments because of its speed of relief. Patient satisfaction with rizatriptan is significantly higher than placebo, but appears equivalent to most other triptans. Migraine-specific quality of life at 24 hours is significantly better in patients treated with rizatriptan compared to placebo, while overall long-term quality of life is less affected. The published clinical trials included in this systematic review are subject to bias due to the open-label nature of preference trials and the doses chosen for comparison in head-to-head trials.Keywords: migraine, rizatriptan, patient preference

  6. A Discrete Choice Conjoint Experiment to Evaluate Parent Preferences for Treatment of Young, Medication Naive Children with ADHD

    Science.gov (United States)

    Waschbusch, Daniel A.; Cunningham, Charles E.; Pelham, William E., Jr.; Rimas, Heather L.; Greiner, Andrew R.; Gnagy, Elizabeth M.; Waxmonsky, James; Fabiano, Gregory A.; Robb, Jessica A.; Burrows-MacLean, Lisa; Scime, Mindy; Hoffman, Martin T.

    2011-01-01

    The current study examined treatment preferences of 183 parents of young (average age = 5.8 years, SD = 0.6), medication naive children with ADHD. Preferences were evaluated using a discrete choice experiment in which parents made choices between different combinations of treatment characteristics, outcomes, and costs. Latent class analysis…

  7. PTSD in Latino patients: illness beliefs, treatment preferences, and implications for care.

    Science.gov (United States)

    Eisenman, David P; Meredith, Lisa S; Rhodes, Hilary; Green, Bonnie L; Kaltman, Stacey; Cassells, Andrea; Tobin, Jonathan N

    2008-09-01

    Little is known about how Latinos with post-traumatic stress disorder (PTSD) understand their illness and their preferences for mental health treatment. To understand the illness beliefs and treatment preferences of Latino immigrants with PTSD. Semi-structured, face-to-face interviews. Sixty foreign-born, Latino adults recruited from five primary care centers in New York and New Jersey and screened for PTSD. Content analytic methods identified common themes, their range, and most frequent or typical responses. Participants identified their primary feelings as sadness, anxiety, nervousness, and fear. The most common feeling was "sad" (triste). Other words frequently volunteered were "angry" (enojada), "nervous" (nerviosa), and "scared" (miedo). Participants viewed their PTSD as impairing health and functioning. They ascribed their somatic symptoms and their general medical problems to the "stress" from the trauma and its consequences on their lives. The most common reason participants volunteered for their work and school functioning being impaired was their poor concentration, often due to intrusive thoughts. Most expressed their desire to receive mental health treatment, to receive it within their primary care center, and preferred psychotherapy over psychotropic medications. Among participants who did not report wanting treatment, most said it was because the trauma was "in the past." Clinicians may consider enquiring about PTSD in Latino patients who report feeling sad, anxious, nervous, or fearful. Our study suggests topics clinicians may include in the psychoeducation of patients with PTSD.

  8. Population preference values for treatment outcomes in chronic lymphocytic leukaemia: a cross-sectional utility study

    Directory of Open Access Journals (Sweden)

    Meiklejohn David

    2010-05-01

    Full Text Available Abstract Background Given that treatments for chronic lymphocytic leukaemia (CLL are palliative rather than curative, evaluating the patient-perceived impacts of therapy is critical. To date, no utility (preference studies from the general public or patient perspective have been conducted in CLL. The objective of this study was to measure preferences for health states associated with CLL treatment. Methods This was a cross-sectional study of 89 members of the general population in the UK (England and Scotland. Using standard gamble, each participant valued four health states describing response status, six describing treatment-related toxicities based on Common Toxicity Criteria, and two describing line of treatment. The health states incorporated standardized descriptions of treatment response (symptoms have "improved," "stabilized," or "gotten worse", swollen glands, impact on daily activities, fatigue, appetite, and night sweats. Utility estimates ranged from 0.0, reflecting dead, to 1.0, reflecting full health. Results Complete response (CR was the most preferred health state (mean utility, 0.91, followed by partial response (PR, 0.84; no change (NC, 0.78; and progressive disease (PD, 0.68. Among the toxicity states, grade I/II nausea and nausea/vomiting had the smallest utility decrements (both were -0.05, and grade III/IV pneumonia had the greatest decrement (-0.20. The utility decrements obtained for toxicity states can be subtracted from utilities for CR, PR, NC, and PD, as appropriate. The utilities for second- and third-line treatments, which are attempted when symptoms worsen, were 0.71 and 0.65, respectively. No significant differences in utilities were observed by age, sex, or knowledge/experience with leukaemia. Conclusions This study reports UK population utilities for a universal set of CLL health states that incorporate intended treatment response and unintended toxicities. These utilities can be applied in future cost

  9. The customer is always right? Subjective target symptoms and treatment preferences in patients with psychosis.

    Science.gov (United States)

    Moritz, Steffen; Berna, Fabrice; Jaeger, Susanne; Westermann, Stefan; Nagel, Matthias

    2016-05-18

    Clinicians and patients differ concerning the goals of treatment. Eighty individuals with schizophrenia were assessed online about which symptoms they consider the most important for treatment, as well as their experience with different interventions. Treatment of affective and neuropsychological problems was judged as more important than treatment of positive symptoms (p < 0.005). While most individuals had experience with Occupational and Sports Therapy, only a minority had received Cognitive-Behavioral Therapy, Family Therapy, and Psychoeducation with family members before. Patients appraised Talk, Psychoanalytic, and Art Therapy as well as Metacognitive Training as the most helpful treatments. Clinicians should carefully take into consideration patients' preferences, as neglect of consumers' views may compromise outcome and adherence to treatment.

  10. effect of sorghum seed treatment in burkina faso varies with baseline ...

    African Journals Online (AJOL)

    ACSS

    Roots from sorghum in the village showing the strongest effect of both seed treatments (>40% yield .... tested in mixed linear models, including experiment ... version 3.2.2 (R Core Team 2015). Yield data from ... at 50 °C, 30 s extension at 72 °C and phase-2 with. 25 cycles of 20 s at ..... Species and ecological diversity within.

  11. Racial and ethnic differences in preferences for end-of-life treatment.

    Science.gov (United States)

    Barnato, Amber E; Anthony, Denise L; Skinner, Jonathan; Gallagher, Patricia M; Fisher, Elliott S

    2009-06-01

    Studies using local samples suggest that racial minorities anticipate a greater preference for life-sustaining treatment when faced with a terminal illness. These studies are limited by size, representation, and insufficient exploration of sociocultural covariables. To explore racial and ethnic differences in concerns and preferences for medical treatment at the end of life in a national sample, adjusting for sociocultural covariables. Dual-language (English/Spanish), mixed-mode (telephone/mail) survey. A total of 2,847 of 4,610 eligible community-dwelling Medicare beneficiaries age 65 or older on July 1, 2003 (62% response). Demographics, education, financial strain, health status, social networks, perceptions of health-care access, quality, and the effectiveness of mechanical ventilation (MV), and concerns and preferences for medical care in the event the respondent had a serious illness and less than 1 year to live. Respondents included 85% non-Hispanic whites, 4.6% Hispanics, 6.3% blacks, and 4.2% "other" race/ethnicity. More blacks (18%) and Hispanics (15%) than whites (8%) want to die in the hospital; more blacks (28%) and Hispanics (21.2%) than whites (15%) want life-prolonging drugs that make them feel worse all the time; fewer blacks (49%) and Hispanics (57%) than whites (74%) want potentially life-shortening palliative drugs, and more blacks (24%, 36%) and Hispanics (22%, 29%) than whites (13%, 21%) want MV for life extension of 1 week or 1 month, respectively. In multivariable analyses, sociodemographic variables, preference for specialists, and an overly optimistic belief in the effectiveness of MV explained some of the greater preferences for life-sustaining drugs and mechanical ventilation among non-whites. Black race remained an independent predictor of concern about receiving too much treatment [adjusted OR = 2.0 (1.5-2.7)], preference for dying in a hospital [AOR = 2.3 (1.6-3.2)], receiving life-prolonging drugs [1.9 (1.4-2.6)], MV for 1 week [2

  12. ASPEN computer simulations of the mixed waste treatment project baseline flowsheet

    Energy Technology Data Exchange (ETDEWEB)

    Dietsche, L.J.; Upadhye, R.S.; Camp, D.W.; Pendergrass, J.A.; Borduin, L.C.; Thompson, T.K.

    1994-07-05

    The treatment and disposal of mixed waste (i.e., waste containing both hazardous and radioactive components) is a challenging waste- management problem of particular concern to Department of Energy (DOE) sites throughout the United States. Traditional technologies used for destroying hazardous wastes must be re- evaluated for their ability to handle mixed wastes, and, in some cases, new technologies must be developed. The Mixed Waste Treatment Project (MWTP), a collaborative effort between Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory, and Pacific Northwest Laboratory (PNL), was established by the DOE`s Waste Operations Program (EM-30) to develop and analyze alternative mixed waste treatment approaches. One of the MWTP`s initiatives, and the objective of this study, was to develop flowsheets for prototype, integrated, mixed-waste treatment facilities that can serve as models for sites developing their own treatment strategies. Evaluation of these flowsheets is being facilitated through the use of computer modeling. The objectives of the flowsheet simulations are to compare process effectiveness and costs of alternative flowsheets and to determine if commercial process-simulation software could be used on the large, complex process of an integrated mixed waste processing facility. Flowsheet modeling is needed to evaluate many aspects of proposed flowsheet designs. A major advantage of modeling the complete flowsheet is the ability to define the internal recycle streams, thereby making it possible to evaluate the impact of one operation on the whole plant. Many effects that can be seen only in this way. Modeling also can be used to evaluate sensitivity and range of operating conditions, radioactive criticality, and relative costs of different flowsheet designs. Further, the modeled flowsheets must be easily modified so that one can examine how alternative technologies and varying feed streams affect the overall integrated process.

  13. Perceptions on physiopathology and preferred treatment of epilepsy and asthma in the Limpopo Province, South Africa

    Directory of Open Access Journals (Sweden)

    Supa Promtussananon

    2003-01-01

    Full Text Available The objectives of this study were to analyse perceptions of epilepsy and asthma, due to attribution of cause, suggested means of risk reduction and preferred treatment. Opsomming Die doelwitte van hierdie studie was om persepsies van epilepsie en asma te analiseer na aanleiding van die toeskrywing van oorsaak, voorgestelde metodes van risikovermindering en verkose behandeling. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  14. Rizatriptan for the acute treatment of migraine: Consistency, preference, satisfaction, and quality of life

    OpenAIRE

    Farnaz Amoozegar; Tamara Pringsheim

    2009-01-01

    Farnaz Amoozegar, Tamara PringsheimCalgary Headache Assessment and Management Program, Department of Clinical Neurosciences, University of Calgary, Calgary, AB, CanadaAbstract: Rizatriptan is a 5HT (IB/ID) agonist with proven efficacy in the acute treatment of migraine headache. We performed a systematic review of the literature for clinical trials of rizatriptan incorporating important patient outcomes including consistency of response, preference, satisfaction, and quality of life. We found...

  15. Suicidal ideation among inmate-patients in state prison: prevalence, reluctance to report, and treatment preferences.

    Science.gov (United States)

    Way, Bruce B; Kaufman, Andrew R; Knoll, James L; Chlebowski, Susan M

    2013-01-01

    This study examined the prevalence, willingness to report, and treatment preferences for suicidal ideation among state prison inmates. The Beck Scale for Suicide Ideation (BSS) and a novel questionnaire were completed by 67 inmate-patients. The BSS score was in the high range for 15% of general population (GP) and 40% of Intermediate Care Program (ICP) patients, with 19% of ICP inmates reporting a "moderate to strong" desire to commit suicide. A majority (64% GP, 86% ICP) had prior suicide attempt(s). Forty-two percent of GP and 31% of ICP inmate-patients were unlikely to tell mental health staff about suicidal thoughts. Family contact and talking with mental health staff were preferred interventions. ICP inmates preferred staff visits and observation in their own cells, but GP inmates did not. Only a small minority (14% GP, 21% ICP) favored transfer to a crisis observation cell, but the least desired option was talking to a corrections officer. While many inmate-patients reported experiencing suicidal thoughts, they preferred not to inform staff. Almost 80% did not favor the current primary intervention: the observation cell. Alternative or supplementary options should be considered. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Characteristics and treatment preferences of people with symptoms of posttraumatic stress disorder: an internet survey.

    Directory of Open Access Journals (Sweden)

    Jay Spence

    Full Text Available BACKGROUND: Although Posttraumatic Stress Disorder (PTSD is a severe and disabling anxiety disorder, relatively few people with this condition access evidence-based care. Barriers to treatment are multiple and complex, but the emerging field of Internet therapy for PTSD may improve access to evidence-based treatment. However, little is known about the characteristics of people with PTSD who seek online treatment, or whether they perceive internet treatment as an acceptable treatment option. METHODOLOGY: An online survey was used to collect information about the demographic and symptom characteristics of individuals with elevated levels of PTSD symptoms, and this was compared to data from corresponding sample from a national survey. Previous treatment experiences, perceived barriers to treatment and treatment preferences for Internet therapy and face-to-face treatment were also compared. PRINCIPAL FINDINGS: High levels of PTSD symptoms were reported by survey respondents. Psychological distress and disability was greater than reported by individuals with PTSD from a national survey. Half of the sample reported not having received treatment for PTSD; however, 88% of those who reported receiving treatment stated they received an evidence-based treatment. Primary barriers to treatment included cost, poor awareness of service availability, lack of prior treatment response and not perceiving personal distress as severe enough to warrant treatment. Most survey respondents indicated they were willing to try Internet treatment for PTSD. CONCLUSIONS: The Internet sample was symptomatically severe and multiple barriers existed to treatment. Internet therapy is an acceptable option for the treatment of PTSD in an internet sample.

  17. Baseline depression severity as a predictor of single and combination antidepressant treatment outcome: Results from the CO-MED Trial

    Science.gov (United States)

    Friedman, Edward S.; Davis, Lori L.; Zisook, Sidney; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; Rush, A. John

    2011-01-01

    The objective of this manuscript is to report associations between baseline depressive severity and (1) baseline sociodemographic and clinical characteristics, (2) treatment outcomes, and (3) differential outcomes for three treatment groups. Six hundred and sixty-five outpatients with nonpsychotic, major depressive disorder were prospectively randomized to treatment with either a selective serotonin reuptake inhibitor (SSRI) monotherapy (escitalopram plus placebo) or one of two antidepressant medication combinations (bupropion-sustained release plus escitalopram, or venlafaxine-extended release plus mirtazapine). For purposes of these analyses, participants were divided into four groups based on baseline severity by the 16-item Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR16) total score: mild (0–10) [N=81], moderate (11–15) [N=238], severe (16–20) [N=260] and very severe (21–27) [N=67]. Treatment outcomes at 12 and 28 weeks were compared among the four severity groups. A history of childhood neglect and/or abuse was strongly associated with the severity of adult depression (1/2 of participants in the very severy group versus 1/5–1/4 of those in the mild group reported abuse and/or neglect). The degree of suicidality (e.g., 15/.4% of the very severe group ever attempted suicide versus none in the mild group), the number of suicide attempts (e.g., mean of .41 +/− 1.99 suicide attempts in the severe group versus o.o +/−0.0 in the mild group) and severity of suicidality (e.g., 9.2% of participants in very severe group had a plan or made a gesture versus 5.6% in moderate group and none in the mild group) were increased in more severe groups. Participants with a greater baseline depressive severity reported significantly more psychiatric comorbitities (e..g. [at p < 0.05] increased rates of agoraphobia, bulimia, generalized anxiety, hypocondriasis, panic disorder, post-traumatic stress disorder, social phobia and somatoform disorder

  18. Baseline study of methane emission from anaerobic ponds of palm oil mill effluent treatment.

    Science.gov (United States)

    Yacob, Shahrakbah; Ali Hassan, Mohd; Shirai, Yoshihito; Wakisaka, Minato; Subash, Sunderaj

    2006-07-31

    The world currently obtains its energy from the fossil fuels such as oil, natural gas and coal. However, the international crisis in the Middle East, rapid depletion of fossil fuel reserves as well as climate change have driven the world towards renewable energy sources which are abundant, untapped and environmentally friendly. Malaysia has abundant biomass resources generated from the agricultural industry particularly the large commodity, palm oil. This paper will focus on palm oil mill effluent (POME) as the source of renewable energy from the generation of methane and establish the current methane emission from the anaerobic treatment facility. The emission was measured from two anaerobic ponds in Felda Serting Palm Oil Mill for 52 weeks. The results showed that the methane content was between 35.0% and 70.0% and biogas flow rate ranged between 0.5 and 2.4 L/min/m(2). Total methane emission per anaerobic pond was 1043.1 kg/day. The total methane emission calculated from the two equations derived from relationships between methane emission and total carbon removal and POME discharged were comparable with field measurement. This study also revealed that anaerobic pond system is more efficient than open digesting tank system for POME treatment. Two main factors affecting the methane emission were mill activities and oil palm seasonal cropping.

  19. Baseline study of methane emission from open digesting tanks of palm oil mill effluent treatment.

    Science.gov (United States)

    Yacob, Shahrakbah; Hassan, Mohd Ali; Shirai, Yoshihito; Wakisaka, Minato; Subash, Sunderaj

    2005-06-01

    Anthropogenic release of greenhouse gases, especially CO2 and CH4 has been recognized as one of the main causes of global warming. Several measures under the Kyoto Protocol 1997 have been drawn up to reduce the greenhouse gases emission. One of the measures is Clean Development Mechanisms (CDM) that was created to enable developed countries to cooperate with developing countries in emission reduction activities. In Malaysia, palm oil industry particularly from palm oil mill effluent (POME) anaerobic treatment has been identified as an important source of CH4. However, there is no study to quantify the actual CH4 emission from the commercial scale wastewater treatment facility. Hence, this paper shall address the CH4 emission from the open digesting tanks in Felda Serting Hilir Palm Oil Mill. CH4 emission pattern was recorded for 52 weeks from 3600 m3 open digesting tanks. The findings indicated that the CH4 content was between 13.5% and 49.0% which was lower than the value of 65% reported earlier. The biogas flow rate ranged between 0.8l min(-1)m(-2) and 9.8l min(-1)m(-2). Total CH4 emission per open digesting tank was 518.9 kgday(-1). Relationships between CH4 emission and total carbon removal and POME discharged were also discussed. Fluctuation of biogas production was observed throughout the studies as a result of seasonal oil palm cropping, mill activities, variation of POME quality and quantity discharged from the mill. Thus only through long-term field measurement CH4 emission can be accurately estimated.

  20. Baseline factors predicting placebo response to treatment in children and adolescents with autism spectrum disorders: a multisite randomized clinical trial.

    Science.gov (United States)

    King, Bryan H; Dukes, Kimberly; Donnelly, Craig L; Sikich, Linmarie; McCracken, James T; Scahill, Lawrence; Hollander, Eric; Bregman, Joel D; Anagnostou, Evdokia; Robinson, Fay; Sullivan, Lisa; Hirtz, Deborah

    2013-11-01

    The finding of factors that differentially predict the likelihood of response to placebo over that of an active drug could have a significant impact on study design in this population. To identify possible nonspecific, baseline predictors of response to intervention in a large randomized clinical trial of children and adolescents with autism spectrum disorders. Randomized clinical trial of citalopram hydrobromide for children and adolescents with autism spectrum disorders and prominent repetitive behavior. Baseline data at study entry were examined with respect to final outcome to determine if response predictors could be identified. A total of 149 children and adolescents 5 to 17 years of age (mean [SD] age, 9.4 [3.1] years) from 6 academic centers were randomly assigned to citalopram (n = 73) or placebo (n = 76). Participants had autistic disorder, Asperger syndrome, or pervasive developmental disorder, not otherwise specified; had illness severity ratings that were moderate or more than moderate on the Clinical Global Impression-Severity scale; and scored moderate or more than moderate on compulsive behaviors measured with the modified Children's Yale-Brown Obsessive-Compulsive Scale. Twelve weeks of treatment with citalopram (10 mg/5 mL) or placebo. The mean (SD) maximum dose of citalopram was 16.5 (6.5) mg by mouth daily (maximum dose, 20 mg/d). A positive response was defined as having a score of at least much improved on the Clinical Global Impression-Improvement scale at week 12. Baseline measures included demographic (sex, age, weight, and pubertal status), clinical, and family measures. Clinical variables included baseline illness severity ratings (the Aberrant Behavior Checklist, the Child and Adolescent Symptom Inventory, the Vineland Adaptive Behavior Scales, the Repetitive Behavior Scale-Revised, and the Children's Yale-Brown Obsessive-Compulsive Scale). Family measures included the Caregiver Strain Questionnaire. Several baseline predictors of

  1. Military sexual assault and homeless women veterans: clinical correlates and treatment preferences.

    Science.gov (United States)

    Decker, Suzanne E; Rosenheck, Robert A; Tsai, Jack; Hoff, Rani; Harpaz-Rotem, Ilan

    2013-01-01

    Both homeless women and women who have experienced military sexual assault (MSA) are at high risk of serious psychological sequelae. However, little is known about the combined impact of MSA and current homelessness on psychological distress, or about distinctive treatment preferences among homeless female veterans affected by MSA. This observational study compared clinical symptoms, pre-military experiences, and treatment preferences among 509 female veterans with and without MSA who enrolled in 11 VA Homeless Women Veterans Programs. Over one third of participants (41.1%) reported MSA. In multivariate analyses, homeless female veterans who reported MSA endorsed greater severity of PTSD and other psychiatric symptoms. Those who had experienced MSA were more likely to report interest in treatment, and treatment focused on safety was reported as especially attractive. Among homeless female veterans, MSA is associated with greater mental health symptoms and greater interest in safety-focused treatment. Services targeting the needs of homeless MSA survivors should be encouraged. Published by Elsevier Inc.

  2. Consumer preferences for household water treatment products in Andhra Pradesh, India.

    Science.gov (United States)

    Poulos, Christine; Yang, Jui-Chen; Patil, Sumeet R; Pattanayak, Subhrendu; Wood, Siri; Goodyear, Lorelei; Gonzalez, Juan Marcos

    2012-08-01

    Over 5 billion people worldwide are exposed to unsafe water. Given the obstacles to ensuring sustainable improvements in water supply infrastructure and the unhygienic handling of water after collection, household water treatment and storage (HWTS) products have been viewed as important mechanisms for increasing access to safe water. Although studies have shown that HWTS technologies can reduce the likelihood of diarrheal illness by about 30%, levels of adoption and continued use remain low. An understanding of household preferences for HWTS products can be used to create demand through effective product positioning and social marketing, and ultimately improve and ensure commercial sustainability and scalability of these products. However, there has been little systematic research on consumer preferences for HWTS products. This paper reports the results of the first state-of-the-art conjoint analysis study of HWTS products. In 2008, we conducted a conjoint analysis survey of a representative sample of households in Andhra Pradesh (AP), India to elicit and quantify household preferences for commercial HWTS products. Controlling for attribute non-attendance in an error components mixed logit model, the study results indicate that the most important features to respondents, in terms of the effect on utility, were the type of product, followed by the extent to which the product removes pathogens, the retail outlet and, the time required to treat 10 L. Holding all other product attributes constant, filters were preferred to combination products and chemical additives. Department stores and weekly markets were the most favorable sales outlets, followed by mobile salespeople. In general, households do not prefer to purchase HWTS products at local shops. Our results can inform the types of products and sales outlets that are likely to be successful in commercial HWTS markets in AP, as well as the influence of different pricing and financing strategies on product demand

  3. Baseline Characteristics of Participants in the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

    Science.gov (United States)

    Grimm, Richard H.; Margolis, Karen L.; Papademetriou, Vasilios; Cushman, William C.; Ford, Charles E.; Bettencourt, Judy; Alderman, Michael H.; Basile, Jan N.; Black, Henry R.; DeQuattro, Vincent; Eckfeldt, John; Hawkins, C. Morton; Perry, H. Mitchell; Proschan, Michael

    2001-01-01

    -Diuretics and ss-blockers have been shown to reduce the risk of cardiovascular morbidity and mortality in people with hypertension in long-term clinical trials. No study has compared newer more costly antihypertensive agents (calcium antagonists, ACE inhibitors, and alpha-adrenergic blockers) with diuretics for reducing the incidence of cardiovascular disease in an ethnically diverse group of middle-aged and elderly hypertensive patients. The study is a randomized, double-blind, active-controlled clinical trial designed to determine whether the incidence of the primary outcome, fatal coronary heart disease or nonfatal myocardial infarction, differs between treatment initiation with a diuretic versus each of 3 other antihypertensive drugs. Men and women aged >/=55 years with at least 1 other cardiovascular disease risk factor were randomly assigned to chlorthalidone (12.5 to 25 mg/d), amlodipine (2.5 to 10 mg/d), lisinopril (10 to 40 mg/d), or doxazosin (2 to 8 mg/d) for planned follow-up of 4 to 8 years. This report describes the baseline characteristics of the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants. A total of 42 448 participants were randomized from 625 sites in the United States, Canada, Puerto Rico, and the US Virgin Islands. The mean age was 67 years, with 35% aged >/=70 years. Among those randomized, 36% were black, 19% were Hispanic, and 47% were women. The sample includes a high proportion of people with diabetes (36%), patients with existing cardiovascular disease (47%), and smokers (22%). There were no important differences between the randomized treatment groups at baseline. ALLHAT will add greatly to our understanding of the management of hypertension by providing an answer to the following question: are newer antihypertensive agents similar, superior, or inferior to traditional treatment with diuretics?

  4. Lipoprotein binding preference of CD36 is altered by filipin treatment

    Directory of Open Access Journals (Sweden)

    Chu Wuying

    2008-06-01

    Full Text Available Abstract The class B scavenger receptor CD36 binds multiple ligands, including oxidized and native lipoprotein species. CD36 and the related receptor SR-B1 have been localized to caveolae, domains that participate in cell signaling, transcytosis, and regulation of cellular cholesterol homeostasis. Previous work has indicated that the ligand preference of CD36 may depend on the cell type in which it is expressed. To determine if the presence or absence of caveolae is the determining factor for lipoprotein preference, we treated CHO-CD36 and C32 cells with filipin. Filipin treatment rapidly increased the binding capacity of CD36 for the native lipoproteins HDL and LDL, but did not affect the binding capacity of CD36 for oxidized LDL. Filipin treatment affected the distribution of caveolin and CD36 suggesting that the presence caveolae may modulate the ligand preference of CD36. However, its molecular mechanism how CD36 and caveolin interaction in regulating lipoprotein transport remains to be further studied.

  5. Preferences for different insomnia treatment options in people with schizophrenia and related psychoses: A qualitative study

    Directory of Open Access Journals (Sweden)

    Flavie eWaters

    2015-07-01

    Full Text Available Symptoms of psychosis such as hallucinations and delusions can be intrusive and unwanted and often remain treatment-resistant. Due to recent progress in basic and clinical sciences, novel approaches such as sleep-based interventions are increasingly becoming offered to address the physical and mental health issues of people with severe mental illness. While the primary outcome is to improve sleep, studies have demonstrated that interventions that target symptoms of insomnia can also produce improvements in the severity of psychotic symptoms, quality of life and functional outcomes. This study presents qualitative data on the attitudes and preferences of people with schizophrenia and schizo-affective disorders to three different types of therapies for insomnia (standard pharmacological, melatonin-based, and cognitive and/or behaviour therapy. Interviews included discussions regarding the perceived advantages and limitations of different therapies, enablers to taking up the preferred option, as well as personal strategies that have helped respondents with sleep problems in the past. Results showed that, when given the choice, these individuals prefer psychological and behavioural-type therapy to other sleep interventions because of its potential to support and empower them in taking responsibility for their own recovery. Pharmacological therapies, by contrast, are viewed as useful in managing acute sleep problems, but only as a short-term solution. Overall, the findings underscore the need for patients’ active engagement when making decisions about treatment options.

  6. Physician preferences in the diagnosis and treatment of Lyme disease in the United States.

    Science.gov (United States)

    Ziska, M H; Donta, S T; Demarest, F C

    1996-01-01

    To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disease endemic areas in the U.S. Seventy-eight responses were analyzed. Both ELISA and Western blot were ordered by 86% of responders. Fifty percent of responders believed that 25% or more of patients who have Lyme disease were seronegative. The treatment was influenced by physician specialty. Antibiotic treatment for tick bite was prescribed by 20% of responders. Erythema migrans rash was treated by all responders without serologic confirmation. The median treatment duration of erythema migrans was 4 weeks. For post-erythema migrans Lyme disease, 43% of responders treat 3 months or more; for chronic Lyme disease, 57% of responders treat 3 months or more. Our survey documents significant differences between published recommendations and actual practices. Physician education and clinical trials are needed to clarify the reasons for these differences.

  7. Should high-dose interleukin-2 still be the preferred treatment for patients with metastatic melanoma?

    Science.gov (United States)

    Dillman, Robert O; Barth, Neil M; VanderMolen, Louis A; Mahdavi, Khosrow; McClure, Stephanie E

    2012-08-01

    For more than 20 years interleukin-2 (IL2) was the preferred treatment for medically fit metastatic melanoma patients, but recently two new agents, ipilimumab and vemurafenib, were approved for stage IV disease. Single-institution data were used to determine the long-term survival rate for IL2-treated melanoma patients, and whether use of inpatient IL2 had declined recently. Between May 1987 and April 2010, 150 patients were hospitalized for high-dose, intravenous (i.v.) IL2. The average number of IL2 patients increased from 5.4 per year during 1987-1991 to 5.8 during 1992-1997 after regulatory approval of IL2, to 8.3 during 1998-2006 after a marketing indication in metastatic melanoma was granted, but dropped to 3.0 during 2007-2010. At the time of treatment, median age was 52 years; 27% were 60 years of age or older. At the time of analysis 122 patients were deceased. Median survival from the start date of IL2 treatment was 15.6 months, with a 20% 5-year survival. Among patients enrolled in clinical trials, there were as many nonresponders who survived 5 years as responders, which is consistent with a delayed immunotherapy benefit. In the absence of long-term survival data for these newer agents, IL2 probably should still be the preferred initial treatment for most patients with metastatic melanoma who are medically fit.

  8. Prioritizing treatment of rare diseases: a survey of preferences of Norwegian doctors.

    Science.gov (United States)

    Desser, Arna S

    2013-10-01

    Understanding doctors' preferences for prioritizing treatment of rare diseases can provide an important context for policy makers who must decide whether to exempt rare disease treatments, which are often quite expensive, from standard cost-effectiveness criteria. We surveyed a random sample of 551 Norwegian doctors in November 2011 and compared results to a similar survey of the Norwegian population. Respondents chose whether to prioritize treatment of patients with rare versus common diseases and then decided how to allocate funds between the two groups for each of two scenarios: (1) equal costs per person and (2) higher costs for the rare disease. Respondents were randomized to treatment costs for the rare disease in the second scenario that were either 8 or 25 times higher than treating the common disease. Except for different prevalence, the diseases were described identically. Doctors displayed no general preference for prioritizing treatment of rare diseases, but a large number favored the principle of reserving a small share of funds for rare disease patients. Doctors' responses differed significantly from those of the general population when the rare disease was more costly to treat. A larger share of doctors prioritized the common disease group for treatment while a smaller share expressed indifference. When dividing funds between the two patient groups, doctors allocated a smaller share of funds to the rare disease. Doctors were much less likely than the general population to divide funds equally between the groups. This study indicates that there is little support among Norwegian doctors for prioritizing the treatment of rare diseases.

  9. Baseline Flowsheet Generation for the Treatment and Disposal of Idaho National Engineering and Environmental Laboratory Sodium Bearing Waste

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, C.M.; Lauerhass, L.; Olson, A.L.; Taylor, D.D.; Valentine, J.H.; Lockie, K.A. (DOE- ID)

    2002-01-16

    The High-Level Waste (HLW) Program at the Idaho National Engineering and Environmental Laboratory (INEEL) must implement technologies and processes to treat and qualify radioactive wastes located at the Idaho Nuclear Technology and Engineering Center (INTEC) for permanent disposal. This paper describes the approach and accomplishments to date for completing development of a baseline vitrification treatment flowsheet for sodium-bearing waste (SBW), including development of a relational database used to manage the associated process assumptions. A process baseline has been developed that includes process requirements, basis and assumptions, process flow diagrams, a process description, and a mass balance. In the absence of actual process or experimental results, mass and energy balance data for certain process steps are based on assumptions. Identification, documentation, validation, and overall management of the flowsheet assumptions are critical to ensuring an integrated, focused program. The INEEL HLW Program initially used a roadmapping methodology, developed through the INEEL Environmental Management Integration Program, to identify, document, and assess the uncertainty and risk associated with the SBW flowsheet process assumptions. However, the mass balance assumptions, process configuration and requirements should be accessible to all program participants. This need resulted in the creation of a relational database that provides formal documentation and tracking of the programmatic uncertainties related to the SBW flowsheet.

  10. Baseline Flowsheet Generation for the Treatment and Disposal of Idaho National Engineering and Environmental Laboratory Sodium Bearing Waste

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, Charles Marshall; Lauerhass, Lance; Olson, Arlin Leland; Taylor, Dean Dalton; Valentine, James Henry; Lockie, Keith Andrew

    2002-02-01

    The High-Level Waste (HLW) Program at the Idaho National Engineering and Environmental Laboratory (INEEL) must implement technologies and processes to treat and qualify radioactive wastes located at the Idaho Nuclear Technology and Engineering Center (INTEC) for permanent disposal. This paper describes the approach and accomplishments to date for completing development of a baseline vitrification treatment flowsheet for sodium-bearing waste (SBW), including development of a relational database used to manage the associated process assumptions. A process baseline has been developed that includes process requirements, basis and assumptions, process flow diagrams, a process description, and a mass balance. In the absence of actual process or experimental results, mass and energy balance data for certain process steps are based on assumptions. Identification, documentation, validation, and overall management of the flowsheet assumptions are critical to ensuring an integrated, focused program. The INEEL HLW Program initially used a roadmapping methodology, developed through the INEEL Environmental Management Integration Program, to identify, document, and assess the uncertainty and risk associated with the SBW flowsheet process assumptions. However, the mass balance assumptions, process configuration and requirements should be accessible to all program participants. This need resulted in the creation of a relational database that provides formal documentation and tracking of the programmatic uncertainties related to the SBW flowsheet.

  11. [Analysis on urban elderly people's preference for prevention and treatment of non-communicable diseases].

    Science.gov (United States)

    Pan, Ming-fan; Feng, Xing-lin

    2014-04-18

    To investigate the outpatient provider preference and its influencing factors among residents older than 45 years in China's urban areas. The data of China Health and Retirement Longitudinal Survey (CHARLS) taking place in the year 2011 were analyzed with the method of multinominal logistic regression. In the last month, the rates of respondents with hypertension or/and diabetes who were reported being ill and seeking treatment were higher than that of those without such diseases. 51.73% of the hypertensive and 64.81% of the diabetic preferred hospitals to community health service (CHS) and private clinics. Regression results showed that people with Urban Employee Basic Medical Insurance (UEBMI), higher education level, higher capacity to pay and diabetes tended to choose hospitals rather than CHS. Urban people with non-communicable diseases (NCDs) preferred to use hospitals rather than the CHS, which reflected CHS's low performance in NCDs management. UEBMI failed to channel off the insured people to CHS. CHS needs to strengthen its ability to manage NCDs, and UEBMI should implement measures to attract patients' flow to CHS.

  12. Patient preference and willingness to pay for knee osteoarthritis treatments

    Directory of Open Access Journals (Sweden)

    Posnett J

    2015-06-01

    Full Text Available John Posnett,1 Sanjeev Dixit,2 Brooks Oppenheimer,2 Sven Kili,3 Nazanin Mehin4 1HERONTM Commercialization, PAREXEL® International, London, UK; 2Reason Research, Philadelphia, PA, USA; 3Sanofi Biosurgery, Oxford, UK; 4Sanofi, Paris, France Purpose: To review treatments for osteoarthritis of the knee (OAK received by patients across five European countries, and to obtain patients’ perceptions and willingness to pay for current treatments.Patients and methods: A prospective, internet-based, double-blind survey of adults with OAK was conducted in France, Germany, Italy, Spain, and the United Kingdom. The questionnaire included questions about diagnosis, treatment history, and perceptions of OAK treatments, followed by a discrete choice-based conjoint exercise to identify preferred attributes of OAK treatments, evaluating 14 sets of four unbranded products.Results: Two thousand and seventy-three patients with self-reported OAK completed the survey; 17.4% of patients rated their knee pain as drastically affecting their ability to perform normal daily activities, and 39.3% of employed patients reported that they had lost work time because of OAK. The most common treatments were exercise (69.7%, physical therapy (68.2%, and nonprescription oral pain medication (73.9%. Treatments perceived as most effective were: viscosupplement injections (74.1%, narcotics (67.8%, and steroid injection (67.6%. Patient co-pay, duration of pain relief, and type of therapy exhibited the largest impact on patient preference for OAK treatments. The average patient was willing to pay €35 and €64 more in co-pay for steroid and viscosupplement injections, respectively, over the cost of oral over-the-counter painkillers (per treatment course, per knee (each P<0.05.Conclusion: OAK is a debilitating condition that affects normal daily activities. In general, treatments most commonly offered to patients are not those perceived as being the most effective. Patients are

  13. Subject preferences for acne treatments containing adapalene gel 0.1%: results of the MORE trial.

    Science.gov (United States)

    Cook-Bolden, Fran

    2006-07-01

    Acne vulgaris can affect adolescents at a time of profound physical, social, and psychological change. The negative impact of acne on self-image and self-confidence can be severe, leading to potential psychiatric problems and limiting social interactions, even in adults. Adherence is necessary for successful treatment of acne, and patient satisfaction is crucial for adherence. The Measuring Acne Outcomes in a Real-World Experience (MORE) trial enrolled 1979 subjects who used combination acne treatments, all containing adapalene gel 0.1%. Among other measures, subjects were surveyed regarding their satisfaction with treatment. Adherence to treatment protocol was high throughout the study (94.5% and 88.0% at weeks 6 and 12, respectively, determined by self-report, and 93.7% and 80.3%, respectively, determined by filled prescriptions). Of the subjects who completed preference surveys, more than 70% rated adapalene gel 0.1% as much superior or superior to other acne treatments; more than 85% of subjects were very satisfied or satisfied with adapalene gel 0.1% to treat their acne; and more than 85% of subjects reported feeling more confident or positive after using this treatment. About 75% of subjects planned to continue using adapalene gel 0.1% and/or use it in the future if they needed acne treatment, and close to 75% of subjects indicated that they would recommend this treatment to a friend. The high level of patient satisfaction with adapalene gel 0.1% as an acne treatment is likely to translate into a high level of adherence to treatment, including maintenance treatment, and a major improvement in quality of life (QOL) for patients with acne.

  14. Baseline rationing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    The standard problem of adjudicating conflicting claims describes a situation in which a given amount of a divisible good has to be allocated among agents who hold claims against it exceeding the available amount. This paper considers more general rationing problems in which, in addition to claims......, there exist baselines (to be interpreted as objective entitlements, ideal targets, or past consumption) that might play an important role in the allocation process. The model we present is able to accommodate real-life rationing situations, ranging from resource allocation in the public health care sector...... to international protocols for the reduction of greenhouse emissions, or water distribution in drought periods. We define a family of allocation methods for such general rationing problems - called baseline rationing rules - and provide an axiomatic characterization for it. Any baseline rationing rule within...

  15. Differentiating LGBT individuals in substance abuse treatment: analyses based on sexuality and drug preference.

    Science.gov (United States)

    Cochran, Bryan N; Peavy, K Michelle; Santa, Annesa Flentje

    2007-01-01

    In a prior study (Cochran & Cauce, 2006), LGBT individuals seeking treatment demonstrated greater substance use severity, more psychosocial stressors, and increased use of psychiatric services when compared to their heterosexual counterparts. That study, and similar to others in the field of LGBT research, collapsed LGBT individuals into a single category and did not examine individual differences within this category. The present study utilizes the same sample of LGBT clients (N = 610); however, an exploratory cluster analysis was conducted, based on drug preference, to determine which subcategories exist within this unique sample. In a subsequent set of analyses, the sample was divided based on sexuality to determine if there were differences between these groups on psychosocial functioning variables. Results indicated three distinct clusters, which differed in both demographic characteristics and severity of substance use problems. Groups based on sexuality differed in terms of primary problem substance, as well as psychosocial variables. Implications for treatment of these subgroups are discussed.

  16. Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Bradley J Robottom

    2011-01-01

    Full Text Available Bradley J RobottomDepartment of Neurology, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Parkinson's disease (PD is the second most common neurodegenerative disease and the most treatable. Treatment of PD is symptomatic and generally focuses on the replacement or augmentation of levodopa. A number of options are available for treatment, both in monotherapy of early PD and to treat complications of advanced PD. This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B inhibitors. Topics covered in the review include mechanism of action, efficacy in early and advanced PD, effects on disability, the controversy regarding disease modification, safety, and patient preference for MAO-B inhibitors.Keywords: monoamine oxidase inhibitors, rasagiline, selegiline, Parkinson's disease, efficacy, safety

  17. Non-communicable disease risk factors and treatment preference of obese patients in Cape Town

    Directory of Open Access Journals (Sweden)

    Kathryn Manning

    2016-03-01

    Full Text Available Background: Insights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning.Aim: To compile a profile of treatment-seeking obese patients with non-communicable diseases (NCDs or NCD risk factors and to compare patients who choose group-based (facility-based therapeutic group [FBTG] versus usual care (individual consultations treatment.Setting: A primary healthcare facility in Cape Town, South Africa.Methods: One hundred and ninety-three patients were recruited in this cross-sectional study. Ninety six chose FBTG while 97 chose usual care. A questionnaire, the hospital database and patients’ folders were used to collect data. Weight, height and waist circumference were measured. STATA 11.0 was used for descriptive statistics and to compare the two groups.Results: The subjects’ mean age was 50.4 years, 78% were women and of low education levels and income, and 41.5% had type 2 diabetes, 83.4% hypertension and 69.5% high cholesterol. Mean (s.d. HbA1c was 9.1 (2.0%, systolic BP 145.6 (21.0 mmHg, diastolic BP 84.5 (12.0 mmHg, cholesterol 5.4 (1.2 mmol/L, body mass indicator (BMI 39.3 (7.3 kg/m2 and waist circumference 117 (12.6 cm. These figures were undesirable although pharmacological treatment for diabetes and hypertension was in place. Only 14% were physically active, while TV viewing was > 2h/day. Mean daily intake of fruit and vegetables (2.2 portions/day was low while added sugar (5 teaspoons and sugar-sweetened beverages (1.3 glasses were high. Usual care patients had a higher smoking prevalence, HbA1c, number of NCD risk factors and refined carbohydrate intake, and a lower fruit and vegetable intake.Conclusion: Treatment seekers were typically middle-aged, low income women with various modifiable and intermediate risk factors for NCDs. Patients choosing usual care could have more NCD risks.Keywords: Non-communicable diseases; primary health care; family

  18. Variation in pre-treatment count lead time and its effect on baseline estimates of cage-level sea lice abundance.

    Science.gov (United States)

    Gautam, R; Boerlage, A S; Vanderstichel, R; Revie, C W; Hammell, K L

    2016-11-01

    Treatment efficacy studies typically use pre-treatment sea lice abundance as the baseline. However, the pre-treatment counting window often varies from the day of treatment to several days before treatment. We assessed the effect of lead time on baseline estimates, using historical data (2010-14) from a sea lice data management programme (Fish-iTrends). Data were aggregated at the cage level for three life stages: (i) chalimus, (ii) pre-adult and adult male and (iii) adult female. Sea lice counts were log-transformed, and mean counts by lead time relative to treatment day were computed and compared separately for each life stage, using linear mixed models. There were 1,658 observations (treatment events) from 56 sites in 5 Bay Management Areas. Our study showed that lead time had a significant effect on the estimated sea lice abundance, which was moderated by season. During the late summer and autumn periods, counting on the day of treatment gave significantly higher values than other days and would be a more appropriate baseline estimate, while during spring and early summer abundance estimates were comparable among counts within 5 days of treatment. A season-based lead time window may be most appropriate when estimating baseline sea lice levels.

  19. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  20. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling

    Science.gov (United States)

    Chiang, Yi Zhen; Al-Niaimi, Firas; Madan, Vishal

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA®), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4®)) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice) were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval) pain score of 5 (±2.58; 3.66-6.46) with Ametop™, 4.38 (±2.53; 2.64-4.89) with EMLA® and 3.91 (±1.95; 2.65-4.76) with LMX4®. There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures. PMID:26644737

  1. Diabetes treatment patterns and goal achievement in primary diabetes care (DiaRegis - study protocol and patient characteristics at baseline

    Directory of Open Access Journals (Sweden)

    Deeg Evelin

    2010-09-01

    Full Text Available Abstract Background Patients with type 2 diabetes are at an increased risk for disease and treatment related complications after the initial approach of oral mono/dual antidiabetic therapy has failed. Data from clinical practice with respect to this patient group are however scarce. Therefore we set up a registry in primary care documenting the course and outcomes of this patient group. Methods Diabetes Treatment Patterns and Goal Achievement in Primary Diabetes Care (DiaRegis is a prospective, observational, German, multicenter registry including patients with type-2 diabetes in which oral mono/dual antidiabetic therapy has failed. Data were recorded at baseline and will be prospectively documented during visits at 6 ± 1, 12 ± 2 and 24 ± 2 months. The primary objective is to estimate the proportion of patients with at least 1 episode of severe hypoglycemia within one year. Results 313 primary care offices included 4,048 patients between June 2009 and March 2010 of which 3,810 patients fulfilled the in- and exclusion criteria. 46.7% of patients were female; patients had a median diabetes duration of 5.5 years and most were obese with respect to BMI or waist circumference. HbA1c at baseline was 7.4%, fasting plasma glucose 142 mg/dl and postprandial glucose 185 mg/dl. Co-morbidity in this patient population was substantial with 17.9% having coronary artery disease, 14.4% peripheral neuropathy, 9.9% heart failure and 6.0% peripheral arterial disease. 68.6% of patients received oral monotherapy, 31.4% dual oral combination therapy. The most frequent antidiabetic agent used as monotherapy was metformin (79.0% followed by sulfonylureas (14.8%. Conclusions DiaRegis is a large, prospective registry in primary diabetes care to document the course and outcomes of patients with type-2 diabetes in which the initial approach of oral mono/dual antidiabetic therapy has failed. The two year follow-up will allow for a prospective evaluation of these patients

  2. Prediction of long-term metabolic effects of olanzapine and risperidone treatment from baseline body mass index in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Bobo, William Victor; Bonaccorso, Stefania; Jayathilake, Karuna; Meltzer, Herbert Yale

    2011-09-30

    Baseline body mass index (BMI), baseline BMI status (normal, overweight, obese) and early (1 month) BMI increases were tested as predictors of 6- and 12-month increases in glucose and lipid measures in 82 olanzapine (OLZ)- and 78 risperidone (RIS)-treated patients with schizophrenia, schizoaffective disorder, or bipolar disorder who participated in a 12-month randomized, prospective metabolic effects study. Baseline BMI predicted greater fasting glucose and HgbA1c levels at 12 months for both treatments. Early BMI change predicted fasting glucose levels at 6 months, but not HgbA1c or BMI, at either time point. For patients who received no concomitant mood stabilizers, early BMI change predicted 12 month HgbA1c values in the OLZ group, and 6- (but not 12-) month fasting glucose and HgbA1c values in the RIS group. Neither baseline BMI nor early BMI change consistently predicted increases in lipids with either drug. OLZ-treated patients with normal baseline BMI had greater increases in total cholesterol, triglycerides, and non-HDL-cholesterol than those who were overweight or obese. In conclusion, higher baseline BMI predicted adverse glycemic changes after 12 months with OLZ and RIS. Individuals with normal baseline BMI may be most susceptible to OLZ-induced hyperlipidosis. Frequency of metabolic screening should be independent of baseline BMI or rapid increases in BMI.

  3. Hepatic artery pseudoaneurysm after surgical treatment for pancreatic cancer: Minimally invasive angiographic techniques as the preferred treatment

    Directory of Open Access Journals (Sweden)

    Sucandy Iswanto

    2014-01-01

    Full Text Available Background: Delayed intra-abdominal bleeding related to hepatic artery pseudoaneurysm is a potentially lethal complication after pancreaticoduodenectomy for pancreatic cancer. Locally advanced tumors, which result in vessel erosion or extensive operative skeletonization, may contribute to weakness of the arterial wall. Reoperation is often technically difficult with high rate of mortality; therefore, alternative less invasive options are ideal. Aims: The study was to present an alternative endovascular treatment of a large hepatic artery pseudoaneurysm after pancreatic resection for locally advanced multicystic adenocarcinoma. Materials and Methods: Transcatheteric mesenteric angiography with deployment of detachable coils in the pseudoaneurysm sac was utilized to manage the hepatic artery pseudoaneurysm. Results: Completion angiography confirmed cessation of contrast enhancement in the pseudoaneurysm sac with preservation of normal antegrade hepatic artery flow. Conclusion: Minimally invasive angiographic technique is the preferred treatment for hepatic artery pseudoaneurysm after pancreatic resections.

  4. Preferences for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD): a discrete choice experiment.

    Science.gov (United States)

    Mühlbacher, Axel C; Rudolph, Ina; Lincke, Hans-Joachim; Nübling, Matthias

    2009-08-13

    While there is an increasing emphasis on patient empowerment and shared decision-making, subjective values for attributes associated with their treatment still need to be measured and considered. This contribution seeks to define properties of an ideal drug treatment of individuals concerned with Attention-Deficit/Hyperactivity Disorder (ADHD). Because of the lack of information on patient needs in the decision-makers assessment of health services, the individuals' preferences often play a subordinate role at present. Discrete Choice Experiments offer strategies for eliciting subjective values and making them accessible for physicians and other health care professionals. The evidence comes from a Discrete Choice Experiments (DCE) performed in 2007. After reviewing the literature about preferences of ADHS we conducted a qualitative study with four focus groups consisting of five to eleven ADHS-patients each. In order to achieve content validity, we aimed at collecting all relevant factors for an ideal ADHS treatment. In a subsequent quantitative study phase (n = 219), data was collected in an online or paper-pencil self-completed questionnaire. It included sociodemographic data, health status and patients' preferences of therapy characteristics using direct measurement (23 items on a five-point Likert-scale) as well as a Discrete-Choice-Experiment (DCE, six factors in a fold-over design). Those concerned were capable of clearly defining success criteria and expectations. In the direct assessment and the DCE, respondents attached special significance to the improvement of their social situation and emotional state (relative importance 40%). Another essential factor was the desire for drugs with a long-lasting effect over the day (relative importance 18%). Other criteria, such as flexibility and discretion, were less important to the respondents (6% and 9%, respectively). Results point out that ADHD patients and their family members have clear ideas of their needs

  5. Determinants of national fire plan fuels treatment expenditures: a revealed preference analysis for northern New Mexico.

    Science.gov (United States)

    Shepherd, Curt; Grimsrud, Kristine; Berrens, Robert P

    2009-10-01

    The accumulation of fire fuels in forests throughout the world contributes significantly to the severity of wildfires. To combat the threat of wildfire, especially in the wildland-urban interface (WUI), US federal land management agencies have implemented a number of forest restoration and wildfire risk reduction programs. In the spirit of revealed preference analyses, the objective of this study is to investigate the pattern and determinants of National Fire Plan (NFP) expenditures for fuel reduction treatments in northern New Mexico (USA). Estimation results from a set of Generalized Estimating Equations models are mixed with respect to risk reduction hypotheses, and also raise issues regarding how risk reduction should be defined for a region characterized by both pockets of urban sprawl into the WUI and large areas of chronic rural poverty. Program preferences for project funding under the federal Collaborative Forest Restoration Program in New Mexico are shown to be distinctly different (e.g., exhibiting greater concern for social equity) than for other NFP-funded projects.

  6. Determinants of National Fire Plan Fuels Treatment Expenditures: A Revealed Preference Analysis for Northern New Mexico

    Science.gov (United States)

    Shepherd, Curt; Grimsrud, Kristine; Berrens, Robert P.

    2009-10-01

    The accumulation of fire fuels in forests throughout the world contributes significantly to the severity of wildfires. To combat the threat of wildfire, especially in the wildland-urban interface (WUI), US federal land management agencies have implemented a number of forest restoration and wildfire risk reduction programs. In the spirit of revealed preference analyses, the objective of this study is to investigate the pattern and determinants of National Fire Plan (NFP) expenditures for fuel reduction treatments in northern New Mexico (USA). Estimation results from a set of Generalized Estimating Equations models are mixed with respect to risk reduction hypotheses, and also raise issues regarding how risk reduction should be defined for a region characterized by both pockets of urban sprawl into the WUI and large areas of chronic rural poverty. Program preferences for project funding under the federal Collaborative Forest Restoration Program in New Mexico are shown to be distinctly different (e.g., exhibiting greater concern for social equity) than for other NFP-funded projects.

  7. Patients' and physicians' needs, experiences and preferences in the treatment of right ventricular outflow tract dysfunction

    Directory of Open Access Journals (Sweden)

    Luciana Scalone

    2012-06-01

    Full Text Available

    Background: patients with congenital heart defects, developing right ventricular outflow tract (rVoT dysfunction, can face repeated open chest interventions over their lifetime. repeating surgery increases difficulties and procedural risks, and exposes patients to burdensome and long recovery times that may induce them to postpone the treatment, with possible severe and irreversible consequences for their health. The percutaneous procedure was introduced to delay the need for open chest surgery. uncertainties still exist regarding the lifelong consequences that may result from adopting different treatment strategies. current decisions on treatment depend on patients’ clinical needs, but also on physicians’ experience and opinion, patients’ preferences, and procedural costs. The objective is to identify which treatment characteristics influence decisions on how to treat patients with rVoT dysfunction.

    Methods: a literature review was conducted, followed by a discussion with a panel of experts. Ten treatment characteristics, potentially relevant for treatment, were identified and rated in a survey, according to the importance assigned to each characteristic by specialist physicians, patients and/or their caregivers.

    Results: while some characteristics appear to be more important (risk of severe complications associated with intervention delays or less important (scar to both physicians and patients/caregivers, other characteristics are rated differently in importance depending on subjects consulted, e.g., risk of complications during the months post intervention was among the most important characteristics for patients/caregivers, but the fifth most important characteristic for physicians.

    Conclusions: to optimize benefits and efficiency of the treatment strategies, perceptions and opinions from the different subjects involved, together with patients

  8. Pre-treatment preferences and characteristics among patients seeking in vitro fertilisation.

    LENUS (Irish Health Repository)

    Walsh, Anthony Ph

    2009-01-01

    BACKGROUND: This study sought to describe patient features before beginning fertility treatment, and to ascertain their perceptions relative to risk of twin pregnancy outcomes associated with such therapy. METHODS: Data on readiness for twin pregnancy outcome from in vitro fertilisation (IVF) was gathered from men and women before initiating fertility treatment by anonymous questionnaire. RESULTS: A total of 206 women and 204 men were sampled. Mean (+\\/- SD) age for women and men being 35.5 +\\/- 5 and 37.3 +\\/- 7 yrs, respectively. At least one IVF cycle had been attempted by 27.2% of patients and 33.9% of this subgroup had initiated >\\/=3 cycles, reflecting an increase in previous failed cycles over five years. Good agreement was noted between husbands and wives with respect to readiness for twins from IVF (77% agreement; Cohen\\'s K = 0.61; 95% CI 0.53 to 0.70). CONCLUSION: Most patients contemplating IVF already have ideas about particular outcomes even before treatment begins, and suggests that husbands & wives are in general agreement on their readiness for twin pregnancy from IVF. However, fertility patients now may represent a more refractory population and therefore carry a more guarded prognosis. Patient preferences identified before IVF remain important, but further studies comparing pre- and post-treatment perceptions are needed.

  9. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer

    DEFF Research Database (Denmark)

    Rønde, Heidi S; Wee, Leonard; Pløen, John

    2017-01-01

    dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS: Retrospective plans...... that preference-informed dose planning is feasible for clinical studies utilizing shared decision making.......PURPOSE/OBJECTIVE: Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multiple...

  10. [Baseline characteristics and changes in treatment after a period of optimization of the patients included in the study EFICAR].

    Science.gov (United States)

    Gómez-Marcos, Manuel A; Agudo-Conde, Cristina; Torcal, Jesús; Echevarria, Pilar; Domingo, Mar; Arietaleanizbeascoa, María; Sanz-Guinea, Aitor; de la Torre, Maria M; Ramírez, Jose I; García-Ortiz, Luis

    2016-03-01

    To describe the baseline date and drugs therapy changes during treatment optimization in patients with heart failure with depressed systolic function included in the EFICAR study. Multicenter randomized clinical trial. Seven Health Centers. 150 patients (ICFSD) age 68±10 years, 77% male. Sociodemographic variables, comorbidities (Charlson index), functional capacity and quality of life. Drug therapy optimization was performed. The main etiology was ischemic heart disease (45%), with 89% in functional class II. The Charlson index was 2.03±1.05. The ejection fraction mean was 37%±8, 19% with ejection fraction <30%. With the stress test 6.3±1.6 mean was reached, with the 6 minutes test 446±78 meters and the chair test 13.7±4.4 seconds. The overall quality of life with ejection fraction was 22.8±18.7 and with the Short Form-36 Health Survey, physical health 43.3±8.4 and mental health 50.1±10.6. After optimizing the treatment, the percentage of patients on drugs therapy and the dose of angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists and beta-blockers were not changed. The majority of the subjects are in functional class II, with functional capacity and quality of life decreased and comorbidity index high. A protocolized drug therapy adjustment did not increase the dose or number of patients with effective drugs for heart failure with depressed systolic function. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  11. Women’s experiences and preferences regarding breast imaging after completing breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Brandzel S

    2017-02-01

    Full Text Available Susan Brandzel,1 Dori E Rosenberg,1 Dianne Johnson,1 Mary Bush,1 Karla Kerlikowske,2–5 Tracy Onega,6,7 Louise Henderson,8 Larissa Nekhlyudov,9,10 Wendy DeMartini,11 Karen J Wernli1 1Group Health Research Institute, Group Health Cooperative, Seattle, WA, 2Department of Medicine, 3Department of Epidemiology, 4Department of Biostatistics, 5Department of Veterans Affairs, University of California, San Francisco, San Francisco, CA, 6Department of Biomedical Data Science, 7Department of Epidemiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, 8Department of Radiology, University of North Carolina, Chapel Hill, NC, 9Department of Population Medicine, Harvard Medical School, 10Department of Medicine, Brigham and Women’s Hospital, Boston, MA, 11Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA Background: After treatment for breast cancer, most women receive an annual surveillance mammography to look for subsequent breast cancers. Supplemental breast MRI is sometimes used in addition to mammography despite the lack of clinical evidence for it. Breast imaging after cancer treatment is an emotionally charged experience, an important part of survivorship care, and a topic about which limited patient information exists. We assessed women’s experiences and preferences about breast cancer surveillance imaging with the goal of determining where gaps in care and knowledge could be filled. Participants and methods: We conducted six focus groups with a convenience sample of 41 women in California, North Carolina, and New Hampshire (USA. Participants were aged 38–75 years, had experienced stage 0–III breast cancer within the previous 5 years, and had completed initial treatment. We used inductive thematic analysis to identify key themes from verbatim transcripts. Results: Women reported various types and frequencies of surveillance imaging and a range of surveillance imaging

  12. A STUDY TO EXPLORE PREFERRED METHOD OF TREATMENT AMONG PHYSIOTHERAPISTS FOR MECHANICAL LOW BACK PAIN

    Directory of Open Access Journals (Sweden)

    Iram Iqbal Shamsi

    2016-02-01

    Full Text Available Background: Conservative treatment remains the standard of care for treating nonspecific mechanical low back pain which is very common problem all around the world. In Pakistan, physiotherapists encounter this problem frequently in clinical practice. Despite a wide variety of treatments, 100 percent results have been unachievable. The purpose of this study was to establish a Standard and Uniform Physiotherapy Protocol for mechanical low back pain. Methods: To achieve the objective of this study, a questionnaire with structured and open ended questions were designed and distributed to hospitals and private clinics. 139 questionnaires were distributed from 1st March 2009 to 30th May 2009. By the end of July 5, 2009, 101 were filled and returned. The data was analyzed using descriptive statistics. Results: Results have shown that McKenzie (25%, combination of McKenzie and Maitland (9% were among the preferred techniques. However, 14% did not use a specific technique. The preferred physical agents were hot packs (22%, combination of hot packs, ultrasound, TENS (22%. However, 4% did not prefer any physical agent. Out of 101 subjects per week, 20 subjects were treated for 7 days, 11 were treated for 5 days, 53 were treated for 3 days, 6 were treated for 2 days and 11 were treated for 1 day. The recurrence rate was 32.14% for those who were treated for six days, 34.75% for those treated for 5 days, 33.55% for those who were treated for 3 days, 31.25% for those who were treated for 2 days, and 37.55% for those who were treated for one day. 39% did not consider ergonomical issues while 27% did not advice regarding the patient nutritional facts. Average depression among patients was 24.7%. Conclusion: This study shows that the results for mechanical low back pain were not as effective with combination of techniques and modalities. If the physiotherapists had taken the psychological factors, ergonomical approach and nutrition into consideration, the

  13. Patient preferences and experiences of CPAP and oral appliances for the treatment of obstructive sleep apnea: a qualitative analysis.

    Science.gov (United States)

    Almeida, Fernanda R; Henrich, Natalie; Marra, Carlo; Lynd, Larry D; Lowe, Alan A; Tsuda, Hiroko; Fleetham, John A; Pliska, Benjamin; Ayas, Najib

    2013-05-01

    The aim of this study is to better understand patients' perspectives and preferences about treatment with continuous positive airway pressure (CPAP) and oral appliance (OA) devices for obstructive sleep apnea. The current study used qualitative analysis of four focus group sessions with current CPAP and OA users. Twenty-two participants with OSA who currently use either CPAP or OA participated in the sessions at the University of British Columbia. Five topics from the focus group sessions were descriptively analyzed using NVivo software: goals and expectations of treatment, benefits of treatment for bed partners, side effects and inconveniences of CPAP, side effects and inconveniences of OA, and factors impacting treatment choice. In order of most to least frequently mentioned, patients expressed six expectations of treatment: improved health, apnea elimination, improved sleep, reduced fatigue, reduced snoring, and bed-partner benefits. The most to least mentioned factors impacting treatment choice were device effectiveness, transportability, embarrassment, and cost. This qualitative study showed that many factors impact patients' experience with their treatment device and that their treatment needs are not only physical but also relate to their lifestyle. This preliminary study provides treatment characteristics and attributes necessary to develop a quantitative questionnaire study, to assist in the selection of therapy, weighing the relative importance of patient and OSA treatment characteristics on treatment preference and adherence. Matching therapy to patient preferences may help identify the most appropriate treatment, and this may achieve greater likelihood of adherence.

  14. Effects of combined nicotine and fluoxetine treatment on adult hippocampal neurogenesis and conditioned place preference.

    Science.gov (United States)

    Faillace, M P; Zwiller, J; Bernabeu, R O

    2015-08-06

    Adult neurogenesis occurs in mammals within the dentate gyrus, a hippocampal subarea. It is known to be induced by antidepressant treatment and reduced in response to nicotine administration. We checked here whether the antidepressant fluoxetine would inverse the decrease in hippocampal neurogenesis caused by nicotine. It is shown that repeated, but not a single injection of rats with fluoxetine was able to abolish the decrease in adult dentate cell proliferation produced by nicotine treatment. We measured the expression of several biochemical parameters known to be associated with neurogenesis in the dentate gyrus. Both drugs increased the expression of p75 neurotrophin receptor, which promotes proliferation and early maturation of dentate gyrus cells. Using the conditioned place preference (CPP) paradigm, we also gave both drugs in a context in which their rewarding properties could be measured. Fluoxetine produced a significant but less robust CPP than nicotine. A single injection of fluoxetine was found to reduce nicotine-induced CPP. Moreover, the rewarding properties of nicotine were completely abolished in response to repeated fluoxetine injections. Expression of nicotine-induced CPP was accompanied by an increase of phospho-CREB (cyclic AMP-responsive element-binding protein) and HDAC2 (histone deacetylase 2) expression in the nucleus accumbens. The data suggest that fluoxetine reward, as opposed to nicotine reward, depends on dentate gyrus neurogenesis. Since fluoxetine was able to disrupt the association between nicotine and the environment, this antidepressant may be tested as a treatment for nicotine addiction using cue exposure therapy.

  15. Standardizing and personalizing the treat to target (T2T) approach for rheumatoid arthritis using the Patient-Reported Outcomes Measurement Information System (PROMIS): baseline findings on patient-centered treatment priorities.

    Science.gov (United States)

    Bacalao, Emily J; Greene, George J; Beaumont, Jennifer L; Eisenstein, Amy; Muftic, Azra; Mandelin, Arthur M; Cella, David; Ruderman, Eric M

    2017-08-01

    A treat to target (T2T) approach to management has become the standard of care for patients with rheumatoid arthritis (RA). While consensus T2T recommendations call for patient involvement in the treatment process, the targets commonly used to drive therapeutic decisions involve limited patient input. A pilot study was developed to explore whether the Patient-Reported Outcomes Measurement Information System (PROMIS) could add value to the T2T approach by providing a way to bring patient goals into the process. We report here the baseline data from this study. RA patients from an academic rheumatology practice were recruited to participate in this 1-year study. Patients were asked to complete PROMIS computer-assisted testing at quarterly visits during the year. At baseline, they were asked to identify the PROMIS domain (Pain Interference, Fatigue, Depression, Physical Function, and Social Function) that felt most important to their quality of life. They were then asked to select five representative items from this domain, to be followed through the year. Complete baseline data was available for 119 patients. Most selected Physical Function (39%) or Pain Interference (37%) as their highest priority PROMIS domain. Sixty percent ranked Depression as their lowest priority domain. Younger patients more frequently prioritized Social Function, while older patients more frequently prioritized Fatigue. The incorporation of PROMIS questionnaires into routine clinic visits is a feasible mechanism for incorporating patient preferences into a T2T approach to managing RA.

  16. Participant Preferences for Pharmacologic Chronic Pain Treatment Trial Characteristics: An ACTTION Adaptive Choice-Based Conjoint Study.

    Science.gov (United States)

    Smith, Shannon M; Gewandter, Jennifer S; Kitt, Rachel A; Markman, John D; Vaughan, Janet A; Cowan, Penney; Kopecky, Ernest A; Malamut, Richard; Sadosky, Alesia; Tive, Leslie; Turk, Dennis C; Dworkin, Robert H

    2016-11-01

    Barriers to clinical trial recruitment can delay study completion, potentially resulting in increased costs and an unrepresentative sample. In the current study of 150 participants with chronic pain, we used a computerized adaptive choice-based conjoint survey that included 8 characteristics that may affect enrollment in pharmacologic pain treatment trials (ie, treatment allocation, frequency of pain ratings, treatment administration method, current medications, number of study visits, availability of evening and weekend visits, invasiveness of laboratory procedures, payment). These data were analyzed using Sawtooth Software ver. 8.4.8 (Sawtooth Software, Inc, Orem, UT), which identifies the characteristics that dominate participants' decisions across multiple sets of potential trials. Three characteristics had the largest relative importance in participants' trial preferences: 1) invasiveness of required laboratory procedures (ie, 22%), with no procedures or blood tests preferred over ice-water sensory testing or skin biopsy; 2) ability to continue current pain medications (21%); and 3) payment for study participation (21%), with higher payment preferred. The fourth most important characteristic was number of study visits (13%), with participants preferring fewer in-person visits and more phone contacts. Understanding the preferences of potential participants is an important step toward enhancing enrollment in pain treatment trials.

  17. Reflux symptoms and side effects among patients with gastroesophageal reflux disease at baseline, during treatment with PPIs, and after Nissen fundoplication.

    Science.gov (United States)

    Rantanen, Tuomo; Kiljander, Toni; Salminen, Paulina; Ranta, Arto; Oksala, Niku; Kellokumpu, Ilmo

    2013-06-01

    There are no prospective studies available on the behavior of extraesophageal and esophageal symptoms and treatment-related side effects in patients without effective antireflux medication, receiving the most effective antireflux medication, and after laparoscopic fundoplication. Extraesophageal and esophageal reflux symptoms and treatment-related side effects were assessed in 60 patients while they were on no effective antireflux medication (three-week washout period), after three month of treatment with double-dose esomeprazole, and 3 months after laparoscopic Nissen fundoplication. Esophageal and extraesophageal reflux symptoms, rectal flatulence, and bloating were analyzed with the visual analog scale. In addition, dysphagia, rectal flatulence, and bloating were recorded as none, mild, moderate, or severe. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were further reduced after fundoplication. Dysphagia and flatulence did not increase from baseline after surgery. Bloating decreased both after treatment with esomeprazole and after fundoplication. In contrast, dysphagia and increased flatus were found more often after surgery than during treatment with esomeprazole. Dysphagia and rectal flatulence were less common during treatment with esomeprazole than at baseline or after surgery. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were reduced further after fundoplication. Any treatment-related side effect was not increased after surgery when compared to baseline. However, compared to esomeprazole there was more dysphagia and flatulence after fundoplication.

  18. Three-year follow-up of ranibizumab treatment of wet age-related macular degeneration: influence of baseline visual acuity and injection frequency on visual outcomes

    Directory of Open Access Journals (Sweden)

    Razi F

    2016-02-01

    Full Text Available Faraz Razi,1 Adnaan Haq,2 Prabhu Tonne,3 Maharatnam Logendran3 1Department of Paediatrics, Basingstoke and North Hampshire Hospital, Basingstoke, UK; 2Department of Ophthalmology, Leicester General Hospital, Leicester, UK; 3Department of Ophthalmology, Northampton General Hospital, Northampton, UK Purpose: To determine the effect of ranibizumab on visual acuity (VA following a 3-year treatment period for patients diagnosed with wet age-related macular degeneration. To establish whether baseline VA and injection frequency influence visual outcomes. Patients and methods: Retrospective review of 70 patients (76 eyes treated with 0.5 mg intravitreal ranibizumab for 3 consecutive months, and pro re nata thereafter (three + pro re nata protocol, over a 3-year period. VA was measured using Early Treatment Diabetic Retinopathy Study (ETDRS charts at baseline, 12, 24, and 36 months. The number of injections administered at the end of years 1, 2, and 3 were also recorded. Eyes were stratified according to baseline VA, as well as the number of injections administered at the end of year 1. Linear regression analysis determined the relationship between VA and both baseline VA and injection frequency. P<0.05 was considered statistically significant. Results: At 36 months, VA improved by a mean of 5.3 ETDRS letters (P=0.002, with 29% of eyes (n=22 demonstrating a clinically significant improvement in VA (gain of ≥15 ETDRS letters. Improvements in VA from baseline to 36 months were inversely proportional to the baseline VA (R=0.414, P=<0.001. A positive correlation was observed between injection frequency and change in VA from baseline to 36 months (R=0.244, P=0.036. Conclusion: Mean improvement in VA is inversely proportional to baseline VA, and directly proportional to injection frequency. Keywords: long-term results, Lucentis, neovascular AMD

  19. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature.

    Science.gov (United States)

    Belinchón, I; Rivera, R; Blanch, C; Comellas, M; Lizán, L

    2016-01-01

    Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU). Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts' opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded. A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4), preferences (n=5) and satisfaction with treatment (n=7). Results related to health-related quality of life articles (n=30) have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is associated with greater clinical improvement. There is a direct association between physician recommendations, patient preferences and several domains of treatment satisfaction. The results of this review support the conclusion that adherence rates in patients with psoriasis are suboptimal and highlight the need to improve patient compliance and satisfaction with treatment. Patients' preferences should be taken

  20. Depression CBT treatment gains among HIV-infected persons with a history of injection drug use varies as a function of baseline substance use.

    Science.gov (United States)

    Labbe, Allison K; O'Cleirigh, Conall M; Stein, Michael; Safren, Steven A

    2015-01-01

    Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment outcomes and accelerated HIV disease progression. Though previous research has demonstrated short-term and follow-up success for cognitive behavioral therapy for adherence and depression (CBT-AD) on depression outcomes among patients with HIV in care and among patients with HIV in active substance abuse treatment for injection drug use (IDU), there is little information regarding possible moderating effects of active use versus abstinence on depression treatment gains. The present study aimed to examine recent substance use at treatment initiation as a moderator of the acute and maintenance effects of CBT-AD on depression. We used data from a two-arm, randomized controlled trial (N = 89) comparing CBT-AD to enhanced treatment as usual in individuals in treatment for IDU. To test whether depression at time of presentation affected outcomes, repeated-measures ANOVAs were conducted for two time frames: (1) acute phase (baseline to post-treatment) (acute) and (2) maintenance phase (baseline to 12-month follow-up). To further examine maintenance of gains, we additionally looked at post-treatment to 12-month follow-up. Depression scores derived from the clinical global impression for severity and the Montgomery-Asberg depression rating scale (MADRS) served as the primary outcome variables. Acute (baseline post treatment) moderation effects were found for those patients endorsing active drug use at baseline in the CBT-AD condition, who demonstrated the greatest reductions in MADRS scores at post-treatment (F[1,76] = 6.78, p = .01) and follow-up (F[1,61] = 5.46, p = .023). Baseline substance use did not moderate differences from post-treatment to 12-month follow-up as depression treatment gains that occurred acutely from baseline to post-treatment were maintained across both patients engaged in substance use and abstainers. We conclude that CBT

  1. Decisional strategy determines whether frame influences treatment preferences for medical decisions.

    Science.gov (United States)

    Woodhead, Erin L; Lynch, Elizabeth B; Edelstein, Barry A

    2011-06-01

    Decision makers are influenced by the frame of information such that preferences vary depending on whether survival or mortality data are presented. Research is inconsistent as to whether and how age impacts framing effects. This paper presents two studies that used qualitative analyses of think-aloud protocols to understand how the type of information used in the decision making process varies by frame and age. In Study 1, 40 older adults, age 65 to 89, and 40 younger adults, age 18 to 24, responded to a hypothetical lung cancer scenario in a within-subject design. Participants received both a survival and mortality frame. Qualitative analyses revealed that two main decisional strategies were used by all participants: one strategy reflected a data-driven decisional process, whereas the other reflected an experience-driven process. Age predicted decisional strategy, with older adults less likely to use a data-driven strategy. Frame interacted with strategy to predict treatment choice; only those using a data-driven strategy demonstrated framing effects. In Study 2, 61 older adults, age 65 to 98, and 63 younger adults, age 18 to 30, responded to the same scenarios as in Study 1 in a between-subject design. The results of Study 1 were replicated, with age significantly predicting decisional strategy and frame interacting with strategy to predict treatment choice. Findings suggest that framing effects may be more related to decisional strategy than to age. (c) 2011 APA, all rights reserved.

  2. Criteria for preferring anterior approach in surgical treatment of cervical spondylotic myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Yurdal Gezercan

    2014-08-01

    Full Text Available Cervical spondylosis is a progressive, chronic and insidious degenerative disease, which origins from the cervical intervertebral disc and then diffuses to surrounding bony and soft tissues. If the spine and nerve roots are involved due to degenerative changes, this is called as cervical spondylotic myeloradiculopathy (CSMR and it is the most frequent cause of myelopathy over age of 50. Cases with progressive character and functional neurological deficits and cases with a prolonged course refractory to conservative therapy shall be treated surgically. The aim of the surgical treatment is to relieve the pressure on the spinal cord and nerve roots, to preserve the proper anatomical alignment of the cervical vertebrae or to reestablish correct anatomical positioning if it is distorted and lastly to increase the life quality by relieving patients neurological signs and complaints. While achieving these goals, complications shall be avoided as much as possible. These goals can be accomplished by anterior or posterior surgical approaches to the cervical vertebrae. The style of the surgical approach can only be decided by a detailed evaluation of the patient's clinical and radiological features. The utmost aim of the surgical procedure, which is to achieve sufficient neurological decompression and to preserve/establish proper cervical vertebral alignment, can be provided best by anterior approaches. In our current study, the criteria to prefer anterior approach in surgical treatment of CSMR will be reviewed. [Cukurova Med J 2014; 39(4.000: 669-678

  3. Impact of baseline anti-cyclic citrullinated peptide-2 antibody concentration on efficacy outcomes following treatment with subcutaneous abatacept or adalimumab: 2-year results from the AMPLE trial.

    Science.gov (United States)

    Sokolove, Jeremy; Schiff, Michael; Fleischmann, Roy; Weinblatt, Michael E; Connolly, Sean E; Johnsen, Alyssa; Zhu, Jin; Maldonado, Michael A; Patel, Salil; Robinson, William H

    2016-04-01

    To examine whether baseline anti-cyclic citrullinated peptide-2 (CCP2) antibody status and concentration correlated with clinical outcomes in patients treated with abatacept or adalimumab on background methotrexate (MTX) in the 2-year AMPLE (Abatacept versus adaliMumab comParison in bioLogic-naïvE rheumatoid arthritis subjects with background MTX) study. In this exploratory analysis, anti-CCP2 antibody concentration was measured at baseline, and antibody-positive patients were divided into equal quartiles, Q1-Q4, representing increasing antibody concentrations. Clinical outcomes analysed by baseline anti-CCP2 status and quartile included change from baseline in disease activity and disability and remission rates. Baseline characteristics were generally comparable across quartiles and treatment groups. In both treatment groups, anti-CCP2 antibody-negative patients responded less well than antibody-positive patients. At year 2, improvements in disease activity and disability and remission rates were similar across Q1-Q3, but were numerically higher in Q4 in the abatacept group; in contrast, treatment effects were similar across all quartiles in the adalimumab group. In AMPLE, baseline anti-CCP2 positivity was associated with a better response for abatacept and adalimumab. Patients with the highest baseline anti-CCP2 antibody concentrations had better clinical response with abatacept than patients with lower concentrations, an association that was not observed with adalimumab. NCT00929864. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    Directory of Open Access Journals (Sweden)

    Natalie Evans

    Full Text Available BACKGROUND: Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients' appointment of surrogate decision-makers in Italy, Spain, Belgium and the Netherlands and examines associated factors. METHODS: A cross-sectional, retrospective survey was conducted with representative GP networks in four countries. GPs recorded the health and care characteristics in the last three months of life of 4,396 patients who died non-suddenly. Prevalences were estimated and logistic regressions were used to examine between country differences and country-specific associated patient and care factors. RESULTS: GP-patient discussion of treatment preferences occurred for 10%, 7%, 25% and 47% of Italian, Spanish, Belgian and of Dutch patients respectively. Furthermore, 6%, 5%, 16% and 29% of Italian, Spanish, Belgian and Dutch patients had a surrogate decision-maker. Despite some country-specific differences, previous GP-patient discussion of primary diagnosis, more frequent GP contact, GP provision of palliative care, the importance of palliative care as a treatment aim and place of death were positively associated with preference discussions or surrogate appointments. A diagnosis of dementia was negatively associated with preference discussions and surrogate appointments. CONCLUSIONS: The study revealed a higher prevalence of treatment preference discussions and surrogate appointments in the two northern compared to the two southern European countries. Factors associated with preference discussions and surrogate appointments suggest that delaying diagnosis discussions impedes anticipatory planning, whereas early preference discussions, particularly for dementia patients, and the provision of palliative care encourage participation.

  5. Preferred Materials and Methods Employed for Endodontic Treatment by Iranian General Practitioners

    Science.gov (United States)

    Raoof, Maryam; Zeini, Negar; Haghani, Jahangir; Sadr, Saeedeh; Mohammadalizadeh, Sakineh

    2015-01-01

    Introduction: The aim of this study was to gather information on the materials and methods employed in root canal treatment (RCT) by general dental practitioners (GDPs) in Iran. Methods and Materials: A questionnaire was distributed among 450 dentists who attended the 53th Iranian Dental Association congress. Participants were asked to consider demographic variables and answer the questions regarding the materials and methods commonly used in RCT. Descriptive statistics were given as absolute frequencies and valid percentages. The chi-square test was used to investigate the influence of gender and the years of professional activity for the employed materials and techniques. Results: The response rate was 84.88%. The results showed that 61.5% of the participants did not perform pulp sensitivity tests prior to RCT. Less than half of the general dental practitioners (47.4%) said that they would trace a sinus tract before starting the treatment. Nearly 16% of practitioners preferred the rubber dam isolation method. Over 36% of the practitioners reported using formocresol for pulpotomy. The combined approach of working length (WL) radiographs and electronic apex locators was used by 35.2% of the practitioners. Most of the respondents used K-file hand instruments for canal preparation and the technique of choice was step-back (43.5%), while 40.1% of respondents used NiTi rotary files, mostly ProTaper and RaCe. The most widely used irrigant was normal saline (61.8%). Calcium hydroxide was the most commonly used inter appointment medicament (84.6%). The most popular obturation technique was cold lateral condensation (81.7%) with 51% using zinc oxide-eugenol-based sealers. Conclusions: The majority of Iranian GDPs who participated in the present survey do not comply with quality guidelines of endodontic treatment. PMID:25834595

  6. Rotigotine transdermal system for long-term treatment of patients with advanced Parkinson's disease: results of two open-label extension studies, CLEOPATRA-PD and PREFER.

    Science.gov (United States)

    LeWitt, Peter A; Boroojerdi, Babak; Surmann, Erwin; Poewe, Werner

    2013-07-01

    Open-label extensions [studies SP516 (NCT00501969) and SP715 (NCT00594386)] of the CLEOPATRA-PD and PREFER studies were conducted to evaluate the safety, tolerability and efficacy of the dopaminergic agonist, rotigotine, over several years of follow-up in patients with advanced Parkinson's disease (PD). Eligible subjects completing the double-blind trials received open-label adjunctive rotigotine (≤16 mg/24 h) for up to 4 and 6 years in Studies SP516 and SP715, respectively. Safety and tolerability were assessed using adverse events, vital signs and laboratory parameters, and efficacy assessed using the unified Parkinson's disease rating scale (UPDRS). Of the 395 and 258 patients enrolled in the SP516 and SP715 studies, 48 and 45 % completed, respectively. Adverse events were typically dopaminergic effects [e.g., somnolence (18-25 %/patient-year), insomnia (5-7 %/patient-year), dyskinesias (4-8 %/patient-year) and hallucinations (4-8 %/patient-year)], or related to the transdermal application of a patch (application site reactions: 14-15 %/patient-year). There were no clinically relevant changes in vital signs or laboratory parameters in either study. Mean UPDRS part II (activities of daily living) and part III (motor function) total scores improved from double-blind baseline during dose titration, then gradually declined over the maintenance period. In study SP516, mean UPDRS part II and III total scores were 0.8 points above and 2.8 points below double-blind baseline, respectively, at end of treatment. In study SP715, mean UPDRS part II and III total scores were 4.1 points above and 0.2 points below baseline, respectively, at end of treatment. In these open-label studies, adjunctive rotigotine was efficacious with an acceptable safety and tolerability profile in patients with advanced PD for up to 6 years.

  7. Anger Management groups for adolescents: a mixed-methods study of efficacy and treatment preferences.

    Science.gov (United States)

    Down, Richard; Willner, Paul; Watts, Louise; Griffiths, Jenny

    2011-01-01

    We compared the efficacy of, and adolescents' preferences for, a Cognitive Behavioural (CBT) and Personal Development (PD) Anger Management (AM) group. The CBT group aimed to help adolescents develop skills to manage predominantly reactive aggression. The PD group aimed to enhance motivation to develop less aggressive identities with less use of proactive aggression. Eighteen adolescents were randomly allocated to a 10-session CBT or PD AM Group; seven additional adolescents formed a control group. They completed pre- and post-intervention questionnaires to assess anger expression and control, use of AM coping skills (also completed by carers) and self-image. Participants were also interviewed pre- and post-intervention; transcripts were subjected to Interpretive Phenomenological Analysis. Both treatment groups demonstrated significant improvements in anger coping and self-esteem, relative to the control group. Participants' age was significantly correlated with self-image and anger control outcomes in the CBT group. Qualitative analysis identified factors associated with improved outcomes, particularly regarding participants' age, motivation and readiness to change, engagement in the therapeutic process, group dynamics and emotional expressiveness. Our ability to interpret data clinically was enhanced by the use of a mixed quantitative-qualitative methodology. The results help us to better match interventions to clients.

  8. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    NARCIS (Netherlands)

    Evans, N.; Pasman, H.R.W.; Vega Alonso, T.; Block, L. van den; Miccinesi, G.; Viviane, V.C.; Donker, G.; Bertolissi, S.; Zurriaga, O.; Deliens, L.

    2013-01-01

    Aim: Making decisions in anticipation of possible future incapacity is part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment preference discussions and appointments of surrogate decision-makers in Italy, Spa

  9. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    NARCIS (Netherlands)

    Evans, N.; Pasman, H.R.W.; Vega Alonso, T.; Block, L. van den; Miccinesi, G.; Viviane, V.C.; Donker, G.; Bertolissi, S.; Zurriaga, O.; Deliens, L.

    2013-01-01

    Aim: Making decisions in anticipation of possible future incapacity is part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment preference discussions and appointments of surrogate decision-makers in Italy,

  10. Baseline hepatitis B core antibody predicts treatment response in chronic hepatitis B patients receiving long-term entecavir.

    Science.gov (United States)

    Xu, J-H; Song, L-W; Li, N; Wang, S; Zeng, Z; Si, C-W; Li, J; Mao, Q; Zhang, D-Z; Tang, H; Sheng, J-F; Chen, X-Y; Ning, Q; Shi, G-F; Xie, Q; Yuan, Q; Yu, Y-Y; Xia, N-S

    2017-02-01

    Studies regarding the clinical significance of quantitative hepatitis B core antibody (anti-HBc) in patients with chronic hepatitis B receiving first-line nucleos(t)ide analogues is limited. The aim of this study was to determine the performance of anti-HBc as a predictor for hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive CHB patients treated with entecavir. This was a retrospective cohort study consisting of 139 Chinese patients enrolled in a multicenter clinical trial treated with entecavir or entecavir maleate for up to 240 weeks. Anti-HBc evaluation was conducted for all the available samples using a newly developed double-sandwich anti-HBc immunoassay. At week 240, 35 (25.2%) patients achieved a serological response (HBeAg seroconversion) and these patients at week 240 had significantly higher levels of anti-HBc (P<.01). We defined 4.65 log10  IU·mL(-1) , with a maximum sum of sensitivity and specificity, as the optimal cut-off value of baseline anti-HBc level to predict seroconversion. Patients with baseline anti-HBc ≥4.65 log10  IU·mL(-1) had 28.0% (26/93) and 35.5% (33/93) chance of seroconversion at weeks 144 and 240, respectively. The baseline anti-HBc level was the strongest predictor for seroconversion at week 144 (OR: 5.78, 95% confidence interval [CI]: 2.05-16.34, P=.001). The baseline anti-HBc level was a strong predictor for seroconversion at week 240 (OR: 5.36, 95% CI: 2.17-13.25, P<.001). Hence, baseline anti-HBc titre is a useful predictor of long-term entecavir therapy efficacy in HBeAg-positive CHB patients, which could be used to optimize antiviral therapy. © 2016 John Wiley & Sons Ltd.

  11. International survey and surgeon’s preferences in diagnostic work-up towards treatment of anterior shoulder instability

    OpenAIRE

    Weel, Hanneke; Tromp, Wouter; Krekel, Peter R; Randelli, Pietro; van den Bekerom, Michel P. J.; van Deurzen, Derek F. P.

    2016-01-01

    Purpose Recurrent anterior shoulder instability after surgical treatment can be caused by bony defects. Several diagnostic tools have been designed to measure the extent of these bony lesions. Currently, there is no consensus which measurement tool to use and decide which type of surgery is most appropriate. We therefore performed an evaluation of agreement in surgeons’ preference of diagnostic work-up and surgical treatment of anterior shoulder instability. Methods An international survey wa...

  12. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Belinchón I

    2016-11-01

    Full Text Available I Belinchón,1 R Rivera,2 C Blanch,3 M Comellas,4 L Lizán4,5 1Department of Dermatology, Hospital General Universitario de Alicante, Alicante, 2Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, 3Novartis Farmacéutica S.A., Barcelona, 4Outcomes’10, Castellón, Spain; 5Medical Department, University Jaime I, Castellón, Spain Background and objective: Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU.Methods: Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts’ opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded.Results: A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4, preferences (n=5 and satisfaction with treatment (n=7. Results related to health-related quality of life articles (n=30 have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is

  13. Baseline characteristics and treatment patterns of patients with schizophrenia initiated on once-every-three-months paliperidone palmitate in a real-world setting.

    Science.gov (United States)

    Joshi, Kruti; Lafeuille, Marie-Hélène; Brown, Brianne; Wynant, Willy; Emond, Bruno; Lefebvre, Patrick; Tandon, Neeta

    2017-10-01

    Since May 2015, adult patients with schizophrenia adequately treated with once monthly paliperidone palmitate (PP1M) may be transitioned to once-every-three-months paliperidone palmitate (PP3M). This study aims to describe baseline characteristics and treatment patterns of patients with schizophrenia initiated on PP3M in a real-world setting. Pharmacy and medical claims from May 2014 to September 2016 for adult patients with schizophrenia initiated on PP3M (index date) in the Symphony Health Solutions database were analyzed. The cohort consisting of all patients and the one restricted to those transitioning from PP1M as per prescribing guideline recommendations were considered. Baseline characteristics were assessed during the 12 month baseline period. PP1M treatment patterns, proportion of days covered (PDC) by mental-health-related medications, and healthcare resource utilization (HRU) patterns were evaluated for each baseline quarter. PP3M treatment patterns were assessed post-index. Among the 1545 adult patients initiated on PP3M who formed the first cohort, 68.8% transitioned from PP1M based on prescribing guidelines and on an adaptation of the strict clinical trial protocol for PP1M to PP3M transition, forming the second cohort. In both cohorts, the proportion of patients with a PDC ≥80% for antipsychotics, antidepressants, anxiolytics, and mood stabilizers increased while the proportion of patients with ≥1 emergency room, inpatient, or outpatient visit decreased in baseline quarters closer to PP3M initiation. Among patients with ≥4 months of follow-up after the first dose, 85-88% had a second dose. Similarly, among those with ≥4 months of follow-up after the second dose, 87-90% received a third dose. Patients initiated on PP3M demonstrated decreased HRU and increased adherence in quarters closer to PP3M initiation, and were persistent on their PP3M treatment.

  14. Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan 

    Directory of Open Access Journals (Sweden)

    Lai TH

    2016-03-01

    Full Text Available Tzu-Hsien Lai,1,2,* Wen-Fu Wang,3,* Bak-Sau Yip,4 Yu-Wan Yang,5 Giia-Sheun Peng,6 Shih-Jei Tsai,7,8 Yi-Chu Liao,9 Ming-Chyi Pai10,111Section of Neurology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, 2Department of Neurology, National Yang-Ming University School of Medicine, Taipei, 3Department of Neurology, Changhua Christian Hospital, Changhua, 4Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, 5Department of Neurology, China Medical University Hospital, Taichung, 6Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 7Department of Neurology, Chung Shan Medical University Hospital, Taichung, 8School of Medicine, Chung Shan Medical University, Taichung, 9Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 10Division of Behavioral Neurology, Department of Neurology, 11Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan *These authors contributed equally to this workPurpose: Among the medications approved for Alzheimer’s disease (AD, rivastigmine is the only one available as transdermal patch. The aim of this study was to evaluate compliance and caregivers’ preference with oral and transdermal (rivastigmine monotherapy in patients with mild-to-moderate AD from Taiwan.Methods: Real-world Evaluation of Compliance And Preference in Alzheimer’s disease treatment (RECAP in Taiwan was a prospective, noninterventional, observational study with a 24-week (±8 weeks observational period for each participant. Eligible patients were grouped into one of the two treatment cohorts based on the baseline AD therapy: oral (donepezil, galantamine, rivastigmine, or memantine or transdermal (rivastigmine patch. The primary end points were caregiver preference and caregiver assessment of patients’ compliance to

  15. Therapy preferences in melanoma treatment--willingness to pay and preference of quality versus length of life of patients, physicians and healthy controls.

    Science.gov (United States)

    Krammer, Ramona; Heinzerling, Lucie

    2014-01-01

    New melanoma therapies, like e.g. ipilimumab, improve survival. However, only a small subset of patients benefits while 60% encounter side effects. Furthermore, these marginal benefits come at a very high price of €110'000 per treatment. This study examines attitudes towards melanoma therapy options of physicians, healthy individuals and patients, their willingness to pay and preference of quality versus length of life. Based on findings from a focus group questionnaires were developed and pretested. After obtaining ethical approval and informed consent surveys were conducted in a total of 90 participants (n = 30 for each group). Statistical analyses were conducted using R. Attitudes vastly differed between healthy participants, physicians and melanoma patients. Whereas melanoma patients show a high willingness to endure side effects despite very small survival gains (down to 1 extra week) or even only hope with no survival benefit, healthy controls are more critical, while physicians are the most therapy adverse. Consequently, if given €100'000 and the free decision what to spend the money on the willingness to pay for therapy was much higher in the patient group (68%) compared to 28% of healthy controls and only 43% of the physicians, respectively. When lowering the amount of cash that could be received instead of ipilimumab to €50'000 or €10'000 to test price sensitivity 69% (+1%) and 76% (+8%) of melanoma patients, respectively, preferred ipilimumab over cash. When judging on societal spending even melanoma patients opted for spending on ipilimumab in only 21%. The judgment about the benefits of new treatment options largely differs between groups, physicians being the most critical against therapy. Price elasticity was low.

  16. The influence of spiritual beliefs and practices on the treatment preferences of African Americans: a review of the literature.

    Science.gov (United States)

    Johnson, Kimberly S; Elbert-Avila, Katja I; Tulsky, James A

    2005-04-01

    Spirituality is an important part of African-American culture and is often cited as an explanation for the more-aggressive treatment preferences of some African Americans at the end of life. This paper reviews the literature on spiritual beliefs that may influence the treatment decisions of African Americans. Medline 1966 to February 2003, Psych Info 1872 to February 2003, and CINAHL 1982 to February 2003 were searched for studies exploring spiritual beliefs that may influence the treatment preferences of African Americans. All candidate papers were examined for quality, and data were extracted on study population, design, analysis, and results to identify recurrent themes. Forty studies met inclusion criteria. Recurrent themes describing spiritual beliefs that may influence the treatment preferences of African Americans throughout the course of illness include the following: spiritual beliefs and practices are a source of comfort, coping, and support and are the most effective way to influence healing; God is responsible for physical and spiritual health; and the doctor is God's instrument. Spiritual beliefs specifically addressing treatment preferences at the end of life include: only God has power to decide life and death, there are religious prohibitions against physician-assisted death or advance directives limiting life-sustaining treatments, and divine intervention and miracles occur. For some African Americans, spiritual beliefs are important in understanding and coping with illness and may provide a framework within which treatment decisions are made. Given the growing ethnic diversity of the United States, some understanding of the complexities of culture and spirituality is essential for healthcare providers.

  17. Inpatients' Preferences, Beliefs, and Stated Willingness to Pay for Complementary and Alternative Medicine Treatments.

    Science.gov (United States)

    Montross-Thomas, Lori P; Meier, Emily A; Reynolds-Norolahi, Kimberly; Raskin, Erin E; Slater, Daniel; Mills, Paul J; MacElhern, Lauray; Kallenberg, Gene

    2017-04-01

    Research demonstrates the benefits of complementary and alternative medicine (CAM) in myriad environments. Yet, the majority of CAM services are offered in outpatient settings. Incorporating CAM into hospital settings may lead to increased patient comfort, well-being, and overall satisfaction with hospital admissions. Few studies have examined CAM services among inpatients. Therefore, this study assessed inpatients' preferences and beliefs regarding CAM, as well as their stated willingness to pay for these services. Adult patients (n = 100), ranging in age from 19-95 years (M = 53 years; SD = 19.2 years), were recruited during their hospitalization in the University of California, San Diego, Healthcare System. The inpatients completed a brief individual interview to gather their perspectives on common CAM services, including acupuncture, aromatherapy, art therapy, guided imagery, healthy food, humor therapy, massage therapy, music therapy, pet therapy, Reiki, and stress management. Inpatients were asked which CAM therapies they perceived as being potentially the most helpful, their willingness to pay for those therapies, and their perceived beliefs regarding the use of those therapies. Inpatients most commonly perceived healthy food (85%), massage therapy (82%), and humor therapy (70%) to be the most helpful, and were most willing to pay for healthy food (71%), massage therapy (70%), and stress management (48%). Inpatients most commonly believed CAM treatments would provide relaxation (88%), increase well-being (86%), and increase their overall satisfaction with the hospitalization (85%). This study suggests that CAM services may be a beneficial addition to hospitals, as demonstrated by inpatients' interest and stated willingness to pay for these services. These findings may help organizational leaders when making choices regarding the development of CAM services within hospitals, particularly since a significant percentage of inpatients reported that

  18. Walking at speeds close to the preferred transition speed as an approach to obesity treatment

    Directory of Open Access Journals (Sweden)

    Ilić Duško

    2012-01-01

    Full Text Available Introduction. Increasing energy expenditure through certain exercise is an important component of effective interventions to enhance initial weight loss and prevent weight regain. Objective. The purpose of this study was to determine the effect of a 16-week weight loss exercise programme on morpho-functional changes in female adults and to examine the programme effects on two subpopulations with different levels of obesity. Methods. Fifty-six middle-aged women were divided into 2 groups according to their body mass index (BMI: 25-29.9 kg/m2 - overweight (OW and ≥30 kg/m2 - obese (OB. The exercise protocol included a walking technique based on hip rotation at horizontal plane at speeds close to the preferred transition speed (PTS. At the initiation of the study and after 16 weeks of the programme, anthropometric, morphological and cardiovascular parameters of all subjects were assessed. The main effects of Group (OW and OB and Time and the interaction effect of Group by Time were tested by time repeated measures General Linear Model (mixed between-within subjects ANOVA. Results. Mean weight loss during the programme was 10.3 kg and 20.1 kg in OW and OB, respectively. The average fat mass (FM loss was 9.4 kg in OW and 16.9 kg in OB. The Mixed ANOVA revealed a significant Group by Time interaction effects for waist circumference, body weight, body water, fat free mass, FM, %FM and BMI (p<0.05. Conclusion. The applied exercise protocol has proved as beneficial in the treatment of obesity, since it resulted in a significant weight loss and body composition changes. The reduction in body weight was achieved mainly on account of the loss of fat mass.

  19. Low Baseline Interleukin-17A Levels Are Associated with Better Treatment Response at 12 Weeks to Tocilizumab Therapy in Rheumatoid Arthritis Patients

    Directory of Open Access Journals (Sweden)

    Sang Jin Lee

    2015-01-01

    Full Text Available T helper 17-related cytokines have been implicated in rheumatoid arthritis (RA pathogenesis. The study aimed to identify cytokines associated with the treatment response of RA patients to tocilizumab (TCZ, a humanized monoclonal antibody against the interleukin- (IL- 6 receptor. As an independent substudy of the 24-week, randomized, double-blinded CWP-TCZ301 trial of TCZ in RA patients with an inadequate response to disease-modifying antirheumatic drugs, serum levels of cytokines including tumor necrosis factor-alpha, IL-17A, IL-21, IL-23, IL-6, and soluble IL-6 receptor were measured. Baseline IL-17A levels were significantly lower in RA patients who achieved disease activity score 28 (DAS28 remission at 12 weeks of TCZ treatment, compared to patients not in remission. Patients were stratified into IL-17A low group and IL-17A high group. Significantly more patients in the IL-17A low group achieved remission as compared to the IL-17A high group (47.6 versus 17.4%, P=0.032. DAS28 improvement was significantly better in the IL-17A low group than in the IL-17A high group at 12 weeks (P=0.045 and 24 weeks (P=0.046 after adjustment. Other baseline cytokines were not associated with treatment response to TCZ. The data demonstrate that low baseline IL-17A levels are associated with better clinical response to TCZ treatment in RA patients.

  20. Low baseline interleukin-17A levels are associated with better treatment response at 12 weeks to tocilizumab therapy in rheumatoid arthritis patients.

    Science.gov (United States)

    Lee, Sang Jin; Park, Won; Park, Sung Hwan; Shim, Seung-Cheol; Baek, Han Joo; Yoo, Dae-Hyun; Kim, Hyun Ah; Lee, Soo Kon; Leee, Yun Jong; Park, Young Eun; Cha, Hoon-Suk; Park, Jin Kyun; Lee, Eun Young; Lee, Eun Bong; Song, Yeong Wook

    2015-01-01

    T helper 17-related cytokines have been implicated in rheumatoid arthritis (RA) pathogenesis. The study aimed to identify cytokines associated with the treatment response of RA patients to tocilizumab (TCZ), a humanized monoclonal antibody against the interleukin- (IL-) 6 receptor. As an independent substudy of the 24-week, randomized, double-blinded CWP-TCZ301 trial of TCZ in RA patients with an inadequate response to disease-modifying antirheumatic drugs, serum levels of cytokines including tumor necrosis factor-alpha, IL-17A, IL-21, IL-23, IL-6, and soluble IL-6 receptor were measured. Baseline IL-17A levels were significantly lower in RA patients who achieved disease activity score 28 (DAS28) remission at 12 weeks of TCZ treatment, compared to patients not in remission. Patients were stratified into IL-17A low group and IL-17A high group. Significantly more patients in the IL-17A low group achieved remission as compared to the IL-17A high group (47.6 versus 17.4%, P = 0.032). DAS28 improvement was significantly better in the IL-17A low group than in the IL-17A high group at 12 weeks (P = 0.045) and 24 weeks (P = 0.046) after adjustment. Other baseline cytokines were not associated with treatment response to TCZ. The data demonstrate that low baseline IL-17A levels are associated with better clinical response to TCZ treatment in RA patients.

  1. Sleep and cognition at baseline and the effects of REM sleep diminution after 1 week of antidepressive treatment in patients with depression.

    Science.gov (United States)

    Göder, Robert; Seeck-Hirschner, Mareen; Stingele, Karoline; Huchzermeier, Christian; Kropp, Cornelia; Palaschewski, Milena; Aldenhoff, Josef; Koch, Jakob

    2011-12-01

    It has been hypothesized that non-rapid eye movement (NREM) sleep facilitates declarative memory consolidation, and rapid eye movement (REM) sleep is particularly important in promoting procedural learning. The aim of this study was to examine the effects of pharmacological REM sleep suppression on performance in different neuropsychological tasks. For our baseline, we chose 41 moderately depressed patients (age range 19-44 years), who were not taking antidepressants. In the morning after polysomnography, we tested memory recall and cognitive flexibility by assessment of verbal and figural fluency, a shift of attention task and the Trail Making Test B. After recording baseline values, patients were assigned randomly to one of three treatment groups: medication with citalopram; medication with reboxetine; or exclusive treatment with psychotherapy. Retesting took place 1 week after onset of treatment. The main results were: (1) an association of slow-wave sleep with verbal memory performance at baseline; (2) a suppression of REM sleep in patients taking citalopram and reboxetine; (3) no differences regarding neuropsychological performance within the treatment groups; and (4) no association of REM sleep diminution with decreases in memory performance or cognitive flexibility in patients treated with citalopram or reboxetine. In line with other studies, our results suggest that there are no negative effects of a decrease in REM sleep on memory performance in patients taking antidepressants.

  2. Treating nicotine dependence by targeting attention-deficit/ hyperactivity disorder (ADHD) with OROS methylphenidate: the role of baseline ADHD severity and treatment response.

    Science.gov (United States)

    Nunes, Edward V; Covey, Lirio S; Brigham, Gregory; Hu, Mei-Chen; Levin, Frances R; Somoza, Eugene C; Winhusen, Theresa M

    2013-10-01

    To determine whether treatment of attention-deficit/hyperactivity disorder (ADHD) with osmotic-release oral system (OROS) methylphenidate promotes abstinence from smoking among smokers with ADHD who have greater severity of ADHD symptoms at baseline or greater improvement in ADHD during treatment. This is a secondary analysis of data from a randomized, double-blind, 11-week trial conducted between December 2005 and January 2008 at 6 clinical sites; the original trial was sponsored by the National Drug Abuse Clinical Trials Network. Adult cigarette smokers (aged 18-55 years) who met DSM-IV criteria for ADHD were randomly assigned to OROS methylphenidate (72 mg/d) (n = 127) or matching placebo (n = 128). All participants received nicotine patches (21 mg/d) and weekly individual smoking cessation counseling. Logistic regression was used to model prolonged abstinence from smoking (ascertained by self-report and breath carbon monoxide testing) as a function of treatment, baseline ADHD Rating Scale-IV (ADHD-RS) score, change in ADHD-RS score during treatment, and their interactions. Treatment interacted with both ADHD-RS score at baseline (P = .01) and change in ADHD-RS score during treatment (P = .008). Among patients with higher ADHD-RS scores (> 36) at baseline and the most improvement in ADHD during treatment (ADHD-RS change score ≥ 24), 70.0% of those who took OROS methylphenidate achieved abstinence from smoking compared to 36.8% of those who took placebo (P = .02). In contrast, among patients with the lowest ADHD-RS baseline scores (≤ 30), 30.3% of those who took OROS methylphenidate achieved abstinence from smoking compared to 60.7% of those who took placebo (P = .02). OROS methylphenidate, in combination with nicotine patch, may be an effective treatment for nicotine dependence among smokers with more severe ADHD and more robust response of ADHD symptoms to medication. OROS methylphenidate may be counterproductive among smokers with lower severity of ADHD

  3. A matter of good taste: Investigating preferences for in-house water treatment in peri-urban communities in Cambodia

    Science.gov (United States)

    Jeuland, M. A.; Orgill, J.; Brown, J.; Shaheed, A.

    2012-12-01

    It is commonly argued that low demand for in-house water treatment technologies is not simply due to their cost, but also results from their other unfavorable features, notably distaste or convenience problems. This research considers household preferences for in-house water treatment in two peri-urban communes around Phnom Penh, Cambodia, with a particular focus on taste. In an effort to measure sensitivity to taste problems, respondents from more than 900 households were given water samples treated with randomly assigned levels of chlorine, as well as a bottled water placebo, and were asked to compare their favorite samples with their existing drinking water source. Households were also asked to complete a series of conjoint tasks in which they selected their preferred drinking water alternative among options that varied in terms of cost, taste, effectiveness against diarrheal disease and quantity of water treated. Our findings suggest that households do perceive distaste for water treated with chlorine products, and that taste is an important feature of their selection of water treatment alternatives. Better understanding of the taste preferences of households in communities without access to safe water is thus critical to interventions seeking to promote in-house water treatment.

  4. Patients' Preferences for Outcome, Process and Cost Attributes in Cancer Treatment: A Systematic Review of Discrete Choice Experiments.

    Science.gov (United States)

    Bien, Daniela R; Danner, Marion; Vennedey, Vera; Civello, Daniele; Evers, Silvia M; Hiligsmann, Mickaël

    2017-03-31

    As several studies have been conducted to elicit patients' preferences for cancer treatment, it is important to provide an overview and synthesis of these studies. This study aimed to systematically review discrete choice experiments (DCEs) about patients' preferences for cancer treatment and assessed the relative importance of outcome, process and cost attributes. A systematic literature review was conducted using PubMed and EMBASE to identify all DCEs investigating patients' preferences for cancer treatment between January 2010 and April 2016. Data were extracted using a predefined extraction sheet, and a reporting quality assessment was applied to all studies. Attributes were classified into outcome, process and cost attributes, and their relative importance was assessed. A total of 28 DCEs were identified. More than half of the studies (56%) received an aggregate score lower than 4 on the PREFS (Purpose, Respondents, Explanation, Findings, Significance) 5-point scale. Most attributes were related to outcome (70%), followed by process (25%) and cost (5%). Outcome attributes were most often significant (81%), followed by process (73%) and cost (67%). The relative importance of outcome attributes was ranked highest in 82% of the cases where it was included, followed by cost (43%) and process (12%). This systematic review suggests that attributes related to cancer treatment outcomes are the most important for patients. Process and cost attributes were less often included in studies but were still (but less) important to patients in most studies. Clinicians and decision makers should be aware that attribute importance might be influenced by level selection for that attribute.

  5. Eliciting preferences for alternative cancer drug treatments. The influence of framing, medium, and rater variables.

    Science.gov (United States)

    O'Connor, A M; Boyd, N F; Tritchler, D L; Kriukov, Y; Sutherland, H; Till, J E

    1985-01-01

    In oncology there is increasing interest in the development of techniques to help patients choose between alternative therapies in ways that are consistent with their preferences. The purpose of this study was to examine some methodological problems associated with the elicitation of preferences. Preferences for alternative drug therapies were sought from 208 visitors to an open house at the Ontario Cancer Institute and from 216 university nursing students. Preferences were not significantly dependent on the sex, age or professional status of the respondents, nor on the medium used for elicitation of preferences (computer terminal versus pencil-and-paper questionnaire). In contrast, the importance of the way decision problems are framed was confirmed. Comparison of a positive frame (outcomes expressed as the probability of surviving) with a negative frame (outcomes expressed as the probability of dying) and a mixed frame (probabilities of surviving and dying were both given) pointed to the presence or absence of the word "survive" in the outcome description as the main source of framing bias. The framing effect was in the opposite direction to that hypothesized.

  6. The interim service preferences of parents waiting for children's mental health treatment: a discrete choice conjoint experiment.

    Science.gov (United States)

    Cunningham, Charles E; Chen, Yvonne; Deal, Ken; Rimas, Heather; McGrath, Patrick; Reid, Graham; Lipman, Ellen; Corkum, Penny

    2013-08-01

    Parents seeking help for children with mental health problems are often assigned to a waiting list. We used a discrete choice conjoint experiment to model preferences for interim services that might be used while waiting for the formal assessment and treatment process to begin. A sample of 1,059 parents (92 % mothers) seeking mental health services for 4 to 16 year olds chose between hypothetical interim services composed by experimentally varying combinations of the levels of 13 interim service attributes. Latent Class analysis yielded a four-segment solution. All segments preferred interim options helping them understand how agencies work, enhancing their parenting knowledge and skill, and providing an opportunity to understand or begin dealing with their own difficulties. The Group Contact segment (35.1 %) preferred interim services in meetings with other parents, supported by phone contacts, frequent checkup calls, and wait-time updates. Virtual Contact parents (29.2 %) preferred to meet other parents in small internet chat groups supported by e-mail contact. Membership in this segment was linked to higher education and computer skills. Frequent Contact parents (24.4 %) preferred face-to-face interim services supported by weekly progress checks and wait time updates. Limited Contact parents (11.3 %) were less intent on using interim services. They preferred to pursue interim services alone, with contacts by phone, supported by fewer check-up calls and less frequent wait time updates. All segments were more likely to enroll in interim services involving their child.

  7. Prescriber preferences for behavioural economics interventions to improve treatment of acute respiratory infections: a discrete choice experiment

    Science.gov (United States)

    Gong, Cynthia L; Hay, Joel W; Meeker, Daniella; Doctor, Jason N

    2016-01-01

    Objective To elicit prescribers' preferences for behavioural economics interventions designed to reduce inappropriate antibiotic prescribing, and compare these to actual behaviour. Design Discrete choice experiment (DCE). Setting 47 primary care centres in Boston and Los Angeles. Participants 234 primary care providers, with an average 20 years of practice. Main outcomes and measures Results of a behavioural economic intervention trial were compared to prescribers' stated preferences for the same interventions relative to monetary and time rewards for improved prescribing outcomes. In the randomised controlled trial (RCT) component, the 3 computerised prescription order entry-triggered interventions studied included: Suggested Alternatives (SA), an alert that populated non-antibiotic treatment options if an inappropriate antibiotic was prescribed; Accountable Justifications (JA), which prompted the prescriber to enter a justification for an inappropriately prescribed antibiotic that would then be documented in the patient's chart; and Peer Comparison (PC), an email periodically sent to each prescriber comparing his/her antibiotic prescribing rate with those who had the lowest rates of inappropriate antibiotic prescribing. A DCE study component was administered to determine whether prescribers felt SA, JA, PC, pay-for-performance or additional clinic time would most effectively reduce their inappropriate antibiotic prescribing. Willingness-to-pay (WTP) was calculated for each intervention. Results In the RCT, PC and JA were found to be the most effective interventions to reduce inappropriate antibiotic prescribing, whereas SA was not significantly different from controls. In the DCE however, regardless of treatment intervention received during the RCT, prescribers overwhelmingly preferred SA, followed by PC, then JA. WTP estimates indicated that each intervention would be significantly cheaper to implement than pay-for-performance incentives of $200/month

  8. Patients' preferences and willingness-to-pay for postmenopausal hormone receptor-positive, HER2-negative advanced breast cancer treatments after failure of standard treatments.

    Science.gov (United States)

    Ngorsuraches, Surachat; Thongkeaw, Klangjai

    2015-01-01

    Patients' preferences increasingly play roles in cancer treatments. The objective of this study is to examine breast cancer patients' preferences and willingness-to-pay (WTP) for postmenopausal hormone receptor-positive, HER2-negative advanced breast cancer treatments after failure of standard treatments. Four attributes, i.e. progression free survival (PFS), anemia, pneumonitis, and cost, and their levels of exemestane and exemestane plus everolimus from literature and patient interviews were used to develop a discrete choice experiment questionnaire. Each questionnaire was composed of seven choice sets and each choice set contained those four attributes with different levels. Breast cancer patients were asked to choose one treatment alternative in each choice set. Multinomial logit model was used to determine relative preferences of each attribute and the WTP for all attributes and treatments were calculated. A total of 146 patients were included in study analyses. Results showed that the patients preferred treatments with higher PFS and lower side effects. The patients were willing to pay US$151.6, US$69.8, and US$278.3 per month in exchange for every 1 month increase in PFS and every 1 % decreased risk of anemia and pneumonitis, respectively. The patients were willing to pay for exemestane and exemestane plus everolimus US$551.8 and US$414.2 per month, respectively. In conclusion, patients weighted importance on PFS, anemia, and pneumonitis, when they needed to choose an aromatase inhibitor plus mammalian target of rapamycin (mTOR) inhibitor for advanced breast cancer treatments after failure of standard treatments. They valued exemestane alone more than exemestane plus everolimus.

  9. Regression to the mean and predictors of MRI disease activity in RRMS placebo cohorts--is there a place for baseline-to-treatment studies in MS?

    Directory of Open Access Journals (Sweden)

    Jan-Patrick Stellmann

    Full Text Available Gadolinium-enhancing (GD+ lesions and T2 lesions are MRI outcomes for phase-2 treatment trials in relapsing-remitting Multiple Sclerosis (RRMS. Little is known about predictors of lesion development and regression-to-the-mean, which is an important aspect in early baseline-to-treatment trials.To quantify regression-to-the-mean and identify predictors of MRI lesion development in placebo cohorts.21 Phase-2 and Phase-3 trials were identified by a systematic literature research. Random-effects meta-analyses were performed to estimate development of T2 and GD+ after 6 months (phase-2 or 2 years (phase-3. Predictors of lesion development were evaluated with mixed-effect meta-regression.The mean number of GD+-lesions per scan was similar after 6 months (1.19, 95%CI: 0.87-1.51 and 2 years (1.19, 95%CI: 1.00-1.39. 39% of the patients were without new T2-lesion after 6 month and 19% after 2 years (95%CI: 12-25%. Mean number of baseline GD+-lesions was the best predictor for new lesions after 6 months.Baseline GD-enhancing lesions predict evolution of Gd- and T2 lesions after 6 months and might be used to control for regression to the mean effects. Overall, proof-of-concept studies with a baseline to treatment design have to face a regression to 1.2 GD+lesions per scan within 6 months.

  10. Patients' preferences for osteoporosis drug treatment: A discrete-choice experiment

    NARCIS (Netherlands)

    M. Hiligsmann (Mickael); B.G.C. Dellaert (Benedict); C.D. Dirksen (Carmen); T. van der Weijden (Trudy); Goemaere, S. (Stefan); J-Y. Reginster (Jean-Yves); V. Watson (Verity); A. Boonen (Annelies)

    2014-01-01

    textabstractIntroduction: The patient's perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of, osteoporosis for medication attributes, and to establish how patients trade between these attr

  11. Patients' preferences for osteoporosis drug treatment: A discrete-choice experiment

    NARCIS (Netherlands)

    M. Hiligsmann (Mickael); B.G.C. Dellaert (Benedict); C.D. Dirksen (Carmen); T. van der Weijden (Trudy); Goemaere, S. (Stefan); J-Y. Reginster (Jean-Yves); V. Watson (Verity); A. Boonen (Annelies)

    2014-01-01

    textabstractIntroduction: The patient's perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of, osteoporosis for medication attributes, and to establish how patients trade between these

  12. The relationship between (stigmatizing views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Nieboer Anna P

    2011-01-01

    Full Text Available Abstract Background Tuberculosis (TB and human immune virus/acquired immune deficiency syndrome (HIV/AIDS stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in relation to preferences and attitudes toward TB treatment. Methods Data were gathered through a survey administered to respondents from 1,020 households in Grahamstown. The survey measured stigmatization surrounding TB and HIV/AIDS, and determined perceptions of respondents whether TB patients should queue with other chronically ill patients. Respondents selected support and treatment options they felt would benefit TB patients. Statistical analysis identified the prevalence of TB and HIV/AIDS stigmas. Logistic regression analyses explored associations between stigmatizing ideas, views regarding TB patients in the chronic illness queue, and attitudes toward support and treatment. Results Respondents with TB stigmatizing ideas held positive attitudes toward volunteer support, special TB queues, and treatment at clinics; they held negative attitudes toward temporary disability grants, provision of information at work or school, and treatment at the TB hospital. Respondents who felt it beneficial for TB patients to queue with other chronically ill patients conversely held positive attitudes toward provision of porridge and disability grants, and treatment at the TB hospital; they held negative attitudes toward volunteer support, special TB queues, information provision at work or school, and treatment at clinics. Conclusion These results showed that two varying views related to visibility factors that expose patients to stigmatization (one characterized by TB stigma, the other by the view that TB patients should queue with other chronically ill patients are associated with opposing attitudes and preferences towards TB treatment. These opposing attitudes complicate

  13. Microbial profiles at baseline and not the use of antibiotics determine the clinical outcome of the treatment of chronic periodontitis

    OpenAIRE

    Bizzarro, S.; Laine, M.L.; Buijs, M.J.; Brandt, B. W.; Crielaard, W; Loos, B.G.; Zaura, E.

    2016-01-01

    Antibiotics are often used in the treatment of chronic periodontitis, which is a major cause of tooth loss. However, evidence in favour of a microbial indication for the prescription of antibiotics is lacking, which may increase the risk of the possible indiscriminate use of antibiotics, and consequent, microbial resistance. Here, using an open-ended technique, we report the changes in the subgingival microbiome up to one year post-treatment of patients treated with basic periodontal therapy ...

  14. Danish physicians' preferences for prescribing escitalopram over citalopram and sertraline to treatment-naïve patients

    DEFF Research Database (Denmark)

    Poulsen, Karen Killerup; Glintborg, Dorte; Moreno, Søren Ilsøe

    2013-01-01

    PURPOSE: To investigate whether general practitioners, hospital physicians and specialized practitioners in psychiatry have similar preferences for initiating treatment with expensive serotonin-specific reuptake inhibitors (SSRIs). METHODS: All first-time prescriptions for the SSRIs escitalopram....... Of the treatment-naïve patients, 19 % were initially prescribed escitalopram. Hospital physicians prescribed escitalopram to 34 % of their treatment-naïve patients, while practitioners specialized in psychiatry prescribed it to 25 %, and general practitioners prescribed it to 17 %. General practitioners, however......, were responsible for initiating 87 % of all treatment-naïve patients. CONCLUSION: The most expensive SSRI, escitalopram, is prescribed as first choice to one in five patients receiving their first antidepressant of escitalopram, citalopram or sertraline. General practitioners made the bulk of all first...

  15. A systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure : rationale, design, and baseline characteristics of BIOSTAT-CHF

    NARCIS (Netherlands)

    Voors, Adriaan A.; Anker, Stefan D.; Cleland, John G.; Dickstein, Kenneth; Filippatos, Gerasimos; van der Harst, Pim; Hillege, Hans L.; Lang, Chim C.; ter Maaten, Jozine M.; Ng, Leong; Ponikowski, Piotr; Samani, Nilesh J.; van Veldhuisen, Dirk J.; Zannad, Faiz; Zwinderman, Aeilko H.; Metra, Marco

    2016-01-01

    AimsDespite major improvements in pharmacological and device treatments, heart failure remains a syndrome with high morbidity and mortality, poor quality of life, and high health-care costs. Given the extensive heterogeneity among patients with heart failure, substantial differences in the response

  16. Baseline depression levels do not affect efficacy of cognitive-behavioral self-help treatment for insomnia

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; van Straten, A.; Spoormaker, V.I.

    2013-01-01

    Background: Cognitive-behavioral therapy can effectively treat insomnia (CBT-I). Randomized controlled trials have shown efficacy of self-help CBT-I, but unclear is whether excluding depressive patients boosted treatment effects. Method: We administered unsupported self-help CBT-I to insomnia patien

  17. Baseline depression levels do not affect efficacy of cognitive-behavioral self-help treatment for insomnia

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; van Straten, A.; Spoormaker, V.I.

    2013-01-01

    Background: Cognitive-behavioral therapy can effectively treat insomnia (CBT-I). Randomized controlled trials have shown efficacy of self-help CBT-I, but unclear is whether excluding depressive patients boosted treatment effects. Method: We administered unsupported self-help CBT-I to insomnia

  18. Microbial profiles at baseline and not the use of antibiotics determine the clinical outcome of the treatment of chronic periodontitis

    NARCIS (Netherlands)

    Bizzarro, S.; Laine, M.L.; Buijs, M.J.; Brandt, B.W.; Crielaard, W.; Loos, B.G.; Zaura, E.

    2016-01-01

    Antibiotics are often used in the treatment of chronic periodontitis, which is a major cause of tooth loss. However, evidence in favour of a microbial indication for the prescription of antibiotics is lacking, which may increase the risk of the possible indiscriminate use of antibiotics, and consequ

  19. Baseline depression levels do not affect efficacy of cognitive-behavioral self-help treatment for insomnia

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; van Straten, A.; Spoormaker, V.I.

    2013-01-01

    Background: Cognitive-behavioral therapy can effectively treat insomnia (CBT-I). Randomized controlled trials have shown efficacy of self-help CBT-I, but unclear is whether excluding depressive patients boosted treatment effects. Method: We administered unsupported self-help CBT-I to insomnia patien

  20. Hot flush frequency and severity at baseline as predictors of time to transient and stable treatment success: pooled analysis of two CE/BZA studies.

    Science.gov (United States)

    Pinkerton, JoAnn V; Bushmakin, Andrew G; Bobula, Joel; Lavenberg, Joanne; Komm, Barry S; Abraham, Lucy

    2017-06-26

    To evaluate the impact of baseline hot flush frequency and severity on time to symptom improvement during treatment with conjugated estrogens/bazedoxifene (CE/BZA). Data were pooled through week 12 from two randomized placebo-controlled trials (SMART-1 and SMART-2) of nonhysterectomized postmenopausal women with hot flushes treated with CE 0.45 mg/BZA 20 mg or CE 0.625 mg/BZA 20 mg. Time to transient and stable improvement (≥ 50% reduction in hot flush frequency/severity) was estimated using nonparametric models. Transient improvement in hot flush frequency occurred earlier in women treated with CE 0.45 mg/BZA 20 mg with less frequent versus more frequent baseline hot flushes per day: median time to transient improvement was 2, 7, and 11 days for women with CE 0.625 mg/BZA 20 mg treatment, though improvement occurred a few days earlier than with CE 0.45 mg/BZA 20 mg. Women with more frequent/severe hot flushes take longer to achieve transient improvements with CE/BZA and should be encouraged to continue treatment, as it may take longer than a few weeks to achieve significant improvement.

  1. Most Trial Eligibility Criteria and Patient Baseline Characteristics Do Not Modify Treatment Effect in Trials Using Targeted Therapies for Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Christensen, Anton Wulf; Tarp, Simon; Furst, Daniel E;

    2015-01-01

    )) for rheumatoid arthritis (RA). METHODS: We conducted a meta-epidemiological study of all trials evaluating a targeted therapy approved by regulatory authorities for treating RA. The database search was completed on December 11th 2013. Eligible trials reported ACR20 data at months 3-6 and used an add-on design......OBJECTIVE: To determine if variations in trial eligibility criteria and patient baseline characteristics could be considered effect modifiers of the treatment response when testing targeted therapies (biological agents and targeted synthetic disease modifying antirheumatic drugs (DMARDs...

  2. Relationship between frequency, length, and treatment outcome of exacerbations to baseline lung function and lung density in alpha-1 antitrypsin-deficient COPD

    Directory of Open Access Journals (Sweden)

    Vijayasaratha K

    2012-11-01

    Full Text Available Kesavaperumal Vijayasaratha,1 Robert A Stockley21Lung Investigation Unit, 2Research and Development, University Hospital Birmingham NHS Trust, Birmingham, UKBackground: Diary cards are useful for analyzing exacerbations in chronic obstructive pulmonary disease (COPD, although factors influencing the length and frequency of each episode are poorly understood. This study investigated factors that influence the features of exacerbations in patients with alpha-1 antitrypsin (AAT deficiency (PiZ phenotype and COPD.Methods: Daily diary cards were collected over 2 years. Patients had emphysema visualized and quantified by computed tomography scan, and had at least one documented exacerbation in the previous year.Results: The patients (n = 23 had a mean age of 52.5 years, forced expiratory volume in one second (FEV1 of 1.2 L (38.4% predicted, corrected gas transfer (KCO of 0.90 mmol/min/kPa/L (59.7% predicted, and 15th percentile lung density of 44.55 g/L. Two hundred and sixty-three exacerbations (164 treated were identified. The frequency of treated exacerbations correlated negatively with KCO% predicted (r = −0.432; P = 0.022. Exacerbation length (determined for 17 of the patients for whom diary card data through the episode were available correlated negatively with baseline 15th percentile lung density (r = −0.361; P = 0.003, and increased the longer treatment was delayed (r = 0.503; P < 0.001. Treatment delay was shorter with higher day 1 symptom score, lower baseline FEV1, FEV1/forced vital capacity, and lower 15th percentile lung density (r = −0.368, 0.272, 0.461, and 0.786; P = 0.004, 0.036, <0.001, and <0.001, respectively. Time to resolution of exacerbation after treatment initiation was not affected by treatment delay, but correlated negatively with KCO% predicted (r = −0.647; P = 0.007.Conclusion: In alpha-1 antitrypsin deficiency, the frequency and length of resolution of exacerbation were related to baseline gas transfer. Treatment

  3. End-user preferences for and performance of competing POU water treatment technologies among the rural poor of Kenya.

    Science.gov (United States)

    Albert, Jeff; Luoto, Jill; Levine, David

    2010-06-15

    Household point-of-use (POU) water treatment technologies targeted at vulnerable populations are microbiologically effective and, in small trials, improve health. We do not understand the factors that influence preference for and adoption of these technologies by target end-users. We cycled 400 rural subsistence farm households in western Kenya through three randomly ordered two-month trials of three POU products: dilute hypochlorite solution, porous ceramic filtration, and a combined flocculant-disinfectant powdered mixture to compare relative end-user preferences and usage. Households reported higher usage of both dilute hypochlorite and filters than the flocculant-disinfectant. Averaged among all participating households, Escherichia coli reductions in treated water were generally higher among those that received dilute hypochlorite solution than among those receiving either of the other two products. Among those households that self-reported product usage, the E. coli reductions achieved by dilute hypochlorite and the flocculant-disinfectant are statistically equivalent to one another and higher than the reductions achieved by filters. At the same time, households ranked filters most frequently as their most preferred product.

  4. Experience of insomnia, symptom attribution and treatment preferences in individuals with moderate to severe COPD: a qualitative study

    Directory of Open Access Journals (Sweden)

    Kauffman KS

    2014-12-01

    Full Text Available Karen S Kauffman,1 Megan Doede,1 Montserrat Diaz-Abad,2 Steven M Scharf,2,3 Wanda Bell-Farrell,2 Valerie E Rogers,1 Jeanne Geiger-Brown1 1Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA; 2Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, MD, USA; 3The University of Maryland Sleep Disorders Center, Baltimore, MD, USA Abstract: Persons with chronic obstructive pulmonary disease (COPD are known to have poor sleep quality. Acceptance of and adherence to therapies for sleep problems may depend on how the person with COPD regards the source of his sleep problem, yet little is known about their attribution as to the cause of these sleep symptoms. The objective of this study was to describe the subjective sleep complaints of individuals with COPD along with their attributions as to the cause of these symptoms, and their treatment preferences for insomnia. Three focus groups were conducted (N=18 with participants who have moderate to severe COPD. Focus group data were transcribed, compared and contrasted to identify themes of attribution. Participants reported difficulty falling asleep, staying asleep, and daytime sleepiness. They attributed their sleep problems primarily to their pulmonary symptoms, but also poor air quality (thick humid air and death anxiety when awake during the night. There was no clear preference for type of treatment to remedy this problem (medication, cognitive therapy, although they indicated that traveling to the clinic was difficult and should be avoided as much as possible. These data suggest that environmental manipulation to improve air quality (eg, air conditioning and modifications to reduce death anxiety could be beneficial to persons with COPD. In-person multi-session therapy may not be acceptable to persons with moderate to severe COPD, however internet-based therapy might make treatment more accessible. Keywords

  5. Characterization Of Chemically Induced Ovarian Carcinomas In An Ethanol-preferring Rat Model: Influence Of Long-term Melatonin Treatment

    OpenAIRE

    Luiz Gustavo A Chuffa; Fioruci-Fontanelli, Beatriz A; Mendes, Leonardo O; Fávaro, Wagner J; Pinheiro, Patricia Fernanda F.; Marcelo Martinez; Francisco Eduardo Martinez

    2013-01-01

    Ovarian cancer is the fourth most common cause of cancer deaths among women, and chronic alcoholism may exert cocarcinogenic effects. Because melatonin (mel) has oncostatic properties, we aimed to investigate and characterize the chemical induction of ovarian tumors in a model of ethanol-preferring rats and to verify the influence of mel treatment on the overall features of these tumors. After rats were selected to receive ethanol (EtOH), they were surgically injected with 100 μg of 7,12-dime...

  6. Treatment preferences in stage IA and IB testicular seminoma: multicenter study of Anatolian Society of Medical Oncology.

    Science.gov (United States)

    Bilici, Ahmet; Ozturk, Turkan; Turkmen, Esma; Odabas, Hatice; Cihan, Sener; Selcukbiricik, Fatih; Erdogan, Bulent; Urakci, Zurat; Kandemir, Nurten; Bayoglu, Ibrahim Vedat; Demirci, Umut; Duran, Ayse Ocak; Sendur, Mehmet Ali Nahit; Yavuzer, Dilek; Harputluoglu, Hakan; Kavgaci, Halil; Gumus, Mahmut

    2015-10-01

    Approximately 75 % of patients with testicular seminoma present with stage I disease, and the probability of long-term survival approaches 100 %. However, the standard adjuvant treatment for stage I seminoma patients remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for men with stage I testicular seminoma. From 1997 to 2013, 282 patients with histologically confirmed stage IA and IB testicular seminoma who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis. Of the 282 patients with stage I seminoma, 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4 %) were treated with adjuvant carboplatin, while the remaining 72 patients (25.5 %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5 months; relapses were observed in 16 patients (22.3 %) on surveillance, in one patient (1.2 %) treated with adjuvant carboplatin and in ten patients (%7.7) who received adjuvant RT. The 5-year disease-free survival (DFS) rate for patients who underwent surveillance was worse than those of patients treated with adjuvant carboplatin and RT (64.2 vs. 97.7 vs. 91.9 %, respectively; p seminoma after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse. Although adjuvant treatment, especially carboplatin, seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in men with stage I seminoma. More reliable predictive factors are needed to make treatment decisions.

  7. Baseline proteinuria, urinary osmotic pressure, and renal function as positive predictors of corticosteroids plus cyclophosphamide treatment efficacy in IgA nephropathy

    Institute of Scientific and Technical Information of China (English)

    Fang Jing; Li Wenge; Li Duo; Tan Zhao

    2014-01-01

    Background Very limited data are available on factors predictive of corticosteroids plus cyclophosphamide treatment efficacy on IgA nephropathy (IgAN).The aim of the study was to research the clinical factors predictive of treatment efficacy in IgAN.Methods One hundred and fifty-nine patients with IgAN (proteinuria ≥2 g/d and estimated glomerular filtration rate 30-89 ml·min-1·1.73 m-2) were treated with corticosteroids/cyclophosphamide followed by a 12-month follow-up.According to their response,these patients were divided into remission group (proteinuria <0.5 g/d) and non-remission group (proteinuria ≥0.5 g/d),and their clinical data collected.Results In the present study,72.96% of the individuals underwent a complete remission,and their response was related to baseline proteinuria,urinary osmotic pressure,and renal function (P <0.05).Patients with baseline proteinuria more than 3 g/d,urinary osmotic pressure greater than 600 mOsm/L,and eGFR 60-89 ml·min-1·1.73 m-2 responded well to the combination of corticosteroids and cyclophosphamide (86.90% vs.57.33%,P=0.000; 81.48% vs.64.10%,P=0.014; 83.17% vs.55.17%,P=0.000).Conclusion The response to the combination of corticosteroids and cyclophosphamide might be well associated with baseline proteinuria,urinary osmotic pressure,and renal function in patients with IgAN.

  8. Acute estradiol treatment affects the expression of cocaine-induced conditioned place preference in ovariectomized female rats.

    Science.gov (United States)

    Bobzean, Samara A M; Dennis, Torry S; Perrotti, Linda I

    2014-04-01

    Women and female rodents are more responsive to the subjective effects of psychostimulant drugs of abuse compared to males. A growing body of literature supports a role for estradiol as a mechanism underlying these sex differences. However, little is known about the influence of acute elevations in levels of estradiol on drug conditioned behaviors. The aim of the present study was to evaluate the influence of an acute increase in systemic estradiol levels on the expression of cocaine conditioned place preference (CPP). Using a six day conditioning procedure, ovariectomized (OVX) female rats were conditioned with one of four doses of cocaine (2.5, 5, 10, or 15mg/kg) to associate one of two large chambers of a CPP apparatus with cocaine or saline. Thirty minutes prior to the start of the CPP preference test, rats were pretreated with either 5μg estradiol benzoate (EB) or peanut oil (PO). PO-treated rats expressed a significant preference for only the mid-range conditioning doses of cocaine (5 and 10mg/kg). However, acute EB treatment resulted in a rightward shift in the cocaine dose-response curve; rats demonstrated a significant preference at only the moderate and high conditioning doses of cocaine (10 and 15mg/kg). These findings demonstrate that acute elevations in estradiol may dampen the expression of conditioned responses to cocaine's secondary rewards at lower conditioning doses of the drug and facilitate CPP at higher doses while estradiol deficiency decreases the threshold dose of cocaine necessary to induce CPP.

  9. Most Trial Eligibility Criteria and Patient Baseline Characteristics Do Not Modify Treatment Effect in Trials Using Targeted Therapies for Rheumatoid Arthritis: A Meta-Epidemiological Study.

    Directory of Open Access Journals (Sweden)

    Anton Wulf Christensen

    Full Text Available To determine if variations in trial eligibility criteria and patient baseline characteristics could be considered effect modifiers of the treatment response when testing targeted therapies (biological agents and targeted synthetic disease modifying antirheumatic drugs (DMARDs for rheumatoid arthritis (RA.We conducted a meta-epidemiological study of all trials evaluating a targeted therapy approved by regulatory authorities for treating RA. The database search was completed on December 11th 2013. Eligible trials reported ACR20 data at months 3-6 and used an add-on design. Odds ratios (ORs were calculated from the response rates and compared among the trial eligibility criteria/patient baseline characteristics of interest. Comparisons are presented as the Ratio of Odds Ratios (ROR.Sixty-two trials (19,923 RA patients were included in the primary analyses using ACR20 response. Overall, targeted therapies constituted an effective treatment (OR 3.96 95% confidence interval (CI 3.41 to 4.60. The majority of the trial eligibility criteria and patient baseline characteristics did not modify treatment effect. The added benefit of targeted therapies was lower in trials including "DMARD-naïve" patients compared with trials including "DMARD inadequate responders" (ROR = 0.45, 95%CI 0.31 to 0.66 and trials including "targeted therapy inadequate responders" (0.50, 95%CI 0.29 to 0.87, test for interaction: p = 0.0002. Longer mean disease duration was associated with a higher likelihood of responding to treatment (β = 1.05, 95%CI 1.00 to 1.11 OR's per year; p = 0.03. Analyses conducted using DAS28-remission as the outcome supported the above-mentioned findings.Our results suggest that a highly selective inclusion is not associated with greater treatment effect, as might otherwise be expected. The added benefit of a targeted therapy was lower in trials including patients who were DMARD-naïve and trials including patients with shorter disease durations.

  10. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol

    Directory of Open Access Journals (Sweden)

    Lutschg Meghan Z

    2011-10-01

    Full Text Available Abstract Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. Methods/design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control. All participants at the hospital (cluster were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. Discussion We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful

  11. Personal preferences and discordant prostate cancer treatment choice in an intervention trial of men newly diagnosed with localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Bosco Jaclyn LF

    2012-09-01

    Full Text Available Abstract Background Men diagnosed with localized prostate cancer (LPC can choose from multiple treatment regimens and are faced with a decision in which medical factors and personal preferences are important. The Personal Patient Profile-Prostate (P3P is a computerized decision aid for men with LPC that focuses on personal preferences. We determined whether the P3P intervention improved the concordance of treatment choice with self-reported influential side-effects compared with a control group. Methods English/Spanish-speaking men diagnosed with LPC (2007–2009 from four US cities were enrolled into a randomized trial and followed through 6-months via mailed or online questionnaire. Men were randomized to receive the P3P intervention or standard education plus links to reputable websites. We classified choice as concordant if men were concerned with (a sexual function and chose external beam radiotherapy or brachytherapy, (b bowel function and chose prostatectomy, (c sex, bowel, and/or bladder function and chose active surveillance, or (d not concerned with any side effect and chose any treatment. Using logistic regression, we calculated odds ratios (OR and 95% confidence intervals (CI for the association between the P3P intervention and concordance. Results Of 448 men, most were Conclusions The P3P intervention did not improve concordance between potential side effects and treatment choice. Information and/or physician consultation immediately after diagnosis was likely to influence decisions despite concerns about side effects. The intervention may be more effective before the first treatment options consultation. Trial registration NCT00692653 http://clinicaltrials.gov/ct2/show/NCT00692653

  12. Controlling preferred orientation and electrical conductivity of zinc oxide thin films by post growth annealing treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, J., E-mail: J.Kennedy@gns.cri.nz [National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt 5010 (New Zealand); The MacDiarmid Institute for Advanced Materials and Nanotechnology (New Zealand); Murmu, P.P.; Leveneur, J. [National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt 5010 (New Zealand); Markwitz, A. [National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt 5010 (New Zealand); The MacDiarmid Institute for Advanced Materials and Nanotechnology (New Zealand); Futter, J. [National Isotope Centre, GNS Science, PO Box 31312, Lower Hutt 5010 (New Zealand)

    2016-03-30

    Graphical abstract: - Highlights: • Annealing dependent microstructural evolution and change in conductivity of ZnO films. • Preferential growth along (0 0 2) and (1 0 0) planes in air and vacuum annealed films. • Resistivity varied between 10{sup 6} and 10{sup −2} Ω cm depending on annealing conditions. • Hydrogen interstitials, and hydrogen-oxygen vacancy complexes affect the conductivity. • Narrow ZnO bandgap assigned to band tail effect related to intrinsic defects states. - Abstract: We report the microstructural evolution of the preferred orientation and electrical conductivity of zinc oxide (ZnO) thin films prepared by ion beam sputtering. Elastic recoil detection analysis results showed 0.6 at% H in as-deposited film which decreased to 0.35 at% in air annealed film due to H diffusion. XRD results showed that the preferred orientation can be tuned by selecting annealing conditions. Vacuum annealed films exhibited (1 0 0) orientation, whereas air annealed film showed (0 0 2) orientation. The annealing conditions caused a dramatic increase in the resistivity of air annealed films (∼10{sup 6} Ω cm), whereas vacuum annealed films showed lower resistivity (∼10{sup −2} Ω cm). High resistivity in air annealed film is attributed to the lack of hydrogen interstitials and hydrogen-oxygen vacancy complexes. Raman results supported the XRD results which demonstrated that annealing assisted in recovery of the crystalline disorder in as-deposited films. Air annealed film exhibited the highest optical transmission (89.7%) in the UV–vis region compared to as-deposited and vacuum annealed films (∼85%). Optical bandgap was found to vary between 3.11 eV and 3.18 eV in as-deposited and annealed films, respectively. The bandgap narrowing is associated with the intrinsic defects which introduced defect states resulting in band tail in ZnO films.

  13. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    National Research Council Canada - National Science Library

    Sanghani, Ruchi M; Moler, Alexander K

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design...

  14. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China's National Methadone Maintenance Treatment Program.

    Directory of Open Access Journals (Sweden)

    Changhe Wang

    Full Text Available Hepatitis C virus (HCV is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT program.Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution.Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17-8.52, p<0.0001 and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96-2.06, p<0.0001. Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001. Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012.The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China.

  15. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China’s National Methadone Maintenance Treatment Program

    Science.gov (United States)

    Rou, Keming; Zhao, Yan; Cao, Xiaobin; Luo, Wei; Liu, Enwu; Wu, Zunyou

    2016-01-01

    Background Hepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program. Methods Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution. Results Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17–8.52, p<0.0001) and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96–2.06, p<0.0001). Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001). Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012. Conclusions The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China. PMID:26906025

  16. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF).

    Science.gov (United States)

    McMurray, John J V; Packer, Milton; Desai, Akshay S; Gong, Jianjian; Lefkowitz, Martin; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Solomon, Scott D; Swedberg, Karl; Zile, Michael R

    2014-07-01

    To describe the baseline characteristics and treatment of the patients randomized in the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and morbidity in Heart Failure) trial, testing the hypothesis that the strategy of simultaneously blocking the renin-angiotensin-aldosterone system and augmenting natriuretic peptides with LCZ696 200 mg b.i.d. is superior to enalapril 10 mg b.i.d. in reducing mortality and morbidity in patients with heart failure and reduced ejection fraction. Key demographic, clinical and laboratory findings, along with baseline treatment, are reported and compared with those of patients in the treatment arm of the Studies Of Left Ventricular Dysfunction (SOLVD-T) and more contemporary drug and device trials in heart failure and reduced ejection fraction. The mean age of the 8442 patients in PARADIGM-HF is 64 (SD 11) years and 78% are male, which is similar to SOLVD-T and more recent trials. Despite extensive background therapy with beta-blockers (93% patients) and mineralocorticoid receptor antagonists (60%), patients in PARADIGM-HF have persisting symptoms and signs, reduced health related quality of life, a low LVEF (mean 29 ± SD 6%) and elevated N-terminal-proB type-natriuretic peptide levels (median 1608 inter-quartile range 886-3221 pg/mL). PARADIGM-HF will determine whether LCZ696 is more beneficial than enalapril when added to other disease-modifying therapies and if further augmentation of endogenous natriuretic peptides will reduce morbidity and mortality in heart failure and reduced ejection fraction. © 2014 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

  17. First-line antihypertensive treatment in patients with pre-diabetes: Rationale, design and baseline results of the ADaPT investigation

    Directory of Open Access Journals (Sweden)

    Bramlage Peter

    2008-07-01

    Full Text Available Abstract Background Recent clinical trials reported conflicting results on the reduction of new-onset diabetes using RAS blocking agents. Therefore the role of these agents in preventing diabetes is still not well defined. Ramipril is an ACE inhibitor (ACEi, that has been shown to reduce cardiovascular events in high risk patients and post-hoc analyses of the HOPE trial have provided evidence for its beneficial action in the prevention of diabetes. Methods The ADaPT investigation ("ACE inhibitor-based versus diuretic-based antihypertensive primary treatment in patients with pre-diabetes" is a 4-year open, prospective, parallel group phase IV study. It compares an antihypertensive treatment regimen based on ramipril versus a treatment based on diuretics or betablockers. The primary evaluation criterion is the first manifestation of type 2 diabetes. The study is conducted in primary care to allow the broadest possible application of its results. The present article provides an outline of the rationale, the design and baseline characteristics of AdaPT and compares these to previous studies including ASCOT-BLPA, VALUE and DREAM. Results Until March 2006 a total of 2,015 patients in 150 general practices (general physicians and internists throughout Germany were enrolled. The average age of patients enrolled was 67.1 ± 10.3 years, with 47% being male and a BMI of 29.9 ± 5.0 kg/m2. Dyslipidemia was present in 56.5%. 37.8% reported a family history of diabetes, 57.8% were previously diagnosed with hypertension (usually long standing. The HbA1c value at baseline was 5.6 %. Compared to the DREAM study patients were older, had more frequently hypertension and patients with cardiovascular disease were not excluded. Conclusion Comparing the ADaPT design and baseline data to previous randomized controlled trial it can be acknowledged that AdaPT included patients with a high risk for diabetes development. Results are expected to be available in 2010. Data

  18. Effects of chronic treatment with the eNOS stimulator Impaza on penis length and sexual behaviors in rats with a high baseline of sexual activity.

    Science.gov (United States)

    Chu, X; Zhavbert, E S; Dugina, J L; Kheyfets, I A; Sergeeva, S A; Epstein, O I; Agmo, A

    2014-01-01

    Endothelial nitric oxide synthase (eNOS) has an important role in erection, and it also affects aspects of sexual behavior. In this experiment, we determined whether a compound enhancing the activity of eNOS, Impaza, could stimulate any aspect of sexual behavior and increase penis length in rats with a high baseline of sexual activity. For comparison, the PDE5 inhibitor sildenafil was included. Male rats were orally treated with Impaza or sildenafil for 28 days. Impaza (3 ml kg(-1)) was given daily while sildenafil (3 mg kg(-1)) was given twice weekly. Tests for sexual incentive motivation and copulatory behavior were performed just before drug treatment and at days 7, 14 and 28 of treatment. In addition, the length of the protruding penis at mount, intromission and ejaculation was measured. Impaza but not sildenafil increased penis length at mount after 14 and 28 days of treatment. The compounds failed to modify sexual incentive motivation or copulatory behavior. It is suggested that Impaza enhanced intracavernous pressure, as such a pressure increase is the most likely explanation for enhanced penis length at mount. This effect, together with an absence of motivational actions, suggests that Impaza may be the most valuable treatment for erectile dysfunction.

  19. Treatment preferences in Turkey for open fracture of the tibial diaphysis

    Directory of Open Access Journals (Sweden)

    Güzelali Özdemir

    2017-03-01

    Conclusion: A wide variation was observed among orthopedics and traumatology specialists in Turkey regarding treatment of open tibial diaphysis fracture in adults. Data obtained from this study together with the available literature may be useful to further develop therapeutic approaches.

  20. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    OpenAIRE

    Sanghani, Ruchi M.; Moler, Alexander K.

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling ...

  1. A randomized clinical trial of a standard versus vegetarian diet for weight loss: the impact of treatment preference.

    Science.gov (United States)

    Burke, L E; Warziski, M; Styn, M A; Music, E; Hudson, A G; Sereika, S M

    2008-01-01

    With obesity rampant, methods to achieve sustained weight loss remain elusive. To compare the long-term weight-loss efficacy of 2 cal and fat-restricted diets, standard (omnivorous) versus lacto-ovo-vegetarian, and to determine the effect of a chosen diet versus an assigned diet. A randomized clinical trial was conducted with 176 adults who were sedentary and overweight (mean body mass index, 34.0 kg/m(2)). Participants were first randomly assigned to either receive their preferred diet or be assigned to a diet group and second, were given their diet of preference or randomly assigned to a standard weight-loss diet or a lacto-ovo-vegetarian diet. Participants underwent a university-based weight-control program consisting of daily dietary and exercise goals plus 12 months of behavioral counseling followed by a 6-month maintenance phase. Percentage change in body weight, body mass index, waist circumference, low- and high-density lipoprotein, glucose, insulin and macronutrient intake. The program was completed by 132 (75%) of the participants. At 18 months, mean percentage weight loss was greater (P=0.01) in the two groups that were assigned a diet (standard, 8.0% (s.d., 7.8%); vegetarian, 7.9% (s.d., 8.1%)) than in those provided the diet of their choice (standard, 3.9% (s.d., 6.1%); vegetarian, 5.3% (s.d., 6.2%)). No difference was observed in weight loss between the two types of diet. Over the 18-month program, all groups showed significant weight loss. Participants assigned to their dietary preference did not have enhanced treatment outcomes. However, all groups lost weight with losses ranging from 4 to 8% at 18 months.

  2. Treatment preferences in juvenile idiopathic arthritis – a comparative analysis in two health care systems

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    Hugle Boris

    2013-01-01

    Full Text Available Abstract Background Variations in the treatment of juvenile idiopathic arthritis (JIA may impact on quality of care. The objective of this study was to identify and compare treatment approaches for JIA in two health care systems. Methods Paediatric rheumatologists in Canada (n=58 and Germany/Austria (n=172 were surveyed by email, using case-based vignettes for oligoarticular and seronegative polyarticular JIA. Data were analysed using descriptive statistics; responses were compared using univariate analysis. Results Total response rate was 63%. Physicians were comparable by age, level of training and duration of practice, with more Canadians based in academic centres. For initial treatment of oligoarthritis, only approximately half of physicians in both groups used intra-articular steroids. German physicians were more likely to institute DMARD treatment in oligoarthritis refractory to NSAID (p Conclusions Treatment of oligo- and polyarticular JIA with DMARD is mostly uniform, with availability and funding obviously influencing physician choice. Usage of intra-articular steroids is variable within physician groups. Physiotherapy has a fundamentally different role in the two health care systems.

  3. Pain Treatments for Nursing Home Residents with Advanced Dementia and Substantial Impaired Communication: A Cross-Sectional Analysis at Baseline of a Cluster Randomized Controlled Trial.

    Science.gov (United States)

    Liu, Justina Yat Wa; Leung, Doris Y P

    2016-09-28

    OBJECTIVES : This is a cross-sectional analysis at baseline of a cluster randomized controlled trial to identify factors associated with the use of pharmacological and nonpharmacological pain treatments by nursing home residents with dementia and impaired communication. METHODS : One hundred thirty-four residents with dementia and impaired communication were recruited. Nine of them were excluded because data on their pain treatments were missing, resulting in 125 for analysis. Hierarchical generalized estimating equations analyses controlling for the clustering effect of nursing homes were used to identify factors associated with the use of pharmacological and nonpharmacological pain treatments. RESULTS : Although all participants had a confirmed pain condition, only 23 (18.4%) and 45 (36%) had received pharmacological or nonpharmacological pain treatments, respectively. Participants with a higher ability to communicate (P = 0.031) and fewer pain locations were found to be more likely to receive pain medications, with the impact of communication ability being greater among participants with better cognitive status than among those with poor cognitive status. Participants who had been living in the home longer and who were more dependent were less likely to receive nonpharmacological treatments. CONCLUSION : Suboptimal pain management was common among this population. Severe impairment in the ability to communicate is a major reason for the underuse of pain medications. Staff may become desensitized and fail to perceive subtle changes in the residents' behavior as indicative of pain, leading to the underadministering of nonpharmacological treatments. To improve this situation, it is suggested that observational pain assessments be systematically carried out in nursing homes.

  4. How different terminology for ductal carcinoma in situ impacts women's concern and treatment preferences: a randomised comparison within a national community survey

    Science.gov (United States)

    McCaffery, Kirsten; Nickel, Brooke; Moynihan, Ray; Hersch, Jolyn; Teixeira-Pinto, Armando; Irwig, Les; Barratt, Alexandra

    2015-01-01

    Objective There have been calls to remove ‘carcinoma’ from terminology for in situ cancers such as ductal carcinoma in situ (DCIS), to reduce overdiagnosis and overtreatment. We investigated the effect of describing DCIS as ‘abnormal cells’ versus ‘pre-invasive breast cancer cells’ on women's concern and treatment preferences. Setting and participants Community sample of Australian women (n=269) who spoke English as their main language at home. Design Randomised comparison within a community survey. Women considered a hypothetical scenario involving a diagnosis of DCIS described as either ‘abnormal cells’ (arm A) or ‘pre-invasive breast cancer cells’ (arm B). Within each arm, the initial description was followed by the alternative term and outcomes reassessed. Results Women in both arms indicated high concern, but still indicated strong initial preferences for watchful waiting (64%). There were no differences in initial concern or preferences by trial arm. However, more women in arm A (‘abnormal cells’ first term) indicated they would feel more concerned if given the alternative term (‘pre-invasive breast cancer cells’) compared to women in arm B who received the terms in the opposite order (67% arm A vs 52% arm B would feel more concerned, p=0.001). More women in arm A also changed their preference towards treatment when the terminology was switched from ‘abnormal cells’ to ‘pre-invasive breast cancer cells’ compared to arm B. In arm A, 18% of women changed their preference to treatment while only 6% changed to watchful waiting (p=0.008). In contrast, there were no significant changes in treatment preference in arm B when the terminology was switched (9% vs 8% changed their stated preference). Conclusions In a hypothetical scenario, interest in watchful waiting for DCIS was high, and changing terminology impacted women's concern and treatment preferences. Removal of the cancer term from DCIS may assist in efforts towards

  5. Lack of Associations of CHRNA5-A3-B4 Genetic Variants with Smoking Cessation Treatment Outcomes in Caucasian Smokers despite Associations with Baseline Smoking.

    Directory of Open Access Journals (Sweden)

    Rachel F Tyndale

    Full Text Available CHRNA5-A3-B4 variants, rs16969968, rs588765 and rs578776, are consistently associated with tobacco consumption among smokers, but the association with smoking cessation is less consistent. Among the studies that reported significant associations with cessation, the effects were observed in smokers treated with placebo treatment in some studies and conversely in those receiving active pharmacological therapy (bupropion and nicotine replacement therapies in others. Thus, it remains unclear whether CHRNA5-A3-B4 is a useful marker for optimizing smoking cessation. Using data from 654 Caucasian smokers treated with placebo, nicotine patch or varenicline, we investigated whether CHRNA5-A3-B4 variants were associated with smoking cessation outcomes, and whether there were significant genotype-by-treatment or haplotype-by-treatment interactions. We observed no significant associations between CHRNA5-A3-B4 variants and smoking cessation, despite replicating previous associations with baseline tobacco consumption. At end of treatment the effect size on smoking cessation in the placebo, patch and varenicline groups for rs16969968 [GG vs. GA+AA] was OR = 0.66 (P = 0.23, OR = 1.01 (P = 0.99, and OR = 1.30 (P = 0.36 respectively, of rs588765 [CC vs. CT+TT] was OR = 0.96 (P = 0.90, OR = 0.84 (P = 0.58, and OR = 0.74 (P = 0.29 respectively, and for rs578776 [GG vs. GA+AA] on smoking cessation was OR = 1.02 (P = 0.95, OR = 0.75 (P = 0.35, and OR = 1.20 (P = 0.51 respectively. Furthermore, we observed no associations with cessation using the CHRNA5-A3-B4 haplotype (constructed using rs16969968 and rs588765, nor did we observe any significant genotype-by-treatment interactions, with or without adjusting for the rate of nicotine metabolism (all P>0.05. We also observed no significant genetic associations with 6 month or 12 month smoking abstinence. In conclusion, we found no association between CHRNA5-A3-B4 variants and smoking cessation rates in this clinical

  6. Lack of Associations of CHRNA5-A3-B4 Genetic Variants with Smoking Cessation Treatment Outcomes in Caucasian Smokers despite Associations with Baseline Smoking.

    Science.gov (United States)

    Tyndale, Rachel F; Zhu, Andy Z X; George, Tony P; Cinciripini, Paul; Hawk, Larry W; Schnoll, Robert A; Swan, Gary E; Benowitz, Neal L; Heitjan, Daniel F; Lerman, Caryn

    2015-01-01

    CHRNA5-A3-B4 variants, rs16969968, rs588765 and rs578776, are consistently associated with tobacco consumption among smokers, but the association with smoking cessation is less consistent. Among the studies that reported significant associations with cessation, the effects were observed in smokers treated with placebo treatment in some studies and conversely in those receiving active pharmacological therapy (bupropion and nicotine replacement therapies) in others. Thus, it remains unclear whether CHRNA5-A3-B4 is a useful marker for optimizing smoking cessation. Using data from 654 Caucasian smokers treated with placebo, nicotine patch or varenicline, we investigated whether CHRNA5-A3-B4 variants were associated with smoking cessation outcomes, and whether there were significant genotype-by-treatment or haplotype-by-treatment interactions. We observed no significant associations between CHRNA5-A3-B4 variants and smoking cessation, despite replicating previous associations with baseline tobacco consumption. At end of treatment the effect size on smoking cessation in the placebo, patch and varenicline groups for rs16969968 [GG vs. GA+AA] was OR = 0.66 (P = 0.23), OR = 1.01 (P = 0.99), and OR = 1.30 (P = 0.36) respectively, of rs588765 [CC vs. CT+TT] was OR = 0.96 (P = 0.90), OR = 0.84 (P = 0.58), and OR = 0.74 (P = 0.29) respectively, and for rs578776 [GG vs. GA+AA] on smoking cessation was OR = 1.02 (P = 0.95), OR = 0.75 (P = 0.35), and OR = 1.20 (P = 0.51) respectively. Furthermore, we observed no associations with cessation using the CHRNA5-A3-B4 haplotype (constructed using rs16969968 and rs588765), nor did we observe any significant genotype-by-treatment interactions, with or without adjusting for the rate of nicotine metabolism (all P>0.05). We also observed no significant genetic associations with 6 month or 12 month smoking abstinence. In conclusion, we found no association between CHRNA5-A3-B4 variants and smoking cessation rates in this clinical trial

  7. Patient's needs and preferences in routine follow-up after treatment for breast cancer

    NARCIS (Netherlands)

    de Bock, GH; Bonnema, J; Zwaan, RE; de Velde, CJH; Kievit, J; Stiggelbout, AM

    2004-01-01

    The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The

  8. The Natural History of Children with Severe Combined Immunodeficiency: Baseline Features of the First Fifty Patients of the Primary Immune Deficiency Treatment Consortium Prospective Study 6901

    Science.gov (United States)

    Dvorak, Christopher C.; Cowan, Morton J.; Logan, Brent R.; Notarangelo, Luigi D.; Griffith, Linda M.; Puck, Jennifer M.; Kohn, Donald B.; Shearer, William T.; O'Reilly, Richard J.; Fleisher, Thomas A.; Pai, Sung-Yun; Hanson, I. Celine; Pulsipher, Michael A.; Fuleihan, Ramsay; Filipovich, Alexandra; Goldman, Frederick; Kapoor, Neena; Small, Trudy; Smith, Angela; Chan, Ka-Wah; Cuvelier, Geoff; Heimall, Jennifer; Knutsen, Alan; Loechelt, Brett; Moore, Theodore; Buckley, Rebecca H.

    2013-01-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) consists of 33 centers in North America. We hypothesized that the analysis of uniform data on patients with severe combined immunodeficiency (SCID) enrolled in a prospective protocol will identify variables that contribute to optimal outcomes following treatment. We report baseline clinical, immunologic, and genetic features of the first 50 patients enrolled, and the initial therapies administered, reflecting current practice in the diagnosis and treatment of both typical (n = 37) and atypical forms (n = 13) of SCID. From August 2010 to May 2012, patients with suspected SCID underwent evaluation and therapy per local center practices. Diagnostic information was reviewed by the PIDTC eligibility review panel, and hematopoietic cell transplantation (HCT) details were obtained from the Center for International Blood and Marrow Transplant Research. Most patients (92%) had mutations in a known SCID gene. Half of the patients were diagnosed by newborn screening or family history, were younger than those diagnosed by clinical signs (median 15 vs. 181 days; P = <0.0001), and went to HCT at a median of 67 days vs. 214 days of life (P = <0.0001). Most patients (92%) were treated with HCT within 1–2 months of diagnosis. Three patients were treated with gene therapy and 1 with enzyme replacement. The PIDTC plans to enroll over 250 such patients and analyze short and long-term outcomes for factors beneficial or deleterious to survival, clinical outcome, and T- and B-cell reconstitution, and which biomarkers are predictive of these outcomes. PMID:23818196

  9. Consumers stated and revealed preferences for community health workers and other strategies for the provision of timely and appropriate treatment of malaria in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Shu Elvis

    2006-12-01

    Full Text Available Abstract Background The African Heads of State meeting in Abuja, Nigeria on Roll Back Malaria adopted effective treatment of malaria nearer the home as one of the strategies for malaria control in Africa. A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers (CHWs. There is paucity of information about people's actual preferences for CHWs and how stated preferences relates to revealed preferences for both the CHW strategy and other strategies for improving the timeliness of malaria treatment in not only Nigeria but in many malaria endemic countries. Objectives To determine peoples' stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers (CHW strategy in their community. Methods A prospective study was undertaken in a rural malaria holo-endemic Nigerian community. A questionnaire was used to collect information on health-seeking from householders before (first survey and after (second survey implementation of a CHW malaria treatement strategy. Results The consumers mostly preferred the CHW strategy over self-treatment in the homes and other strategies of treatment. The use of community health workers (CHWs increased from 0% to 26.1% (p Conclusion Community health workers can be used to improve and ensure timely and appropriate treatment of malaria. The CHW strategy could also be sustained since it was preferred and used by consumers over self-treatment in the homes as well as other strategies for improving treatment. Hence, the CHW strategy is a feasible and promising method of improving home-management of uncomplicated malaria.

  10. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC

    DEFF Research Database (Denmark)

    Jensen, Lars Henrik; Osterlind, Kell; Rytter, Carsten

    2008-01-01

    BACKGROUND: Most chemotherapeutics are administrated intravenously (iv), but some are also available in an oral (po) formulation. This study was designed with the primary objective to estimate the patients' preference for po or iv vinorelbine in combination with carboplatin for the palliative.......001). The response rate was 23% and median survival 11.4 months. Patients with preference for po treatment stated that side effects were less with capsules and that daily life was less affected by capsules. CONCLUSION: Three out of four patients preferred oral vinorelbine. Clinical outcomes were comparable to other...

  11. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.

    Science.gov (United States)

    Sanghani, Ruchi M; Moler, Alexander K

    2015-01-01

    Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

  12. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    Directory of Open Access Journals (Sweden)

    Ruchi M. Sanghani

    2015-01-01

    Full Text Available Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors’ scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

  13. Truth Telling and Treatment Strategies in End-of-Life Care in Physician-Led Accountable Care Organizations: Discrepancies Between Patients' Preferences and Physicians' Perceptions.

    Science.gov (United States)

    Huang, Hsien-Liang; Cheng, Shao-Yi; Yao, Chien-An; Hu, Wen-Yu; Chen, Ching-Yu; Chiu, Tai-Yuan

    2015-04-01

    Providing patient-centered care from preventive medicine to end-of-life care in order to improve care quality and reduce medical cost is important for accountable care. Physicians in the accountable care organizations (ACOs) are suitable for participating in supportive end-of-life care especially when facing issues in truth telling and treatment strategy. This study aimed to investigate patients' attitudes toward truth telling and treatment preferences in end-of-life care and compare patients' attitudes with their ACOs physicians' perceptions.This nationwide study applied snowball sampling to survey physicians in physician-led ACOs and their contracted patients by questionnaire from August 2010 to July 2011 in Taiwan. The main outcome measures were beliefs about palliative care, attitudes toward truth telling, and treatment preferences.The data of 314 patients (effective response rate = 88.7%) and 177 physicians (88.5%) were analyzed. Regarding truth telling about disease prognosis, 94.3% of patients preferred to be fully informed, whereas only 80% of their physicians had that perception (P truth telling even when encountering terminal disease status (98.1% vs 85.3%). Regarding treatment preferences in terminal illness, nearly 90% of patients preferred supportive care, but only 15.8% of physicians reported that their patients had this preference (P truth telling and treatment strategies in end-of-life care. It is important to enhance physician-patient communication about end-of-life care preferences in order to achieve the goal of ACOs. Continuing education on communication about end-of-life care during physicians' professional development would be helpful in the reform strategies of establishing accountable care around the world.

  14. Improvement of Quality of Life (QOL) in Osteoporotic Patients by Elcatonin Treatment: A Trial Taking the Participants' Preference into Account.

    Science.gov (United States)

    Yoh, K; Uzawa, T; Orito, T; Tanaka, K

    2012-01-01

    Osteoporosis is associated with compromised quality of life (QOL), to which pain has the most important contribution. Elcatonin, a derivative of calcitonin, is widely used in the treatment of osteoporosis in two ways. One is as the inhibitor of osteoclastic bone resorption. The other is for osteoporosis-related pain based on the unique analgesic effects of elcatonin. Since pain is subjective in nature, and QOL is the only clinical outcome representing the patients' subjective perception of health status, pain associated with osteoporosis would be best evaluated based on QOL assessment. Evidence based medicine gives the highest remarks to the double-blinded, randomized controlled trial, which, however, cannot be free from methodological problems on some occasions. For example, it is practically impossible to remain blinded in the trial of a potent analgesia, which in turn causes biases. Thus, the significance of taking the patients' preference into account is increasingly acknowledged. In this study, 45 osteoporotic patients were given brochures describing the pros and cons on the three treatment choices; calcium and alfacalcidol, additional use of elcatonin, and additional use of bisphosphonate. Those who favored elcatonin were older, had more vertebral fractures, and lower QOL scores. QOL was evaluated before and three months after the treatment using SF-8; the most widely used generic questionnaire, and RDQ; a lumbago-specific measure. Elcatonin treatment improved physical function, general health, and vitality of SF-8, and RDQ score. Although this is a preliminary study, our results suggest that patients with vertebral fracture(s) have impaired QOL and more likely to favor elcatonin treatment expecting analgesia.

  15. Treatment acceptability and preferences for managing severe health anxiety: Perceptions of internet-delivered cognitive behaviour therapy among primary care patients.

    Science.gov (United States)

    Soucy, Joelle N; Hadjistavropoulos, Heather D

    2017-12-01

    While cognitive behaviour therapy (CBT) is an established treatment for health anxiety, there are barriers to service access. Internet-delivered cognitive behaviour therapy (ICBT) has demonstrated effectiveness and has the potential to improve access to treatment. Nevertheless, it is unknown how patients perceive ICBT relative to other interventions for health anxiety and what factors predict ICBT acceptability. This study investigated these questions. Primary care patients (N = 116) who reported elevated levels of health anxiety were presented three treatment vignettes that each described a different protocol for health anxiety (i.e., medication, CBT, ICBT). Acceptability and credibility of the treatments were assessed following the presentation of each vignette. Participants then ranked the three treatments and provided a rational for their preferences. The treatments were similarly rated as moderately acceptable. Relative to medication and ICBT, CBT was perceived as the most credible treatment for health anxiety. The highest preference ranks were for CBT and medication. Regression analyses indicated that lower computer anxiety, past medication use, and lower ratings of negative cognitions about difficulty coping with an illness significantly predicted greater ICBT acceptability. Health anxiety was not assessed with a diagnostic interview. Primary care patients were recruited through a Qualtrics panel. Patients did not have direct experience with treatment but learned about treatment options through vignettes. Medication and CBT are preferred over ICBT. If ICBT is to increase treatment access, methods of improving perceptions of this treatment option are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Contrasting responses to interferon β-1b treatment in relapsing-remitting multiple sclerosis: Does baseline interleukin- 12p35 messenger RNA predict the efficacy of treatment?

    NARCIS (Netherlands)

    Boxel van-Dezaire, A.H.H.; Trigt van-Hoff, S.C.J.; Killestein, J.; Schrijver, H.M.; Houwelingen, J.C. van; Polman, C.H.; Nagelkerken, L.

    2000-01-01

    Interferon (IFN)-β treatment is effective in relapsing-remitting multiple sclerosis (RR-MS) via an as yet unidentified mechanism. In the present study, we investigated whether the expression of messenger RNA (mRNA) encoding the interleukin (IL)-12 subunits p40 and p35, IL-12 receptor chains, IL-18,

  17. Preferences and flexibility in decision-making among dental clinicians regarding the treatment of multirooted teeth: an interactive communication device-based survey at two academic conferences

    Science.gov (United States)

    2016-01-01

    Purpose Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences. Methods Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies. Results In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants. Conclusions Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields. PMID:27382505

  18. Assessing preferences for wastewater treatment in a rural area using choice experiments

    Science.gov (United States)

    Genius, Margarita; Menegaki, Angeliki N.; Tsagarakis, Konstantinos P.

    2012-04-01

    In areas that are still not serviced by a wastewater treatment plant (WWTP), economic valuation of the benefits derived from its construction should focus not only on those attributes that are linked to the services provided by the plant, such as cleaner environment and the possibility of reuse, but also on those attributes that are linked to its existence such as possible landscape and odor effects. This paper presents a choice modeling (CM) application that elicits the value of the attributes of a WWTP, where the latter are given by odor and landscape effects, jobs created, water quality, irrigation applications of the produced recycled water, and the additional charging. The results show that for rural populations such as farmers' communities, the potential increase of irrigated agricultural land is the main driver of willingness to pay while concerns over possible odor effects are also important. In addition, ignoring possible correlations across subsets of alternatives and variance heterogeneity would lead to substantial overestimation of willingness to pay.

  19. Impulsivity and voucher versus money preference in polydrug-dependent participants enrolled in a contingency-management-based substance abuse treatment program.

    Science.gov (United States)

    Reilly, M P; Roll, J M; Downey, K K

    2000-10-01

    Thirty-four polydrug-dependent participants enrolled in a voucher-based substance abuse treatment program were given choices between hypothetical amounts of money and hypothetical amounts of vouchers, which are traded for goods and services, to determine their preferences for the two payment modalities. It was hypothesized that the majority of participants would prefer money to voucher because under the circumstances of the treatment program, the delay associated with money exchange is shorter than the delay associated with voucher exchange. It was further hypothesized that those participants who selected money over voucher also would have greater levels of impulsivity as assessed by the Barratt Impulsiveness Rating Scale (BIS) (Barratt, 1965). The results show large individual differences in money/voucher preference with approximately half of the participants preferring money to voucher when the two amounts are equivalent. In addition, as the magnitude of the money/voucher comparisons increased from 0.50 dollars to 32.00 dollars, the percentage of participants that preferred money increased. No correlations were found between money/voucher preference and impulsivity scores.

  20. The natural history of children with severe combined immunodeficiency: baseline features of the first fifty patients of the primary immune deficiency treatment consortium prospective study 6901.

    Science.gov (United States)

    Dvorak, Christopher C; Cowan, Morton J; Logan, Brent R; Notarangelo, Luigi D; Griffith, Linda M; Puck, Jennifer M; Kohn, Donald B; Shearer, William T; O'Reilly, Richard J; Fleisher, Thomas A; Pai, Sung-Yun; Hanson, I Celine; Pulsipher, Michael A; Fuleihan, Ramsay; Filipovich, Alexandra; Goldman, Frederick; Kapoor, Neena; Small, Trudy; Smith, Angela; Chan, Ka-Wah; Cuvelier, Geoff; Heimall, Jennifer; Knutsen, Alan; Loechelt, Brett; Moore, Theodore; Buckley, Rebecca H

    2013-10-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) consists of 33 centers in North America. We hypothesized that the analysis of uniform data on patients with severe combined immunodeficiency (SCID) enrolled in a prospective protocol will identify variables that contribute to optimal outcomes following treatment. We report baseline clinical, immunologic, and genetic features of the first 50 patients enrolled, and the initial therapies administered, reflecting current practice in the diagnosis and treatment of both typical (n = 37) and atypical forms (n = 13) of SCID. From August 2010 to May 2012, patients with suspected SCID underwent evaluation and therapy per local center practices. Diagnostic information was reviewed by the PIDTC eligibility review panel, and hematopoietic cell transplantation (HCT) details were obtained from the Center for International Blood and Marrow Transplant Research. Most patients (92 %) had mutations in a known SCID gene. Half of the patients were diagnosed by newborn screening or family history, were younger than those diagnosed by clinical signs (median 15 vs. 181 days; P = <0.0001), and went to HCT at a median of 67 days vs. 214 days of life (P = <0.0001). Most patients (92 %) were treated with HCT within 1-2 months of diagnosis. Three patients were treated with gene therapy and 1 with enzyme replacement. The PIDTC plans to enroll over 250 such patients and analyze short and long-term outcomes for factors beneficial or deleterious to survival, clinical outcome, and T- and B-cell reconstitution, and which biomarkers are predictive of these outcomes.

  1. Patients’ and physicians’ preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment

    Science.gov (United States)

    Morillas, Carlos; Feliciano, Rosa; Catalina, Pablo Fernández; Ponte, Carla; Botella, Marta; Rodrigues, João; Esmatjes, Enric; Lafita, Javier; Lizán, Luis; Llorente, Ignacio; Morales, Cristóbal; Navarro-Pérez, Jorge; Orozco-Beltran, Domingo; Paz, Silvia; Ramirez de Arellano, Antonio; Cardoso, Cristina; Tribaldos Causadias, Maribel

    2015-01-01

    Objective To assess Spanish and Portuguese patients’ and physicians’ preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects. Methods An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model. Results Three-hundred and thirty (n=330) patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body mass index 32.5 [6.8] kg/m2, 41.8% received oral + injected medication, 40.3% received oral, and 17.6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41.9 [SD: 10.5] years, 33.5% endocrinologists, 66.5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68.14 [95% confidence interval: 54.55–85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29–82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287.18 [95% confidence interval: 160.31–1,387.21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166.87 [88.63–843.09] and €154.30 [98.13–434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30–622.75) and €24.28 (18.41–30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39–543.62) and €42.74 (23.89–61.77) to avoid nausea. Conclusion Both patients and physicians in Spain and Portugal are willing to pay for the health benefits

  2. Technology Use and Preferences for Mobile Phone-Based HIV Prevention and Treatment Among Black Young Men Who Have Sex With Men: Exploratory Research.

    Science.gov (United States)

    Holloway, Ian W; Winder, Terrell Ja; Lea, Charles Herbert; Tan, Diane; Boyd, Donte; Novak, David

    2017-04-13

    Black young men who have sex with men (BYMSM) experience higher human immunodeficiency virus (HIV) incidence than their white and Latino counterparts. The aim of our study was to understand BYMSM's preferences for mobile phone-based HIV prevention and treatment in order to inform culturally tailored interventions to reduce the spread of HIV and improve HIV treatment outcomes in this population. Qualitative focus groups (N=6) with BYMSM aged 18-29 years (N=41; 46%, 19/41 HIV-positive) were conducted to elucidate their preferences for the design and delivery of mobile phone-based HIV prevention and treatment interventions. A modified grounded theory approach to data analysis was undertaken using ATLAS.ti textual analysis software. Participants preferred holistic health interventions that did not focus exclusively on HIV prevention and treatment. Issues of privacy and confidentiality were paramount. Participants preferred functionality that enables discreet connections to culturally competent health educators and treatment providers who can address the range of health and psychosocial concerns faced by BYMSM. Mobile phone-based HIV prevention has the potential to increase engagement with HIV prevention and treatment resources among BYMSM. For these approaches to be successful, researchers must include BYMSM in the design and creation of these interventions.

  3. Utility of baseline, interim and end-of-treatment 18F-FDG PET/CT in extranodal natural killer/T-cell lymphoma patients treated with L-asparaginase/pegaspargase

    Science.gov (United States)

    Chang, Yu; Fu, Xiaorui; Sun, Zhenchang; Xie, Xinli; Wang, Ruihua; Li, Zhaoming; Zhang, Xudong; Sheng, Guangyao; Zhang, Mingzhi

    2017-01-01

    Positron emission tomography-computed tomography (PET/CT) is widely used for initial staging and monitoring treatment responses in Hodgkin and diffuse large B-cell lymphoma. However, its prognostic value in extranodal natural killer (NK)/T-cell lymphoma (ENKL) remains unclear. Here, we conducted a retrospective study to determine the impact of PET/CT in ENKL. Fifty-two patients newly diagnosed with ENKL were enrolled. Baseline maximum standardized uptake values (SUVmax), whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) were recorded. Additionally, interim PET/CT (I-PET) and end-of-treatment PET/CT (E-PET) results were scored using a 5-point scale. Patients were divided into groups using baseline parameter cut-off values; significant differences were found in overall survival (OS) and progression-free survival (PFS) between the high and low WBMTV and WBTLG groups and in OS between the two SUVmax groups. Positive I-PET and E-PET results predicted inferior PFS and OS. A multivariate analysis showed that baseline WBTLG, I-PET and E-PET results were associated with PFS and OS, and baseline SUVmax was an independent predictor of OS. Thus, baseline WBTLG, I-PET and E-PET results are good predictors of PFS and OS in ENKL patients who received L-asparaginase/pegaspargase in their first-line treatment, and baseline SUVmax is a valuable tool for assessing OS. PMID:28117395

  4. Independent preferences

    DEFF Research Database (Denmark)

    Vind, Karl

    1991-01-01

    A simple mathematical result characterizing a subset of a product set is proved and used to obtain additive representations of preferences. The additivity consequences of independence assumptions are obtained for preferences which are not total or transitive. This means that most of the economic...... theory based on additive preferences - expected utility, discounted utility - has been generalized to preferences which are not total or transitive. Other economic applications of the theorem are given...

  5. Impact of medical treatment on lung diffusion capacity in elderly patients with heart failure. Baseline characteristics and 1-year follow up after medical treatment

    DEFF Research Database (Denmark)

    Petersen, Claus Leth; Kjaer, Andreas

    2005-01-01

    AIM: The aim of this investigation was (1) to study the effect of untreated chronic heart failure (CHF) on alveolar membrane diffusion capacity (transfer coefficient, K(CO)) in elderly patients and (2) to study the impact of the standard regime of medical treatment with diuretics and ACE......-inhibitor/angiotensin-II receptor antagonists on K(CO) in these patients. METHODS: Non-medicated patients (except for diuretics) with symptoms of heart failure (NYHA II-III) and echocardiographically estimated left ventricular ejection fraction (LVEF) ... of multiple ECG-gated radionuclide ventriculography (MUGA). LVEFheart failure (HF). A total of 20 patients fulfilled the criteria. All patients had a lung function test including measurement of K(CO) and a MUGA for LVEF measurement performed prior to medical...

  6. Assessment of Malawian mothers' malaria knowledge, healthcare preferences and timeliness of seeking fever treatments for children under five.

    Science.gov (United States)

    Oyekale, Abayomi Samuel

    2015-01-09

    Malaria is one of the major public health problems in Malawi, contributing to the majority of morbidity and mortality among children under five. Ignorance of malaria symptoms results in delayed treatment, which often degenerates into fatal emergencies. This study analyzed the impact of maternal malaria knowledge on healthcare preferences and timeliness of treating children with reported fever. The Malaria Indicator Survey data for 2012, which were adequately weighted, were analyzed using multinomial logit and Poisson regression models. The results showed low maternal average years of formal education (3.52) and average mothers' age was 27.97 years. Majority of the women (84.98%) associated fever with malaria, while 44.17% associated it with chilling. Also, 54.42% and 32.43% of the children were treated for fever on the same day and the following day that fever started, respectively. About 9.70% paid for fever treatment from their regular incomes, while 51.38% sought treatment from either public or private health centers. Multinomial Logit regression results showed that relative to using of other treatments, probabilities of selecting private hospitals and public health centers increased with age of the household heads, resident in urban areas, mothers' years of education, number of days taken off for treatment, paying medical bills from regular, occasional and borrowed incomes, and knowledge of diarrhea and shivering as symptoms of malaria. In the Poisson regression results, timeliness of seeking treatment was significantly enhanced by knowledge of fever as malaria symptom, residence in northern and central regions of Malawi and use of income from sale of assets to pay medical bills (p children was motivated by age of the household heads, number of days taken off to care for sick child and usage of regular, borrowed and other incomes to pay medical bills. (p < 0.05). It was concluded that efficiency of public sector in treating malaria holds significant prospects

  7. School Psychologists and the Secret Illness: Perceived Knowledge, Role Preferences, and Training Needs regarding the Prevention and Treatment of Internalizing Disorders

    Science.gov (United States)

    Miller, David N.; Jome, LaRae M.

    2010-01-01

    This descriptive study examined the perceptions of a national sample of school psychologists in the United States regarding their perceived knowledge, preferred roles, and training needs in the prevention and treatment of nine prominent child and adolescent internalizing disorders. The results indicated that participants perceived the prevention…

  8. Abriendo Puertas: baseline findings from an integrated intervention to promote prevention, treatment and care among FSW living with HIV in the Dominican Republic.

    Directory of Open Access Journals (Sweden)

    Yeycy Donastorg

    Full Text Available Female sex workers (FSW are often the focus of primary HIV prevention efforts. However, little attention has been paid to the prevention, treatment, and care needs of FSW living with HIV. Based on formative research, we developed an integrated model to promote prevention and care for FSW living with HIV in Santo Domingo, Dominican Republic, including (1 individual counseling and education; (2 peer navigation; (3 clinical provider training; and (4 community mobilization. We enrolled 268 FSW living with HIV into the intervention and conducted socio-behavioral surveys, sexually transmitted infection (STI testing, and viral load (VL assessments. We used multivariate logistic regression to identify behavioral and socio-demographic factors associated with detectable VL (>50 copies/mL and STI prevalence. Over half of all participants (51.9% had a detectable VL, even though most received HIV-related care in the last 6 months (85.1% and were currently on anti-retroviral treatment (ART (72.4%. Factors positively associated with a detectable VL included being 18-35 years of age (Adjusted Odds Ratio [AOR] 2.46, 95% CI 1.31-4.60, having ever used drugs (AOR 2.34, 95% CI 1.14-4.79, and having ever interrupted ART (AOR 3.09, 95% CI 1.44-6.59. Factors protective against having a detectable VL included being single (AOR 0.45, 95% 0.20-0.98 and being currently on ART (AOR 0.17, 95% CI 0.07-0.41. Nearly one-quarter (23.1% had an STI, which was associated with being single (AOR 3.21, 95% CI 1.27-8.11 and using drugs in the last 6 months (AOR 3.54, 95% CI 1.32-9.45. Being on ART was protective against STI (AOR 0.51, 95% CI 0.26-1.00. Baseline findings indicate significant barriers to VL suppression and STI prevention among FSW living with HIV and highlight gaps in the continuum of HIV care and treatment. These findings have important implications for both the individual health of FSW and population-level HIV transmission dynamics.

  9. Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in an homogenous patient population

    Energy Technology Data Exchange (ETDEWEB)

    Dinapoli, Nicola [Catholic Univ. of the Sacred Heart, Rome (Italy). Dept. of Radiation Oncology; Parrilla, Claudio; Galli, Jacopo [Catholic Univ. of the Sacred Heart, Rome (IT). Dept. of Otorhinolaryngoiatry] (and others)

    2010-11-15

    To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma. Patients, affected by laryngeal glottic carcinoma, treated by laser CO{sub 2} surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software. A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001). This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined. (orig.)

  10. Baseline Blood Pressure Effect on the Benefit and Safety of Intra-Arterial Treatment in MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands).

    Science.gov (United States)

    Mulder, Maxim J H L; Ergezen, Saliha; Lingsma, Hester F; Berkhemer, Olvert A; Fransen, Puck S S; Beumer, Debbie; van den Berg, Lucie A; Lycklama À Nijeholt, Geert; Emmer, Bart J; van der Worp, H Bart; Nederkoorn, Paul J; Roos, Yvo B W E M; van Oostenbrugge, Robert J; van Zwam, Wim H; Majoie, Charles B L M; van der Lugt, Aad; Dippel, Diederik W J

    2017-07-01

    High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands). BP was measured at baseline, before IAT or stroke unit admission. We estimated the association of baseline BP with the score on the modified Rankin Scale at 90 days and safety parameters with ordinal and logistic regression analysis. Effect of BP on the effect of IAT was tested with multiplicative interaction terms. Systolic BP (SBP) had the best correlation with functional outcome. This correlation was U-shaped; both low and high baseline SBP were associated with poor functional outcome. Higher SBP was associated with symptomatic intracranial hemorrhage (adjusted odds ratio, 1.25 for every 10 mm Hg higher SBP [95% confidence interval, 1.09-1.44]). Between SBP and IAT, there was no interaction for functional outcome, symptomatic intracranial hemorrhage, or other safety parameters; the absolute benefit of IAT was evident for the whole SBP range. The same was found for diastolic BP. BP does not affect the benefit or safety of IAT in patients with acute ischemic stroke caused by proximal intracranial vessel occlusion. Our data provide no arguments to withhold or delay IAT based on BP. URL: http://www.isrctn.com. Unique identifier: ISRCTN10888758. © 2017 American Heart Association, Inc.

  11. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC

    DEFF Research Database (Denmark)

    Jensen, Lisa Helene Toft; Østerlind, Kell Erik; Rytter, C.

    2008-01-01

    BACKGROUND: Most chemotherapeutics are administrated intravenously (iv), but some are also available in an oral (po) formulation. This study was designed with the primary objective to estimate the patients' preference for po or iv vinorelbine in combination with carboplatin for the palliative...... treatment of non-small cell lung cancer (NSCLC). Secondary aims were to evaluate toxicity, efficacy, and subjective reasons the preference. PATIENTS AND METHODS: Sixty-one patients were randomized in a cross-over trial to two cycles of carboplatin day 1 and vinorelbine day 1 and day 8 iv followed by two...

  12. Combined treatment with formoterol and tiotropium is more efficacious than treatment with tiotropium alone in patients with chronic obstructive pulmonary disease, regardless of smoking status, inhaled corticosteroid use, baseline severity, or gender.

    Science.gov (United States)

    Tashkin, Donald P; Varghese, Santosh T

    2011-02-01

    A recent randomized, double-blind, parallel-group, active-controlled, multicenter study of 255 patients ≥ 40 years of age with chronic obstructive pulmonary disease (COPD) showed that combined formoterol (FOR) and tiotropium (TIO) treatment in patients with COPD significantly improved lung function as well as symptoms and other patient-reported outcomes compared with TIO alone. FOR and TIO are long-acting bronchodilators that represent the β₂-adrenergic agonist and anticholinergic classes, respectively. However, the possible influence of smoking status, inhaled corticosteroid (ICS) use, baseline disease severity, and gender differences on bronchodilator efficacy requires further investigation. Using data from the previously published study mentioned above, a post hoc analysis was performed to examine the efficacy of combined FOR + TIO treatment compared with TIO monotherapy in subgroup analyses of men and women, current and ex-smokers, ICS users and non-ICS users, and patients with moderate and severe/very severe COPD. Efficacy comparisons were based on the changes in forced expiratory volume in 1 s measured 0-4 h after the morning dose (FEV₁ AUC₀₋₄h). After a run-in period, patients were treated for 12 weeks with either FOR 12 μg twice daily (BID) plus TIO 18 μg once daily (QD) in the morning (AM, n = 124) or with FOR placebo BID plus TIO 18 μg QD AM (n = 131). The least squares mean change from baseline in the normalized FEV₁ AUC₀₋₄h was assessed using analysis of covariance. With the exception of treatment differences at week 4 in smokers and subjects with "very severe" COPD, and at weeks 4, 8, and 12 for ICS users and non-ICS users (p values not determined), FOR + TIO was significantly superior (P ICS use, or COPD severity. We conclude that coadministered FOR + TIO significantly improves lung function compared with TIO treatment alone in COPD patients regardless of differences in patient subgroups.

  13. Auditor Preference

    OpenAIRE

    2012-01-01

    We analyze theoretically and empirically the effect of preference policies, which favor some auditors over others for reasons unrelated to the audit. For example, an auditee may prefer minority-owned auditors, all else equal. We construct an analytical model of the competitive bidding process for audit services. We show that preference policies can sometimes improve the audit procurement process by encouraging price concessions from non-preferenced auditors. We test model predictions in a set...

  14. Patient preference with respect to QoL and reduction in opioid-induced constipation (OIC) after treatment with prolonged-release (PR) oxycodone/naloxone compared with previous analgesic therapy [PREFER study].

    Science.gov (United States)

    van Dongen, V C P C; Vanelderen, P J L; Koopmans-Klein, G; van Megen, Y J B; Van Zundert, J; Huygen, F J P M

    2014-11-01

    The aim of this study was to assess patient preference in terms of quality of life (QoL), analgesia and bowel function for patients with moderate to severe chronic non-malignant pain, when treated with oxycodone PR/naloxone PR compared with the previous WHO-step I and/or WHO-step II analgesic treatment . This was a 3-week open-label phase 3b study conducted in Belgium and the Netherlands, after 3 weeks patients could enter an extension phase. Patient preference with respect to QoL for oxycodone PR/naloxone PR treatment compared with previous WHO-step I and/or WHO-step II analgesics was assessed. A patient was considered a responder with respect to QoL if this assessment was 'better' or 'much better' compared with previous WHO-step I or II analgesics at any time point. Response rate with respect to QoL was 59.2% (95% CI: 51.7-66.8%) for the Full Analysis (FA)-population, for the Per Protocol-population response rate was 71.7% (95% CI: 63.1-80.3%). Explorative analysis showed that response rate with respect to QoL was highest in constipated patients pretreated with WHO-step II analgesics (73.8%). Mean ± SD pain score in the FA-population at start was 74.7 ± 16.6 decreasing to 53.9 ± 24.3 after a median (range) treatment period of 173.5 (31-771) days. For constipated subjects the significant reduction in constipation [improvement of the Bowel Function Index (BFI)], was -24.8 points (95% CI: -17.1 to -32.5). BFI for non-constipated subjects remained well below 28.8. Adverse events with oxycodone PR/naloxone PR treatment were well-known opioid-related adverse events. This study shows that the studied patients previously treated with WHO-step I and/or WHO-step II analgesics prefer treatment with oxycodone PR/naloxone PR with respect to QoL. Moreover, the study shows that treatment with oxycodone PR/naloxone PR significantly reduces OIC in constipated patients and that non-constipated patients do not develop OIC during treatment with oxycodone PR/naloxone PR.

  15. What do the patients with medication overuse headache expect from treatment and what are the preferred sources of information?

    DEFF Research Database (Denmark)

    Munksgaard, S B; Allena, M; Tassorelli, C

    2011-01-01

    % selected personal verbal information as their primary need, significantly higher than the percentage of patients who selected leaflets and website information 35 and 35%, respectively (p source preferred...... was again personal verbal information (82%), significantly higher than all other information sources (p ... in specialized headache centres prefer personal information, that expectations are very high, and that education and information are important. Providing the right information and thus give patients realistic expectations might enhance compliance and improve outcome....

  16. Patients’ and physicians’ preferences for type 2 diabetes mellitus treatments in Spain and Portugal: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Morillas C

    2015-10-01

    Full Text Available Carlos Morillas,1 Rosa Feliciano,2 Pablo Fernández Catalina,3 Carla Ponte,4 Marta Botella,5 João Rodrigues,6 Enric Esmatjes,7 Javier Lafita,8 Luis Lizán,9 Ignacio Llorente,10 Cristóbal Morales,11 Jorge Navarro-Pérez,12 Domingo Orozco-Beltran,13 Silvia Paz,9 Antonio Ramirez de Arellano,14 Cristina Cardoso,15 Maribel Tribaldos Causadias9 1Hospital Universitario Dr Peset, Valencia, Spain; 2USF São Domingos, Santarém, Portugal; 3Hospital Montecelo de Pontevedra, Galicia, Spain; 4USF Porta do Sol, Matosinhos, Portugal; 5Hospital Universitario Principe de Asturias, Madrid, Spain; 6USF Serra da Lousã, Lousã, Portugal; 7Hospital Clinic, Barcelona, Spain; 8Hospital de Navarra, Navarra, Spain; 9Outcomes’10, Universidad Jaume I, Castellón, Spain; 10Hospital Universitario Nuestra Señora de la Candelaria, Canarias, Spain; 11Hospital Universitario Virgen de la Macarena, Sevilla, Spain; 12INCLIVA, CIBERESP, Universidad de Valencia, Valencia, Spain; 13Sociedad Española de Medicina Familiar y Comunitaria, Valencia, Spain; 14Novo Nordisk EU-HEOR Europe, Madrid, Spain; 15Novo Nordisk, Lisbon, Portugal Objective: To assess Spanish and Portuguese patients’ and physicians’ preferences regarding type 2 diabetes mellitus (T2DM treatments and the monthly willingness to pay (WTP to gain benefits or avoid side effects.Methods: An observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model.Results: Three-hundred and thirty (n=330 patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body

  17. Characterization of chemically induced ovarian carcinomas in an ethanol-preferring rat model: influence of long-term melatonin treatment.

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo A Chuffa

    Full Text Available Ovarian cancer is the fourth most common cause of cancer deaths among women, and chronic alcoholism may exert co-carcinogenic effects. Because melatonin (mel has oncostatic properties, we aimed to investigate and characterize the chemical induction of ovarian tumors in a model of ethanol-preferring rats and to verify the influence of mel treatment on the overall features of these tumors. After rats were selected to receive ethanol (EtOH, they were surgically injected with 100 µg of 7,12-dimethyl-benz[a]anthracene (DMBA plus sesame oil directly under the left ovarian bursa. At 260 days old, half of the animals received i.p. injections of 200 µg mel/100 g b.w. for 60 days. Four experimental groups were established: Group C, rats bearing ovarian carcinomas (OC; Group C+EtOH, rats voluntarily consuming 10% (v/v EtOH and bearing OC; Group C+M, rats bearing OC and receiving mel; and Group C+EtOH+M, rats with OC consuming EtOH and receiving mel. Estrous cycle and nutritional parameters were evaluated, and anatomopathological analyses of the ovarian tumors were conducted. The incidence of ovarian tumors was higher in EtOH drinking animals 120 days post-DMBA administration, and mel efficiently reduced the prevalence of some aggressive tumors. Although mel promoted high EtOH consumption, it was effective in synchronizing the estrous cycle and reducing ovarian tumor mass by 20%. While rats in the C group displayed cysts containing serous fluid, C+EtOH rats showed solid tumor masses. After mel treatment, the ovaries of these rats presented as soft and mobile tissues. EtOH consumption increased the incidence of serous papillary carcinomas and sarcomas but not clear cell carcinomas. In contrast, mel reduced the incidence of sarcomas, endometrioid carcinomas and cystic teratomas. Combination of DMBA with EtOH intake potentiated the incidence of OC with malignant histologic subtypes. We concluded that mel reduces ovarian masses and the incidence of

  18. Characterization of Chemically Induced Ovarian Carcinomas in an Ethanol-Preferring Rat Model: Influence of Long-Term Melatonin Treatment

    Science.gov (United States)

    Chuffa, Luiz Gustavo A.; Fioruci-Fontanelli, Beatriz A.; Mendes, Leonardo O.; Fávaro, Wagner J.; Pinheiro, Patricia Fernanda F.; Martinez, Marcelo; Martinez, Francisco Eduardo

    2013-01-01

    Ovarian cancer is the fourth most common cause of cancer deaths among women, and chronic alcoholism may exert co-carcinogenic effects. Because melatonin (mel) has oncostatic properties, we aimed to investigate and characterize the chemical induction of ovarian tumors in a model of ethanol-preferring rats and to verify the influence of mel treatment on the overall features of these tumors. After rats were selected to receive ethanol (EtOH), they were surgically injected with 100 µg of 7,12-dimethyl-benz[a]anthracene (DMBA) plus sesame oil directly under the left ovarian bursa. At 260 days old, half of the animals received i.p. injections of 200 µg mel/100 g b.w. for 60 days. Four experimental groups were established: Group C, rats bearing ovarian carcinomas (OC); Group C+EtOH, rats voluntarily consuming 10% (v/v) EtOH and bearing OC; Group C+M, rats bearing OC and receiving mel; and Group C+EtOH+M, rats with OC consuming EtOH and receiving mel. Estrous cycle and nutritional parameters were evaluated, and anatomopathological analyses of the ovarian tumors were conducted. The incidence of ovarian tumors was higher in EtOH drinking animals 120 days post-DMBA administration, and mel efficiently reduced the prevalence of some aggressive tumors. Although mel promoted high EtOH consumption, it was effective in synchronizing the estrous cycle and reducing ovarian tumor mass by 20%. While rats in the C group displayed cysts containing serous fluid, C+EtOH rats showed solid tumor masses. After mel treatment, the ovaries of these rats presented as soft and mobile tissues. EtOH consumption increased the incidence of serous papillary carcinomas and sarcomas but not clear cell carcinomas. In contrast, mel reduced the incidence of sarcomas, endometrioid carcinomas and cystic teratomas. Combination of DMBA with EtOH intake potentiated the incidence of OC with malignant histologic subtypes. We concluded that mel reduces ovarian masses and the incidence of adenocarcinomas in

  19. Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment.

    Science.gov (United States)

    Warszawski, Leila; Kasuki, Leandro; Sá, Rodrigo; Dos Santos Silva, Cintia Marques; Volschan, Isabela; Gottlieb, Ilan; Pedrosa, Roberto Coury; Gadelha, Mônica R

    2016-12-01

    The incidence of arrhythmias may be increased in acromegaly, but the pathophysiologic mechanisms involved are still unclear, and it has never been correlated with structural heart changes analyzed by the gold-standard method cardiac magnetic resonance (CMR). Evaluate the frequency of arrhythmias in drug-naïve acromegaly patients at baseline and after 1 year of somatostatin analogs (SA) treatment and to correlate the occurrence of arrhythmias with the presence of structural heart changes. Consecutive drug-naïve acromegaly patients were recruited. The occurrence of arrhythmias and structural heart changes were studied through 24-h Holter and CMR, respectively, at baseline and after 1-year SA treatment. Thirty-six patients were studied at baseline and 28 were re-evaluated after 1 year of SA treatment. There were 13 females and median age was 48 years (20-73 years). Nine patients (32 %) were controlled after treatment. No sustained arrhythmias were reported in the 24-h Holter. No arrhythmia-related symptoms were observed. Only two patients presented left ventricular hypertrophy and three patients presented fibrosis at baseline. There was no correlation of the left ventricular mass with the number of episodes of arrhythmias and they were not more prevalent in the patients presenting cardiac fibrosis. We found no sustained arrhythmias and a lack of arrhythmia-related symptoms at baseline and after 1 year of SA treatment in a contemporary cohort of acromegaly patients that also present a low frequency of structural heart changes, indicating that these patients may have a lower frequency of heart disease than previously reported.

  20. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial.

    Science.gov (United States)

    Burke, Lora E; Hudson, Alana G; Warziski, Melanie T; Styn, Mindi A; Music, Edvin; Elci, Okan U; Sereika, Susan M

    2007-09-01

    A vegetarian diet may lead to numerous health benefits, including weight loss. We examined the joint effects of personal preference of dietary treatment and a calorie-restricted, low-fat lactoovovegetarian diet (LOV-D) compared with a standard calorie-restricted, low-fat omnivorous diet (STD-D) on changes in weight, total cholesterol, ratio of LDL to HDL cholesterol (LDL:HDL cholesterol), triacylglycerols, insulin resistance, and macronutrient intake during an 18-mo study. This was a randomized clinical trial of 176 overweight and obese adults who were recruited and randomly assigned first to 1 of 2 preference conditions (yes or no). If assigned to Preference-No, they were randomly assigned to 1 of the 2 diet conditions (STD-D or LOV-D). If assigned to Preference-Yes, they were assigned to the diet they indicated as preferred at screening. The 12-mo intervention was followed by a 6-mo maintenance phase. Participants were mainly women (86.9%) and white (70.5%); 75% completed the 18-mo study. A significant interaction between preference and dietary treatment was not observed for any of the outcome variables. However, participants in the Preference-No groups significantly decreased their triacylglycerols (P = 0.04). The only effect observed for diet was a borderline significant decrease in LDL:HDL cholesterol for the LOV-D group (P = 0.06). Within the LOV-D groups, those who were 100% adherent to the LOV-D had significant and marginally significant reductions in monounsaturated fat (P = 0.02) and total fat (P = 0.05) intakes at 18 mo. Our findings suggest that neither prescribing a vegetarian diet nor allowing persons to choose their preferred diet had a significant effect on outcome measures. However, all participants had a significant reduction in total energy and fat intakes and an increase in energy expenditure, which was reflected in reduced body weight. This clinical trial was registered at www.clinicaltrials.gov as NCT00330629.

  1. [Orthodontics in general practice 3. Angle Class II/1 malocclusion: one-phase treatment treatment preferred to two-phase treatment

    NARCIS (Netherlands)

    Kuijpers, M.A.; Kuijpers-Jagtman, A.M.

    2008-01-01

    With regard to the optimal treatment timing for children with an Angle Class II division 1 malocclusion, there is an ongoing controversy on the effectiveness of a two-phase or a one-phase therapy. Two-phase treatment involves a first phase to correct the jaw relationship starting at the age of 7 to

  2. Preference Learning

    CERN Document Server

    Furnkranz, Johannes

    2011-01-01

    The topic of preferences is a new branch of machine learning and data mining, and it has attracted considerable attention in artificial intelligence research in previous years. It involves learning from observations that reveal information about the preferences of an individual or a class of individuals. Representing and processing knowledge in terms of preferences is appealing as it allows one to specify desires in a declarative way, to combine qualitative and quantitative modes of reasoning, and to deal with inconsistencies and exceptions in a flexible manner. And, generalizing beyond traini

  3. What do the patients with medication overuse headache expect from treatment and what are the preferred sources of information?

    DEFF Research Database (Denmark)

    Munksgaard, S B; Allena, M; Tassorelli, C

    2011-01-01

    % selected personal verbal information as their primary need, significantly higher than the percentage of patients who selected leaflets and website information 35 and 35%, respectively (p consultation was requested by 59 and 48%, respectively. The information source preferred...... was again personal verbal information (82%), significantly higher than all other information sources (p consultation (48%), E-mail consultation (44%), website information (41%), and leaflets (33%). 51% expected their headache to be cured, 71 and 57...... in specialized headache centres prefer personal information, that expectations are very high, and that education and information are important. Providing the right information and thus give patients realistic expectations might enhance compliance and improve outcome....

  4. Long-term real-world entecavir therapy in treatment-naïve hepatitis B patients: base-line hepatitis B virus DNA and hepatitis B surface antigen levels predict virologic response.

    Science.gov (United States)

    Cho, Ju-Yeon; Sohn, Won; Sinn, Dong-Hyun; Gwak, Geum-Youn; Paik, Yong-Han; Choi, Moon Seok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul; Lee, Joon Hyeok

    2017-07-01

    Entecavir is a potent nucleoside analogue with high efficacy and barrier for resistance. We aimed to investigate the long-term efficacy and viral resistance rate of entecavir and explore the factors associated with virologic response, including quantitative hepatitis B surface antigen (qHBsAg) levels. One thousand and nine treatment-naïve chronic hepatitis B (CHB) patients were evaluated for cumulative rates of virologic response, biochemical response, and entecavir mutations. The role of baseline qHBsAg for virologic response was assessed in 271 patients with qHBsAg prior to entecavir treatment. The median duration of entecavir treatment was 26.5 months. The cumulative rate of virologic response at years 1, 3, and 5 were 79.0%, 95.6%, and 99.4%, respectively. The cumulative rate of entecavir resistance was 1.0% and 2.1% in years 3 and 5. Multivariate analysis identified baseline hepatitis B e antigen (HBeAg) negative status (p < 0.001) and lower hepatitis B virus (HBV) DNA (p < 0.001) as predictors of virologic response. Lower qHBsAg was an independent predictor of virologic response in patients with baseline qHBsAg. There were no serious adverse events during treatment. Long-term entecavir treatment of nucleos(t)ide-naïve CHB patients was associated with an excellent virologic response and a low rate of entecavir-resistant mutations at 5 years. Baseline HBV DNA load, qHBsAg levels, and HBeAg status were predictors of virologic response during entecavir treatment.

  5. 急诊首选B超定位ESWL治疗输尿管结石%Preferred B-positioning emergency ESWL treatment of ureteral calculi

    Institute of Scientific and Technical Information of China (English)

    夏远峰

    2014-01-01

    目的:总结急诊首选B超定位ESWL治疗输尿管结石的临床经验。方法:回顾分析2010年5月~2014年3月急诊首选第五代JC-Eswl-B型体外碎石机治疗2328例输尿管结石患者临床资料。结果:ESWL治疗输尿管结石成功率97.2%(1次成功率86.3%)。结论:急诊首选B超定位ESWL治疗输尿管结石是有效的,但要严格掌握适应证,以提高治疗效果。%Objective:To summarize the preferred B ~positioning emergency ESWL treatment of ureteral calculi clinical experience . Methods:Analysis from May 2010-November 2014 B-positioning emergency preferred using electromagnetic shock wave lithotripsy ma -chine2328 cases of clinical data in patients with ureteral calculi .Results:ESWL treatment of ureteral calculi success rate of 97.2% ( a success rate of 86.3%).Conclusion:Preferred B-positioning emergency ESWL treatment of ureteral calculi was effective , but to strictly indications to improve the therapeutic effect .

  6. Physician experiences and preferences in the treatment of HR+/HER2- metastatic breast cancer in the United States: a physician survey.

    Science.gov (United States)

    Lin, Peggy L; Hao, Yanni; Xie, Jipan; Li, Nanxin; Zhong, Yichen; Zhou, Zhou; Signorovitch, James E; Wu, Eric Q

    2016-02-01

    Sequential endocrine therapy (ET) is recommended for postmenopausal women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (mBC) and without visceral symptoms. Chemotherapy (CT) can be considered after sequential ETs, but is associated with adverse side effects. We assessed physicians' preferences and self-reported prescribing patterns for ET and CT in the treatment of HR+/HER2- mBC at community practices in the United States. Community-based oncologists/hematologists from a nationwide online panel who treated postmenopausal women with HR+/HER2- mBC were invited to complete a survey, blinded to the identity of study sponsor. Treatment preferences were collected by treatment class of ET-based regimens versus CT and by agent for postmenopausal HR+/HER2- mBC patients after prior nonsteroidal aromatase inhibitor use in the adjuvant or mBC setting. Among 213 physicians who completed the survey, 78% were male, 71% were based in small/intermediate practices (2-9 oncologists/subspecialists), 55% had >10 years of experience, and 58% referred to the National Comprehensive Cancer Network Guidelines when treating mBC. Among first-line ETs, anastrozole was the most frequently used treatment (35%), followed by everolimus-based (EVE, 34%) and fulvestrant-based (FUL, 15%) therapy. After first-line ET, the most preferred second- and third-line treatments were ET monotherapy (48% and 39%), ET combination therapy (31% and 19%), and CT monotherapy (13% and 30%). Comparing EVE versus FUL, physicians preferred EVE in all lines but first line. Efficacy was the most important consideration for treatment choice. Physicians prescribed CT in early lines mainly because of visceral symptoms. This survey of treatment patterns for HR+/HER2- mBC in community practice suggested that after first-line ET, ET mono- or combination therapy was commonly used for the second- and third-line treatments and CT monotherapy for third- or

  7. Effects of acute corticosterone treatment on male prairie voles (Microtus ochrogaster): Territorial aggression does not accompany induced social preference.

    Science.gov (United States)

    Blondel, Dimitri V; Phelps, Steven M

    2016-11-01

    Corticosterone (CORT) is a stress-related steroid hormone found in vertebrates, and is known to interact with behavior. In the socially monogamous prairie vole (Microtus ochrogaster), acute stress and specifically acute CORT administration have been shown to facilitate male social preference for a familiar female, and this effect has been described as facilitation of the monogamous pair bond. It is possible, however, that the effects of stress on social preference may initially represent a short-term coping strategy. Here we test whether the effect of acute CORT administration extends to territoriality, a defining component of the prairie vole monogamous suite of behaviors. Onset of territoriality would provide further support for an induced pair bond, whereas no increase in aggression would suggest an initial coping response. Using acute exogenous CORT injections followed by behavioral trials, we found a facilitation of social preference, but we did not find increased aggression. This result suggests that the social preference that develops in response to CORT is at least in part a coping response rather than facilitation of comprehensive monogamous pair bond behavior. Our results are consistent with previous studies both within prairie voles and across other taxa that suggest that social contact may be involved in the regulation of stress responses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Early postpartum pup preference is altered by gestational cocaine treatment: associations with infant cues and oxytocin expression in the MPOA.

    Science.gov (United States)

    Lippard, E T Cox; Jarrett, T M; McMurray, M S; Zeskind, P S; Garber, K A; Zoghby, C R; Glaze, K; Tate, W; Johns, J M

    2015-02-01

    Cross-fostering studies suggest cocaine-induced deficits in maternal behavior could be associated with altered behavior of offspring following prenatal cocaine-exposure. Neonatal vocalizations are an important offspring cue facilitating early interactions between dam and rodent pup offspring and have been shown to be altered following prenatal cocaine-exposure. It is unclear how variations in acoustic parameters of USVs impact maternal behavior and the mechanism(s) underlying these processes. The present study examined differences in cocaine-exposed and control rodent dam maternal preference of cocaine-exposed or untreated pups in a dual choice apparatus. Relationship of preference-like behavior with pup USVs and dam oxytocin expression was explored. Gestational cocaine-exposure interfered with preference-like behavior of dams on postpartum day 1 with cocaine-exposure associated with decreased time spent on the cocaine-exposed pup side compared to the control pup side, and decreases in preference-like behavior associated in part with decreased number of USVs being emitted by cocaine-exposed pups. On postpartum day 5, decreased oxytocin expression in the medial preoptic area was associated with altered preference-like behavior in cocaine-exposed dams, including frequency and latency to touch/sniff pups. Results indicate cocaine's effects on the mother-infant relationship is likely synergistic, in that cocaine influences mother and offspring both independently and concertedly and that variations within pup vocalizations and the oxytocin system may be potential mechanism(s) underlying this synergistic relationship during the postpartum period.

  9. Do health workers’ preferences influence their practices? Assessment of providers’ attitude and personal use of new treatment recommendations for management of uncomplicated malaria, Tanzania

    Directory of Open Access Journals (Sweden)

    Masanja Irene M

    2012-11-01

    Full Text Available Abstract Background Due to growing antimalarial drug resistance, Tanzania changed malaria treatment policies twice within a decade. First in 2001 chloroquine (CQ was replaced by sulfadoxine-pyrimethamine (SP for management of uncomplicated malaria and by late 2006, SP was replaced by artemether-lumefantrine (AL. We assessed health workers’ attitudes and personal practices following the first treatment policy change, at six months post-change and two years later. Methods Two cross-sectional surveys were conducted in 2002 and 2004 among healthcare workers in three districts in South-East Tanzania using semi-structured questionnaires. Attitudes were assessed by enquiring which antimalarial was considered most suitable for the management of uncomplicated malaria for the three patient categories: i children below 5; ii older children and adults; and iii pregnant women. Practice was ascertained by asking which antimalarial was used in the last malaria episode by the health worker him/herself and/or dependants. Univariate and multivariate logistic regression was used to identify factors associated with reported attitudes and practices towards the new treatment recommendations. Results A total of 400 health workers were interviewed; 254 and 146 in the first and second surveys, respectively. SP was less preferred antimalarial in hospitals and private health facilities (p Conclusion Following changes in malaria treatment recommendations, most health workers did not prefer the new antimalarial drug, and their preferences worsened over time. However, many of them still used the newly recommended drug for management of their own or family members’ malaria episode. This indicates that, other factors than providers’ attitude may have more influence in their personal treatment practices.

  10. The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

    Directory of Open Access Journals (Sweden)

    Hagedorn Hildi J

    2010-06-01

    Full Text Available Abstract Background The Organizational Readiness to Change Assessment (ORCA is a measure of organizational readiness for implementing practice change in healthcare settings that is organized based on the core elements and sub-elements of the Promoting Action on Research Implementation in Health Services (PARIHS framework. General support for the reliability and factor structure of the ORCA has been reported. However, no published study has examined the utility of the ORCA in a clinical setting. The purpose of the current study was to examine the relationship between baseline ORCA scores and implementation of hepatitis prevention services in substance use disorders (SUD clinics. Methods Nine clinic teams from Veterans Health Administration SUD clinics across the United States participated in a six-month training program to promote evidence-based practices for hepatitis prevention. A representative from each team completed the ORCA evidence and context subscales at baseline. Results Eight of nine clinics reported implementation of at least one new hepatitis prevention practice after completing the six-month training program. Clinic teams were categorized by level of implementation-high (n = 4 versus low (n = 5-based on how many hepatitis prevention practices were integrated into their clinics after completing the training program. High implementation teams had significantly higher scores on the patient experience and leadership culture subscales of the ORCA compared to low implementation teams. While not reaching significance in this small sample, high implementation clinics also had higher scores on the research, clinical experience, staff culture, leadership behavior, and measurement subscales as compared to low implementation clinics. Conclusions The results of this study suggest that the ORCA was able to measure differences in organizational factors at baseline between clinics that reported high and low implementation of practice

  11. Patients’ and rheumatologists’ preferences for the attributes of biological agents used in the treatment of rheumatic diseases in Spain

    Science.gov (United States)

    Nolla, Joan M; Rodríguez, Manuel; Martin-Mola, Emilio; Raya, Enrique; Ibero, Isabel; Nocea, Gonzalo; Aragon, Belén; Lizán, Luis; Prades, Miriam

    2016-01-01

    Purpose To define importance values assigned to attributes of biological agents (BAs) by Spanish patients with rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis) and rheumatologists. Patients and methods This was an observational, cross-sectional design based upon a rank-based full-profile conjoint analysis. A literature review and four focus groups were undertaken to identify attributes and levels. An orthogonal matrix, combining the selected levels of attributes, was used to define scenarios. Participants ranked eight scenarios from 1 (most preferred) to 8 (least preferred). The relative importance (RI) of attributes was calculated. Multivariate regression analysis was performed to identify the characteristics that influenced the values of RI. A total of 488 patients (male 50.9%, mean age 50.6 [standard deviation {SD} 12.06] years, rheumatoid arthritis 33.8%, ankylosing spondylitis 32.4%, psoriatic arthritis 33.8%; mean time since diagnosis 12.6 [SD 8.2] years) and 136 rheumatologists (male 50.4%, mean age 46.4 [SD 9.1] years, mean time of practice 16.7 [SD 8.8] years) participated. Results The ideal BAs for patients and physicians, respectively, should allow pain relief and improvement of functional capacity (RI 39% and 44.7%), with low risk of adverse events (RI 24.9% and 30.5%), a long time prior to perceiving the need for a new dose (RI 16.4% and 12.4%), and self-administration at home (RI 19.7% and 12.5%), as identified through their preferences. Conclusion Although efficacy and safety are paramount for patients and rheumatologists to make a choice regarding BAs, the need for a low frequency of administration and the administration method also play a role as preference attributes for BAs. PMID:27382258

  12. Social preferences

    DEFF Research Database (Denmark)

    Gulløv, Eva

    2014-01-01

    The focus of this article is social divisions among preschool children in daycare centers. Based on ethnographic fieldwork in three daycare centers in Denmark, the analysis concerns young children’s social preferences. The ethnographic material shows that despite an explicit political ambition...... of daycares as means for social and cultural integration, lines of division do exist amongst the children. Such divisions are established in the daily interactions of the daycare, but they also reflect those of the broader society. With a focus on children’s interactions and social preferences, the material...

  13. Terminally Ill Taiwanese Cancer Patients' and Family Caregivers' Agreement on Patterns of Life-Sustaining Treatment Preferences Is Poor to Fair and Declines Over a Decade: Results From Two Independent Cross-Sectional Studies.

    Science.gov (United States)

    Liu, Tsang-Wu; Wen, Fur-Hsing; Wang, Cheng-Hsu; Hong, Ruey-Long; Chow, Jyh-Ming; Chen, Jen-Shi; Chiu, Chang-Fang; Tang, Siew Tzuh

    2017-07-01

    Temporal changes have not been examined in patient-caregiver agreement on life-sustaining treatment (LST) preferences at end of life (EOL). We explored the extent of and changes in patient-caregiver agreement on LST-preference patterns for two independent cohorts of Taiwanese cancer patient-family caregiver dyads recruited a decade apart. We surveyed preferences for cardiopulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, tube feeding, and dialysis among 1049 and 1901 dyads in 2003-2004 and 2011-2012, respectively. LST-preference patterns were examined by multi-group latent class analysis. Extent of patient-caregiver agreement on LST-preference patterns was determined by percentage agreement and kappa coefficients. For both patients and family caregivers, we identified seven distinct LST-preference classes. Patient-caregiver agreement on LST-preference patterns was poor to fair across both study cohorts, indicated by 24.4%-43.5% agreement and kappa values of 0.06 (95% CI: 0.04, 0.09) to 0.27 (0.23, 0.30), and declined significantly over time. Agreement on LST-preference patterns was most likely when both patients and caregivers uniformly rejected LSTs. When patients disagreed with caregivers on LST-preference patterns, discrepancies were most likely when patients totally rejected LSTs but caregivers uniformly preferred LSTs or preferred nutritional support but rejected other treatments. Patients and family caregivers had poor-to-fair agreement on LST-preference patterns, and agreement declined significantly over a decade. Encouraging an open dialogue between patients and their family caregivers about desired EOL care would facilitate patient-caregiver agreement on LST-preference patterns, thus honoring terminally ill cancer patients' wishes when they cannot make EOL-care decisions. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc

  14. A Randomised, Double-Blind, Placebo-Controlled Trial with Vitamin D3 in MS: Subgroup Analysis of Patients with Baseline Disease Activity Despite Interferon Treatment

    Directory of Open Access Journals (Sweden)

    J. Åivo

    2012-01-01

    Full Text Available We present a subgroup analysis of the first double-blind, placebo-controlled, randomised trial with vitamin D3 in MS. In the overall study population, there were 34 patients in the vitamin D arm and 32 patients in the placebo arm. All the patients were using interferon-β-1b (IFNB therapy. The subgroup consisted of 15 patients in the vitamin D arm and 15 patients in the placebo arm, who had either at least one relapse during the year preceding the study or enhancing T1 lesions at the baseline MRI scan. We measured the total number of MRI T1 enhancing lesions, the number of new/enlarging T2 lesions and T2 lesion volume (BOD (mm3, EDSS (Expanded Disability Status Scale, annual relapse Rate (ARR, timed 25-foot walk (T25FW, and timed 10-foot tandem walk (TT10W at baseline and at 12 months in the vitamin D-treated and in the placebo-treated patients. There was a statistically significant reduction in the number of T1 enhancing lesions, a smaller T2 lesion volume growth and less new/enlarging T2 brain MRI lesions in the vitamin D3-treated than in the placebo-treated subgroup patients. The MRI results were slightly more pronounced in the subgroup than in the overall study population.

  15. TWRS privatization process technical baseline

    Energy Technology Data Exchange (ETDEWEB)

    Orme, R.M.

    1996-09-13

    The U.S. Department of Energy (DOE) is planning a two-phased program for the remediation of Hanford tank waste. Phase 1 is a pilot program to demonstrate the procurement of treatment services. The volume of waste treated during the Phase 1 is a small percentage of the tank waste. During Phase 2, DOE intends to procure treatment services for the balance of the waste. The TWRS Privatization Process Technical Baseline (PPTB) provides a summary level flowsheet/mass balance of tank waste treatment operations which is consistent with the tank inventory information, waste feed staging studies, and privatization guidelines currently available. The PPTB will be revised periodically as privatized processing concepts are crystallized.

  16. Magic Baseline Beta Beam

    CERN Document Server

    Agarwalla, Sanjib Kumar; Raychaudhuri, Amitava

    2007-01-01

    We study the physics reach of an experiment where neutrinos produced in a beta-beam facility at CERN are observed in a large magnetized iron calorimeter (ICAL) at the India-based Neutrino Observatory (INO). The CERN-INO distance is close to the so-called "magic" baseline which helps evade some of the parameter degeneracies and allows for a better measurement of the neutrino mass hierarchy and $\\theta_{13}$.

  17. Rationing with baselines

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    We introduce a new operator for general rationing problems in which, besides conflicting claims, individual baselines play an important role in the rationing process. The operator builds onto ideas of composition, which are not only frequent in rationing, but also in related problems...... such as bargaining, choice, and queuing. We characterize the operator and show how it preserves some standard axioms in the literature on rationing. We also relate it to recent contributions in such literature....

  18. The TDAQ Baseline Architecture

    CERN Multimedia

    Wickens, F J

    The Trigger-DAQ community is currently busy preparing material for the DAQ, HLT and DCS TDR. Over the last few weeks a very important step has been a series of meetings to complete agreement on the baseline architecture. An overview of the architecture indicating some of the main parameters is shown in figure 1. As reported at the ATLAS Plenary during the February ATLAS week, the main area where the baseline had not yet been agreed was around the Read-Out System (ROS) and details in the DataFlow. The agreed architecture has: Read-Out Links (ROLs) from the RODs using S-Link; Read-Out Buffers (ROB) sited near the RODs, mounted in a chassis - today assumed to be a PC, using PCI bus at least for configuration, control and monitoring. The baseline assumes data aggregation, in the ROB and/or at the output (which could either be over a bus or in the network). Optimization of the data aggregation will be made in the coming months, but the current model has each ROB card receiving input from 4 ROLs, and 3 such c...

  19. Usefulness of baseline lipids and C-reactive protein in women receiving menopausal hormone therapy as predictors of treatment-related coronary events.

    Science.gov (United States)

    Bray, Paul F; Larson, Joseph C; Lacroix, Andrea Z; Manson, Joann; Limacher, Marian C; Rossouw, Jacques E; Lasser, Norman L; Lawson, William E; Stefanick, Marcia L; Langer, Robert D; Margolis, Karen L

    2008-06-01

    Blood lipids and high-sensitivity C-reactive protein (hs-CRP) are altered by hormone therapy. The goal of the present study was to determine whether lipids and hs-CRP have predictive value for hormone therapy benefit or risk for coronary heart disease events in postmenopausal women without previous cardiovascular disease. A nested case-control study was performed in the Women's Health Initiative hormone trials. Baseline lipids and hs-CRP were obtained from 271 incident patients with coronary heart disease (cases) and 707 controls. In a combined trial analysis, favorable lipid status at baseline tended to predict better coronary heart disease outcomes when using conjugated equine estrogen (CEE) with or without medroxyprogesterone acetate (MPA). Women with a low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol ratio disease when using CEE with or without MPA (odds ratio 0.60, 95% confidence interval 0.34 to 1.06), whereas women with an LDL/HDL cholesterol ratio > or =2.5 had increased risk of coronary heart disease (odds ratio 1.73, 95% confidence interval 1.18 to 2.53, p for interaction = 0.02). Low hs-CRP added marginally to the value of LDL/HDL ratio disease benefit on hormone therapy. In conclusion, postmenopausal women with undesirable lipid levels had excess coronary heart disease risk when using CEE with or without MPA. However, women with favorable lipid levels, especially LDL/HDL cholesterol ratio disease with CEE with or without MPA irrespective of hs-CRP.

  20. Men’s preferences for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Mankowski C

    2016-11-01

    Full Text Available Colette Mankowski,1 Divine Ikenwilo,2,† Sebastian Heidenreich,2 Mandy Ryan,2 Jameel Nazir,1 Cathy Newman,1 Verity Watson2 1Health Economics and Outcomes Research, Astellas Pharma Europe Ltd., Chertsey, 2Health Economics Research Unit, University of Aberdeen, Aberdeen, UK †Dr Ikenwilo passed away on November 27, 2015 Objective: To explore and quantify men’s preferences and willingness to pay (WTP for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment. Subjects and methods: Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hyperplasia (based on self-reported International Prostate Symptom Score ≥8 were recruited. An online discrete choice experiment survey was administered. Eligible men were asked to consider different medication scenarios and select their preferred medication according to seven attributes: daytime and nighttime (nocturia urinary frequency, urinary urgency, sexual and nonsexual side effects, number of tablets/day, and cost/month. A mixed-logit model was used to estimate preferences and WTP for medication attributes. Results: In all, 247 men completed the survey. Men were willing to trade-off symptom improvements and treatment side effects. Men preferred medications that reduced urinary urgency and reduced day- and nighttime urinary frequency. Men preferred medications without side effects (base-case level, but did not care about the number of tablets per day. WTP for symptomatic improvement was £25.33/month for reduced urgency (urge incontinence to mild urgency, and £6.65/month and £1.39/month for each unit reduction in night- and ­daytime urination frequency, respectively. The sexual and nonsexual side effects reduced WTP by up to £30.07/month. There was significant heterogeneity in preferences for most attributes, except for reduced urinary urgency from urge incontinence to mild

  1. Drug Preferences of Multiple Drug Abusers.

    Science.gov (United States)

    Harford, Robert J.

    1978-01-01

    Examined drug preferences of a group of active multiple drug abusers referred for treatment. Nearly half the respondents preferred drugs other than type they most frequently used. Preferences were related to method of administration. Results suggest preference is one among several determinants of drug use. (Author/BEF)

  2. Physician experiences and preferences in the treatment of HR+/HER2− metastatic breast cancer in the United States: a physician survey

    OpenAIRE

    Lin, Peggy L.; Hao, Yanni; Xie, Jipan; Li, Nanxin; Zhong, Yichen; Zhou, Zhou; Signorovitch,James E.; Wu, Eric Q.

    2015-01-01

    Abstract Sequential endocrine therapy (ET) is recommended for postmenopausal women with hormone receptor‐positive (HR+)/human epidermal growth factor receptor 2‐negative (HER2−) metastatic breast cancer (mBC) and without visceral symptoms. Chemotherapy (CT) can be considered after sequential ETs, but is associated with adverse side effects. We assessed physicians' preferences and self‐reported prescribing patterns for ET and CT in the treatment of HR+/HER2− mBC at community practices in the U...

  3. The influence of pre-fermentative treatments on the volatile, chromatic features, organic acids and phenolic content of Fetească albă Romanian wine

    Directory of Open Access Journals (Sweden)

    Moroşanu Ana-Maria

    2016-01-01

    Full Text Available The present study evaluates the influence of some pre-fermentative treatments on the volatile content, the chromatic parameters, the total polyphenol index and Folin-Ciocâlteu index of experimental wines obtained from Fetească albă grape variety. Five experimental samples were produced: FA V0 (control sample, FA V1 (sodium bentonite treatment, FA V2 (glutathione treatment, FA V3 (tannin treatment, FA V4 (oenological coal treatment. The use of pre-fermentative treatments show lower values of Folin-Ciocâlteu index and total polyphenol index, excepting sample treated with tannin. Major color differences are found in the sample treated with tannin and oenological coal. Gas-chromatographic analysis reveals the presence of common wine esters, such as: hexanoic acid ethyl ester, ethyl caprylate, ethyl lactate, ethyl caprate, ethyl myristate, ethyl palmitate, that contributes at the accomplishment of the wines from the sensorial point of view. Diethyl malonate, a compound that occurs naturally in grapes has an apple-like odor and it was identified in the control sample and in the samples treated with tannin and oenological coal, being found n greater quantity in the control sample (0.02 mmol/Land the sample treated with coal (0.03 mmol/L. Another ester, methyl oleate that offers a mild-fatty odor wasn't identified in the control sample, but it was detected in the samples treated with clay, tannin and oenological coal. Using the HPLC method it was also analysed the presence of some organic acids in wine samples.

  4. METODO, a prospective observational study to assess the efficacy and tolerability of methadone in heroin-addicted patients undergoing a methadone maintenance treatment: preliminary results at baseline evaluation.

    Science.gov (United States)

    D'Egidio, Pietro Fausto; Bignamini, Emanuele; De Vivo, Enrico; Leonardi, Claudio; Pieri, Maria Chiara; González-Saiz, Francisco; Lucchini, Alfio

    2013-12-01

    METODO (methadone efficacy therapy optimization dosage on-going) is a prospective observational study to assess the efficacy and tolerability of methadone in 500 heroin-addicted patients taking a methadone maintenance treatment, enrolled through 2010 to 2011 in five Italian sites, observed over 2 years. The Opiate Dosage Adequacy Scale has been used for the evaluation of the "adequacy" of the methadone dosage and to stratify patients in adequate and not adequate groups. The treatment efficacy has been evaluated in correlation to the dosage adequacy during the visits. Moreover, patients have been evaluated according to the retention rate and duration of retention in treatment and a series of questionnaires.

  5. Social preferences

    DEFF Research Database (Denmark)

    Gulløv, Eva

    2014-01-01

    indicates that children’s choices of playmates run along lines of ethnic and class divisions. The article will address this pattern and analyze its causes in order to understand why such lines of divisions are to be found in an institutional context designed to overcome social inequality and prevent social......The focus of this article is social divisions among preschool children in daycare centers. Based on ethnographic fieldwork in three daycare centers in Denmark, the analysis concerns young children’s social preferences. The ethnographic material shows that despite an explicit political ambition...... of daycares as means for social and cultural integration, lines of division do exist amongst the children. Such divisions are established in the daily interactions of the daycare, but they also reflect those of the broader society. With a focus on children’s interactions and social preferences, the material...

  6. Patients with ≥ 20 × 10(9)/l platelets at baseline may have a prompt response to romiplostim during the early phase of treatment: an italian single-institution experience.

    Science.gov (United States)

    Baldini, Simone; Rigacci, Luigi; Carrai, Valentina; Alterini, Renato; Fjerza, Rajmonda; Bosi, Alberto

    2012-01-01

    Patients with chronic immune thrombocytopenia treated with romiplostim may benefit from a higher starting dose when a rapid increase in count is needed, but it could be avoided in those with a prompt response to the standard dosage. We hypothesized that a platelet count ≥ 20 × 10(9)/l at baseline could distinguish subjects with such response from those with a delayed one during the early phase of treatment. Our work is a retrospective and single-institution analysis comparing the median platelet count, the median weekly dosage of romiplostim and the median number of weekly platelet counts < 50 × 10(9)/l between patients with a baseline ≥ 20 × 10(9)/l platelets (n=10, 2 splenectomized) and those with a lower one (n=8, 3 splenectomized) during the first month of treatment with romiplostim. The results show a higher median platelet count (79,5 vs 40,5 × 10(9)/l, p=0,002) and a lower median dose of romiplostim (1 vs 2 mcg/kg/week, p=0,01) in subjects with a baseline ≥ 20 × 10(9)/l platelets, who also had a trend of less weekly counts < 50 × 10(9)/l platelets (1 vs 2, p=0,054). These data suggest that patients with ≥ 20 × 10(9)/l platelets at baseline may achieve a prompt response with the standard dose of romiplostim, but further and larger data are needed in order to assess whether it can be considered in clinical practice.

  7. In-treatment midwall and endocardial fractional shortening predict cardiovascular outcome in hypertensive patients with preserved baseline systolic ventricular function: the Losartan Intervention For Endpoint reduction study

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Gerdts, Eva; Palmieri, Vittorio;

    2010-01-01

    Endocardial fractional shortening (EFS) and midwall shortening (MWS) are impaired in patients with left ventricular hypertrophy. However, it remains unknown whether improvement of left ventricular systolic function during treatment reduces cardiovascular morbidity and mortality in hypertensive pa...

  8. Depression CBT treatment gains among HIV-infected persons with a history of injection drug use varies as a function of baseline substance use

    OpenAIRE

    Labbe, Allison K.; O'Cleirigh, Conall M.; Stein, Michael; Safren, Steven A.

    2015-01-01

    Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment outcomes and accelerated HIV disease progression. Though previous research has demonstrated short-term and follow-up success for cognitive behavioral therapy for adherence and depression (CBT-AD) on depression outcomes among patients with HIV in care (Safren et al., 2009) and among patients with HIV in active substance abuse treatment for injection drug use (IDU) (Safren et al., 2012)...

  9. Sequential effects in preference decision: Prior preference assimilates current preference.

    Science.gov (United States)

    Chang, Seah; Kim, Chai-Youn; Cho, Yang Seok

    2017-01-01

    An important factor affecting preference formation is the context in which that preference decision takes place. The current research examined whether one's preference formed for a previously presented stimulus influences the processing of a subsequent preference decision, henceforth referred to as the preference sequence effect. Using a novel sequential rating/judgment paradigm, the present study demonstrated the presence of a preference sequence effect using artistic photographs and face stimuli: A neutral stimulus was preferred more following a preferable stimulus than a less preferable stimulus. Furthermore, a similar trend was found even when the potential influence of response bias was controlled. These results suggest that an assimilative sequential effect exists even when sequential judgments are made solely based on one's subjective feeling; preference formed for a preceding stimulus modulates preference for a subsequent stimulus. This implies the need for a consideration of trial sequence as a factor creating a psychological context affecting the subsequent preference decisions.

  10. Patterns of Change in Collaboration Are Associated with Baseline Characteristics and Predict Outcome and Dropout Rates in Treatment of Multi-Problem Families. A Validation Study

    Directory of Open Access Journals (Sweden)

    Egon Bachler

    2017-07-01

    Full Text Available Objective: The present study validates the Multi-Problem Family (MPF-Collaboration Scale, which measures the progress of goal directed collaboration of patients in the treatment of families with MPF and its relation to drop-out rates and treatment outcome.Method: Naturalistic study of symptom and competence-related changes in children of ages 4–18 and their caregivers.Setting: Integrative, structural outreach family therapy.Measures: The data of five different groups of goal directed collaboration (deteriorating collaboration, stable low collaboration, stable medium collaboration, stable high collaboration, improving collaboration were analyzed in their relation to treatment expectation, individual therapeutic goals (ITG, family adversity index, severity of problems and global assessment of a caregiver’s functioning, child, and relational aspects.Results: From N = 810 families, 20% displayed stable high collaboration (n = 162 and 21% had a pattern of improving collaboration. The families with stable high or improving collaboration rates achieved significantly more progress throughout therapy in terms of treatment outcome expectancy (d = 0.96; r = 0.43, reaching ITG (d = 1.17; r = 0.50, family adversities (d = 0.55; r = 0.26, and severity of psychiatric symptoms (d = 0.31; r = 0.15. Furthermore, families with stable high or improving collaboration maintained longer treatments and had a bigger chance of finishing the therapy as planned. The odds of having a stable low or deteriorating collaboration throughout treatment were significantly higher for subjects who started treatment with low treatment expectation or high family-related adversities.Conclusion: The positive outcomes of homebased interventions for multi-problem families are closely related to “stable high” and an “improving” collaboration as measured with the MPF-Collaboration Scale. Patients who fall into these groups have a high treatment outcome expectancy and reduce

  11. Patterns of Change in Collaboration Are Associated with Baseline Characteristics and Predict Outcome and Dropout Rates in Treatment of Multi-Problem Families. A Validation Study

    Science.gov (United States)

    Bachler, Egon; Fruehmann, Alexander; Bachler, Herbert; Aas, Benjamin; Nickel, Marius; Schiepek, Guenter K.

    2017-01-01

    Objective: The present study validates the Multi-Problem Family (MPF)-Collaboration Scale), which measures the progress of goal directed collaboration of patients in the treatment of families with MPF and its relation to drop-out rates and treatment outcome. Method: Naturalistic study of symptom and competence-related changes in children of ages 4–18 and their caregivers. Setting: Integrative, structural outreach family therapy. Measures: The data of five different groups of goal directed collaboration (deteriorating collaboration, stable low collaboration, stable medium collaboration, stable high collaboration, improving collaboration) were analyzed in their relation to treatment expectation, individual therapeutic goals (ITG), family adversity index, severity of problems and global assessment of a caregiver’s functioning, child, and relational aspects. Results: From N = 810 families, 20% displayed stable high collaboration (n = 162) and 21% had a pattern of improving collaboration. The families with stable high or improving collaboration rates achieved significantly more progress throughout therapy in terms of treatment outcome expectancy (d = 0.96; r = 0.43), reaching ITG (d = 1.17; r = 0.50), family adversities (d = 0.55; r = 0.26), and severity of psychiatric symptoms (d = 0.31; r = 0.15). Furthermore, families with stable high or improving collaboration maintained longer treatments and had a bigger chance of finishing the therapy as planned. The odds of having a stable low or deteriorating collaboration throughout treatment were significantly higher for subjects who started treatment with low treatment expectation or high family-related adversities. Conclusion: The positive outcomes of homebased interventions for multi-problem families are closely related to “stable high” and an “improving” collaboration as measured with the MPF-Collaboration Scale. Patients who fall into these groups have a high treatment outcome expectancy and reduce

  12. Modeling Preference Change through Brand Satiation

    OpenAIRE

    Terui, Nobuhiko; HASEGAWA, Shohei

    2013-01-01

    In this study, we develop structural models of preference change due to consumer state dependence through satiation by purchase experience. A dynamic factor model with switching structure is proposed to explain consumer preference changes. Two types of dynamic factor models are separately applied to baseline and satiation parameters in a direct utility model that accommodates multiple discreteness data. The first dynamic factor model has a switching structure for consumer preference, and deco...

  13. Levodopa/carbidopa and entacapone in the treatment of Parkinson’s disease: efficacy, safety and patient preference

    Directory of Open Access Journals (Sweden)

    Thomas Müller

    2009-01-01

    Full Text Available Thomas Müller1,21Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Berlin, Germany; 2IGSN, Ruhr University of Bochum, Bochum, GermanyAbstract: Levodopa (LD is the oldest, most efficacious and best-tolerated drug for dopaminergic substitution of patients with Parkinson’s disease (PD. Its main drawback is its short half-life, which supports onset of motor complications in the long term. Therefore well-informed PD patients mostly accept LD therapy as late as possible. Recent LD trials indicate that a combination of LD with carbidopa (CD and the catechol-O-methyltransferase (COMT inhibitor entacapone (EN may reduce the onset of these motor complications to a certain extent. This observation is further supported by pharmacokinetic trials and experimental research, but there is still a need to confirm this in a clinical trial, which is under way. Additionally, combined LD/CD/EN was superior to LD/CD administration regarding cognition, muscle behavior and gastrointestinal function in small clinical trials. Moreover there is accumulating evidence that combined COMT inhibition with LD administration reduces homocysteine synthesis. In the long term, homocysteine elevation supports onset of arteriosclerosis-related disorders, which are more frequent in PD patients according to epidemiological studies than in the normal healthy population. The introduction of LD/CD/EN in one tablet supported patients’ preference of COMT inhibition as an essential component of LD/DDI therapy, as this combination reduced number and size of tablets.Keywords: levodopa, entacapone, Parkinson’s disease, preference, compliance, acceptance

  14. Baseline quasispecies selection and novel mutations contribute to emerging resistance-associated substitutions in hepatitis C virus after direct-acting antiviral treatment

    Science.gov (United States)

    Kai, Yugo; Hikita, Hayato; Morishita, Naoki; Murai, Kazuhiro; Nakabori, Tasuku; Iio, Sadaharu; Hagiwara, Hideki; Imai, Yasuharu; Tamura, Shinji; Tsutsui, Syusaku; Naito, Masafumi; Nishiuchi, Meiko; Kondo, Yasuteru; Kato, Takanobu; Suemizu, Hiroshi; Yamada, Ryoko; Oze, Tsugiko; Yakushijin, Takayuki; Hiramatsu, Naoki; Sakamori, Ryotaro; Tatsumi, Tomohide; Takehara, Tetsuo

    2017-01-01

    Resistance-associated substitutions (RASs) in hepatitis C virus (HCV) appear upon failure of treatment with direct-acting antivirals (DAAs). However, their origin has not been clarified in detail. Among 11 HCV genotype 1b patients who experienced virologic failure with asunaprevir (ASV)/daclatasvir (DCV), 10 had major NS5A L31M/V-Y93H variants after treatment. L31M/V-Y93H variants were detected as a minor clone before therapy in 6 patients and were the most closely related to the post-treatment variants by phylogenetic tree analysis in 4 patients. Next, to consider the involvement of a trace amount of pre-existing variants below the detection limit, we analysed human hepatocyte chimeric mice infected with DAA-naïve patient serum. L31V-Y93H variants emerged after treatment with ledipasvir (LDV)/GS-558093 (nucleotide NS5B inhibitor) and decreased under the detection limit, but these variants were dissimilar to the L31V-Y93H variants reappearing after ASV/DCV re-treatment. Finally, to develop an infection derived from a single HCV clone, we intrahepatically injected full-genome HCV RNA (engineered based on the wild-type genotype 1b sequence) into chimeric mice. A new Y93H mutation actually occurred in this model after LDV monotherapy failure. In conclusion, post-treatment RASs appear by 2 mechanisms: the selection of pre-existing substitutions among quasispecies and the generation of novel mutations during therapy. PMID:28134353

  15. End-of-life decisions: a cross-national study of treatment preference discussions and surrogate decision-maker appointments.

    NARCIS (Netherlands)

    Evans, N.; Pasman, H.R.; Vega Alonso, T.; Block, L. van den; Miccinesi, G.; Casteren, V. van; Donker, G.; Bertolissi, S.; Zurriaga, O.; Deliens, L.; Onwuteaka-Philipsen, B.

    2013-01-01

    Background: Making treatment decisions in anticipation of possible future incapacity is an important part of patient participation in end-of-life decision-making. This study estimates and compares the prevalence of GP-patient end-of-life treatment discussions and patients’ appointment of surrogate

  16. The impact of cardiovascular risk, baseline LDL-cholesterol, treatment dose and adherence on cost-effectiveness of statins in newly diagnosed diabetes patients

    NARCIS (Netherlands)

    De Vries, Dianna; Hak, Eelko; Postma, Maarten J.

    2015-01-01

    Background: Statins have shown to be cost-effective in most diabetes patients. Treatment decisions in patients newly diagnosed with diabetes are primarily based on the cardiovascular risk. The effect of statins is, however, primarily based on the LDL-cholesterol reduction that is achieved, which is

  17. The impact of cardiovascular risk, baseline LDL-cholesterol, treatment dose and adherence on cost-effectiveness of statins in newly diagnosed diabetes patients

    NARCIS (Netherlands)

    De Vries, Dianna; Hak, Eelko; Postma, Maarten J.

    2015-01-01

    Background: Statins have shown to be cost-effective in most diabetes patients. Treatment decisions in patients newly diagnosed with diabetes are primarily based on the cardiovascular risk. The effect of statins is, however, primarily based on the LDL-cholesterol reduction that is achieved, which is

  18. APPLICATION OF PRINCIPLE OF "PREVENTION IN PREFERENCE TO TREATMENT OF DISEASES"IN ACUPUNCTURE-MOXIBUSTION CLINIC

    Institute of Scientific and Technical Information of China (English)

    王茎

    2004-01-01

    In the present paper the author reviews the viewpoint of "preventive treatment of diseases" in the ancient literature of traditional Chinese medicine (TCM) and its clinical application from ① prevention first before the occurrence of diseases; and ② preventing development after onset of diseases. In the preventive treatment of diseases, the ancient Chinese doctors usually ① regulated qi of both Conception Vessel and Governor Vessel for health care; ② performed regular moxibustion; and ③ applied plaster to the acupoint in summer for treating winter-diseases. In the treatment of diseases after onset, the ancient Chinese usually ① tried best to make early diagnosis and early treatment; and ② strengthened the related internal organ in advance to check their development; and ③ employed appropriate remedies to recuperate the patient's health.

  19. Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Nikolaos Papadopoulos

    2016-01-01

    Full Text Available Hyperbilirubinemia is an adverse reaction of simeprevir (SMV. The majority of these patients were taking concurrent ribavirin presenting elevated unconjugated hyperbilirubinemia due to hemolysis. However, cases of hepatic failure with elevated bilirubin level have also been reported in patients with decompensated cirrhosis. We describe a 51-year-old female patient with HbS beta 0-thalassemia and recently diagnosed compensated cirrhosis due to chronic hepatitis C infection. Laboratory evaluation revealed total bilirubin: 2.7 mg/dL and serum HCV-RNA 137.204 IU/mL. HCV was genotyped as 4. A FibroScan revealed 35.3 kPa. She was considered as illegible for pegylated-interferon-free treatment with direct acting antivirals and a course with simeprevir and sofosbuvir (SOF combination for twelve weeks was planned. Hyperbilirubinemia developed from the beginning with peak values during the 3rd month of treatment. However, no findings of liver decompensation were noticed. Hyperbilirubinemia was benign and fully reversible and our patient finally achieved sustained virological response 24 weeks after the end of treatment.

  20. Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia

    Science.gov (United States)

    Deutsch, Melanie; Georgalas, Athanasios; Poulakidas, Helias; Karnesis, Lazaros

    2016-01-01

    Hyperbilirubinemia is an adverse reaction of simeprevir (SMV). The majority of these patients were taking concurrent ribavirin presenting elevated unconjugated hyperbilirubinemia due to hemolysis. However, cases of hepatic failure with elevated bilirubin level have also been reported in patients with decompensated cirrhosis. We describe a 51-year-old female patient with HbS beta 0-thalassemia and recently diagnosed compensated cirrhosis due to chronic hepatitis C infection. Laboratory evaluation revealed total bilirubin: 2.7 mg/dL and serum HCV-RNA 137.204 IU/mL. HCV was genotyped as 4. A FibroScan revealed 35.3 kPa. She was considered as illegible for pegylated-interferon-free treatment with direct acting antivirals and a course with simeprevir and sofosbuvir (SOF) combination for twelve weeks was planned. Hyperbilirubinemia developed from the beginning with peak values during the 3rd month of treatment. However, no findings of liver decompensation were noticed. Hyperbilirubinemia was benign and fully reversible and our patient finally achieved sustained virological response 24 weeks after the end of treatment. PMID:27042368

  1. Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia.

    Science.gov (United States)

    Papadopoulos, Nikolaos; Deutsch, Melanie; Georgalas, Athanasios; Poulakidas, Helias; Karnesis, Lazaros

    2016-01-01

    Hyperbilirubinemia is an adverse reaction of simeprevir (SMV). The majority of these patients were taking concurrent ribavirin presenting elevated unconjugated hyperbilirubinemia due to hemolysis. However, cases of hepatic failure with elevated bilirubin level have also been reported in patients with decompensated cirrhosis. We describe a 51-year-old female patient with HbS beta 0-thalassemia and recently diagnosed compensated cirrhosis due to chronic hepatitis C infection. Laboratory evaluation revealed total bilirubin: 2.7 mg/dL and serum HCV-RNA 137.204 IU/mL. HCV was genotyped as 4. A FibroScan revealed 35.3 kPa. She was considered as illegible for pegylated-interferon-free treatment with direct acting antivirals and a course with simeprevir and sofosbuvir (SOF) combination for twelve weeks was planned. Hyperbilirubinemia developed from the beginning with peak values during the 3rd month of treatment. However, no findings of liver decompensation were noticed. Hyperbilirubinemia was benign and fully reversible and our patient finally achieved sustained virological response 24 weeks after the end of treatment.

  2. Compliance with a three-day course of artesunate-mefloquine combination and baseline anti-malarial treatment in an area of Thailand with highly multidrug resistant falciparum malaria

    Directory of Open Access Journals (Sweden)

    Na-Bangchang Kesara

    2010-02-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT is presently recommended by the World Health Organization as first-line treatment for uncomplicated Plasmodium falciparum malaria in several countries, as a mean of prolonging the effectiveness of first-line malaria treatment regimens. A three-day course of artesunate-mefloquine (4 mg/kg body weight once daily for three consecutive days, plus 15 and 10 mg/kg body weight mefloquine on the first and second days has been adopted by Malaria Control Programme of Thailand as first-line treatment for uncomplicated falciparum malaria all over the country since 2008. The gametocytocydal anti-malarial drug primaquine is administered at the dose of 30 mg (0.6 mg/kg on the last day. The aim of the present study was to assess patient compliance of this combination regimen when applied to field condition. Methods A total of 240 patients (196 males and 44 females who were attending the malaria clinics in Mae-Sot, Tak Province and presenting with symptomatic acute uncomplicated falciparum malaria, with no reappearance of Plasmodium vivax parasitaemia during follow-up were included into the study. The first dose of the treatment was given to the patients under direct supervision. All patients were given the medication for self-treatment at home and were requested to come back for follow-up on day 3 of the initial treatment. Baseline (day 0 and day 3 whole blood mefloquine and plasma primaquine concentrations were determined by high performance liquid chromatography. Results Two patients had recrudescence on days 28 and 35. The Kaplan-Meier estimate of the 42-day efficacy rate of this combination regimen was 99.2% (238/240. Based on whole blood mefloquine and plasma primaquine concentrations on day 3 of the initial treatment, compliance with mefloquine and primaquine in this three-day artesunate-mefloquine combination regimen were 96.3% (207/215, and 98.5% (197/200, respectively. Baseline mefloquine

  3. Daily baseline skin care in the prevention, treatment, and supportive care of skin toxicity in oncology patients: recommendations from a multinational expert panel.

    Science.gov (United States)

    Bensadoun, René-Jean; Humbert, Phillipe; Krutman, Jean; Luger, Thomas; Triller, Raoul; Rougier, André; Seite, Sophie; Dreno, Brigitte

    2013-01-01

    Skin reactions due to radiotherapy and chemotherapy are a significant problem for an important number of cancer patients. While effective for treating cancer, they disturb cutaneous barrier function, causing a reaction soon after initiation of treatment that impacts patient quality of life. Managing these symptoms with cosmetics and nonpharmaceutical skin care products for camouflage or personal hygiene may be important for increasing patient self-esteem. However, inappropriate product choice or use could worsen side effects. Although recommendations exist for the pharmaceutical treatment of skin reactions, there are no recommendations for the choice or use of dermatologic skin care products for oncology patients. The present guidelines were developed by a board of European experts in dermatology and oncology to provide cancer care professionals with guidance for the appropriate use of non-pharmaceutical, dermocosmetic skin care management of cutaneous toxicities associated with radiotherapy and systemic chemotherapy, including epidermal growth factor inhibitors and monoclonal antibodies. The experts hope that these recommendations will improve the management of cutaneous side effects and hence quality of life for oncology patients.

  4. Endoscopic management is the preferred treatment modality for a Grade III vesicoureteric reflux with breakthrough infections in a young girl

    Directory of Open Access Journals (Sweden)

    S S Joshi

    2008-01-01

    Full Text Available Endoscopic injection treatment for VUR appears to have less success rate than open surgical treatment, even in Gr 3 VUR. Economics of use of deflux injection and its success rate do not suit Indian milieu. To achieve high success rate of Atlanta group in endoscopic injection treatmnent , requires a longer learning curve and yet it has not achieved success rate of 96-98% achieved by open surgical techniques. Recent addition of modified extravesical reimplantation technique has reduced significantly the post operative pain and patient can be discharged within 2 days from the hospital.

  5. Long Baseline Neutrino Experiments

    Science.gov (United States)

    Mezzetto, Mauro

    2016-05-01

    Following the discovery of neutrino oscillations by the Super-Kamiokande collaboration, recently awarded with the Nobel Prize, two generations of long baseline experiments had been setup to further study neutrino oscillations. The first generation experiments, K2K in Japan, Minos in the States and Opera in Europe, focused in confirming the Super-Kamiokande result, improving the precision with which oscillation parameters had been measured and demonstrating the ντ appearance process. Second generation experiments, T2K in Japan and very recently NOνA in the States, went further, being optimized to look for genuine three neutrino phenomena like non-zero values of θ13 and first glimpses to leptonic CP violation (LCPV) and neutrino mass ordering (NMO). The discovery of leptonic CP violation will require third generation setups, at the moment two strong proposals are ongoing, Dune in the States and Hyper-Kamiokande in Japan. This review will focus a little more in these future initiatives.

  6. Biofuels Baseline 2008

    Energy Technology Data Exchange (ETDEWEB)

    Hamelinck, C.; Koper, M.; Berndes, G.; Englund, O.; Diaz-Chavez, R.; Kunen, E.; Walden, D.

    2011-10-15

    The European Union is promoting the use of biofuels and other renewable energy in transport. In April 2009, the Renewable Energy Directive (2009/28/EC) was adopted that set a 10% target for renewable energy in transport in 2020. The directive sets several requirements to the sustainability of biofuels marketed in the frame of the Directive. The Commission is required to report to the European Parliament on a regular basis on a range of sustainability impacts resulting from the use of biofuels in the EU. This report serves as a baseline of information for regular monitoring on the impacts of the Directive. Chapter 2 discusses the EU biofuels market, the production and consumption of biofuels and international trade. It is derived where the feedstock for EU consumed biofuels originally come from. Chapter 3 discusses the biofuel policy framework in the EU and major third countries of supply. It looks at various policy aspects that are relevant to comply with the EU sustainability requirements. Chapter 4 discusses the environmental and social sustainability aspects associated with EU biofuels and their feedstock. Chapter 5 discusses the macro-economic effects that indirectly result from increased EU biofuels consumption, on commodity prices and land use. Chapter 6 presents country factsheets for main third countries that supplied biofuels to the EU market in 2008.

  7. Patient Race and Outcome Preferences as Predictors of Urologists Treatment Recommendations and Referral Patterns in Early-Stage Prostate Cancer

    Science.gov (United States)

    2006-11-01

    of social support by race, economic status, and disease activity in systemic lupus erythematosus . J Rheumatol. 2001;28:1245–1251. 25. Nicolaidis C, Ko...State. BMC Pregnancy Childbirth. 2004;4:10. 26. Demark-Wahnefried W, Schildkraut JM, Iselin CE, et al. Treatment options, selection, and satisfaction

  8. The relationship between (stigmatizing) views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: Tuberculosis (TB) and human immune virus/acquired immune deficiency syndrome (HIV/AIDS) stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in rela

  9. The relationship between (stigmatizing) views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: Tuberculosis (TB) and human immune virus/acquired immune deficiency syndrome (HIV/AIDS) stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in

  10. Perceived need for information among patients with a haematological malignancy: associations with information satisfaction and treatment decision-making preferences.

    Science.gov (United States)

    Rood, Janneke A J; van Zuuren, Florence J; Stam, Frank; van der Ploeg, Tjeerd; Eeltink, Corien; Verdonck-de Leeuw, Irma M; Huijgens, Peter C

    2015-06-01

    For patients with haematological malignancies, information on disease, prognosis, treatment and impact on quality of life is of the utmost importance. To gain insight into the perceived need for information in relation to sociodemographic and clinical parameters, comorbidity, quality of life (QoL) and information satisfaction, we compiled a questionnaire based on existing validated questionnaires. A total of 458 patients diagnosed with a haematological malignancy participated. The perceived need for information was moderate to high (40-70%). Multivariate regression analyses showed that a higher need for information was related to younger age, worse QoL, being member of a patient society and moderate comorbidity. The need for disease and treatment-related information was higher than the need for psychosocial information. A higher need for disease and treatment-related information was associated to being diagnosed with multiple myeloma. A higher need for psychosocial information was related to a lower educational level. The information provision could be improved according to 41% of the patients. Higher satisfaction with provided information was associated with better QoL. Most patients (62%) reported that they wanted to be fully informed about their illness and actively involved in treatment decision-making. The results contribute to improving patient-tailored information provision and shared decision-making in clinical practice. Copyright © 2014 John Wiley & Sons, Ltd.

  11. Daily baseline skin care in the prevention, treatment, and supportive care of skin toxicity in oncology patients: recommendations from a multinational expert panel

    Directory of Open Access Journals (Sweden)

    Bensadoun RJ

    2013-12-01

    Full Text Available René-Jean Bensadoun,1 Phillipe Humbert,2 Jean Krutman,3 Thomas Luger,4 Raoul Triller,5 André Rougier,6 Sophie Seite,6 Brigitte Dreno71Department of Radiation Oncology, CHU Poitiers, Poitiers Cedex, 2Department of Dermatology, University Hospital of Besançon, Besançon, France; 3IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine University, Düsseldorf, 4Department of Dermatology, University of Münster, Münster, Germany; 5Centre of Dermatology, Hertford British Hospital, Levallois-Perret, 6La Roche-Posay Laboratoire Pharmaceutique, Asnières, 7Department of Cancero-Dermatology, Hôtel Dieu, CHU Nantes, FranceAbstract: Skin reactions due to radiotherapy and chemotherapy are a significant problem for an important number of cancer patients. While effective for treating cancer, they disturb cutaneous barrier function, causing a reaction soon after initiation of treatment that impacts patient quality of life. Managing these symptoms with cosmetics and nonpharmaceutical skin care products for camouflage or personal hygiene may be important for increasing patient self-esteem. However, inappropriate product choice or use could worsen side effects. Although recommendations exist for the pharmaceutical treatment of skin reactions, there are no recommendations for the choice or use of dermatologic skin care products for oncology patients. The present guidelines were developed by a board of European experts in dermatology and oncology to provide cancer care professionals with guidance for the appropriate use of non-pharmaceutical, dermocosmetic skin care management of cutaneous toxicities associated with radiotherapy and systemic chemotherapy, including epidermal growth factor inhibitors and monoclonal antibodies. The experts hope that these recommendations will improve the management of cutaneous side effects and hence quality of life for oncology patients.Keywords: skin care, cosmetic, dermatological toxicity, folliculitis

  12. Do baseline Cereblon gene expression and IL-6 receptor expression determine the response to thalidomide-dexamethasone treatment in multiple myeloma patients?

    Science.gov (United States)

    Bedewy, Ahmed M L; El-Maghraby, Shereen M

    2014-01-01

    Immunomodulatory drugs (IMiDs) are key components of treatment for hematologic malignancies, especially multiple myeloma (MM). Cereblon (CRBN) expression was described to be essential for the activity of thalidomide. Furthermore, IMiD binding to CRBN is cytotoxic to multiple myeloma cells and absence of CRBN confers IMiDs resistance. Interleukin-6 (IL-6) is a potent pleiotropic cytokine that regulates plasma cell (PC) growth via the IL-6 receptor (IL-6R). IL-6/IL-6R autocrine activity is implicated in the development and progression of cancers including cervical cancer, prostate cancer, and multiple myeloma. The aim of the study was to evaluate CRBN and IL-6R expressions and their impact on clinical efficacy of dexamethasone-thalidomide therapy in multiple myeloma (MM) patients, in addition to their association with other clinical and prognostic parameters. Forty-six newly diagnosed MM patients were enrolled in the study. We measured CRBN expression prior to therapy initiation by real-time polymerase chain reaction in 46 bone marrow (BM) aspiration samples of patients and controls. In addition, IL-6R expression was evaluated on BM biopsies of patients and controls by immunohistochemistry (IHC). Twenty-eight males (60.9%) and 18 females (39.1%) were enrolled. The mean age was 65.11 ± 7.3 yr (range 39-77 yr). Median CRBN expression in 46 BM samples of MM patients was significantly higher than in controls (P CRBN expression. IL-6R expression was significantly higher in patients than in controls. IL-6R expression was significantly associated with response to treatment (P CRBN expression (P = 0.001).In conclusion, CRBN expression may provide a biomarker to predict response to IMiD in patients with MM and its high expression can serve as a marker of good prognosis. Strong IL-6R expression is associated with poor response to therapy in multiple myeloma patients and may be used as a prognostic marker.

  13. Types of adult attention-deficit hyperactivity disorder (ADHD): baseline characteristics, initial response, and long-term response to treatment with methylphenidate.

    Science.gov (United States)

    Reimherr, Fred W; Marchant, Barrie K; Gift, Thomas E; Steans, Tammy A; Wender, Paul H

    2015-06-01

    Much recent research describes the importance of emotional symptoms in ADHD. While there is no accepted system for including emotionality in diagnosing ADHD, the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) provides a tool to facilitate this. It assesses a range of adult ADHD symptoms which load on two factors: inattentive and emotional dysregulation. The consistently high inattentive factor was used to define significant elevation on the more variable emotional dysregulation factor (which contains four WRAADDS domains: hyperactivity/restlessness, temper, affective lability, and emotional over-reactivity) allowing the definition of two ADHD diagnostic types. We compared these two types on a broad range of adult subject characteristics, including response to methylphenidate (MPH) treatment assessed during two clinical trials. Marked impairment in three of the four emotional domains reflected a symptom severity level equivalent to that of the inattentive factor. 59 % met this threshold, defining them as ADHD emotion dysregulation presentation, as opposed to 41 % with ADHD inattentive presentation. Cluster analysis validated these groups by generating similar clusters with 85 % agreement regarding membership. ADHD emotional dysregulation presentation subjects showed more childhood ADHD symptoms, adult symptoms of oppositional defiant disorder, and evidence of personality disorder. Both types showed similar improvement during the double-blind MPH arm of the trials and during a 6-month open-label phase. Based on the presence of symptoms of emotional dysregulation, ADHD in adults can be conceptualized as two types. Impairment and comorbidity in adults with ADHD are largely concentrated in ADHD emotional dysregulation presentation patients.

  14. Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Elena Losina

    Full Text Available Arthroscopic partial meniscectomy (APM is extensively used to relieve pain in patients with symptomatic meniscal tear (MT and knee osteoarthritis (OA. Recent studies have failed to show the superiority of APM compared to other treatments. We aim to examine whether existing evidence is sufficient to reject use of APM as a cost-effective treatment for MT+OA.We built a patient-level microsimulation using Monte Carlo methods and evaluated three strategies: Physical therapy ('PT' alone; PT followed by APM if subjects continued to experience pain ('Delayed APM'; and 'Immediate APM'. Our subject population was US adults with symptomatic MT and knee OA over a 10 year time horizon. We assessed treatment outcomes using societal costs, quality-adjusted life years (QALYs, and calculated incremental cost-effectiveness ratios (ICERs, incorporating productivity costs as a sensitivity analysis. We also conducted a value-of-information analysis using probabilistic sensitivity analyses.Calculated ICERs were estimated to be $12,900/QALY for Delayed APM as compared to PT and $103,200/QALY for Immediate APM as compared to Delayed APM. In sensitivity analyses, inclusion of time costs made Delayed APM cost-saving as compared to PT. Improving efficacy of Delayed APM led to higher incremental costs and lower incremental effectiveness of Immediate APM in comparison to Delayed APM. Probabilistic sensitivity analyses indicated that PT had 3.0% probability of being cost-effective at a willingness-to-pay (WTP threshold of $50,000/QALY. Delayed APM was cost effective 57.7% of the time at WTP = $50,000/QALY and 50.2% at WTP = $100,000/QALY. The probability of Immediate APM being cost-effective did not exceed 50% unless WTP exceeded $103,000/QALY.We conclude that current cost-effectiveness evidence does not support unqualified rejection of either Immediate or Delayed APM for the treatment of MT+OA. The amount to which society would be willing to pay for additional information

  15. Expressing Preferences using Preference Set Constraint Atoms

    CERN Document Server

    Brik, Alex

    2012-01-01

    This paper introduces an extension of Answer Set Programming called Preference Set Constraint Programming which is a convenient and general formalism to reason with preferences. PSC programming extends Set Constraint Programming introduced by Marek and Remmel (Marek and Remmel 2004) by introducing two types of preference set constraint atoms, measure preference set constraint atoms and pre-ordered preference set constraint atoms, which are extensions of set constraint atoms. We show that the question of whether a PSC program has a preferred stable model is CoNP-complete. We give examples of the uses of the preference set constraint atoms and show that Answer Set Optimization (Brewka, Niemel\\"a, and Truszczynski 2003) and General Preference (Son and Pontelli 2006) can be expressed using preference set constraint atoms.

  16. Racial and ethnic differences in advance care planning among patients with cancer: impact of terminal illness acknowledgment, religiousness, and treatment preferences.

    Science.gov (United States)

    Smith, Alexander K; McCarthy, Ellen P; Paulk, Elizabeth; Balboni, Tracy A; Maciejewski, Paul K; Block, Susan D; Prigerson, Holly G

    2008-09-01

    Despite well-documented racial and ethnic differences in advance care planning (ACP), we know little about why these differences exist. This study tested proposed mediators of racial/ethnic differences in ACP. We studied 312 non-Hispanic white, 83 non-Hispanic black, and 73 Hispanic patients with advanced cancer in the Coping with Cancer study, a federally funded multisite prospective cohort study designed to examine racial/ethnic disparities in ACP and end-of-life care. We assessed the impact of terminal illness acknowledgment, religiousness, and treatment preferences on racial/ethnic differences in ACP. Compared with white patients, black and Hispanic patients were less likely to have an ACP (white patients, 80%; black patients, 47%; Hispanic patients, 47%) and more likely to want life-prolonging care even if he or she had only a few days left to live (white patients, 14%; black patients, 45%; Hispanic patients, 34%) and to consider religion very important (white patients, 44%; black patients, 88%; Hispanic patients, 73%; all P Hispanic patients with white patients). Hispanic patients were less likely and black patients marginally less likely to acknowledge their terminally ill status (white patients, 39% v Hispanic patients, 11%; P Hispanic v white patients, 0.65 [95% CI, 0.47 to 0.89]). Although black and Hispanic patients are less likely to consider themselves terminally ill and more likely to want intensive treatment, these factors did not explain observed disparities in ACP.

  17. Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries

    Directory of Open Access Journals (Sweden)

    Littrell Megan

    2011-10-01

    Full Text Available Abstract Background Access to artemisinin-based combination therapy (ACT remains limited in high malaria-burden countries, and there are concerns that the poorest people are particularly disadvantaged. This paper presents new evidence on household treatment-seeking behaviour in six African countries. These data provide a baseline for monitoring interventions to increase ACT coverage, such as the Affordable Medicines Facility for malaria (AMFm. Methods Nationally representative household surveys were conducted in Benin, the Democratic Republic of Congo (DRC, Madagascar, Nigeria, Uganda and Zambia between 2008 and 2010. Caregivers responded to questions about management of recent fevers in children under five. Treatment indicators were tabulated across countries, and differences in case management provided by the public versus private sector were examined using chi-square tests. Logistic regression was used to test for association between socioeconomic status and 1 malaria blood testing, and 2 ACT treatment. Results Fever treatment with an ACT is low in Benin (10%, the DRC (5%, Madagascar (3% and Nigeria (5%, but higher in Uganda (21% and Zambia (21%. The wealthiest children are significantly more likely to receive ACT compared to the poorest children in Benin (OR = 2.68, 95% CI = 1.12-6.42; the DRC (OR = 2.18, 95% CI = 1.12-4.24; Madagascar (OR = 5.37, 95% CI = 1.58-18.24; and Nigeria (OR = 6.59, 95% CI = 2.73-15.89. Most caregivers seek treatment outside of the home, and private sector outlets are commonly the sole external source of treatment (except in Zambia. However, children treated in the public sector are significantly more likely to receive ACT treatment than those treated in the private sector (except in Madagascar. Nonetheless, levels of testing and ACT treatment in the public sector are low. Few caregivers name the national first-line drug as most effective for treating malaria in Madagascar (2%, the DRC (2%, Nigeria (4% and Benin (10

  18. Paricalcitol versus cinacalcet plus low-dose vitamin D for the treatment of secondary hyperparathyroidism in patients receiving haemodialysis: study design and baseline characteristics of the IMPACT SHPT study

    Science.gov (United States)

    Martin, Kevin J.; Cozzolino, Mario; Goldsmith, David; Sharma, Amit; Khan, Samina; Dumas, Emily; Amdahl, Michael; Marx, Steven; Audhya, Paul

    2012-01-01

    Background. Paricalcitol and cinacalcet are common therapies for patients on haemodialysis with secondary hyperparathyroidism (SHPT). We conducted a multi-centre study in 12 countries to compare the safety and efficacy of paricalcitol and cinacalcet for the treatment of SHPT. Methods. Patients aged ≥18 years with Stage 5 chronic kidney disease receiving maintenance haemodialysis and with intact parathyroid hormone (iPTH) 300–800 pg/mL, calcium 8.4–10.0 mg/dL (2.09–2.49 mmol/L) and phosphorus ≤6.5 mg/dL (2.09 mmol/L) were randomized within two strata defined by the mode of paricalcitol administration to treatment with paricalcitol- (intra-venous, US and Russian sites, IV stratum; oral, non-US and non-Russian sites, oral stratum) or cinacalcet-centred therapy. The primary endpoint is the proportion of patients in each treatment group who achieve a mean iPTH value of 150–300 pg/mL during Weeks 21–28 of treatment. Assuming efficacy response rates of 36 and 66% for cinacalcet and paricalcitol, respectively, and a 20% discontinuation rate, 124 subjects in each stratum were estimated to provide 81% power to detect a 30% absolute difference in the primary endpoint. Results. Of 746 patients screened, 272 (mean age, 63 years; mean iPTH, 509 pg/mL) were randomized. Mean duration of haemodialysis at baseline was 3.7 years. Comorbidities included hypertension (90.4%), Type 2 diabetes (40.4%), congestive heart failure (17.3%), coronary artery disease (34.6%) and gastrointestinal disorders (75%). Conclusions. The study participants are representative of a multinational cohort of patients on haemodialysis with elevated iPTH. The study results will provide valuable information on the best available treatment of SHPT in patients on haemodialysis. PMID:21931122

  19. Baseline Biomarkers for Outcome of Melanoma Patients Treated with Pembrolizumab

    NARCIS (Netherlands)

    Weide, Benjamin; Martens, Alexander; Hassel, Jessica C.; Berking, Carola; Postow, Michael A.; Bisschop, Kees; Simeone, Ester; Mangana, Johanna; Schilling, Bastian; Di Giacomo, Anna Maria; Brenner, Nicole; Kaehler, Katharina; Heinzerling, Lucie; Gutzmer, Ralf; Bender, Armin; Gebhardt, Christoffer; Romano, Emanuela; Meier, Friedegund; Martus, Peter; Maio, Michele; Blank, Christian; Schadendorf, Dirk; Dummer, Reinhard; Ascierto, Paolo A.; Hospers, Geke; Garbe, Claus; Wolchok, Jedd D.

    2016-01-01

    Purpose: Biomarkers for outcome after immune-checkpoint blockade are strongly needed as these may influence individual treatment selection or sequence. We aimed to identify baseline factors associated with overall survival (OS) after pembrolizumab treatment in melanoma patients. Experimental Design:

  20. What is the preferred number of consecutive night shifts?

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Jensen, Marie Aarrebo; Hansen, Åse Marie

    2016-01-01

    Among police officers in Denmark, we studied (i) how many consecutive night shifts participants preferred at baseline; (ii) preferences regarding three intervention conditions (two, four, and seven consecutive night shifts followed by the same number of days off/day shifts: '2 + 2', '4 + 4', '7 + 7...... work. The participants' preferences are likely to be influenced by their previous shift work experience. Practitioner Summary: We investigated police officers' preferences regarding the number of consecutive night shifts. The majority preferred four consecutive night shifts. Those who preferred...

  1. Hanford Site technical baseline database

    Energy Technology Data Exchange (ETDEWEB)

    Porter, P.E.

    1996-09-30

    This document includes a cassette tape that contains the Hanford specific files that make up the Hanford Site Technical Baseline Database as of September 30, 1996. The cassette tape also includes the delta files that dellinate the differences between this revision and revision 4 (May 10, 1996) of the Hanford Site Technical Baseline Database.

  2. Hanford Site technical baseline database

    Energy Technology Data Exchange (ETDEWEB)

    Porter, P.E., Westinghouse Hanford

    1996-05-10

    This document includes a cassette tape that contains the Hanford specific files that make up the Hanford Site Technical Baseline Database as of May 10, 1996. The cassette tape also includes the delta files that delineate the differences between this revision and revision 3 (April 10, 1996) of the Hanford Site Technical Baseline Database.

  3. Sociodemographic and clinical factors associated with the preference between NNRTIs and PIs for the initial treatment of HIV infection: Perfil-es study.

    Science.gov (United States)

    Viciana, Pompeyo; Ocampo, Antonio; Hevia, Henar; Palazuelos, Marta; Ledesma, Francisco

    2016-10-01

    The Perfil-es study demonstrated that, while non-nucleoside reverse transcriptase inhibitor (NNRTI)-based initial antiretroviral therapy (ART) is more frequently used in human immunodeficiency virus (HIV)-infected naïve patients, ritonavir-boosted protease inhibitors (PI/r)-based regimens are the preferred option in patients with advanced infectious stages or high baseline viral load. The present analysis focused on the second phase of the Perfil-es study, where sociodemographic and clinical data were retrospectively collected from patients starting NNRTI- or PI/r-based regimens in order to identify factors that could influence the choice of initial ART. Patients' characteristics were compared by both bivariate and multivariate analyses. A total of 642 patients were evaluated. The main transmission group was men who have sex with men (MSM) (48%), and 24% of patients were coinfected with hepatitis B or C. Patients with cardiovascular risk accounted for 56%, and 15% had a neuropsychiatric history. Anxiolytics (29%), antidepressants (18%) and methadone (18%) were the most frequent concomitant medications. The use of PI/r-based regimens was more frequent in older patients, childbearing potential women patients coinfected with hepatitis B or C, and those with cardiovascular risk and a neuropsychiatric history. The presence of a neuropsychiatric disorder (OR: 1.912; CI 95%: 1.146-3.191; p < .05) and the use of concomitant medication (OR: 1.736; CI 95%: 1.204-2.502; p < .01) were identified as independent factors associated with the selection of PI/r-based regimens. MSM sexual conduct was the only independent factor related to the selection of NNRTI-based ART (OR: 0.699; CI 95%: 0.504-0.970; p < .05). Neither the physicians' characteristics nor the geographical area where HIV patients were attended influenced the choice of ART. In conclusion, patients' comorbidity, pregnancy potential and lifestyle seem to influence the choice of ART. Neuropsychiatric

  4. Plutonium Immobilization Project Baseline Formulation

    Energy Technology Data Exchange (ETDEWEB)

    Ebbinghaus, B.

    1999-02-01

    A key milestone for the Immobilization Project (AOP Milestone 3.2a) in Fiscal Year 1998 (FY98) is the definition of the baseline composition or formulation for the plutonium ceramic form. The baseline formulation for the plutonium ceramic product must be finalized before the repository- and plant-related process specifications can be determined. The baseline formulation that is currently specified is given in Table 1.1. In addition to the baseline formulation specification, this report provides specifications for two alternative formulations, related compositional specifications (e.g., precursor compositions and mixing recipes), and other preliminary form and process specifications that are linked to the baseline formulation. The preliminary specifications, when finalized, are not expected to vary tremendously from the preliminary values given.

  5. Cost-effectiveness of modified-release prednisone in the treatment of moderate to severe rheumatoid arthritis with morning stiffness based on directly elicited public preference values

    Directory of Open Access Journals (Sweden)

    Dunlop W

    2013-10-01

    -prednisone. Furthermore, utility benefits were not captured in the clinical setting. Conclusion: This analysis demonstrates that, based on the CAPRA-1 trial and directly elicited public preference values, MR-prednisone is a cost-effective treatment option when compared with IR-prednisone for RA patients with morning stiffness over one year, according to commonly applied UK thresholds (£20,000–£30,000 per QALY. Further research into the costs of morning stiffness in RA is required. Keywords: modified-release prednisone, rheumatoid arthritis, morning stiffness, cost-effectiveness analysis, cost utility analysis, quality of life

  6. Veterans Administration Cooperative Dental Implant Study--comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part I: Methodology and comparisons between treatment groups at baseline.

    Science.gov (United States)

    Kapur, K K

    1987-10-01

    approach produced two treatment groups with comparable age, number of remaining maxillary and mandibular teeth, type of opposing dentition, and percent of patients with Kennedy class I and class II edentulous conditions. The mean scores of bone support, tooth mobility, and sulcular depths of abutment teeth were also similar. Significant but comparable improvements in oral hygiene and sulcular depth occurred in the two groups after treatment. The periodontal health scores at the 16-week interval serve as the baseline to measure subsequent changes in periodontal health.(ABSTRACT TRUNCATED AT 400 WORDS)

  7. Reusable and disposable insulin pens for the treatment of diabetes: understanding the global differences in user preference and an evaluation of inpatient insulin pen use.

    Science.gov (United States)

    Perfetti, Riccardo

    2010-06-01

    Insulin is essential for the management of type 1 diabetes and is more commonly being used for the treatment of type 2 diabetes. Insulin pen devices were first introduced over 20 years ago and have evolved to provide significant practical advantages compared with the vial and syringe. Pen devices are now used by patients with diabetes worldwide, but there are marked geographical variations in the use of reusable and disposable pens. In some countries the vial and syringe is still the most popular method of administering insulin, whereas in other countries the use of reusable or disposable pens is more prevalent. Therefore, the aim of this review is to discuss the factors that seem to be involved in these differences, which include patient access to insulin, cost, and physician/patient awareness and preference. Inpatient use of insulin is also common, and the use of insulin pens could offer substantial benefits in this patient population, not only during the admission period but also after discharge from the hospital. However, the evidence base for inpatient use is still weak, and more studies are needed to investigate the use of insulin pens in this patient population.

  8. Oscillation Baselining and Analysis Tool

    Energy Technology Data Exchange (ETDEWEB)

    2017-03-27

    PNNL developed a new tool for oscillation analysis and baselining. This tool has been developed under a new DOE Grid Modernization Laboratory Consortium (GMLC) Project (GM0072 - “Suite of open-source applications and models for advanced synchrophasor analysis”) and it is based on the open platform for PMU analysis. The Oscillation Baselining and Analysis Tool (OBAT) performs the oscillation analysis and identifies modes of oscillations (frequency, damping, energy, and shape). The tool also does oscillation event baselining (fining correlation between oscillations characteristics and system operating conditions).

  9. Quivira NWR biological baseline data

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This dataset is biological baseline data for Quivira National Wildlife Refuge as of January 2016. It contains data on species found on the refuge, when and where...

  10. 324 Building Baseline Radiological Characterization

    Energy Technology Data Exchange (ETDEWEB)

    R.J. Reeder, J.C. Cooper

    2010-06-24

    This report documents the analysis of radiological data collected as part of the characterization study performed in 1998. The study was performed to create a baseline of the radiological conditions in the 324 Building.

  11. Transitivity of Preferences

    Science.gov (United States)

    Regenwetter, Michel; Dana, Jason; Davis-Stober, Clintin P.

    2011-01-01

    Transitivity of preferences is a fundamental principle shared by most major contemporary rational, prescriptive, and descriptive models of decision making. To have transitive preferences, a person, group, or society that prefers choice option "x" to "y" and "y" to "z" must prefer "x" to "z". Any claim of empirical violations of transitivity by…

  12. Which method better evaluates the molecular response in newly diagnosed chronic phase chronic myeloid leukemia patients with imatinib treatment, BCR-ABL(IS) or log reduction from the baseline level?

    Science.gov (United States)

    Qin, Ya-Zhen; Jiang, Qian; Jiang, Hao; Li, Jin-Lan; Li, Ling-Di; Zhu, Hong-Hu; Lai, Yue-Yun; Lu, Xi-Jing; Liu, Yan-Rong; Jiang, Bin; Huang, Xiao-Jun

    2013-09-01

    The molecular response of chronic myeloid leukemia (CML) patients to tyrosine kinase inhibitor treatment can be evaluated either by BCR-ABL mRNA levels on international scale (IS) or by log reduction from the baseline level of the laboratory. Both methods were compared in 248 newly diagnosed chronic phase CML patients treated with imatinib. The major molecular responses (MMR) obtained by both methods predict progression-free survival (PFS, all Plog reduction method, had the same PFS as MMR patients identified by both methods. The molecular responses of patients at 3 and 6 months, as evaluated by the two methods, have similar predictive values on their cytogenetic responses at 12 months and on their molecular responses at 18 months. Both ≤ 10%(IS) and ≥ 1 log reduction at 3 months and ≤ 1%(IS) at 6 months were significantly associated with PFS (P=0.0011, 0.0090, and 0.0064). The percentages of patients with BCR-ABL(IS) of ≤ 1%, >1-10%, and of >10% at 3 months and 6 months in the German CML Study IV were similar with those with corresponding BCR-ABL(IS) in our center, but was significantly different with those evaluated by the log reduction method. Therefore, the molecular response evaluated by BCR-ABL(IS) has similar trends in PFS and in response prediction, but can better differentiate patients than that by the log reduction method. Furthermore, the IS method allows comparison among molecular response results from different laboratories.

  13. Clomipramine in treatment of sexual preference disorders%氯丙咪嗪控制性偏好障碍的初步观察

    Institute of Scientific and Technical Information of China (English)

    杨华渝

    1997-01-01

    Sisx ease of sexual preference disorders were treated with clomipramine.their impulsions of voyeur,exhibiton,fetish,toucheur and frotteur were under control,with slight effect on sexual desire and function.

  14. Comparison of emerald ash borer preference for ash of different species, sun exposure, age, and stress treatments in relation to foliar volatiles and nutrition

    Science.gov (United States)

    Therese M. Poland; Deepa S. Pureswaran; Yigen Chen

    2009-01-01

    We investigated the host selection behavior and feeding preference of the emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae) on six different species of ash including Manchurian ash (F...

  15. Learning to Baseline Business Technology

    Directory of Open Access Journals (Sweden)

    David Gore

    2013-10-01

    Full Text Available bills, sign multi-­‐year contracts, and make purchasing decisions without having an overall technology plan. That plan includes a technology baseline to fully assess existing technology. A CIO's goal is to align IT with business goals. Businesses must know total cost of ownership and the return on investment for all technology purchases and monthly costs. A business must also be able to manage technology assets and best utilize resources across the business. Teaching students to baseline technology will enable them to track and manage costs, discover errors and waste, and consolidate and improve existing technology.

  16. Learning the Personalized Intransitive Preferences of Images.

    Science.gov (United States)

    Chen, Jun; Wang, Chaokun; Wang, Jianmin; Ying, Xiang; Wang, Xuecheng

    2017-09-01

    Most of the previous studies on the user preferences assume that there is a personal transitive preference ranking of the consumable media like images. For example, the transitivity of preferences is one of the most important assumptions in the recommender system research. However, the intransitive relations have also been widely observed, such as the win/loss relations in online video games, in sport matches, and even in rock-paper-scissors games. It is also found that different subjects demonstrate the personalized intransitive preferences in the pairwise comparisons between the applicants for college admission. Since the intransitivity of preferences on images has barely been studied before and has a large impact on the research of personalized image search and recommendation, it is necessary to propose a novel method to predict the personalized intransitive preferences of images. In this paper, we propose the novel Multi-Criterion preference (MuCri) models to predict the intransitive relations in the image preferences. The MuCri models utilize different kinds of image content features as well as the latent features of users and images. Meanwhile, a new data set is constructed in this paper, in order to evaluate the performance of the MuCri models. The experimental evaluation shows that the MuCri models outperform all the baselines. Due to the interdisciplinary nature of this topic, we believe it would widely attract the attention of researchers in the image processing community as well as in other communities, such as machine learning, multimedia, and recommender system.

  17. Baseline Removal From EMG Recordings

    Science.gov (United States)

    2007-11-02

    a time-varying baseline contamination. Acknowledgements: Work funded by the Departamento de Salud del Gobierno de Navarrra and by a Spanish MEC...Name(s) and Address(es) Departamento de Ingenieria Electra y Electronica Universidad Publica de Navarra Pamplona, Spain Performing Organization Report

  18. Naloxone treatment alters gene expression in the mesolimbic reward system in 'junk food' exposed offspring in a sex-specific manner but does not affect food preferences in adulthood.

    Science.gov (United States)

    Gugusheff, J R; Ong, Z Y; Muhlhausler, B S

    2014-06-22

    We have previously reported that the opioid receptor blocker, naloxone, is less effective in reducing palatable food intake in offspring exposed to a maternal cafeteria diet during the perinatal period, implicating a desensitization of the central opioid pathway in the programming of food preferences. The present study aimed to investigate the effect of a maternal cafeteria diet and naloxone treatment on the development of the mesolimbic reward pathway and food choices in adulthood. We measured mRNA expression of key components of the reward pathway (mu-opioid receptor, proenkephalin, tyrosine hydroxylase, D1 and D2 receptors and the dopamine active transporter (DAT)) in the nucleus accumbens (NAc) and ventral tegmental area (VTA) of the offspring of control and cafeteria fed (JF) dams at weaning and after a 10-day naloxone treatment post-weaning and determined food preferences in adulthood in the remaining offspring. Naloxone treatment decreased the expression of DAT by 8.2 fold in female control offspring but increased it by 4.3 fold in female offspring of JF dams relative to the saline-injected reference groups. Proenkephalin mRNA expression was higher in the NAc of female JF offspring compared to controls, independent of naloxone treatment (Pfood preferences in adulthood in either control or JF offspring. These data indicate that prenatal exposure to a cafeteria diet alters the impact of opioid signaling blockade in the early post-weaning period on gene expression in the central reward pathway in a sex specific manner, but that these changes in gene expression do not appear to have any persistent impact on food preferences in adulthood. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Use of behavioral economics and social psychology to improve treatment of acute respiratory infections (BEARI): rationale and design of a cluster randomized controlled trial [1RC4AG039115-01] - study protocol and baseline practice and provider characteristics

    Science.gov (United States)

    2013-01-01

    Background Inappropriate antibiotic prescribing for nonbacterial infections leads to increases in the costs of care, antibiotic resistance among bacteria, and adverse drug events. Acute respiratory infections (ARIs) are the most common reason for inappropriate antibiotic use. Most prior efforts to decrease inappropriate antibiotic prescribing for ARIs (e.g., educational or informational interventions) have relied on the implicit assumption that clinicians inappropriately prescribe antibiotics because they are unaware of guideline recommendations for ARIs. If lack of guideline awareness is not the reason for inappropriate prescribing, educational interventions may have limited impact on prescribing rates. Instead, interventions that apply social psychological and behavioral economic principles may be more effective in deterring inappropriate antibiotic prescribing for ARIs by well-informed clinicians. Methods/design The Application of Behavioral Economics to Improve the Treatment of Acute Respiratory Infections (BEARI) Trial is a multisite, cluster-randomized controlled trial with practice as the unit of randomization. The primary aim is to test the ability of three interventions based on behavioral economic principles to reduce the rate of inappropriate antibiotic prescribing for ARIs. We randomized practices in a 2 × 2 × 2 factorial design to receive up to three interventions for non-antibiotic-appropriate diagnoses: 1) Accountable Justifications: When prescribing an antibiotic for an ARI, clinicians are prompted to record an explicit justification that appears in the patient electronic health record; 2) Suggested Alternatives: Through computerized clinical decision support, clinicians prescribing an antibiotic for an ARI receive a list of non-antibiotic treatment choices (including prescription options) prior to completing the antibiotic prescription; and 3) Peer Comparison: Each provider’s rate of inappropriate antibiotic prescribing relative to top

  20. A preference for migration

    OpenAIRE

    Stark, Oded

    2007-01-01

    At least to some extent migration behavior is the outcome of a preference for migration. The pattern of migration as an outcome of a preference for migration depends on two key factors: imitation technology and migration feasibility. We show that these factors jointly determine the outcome of a preference for migration and we provide examples that illustrate how the prevalence and transmission of a migration-forming preference yield distinct migration patterns. In particular, the imitation of...

  1. A preference for migration

    OpenAIRE

    Stark, Oded

    2007-01-01

    At least to some extent migration behavior is the outcome of a preference for migration. The pattern of migration as an outcome of a preference for migration depends on two key factors: imitation technology and migration feasibility. We show that these factors jointly determine the outcome of a preference for migration and we provide examples that illustrate how the prevalence and transmission of a migration-forming preference yield distinct migration patterns. In particular, the imitation of...

  2. Preferences of patients and health professionals for route and frequency of administration of biologic agents in the treatment of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Huynh, Tuan Khai; Ostergaard, Ann; Egsmose, Charlotte;

    2014-01-01

    OBJECTIVES: To examine the preferences of rheumatoid arthritis (RA) patients and health professionals (HPs) for the route and frequency of administration of biologic drugs. METHODS: One hundred and seven RA patients treated with biological agents for intravenous or subcutaneous use, 35 biologic-n...

  3. STD patients’ preferences for HIV prevention strategies

    Science.gov (United States)

    Castro, Jose G; Jones, Deborah L; Weiss, Stephen M

    2014-01-01

    The objective of this pilot study was to explore the knowledge of and preferences regarding effective biomedical interventions among high risk individuals attending a sexually transmitted diseases clinic, and to examine the effect of a brief information intervention on preference. Participants completed a baseline assessment, attended a presentation on human immunodeficiency virus (HIV) prevention methods, and completed a postintervention assessment. Outcome measures included: demographics and sexual risk factors, self-perceived HIV risk, and knowledge and attitudes regarding new biomedical methods of HIV prevention. After the baseline evaluation, participants were provided with information on new biomedical prevention strategies. Participants were given the option to review the information by reading a pamphlet or by viewing a brief video containing the same information. Participants (n=97) were female (n=51) and male (n=46). At baseline, only a small minority of participants were aware of the newer biomedical strategies to prevent HIV infection. Postintervention, 40% endorsed having heard about the use of HIV medications to prevent HIV infection; 72% had heard that male circumcision can decrease the risk of acquiring HIV infection in men; and 73% endorsed knowledge of the potential role of microbicides in decreasing the risk of acquiring HIV. Following the intervention, the most preferred prevention method was male condoms, followed by preexposure prophylaxis, and microbicides. The least preferred methods were male circumcision and female condoms. This study provides preliminary information on knowledge and attitudes regarding newer biomedical interventions to protect against HIV infection. PMID:25540597

  4. Activation instead of blocking mesolimbic dopaminergic reward circuitry is a preferred modality in the long term treatment of reward deficiency syndrome (RDS: a commentary

    Directory of Open Access Journals (Sweden)

    Waite Roger L

    2008-11-01

    Full Text Available Abstract Background and hypothesis Based on neurochemical and genetic evidence, we suggest that both prevention and treatment of multiple addictions, such as dependence to alcohol, nicotine and glucose, should involve a biphasic approach. Thus, acute treatment should consist of preferential blocking of postsynaptic Nucleus Accumbens (NAc dopamine receptors (D1-D5, whereas long term activation of the mesolimbic dopaminergic system should involve activation and/or release of Dopamine (DA at the NAc site. Failure to do so will result in abnormal mood, behavior and potential suicide ideation. Individuals possessing a paucity of serotonergic and/or dopaminergic receptors, and an increased rate of synaptic DA catabolism due to high catabolic genotype of the COMT gene, are predisposed to self-medicating any substance or behavior that will activate DA release, including alcohol, opiates, psychostimulants, nicotine, gambling, sex, and even excessive internet gaming. Acute utilization of these substances and/or stimulatory behaviors induces a feeling of well being. Unfortunately, sustained and prolonged abuse leads to a toxic" pseudo feeling" of well being resulting in tolerance and disease or discomfort. Thus, a reduced number of DA receptors, due to carrying the DRD2 A1 allelic genotype, results in excessive craving behavior; whereas a normal or sufficient amount of DA receptors results in low craving behavior. In terms of preventing substance abuse, one goal would be to induce a proliferation of DA D2 receptors in genetically prone individuals. While in vivo experiments using a typical D2 receptor agonist induce down regulation, experiments in vitro have shown that constant stimulation of the DA receptor system via a known D2 agonist results in significant proliferation of D2 receptors in spite of genetic antecedents. In essence, D2 receptor stimulation signals negative feedback mechanisms in the mesolimbic system to induce mRNA expression causing

  5. Preferences, Consumption Smoothing and Risk Premia

    NARCIS (Netherlands)

    Lettau, M.; Uhlig, H.F.H.V.S.

    1997-01-01

    Risk premia in the consumption capital asset pricing model depend on preferences and dividend. We develop a decomposition which allows a separate treatment of both components. We show that preferences alone determine the risk-return tradeoff measured by the Sharpe-ratio. In general, the risk-return

  6. Preferences, Consumption Smoothing and Risk Premia

    NARCIS (Netherlands)

    Lettau, M.; Uhlig, H.F.H.V.S.

    1997-01-01

    Risk premia in the consumption capital asset pricing model depend on preferences and dividend. We develop a decomposition which allows a separate treatment of both components. We show that preferences alone determine the risk-return tradeoff measured by the Sharpe-ratio. In general, the risk-return

  7. Mode S Baseline Radar Tracking.

    Science.gov (United States)

    1982-11-01

    range units and 20 azimuth units) overlaying the position of the beacon reports. In the cases analyzed where beacon reports were not radar reinforced ...82/53 j~ C ~ 7 C _ _ _ _ _ _ 4. Title end Su.btitle 5. Neget at. November 1982 MDDE S BASELINE RADAR TRACKIN4G 6. Poelin Orgeuianti.. Cede ACT-100...Ground Clutter 33 Mode S/ARTS III 100-Scan False Radar Track Summary 74 34 Percent Beacon Radar Reinforcement 77 vii INTRODUCTION PURPOSE. The purpose of

  8. Preferences over Social Risk

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Lau, Morten; Rutström, E. Elisabet;

    2013-01-01

    the methodological issues extend to larger groups that form endogenously (e.g., families, committees, communities). Preferences over social risk can be closely approximated by individual risk attitudes when subjects have no information about the risk preferences of other group members. We find no evidence......We elicit individual preferences over social risk. We identify the extent to which these preferences are correlated with preferences over individual risk and the well-being of others. We examine these preferences in the context of laboratory experiments over small, anonymous groups, although...... that subjects systematically reveal different risk attitudes in a social setting with no prior knowledge about the risk preferences of others compared to when they solely bear the consequences of the decision. However, we also find that subjects are significantly more risk averse when they know the risk...

  9. The Impact of a Low-Fat Diet and the Use of Fat Substitutes on Fat Preferences Among Overweight Women Seeking Weight Loss Treatment

    Science.gov (United States)

    2003-01-01

    PREFERENCE scored higher on the body dissatisfaction scale, fear of maturity, and perfectionism subscales than the eating disordered women used to...terminated (Hetherington, 1993). Individuals with eating disorders or obesity may have a skewed experience of pleasure from eating . That is, negative...pathology, defined by a score of greater than 10.5 on the bulimia subscale of the Eating Disorders Inventory (EDI). In addition, participants had

  10. Talk or text to tell? How young adults in Canada and South Africa prefer to receive STI results, counseling, and treatment updates in a wireless world.

    Science.gov (United States)

    Labacher, Lukas; Mitchell, Claudia

    2013-01-01

    Young adults often lack access to confidential, long-lasting, and nonjudgmental interactions with sexual health professionals at brick-and-mortar clinics. To ensure that patients return for their STI test results, post-result counseling, and STI-related information, computer-mediated health intervention programming allows them to receive sexual health information through onsite computers, the Internet, and mobile phone calls and text messages. To determine whether young adults (age: M = 21 years) prefer to communicate with health professionals about the status of their sexual health through computer-mediated communication devices, 303 second-year university students (183 from an urban North American university and 120 from a periurban university in South Africa) completed a paper-based survey indicating how they prefer to communicate with doctors and nurses: talking face to face, mobile phone call, text message, Internet chat programs, Facebook, Twitter, or e-mail. Nearly all students, and female students in South Africa in particular, prefer to receive their STI test results, post-results counseling, and STI-related information by talking face to face with doctors and nurses rather than communicating through computers or mobile phones. Results are clarified in relation to gender, availability of various technologies, and prevalence of HIV in Canada and in South Africa.

  11. The telmisartan renoprotective study from incipient nephropathy to overt nephropathy--rationale, study design, treatment plan and baseline characteristics of the incipient to overt: angiotensin II receptor blocker, telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) Study.

    Science.gov (United States)

    Makino, H; Haneda, M; Babazono, T; Moriya, T; Ito, S; Iwamoto, Y; Kawamori, R; Takeuchi, M; Katayama, S

    2005-01-01

    We planned the INNOVATION study to determine whether telmisartan, an angiotensin-2-receptor blocker, delays the progression of renal disease from incipient nephropathy to overt nephropathy in hypertensive or normotensive Japanese patients with type 2 diabetes mellitus. The INNOVATION study is a randomized, double-blind, placebo-controlled trial. Eligible patients must have incipient nephropathy (defined as a urinary albumin to creatinine ratio of 100-300 mg/g creatinine) and a serum creatinine concentration of 300 mg/g creatinine and 30% higher than the baseline on at least two consecutive visits). A total of 1855 patients have been enrolled from 160 study centres. In 527 randomized patients (28.4% of the enrolled patients), mean (SD) urinary albumin to creatinine ratio and serum creatinine concentration at baseline were 173.3 (47.2) mg/g creatinine and 0.78 (0.19) mg/dl. Sixty-eight per cent of the patients had hypertension at baseline. Mean (SD) systolic and diastolic blood pressures at baseline were 137.1 (14.6) and 77.5 (10.3) mmHg. The INNOVATION study will determine whether telmisartan, an angiotensin II receptor blocker, provides clinical benefits in hypertensive or normotensive patients with diabetes mellitus and diabetic nephropathy.

  12. Long-Baseline Neutrino Experiments

    CERN Document Server

    Diwan, M V; Qian, X; Rubbia, A

    2016-01-01

    We review long-baseline neutrino experiments in which neutrinos are detected after traversing macroscopic distances. Over such distances neutrinos have been found to oscillate among flavor states. Experiments with solar, atmospheric, reactor, and accelerator neutrinos have resulted in a coherent picture of neutrino masses and mixing of the three known flavor states. We will summarize the current best knowledge of neutrino parameters and phenomenology with our focus on the evolution of the experimental technique. We proceed from the first evidence produced by astrophysical neutrino sources to the current open questions and the goals of future research.

  13. Long-Baseline Neutrino Experiments

    Science.gov (United States)

    Diwan, M. V.; Galymov, V.; Qian, X.; Rubbia, A.

    2016-10-01

    We review long-baseline neutrino experiments in which neutrinos are detected after traversing macroscopic distances. Over such distances neutrinos have been found to oscillate among flavor states. Experiments with solar, atmospheric, reactor, and accelerator neutrinos have resulted in a coherent picture of neutrino masses and mixing of the three known flavor states. We summarize the current best knowledge of neutrino parameters and phenomenology, with a focus on the evolution of the experimental technique. We proceed from the first evidence produced by astrophysical neutrino sources to the current open questions and the goals of future research.

  14. Baseline LAW Glass Formulation Testing

    Energy Technology Data Exchange (ETDEWEB)

    Kruger, Albert A. [USDOE Office of River Protection, Richland, WA (United States); Mooers, Cavin [The Catholic University of America, Washington, DC (United States). Vitreous State Lab.; Bazemore, Gina [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Pegg, Ian L. [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Hight, Kenneth [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Lai, Shan Tao [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Buechele, Andrew [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Rielley, Elizabeth [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Gan, Hao [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Muller, Isabelle S. [The Catholic University of America, Washington, DC (United States). Vitreous State Lab; Cecil, Richard [The Catholic University of America, Washington, DC (United States). Vitreous State Lab

    2013-06-13

    The major objective of the baseline glass formulation work was to develop and select glass formulations that are compliant with contractual and processing requirements for each of the LAW waste streams. Other objectives of the work included preparation and characterization of glasses with respect to the properties of interest, optimization of sulfate loading in the glasses, evaluation of ability to achieve waste loading limits, testing to demonstrate compatibility of glass melts with melter materials of construction, development of glass formulations to support ILAW qualification activities, and identification of glass formulation issues with respect to contract specifications and processing requirements.

  15. FED baseline engineering studies report

    Energy Technology Data Exchange (ETDEWEB)

    Sager, P.H.

    1983-04-01

    Studies were carried out on the FED Baseline to improve design definition, establish feasibility, and reduce cost. Emphasis was placed on cost reduction, but significant feasibility concerns existed in several areas, and better design definition was required to establish feasibility and provide a better basis for cost estimates. Design definition and feasibility studies included the development of a labyrinth shield ring concept to prevent radiation streaming between the torus spool and the TF coil cryostat. The labyrinth shield concept which was developed reduced radiation streaming sufficiently to permit contact maintenance of the inboard EF coils. Various concepts of preventing arcing between adjacent shield sectors were also explored. It was concluded that installation of copper straps with molybdenum thermal radiation shields would provide the most reliable means of preventing arcing. Other design studies included torus spool electrical/structural concepts, test module shielding, torus seismic response, poloidal conditions in the magnets, disruption characteristics, and eddy current effects. These additional studies had no significant impact on cost but did confirm the feasibility of the basic FED Baseline concept.

  16. Shared decision making in dermato-oncology: preference for involvement of melanoma patients.

    Science.gov (United States)

    Albrecht, Karoline J; Nashan, Dorothée; Meiss, Frank; Bengel, Jürgen; Reuter, Katrin

    2014-02-01

    Increasing importance is being conferred to the implementation of shared decision making (SDM) in clinical practice for medical, ethical, and sociological reasons. In Germany, SDM has recently been adopted as an explicit goal in the S3-melanoma treatment guideline. The aim of this study is to present data on how melanoma patients want to be involved in treatment decisions and second on the dynamic of these preferences for involvement. This was investigated in consecutively recruited melanoma patients (stages I-III) in two German Skin Cancer Centers as part of a longitudinal questionnaire study. The Control Preference Scale assessed patients' preferences at baseline (n=405) and was readministered 1 year later (n=314) to detect potential changes. In addition, the perceived realization of SDM in the adjuvant interferon-α treatment decision was investigated in a subgroup of patients (n=108) using the nine-item Shared Decision Making Questionnaire (SDM-Q-9). More than 80% of the patients want to play an active role (autonomous or collaborative) in treatment decisions and only 17% want to delegate their decision to the doctor. We found a significant preference shift within a year in 43% of the patients, predominantly toward more active involvement. The results of the SDM-Q-9 indicate a moderate degree of perceived participation, with differing perceived implementation of the individual the SDM process steps. With the majority of melanoma patients preferring an active role in treatment decisions and improvable implementation of the SDM process steps in clinical practice, our findings support the relevance of SDM in dermato-oncology.

  17. Pinellas Plant Environmental Baseline Report

    Energy Technology Data Exchange (ETDEWEB)

    1997-06-01

    The Pinellas Plant has been part of the Department of Energy`s (DOE) nuclear weapons complex since the plant opened in 1957. In March 1995, the DOE sold the Pinellas Plant to the Pinellas County Industry Council (PCIC). DOE has leased back a large portion of the plant site to facilitate transition to alternate use and safe shutdown. The current mission is to achieve a safe transition of the facility from defense production and prepare the site for alternative uses as a community resource for economic development. Toward that effort, the Pinellas Plant Environmental Baseline Report (EBR) discusses the current and past environmental conditions of the plant site. Information for the EBR is obtained from plant records. Historical process and chemical usage information for each area is reviewed during area characterizations.

  18. Integrated Baseline Review (IBR) Handbook

    Science.gov (United States)

    Fleming, Jon F.; Kehrer, Kristen C.

    2016-01-01

    The purpose of this handbook is intended to be a how-to guide to prepare for, conduct, and close-out an Integrated Baseline Review (IBR). It discusses the steps that should be considered, describes roles and responsibilities, tips for tailoring the IBR based on risk, cost, and need for management insight, and provides lessons learned from past IBRs. Appendices contain example documentation typically used in connection with an IBR. Note that these appendices are examples only, and should be tailored to meet the needs of individual projects and contracts. Following the guidance in this handbook will help customers and suppliers preparing for an IBR understand the expectations of the IBR, and ensure that the IBR meets the requirements for both in-house and contract efforts.

  19. TOIB Study. Are topical or oral ibuprofen equally effective for the treatment of chronic knee pain presenting in primary care: a randomised controlled trial with patient preference study. [ISRCTN79353052

    Directory of Open Access Journals (Sweden)

    Parsons Suzanne

    2005-11-01

    Full Text Available Abstract Background Many older people have chronic knee pain. Both topical and oral non- steroidal anti-inflammatory drugs (NSAIDs are commonly used to treat this. Oral NSAIDS are effective, at least in the short term, but can have severe adverse effects. Topical NSAIDs also appear to be effective, at least in the short term. One might expect topical NSAIDs both to be less effective and to have fewer adverse effects than oral NSAIDs. If topical NSAIDs have fewer adverse effects this may outweigh both the reduction in effectiveness and the higher cost of topical compared to oral treatment. Patient preferences may influence the comparative effectiveness of drugs delivered via different routes. Methods TOIB is a randomised trial comparing topical and oral ibuprofen, with a parallel patient preference study. We are recruiting people aged 50 or over with chronic knee pain, from 27 MRC General Practice Research Framework practices across the UK. We are seeking to recruit 283 participants to the RCT and 379 to the PPS. Participants will be followed up for up to two years (with the majority reaching one year. Outcomes will be assessed by postal questionnaire, nurse examination, laboratory tests and medical record searches at one and two years or the end of the study. Discussion This study will provide new evidence on the overall costs and benefits of treating chronic knee pain with either oral or topical ibuprofen. The use of a patient preference design is unusual, but will allow us to explore how preference influences response to a medication. In addition, it will provide more information on adverse events. This study will provide evidence to inform primary care practitioners, and possibly influence practice.

  20. Preference, priorities and belief

    NARCIS (Netherlands)

    de Jongh, D.; Liu, F.; Grüne-Yanoff, T.; Hansson, S.O.

    2009-01-01

    In this paper we consider preference over objects. We show how this preference can be derived from priorities, properties of these objects, a concept which is initially from optimality theory. We do this both in the case when an agent has complete information and in the case when an agent only has b

  1. von Neumann Morgenstern Preferences

    DEFF Research Database (Denmark)

    Vind, Karl

    von Neumann Morgenstern utility is generalized to von Neumann Morgenstern preferences. The proof is an application of simple hyperplane theorems......von Neumann Morgenstern utility is generalized to von Neumann Morgenstern preferences. The proof is an application of simple hyperplane theorems...

  2. von Neumann Morgenstern Preferences

    DEFF Research Database (Denmark)

    Vind, Karl

    2000-01-01

    von Neumann Morgenstern utility is generalized to von Neumann Morgenstern preferences. The proof is an application of simple hyperplane theorems......von Neumann Morgenstern utility is generalized to von Neumann Morgenstern preferences. The proof is an application of simple hyperplane theorems...

  3. Eye tracking social preferences

    NARCIS (Netherlands)

    Jiang, Ting; Potters, Jan; Funaki, Yukihiko

    We hypothesize that if people are motivated by a particular social preference, then choosing in accordance with this preference will lead to an identifiable pattern of eye movements. We track eye movements while subjects make choices in simple three-person distribution experiments. We characterize

  4. Consumers’ preferences for bread

    DEFF Research Database (Denmark)

    Edenbrandt, Anna Kristina; Gamborg, Christian; Thorsen, Bo Jellesmark

    2017-01-01

    Consumers are apprehensive about transgenic technologies, so cisgenics, which limit gene transfers to sexually compatible organisms, have been suggested to address consumer concerns. We study consumer preferences for rye bread alternatives based on transgenic or cisgenic rye, grown conventionally...... pesticide-free production methods, and that while cisgenics is preferred over transgenics, the majority of respondents favour traditional breeding methods. The distribution in preferences suggests that some respondents prefer bread from cisgenic crops produced without pesticides over traditional crops...... produced using pesticides. Preferences for organic bread are stronger than for pesticide-free products. From a policy perspective results suggest that excluding cisgenics from mandatory labeling in the EU, or including it in the voluntary non-GM labelling in the US, would cause welfare losses for consumers....

  5. 2016 Annual Technology Baseline (ATB)

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; O' Connor, Patrick; Waldoch, Connor

    2016-09-01

    Consistent cost and performance data for various electricity generation technologies can be difficult to find and may change frequently for certain technologies. With the Annual Technology Baseline (ATB), National Renewable Energy Laboratory provides an organized and centralized dataset that was reviewed by internal and external experts. It uses the best information from the Department of Energy laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information. The ATB includes both a presentation with notes (PDF) and an associated Excel Workbook. The ATB includes the following electricity generation technologies: land-based wind; offshore wind; utility-scale solar PV; concentrating solar power; geothermal power; hydropower plants (upgrades to existing facilities, powering non-powered dams, and new stream-reach development); conventional coal; coal with carbon capture and sequestration; integrated gasification combined cycle coal; natural gas combustion turbines; natural gas combined cycle; conventional biopower. Nuclear laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information.

  6. 2016 Annual Technology Baseline (ATB) - Webinar Presentation

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; Porro, Gian; O' Connor, Patrick; Waldoch, Connor

    2016-09-13

    This deck was presented for the 2016 Annual Technology Baseline Webinar. The presentation describes the Annual Technology Baseline, which is a compilation of current and future cost and performance data for electricity generation technologies.

  7. Atlantic NAD 83 SLA Baseline Points

    Data.gov (United States)

    Bureau of Ocean Energy Management, Department of the Interior — This data set contains baseline points in ArcGIS shapefile format for the BOEM Atlantic Region. Baseline points are the discrete coordinate points along the...

  8. Atlantic NAD 83 SLA Baseline Points

    Data.gov (United States)

    Bureau of Ocean Energy Management, Department of the Interior — This data set contains baseline points in ArcGIS shapefile format for the BOEM Atlantic Region. Baseline points are the discrete coordinate points along the...

  9. Atlantic NAD 83 SLA Baseline Tangents

    Data.gov (United States)

    Bureau of Ocean Energy Management, Department of the Interior — This data set contains baseline tangent lines in ArcGIS shapefile format for the BOEM Atlantic Region. Baseline tangent lines are typically bay or river closing...

  10. Visual aesthetics and human preference.

    Science.gov (United States)

    Palmer, Stephen E; Schloss, Karen B; Sammartino, Jonathan

    2013-01-01

    Human aesthetic preference in the visual domain is reviewed from definitional, methodological, empirical, and theoretical perspectives. Aesthetic science is distinguished from the perception of art and from philosophical treatments of aesthetics. The strengths and weaknesses of important behavioral techniques are presented and discussed, including two-alternative forced-choice, rank order, subjective rating, production/adjustment, indirect, and other tasks. Major findings are reviewed about preferences for colors (single colors, color combinations, and color harmony), spatial structure (low-level spatial properties, shape properties, and spatial composition within a frame), and individual differences in both color and spatial structure. Major theoretical accounts of aesthetic response are outlined and evaluated, including explanations in terms of mere exposure effects, arousal dynamics, categorical prototypes, ecological factors, perceptual and conceptual fluency, and the interaction of multiple components. The results of the review support the conclusion that aesthetic response can be studied rigorously and meaningfully within the framework of scientific psychology.

  11. 40 CFR 1042.825 - Baseline determination.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Baseline determination. 1042.825... Provisions for Remanufactured Marine Engines § 1042.825 Baseline determination. (a) For the purpose of this... not valid. (f) Use good engineering judgment for all aspects of the baseline determination. We may...

  12. STD patients’ preferences for HIV prevention strategies

    Directory of Open Access Journals (Sweden)

    Castro JG

    2014-12-01

    Full Text Available Jose G Castro,1 Deborah L Jones,2 Stephen M Weiss2 1Infectious Diseases, Department of Medicine, 2Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA Abstract: The objective of this pilot study was to explore the knowledge of and preferences regarding effective biomedical interventions among high risk individuals attending a sexually transmitted diseases clinic, and to examine the effect of a brief information intervention on preference. Participants completed a baseline assessment, attended a presentation on human immunodeficiency virus (HIV prevention methods, and completed a postintervention assessment. Outcome measures included: demographics and sexual risk factors, self-perceived HIV risk, and knowledge and attitudes regarding new biomedical methods of HIV prevention. After the baseline evaluation, participants were provided with information on new biomedical prevention strategies. Participants were given the option to review the information by reading a pamphlet or by viewing a brief video containing the same information. Participants (n=97 were female (n=51 and male (n=46. At baseline, only a small minority of participants were aware of the newer biomedical strategies to prevent HIV infection. Postintervention, 40% endorsed having heard about the use of HIV medications to prevent HIV infection; 72% had heard that male circumcision can decrease the risk of acquiring HIV infection in men; and 73% endorsed knowledge of the potential role of microbicides in decreasing the risk of acquiring HIV. Following the intervention, the most preferred prevention method was male condoms, followed by preexposure prophylaxis, and microbicides. The least preferred methods were male circumcision and female condoms. This study provides preliminary information on knowledge and attitudes regarding newer biomedical interventions to protect against HIV infection. Keywords: STD clinic, biomedical HIV prevention, PrEP, male

  13. Estimating exponential scheduling preferences

    DEFF Research Database (Denmark)

    Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid

    time by maximising expected total utility over the day, their departure times are conditional on rates of utility derived at these locations. For forecasting and economic evaluation of planning alternatives, it is desirable to have simple forms of utility rates with few parameters. Several forms...... the travel time is random, Noland and Small (1995) suggested using expected utility theory to derive the reduced form of expected travel time cost that includes the cost of TTV. For the α-β-γ formulation of scheduling preferences and exponential or uniform distribution of travel time, Noland and Small (1995....... The purpose of this paper is to explore how well these scheduling preferences explain behaviour, compared to other possible scheduling models, and whether empirical estimation of the more complex exponential scheduling preferences is feasible. We use data from a stated preference survey conducted among car...

  14. Estimating exponential scheduling preferences

    DEFF Research Database (Denmark)

    Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid

    time by maximising expected total utility over the day, their departure times are conditional on rates of utility derived at these locations. For forecasting and economic evaluation of planning alternatives, it is desirable to have simple forms of utility rates with few parameters. Several forms...... the travel time is random, Noland and Small (1995) suggested using expected utility theory to derive the reduced form of expected travel time cost that includes the cost of TTV. For the α-β-γ formulation of scheduling preferences and exponential or uniform distribution of travel time, Noland and Small (1995....... The purpose of this paper is to explore how well these scheduling preferences explain behaviour, compared to other possible scheduling models, and whether empirical estimation of the more complex exponential scheduling preferences is feasible. We use data from a stated preference survey conducted among car...

  15. Preferred axis in cosmology

    CERN Document Server

    Zhao, Wen

    2016-01-01

    The foundation of modern cosmology relies on the so-called cosmological principle which states an homogeneous and isotropic distribution of matter in the universe on large scales. However, recent observations, such as the temperature anisotropy of the cosmic microwave background (CMB) radiation, the motion of galaxies in the universe, the polarization of quasars and the acceleration of the cosmic expansion, indicate preferred directions in the sky. If these directions have a cosmological origin, the cosmological principle would be violated, and modern cosmology should be reconsidered. In this paper, by considering the preferred axis in the CMB parity violation, we find that it coincides with the preferred axes in CMB quadrupole and CMB octopole, and they all align with the direction of the CMB kinematic dipole. In addition, the preferred directions in the velocity flows, quasar alignment, anisotropy of the cosmic acceleration, the handedness of spiral galaxies, and the angular distribution of the fine-structu...

  16. Student Preferences in Typography.

    Science.gov (United States)

    Bell, Richard C.; Sullivan, James L. F.

    1981-01-01

    Describes a study in which 245 university students ranked their preferences among typographical variants of typeface, size, emphasis, and interline space in 16 paragraphs. Six references are listed. (CHC)

  17. Effects of ampicillin, cefazolin and cefoperazone treatments on GLT-1 expressions in the mesocorticolimbic system and ethanol intake in alcohol-preferring rats.

    Science.gov (United States)

    Rao, P S S; Goodwani, S; Bell, R L; Wei, Y; Boddu, S H S; Sari, Y

    2015-06-01

    Chronic ethanol consumption is known to downregulate expression of the major glutamate transporter 1 (GLT-1), which increases extracellular glutamate concentrations in subregions of the mesocorticolimbic reward pathway. While β-lactam antibiotics were initially identified as potent upregulators of GLT-1 expression, only ceftriaxone has been extensively studied in various drug addiction models. Therefore, in this study, adult male alcohol-preferring (P) rats exposed chronically to ethanol were treated with other β-lactam antibiotics, ampicillin, cefazolin or cefoperazone (100mg/kg) once daily for five consecutive days to assess their effects on ethanol consumption. The results demonstrated that each compound significantly reduced ethanol intake compared to the saline-treated control group. Importantly, each compound significantly upregulated both GLT-1 and pAKT expressions in the nucleus accumbens and prefrontal cortex compared to saline-treated control group. In addition, only cefoperazone significantly inhibited hepatic aldehyde dehydrogenase-2 enzyme activity. Moreover, these β-lactams exerted only a transient effect on sucrose drinking, suggesting specificity for chronically inhibiting ethanol reward in adult male P rats. Cerebrospinal fluid concentrations of ampicillin, cefazolin or cefoperazone have been confirmed using high-performance liquid chromatography. These findings demonstrate that multiple β-lactam antibiotics demonstrate efficacy in reducing alcohol consumption and appear to be potential therapeutic compounds for treating alcohol abuse and/or dependence. In addition, these results suggest that pAKT may be an important player in this effect, possibly through increased transcription of GLT-1.

  18. Preference for newspaper size.

    Science.gov (United States)

    Tsang, Steve N H; Hoffmann, Errol R; Chan, Alan H S

    2014-05-01

    The past few years has seen a change in the size of newspapers, with publishers moving to a smaller size format. Five 'standard' newspaper sizes are used in different countries: Broadsheet, Rhensch, Tabloid, Tall Tabloid and Berliner. These papers vary in both width and height of pages and hence there are implications for human reading comfort, which may be dependent on reading location such as on a lounge chair or on a train. Experiments were carried out to determine preferences for the different sizes and to relate these preferences to the geometric characteristics of the newspapers. For both comfortable and cramped/uncomfortable reading conditions, the rank order of preference for paper types was, from least to most-preferred, Broadsheet, Rhensch, Berliner, Tall Tabloid and Tabloid. Preferences were much stronger when determined in cramped/uncomfortable reading conditions, where most comparisons were significantly different. There was good correlation between participant ratings on several scales and preference, where most factors were related to comfort of holding and controlling the paper. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Comparison of non-radiographic axial spondyloarthritis and ankylosing spondylitis patients - baseline characteristics, treatment adherence, and development of clinical variables during three years of anti-TNF therapy in clinical practice

    DEFF Research Database (Denmark)

    Wallman, Johan K; Kapetanovic, Meliha C; Petersson, Ingemar F

    2015-01-01

    BACKGROUND: The relationship between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) is currently debated. Using observational data from the South Swedish Arthritis Treatment Group register, we thus aimed to compare clinical development and treatment adherence...

  20. Baseline survey of pregnant women 's knowledge of treat-ment to prevent mother-to-child human immuno-deficien-cy virus transmission in a resource limited setting

    Institute of Scientific and Technical Information of China (English)

    Stephen Onwere; Obioha Okoro; Bright Chigbu; Chuks Kamanu; Christian Aluka; Paul Feyi-Wa-boso

    2008-01-01

    Despite continuing advances in scientific knowledge about treatments to prevent mother-to-child (MTCT)of the human immune deficiency virus (HIV),there is a paucity of data on pregnant women's knowledge of treat-ments to prevent MTCT of HIV in Aba,South Eastern Nigeria.We investigated pregnant women's knowledge of the availability of treatments to prevent MTCT of HIV in the low resourced setting of Aba town in South Eastern Nigeria.A descriptive study involving 100 consecutive and consenting patients at the antenatal clinic of Abia State University Teaching Hospital (ABSUTH),Aba,South Eastern Nigeria over the period 1st November, 2007 to 30th November,2007.Using a structured questionnaire,the respondents'sociodemographic data were obtained as well as their knowledge of the availability of treatments to prevent mother to child HIV transmission in pregnant women and self-reported data on their having ever tested for HIV.Knowledge regarding availability of treatment to prevent mother to child transmission of HIV was good as 95% of the respondents were aware that such treatment was available.Knowledge that treatment is available to help someone infected by HIV to live longer was also good as 96% of the respondents were aware of the availability of such treatment.Seventy one percent of the respondents had ever tested for HIV.The levels of knowledge regarding the availability of treatment to prevent mother to child HIV transmission and to help someone infected with HIV are good.Thus, utilization of anti-retroviral prophylaxis amongst HIV infected pregnant women in this community would be ex-pected to be high if the drugs were available.This will reduce the impact of HIV,especially in children.

  1. Patient Race and Outcome Preferences as Predictors of Urologists’ Treatment Recommendations and Referral Patterns in Early-Stage Prostate Cancer

    Science.gov (United States)

    2007-11-01

    social support by race, economic status, and disease activity in systemic lupus erythematosus . J Rheumatol. 2001;28:1245–1251. 25. Nicolaidis C, Ko CW...BMC Pregnancy Childbirth. 2004;4:10. 26. Demark-Wahnefried W, Schildkraut JM, Iselin CE, et al. Treatment options, selection, and satisfaction among

  2. Preimplantation genetic screening as an alternative to prenatal testing for Down syndrome : preferences of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment

    NARCIS (Netherlands)

    Twisk, Moniek; Haadsma, Maaike L.; van der Veen, Fulco; Repping, Sjoerd; Mastenbroek, Sebastiaan; Heineman, Maas-Jan; Bossuyt, Patrick M. M.; Korevaar, Johanna C.

    2007-01-01

    Objective: Although the primary goal of preimplantation genetic screening (PGS) is to increase pregnancy rates in women undergoing IVF/intracytoplasmic sperm injection treatment, it has been suggested that it may also be used as an alternative to prenatal testing for Down syndrome. Design: Trade-off

  3. Finger Tapping-Related Activation Differences in Treatment-Naive Pediatric Tourette Syndrome: A Comparison of the Preferred and Nonpreferred Hand

    Science.gov (United States)

    Roessner, Veit; Wittfoth, Matthias; August, Julia M.; Rothenberger, Aribert; Baudewig, Jurgen; Dechent, Peter

    2013-01-01

    Background: Disturbances of motor circuitry are commonly encountered in Tourette syndrome (TS). The aim of this study was to investigate simple motor performance differences between boys with TS and healthy controls. Methods: We attempted to provide insight into motor network alterations by studying a group of treatment-naive patients suffering…

  4. Pre-fermentative cold maceration, saignée, and various thermal treatments as options for modulating volatile aroma and phenol profiles of red wine.

    Science.gov (United States)

    Lukić, Igor; Budić-Leto, Irena; Bubola, Marijan; Damijanić, Kristijan; Staver, Mario

    2017-06-01

    The effects of six maceration treatments on volatile aroma and phenol composition of Teran red wine were studied: standard maceration (control C), cold pre-fermentation maceration (CPM), saignée (S), pre-fermentation heating with extended maceration (PHT) or juice fermentation (PHP), and post-fermentation heating (POH). PHP wine contained the highest amounts of esters, fatty acids and anthocyanins, and the lowest content of other phenols. Alternative treatments decreased higher alcohols in relation to control C. CPM treatment lowered the extraction of seed tannins, exhibited the highest acetaldehyde, ethyl acetate and C6-compounds levels, and had increased ester levels in relation to control C. POH wine contained the highest concentration of total phenols, flavonoids, monomeric, oligomeric and polymeric flavanols, and color intensity and hue. S and PHT wines contained lower amount of total phenols, but higher than in C and CPM wines. The calculated Odor Activity Values were used to establish significant differences between the treatments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Measuring children's food preferences

    DEFF Research Database (Denmark)

    Olsen, Annemarie; Kildegaard, Heidi; Gabrielsen, Gorm

    2012-01-01

    The aim of this study is to investigate if children’s food preferences can be reliable measured by using pictures of foods presented on a computer screen in a conjoint layout.We investigate reproducibility (test–retest) and infer validity by comparison with traditional hedonic evaluations...... juices (tangible products), chosen to span the preference spectrum, were hedonically evaluated for appearance and taste. Finally, an actual product choice was performed by having the children choose between two buns and two juices.Results showed that the computer evaluationswith pictures of foods...... provided reproducible information about the children’s visual food preferences, which were in concordance with both hedonic measures and products choices, and can thus be considered valid....

  6. The Combination of Marketed Antagonists of α1b-Adrenergic and 5-HT2A Receptors Inhibits Behavioral Sensitization and Preference to Alcohol in Mice: A Promising Approach for the Treatment of Alcohol Dependence.

    Directory of Open Access Journals (Sweden)

    Fabrice Trovero

    Full Text Available Alcohol-dependence is a chronic disease with a dramatic and expensive social impact. Previous studies have indicated that the blockade of two monoaminergic receptors, α1b-adrenergic and 5-HT2A, could inhibit the development of behavioral sensitization to drugs of abuse, a hallmark of drug-seeking and drug-taking behaviors in rodents. Here, in order to develop a potential therapeutic treatment of alcohol dependence in humans, we have blocked these two monoaminergic receptors by a combination of antagonists already approved by Health Agencies. We show that the association of ifenprodil (1 mg/kg and cyproheptadine (1 mg/kg (α1-adrenergic and 5-HT2 receptor antagonists marketed as Vadilex ® and Periactine ® in France, respectively blocks behavioral sensitization to amphetamine in C57Bl6 mice and to alcohol in DBA2 mice. Moreover, this combination of antagonists inhibits alcohol intake in mice habituated to alcohol (10% v/v and reverses their alcohol preference. Finally, in order to verify that the effect of ifenprodil was not due to its anti-NMDA receptors property, we have shown that a combination of prazosin (0.5 mg/kg, an α1b-adrenergic antagonist, Mini-Press ® in France and cyproheptadine (1 mg/kg could also reverse alcohol preference. Altogether these findings strongly suggest that combined prazosin and cyproheptadine could be efficient as a therapy to treat alcoholism in humans. Finally, because α1b-adrenergic and 5-HT2A receptors blockade also inhibits behavioral sensitization to psychostimulants, opioids and tobacco, it cannot be excluded that this combination will exhibit some efficacy in the treatment of addiction to other abused drugs.

  7. Post Auction Coverage Baseline 2.0

    Data.gov (United States)

    Federal Communications Commission — FINAL TELEVISION CHANNEL ASSIGNMENT INFORMATION RELATED TO INCENTIVE AUCTION REPACKING. NOTE: This file provides new baseline coverage and population data for all...

  8. Estimating exponential scheduling preferences

    DEFF Research Database (Denmark)

    Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid

    2015-01-01

    Different assumptions about travelers' scheduling preferences yield different measures of the cost of travel time variability. Only few forms of scheduling preferences provide non-trivial measures which are additive over links in transport networks where link travel times are arbitrarily...... of car drivers' route and mode choice under uncertain travel times. Our analysis exposes some important methodological issues related to complex non-linear scheduling models: One issue is identifying the point in time where the marginal utility of being at the destination becomes larger than the marginal...

  9. Revealed smooth nontransitive preferences

    DEFF Research Database (Denmark)

    Keiding, Hans; Tvede, Mich

    2013-01-01

    consumption bundle, all strictly preferred bundles are more expensive than the observed bundle. Our main result is that data sets can be rationalized by a smooth nontransitive preference relation if and only if prices can normalized such that the law of demand is satisfied. Market data sets consist of finitely...... many observations of price vectors, lists of individual incomes and aggregate demands. We apply our main result to characterize market data sets consistent with equilibrium behaviour of pure-exchange economies with smooth nontransitive consumers....

  10. Attitudes and beliefs of Michigan emergency physicians toward tissue plasminogen activator use in stroke: baseline survey results from the INcreasing Stroke Treatment through INteractive behavioral Change Tactic (INSTINCT) trial hospitals.

    Science.gov (United States)

    Scott, Phillip A; Xu, Zhenzhen; Meurer, William J; Frederiksen, Shirley M; Haan, Mary N; Westfall, Michael W; Kothari, Sandip U; Morgenstern, Lewis B; Kalbfleisch, John D

    2010-09-01

    The objective of this study was to determine the baseline proportion of emergency physicians with favorable attitudes and beliefs toward intravenous tissue plasminogen activator (tPA) use in a cohort of randomly selected Michigan hospitals. Two hundred seventy-eight emergency physicians from 24 hospitals were surveyed. A confidential, self-administered, pilot-tested survey assessing demographics, practice environment, attitudes, and beliefs regarding tPA use in stroke was used. Main outcome measures assessed belief in a legal standard of care, likelihood of use in an ideal setting, comfort in use without a specialist consultation, and belief that science on tPA use is convincing. ORs with robust 95% CIs (adjusted for clustering) were calculated to quantify the association between responses and physician- and hospital-level characteristics. One hundred ninety-nine surveys completed (gross response rate 71.6%). Ninety-nine percent (95% CI: 97.8 to 100) indicated use of tPA in eligible patients represented either acceptable or ideal patient care. Twenty-seven percent (95% CI: 21.7 to 32.3) indicated use of tPA represented a legal standard of care. Eighty-three percent (95% CI: 78.5 to 87.5) indicated they were "likely" or "very likely" to use tPA given an ideal setting. When asked about using tPA without a consultation, 65% (95% CI: 59.3 to 70.7) indicated they were uncomfortable. Forty-nine percent (95% CI: 43.0 to 55.0) indicated the science regarding use of tPA in stroke is convincing with 30% remaining neutral. Characteristics associated with favorable attitudes included non-emergency medicine board certification; older age, and a smaller hospital practice environment. In this cohort, emergency physician attitudes and beliefs toward intravenous tPA use in stroke are considerably more favorable than previously reported.

  11. Influence of Baseline Characteristics, Operative Conduct and Postoperative Course on 30-day Outcomes of Coronary Artery Bypass Grafting among Patients with Left Ventricular Dysfunction: Results from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial

    Science.gov (United States)

    Wrobel, Krzysztof; Stevens, Susanna R.; Jones, Robert H.; Selzman, Craig H.; Lamy, Andre; Beaver, Thomas M.; Djokovic, Ljubomir T.; Wang, Nan; Velazquez, Eric J.; Sopko, George; Kron, Irving L.; DiMaio, J. Michael; Michler, Robert E.; Lee, Kerry L.; Yii, Michael; Leng, Chua Yeow; Zembala, Marian; Rouleau, Jean L.; Daly, Richard C.; Al-Khalidi, Hussein R.

    2015-01-01

    Background Patients with severe left ventricular (LV) dysfunction, ischemic heart failure and coronary artery disease (CAD) suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk, which makes decision-making regarding whether to proceed to surgery difficult in such patients. To better inform such decision-making, we analyzed the STICH CABG population for detailed information on perioperative risk and outcomes. Methods and Results In both STICH trials (hypotheses), 2136 patients with a left ventricular ejection fraction (LVEF) ≤ 35% and coronary artery disease were allocated to medical therapy, CABG plus medical therapy or CABG with surgical ventricular reconstruction (SVR). Relationships of baseline characteristics and operative conduct with morbidity and mortality at 30 days were evaluated. There were a total of 1460 patients who received surgery, and 346 of them (roughly, one-quarter) of these high-risk patients developed a severe complication within 30 days. Worsening renal insufficiency, cardiac arrest with cardiopulmonary resuscitation, and ventricular arrhythmias were the most frequent complications and those most commonly associated with death. Mortality at 30 days was 5.1% and was generally preceded by a serious complication (65 of 74 deaths). LV size, renal dysfunction, advanced age, and atrial fibrillation/flutter were significant preoperative predictors of mortality within 30 days. Cardiopulmonary bypass time was the only independent surgical variable predictive of 30-day mortality. Conclusions CABG can be performed with relatively low 30-day mortality in patients with LV dysfunction. Serious postoperative complications occurred in nearly 1 in 4 patients and were associated with mortality. Clinical Trial

  12. Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder : Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions

    NARCIS (Netherlands)

    Vuijk, R.; Arntz, A.

    Background To our knowledge treatment of personality disorder (PD) comorbidity in adults with ASD is understudied and is still in its infancy. This study investigates the effectiveness of schema therapy for PD-psychopathology in adult patients with both ASD and PD. Methods/design Twelve adult

  13. TAPIR--Finnish national geochemical baseline database.

    Science.gov (United States)

    Jarva, Jaana; Tarvainen, Timo; Reinikainen, Jussi; Eklund, Mikael

    2010-09-15

    In Finland, a Government Decree on the Assessment of Soil Contamination and Remediation Needs has generated a need for reliable and readily accessible data on geochemical baseline concentrations in Finnish soils. According to the Decree, baseline concentrations, referring both to the natural geological background concentrations and the diffuse anthropogenic input of substances, shall be taken into account in the soil contamination assessment process. This baseline information is provided in a national geochemical baseline database, TAPIR, that is publicly available via the Internet. Geochemical provinces with elevated baseline concentrations were delineated to provide regional geochemical baseline values. The nationwide geochemical datasets were used to divide Finland into geochemical provinces. Several metals (Co, Cr, Cu, Ni, V, and Zn) showed anomalous concentrations in seven regions that were defined as metal provinces. Arsenic did not follow a similar distribution to any other elements, and four arsenic provinces were separately determined. Nationwide geochemical datasets were not available for some other important elements such as Cd and Pb. Although these elements are included in the TAPIR system, their distribution does not necessarily follow the ones pre-defined for metal and arsenic provinces. Regional geochemical baseline values, presented as upper limit of geochemical variation within the region, can be used as trigger values to assess potential soil contamination. Baseline values have also been used to determine upper and lower guideline values that must be taken into account as a tool in basic risk assessment. If regional geochemical baseline values are available, the national guideline values prescribed in the Decree based on ecological risks can be modified accordingly. The national geochemical baseline database provides scientifically sound, easily accessible and generally accepted information on the baseline values, and it can be used in various

  14. Attenuation of high sweet solution preference by mood stabilizers: a possible mouse model for the increased reward-seeking domain of mania.

    Science.gov (United States)

    Flaisher-Grinberg, Shlomit; Overgaard, Shauna; Einat, Haim

    2009-02-15

    The lack of appropriate animal models for bipolar disorder (BPD) is a major factor hindering the research of its pathophysiology and the development of new drug treatments. In line with the notion that BPD might represent a heterogeneous group of disorders, it was suggested that models for specific domains of BPD should be developed and then integrated. The present study tested sweet solution preference as a rodent model for increased reward seeking, a central component of manic behavior and a possible endophenotype of the disorder. The study identified that Black Swiss mice show high baseline saccharin preference compared with C57bl/6, CBA/J and A/J strains. Sweet solution preference in Black Swiss mice was therefore evaluated across a number of saccharin concentrations, with or without treatment with the mood stabilizers lithium and valproate and the antidepressant imipramine. Results indicated that the structurally dissimilar mood stabilizers lithium and valproate, but not the antidepressant imipramine, reduce sweet solution preference. However, different dosing schedules were needed for the two drugs to induce this effect. These findings support the face and the predictive validity of the sweet solution preference test as an animal model for the elevated reward-seeking domain of mania. As such, this test might be well integrated into a battery of models for different domains of BPD. Such a battery can be effectively utilized to screen new treatments, to distinguish between specific effects of different drugs, and to explore the mechanisms underlying BPD.

  15. Collection Preferences of Children

    Science.gov (United States)

    Walls, Richard T.; And Others

    1975-01-01

    Eighty nursery school and upper elementary school children selected picture cards from varying stimulus arrays in order to indicate their preference for unorganized mixed collections, groups of identical cards, or sets of different cards that together formed a whole figure. (CW)

  16. FUZZY PREFERENCES IN CONFLICTS

    Institute of Scientific and Technical Information of China (English)

    Mubarak S. AL-MUTAIRI; Keith W. HIPEL; Mohamed S. KAMEL

    2008-01-01

    A systematic fuzzy approach is developed to model fuzziness and uncertainties in the preferences of decision makers involved in a conflict. This unique fuzzy preference formulation is used within the paradigm of the Graph Model for Conflict Resolution in which a given dispute is modeled in terms of decision makers, each decision maker's courses of actions or options, and each decision maker's preferences concerning the states or outcomes which could take place. In order to be able to determine the stability of each state for each decision maker and the possible equilibria or resolutions, a range of solution concepts describing potential human behavior under conflict are defined for use with fuzzy preferences. More specifically, strong and weak definitions of stability are provided for the solution concepts called Nash, general metarational, symmetric metarational, and sequential stability. To illustrate how these solution concepts can be conveniently used in practice, they are applied to a dispute over the contamination of an aquifer by a chemical company located in Elmira, Ontario, Canada.

  17. Preferred Dance Tempo

    DEFF Research Database (Denmark)

    Dahl, Sofia; Huron, David; Brod, Garvin

    2014-01-01

    In two experiments participants tuned a drum machine to their preferred dance tempo. Measurements of height, shoulder width, leg length, and weight were taken for each participant, and their sex recorded. Using a multiple regression analysis, height and leg length combined was found to be the bes...

  18. Patterns of Environmental Preference

    Science.gov (United States)

    Kaplan, Rachel

    1977-01-01

    This study sought to evaluate components of the Environmental Preference Questionnaire (EPQ). The 267 teenagers who completed the EPQ in this study also responded to questions relating to facets of self esteem and the reasons for selecting their favorite activities. (BT)

  19. Arm chair perspective preferences

    NARCIS (Netherlands)

    Koenderink, Jan; van Doorn, A.J.; Pinna, Baingio; Pepperell, Robert

    2016-01-01

    Do generic observers in their free-style viewing of postcard-size pictures have a preference for specific modes of perspective rendering? This most likely depends upon the phrasing of the question. Here we consider the feeling of ‘presence’: does the observer experience a sense of being ‘immersed in

  20. Category expectation modulates baseline and stimulus-evoked activity in human inferotemporal cortex.

    Science.gov (United States)

    Puri, Amrita M; Wojciulik, Ewa; Ranganath, Charan

    2009-12-08

    Expectation of locations and low-level features increases activity in extrastriate visual areas even in the absence of a stimulus, but it is unclear whether or how expectation of higher-level stimulus properties affects visual responses. Here, we used event-related functional magnetic resonance imaging (fMRI) to test whether category expectation affects baseline and stimulus-evoked activity in higher-level, category-selective inferotemporal (IT) visual areas. Word cues indicating an image category (FACE or HOUSE) were followed by a delay, then a briefly presented image of a face or a house. On most trials, the cue correctly predicted the upcoming stimulus. Baseline activity in regions within the fusiform face area (FFA) and parahippocampal place area (PPA) was modulated such that activity was higher during expectation of the preferred (e.g., FACE for FFA) vs. non-preferred category. Stimulus-evoked responses reflected an initial bias (higher overall activity) followed by increased selectivity (greater difference between activity to a preferred vs. non-preferred stimulus) after expectation of the preferred vs. non-preferred category. Consistent with the putative role of a frontoparietal network in top-down modulation of activity in sensory cortex, expectation-related activity in several frontal and parietal areas correlated with the magnitude of baseline shifts in the FFA and PPA across subjects. Furthermore, expectation-related activity in lateral prefrontal cortex also correlated with the magnitude of expectation-based increases in stimulus selectivity in IT areas. These findings demonstrate that category expectation influences both baseline and stimulus-evoked activity in category-selective inferotemporal visual areas, and that these modulations may be driven by a frontoparietal attentional control network.

  1. Arc melter demonstration baseline test results

    Energy Technology Data Exchange (ETDEWEB)

    Soelberg, N.R.; Chambers, A.G.; Anderson, G.L.; Oden, L.L.; O`Connor, W.K.; Turner, P.C.

    1994-07-01

    This report describes the test results and evaluation for the Phase 1 (baseline) arc melter vitrification test series conducted for the Buried Waste Integrated Demonstration program (BWID). Phase 1 tests were conducted on surrogate mixtures of as-incinerated wastes and soil. Some buried wastes, soils, and stored wastes at the INEL and other DOE sites, are contaminated with transuranic (TRU) radionuclides and hazardous organics and metals. The high temperature environment in an electric arc furnace may be used to process these wastes to produce materials suitable for final disposal. An electric arc furnace system can treat heterogeneous wastes and contaminated soils by (a) dissolving and retaining TRU elements and selected toxic metals as oxides in the slag phase, (b) destroying organic materials by dissociation, pyrolyzation, and combustion, and (c) capturing separated volatilized metals in the offgas system for further treatment. Structural metals in the waste may be melted and tapped separately for recycle or disposal, or these metals may be oxidized and dissolved into the slag. The molten slag, after cooling, will provide a glass/ceramic final waste form that is homogeneous, highly nonleachable, and extremely durable. These features make this waste form suitable for immobilization of TRU radionuclides and toxic metals for geologic timeframes. Further, the volume of contaminated wastes and soils will be substantially reduced in the process.

  2. What is the preferred number of consecutive night shifts? results from a crossover intervention study among police officers in Denmark.

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Jensen, Marie Aarrebo; Hansen, Åse Marie; Kristiansen, Jesper; Garde, Anne Helene

    2016-10-01

    Among police officers in Denmark, we studied (i) how many consecutive night shifts participants preferred at baseline; (ii) preferences regarding three intervention conditions (two, four, and seven consecutive night shifts followed by the same number of days off/day shifts: '2 + 2', '4 + 4', '7 + 7') at follow-up; (iii) characteristics of participants preferring each of these intervention conditions. Questionnaire data from a crossover intervention study were used (baseline: n = 73; follow-up: n = 68). At baseline, 49% preferred four consecutive night shifts. At follow-up, 57% preferred '4 + 4', 26% preferred '2 + 2' and 26% preferred '7 + 7'. Participants, who preferred longer spells of night work experienced that night work was less demanding, found it easier to sleep at different times of the day, and were more frequently evening types compared with participants who preferred shorter spells of night work. The participants' preferences are likely to be influenced by their previous shift work experience. Practitioner Summary: We investigated police officers' preferences regarding the number of consecutive night shifts. The majority preferred four consecutive night shifts. Those who preferred the longer spells of night work found night work less demanding, found it easier to sleep at different times of the day, and were more frequently evening types.

  3. Baseline predictors of visual acuity and retinal thickness in patients with retinal vein occlusion.

    Science.gov (United States)

    Kim, Sang Jin; Yoon, Young Hee; Kim, Ha Kyoung; Yoon, Hee Seong; Kang, Se Woong; Kim, June-Gone; Park, Kyu Hyung; Jo, Young Joon; Lee, Dong-Hoon

    2015-04-01

    This study investigated the baseline predictors of best corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months in patients with treatment-naïve branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). This multicenter, interventional case series included 208 BRVO and 123 CRVO patients with follow-up period of 6 months or more. Outcome measures of BCVA (logMAR) included absolute change from baseline and a gain or loss of ≥ 0.3 from baseline. Outcome measures of CRT included absolute change from baseline and a measurement of ≤ 250 µm or ≥ 400 µm at 6 months. Univariate and multiple regression analyses were done to find baseline predictors. For BRVO, younger age, worse baseline BCVA, and shorter duration of symptom were associated with more gain in BCVA. For CRVO, worse baseline BCVA was associated with more gain in BCVA. For CRT outcomes, higher baseline CRT predicted greater decrease at 6 months in both BRVO and CRVO. Younger age and better baseline BCVA were associated with an increased likelihood of measurement of a ≤ 250 µm outcome for BRVO and CRVO, respectively. For CRVO, smoking was associated with greater decrease from baseline and decreased likelihood of measurement of a CRT ≥ 400 µm at 6 months. In conclusion, several baseline factors including age, symptom duration, and baseline BCVA and CRT are associated with BCVA and CRT outcomes at 6 months, which may help to predict disease course for RVO patients.

  4. Physicians' Preferences for Asthma Guidelines Implementation

    OpenAIRE

    2010-01-01

    Purpose Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. Methods We obtained information through a questionnaire survey. The questionnaire was distr...

  5. Life Support Baseline Values and Assumptions Document

    Science.gov (United States)

    Anderson, Molly S.; Ewert, Michael K.; Keener, John F.; Wagner, Sandra A.

    2015-01-01

    The Baseline Values and Assumptions Document (BVAD) provides analysts, modelers, and other life support researchers with a common set of values and assumptions which can be used as a baseline in their studies. This baseline, in turn, provides a common point of origin from which many studies in the community may depart, making research results easier to compare and providing researchers with reasonable values to assume for areas outside their experience. With the ability to accurately compare different technologies' performance for the same function, managers will be able to make better decisions regarding technology development.

  6. PREFERENCE, PRINCIPLE AND PRACTICE

    DEFF Research Database (Denmark)

    Skovsgaard, Morten; Bro, Peter

    2011-01-01

    journalists justify themselves and their work. This article introduces an analytical framework for understanding legitimacy in a journalistic context. A framework based on a review of material ranging from historical accounts to research articles, and book-length studies. The framework comprises three...... distinct, but interconnected categories*preference, principle, and practice. Through this framework, historical attempts to justify journalism and journalists are described and discussed in the light of the present challenges for the profession....

  7. PREFERENCE, PRINCIPLE AND PRACTICE

    DEFF Research Database (Denmark)

    Skovsgaard, Morten; Bro, Peter

    2011-01-01

    Legitimacy has become a central issue in journalism, since the understanding of what journalism is and who journalists are has been challenged by developments both within and outside the newsrooms. Nonetheless, little scholarly work has been conducted to aid conceptual clarification as to how jou...... distinct, but interconnected categories*preference, principle, and practice. Through this framework, historical attempts to justify journalism and journalists are described and discussed in the light of the present challenges for the profession....

  8. Coaching preferences of athletes.

    Science.gov (United States)

    Terry, P C; Howe, B L

    1984-12-01

    The study examined the coaching preferences of 80 male and 80 female athletes, as measured by the Leadership Scale for Sports (Chelladurai and Saleh, 1978, 1980). In addition, it attempted to assess the applicability to sport of the Life-cycle and Path-goal theories of leadership. Comparisons between groups were made on the basis of sex, age, and type of sport. A MANOVA indicated that athletes in independent sports preferred more democratic behaviour (p less than .001) and less autocratic behaviour (p = .028) than athletes in interdependent sports. No differences in coaching preferences were found which could be attributed to the age or sex of the athlete, or the variability of the sports task. These results partially supported the Path-goal theory, but did not support the Life-cycle theory. Athletes of all groups tended to favour coaches who displayed training behaviour and rewarding behaviour "often", democratic behaviour and social support behaviour "occasionally", and autocratic behaviour "seldom". This consistency may be a useful finding for those organizations and institutions interested in preparing coaches.

  9. Perspectives on Preference Aggregation.

    Science.gov (United States)

    Regenwetter, Michel

    2009-07-01

    For centuries, the mathematical aggregation of preferences by groups, organizations, or society itself has received keen interdisciplinary attention. Extensive theoretical work in economics and political science throughout the second half of the 20th century has highlighted the idea that competing notions of rational social choice intrinsically contradict each other. This has led some researchers to consider coherent democratic decision making to be a mathematical impossibility. Recent empirical work in psychology qualifies that view. This nontechnical review sketches a quantitative research paradigm for the behavioral investigation of mathematical social choice rules on real ballots, experimental choices, or attitudinal survey data. The article poses a series of open questions. Some classical work sometimes makes assumptions about voter preferences that are descriptively invalid. Do such technical assumptions lead the theory astray? How can empirical work inform the formulation of meaningful theoretical primitives? Classical "impossibility results" leverage the fact that certain desirable mathematical properties logically cannot hold in all conceivable electorates. Do these properties nonetheless hold true in empirical distributions of preferences? Will future behavioral analyses continue to contradict the expectations of established theory? Under what conditions do competing consensus methods yield identical outcomes and why do they do so?

  10. Reinforcement Magnitude: An Evaluation of Preference and Reinforcer Efficacy

    OpenAIRE

    Trosclair-Lasserre, Nicole M.; Lerman, Dorothea C; Call, Nathan A; Addison, Laura R; Kodak, Tiffany

    2008-01-01

    Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimenta...

  11. Breton Island, Louisiana Baseline (Geographic, NAD83)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Breton Island, Louisiana Baseline (Geographic, NAD83) consists of vector line data that were input into the Digital Shoreline Analysis System (DSAS) version 4.0,...

  12. SSA FITARA Common Baseline Implementation Plan

    Data.gov (United States)

    Social Security Administration — This document describes the agency's plan to implement the Federal Information Technology Acquisition Reform Act (FITARA) Common Baseline per OMB memorandum M-15-14.

  13. NRAO Very Long Baseline Array (VLBA)

    Data.gov (United States)

    Federal Laboratory Consortium — The Very Long Baseline Array (VLBA) comprises ten radio telescopes spanning 5,351 miles. It's the world's largest, sharpest, dedicated telescope array. With an eye...

  14. Breton Island, Louisiana Baseline (Geographic, NAD83)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Breton Island, Louisiana Baseline (Geographic, NAD83) consists of vector line data that were input into the Digital Shoreline Analysis System (DSAS) version 4.0,...

  15. Hanford Site technical baseline database. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Porter, P.E.

    1995-01-27

    This report lists the Hanford specific files (Table 1) that make up the Hanford Site Technical Baseline Database. Table 2 includes the delta files that delineate the differences between this revision and revision 0 of the Hanford Site Technical Baseline Database. This information is being managed and maintained on the Hanford RDD-100 System, which uses the capabilities of RDD-100, a systems engineering software system of Ascent Logic Corporation (ALC). This revision of the Hanford Site Technical Baseline Database uses RDD-100 version 3.0.2.2 (see Table 3). Directories reflect those controlled by the Hanford RDD-100 System Administrator. Table 4 provides information regarding the platform. A cassette tape containing the Hanford Site Technical Baseline Database is available.

  16. Patients' preference in migraine

    NARCIS (Netherlands)

    Dekker, François (Frans)

    2014-01-01

    This thesis is about migraine. Three elements are discussed. First element is preventive treatment, second element is attack treatment and the third part focuses on medication overuse headache. The preventive treatment of migraine is a valuable intervention in primary care. If preventive treatment i

  17. Hypertension Prevalence, Awareness, Treatment, and Control and Sodium Intake in Shandong Province, China: Baseline Results From Shandong–Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011

    Science.gov (United States)

    Bi, Zhenqiang; Liang, Xiaofeng; Xu, Aiqiang; Wang, Linghong; Shi, Xiaoming; Zhao, Wenhua; Ma, Jixiang; Guo, Xiaolei; Zhang, Xiaofei; Zhang, Jiyu; Ren, Jie; Yan, Liuxia; Lu, Zilong; Wang, Huicheng; Tang, Junli; Cai, Xiaoning; Dong, Jing; Zhang, Juan; Chu, Jie; Engelgau, Michael; Yang, Quanhe; Hong, Yuling

    2014-01-01

    Introduction In China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control. Methods Complex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications. Results Overall, 23.4% (95% confidence interval [CI], 20.9%–26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg–6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg–4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg–5,683 mg). Conclusion Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China. PMID:24854239

  18. Puerto Rico Revealed Preference data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Revealed preference models provide insights into recreational angler behavior and the economic value of recreational fishing trips. Revealed preference data is...

  19. Human preference for air movement

    DEFF Research Database (Denmark)

    Toftum, Jørn; Melikov, Arsen Krikor; Tynel, A.

    2002-01-01

    Human preference for air movement was studied at slightly cool, neutral, and slightly warm overall thermal sensations and at temperatures ranging from 18 deg.C to 28 deg.C. Air movement preference depended on both thermal sensation and temperature, but large inter-individual differences existed...... between subjects. Preference for less air movement was linearly correlated with draught discomfort, but the percentage of subjects who felt draught was lower than the percentage who preferred less air movement....

  20. Treatment for periodic paralysis.

    Science.gov (United States)

    Sansone, V; Meola, G; Links, T P; Panzeri, M; Rose, M R

    2008-01-23

    Primary periodic paralyses are rare inherited muscle diseases characterised by episodes of flaccid weakness affecting one or more limbs, lasting several hours to several days, caused by mutations in skeletal muscle channel genes. The objective of this review was to systematically review treatment of periodic paralyses. We searched the Cochrane Neuromuscular Disease Group Trials Register, MEDLINE (from January 1966 to July 2007), and EMBASE (from January 1980 to July 2007) and any other available international medical library sources from the University of Milan for randomised trials. We included randomised (including cross-over studies) and quasi-randomised trials in participants with primary periodic paralyses, in which any form of treatment, including physical therapy and alternative therapies, was compared to placebo or another treatment. Our primary outcome measure was the change in attack severity or frequency by eight weeks from the start of treatment. Our secondary outcome measures were: change in muscle strength and mass; change in Quality of Life, using Short Form 36 (SF36) or similar; preference of treatment strategy; adverse effects at eight weeks. Three studies met our inclusion criteria. In one study dichlorphenamide (DCP) vs placebo was tested in two groups of participants: 42 with hypokalemic periodic paralysis (HypoPP) and 31 with hyperkalemic periodic paralysis (HyperPP), based on clinical criteria. Thirty-four of 42 participants with hypokalemic periodic paralysis completed both treatment phases. For the 34 participants having attack rate data for both treatment phases, the mean improvement in attack rate (P = 0.02) and severity-weighted attack rate (P = 0.01) on DCP relative to placebo were statistically significant. Fifteen preferred DCP, three placebo and six their baseline medication. Twenty-four of 31 participants with hyperkalemic periodic paralysis completed both treatment phases: for the 16 participants who had attack rate data for both

  1. Immigrants' location preferences

    DEFF Research Database (Denmark)

    Damm, Anna Piil

    This paper exploits a spatial dispersal policy for refugee immigrants to estimate the importance of local and regional factors for refugees' location preferences. The main results of a mixed proportional hazard competing risks model are that placed refugees react to high regional unemployment...... and lack of a local immigrant population by migrating to large municipalities. Lack of local fellow countrymen, however, increases the exit rate to medium-sized as well as large municipalities. This finding is likely to be a result of the dispersal policy. Finally, refugees react strongly to assignment...

  2. Reinforcement Magnitude: An Evaluation of Preference and Reinforcer Efficacy

    Science.gov (United States)

    Trosclair-Lasserre, Nicole M.; Lerman, Dorothea C.; Call, Nathan A.; Addison, Laura R.; Kodak, Tiffany

    2008-01-01

    Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current…

  3. Cognitive impairment and preferences for current health

    Directory of Open Access Journals (Sweden)

    Tsevat Joel

    2009-01-01

    Full Text Available Abstract Background We assessed preferences for current health using the visual analogue scale (VAS, standard gamble (SG, time trade-off (TTO, and willingness to pay (WTP in patients with cerebral aneurysms, a population vulnerable to cognitive deficits related to aneurysm bleeding or treatment. Methods We measured VAS, SG, TTO, and WTP values for current health in 165 outpatients with cerebral aneurysms. We assessed cognitive impairment with the Mini Mental State Examination (MMSE; scores Results Eleven patients (7% had MMSE scores Conclusion Cognitive impairment is associated with lower preferences for current health in patients with cerebral aneurysms. Cognitively impaired patients have poor inter-preference test correlations and different response distributions compared to unimpaired patients.

  4. Nonintrusive methodology for wellness baseline profiling

    Science.gov (United States)

    Chung, Danny Wen-Yaw; Tsai, Yuh-Show; Miaou, Shaou-Gang; Chang, Walter H.; Chang, Yaw-Jen; Chen, Shia-Chung; Hong, Y. Y.; Chyang, C. S.; Chang, Quan-Shong; Hsu, Hon-Yen; Hsu, James; Yao, Wei-Cheng; Hsu, Ming-Sin; Chen, Ming-Chung; Lee, Shi-Chen; Hsu, Charles; Miao, Lidan; Byrd, Kenny; Chouikha, Mohamed F.; Gu, Xin-Bin; Wang, Paul C.; Szu, Harold

    2007-04-01

    We develop an accumulatively effective and affordable set of smart pair devices to save the exuberant expenditure for the healthcare of aging population, which will not be sustainable when all the post-war baby boomers retire (78 millions will cost 1/5~1/4 GDP in US alone). To design an accessible test-bed for distributed points of homecare, we choose two exemplars of the set to demonstrate the possibility of translation of modern military and clinical know-how, because two exemplars share identically the noninvasive algorithm adapted to the Smart Sensor-pairs for the real world persistent surveillance. Currently, the standard diagnoses for malignant tumors and diabetes disorders are blood serum tests, X-ray CAT scan, and biopsy used sometime in the physical checkup by physicians as cohort-average wellness baselines. The loss of the quality of life in making second careers productive may be caused by the missing of timeliness for correct diagnoses and easier treatments, which contributes to the one quarter of human errors generating the lawsuits against physicians and hospitals, which further escalates the insurance cost and wasteful healthcare expenditure. Such a vicious cycle should be entirely eliminated by building an "individual diagnostic aids (IDA)," similar to the trend of personalized drug, developed from daily noninvasive intelligent databases of the "wellness baseline profiling (WBP)". Since our physiology state undulates diurnally, the Nyquist anti-aliasing theory dictates a minimum twice-a-day sampling of the WBP for the IDA, which must be made affordable by means of noninvasive, unsupervised and unbiased methodology at the convenience of homes. Thus, a pair of military infrared (IR) spectral cameras has been demonstrated for the noninvasive spectrogram ratio test of the spontaneously emitted thermal radiation from a normal human body at 37°C temperature. This invisible self-emission spreads from 3 microns to 12 microns of the radiation wavelengths

  5. Negative Average Preference Utilitarianism

    Directory of Open Access Journals (Sweden)

    Roger Chao

    2012-03-01

    Full Text Available For many philosophers working in the area of Population Ethics, it seems that either they have to confront the Repugnant Conclusion (where they are forced to the conclusion of creating massive amounts of lives barely worth living, or they have to confront the Non-Identity Problem (where no one is seemingly harmed as their existence is dependent on the “harmful” event that took place. To them it seems there is no escape, they either have to face one problem or the other. However, there is a way around this, allowing us to escape the Repugnant Conclusion, by using what I will call Negative Average Preference Utilitarianism (NAPU – which though similar to anti-frustrationism, has some important differences in practice. Current “positive” forms of utilitarianism have struggled to deal with the Repugnant Conclusion, as their theory actually entails this conclusion; however, it seems that a form of Negative Average Preference Utilitarianism (NAPU easily escapes this dilemma (it never even arises within it.

  6. Why Languages Prefer Prohibitives

    Institute of Scientific and Technical Information of China (English)

    Johan van der Auwera

    2006-01-01

    This paper deals with prohibitive markers, i.e., negative markers that are more or less dedicated to the expression of a prohibition. It documents the variety in the formal make-up of these markers and it confims the earlier claims that they are frequent everywhere, with at least one exception, viz., Western Europe. Four origins are discussed:prohibitive markers may derive from predicative constructions, they may appear as a side product of Jespersen's cycle,they may derive from a univerbation of imperative and negative markers, and they may be borrowed. As explanation is offered as to why languages prefer to have prohibitive markers. It is argued that attempts to explain this preference in terms of morphosyntax are misguided. Instead a frequency-based semantic explanation is offered. The most frequent use of negatives are declarative, thereby inviting a static ‘it is not the case that' paraphrase. It is important, however, to mark clearly that prohibitives are instances of a dynamic ‘let it be the case that' appeal. The paper ends on a discussion of languages that do not employ prohibitive markers.

  7. Importance of baseline in event-related desynchronization during a combination task of motor imagery and motor observation

    Science.gov (United States)

    Tangwiriyasakul, Chayanin; Verhagen, Rens; van Putten, Michel J. A. M.; Rutten, Wim L. C.

    2013-04-01

    Objective. Event-related desynchronization (ERD) or synchronization (ERS) refers to the modulation of any EEG rhythm in response to a particular event. It is typically quantified as the ratio between a baseline and a task condition (the event). Here, we focused on the sensorimotor mu-rhythm. We explored the effects of different baselines on mu-power and ERD of the mu-rhythm during a motor imagery task. Methods. Eighteen healthy subjects performed motor imagery tasks while EEGs were recorded. Five different baseline movies were shown. For the imagery task a right-hand opening/closing movie was shown. Power and ERD of the mu-rhythm recorded over C3 and C4 for the different baselines were estimated. Main Results. 50% of the subjects showed relatively high mu-power for specific baselines only, and ERDs of these subjects were strongly dependent on the baseline used. In 17% of the subjects no preference was found. Contralateral ERD of the mu-rhythm was found in about 67% of the healthy volunteers, with a significant baseline preference in about 75% of that subgroup. Significance. The sensorimotor ERD quantifies activity of the brain during motor imagery tasks. Selection of the optimal baseline increases ERD.

  8. 19 CFR 10.778 - Filing of claim for tariff preference level.

    Science.gov (United States)

    2010-04-01

    ... Free Trade Agreement Tariff Preference Level § 10.778 Filing of claim for tariff preference level. A... under § 10.770 of this subpart may nevertheless be entitled to preferential tariff treatment under...

  9. Collective preferences in strategic decisions.

    Science.gov (United States)

    Rose, Jo; Colman, Andrew M

    2007-12-01

    In the theories of team reasoning of Sugden and Bacharach, players are assumed to be motivated in some circumstances to maximize collective rather than individual utilities. An experiment was performed to assess whether preferences underlying such collective payoff maximization occur. An opportunistic sample of 50 undergraduate and graduate students, 7 men and 43 women ages 19 to 42 years (M= 23.0, SD=5.4), expressed preferences among the outcomes of strategic decisions presented in vignettes designed to engage social value orientations of individualism, altruism, competitiveness, equality seeking, or collective preferences. In the vignettes designed to engage collective preferences, and significantly less frequently in the other vignettes, preferences were biased toward outcomes maximizing collective payoffs, and respondents invariably gave team-reasoning explanations for their preferences. These results provide evidence for collective preferences according to theories of team reasoning and empirical support for one of the essential assumptions of these theories.

  10. Patient preferences and healthcare outcomes: an ecological perspective.

    Science.gov (United States)

    Street, Richard L; Elwyn, Glyn; Epstein, Ronald M

    2012-04-01

    This article examines the nature of patients' preferences for healthcare and whether clinician accommodation of patient preferences influences health outcomes. First, we provide a conceptualization of patient preferences along with their key attributes. Second, we review research on the relationship between health outcomes and patient preferences for treatments and for the process of care (e.g., preferred involvement in decision-making). Third, following a critique of this literature, we present an ecological model of patient preferences that, while acknowledging that patient preferences may emerge from various contexts (e.g., family or media exposure), we focus on the important role that clinical encounters and patients' health-related experiences play in the elicitation and construction of patient preferences. Fourth, we propose two pathways, one behavioral (adherence) and the other psychological (sense of autonomy or satisfaction with decision), through which meeting patient preferences could lead to better health outcomes. Fifth, we discuss how preferences can be elicited and clarified through patient-centered conversations. We conclude with implications for future research and clinical practice.

  11. Salton Sea sampling program: baseline studies

    Energy Technology Data Exchange (ETDEWEB)

    Tullis, R.E.; Carter, J.L.; Langlois, G.W.

    1981-04-13

    Baseline data are provided on three species of fish from the Salton Sea, California. The fishes considered were the orange mouth corvina (Cynoscion xanthulus), gulf croaker (Bairdiella icistius) and sargo (Anisotremus davidsonii). Morphometric and meristic data are presented as a baseline to aid in the evaluation of any physiological stress the fish may experience as a result of geothermal development. Analyses were made on muscle, liver, and bone of the fishes sampled to provide baseline data on elemental tissue burdens. The elements measured were: As, Br, Ca, Cu, Fe, Ga, K, Mn, Mi, Pb, Rb, Se, Sr, Zn, and Zr. These data are important if an environmentally sound progression of geothermal power production is to occur at the Salton Sea.

  12. Baseline methodologies for clean development mechanism projects

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M.K. (ed.); Shrestha, R.M.; Sharma, S.; Timilsina, G.R.; Kumar, S.

    2005-11-15

    The Kyoto Protocol and the Clean Development Mechanism (CDM) came into force on 16th February 2005 with its ratification by Russia. The increasing momentum of this process is reflected in more than 100 projects having been submitted to the CDM Executive Board (CDM-EB) for approval of the baselines and monitoring methodologies, which is the first step in developing and implementing CDM projects. A CDM project should result in a net decrease of GHG emissions below any level that would have resulted from other activities implemented in the absence of that CDM project. The 'baseline' defines the GHG emissions of activities that would have been implemented in the absence of a CDM project. The baseline methodology is the process/algorithm for establishing that baseline. The baseline, along with the baseline methodology, are thus the most critical element of any CDM project towards meeting the important criteria of CDM, which are that a CDM should result in 'real, measurable, and long term benefits related to the mitigation of climate change'. This guidebook is produced within the frame work of the United Nations Environment Programme (UNEP) facilitated 'Capacity Development for the Clean Development Mechanism (CD4CDM)' Project. This document is published as part of the projects effort to develop guidebooks that cover important issues such as project finance, sustainability impacts, legal framework and institutional framework. These materials are aimed to help stakeholders better understand the CDM and are believed to eventually contribute to maximize the effect of the CDM in achieving the ultimate goal of UNFCCC and its Kyoto Protocol. This Guidebook should be read in conjunction with the information provided in the two other guidebooks entitled, 'Clean Development Mechanism: Introduction to the CDM' and 'CDM Information and Guidebook' developed under the CD4CDM project. (BA)

  13. Geochemical baseline studies of soil in Finland

    Science.gov (United States)

    Pihlaja, Jouni

    2017-04-01

    The soil element concentrations regionally vary a lot in Finland. Mostly this is caused by the different bedrock types, which are reflected in the soil qualities. Geological Survey of Finland (GTK) is carrying out geochemical baseline studies in Finland. In the previous phase, the research is focusing on urban areas and mine environments. The information can, for example, be used to determine the need for soil remediation, to assess environmental impacts or to measure the natural state of soil in industrial areas or mine districts. The field work is done by taking soil samples, typically at depth between 0-10 cm. Sampling sites are chosen to represent the most vulnerable areas when thinking of human impacts by possible toxic soil element contents: playgrounds, day-care centers, schools, parks and residential areas. In the mine districts the samples are taken from the areas locating outside the airborne dust effected areas. Element contents of the soil samples are then analyzed with ICP-AES and ICP-MS, Hg with CV-AAS. The results of the geochemical baseline studies are published in the Finnish national geochemical baseline database (TAPIR). The geochemical baseline map service is free for all users via internet browser. Through this map service it is possible to calculate regional soil baseline values using geochemical data stored in the map service database. Baseline data for 17 elements in total is provided in the map service and it can be viewed on the GTK's web pages (http://gtkdata.gtk.fi/Tapir/indexEN.html).

  14. Neutrino Interactions and Long-Baseline Experiments

    CERN Document Server

    Mosel, Ulrich

    2016-01-01

    The extraction of neutrino mixing parameters and the CP-violating phase requires knowledge of the neutrino energy. This energy must be reconstructed from the final state of a neutrino-nucleus reaction since all long-baseline experiments use nuclear targets. This reconstruction requires detailed knowledge of the neutrino reactions with bound nucleons and of the final state interactions of hadrons with the nuclear environment. Quantum-kinetic transport theory can be used to build an event generator for this reconstruction that takes basic nuclear properties, such as binding, into account. Some examples are discussed that show the effects of nuclear interactions on observables in long-baseline experiments

  15. Long-baseline Neutrino Oscillation at DUNE

    Science.gov (United States)

    Worcester, Elizabeth; DUNE Collaboration Collaboration

    2017-01-01

    The Deep Underground Neutrino Experiment (DUNE) is a long-baseline neutrino oscillation experiment with primary physics goals of determining the neutrino mass hierarchy and measuring δc P with sufficient sensitivity to discover CP violation in neutrino oscillation. CP violation sensitivity in DUNE requires careful understanding of systematic uncertainty, with contributions expected from uncertainties in the neutrino flux, neutrino interactions, and detector effects. In this presentation, we will describe the expected sensitivity of DUNE to long-baseline neutrino oscillation parameters, how various aspects of the experimental design contribute to that sensitivity, and the planned strategy for constraining systematic uncertainty in these measurements.

  16. Are preference and resistance to change convergent expressions of stimulus value?

    Science.gov (United States)

    Podlesnik, Christopher A; Jimenez-Gomez, Corina; Shahan, Timothy A

    2013-07-01

    Behavioral momentum theory asserts that preference and relative resistance to disruption depend on reinforcement rates and provide converging expressions of the conditioned value of discriminative stimuli. However, preference and resistance to disruption diverge when assessing preference during brief extinction probes. We expanded upon this opposing relation by arranging target stimuli signaling equal variable-interval schedules across components of a multiple schedule. We paired one target stimulus with a richer reinforced alternative and the other with a leaner alternative. Furthermore, we varied reinforcement rates for the paired alternatives to assess the effects of manipulating relative conditioned value on preference and resistance to disruption by presession feeding, intercomponent food, and extinction. We replicated the opposing relation between preference and resistance to disruption but varying reinforcement rates for the paired alternatives did not systematically affect preference or resistance to disruption beyond levels observed in our initial condition. Importantly, we found that only preference between the target stimuli was related to relative baseline response rates in the presence of those stimuli. These findings suggest that preference during extinction probes might reveal more about baseline response rates between concurrently available alternatives than relative conditioned value. Resistance to disruption, conversely, appears to better reflect conditioned value because it is less confounded with baseline response rates and is a function of all sources of reinforcement obtained in the presence of a stimulus context. © Society for the Experimental Analysis of Behavior.

  17. Waste management project technical baseline description

    Energy Technology Data Exchange (ETDEWEB)

    Sederburg, J.P.

    1997-08-13

    A systems engineering approach has been taken to describe the technical baseline under which the Waste Management Project is currently operating. The document contains a mission analysis, function analysis, requirement analysis, interface definitions, alternative analysis, system definition, documentation requirements, implementation definitions, and discussion of uncertainties facing the Project.

  18. How Valid Are the Portland Baseline Essays?

    Science.gov (United States)

    Martel, Erich

    1991-01-01

    Portland, Oregon's "African-American Baseline Essays," widely used in creating multicultural curricula, inaccurately depicts ancient Egyptians as black people and Olmec civilization as derived from African influences. The authors advance racial theories long abandoned by mainline Africa scholars, attribute mystical powers to pyramids,…

  19. Physics Potential of Long-Baseline Experiments

    Directory of Open Access Journals (Sweden)

    Sanjib Kumar Agarwalla

    2014-01-01

    Full Text Available The discovery of neutrino mixing and oscillations over the past decade provides firm evidence for new physics beyond the Standard Model. Recently, θ13 has been determined to be moderately large, quite close to its previous upper bound. This represents a significant milestone in establishing the three-flavor oscillation picture of neutrinos. It has opened up exciting prospects for current and future long-baseline neutrino oscillation experiments towards addressing the remaining fundamental questions, in particular the type of the neutrino mass hierarchy and the possible presence of a CP-violating phase. Another recent and crucial development is the indication of non-maximal 2-3 mixing angle, causing the octant ambiguity of θ23. In this paper, I will review the phenomenology of long-baseline neutrino oscillations with a special emphasis on sub-leading three-flavor effects, which will play a crucial role in resolving these unknowns. First, I will give a brief description of neutrino oscillation phenomenon. Then, I will discuss our present global understanding of the neutrino mass-mixing parameters and will identify the major unknowns in this sector. After that, I will present the physics reach of current generation long-baseline experiments. Finally, I will conclude with a discussion on the physics capabilities of accelerator-driven possible future long-baseline precision oscillation facilities.

  20. Geochemical modelling baseline compositions of groundwater

    DEFF Research Database (Denmark)

    Postma, Diederik Jan; Kjøller, Claus; Andersen, Martin Søgaard

    2008-01-01

    Reactive transport models, were developed to explore the evolution in groundwater chemistry along the flow path in three aquifers; the Triassic East Midland aquifer (UK), the Miocene aquifer at Valreas (F) and the Cretaceous aquifer near Aveiro (P). All three aquifers contain very old groundwaters...... of the evolution in natural baseline properties in groundwater....

  1. Solid Waste Program technical baseline description

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, A.B.

    1994-07-01

    The system engineering approach has been taken to describe the technical baseline under which the Solid Waste Program is currently operating. The document contains a mission analysis, function analysis, system definition, documentation requirements, facility and project bases, and uncertainties facing the program.

  2. Rationing in the presence of baselines

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter

    2013-01-01

    We analyze a general model of rationing in which agents have baselines, in addition to claims against the (insufficient) endowment of the good to be allocated. Many real-life problems fit this general model (e.g., bankruptcy with prioritized claims, resource allocation in the public health care...

  3. National Cyberethics, Cybersafety, Cybersecurity Baseline Study

    Science.gov (United States)

    Education Digest: Essential Readings Condensed for Quick Review, 2009

    2009-01-01

    This article presents findings from a study that explores the nature of the Cyberethics, Cybersafety, and Cybersecurity (C3) educational awareness policies, initiatives, curriculum, and practices currently taking place in the U.S. public and private K-12 educational settings. The study establishes baseline data on C3 awareness, which can be used…

  4. Food preferences and weight change during low-fat and low-carbohydrate diets

    Science.gov (United States)

    McVay, Megan A.; Voils, Corrine I.; Geiselman, Paula J.; Smith, Valerie A.; Coffman, Cynthia J.; Mayer, Stephanie; Yancy, William S.

    2016-01-01

    Understanding associations between food preferences and weight loss during various effective diets could inform efforts to personalize dietary recommendations and provide insight into weight loss mechanisms. We conducted a secondary analysis of data from a clinical trial in which participants were randomized to either a ‘choice’ arm, in which they were allowed to select between a low-fat diet (n=44) or low-carbohydrate diet (n=61), or to a ‘no choice’ arm, in which they were randomly assigned to a low-fat diet (n=49) or low-carbohydrate diet (n=53). All participants were provided 48 weeks of lifestyle counseling. Food preferences were measured at baseline and every 12 weeks thereafter with the Geiselman Food Preference Questionnaire. Participants were 73% male and 51% African American, with a mean age of 55. Baseline food preferences, including congruency of food preferences with diet, were not associated with weight outcomes. In the low-fat diet group, no associations were found between changes in food preferences and weight over time. In the low-carbohydrate diet group, increased preference for low-carbohydrate diet congruent foods from baseline to 12 weeks was associated with weight loss from 12 to 24 weeks. Additionally, weight loss from baseline to 12 weeks was associated with increased preference for low-carbohydrate diet congruent foods from 12 to 24 weeks. Results suggest that basing selection of low-carbohydrate diet or low-fat diet on food preferences is unlikely to influence weight loss. Congruency of food preferences and weight loss may influence each other early during a low-carbohydrate diet but not low-fat diet, possibly due to different features of these diets. PMID:27133551

  5. Music-induced context preference following cocaine conditioning in rats.

    Science.gov (United States)

    Polston, J E; Glick, S D

    2011-08-01

    Traditional models of drug-seeking behavior have shown that exposure to associated environmental cues can trigger relapse. These learned associations take place during repeated drug administration, resulting in conditioned reinforcement. Although considerable investigation has occurred regarding simple conditioned stimuli, less is known about complex environmental cues, particularly those that may be salient in human addiction. Recent studies indicate that music can serve as a contextual conditioned stimulus in rats and influence drug-seeking behavior during abstinence. The purpose of the present study was to further assess the effectiveness of music as a conditioned stimulus in rats, to determine rats' preferences for two contrasting pieces of music, and to determine rats' preferences for music versus silence. To this end, we created an apparatus that gave instrumental control of musical choice (Miles Davis vs. Beethoven) to the rats themselves. After determining baseline musical preference, animals were conditioned with cocaine (10 mg/kg) to the music they initially preferred least, with alternating conditioning sessions pairing saline with the music preferred most. The animals were subsequently tested in a drug-free state to determine what effect this conditioning had on musical preference. The results indicate that music serves as an effective contextual conditioned stimulus, significantly increasing both musical preference and locomotor activity after repeated cocaine conditioning. Furthermore, we found that rats initially favor silence over music, but that this preference can be altered as a result of cocaine-paired conditioning. These findings demonstrate that, after repeated association with reward (cocaine), music can engender a conditioned context preference in rats; these findings are consistent with other evidence showing that musical contextual cues can reinstate drug-seeking behavior in rats.

  6. Circadian preference in bipolar disorder.

    Science.gov (United States)

    Giglio, Larriany Maria Falsin; Magalhães, Pedro V S; Andersen, Mônica Levy; Walz, Julio Cesar; Jakobson, Lourenço; Kapczinski, Flávio

    2010-06-01

    A role for circadian rhythm abnormalities in the pathogenesis of bipolar disorder (BD) has been suggested. The present study assessed circadian preference, a subjective preference for activities in the morning or evening related to chronotype. The sample was comprised of 81 outpatients with BD in remission and 79 control subjects. Circadian preference was derived from an interview evaluating biological rhythms and sleep pattern from the Pittsburgh Sleep Quality Index. Patients were significantly more likely to have an evening preference than control subjects. Circadian preference was also associated with sleep latency. The association of evening preference and longer sleep latency may be related to the frequent clinical observation of a sleep/wake cycle reversal in bipolar disorder.

  7. Cultural legacies and political preferences

    DEFF Research Database (Denmark)

    Hechter, Michael Norman; Siroky, David; Mueller, Sean

    2015-01-01

    , ecological constraints such as geography and topography affect social interaction with like-minded individuals. On the basis of both these political preferences and ecological constraints, individuals then make rational choices about the desirability of secession. Instrumental considerations are therefore...... that cultural identities matter for explaining secessionism, but not because of primordial attachments. Rather, religious and linguistic groups matter because their members are imbued with cultural legacies that lead to distinct political preferences – in this case preferences over welfare statism. Further...

  8. Preference formation and institutional change

    Directory of Open Access Journals (Sweden)

    Sérgio Praça

    2009-06-01

    Full Text Available This essay critically analyses how historical institutionalists and rational choice scholars study institutional stability and change. Special attention is paid to the thorny issued of how political actors’ preferences are formed, with historical institutionalists considering preferences as endogenously formed, and rational choice analysts postulating that preferences are fixed and exogenous. An argument is made in favour of the perspective that considers preferences as being formed within the functioning of the political system over time, endogenously. The essay also proposes the incorporation of ideas and non-decisions as tools to elucidate processes of change.

  9. Intelligence and musical mode preference

    DEFF Research Database (Denmark)

    Bonetti, Leonardo; Costa, Marco

    2016-01-01

    The relationship between fluid intelligence and preference for major–minor musical mode was investigated in a sample of 80 university students. Intelligence was assessed by the Raven’s Advanced Progressive Matrices. Musical mode preference was assessed by presenting 14 pairs of musical stimuli th...... differences at the cognitive and personality level related to the enjoyment of sad music.......The relationship between fluid intelligence and preference for major–minor musical mode was investigated in a sample of 80 university students. Intelligence was assessed by the Raven’s Advanced Progressive Matrices. Musical mode preference was assessed by presenting 14 pairs of musical stimuli...

  10. Changes in taste and smell function, dietary intake, food preference, and body composition in testicular cancer patients treated with cisplatin-based chemotherapy.

    Science.gov (United States)

    IJpma, Irene; Renken, Remco J; Gietema, Jourik A; Slart, Riemer H J A; Mensink, Manon G J; Lefrandt, Joop D; Ter Horst, Gert J; Reyners, Anna K L

    2016-10-27

    Taste and smell changes due to chemotherapy may contribute to the high prevalence of overweight in testicular cancer patients (TCPs). This study investigates the taste and smell function, dietary intake, food preference, and body composition in TCPs before, during, and up to 1 year after cisplatin-based chemotherapy. Twenty-one consecutive TCPs participated. At baseline TCPs were compared to healthy controls (N = 48). Taste strips and 'Sniffin' Sticks' were used to determine psychophysical taste and smell function. Subjective taste, smell, appetite, and hunger were assessed using a questionnaire. Dietary intake was analyzed using a food frequency questionnaire. Food preference was assessed using food pictures varying in taste (sweet/savoury) and fat or protein content. A Dual-Energy X-ray Absorptiometry (DEXA) scan was performed to measure whole body composition. Compared to controls, TCPs had a lower smell threshold (P = 0.045) and lower preference for high fat sweet foods at baseline (P = 0.024). Over time, intra-individual psychophysical taste and smell function was highly variable. The salty taste threshold increased at completion of chemotherapy compared to baseline (P = 0.006). A transient decrease of subjective taste, appetite, and hunger feelings was observed per chemotherapy cycle. The percentage of fat mass increased during chemotherapy compared to baseline, while the lean mass and bone density decreased (P < 0.05). Coping strategies regarding subjective taste impairment should especially be provided during the first week of each chemotherapy cycle. Since the body composition of TCPs already had changed at completion of chemotherapy, intervention strategies to limit the impact of cardiovascular risk factors should probably start during treatment. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  11. Clinical efficacy of preferred use of high-frequency oscillatory ventilation in treatment of neonatal pulmonary hemorrhage%首选使用高频振荡通气治疗新生儿肺出血的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    王华; 杜立中; 唐军; 伍金林; 母得志

    2015-01-01

    ObjectiveTo investigate the clinical efifcacy and safety of preferred use of high-frequency oscillatory ventilation (HFOV) in the treatment of neonatal pulmonary hemorrhage.MethodsThe clinical efifcacy of preferred use of HFOV (preferred use group) and rescue use of HFOV after conventional mechanical ventilation proved ineffective (rescue use group) in the treatment of 26 cases of neonatal pulmonary hemorrhage was retrospectively analyzed. The oxygenation index (OI), pulmonary hemorrhage time, hospitalization time, ventilation time, oxygen therapy time, complications, and outcome of the two groups were compared.ResultsCompared with the rescue use group, the preferred use group had signiifcantly lower IO values at 1, 6, 12, 24, 48, and 72 hours after treatment (P0.05). Compared with those in the rescue use group, children who survived in the preferred use group had signiifcantly shorter pulmonary hemorrhage time, hospitalization time, ventilation time, and oxygen therapy time (P0.05)。存活患儿中,首选组在肺出血时间、住院时间、上机时间、氧疗时间上较解救组明显缩短(P<0.05)。结论与解救组相比,首选HFOV较解救性使用HFOV能更好地改善肺出血患儿氧合功能,降低VAP的发生率,缩短病程,提高治愈率,且未增加不良反应的发生率。

  12. CASA Uno GPS orbit and baseline experiments

    Science.gov (United States)

    Schutz, B. E.; Ho, C. S.; Abusali, P. A. M.; Tapley, B. D.

    1990-01-01

    CASA Uno data from sites distributed in longitude from Australia to Europe have been used to determine orbits of the GPS satellites. The characteristics of the orbits determined from double difference phase have been evaluated through comparisons of two-week solutions with one-week solutions and by comparisons of predicted and estimated orbits. Evidence of unmodeled effects is demonstrated, particularly associated with the orbit planes that experience solar eclipse. The orbit accuracy has been assessed through the repeatability of unconstrained estimated baseline vectors ranging from 245 km to 5400 km. Both the baseline repeatability and the comparison with independent space geodetic methods give results at the level of 1-2 parts in 100,000,000. In addition, the Mojave/Owens Valley (245 km) and Kokee Park/Ft. Davis (5409 km) estimates agree with VLBI and SLR to better than 1 part in 100,000,000.

  13. Joint Multi-baseline SAR Interferometry

    Directory of Open Access Journals (Sweden)

    S. Tebaldini

    2005-12-01

    Full Text Available We propose a technique to provide interferometry by combining multiple images of the same area. This technique differs from the multi-baseline approach in literature as (a it exploits all the images simultaneously, (b it performs a spectral shift preprocessing to remove most of the decorrelation, and (c it exploits distributed targets. The technique is mainly intended for DEM generation at centimetric accuracy, as well as for differential interferometry. The problem is framed in the contest of single-input multiple-output (SIMO channel estimation via the cross-relations (CR technique and the resulting algorithm provides significant improvements with respect to conventional approaches based either on independent analysis of single interferograms or multi-baselines phase analysis of single pixels of current literature, for those targets that are correlated in all the images, like for long-term coherent areas, or for acquisitions taken with a short revisit time (as those gathered with future satellite constellations.

  14. Dissipative Effect in Long Baseline Neutrino Experiments

    CERN Document Server

    Oliveira, Roberto L N

    2016-01-01

    The propagation of neutrinos in long baselines experiments may be influenced by dissipation effects. Using Lindblad Master Equation we evolve neutrinos taking into account these dissipative effects. The MSW and the dissipative effects may change the probabilities behavior. In this work, we show and explain how the behavior of the probabilities can change due to the decoherence and relaxation effects acting individually with the MSW effect. A new exotic peak appears in this case and we show the difference between the decoherence and relaxation effects in the appearance of this peak. We also adapt the usual approximate expression for survival and appearance probabilities with all possible decoherence effects. We suppose the baseline of DUNE and show how each decoherence parameters change the probabilities analyzing the possible modification using numeric and analytic approach.

  15. CASA Uno GPS orbit and baseline experiments

    Science.gov (United States)

    Schutz, B. E.; Ho, C. S.; Abusali, P. A. M.; Tapley, B. D.

    1990-01-01

    CASA Uno data from sites distributed in longitude from Australia to Europe have been used to determine orbits of the GPS satellites. The characteristics of the orbits determined from double difference phase have been evaluated through comparisons of two-week solutions with one-week solutions and by comparisons of predicted and estimated orbits. Evidence of unmodeled effects is demonstrated, particularly associated with the orbit planes that experience solar eclipse. The orbit accuracy has been assessed through the repeatability of unconstrained estimated baseline vectors ranging from 245 km to 5400 km. Both the baseline repeatability and the comparison with independent space geodetic methods give results at the level of 1-2 parts in 100,000,000. In addition, the Mojave/Owens Valley (245 km) and Kokee Park/Ft. Davis (5409 km) estimates agree with VLBI and SLR to better than 1 part in 100,000,000.

  16. Chronic NMDA receptor blockade in early postnatal period, but not in adulthood, impairs methamphetamine-induced conditioned place preference in rats.

    Science.gov (United States)

    Furuie, Hiroki; Yamada, Kazuo; Ichitani, Yukio

    2016-03-15

    Early postnatal glutamatergic N-methyl-d-aspartate (NMDA) receptor blockade in animals is known to produce various behavioral deficits in adulthood. In the present study rats postnatally (day 7-20) treated chronically with MK-801, an NMDA receptor antagonist, were tested later in adulthood in methamphetamine (MAP)-induced conditioned place preference (CPP) using a unbiased procedure in a three-compartment apparatus. Rats with the same chronic treatment in adulthood were also tested. CPP test consisted of a baseline test before conditioning, place conditioning, and a preference test after conditioning. Rats postnatally treated with MK-801 did not show any evidence of preference for MAP-paired compartment compared with that for unpaired one in the preference test that was shown in rats postnatally treated with saline. On the other hand, rats treated with MK-801 in adulthood were not affected by the treatment and showed significant CPP as was shown in saline-treated control animals. Results suggest the possibility that chronic early postnatal, but not adulthood, NMDA receptor blockade induces persistent deficit of subsequent appetitive classical conditioning.

  17. Systematic errors in long baseline oscillation experiments

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Deborah A.; /Fermilab

    2006-02-01

    This article gives a brief overview of long baseline neutrino experiments and their goals, and then describes the different kinds of systematic errors that are encountered in these experiments. Particular attention is paid to the uncertainties that come about because of imperfect knowledge of neutrino cross sections and more generally how neutrinos interact in nuclei. Near detectors are planned for most of these experiments, and the extent to which certain uncertainties can be reduced by the presence of near detectors is also discussed.

  18. The Gambia Impact Evaluation Baseline Report

    OpenAIRE

    2015-01-01

    The Government of The Gambia is implementing the Maternal and Child Nutrition and Health Results Project (MCNHRP) to increase the utilization of community nutrition and primary maternal and child health services. In collaboration with the Government, the World Bank is conducting an impact evaluation (IE) to assess the impact of the project on key aspects of maternal and child nutrition and health. The baseline survey for the MCNHRP IE took place between November 2014 and February 2015. It c...

  19. Geochemical baseline data, Youngs Bay, Oregon, 1974

    Energy Technology Data Exchange (ETDEWEB)

    McMechan, K.J. (ed.); Johnson, V.G.; Cutshall, N.H.

    1975-04-01

    This report comprises one part of a final report to the Alumax Pacific Aluminum Corporation on the Physical, Chemical and Biological Studies of Youngs Bay''. The data reported herein are the product of the geochemical baseline section of the project. The primary objectives of the geochemical study were: to provide a baseline record of fluoride and selected trace metal levels in Youngs Bay bottom sediment, to identify areas that might function as heavy metal traps, to attempt to determine the recent depositional history of sediment in the bay. In addition to these primary objectives, a number of secondary tasks were undertaken during the study. While time did not allow these additional studies to be carried to completion, preliminary results are included herein because of their potential usefulness in assessing the impact of environmental releases of fluoride to aquatic systems in the vicinity of Youngs Bay or elsewhere. This report is made up of two major sections. In the first, a description of sample collection and analytical procedures is followed by a discussion of the baseline results. Obvious vertical and horizontal patterns of elemental distribution are identified and their origins considered. Problems needed further research are also discussed. In the second section, the data are presented in interpretive, graphical form, as well as in tables. 35 refs., 29 figs., 14 tabs.

  20. Efficient Wide Baseline Structure from Motion

    Science.gov (United States)

    Michelini, Mario; Mayer, Helmut

    2016-06-01

    This paper presents a Structure from Motion approach for complex unorganized image sets. To achieve high accuracy and robustness, image triplets are employed and (an approximate) camera calibration is assumed to be known. The focus lies on a complete linking of images even in case of large image distortions, e.g., caused by wide baselines, as well as weak baselines. A method for embedding image descriptors into Hamming space is proposed for fast image similarity ranking. The later is employed to limit the number of pairs to be matched by a wide baseline method. An iterative graph-based approach is proposed formulating image linking as the search for a terminal Steiner minimum tree in a line graph. Finally, additional links are determined and employed to improve the accuracy of the pose estimation. By this means, loops in long image sequences are implicitly closed. The potential of the proposed approach is demonstrated by results for several complex image sets also in comparison with VisualSFM.

  1. Human preference for air movement

    DEFF Research Database (Denmark)

    Toftum, Jørn; Melikov, Arsen Krikor; Tynel, A.;

    2002-01-01

    Human preference for air movement was studied at slightly cool, neutral, and slightly warm overall thermal sensations and at temperatures ranging from 18 deg.C to 28 deg.C. Air movement preference depended on both thermal sensation and temperature, but large inter-individual differences existed...

  2. Voter-Weighted Environmental Preferences

    Science.gov (United States)

    Bell, Jason; Huber, Joel; Viscusi, W. Kip

    2009-01-01

    This article examines the political economy of preferences with respect to the environment using a new stated preference survey that presents the first benefit values for national water quality levels. The mean valuation greatly exceeds the median value, as the distribution of valuations is highly skewed. The study couples the survey valuations…

  3. Social preferences and portfolio choice

    NARCIS (Netherlands)

    Riedl, A.M.; Smeets, P.M.A.

    2013-01-01

    This paper explores whether social preferences influence portfolio choices of retail investors. We use administrative investor trading records which we link to decisions of the same investors in experiments with real money at stake. We show that social preferences rather than return expectations or

  4. Do children prefer mentalistic descriptions?

    Science.gov (United States)

    Dore, Rebecca A; Lillard, Angeline S

    2014-01-01

    Against a long tradition of childhood realism (Piaget, 1929), A. S. Lillard and J. H. Flavell (1990) found that 3-year-olds prefer to characterize people by their mental states (beliefs, desires, emotions) than by their visible behaviors. In this exploratory study, we extend this finding to a new cohort of 3-year-olds, examine how these preferences change from 3-4 years, and explore relationships with theory of mind and parental mind-mindedness. The results showed a developmental change and a possible cohort difference: at 3 years, children in the sample preferred behavioral descriptions, although by 4 years of age, they preferred mentalistic ones. Interestingly, mentalistic preferences were unrelated to theory of mind or parental mind-mindedness, concurrently or over time. Perspective-taking skills at 3 years, however, predicted an increase in mentalistic responses from 3 years to 4 years. Possible explanations for each finding are discussed.

  5. Interface between culturally based preferences and genetic preferences: female mate choice in Poecilia reticulata.

    Science.gov (United States)

    Dugatkin, L A

    1996-01-01

    The relative contribution of genetic and socio-cultural factors in the shaping of behavior is of fundamental importance to biologists and social scientists, yet it has proven to be extremely difficult to study in a controlled, experimental fashion. Here I describe experiments that examined the strength of genetic and cultural (imitative) factors in determining female mate choice in the guppy, Poecilia reticulata. Female guppies from the Paria River in Trinidad have a genetic, heritable preference for the amount of orange body color possessed by males. Female guppies will, however, also copy (imitate) the mate choice of other females in that when two males are matched for orange color, an "observer" female will copy the mate choice of another ("model") female. Three treatments were undertaken in which males differed by an average of 12%, 24%, or 40% of the total orange body color. In all cases, observer females viewed a model female prefer the less colorful male. When males differed by 12% or 24%, observer females preferred the less colorful male and thus copied the mate choice of others, despite a strong heritable preference for orange body color in males. When males differed by 40% orange body color, however, observer females preferred the more colorful male and did not copy the mate choice of the other female. In this system, then, imitation can "override" genetic preferences when the difference between orange body color in males is small or moderate, but genetic factors block out imitation effects when the difference in orange body color in males is large. This experiment provides the first attempt to experimentally examine the relative strength of cultural and genetic preferences for a particular trait and suggests that these two factors moderate one another in shaping social behavior. PMID:11607646

  6. Planning with Partial Preference Models

    CERN Document Server

    Nguyen, Tuan; Gerevini, Alfonso; Serina, Ivan; Srivastava, Biplav; Kambhampati, Subbarao

    2011-01-01

    Current work in planning with preferences assume that the user's preference models are completely specified and aim to search for a single solution plan. In many real-world planning scenarios, however, the user probably cannot provide any information about her desired plans, or in some cases can only express partial preferences. In such situations, the planner has to present not only one but a set of plans to the user, with the hope that some of them are similar to the plan she prefers. We first propose the usage of different measures to capture quality of plan sets that are suitable for such scenarios: domain-independent distance measures defined based on plan elements (actions, states, causal links) if no knowledge of the user's preferences is given, and the Integrated Convex Preference measure in case the user's partial preference is provided. We then investigate various heuristic approaches to find set of plans according to these measures, and present empirical results demonstrating the promise of our app...

  7. Pipeline integrity: ILI baseline data for QRA

    Energy Technology Data Exchange (ETDEWEB)

    Porter, Todd R. [Tuboscope Pipeline Services, Houston, TX (United States)]. E-mail: tporter@varco.com; Silva, Jose Augusto Pereira da [Pipeway Engenharia, Rio de Janeiro, RJ (Brazil)]. E-mail: guto@pipeway.com; Marr, James [MARR and Associates, Calgary, AB (Canada)]. E-mail: jmarr@marr-associates.com

    2003-07-01

    The initial phase of a pipeline integrity management program (IMP) is conducting a baseline assessment of the pipeline system and segments as part of Quantitative Risk Assessment (QRA). This gives the operator's integrity team the opportunity to identify critical areas and deficiencies in the protection, maintenance, and mitigation strategies. As a part of data gathering and integration of a wide variety of sources, in-line inspection (ILI) data is a key element. In order to move forward in the integrity program development and execution, the baseline geometry of the pipeline must be determined with accuracy and confidence. From this, all subsequent analysis and conclusions will be derived. Tuboscope Pipeline Services (TPS), in conjunction with Pipeway Engenharia of Brazil, operate ILI inertial navigation system (INS) and Caliper geometry tools, to address this integrity requirement. This INS and Caliper ILI tool data provides pipeline trajectory at centimeter level resolution and sub-metre 3D position accuracy along with internal geometry - ovality, dents, misalignment, and wrinkle/buckle characterization. Global strain can be derived from precise INS curvature measurements and departure from the initial pipeline state. Accurate pipeline elevation profile data is essential in the identification of sag/over bend sections for fluid dynamic and hydrostatic calculations. This data, along with pipeline construction, operations, direct assessment and maintenance data is integrated in LinaViewPRO{sup TM}, a pipeline data management system for decision support functions, and subsequent QRA operations. This technology provides the baseline for an informed, accurate and confident integrity management program. This paper/presentation will detail these aspects of an effective IMP, and experience will be presented, showing the benefits for liquid and gas pipeline systems. (author)

  8. SRP baseline hydrogeologic investigation, Phase 2

    Energy Technology Data Exchange (ETDEWEB)

    Bledsoe, H.W.

    1987-11-01

    As discussed in the program plan for the Savannah River Plant (SRP) Baseline Hydrogeologic Investigation, this program has been implemented for the purpose of updating and improving the current state of knowledge and understanding of the hydrogeologic systems underlying the Savannah River Plant (SRP). The objective of the program is to install a series of observation well clusters (wells installed in each major water bearing formation at the same site) at key locations across the plant site in order to: (1) provide detailed information on the lithology, stratigraphy, and groundwater hydrology, (2) provide observation wells to monitor the groundwater quality, head relationships, gradients, and flow paths.

  9. Very Long Baseline Interferometry with the SKA

    CERN Document Server

    Paragi, Zsolt; Reynolds, Cormac; Rioja, Maria; Deller, Adam; Zhang, Bo; Gurvits, Leonid; Bietenholz, Michael; Szomoru, Arpad; Bignall, Hayley; Boven, Paul; Charlot, Patrick; Dodson, Richard; Frey, Sandor; Garrett, Michael; Imai, Hiroshi; Lobanov, Andrei; Reid, Mark; Ros, Eduardo; van Langevelde, Huib; Zensus, J Anton; Zheng, Xing Wu; Alberdi, Antxon; Agudo, Ivan; An, Tao; Argo, Megan; Beswick, Rob; Biggs, Andy D; Brunthaler, Andreas; Campbell, Robert M; Cimo, Giuseppe; Colomer, Francisco; Corbel, Stephane; Conway, John; Cseh, David; Deane, Roger; Falcke, Heino; Gabanyi, Krisztina; Gawronski, Marcin; Gaylard, Michael; Giovannini, Gabriele; Giroletti, Marcello; Goddi, Ciriaco; Goedhart, Sharmila; Gomez, Jose L; Gunn, Alastair; Jung, Taehyun; Kharb, Preeti; Klockner, Hans-Rainer; Kording, Elmar; Kovalev, Yurii Yu; Kunert-Bajraszewska, Magdalena; Lindqvist, Michael; Lister, Matt; Mantovani, Franco; Marti-Vidal, Ivan; Mezcua, Mar; McKean, John; Middelberg, Enno; Miller-Jones, James; Moldon, Javier; Muxlow, Tom; O'Brien, Tim; Pérez-Torres, Miguel; Pogrebenko, Sergei; Quick, Jonathan; Rushton, Anthony P; Schilizzi, Richard; Smirnov, Oleg; Sohn, Bong Won; Surcis, Gabriele; Taylor, Greg; Tingay, Steven; Tudose, Valeriu; van der Horst, Alexander; van Leeuwen, Joeri; Venturi, Tiziana; Vermeulen, Rene; Vlemmings, Wouter; de Witt, Aletha; Wucknitz, Olaf; Yang, Jun

    2014-01-01

    Adding VLBI capability to the SKA arrays will greatly broaden the science of the SKA, and is feasible within the current specifications. SKA-VLBI can be initially implemented by providing phased-array outputs for SKA1-MID and SKA1-SUR and using these extremely sensitive stations with other radio telescopes, and in SKA2 by realising a distributed configuration providing baselines up to thousands of km, merging it with existing VLBI networks. The motivation for and the possible realization of SKA-VLBI is described in this paper.

  10. Optimization of the CLIC Baseline Collimation System

    Energy Technology Data Exchange (ETDEWEB)

    Resta-Lopez, Javier; /Oxford U., JAI; Angal-Kalinin, Deepa; /Daresbury; Fernandez-Hernando, Juan; /Daresbury; Jackson, Frank; /Daresbury; Dalena, Barbara; /CERN; Schulte, Daniel; /CERN; Tomas, Rogelio; /CERN; Seryi, Andrei; /SLAC

    2012-07-06

    Important efforts have recently been dedicated to the improvement of the design of the baseline collimation system of the Compact Linear Collider (CLIC). Different aspects of the design have been optimized: the transverse collimation depths have been recalculated in order to reduce the collimator wakefield effects while maintaining a good efficiency in cleaning the undesired beam halo; the geometric design of the spoilers have also been reviewed to minimize wakefields; in addition, the optics design have been polished to improve the collimation efficiency. This paper describes the current status of the CLIC collimation system after this optimization.

  11. SRP Baseline Hydrogeologic Investigation, Phase 3

    Energy Technology Data Exchange (ETDEWEB)

    Bledsoe, H.W.

    1988-08-01

    The SRP Baseline Hydrogeologic Investigation was implemented for the purpose of updating and improving the knowledge and understanding of the hydrogeologic systems underlying the SRP site. Phase III, which is discussed in this report, includes the drilling of 7 deep coreholes (sites P-24 through P-30) and the installation of 53 observation wells ranging in depth from approximately 50 ft to more than 970 ft below the ground surface. In addition to the collection of geologic cores for lithologic and stratigraphic study, samples were also collected for the determination of physical characteristics of the sediments and for the identification of microorganisms.

  12. SRP baseline hydrogeologic investigation: Aquifer characterization

    Energy Technology Data Exchange (ETDEWEB)

    Strom, R.N.; Kaback, D.S.

    1992-03-31

    An investigation of the mineralogy and chemistry of the principal hydrogeologic units and the geochemistry of the water in the principal aquifers at Savannah River Site (SRS) was undertaken as part of the Baseline Hydrogeologic Investigation. This investigation was conducted to provide background data for future site studies and reports and to provide a site-wide interpretation of the geology and geochemistry of the Coastal Plain Hydrostratigraphic province. Ground water samples were analyzed for major cations and anions, minor and trace elements, gross alpha and beta, tritium, stable isotopes of hydrogen, oxygen, and carbon, and carbon-14. Sediments from the well borings were analyzed for mineralogy and major and minor elements.

  13. Incorporating patients' preferences into medical decision making.

    Science.gov (United States)

    Fraenkel, Liana

    2013-02-01

    Current models of care emphasize the importance of including patients' values in the decision-making process. This is particularly important for decisions for which there are few data supporting a clear strategy or treatment choice. Constructing preferences for complex decisions requires that patients be able to consider multiple trade-offs between specific risks and benefits. Several marketing research techniques have been recently applied to heath care settings to facilitate this process. Most can be programmed to generate patients' preferences or priorities, which can then be used to improve patient-physician communication. In this article, we will describe some of the currently available approaches that have been successfully used in the health care setting. We provide case examples to illustrate the potential value of adopting each of these approaches in clinical practice.

  14. Elicitation of ostomy pouch preferences

    DEFF Research Database (Denmark)

    Bonnichsen, Ole

    2011-01-01

    in ostomy pouch attributes. The theory, study design, elicitation procedure, and resulting preference structure of the sample is described. Methods: A discrete-choice experiment (DCE) was used to elicit preferences. Respondents were asked to choose between alternatives in choice sets, in which each...... pouches when cost is included as an attribute. A total of 254 patients responded to the survey and preferences were estimated using a random parameter logit econometric specification. Results: Respondents had significantly positive WTP for all potential attribute improvements presented in the survey...

  15. Preferences for Simultaneous Polydrug Use:

    DEFF Research Database (Denmark)

    Østergaard, Jeanette; Østergaard, Stine Vernstrøm; Fletcher, Adam

    2016-01-01

    use (PSPU) vary among club/bar-goers in two European countries, Denmark and England, typically cited as exemplars of the normalization of illegal drug use. The study considers the utility of the normalization thesis for understanding preferences for polydrug use in the European nighttime economy....... Lifetime cocaine use was 38% in England and 17% in Denmark. In England, young adults with drug experience preferred to mix alcohol with cocaine (65%). In Denmark, young adults with drug experience preferred to mix alcohol with cannabis (78%). In multinominal regression, Danish young adults’ educational...

  16. Stated preference methods using R

    CERN Document Server

    Aizaki, Hideo; Sato, Kazuo

    2014-01-01

    Stated Preference Methods Using R explains how to use stated preference (SP) methods, which are a family of survey methods, to measure people's preferences based on decision making in hypothetical choice situations. Along with giving introductory explanations of the methods, the book collates information on existing R functions and packages as well as those prepared by the authors. It focuses on core SP methods, including contingent valuation (CV), discrete choice experiments (DCEs), and best-worst scaling (BWS). Several example data sets illustrate empirical applications of each method with R

  17. Endogenous scheduling preferences and congestion

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Small, Kenneth

    2010-01-01

    Dynamic models of congestion so far rely on exogenous scheduling preferences of travelers, based for example on disutility of deviation from a preferred departure or arrival time for a trip. This paper provides a more fundamental view in which travelers derive utility just from consumption...... and leisure, but agglomeration economies at home and at work lead to scheduling preferences forming endogenously. Using bottleneck congestion technology, we obtain an equilibrium queuing pattern consistent with a general version of the Vickrey bottleneck model. However, the policy implications are different...

  18. Children with seizures exhibit preferences for foods compatible with the ketogenic diet.

    Science.gov (United States)

    Amari, Adrianna; Dahlquist, Lynnda; Kossoff, Eric H; Vining, Eileen P G; Trescher, William H; Slifer, Keith J

    2007-08-01

    Although highly effective for the treatment of intractable epilepsy, the ketogenic diet is not always included in the treatment option hierarchy presented to families, in part due to perceptions that children will find the high-fat/low-carbohydrate regimen unpalatable. This study assessed if children with seizures exhibit food preferences compatible with the diet, as well as if caregivers were accurate in predicting preferences. Children aged 2-17, with (n=29) and without (n=30) a history of seizures, participated in a paired choice food preference assessment while parents estimated child preferences verbally. Children with seizures exhibited significantly higher preferences for fat versus carbohydrate foods compared with controls, and parents demonstrated low accuracy. Future studies could use similar assessment methods to prospectively track whether such preferences predict diet compliance and/or efficacy. Research into the underlying metabolic basis for this preference and possible related neurophysiological mechanisms in seizure etiology and treatment is warranted.

  19. Baseline Response Levels Are a Nuisance in Infant Contingency Learning

    Science.gov (United States)

    Millar, W. S.; Weir, Catherine

    2015-01-01

    The impact of differences in level of baseline responding on contingency learning in the first year was examined by considering the response acquisition of infants classified into baseline response quartiles. Whereas the three lower baseline groups showed the predicted increment in responding to a contingency, the highest baseline responders did…

  20. Physics Potential of Long-Baseline Experiments

    CERN Document Server

    Agarwalla, Sanjib Kumar

    2014-01-01

    The discovery of neutrino mixing and oscillations over the past decade provides firm evidence for new physics beyond the Standard Model. Recently, theta13 has been determined to be moderately large, quite close to its previous upper bound. This represents a significant milestone in establishing the three-flavor oscillation picture of neutrinos. It has opened up exciting prospects for current and future long-baseline neutrino oscillation experiments towards addressing the remaining fundamental questions, in particular the type of the neutrino mass hierarchy and the possible presence of a CP-violating phase. Another recent and crucial development is the indication of non-maximal 2-3 mixing angle, causing the octant ambiguity of theta23. In this paper, I will review the phenomenology of long-baseline neutrino oscillations with a special emphasis on sub-leading three-flavor effects, which will play a crucial role in resolving these unknowns. First, I will give a brief description of neutrino oscillation phenomeno...

  1. Baseline and benchmark model development for hotels

    Science.gov (United States)

    Hooks, Edward T., Jr.

    The hotel industry currently faces rising energy costs and requires the tools to maximize energy efficiency. In order to achieve this goal a clear definition of the current methods used to measure and monitor energy consumption is made. Uncovering the limitations to the most common practiced analysis strategies and presenting methods that can potentially overcome those limitations is the main purpose. Techniques presented can be used for measurement and verification of energy efficiency plans and retrofits. Also, modern energy modeling tool are introduced to demonstrate how they can be utilized for benchmarking and baseline models. This will provide the ability to obtain energy saving recommendations and parametric analysis to explore energy savings potential. These same energy models can be used in design decisions for new construction. An energy model is created of a resort style hotel that over one million square feet and has over one thousand rooms. A simulation and detailed analysis is performed on a hotel room. The planning process for creating the model and acquiring data from the hotel room to calibrate and verify the simulation will be explained. An explanation as to how this type of modeling can potentially be beneficial for future baseline and benchmarking strategies for the hotel industry. Ultimately the conclusion will address some common obstacles the hotel industry has in reaching their full potential of energy efficiency and how these techniques can best serve them.

  2. Vegetation baseline report : Connacher great divide project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-08-01

    This baseline report supported an application by Connacher Oil and Gas Ltd. to the Alberta Energy and Utilities Board (EUB) and Alberta Environment (AENV) for the Great Divide Steam Assisted Gravity Drainage (SAGD) Project. The goal of the report was to document the distribution and occurrence of ecosite phases and wetland classes in the project footprint as well as to document the distribution of rare plants; rare plant communities: and intrusive species and old growth communities, including species of management concern. A methodology of the baseline report was presented, including details of mapping and field surveys. Six vegetation types in addition to the disturbed land unit were identified in the project footprint and associated buffer. It was noted that all vegetation types are common for the boreal forest natural regions. Several species of management concern were identified during the spring rare plant survey, including rare bryophytes and non-native or invasive species. Mitigation was identified through a slight shift of the footprint, transplant of appropriate bryophyte species and implementation of a weed management plan. It was noted that results of future surveys for rare plants will be submitted upon completion. It was concluded that the effects of the project on existing vegetation is expected to be low because of the small footprint, prior disturbance history, available mitigation measures and conservation and reclamation planning. 27 refs., 5 tabs., 4 figs.

  3. Endogenous scheduling preferences and congestion

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Small, Kenneth

    2010-01-01

    Dynamic models of congestion so far rely on exogenous scheduling preferences of travelers, based for example on disutility of deviation from a preferred departure or arrival time for a trip. This paper provides a more fundamental view in which travelers derive utility just from consumption...... and leisure, but agglomeration economies at home and at work lead to scheduling preferences forming endogenously. Using bottleneck congestion technology, we obtain an equilibrium queuing pattern consistent with a general version of the Vickrey bottleneck model. However, the policy implications are different....... Compared to the predictions of an analyst observing untolled equilibrium and taking scheduling preferences as exogenous, we find that both the optimal capacity and the marginal external cost of congestion have changed. The benefits of tolling are greater, and the optimal time varying toll is different....

  4. Preferences With Grades of Indecisiveness

    OpenAIRE

    Stefania Minardi; Andrei Savochkin

    2013-01-01

    Departing from the traditional approach to modeling an agent who finds it difficult to make clear-cut comparisons between alternatives, we introduce the notion of graded preferences: Given two alternatives, the agent reports a number between 0 and 1, which reflects her inclination to prefer the first option over the second or, put differently, how confident she is about the superiority of the first one. In the classical framework of uncertainty, we derive a representation of a graded preferen...

  5. Preferred extensions as stable models

    OpenAIRE

    2008-01-01

    Given an argumentation framework AF, we introduce a mapping function that constructs a disjunctive logic program P, such that the preferred extensions of AF correspond to the stable models of P, after intersecting each stable model with the relevant atoms. The given mapping function is of polynomial size w.r.t. AF. In particular, we identify that there is a direct relationship between the minimal models of a propositional formula and the preferred extensions of an argumentation framework by w...

  6. Gender Differences in Investment Preferences

    OpenAIRE

    Nizamettin Bayyurt; Vildan Karisik; Ali Coskun

    2016-01-01

    The paper attempts to explore how women and men differ in their individual investment preferences. Although there are some studies for the investors in developed countries, the subject has been overlooked in emerging and underdeveloped countries. Therefore, this study is the first empirical study exploring the investment behaviors of women and men by focusing on an emerging country, Turkey. For the purpose to find out how investment preferences of men and women differ towards s...

  7. The value of baseline CT head scans in the assessment of shunt complications in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Cantrell, P. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Fraser, F. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Pilling, D. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Carty, H. (Alder Hey Children' s Hospital, Liverpool (United Kingdom))

    1993-10-01

    The purpose of this study was to determine the value of a baseline CT head scan in the assessment of patients who subsequently presented with symptoms which may have been due to shunt complications (such as blockage or infection). In all these patients the shunt had been inserted in the treatment of hydrocephalus. We conclude that the presence of a baseline scan does not add to the interpretation of CT scans done when the patient presents with symptoms of possible shunt malfunction. (orig.)

  8. Identification of preferred dipole design options and cost estimates: Deliverable D5.2

    CERN Document Server

    Tommasini, Davide

    2017-01-01

    This document contains a description of the preferred 16 Tesla dipole magnet baseline design with its expected performances. The document also includes an analysis of the individual merits and risks of the different, initial design options and gives a justification for the selection of the baseline design. The deliverable includes expected field levels, field errors and a cost estimate, which serve as input for the arc design consolidation.

  9. Human preference for individual colors

    Science.gov (United States)

    Palmer, Stephen E.; Schloss, Karen B.

    2010-02-01

    Color preference is an important aspect of human behavior, but little is known about why people like some colors more than others. Recent results from the Berkeley Color Project (BCP) provide detailed measurements of preferences among 32 chromatic colors as well as other relevant aspects of color perception. We describe the fit of several color preference models, including ones based on cone outputs, color-emotion associations, and Palmer and Schloss's ecological valence theory. The ecological valence theory postulates that color serves an adaptive "steering' function, analogous to taste preferences, biasing organisms to approach advantageous objects and avoid disadvantageous ones. It predicts that people will tend to like colors to the extent that they like the objects that are characteristically that color, averaged over all such objects. The ecological valence theory predicts 80% of the variance in average color preference ratings from the Weighted Affective Valence Estimates (WAVEs) of correspondingly colored objects, much more variance than any of the other models. We also describe how hue preferences for single colors differ as a function of gender, expertise, culture, social institutions, and perceptual experience.

  10. Perinatal antidepressant use: understanding women's preferences and concerns.

    Science.gov (United States)

    Battle, Cynthia L; Salisbury, Amy L; Schofield, Casey A; Ortiz-Hernandez, Samia

    2013-11-01

    Perinatal depression is prevalent and linked with a host of adverse consequences for women and newborns. Rates of engagement in depression treatment are, however, strikingly low among pregnant and postpartum women, with the majority of affected women receiving no mental health treatment. Research indicates that perinatal women are extremely reluctant to take antidepressant medications, yet the nature of women's concerns and treatment decision- making patterns have not been well documented. Developing a clearer understanding of women's treatment preferences and behaviors may help identify solutions to the under-treatment of perinatal depression. In this mixed methods study, we conducted in-depth interviews with 61 pregnant women, approximately half of whom were experiencing clinical levels of depression. In addition to assessing psychiatric diagnoses, symptoms, and functional impairment, we conducted qualitative interviews addressing women's preferences for depression treatment, concerns, and decision-making patterns. Consistent with prior reports, women were significantly more likely to voice a preference for non-pharmacologic depression treatments, as opposed to antidepressant medications. Many depressed women reported a great degree of uncertainty regarding how to treat their depression, and those with more severe depression symptoms were more likely to endorse decisional conflict. Analysis of qualitative comments yielded detailed information about the nature of women's concerns and preferences related to use of antidepressant medications and other aspects of treatment engagement. We discuss findings in the context of improving patient-centered care for perinatal depression.

  11. Radio sources - Very, Very Long Baseline Interferometry

    Science.gov (United States)

    Roberts, D. H.

    1983-03-01

    With resolution of a thousandth of an arcsecond, the radio technique of Very Long Baseline Interferometry (VLBI) provides astronomers with their highest-resolution view of the universe. Data taken with widely-separated antennas are combined, with the help of atomic clocks, to form a Michelson interferometer whose size may be as great as the earth's diameter. Extraordinary phenomena, from the birth of stars as signaled by the brilliant flashes of powerful interstellar masers to the 'faster-than-light' expansion of the cores of distant quasars, are being explored with this technique. However, earth-bound VLBI suffers from several restrictions due to the location of the component antennas at fixed places on the earth's surface. The use of one or more antennas in space in concert with ground-based equipment will greatly expand the technical and scientific capabilities of VLBI, leading to a more complete and even higher resolution view of cosmic phenomena.

  12. The OPERA long baseline neutrino oscillation experiment

    Science.gov (United States)

    Wilquet, G.

    2008-05-01

    OPERA is a long baseline neutrino oscillation experiment designed to observe the appearance of vτ in a pure vμ beam in the parameter space indicated by the atmospheric neutrinos oscillation signal. The detector is situated in the underground LNGS laboratory under 3 800 water meter equivalent at a distance of 730 km from CERN where the CNGS neutrino beam to which it is exposed originates. It consists of two identical 0.68 kilotons lead/nuclear emulsion targets, each instrumented with a tracking device and complemented by a muon spectrometer. The concept and the status of the detector are described and the first results obtained with cosmic rays and during two weeks of beam commissioning in 2006 are reported.

  13. In-Space Manufacturing Baseline Property Development

    Science.gov (United States)

    Stockman, Tom; Schneider, Judith; Prater, Tracie; Bean, Quincy; Werkheiser, Nicki

    2016-01-01

    The In-Space Manufacturing (ISM) project at NASA Marshall Space Flight Center currently operates a 3D FDM (fused deposition modeling) printer onboard the International Space Station. In order to enable utilization of this capability by designer, the project needs to establish characteristic material properties for materials produced using the process. This is difficult for additive manufacturing since standards and specifications do not yet exist for these technologies. Due to availability of crew time, there are limitations to the sample size which in turn limits the application of the traditional design allowables approaches to develop a materials property database for designers. In this study, various approaches to development of material databases were evaluated for use by designers of space systems who wish to leverage in-space manufacturing capabilities. This study focuses on alternative statistical techniques for baseline property development to support in-space manufacturing.

  14. Pentek concrete scabbling system: Baseline report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-31

    The Pentek scabbling technology was tested at Florida International University (FIU) and is being evaluated as a baseline technology. This report evaluates it for safety and health issues. It is a commercially available technology and has been used for various projects at locations throughout the country. The Pentek concrete scabbling system consisted of the MOOSE{reg_sign}, SQUIRREL{reg_sign}-I, and SQUIRREL{reg_sign}-III scabblers. The scabblers are designed to scarify concrete floors and slabs using cross-section, tungsten carbide tipped bits. The bits are designed to remove concrete in 318 inch increments. The bits are either 9-tooth or demolition type. The scabblers are used with a vacuum system designed to collect and filter the concrete dust and contamination that is removed from the surface. The safety and health evaluation during the human factors assessment focused on two main areas: noise and dust.

  15. Steganography Based on Baseline Sequential JPEG Compression

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Information hiding in Joint Photographic Experts Group (JPEG) compressed images are investigated in this paper. Quantization is the source of information loss in JPEG compression process. Therefore, information hidden in images is probably destroyed by JPEG compression. This paper presents an algorithm to reliably embed information into the JPEG bit streams in the process of JPEG encoding. Information extraction is performed in the process of JPEG decoding. The basic idea of our algorithm is to modify the quantized direct current (DC) coefficients and non-zero alternating current (AC) coefficients to represent one bit information (0 or 1). Experimental results on gray images using baseline sequential JPEG encoding show that the cover images (images without secret information) and the stego-images (images with secret information) are perceptually indiscernible.

  16. Intensity interferometry: Optical imaging with kilometer baselines

    CERN Document Server

    Dravins, Dainis

    2016-01-01

    Optical imaging with microarcsecond resolution will reveal details across and outside stellar surfaces but requires kilometer-scale interferometers, challenging to realize either on the ground or in space. Intensity interferometry, electronically connecting independent telescopes, has a noise budget that relates to the electronic time resolution, circumventing issues of atmospheric turbulence. Extents up to a few km are becoming realistic with arrays of optical air Cherenkov telescopes (primarily erected for gamma-ray studies), enabling an optical equivalent of radio interferometer arrays. Pioneered by Hanbury Brown and Twiss, digital versions of the technique have now been demonstrated, reconstructing diffraction-limited images from laboratory measurements over hundreds of optical baselines. This review outlines the method from its beginnings, describes current experiments, and sketches prospects for future observations.

  17. Long-Baseline Neutrino Oscillation Experiments

    CERN Document Server

    Sousa, Alexandre

    2011-01-01

    During the past decade, long-baseline neutrino experiments played a fundamental role in confirming neutrino flavor change and in measuring the neutrino mixing matrix with high precision. This role will be amplified with the next generation of experiments, which will begin probing the possibility of CP violation in the leptonic sector and possibly pin down the neutrino mass hierarchy. An account of the most recent results from the MINOS experiment is presented, along with the earlier measurement from the K2K experiment. The next generation projects, T2K and NOvA, are described and their current status, schedule and physics reach discussed. Finally, we report on future efforts, currently in the R&D stage, such as the LBNE and T2KK projects.

  18. The WITCH Model. Structure, Baseline, Solutions.

    Energy Technology Data Exchange (ETDEWEB)

    Bosetti, V.; Massetti, E.; Tavoni, M.

    2007-07-01

    WITCH - World Induced Technical Change Hybrid - is a regionally disaggregated hard link hybrid global model with a neoclassical optimal growth structure (top down) and an energy input detail (bottom up). The model endogenously accounts for technological change, both through learning curves affecting prices of new vintages of capital and through R and D investments. The model features the main economic and environmental policies in each world region as the outcome of a dynamic game. WITCH belongs to the class of Integrated Assessment Models as it possesses a climate module that feeds climate changes back into the economy. In this paper we provide a thorough discussion of the model structure and baseline projections. We report detailed information on the evolution of energy demand, technology and CO2 emissions. Finally, we explicitly quantifiy the role of free riding in determining the emissions scenarios. (auth)

  19. Octant degeneracy, CPV phase at Long Baseline $\

    CERN Document Server

    Bora, Kalpana; Dutta, Debajyoti

    2015-01-01

    In a recent work by two of us, we have studied, how CP violation discovery potential can be improved at long baseline neutrino experiments (LBNE/DUNE), by combining with its ND (near detector) and reactor experiments. In this work, we discuss how this study can be further analysed to resolve entanglement of the quadrant of CPV phase and Octant of atmospheric mixing angle {\\theta}23, at LBNEs. The study is done for both NH (Normal hierarchy) and IH (Inverted hierarchy). We further show how leptogenesis can enhance this effect of resolving this entanglement. A detailed analytic and numerical study of baryogenesis through leptogenesis is performed in this framework in a model independent way. We then compare our result of the baryon to photon ratio with the the current observational data of the baryon asymmetry.

  20. Tightly coupled long baseline/ultra-short baseline integrated navigation system

    Science.gov (United States)

    Batista, Pedro; Silvestre, Carlos; Oliveira, Paulo

    2016-06-01

    This paper proposes a novel integrated navigation filter based on a combined long baseline/ultra short baseline acoustic positioning system with application to underwater vehicles. With a tightly coupled structure, the position, linear velocity, attitude, and rate gyro bias are estimated, considering the full nonlinear system dynamics without resorting to any algebraic inversion or linearisation techniques. The resulting solution ensures convergence of the estimation error to zero for all initial conditions, exponentially fast. Finally, it is shown, under simulation environment, that the filter achieves very good performance in the presence of sensor noise.

  1. Owning the program technical baseline for future space systems acquisition: program technical baseline tracking tool

    Science.gov (United States)

    Nguyen, Tien M.; Guillen, Andy T.; Hant, James J.; Kizer, Justin R.; Min, Inki A.; Siedlak, Dennis J. L.; Yoh, James

    2017-05-01

    The U.S. Air Force (USAF) has recognized the needs for owning the program and technical knowledge within the Air Force concerning the systems being acquired to ensure success. This paper extends the previous work done by the authors [1-2] on the "Resilient Program Technical Baseline Framework for Future Space Systems" and "Portfolio Decision Support Tool (PDST)" to the development and implementation of the Program and Technical Baseline (PTB) Tracking Tool (PTBTL) for the DOD acquisition life cycle. The paper describes the "simplified" PTB tracking model with a focus on the preaward phases and discusses how to implement this model in PDST.

  2. Biological baseline data Youngs Bay, Oregon, 1974

    Energy Technology Data Exchange (ETDEWEB)

    McMechan, K.J. (ed.); Higley, D.L.; Holton, R.L.

    1975-04-01

    This report presents biological baseline information gathered during the research project, Physical, Chemical and Biological Studies on Youngs Bay.'' Youngs Bay is a shallow embayment located on the south shore of the Columbia River, near Astoria, Oregon. Research on Youngs Bay was motivated by the proposed construction by Alumax Pacific Aluminum Corporation of an aluminum reduction plant at Warrenton, Oregon. The research was designed to provide biological baseline information on Youngs Bay in anticipation of potential harmful effects from plant effluents. The information collected concerns the kinds of animals found in the Youngs Bay area, and their distribution and seasonal patterns of abundance. In addition, information was collected on the feeding habits of selected fish species, and on the life history and behavioral characteristics of the most abundant benthic amphipod, Corophium salmonis. Sampling was conducted at approximately three-week intervals, using commonly accepted methods of animal collection. Relatively few stations were sampled for fish, because of the need to standardize conditions of capture. Data on fish capture are reported in terms of catch-per-unit effort by a particular sampling gear at a specific station. Methods used in sampling invertebrates were generally more quantitative, and allowed sampling at a greater variety of places, as well as a valid basis for the computation of densities. Checklists of invertebrate species and fish species were developed from these samples, and are referred to throughout the report. The invertebrate checklist is more specific taxonomically than are tables reporting invertebrate densities. This is because the methods employed in identification were more precise than those used in counts. 9 refs., 27 figs., 25 tabs.

  3. Patient Admission Preferences and Perceptions

    Science.gov (United States)

    Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.

    2015-01-01

    Introduction Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire. Results Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed. PMID:26587095

  4. 贵州省社区女性人群高血压基线调查与社区综合防治效果评价%Baseline investigation of female hypertension and effect evaluation of community comprehensive prevention and treatment in Guizhou

    Institute of Scientific and Technical Information of China (English)

    潘仰中; 蔡运昌; 郑流波; 柳桂娥; 张彪; 谢春凤; 刘宏珍; 邓小林; 夏旻

    2005-01-01

    administrative areas.SETTING: Guizhou Institute of Cardiovascular Disease, Renmin Hospital of Yunyan District in Guiyang, Guizhou Clinical Examination Center.PARTICIPANTS: Since 1996, a series of comprehensive prevention and treatment had been carried in the communities for cardiac cerebral vascular disease in Guizhou, involved 13 administrative areas and 112 villagecitizen groups, in which, 26 604 people were employed, living in the regions between town and country. Social natural condition and life behavior of majority citizen reflected the common state of people in town and country. Totally 3 934 people aged over 15 years were investigated in the communities, and were all in the known of investigation. The samples without complete data were excluded.METHODS: ① Base-line investigation was carried on for the groups over 15 years old according to the requirement for administrative region designed by Institute of Preventive Medicine of China Academy of Sciences from April 1st 2001 to May 15th . ② Health education and health promotion activity were carried on for the included groups. ③ Survey after intervention was given for females according to the survey items designed by Institute of Preventive Medicine of China Academy of Sciences from July 2002to June 2003. ④ Normal body-mass index (BMI) was 18.5-23.9 kg/m2,overweight was indicated if BMI was 24-27.9 kg/m2 and obesity was diagnosed if BMI ≥28 kg/m2. ⑤ Analysis was applied on comparison of BMI,waist to hip ratio (WHR), average blood pressure, the rates of incidence,awareness and treatment of hypertension and rate of high-salty and lipid diet. ⑥ t test was adopted for comparison of means between two samples and x2 test was used for rate comparison.MAIN OUTCOME MEASURES: ① Comparison of the rates of incidence, awareness, treatment and control of hypertension for females of different ages in community base-line investigation in Guizhou. ② Comparison of BMI, WHR and BP of females of various ages in baseline

  5. Patients' Preference of the Timed Up and Go Test or Patient-Reported Outcome Measures Before and After Surgery for Lumbar Degenerative Disk Disease.

    Science.gov (United States)

    Joswig, Holger; Stienen, Martin N; Smoll, Nicolas R; Corniola, Marco V; Chau, Ivan; Schaller, Karl; Hildebrandt, Gerhard; Gautschi, Oliver P

    2017-03-01

    The Timed Up and Go (TUG) test, as a measure of objective functional impairment in lumbar degenerative disk disease (DDD), complements patient-reported outcome measures (PROMs) of subjective functional impairment. Prospective 2-center study on consecutive patients scheduled for surgical treatment for lumbar DDD who underwent an objective (TUG test) and subjective (PROMs) functional assessment before and 1 and 3 days after surgery. PROMs included the visual analog scale (VAS), Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), Euro-Qol (EQ-5D), and Short Form 12 (SF-12) questionnaires. On completion of each assessment, patients were asked whether they would prefer performing the TUG test or completing the PROMs questionnaires. A total of 109 of 125 patients (87.2%) completed the assessments. Preoperatively, patients were 2.18 times as likely to prefer the TUG test to the PROMs (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.27-3.75). On postoperative days 1 and 3, patients were 5.79 (OR, 5.79; 95% CI, 3.23-10.37) and 6.33 times as likely to prefer the TUG test to the PROMs, respectively (OR, 6.33; 95% CI, 3.51-11.41). There were no statistical differences in baseline characteristics, TUG t scores, VAS, RMDI, ODI, SF-12, and EQ-5D index between patients preferring either the TUG test or the PROMs questionnaires. The TUG test is preferred over a battery of PROMs by 60%-70% of patients with lumbar DDD not only in the preoperative, but also in the postoperative, setting. High functional disability does not result in avoidance of the TUG test, and repeated assessments lead to higher preference. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Male Drosophila melanogaster learn to prefer an arbitrary trait associated with female mating status

    DEFF Research Database (Denmark)

    Verzijden, Machteld Nicolette; Abbott, Jessica K.; Philipsborn, Anne von

    2015-01-01

    for female eye color (red versus brown), 2) if males could learn to associate an eye color cue with female receptivity, and 3) whether this association disappeared when the males were unable to use this visual cue in the dark. We found that naïve males had no baseline preference for females of either eye...... color, but that males which were trained with sexually receptive females of a given eye color showed a preference for that color during a standard binary choice experiment. The learned cue was indeed likely to be truly visual, since the preference disappeared when the binary choice phase...

  7. Preference pulses induced by reinforcement.

    Science.gov (United States)

    Hachiga, Yosuke; Sakagami, Takayuki; Silberberg, Alan

    2014-11-01

    Eight rats responded on concurrent Variable-Ratio 20 Extinction schedules for food reinforcement. The assignment of variable-ratio reinforcement to a left or right lever varied randomly following each reinforcer, and was cued by illumination of a stimulus light above that lever. Postreinforcement preference levels decreased substantially and reliably over time when the lever that just delivered reinforcement was now in extinction; however, if that lever was once again associated with variable ratio, this decrease in same-lever preference tended to be small, and for some subjects, not in evidence. The changes in preference level to the extinction lever were well described by a modified version of Killeen, Hanson, and Osborne's (1978) induction model. Consistent with this model's attribution of preference change to induction, we attribute preference change in this report to a brief period of reinforcer-induced arousal that energizes responding to the lever that delivered the last reinforcer. After a few seconds, this induced responding diminishes, and the operant responding that remains comes under the control of the stimulus light cuing the lever providing variable-ratio reinforcement.

  8. The allometry of prey preferences.

    Directory of Open Access Journals (Sweden)

    Gregor Kalinkat

    Full Text Available The distribution of weak and strong non-linear feeding interactions (i.e., functional responses across the links of complex food webs is critically important for their stability. While empirical advances have unravelled constraints on single-prey functional responses, their validity in the context of complex food webs where most predators have multiple prey remain uncertain. In this study, we present conceptual evidence for the invalidity of strictly density-dependent consumption as the null model in multi-prey experiments. Instead, we employ two-prey functional responses parameterised with allometric scaling relationships of the functional response parameters that were derived from a previous single-prey functional response study as novel null models. Our experiments included predators of different sizes from two taxonomical groups (wolf spiders and ground beetles simultaneously preying on one small and one large prey species. We define compliance with the null model predictions (based on two independent single-prey functional responses as passive preferences or passive switching, and deviations from the null model as active preferences or active switching. Our results indicate active and passive preferences for the larger prey by predators that are at least twice the size of the larger prey. Moreover, our approach revealed that active preferences increased significantly with the predator-prey body-mass ratio. Together with prior allometric scaling relationships of functional response parameters, this preference allometry may allow estimating the distribution of functional response parameters across the myriads of interactions in natural ecosystems.

  9. Relationship of Baseline Hemoglobin Level with Serum Ferritin, Postphlebotomy Hemoglobin Changes, and Phlebotomy Requirements among HFE C282Y Homozygotes

    Directory of Open Access Journals (Sweden)

    Seyed Ali Mousavi

    2015-01-01

    Full Text Available Objectives. We aimed to examine whether baseline hemoglobin levels in C282Y-homozygous patients are related to the degree of serum ferritin (SF elevation and whether patients with different baseline hemoglobin have different phlebotomy requirements. Methods. A total of 196 patients (124 males and 72 females who had undergone therapeutic phlebotomy and had SF and both pre- and posttreatment hemoglobin values were included in the study. Results. Bivariate correlation analysis suggested that baseline SF explains approximately 6 to 7% of the variation in baseline hemoglobin. The results also showed that males who had higher (≥150 g/L baseline hemoglobin levels had a significantly greater reduction in their posttreatment hemoglobin despite requiring fewer phlebotomies to achieve iron depletion than those who had lower (<150 g/L baseline hemoglobin, regardless of whether baseline SF was below or above 1000 µg/L. There were no significant differences between hemoglobin subgroups regarding baseline and treatment characteristics, except for transferrin saturation between male subgroups with SF above 1000 µg/L. Similar differences were observed when females with higher (≥138 g/L baseline hemoglobin were compared with those with lower (<138 g/L baseline hemoglobin. Conclusion. Dividing C282Y-homozygous patients into just two subgroups according to the degree of baseline SF elevation may obscure important subgroup variations.

  10. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse.

    Science.gov (United States)

    Korbly, Nicole B; Kassis, Nadine C; Good, Meadow M; Richardson, Monica L; Book, Nicole M; Yip, Sallis; Saguan, Docile; Gross, Carey; Evans, Janelle; Lopes, Vrishali V; Harvie, Heidi S; Sung, Vivian W

    2013-11-01

    The purpose of this study was to describe patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse symptoms and to describe predictors of preference for uterine preservation. This multicenter, cross-sectional study evaluated patient preferences for uterine preservation vs hysterectomy in women with prolapse symptoms who were being examined for initial urogynecologic evaluation. Before meeting the physician, the women completed a questionnaire that asked them to indicate their prolapse treatment preference (uterine preservation vs hysterectomy) for scenarios in which the efficacy of treatment varied. Patient characteristics that were associated with preferences were determined, and predictors for uterine preservation preference were identified with multivariable logistic regression. Two hundred thirteen women participated. Assuming outcomes were equal between hysterectomy and uterine preservation, 36% of the women preferred uterine preservation; 20% of the women preferred hysterectomy, and 44% of the women had no strong preference. If uterine preservation was superior, 46% of the women preferred uterine preservation, and 11% of the women preferred hysterectomy. If hysterectomy was superior, 21% of the women still preferred uterine preservation, despite inferior efficacy. On multivariable logistic regression, women in the South had decreased odds of preferring uterine preservation compared with women in the Northeast (odds ratio [OR], 0.17; 95% CI, 0.05-0.66). Women with at least some college education (OR, 2.87; 95% CI, 1.08-7.62) and those who believed that the uterus is important for their sense of self (OR, 28.2; 95% CI, 5.00-158.7) had increased odds for preferring uterine preservation. A higher proportion of women with prolapse symptoms who were examined for urogynecologic evaluation preferred uterine preservation, compared with hysterectomy. Geographic region, education level, and belief that the uterus is important for

  11. Treatment

    National Research Council Canada - National Science Library

    Safaa M. Raghab; Ahmed M. Abd El Meguid; Hala A. Hegazi

    2013-01-01

    .... This paper presents the results of the analyses of leachate treatment from the solid waste landfill located in Borg El Arab landfill in Alexandria using an aerobic treatment process which was applied...

  12. Reader preference for report typefaces.

    Science.gov (United States)

    Cooper, M B; Daglish, H N; Adams, J A

    1979-06-01

    A postal survey of typeface preference is described. The survey was designed to help in the choice of typeface to be used for the internal technical Reports produced by the Post Office Research Department. Type setting for these Reports is carried out using an IBM Selectric Composer for which seven typefaces suitable for reports are available. One hundred and twenty-five people who regularly receive copies of these Reports and 57 Trainee Technicians (Apprentices) were asked to arrange these seven typefaces in order of preference and record this ranking on a response sheet. About 85% of both groups returned response sheets for statistical analysis. The results showed a significant preference for three of the typefaces: Press Roman, Theme and Univers. Of these, Press Roman is used for the text of Research Department Reports and Univers is used on diagrams and tables.

  13. Gender Differences in Investment Preferences

    Directory of Open Access Journals (Sweden)

    Nizamettin Bayyurt

    2013-05-01

    Full Text Available The paper attempts to explore how women and men differ in their individual investment preferences. Although there are some studies for the investors in developed countries, the subject has been overlooked in emerging and underdeveloped countries. Therefore, this study is the first empirical study exploring the investment behaviors of women and men by focusing on an emerging country, Turkey. For the purpose to find out how investment preferences of men