WorldWideScience

Sample records for before and after studies

  1. Before and after Snowden

    OpenAIRE

    Wright, S; Wood, D.M.

    2015-01-01

    This editorial for the Surveillance and Security Intelligence After Snowden issue provides a very brief history of National Security Agency whistleblowers and investigations before Edward Snowden, and sets the current wave of NSA whistleblowing in the context of a growing demand for openness, transparency and accountability opposing the renewed closures and secrecy of the War on Terror. It also provides some links for further research and reading

  2. Before and After Snowden

    OpenAIRE

    Wood, DM; Wright, S

    2015-01-01

    This editorial for the Surveillance and Security Intelligence After Snowden issue provides a very brief history of National Security Agency whistleblowers and investigations before Edward Snowden, and sets the current wave of NSA whistleblowing in the context of a growing demand for openness, transparency and accountability opposing the renewed closures and secrecy of the War on Terror. It also provides some links for further research and reading.

  3. EPR study on tomatoes before and after gamma-irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Aleksieva, K. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria); Georgieva, L.; Tzvetkova, E. [Institute of Cryobiology and Food Technology, 1162 Sofia (Bulgaria); Yordanov, N.D. [Laboratory EPR, Institute of Catalysis, Bulgarian Academy of Sciences, 1113 Sofia (Bulgaria)], E-mail: ndyepr@bas.bg

    2009-09-15

    The results from the EPR studies on fresh, air-dried and lyophilized tomato samples before and after gamma-irradiation are reported. Before irradiation fresh and air-dried tomatoes exhibit one singlet EPR line characterized with common g-factor of 2.0048{+-}0.0005, whereas freeze-dried tomato does not show any EPR spectrum. After irradiation, a typical 'cellulose-like' triplet EPR spectrum appears in all samples, attributed to cellulose free radicals, generated by gamma-irradiation. It consists of intense central line with g=2.0048{+-}0.0005 and two weak satellite lines separated ca. 3 mT left and right of it. In air-dried and lyophilized tomatoes the 'cellulose-like' EPR spectrum is superimposed by an additional partly resolved carbohydrate spectrum. Fading measurements of the radiation-induced EPR signals indicate that the intensity of the EPR spectra of air-dried and freeze-dried tomato are reduced to about 50% after 50 days, whereas those of fresh irradiated tomatoes kept at 4 {sup o}C fade completely in 15 days. The reported results unambiguously show that the presence of two satellite lines in the EPR 'cellulose-like' spectra of tomato samples can be used for identification of radiation processing.

  4. EPR study on tomatoes before and after gamma-irradiation

    Science.gov (United States)

    Aleksieva, K.; Georgieva, L.; Tzvetkova, E.; Yordanov, N. D.

    2009-09-01

    The results from the EPR studies on fresh, air-dried and lyophilized tomato samples before and after gamma-irradiation are reported. Before irradiation fresh and air-dried tomatoes exhibit one singlet EPR line characterized with common g-factor of 2.0048±0.0005, whereas freeze-dried tomato does not show any EPR spectrum. After irradiation, a typical "cellulose-like" triplet EPR spectrum appears in all samples, attributed to cellulose free radicals, generated by gamma-irradiation. It consists of intense central line with g=2.0048±0.0005 and two weak satellite lines separated ca. 3 mT left and right of it. In air-dried and lyophilized tomatoes the "cellulose-like" EPR spectrum is superimposed by an additional partly resolved carbohydrate spectrum. Fading measurements of the radiation-induced EPR signals indicate that the intensity of the EPR spectra of air-dried and freeze-dried tomato are reduced to about 50% after 50 days, whereas those of fresh irradiated tomatoes kept at 4 °C fade completely in 15 days. The reported results unambiguously show that the presence of two satellite lines in the EPR "cellulose-like" spectra of tomato samples can be used for identification of radiation processing.

  5. PHILOSOPHERS BEFORE AND AFTER SPACEFLIGHT

    Directory of Open Access Journals (Sweden)

    Fabio Grigenti

    2011-12-01

    Full Text Available In my contribution, I will show the ways by which philosophers have treated the topic of space-travel before and after its implementation. I will discuss the following points: a Introduction: the human condition. b Philosophers before spaceflight: the Astolfo Protocol. c Philosophers after spaceflight: the Promethean suspect. In this paper I will emphasize the elements of two different and alternative visions of spaceflight that can be found in the Western tradition of philosophical thought.

  6. Neuropsychological Outcome One Year after Carotid Revascularization: A before-and-after Study

    Science.gov (United States)

    Casas-Hernanz, Laura; Garolera, Maite; Badenes, Dolors; Quintana, Salvador; Millán, Susana; Calzado, Noemi; de Francisco, Jorge; Royo, Josep; Aguilar, Miquel

    2017-01-01

    Purpose The aim of our study was to determine the clinical profile of patients considered cognitive ‘responders’ to surgery in order to establish clinical variables associated with a favorable cognitive performance. Materials and Methods A total of 70 patients were included in the study. A well-validated, comprehensive standardized neurocognitive battery of tests of about 2 hours was administered. Patients were examined twice, 1-week before surgery and 1-year postoperatively. The criterion to be included in the ‘responder’ group was the following: to obtain a positive difference between post-revascularization and pre-revascularization neuropsychological assessment ≥1 standard deviation in ≥2 tests. Results Twenty-seven patients (38.6%) were cognitive responders to treatment. In bivariate analysis between responders and non-responders, presence of atrophy (P=0.003), small vessels (P=0.577), symptoms (P=0.046), and age (P=0.030) were the factors statistically significant. When comparing cognitive performance before and after carotid revascularization, significant differences were observed in semantic fluency with a lower performance after 12 months (P=0.004, d=0.29), and in the Language index (Repeatable Battery for the Assessment of Neuropsychological Status) (P=0.005, d=0.34). Conclusion Patients without neurological symptoms, of a younger age and without atrophy and white matter small vessel lesions are better cognitive responders 1-year after carotid revascularization. PMID:29354625

  7. Nasal Mucociliary Transport Before and After Jogging.

    Science.gov (United States)

    Cederlund, Anna; And Others

    1987-01-01

    A study of nasal mucociliary transport in 11 healthy subjects before and after they jogged 8-10 kilometers indicated that the transport time was significantly longer after jogging than before jogging. (Author/CB)

  8. Change in antihypertensive drug prescribing after guideline implementation: a controlled before and after study

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    Helin-Salmivaara Arja

    2011-08-01

    Full Text Available Abstract Background Antihypertensive drug choices and treatment levels are not in accordance with the existing guidelines. We aimed to assess the impact of a guideline implementation intervention on antihypertensive drug prescribing. Methods In this controlled before and after study, the effects of a multifaceted (education, audit and feedback, local care pathway quality programme was evaluated. The intervention was carried out in a health centre between 2002 and 2003. From each health care unit (n = 31, a doctor-nurse pair was trained to act as peer facilitators in the intervention. All antihypertensive drugs prescribed by 25 facilitator general practitioners (intervention GPs and 53 control GPs were retrieved from the nationwide Prescription Register for three-month periods in 2001 and 2003. The proportions of patients receiving specific antihypertensive drugs and multiple antihypertensive drugs were measured before and after the intervention for three subgroups of hypertension patients: hypertension only, with coronary heart disease, and with diabetes. Results In all subgroups, the use of multiple concurrent medications increased. For intervention patients with hypertension only, the odds ratio (OR was 1.12 (95% CI 0.99, 1.25; p = 0.06 and for controls 1.13 (1.05, 1.21; p = 0.002. We observed no statistically significant differences in the change in the prescribing of specific antihypertensive agents between the intervention and control groups. The use of agents acting on the renin-angiotensin-aldosterone system increased in all subgroups (hypertension only intervention patients OR 1.19 (1.06, 1.34; p = 0.004 and controls OR 1.24 (1.15, 1.34; p Conclusions A multifaceted guideline implementation intervention does not necessarily lead to significant changes in prescribing performance. Rigorous planning of the interventions and quality projects and their evaluation are essential.

  9. A study on chaos in crude oil markets before and after 2008 international financial crisis

    Science.gov (United States)

    Lahmiri, Salim

    2017-01-01

    The purpose of this study is to investigate existence of chaos in crude oil markets (Brent and WTI) before and after recent 2008 international financial crisis. Largest Lyapunov exponent is estimated for prices, returns, and volatilities. The empirical results show strong evidence that chaos does not exist in prices and returns in both crude oil markets before and after international crisis. However, we find strong evidence of chaotic dynamics in both Brent and WTI volatilities after international financial crisis.

  10. Cohort study of adherence to correct hand antisepsis before and after performance of clinical procedures

    DEFF Research Database (Denmark)

    Laustsen, Sussie; Lund, Elisabeth; Bibby, Bo Martin

    2009-01-01

    -based hand rub before performance (odds ratio [OR] 1.51 [95% confidence interval {CI}, 1.09-2.10]) and after performance (OR, 1.73 [95% CI, 1.27-2.36]) of clinical procedures. In general, the rate of adherence was significantly higher after the performance of clinical procedures, compared with before (OR, 1......OBJECTIVE: To investigate the rate of adherence by hospital staff members to the correct use of alcohol-based hand rub before and after performance of clinical procedures. DESIGN: A cohort study conducted during the period from 2006 through 2007 and 2 cross-sectional studies conducted in 2006...... and after performance of a clinical procedure. RESULTS: A total of 496 participants were observed during 22,906 opportunities for hand hygiene (ie, 11,177 before and 11,729 after clinical procedures) that required the use of alcohol-based hand rub. The overall rates of adherence to the correct use...

  11. Physics before and after Einstein

    CERN Document Server

    Capria, M Mamone

    2005-01-01

    It is now a century ago that one of the icons of modern physics published some of the most influential scientific papers of all times. With his work on relativity and quantum theory, Albert Einstein has altered the field of physics forever. It should not come as a surprise that looking back at Einstein''s work, one needs to rethink the whole scope of physics, before and after his time. This books aims to provide a perspective on the history of modern physics, spanning from the late 19th century up to today. It is not an encyclopaedic work, but it presents the groundbreaking and sometimes provocative main contributions by Einstein as marking the line between ''old'' and ''new'' physics, and expands on some of the developments and open issues to which they gave rise.

  12. Student Reflective Writing: Cognition and Affect before, during, and after Study Abroad

    Science.gov (United States)

    Savicki, Victor; Price, Michele V.

    2015-01-01

    Reflective thinking is an important feature of study-abroad learning, yet research on reflection in this context is sparse. The current study examined student reflection on 3 content areas (Academic Expectations, Cultural Expectations, and Psychological Issues) at 3 times (before, during, and after study abroad). A content analysis approach with…

  13. The paranasal sinuses before and after radiotherapy for nasopharyngeal carcinoma: a computed tomographic study

    Energy Technology Data Exchange (ETDEWEB)

    Porter, M.J.; Leung, S.F.; Ambrose, R.; Cheung, H.S.; Hasselt, C.A. van [Chinese University of Hong Kong, Shatin (Hong Kong). Prince of Wales Hospital

    1996-01-01

    A study comparing the pre- and post-radiotherapy computed tomographic scans of patients treated for nasopharyngeal carcinoma revealed that the incidence of major mucosal abnormality was significantly increased and approximately doubled after radiotherapy. The most significant factor predicting major mucosal abnormality after radiotherapy was the presence of tumour in the sinus before treatment. In the maxillary sinus there was significant association of major mucosal abnormality before and after radiotherapy although this was not so for the other sinuses. The mucosal changes observed were evident as early as six months after radiotherapy. (author).

  14. Study of Blood Leptin Levels before and After Treatment with Metformin in Diabetes Type Ii Patients

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    R Didehdar

    2005-04-01

    Full Text Available Introduction: Leptin is a fat tissue hormone that has 176 amino acids with a molecular weight of 16 KD . Leptin has effects on the hypothalamus and peripheral tissues resulting in decreased food absorption and increased energy consumption that finally reduces the body weight and BMI. The aim of this research was to investigate the blood levels of leptin before and after treatment with Metformin in type II diabetic patients. Methods: 25 type II diabetic patients without any previous drug treatment history were investigated. This study was a clinical trail before and after treatment with Metformin. Results: There was no particular difference in BMI, average body weight, fat mass and free fat mass before and after treatment. Similarly, the difference in concentration levels of blood glucose, cholesterol, tri-glycerides and LDL-cholesterol before and after treatment was not statistically significant. Also, there was no difference in the average concentration of leptin and insulin before and after treatment Conclusion: This result showed that although metformin decreased glucose and lipid levels during the treatment period, (1 month it did not have an effect on leptin, Insulin and other related factors during treatment.;

  15. Third-Graders' Conceptions about the Origin of Species before and after Instruction: An Exploratory Study

    Science.gov (United States)

    Berti, Anna Emilia; Barbetta, Valentina; Toneatti, Laura

    2017-01-01

    This study examines how third-graders' conceptions about the origin of species are affected by formal instruction and whether children can learn not only about evolution but also about natural selection. We interviewed the same group of third-grade children (8-9 years old) twice, before and after following a curriculum about these topics.…

  16. Having a Pap smear, quality of life before and after cervical screening: a questionnaire study

    NARCIS (Netherlands)

    Korfage, I. J.; van Ballegooijen, M.; Wauben, B.; Looman, C. W. N.; Habbema, J. D. F.; Essink-Bot, M.-L.

    2012-01-01

    Please cite this paper as: Korfage I, van Ballegooijen M, Wauben B, Looman C, Habbema J, Essink-Bot M. Having a Pap smear, quality of life before and after cervical screening: a questionnaire study. BJOG 2012;119:936944. Objective To assess the health-related quality of life (HRQoL) impact of

  17. COMPARATIVE STUDY OF EMOTIONAL DISORDERS STRUCTURE IN PATIENTS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION

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    T. G. Mikhaylichenko

    2011-01-01

    Full Text Available Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases, 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety. 

  18. Psychological and health comorbidities before and after bariatric surgery: a longitudinal study

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    Susana Sofia Pereira da Silva

    2013-12-01

    Full Text Available INTRODUCTION: Morbid obesity has multiple implications for psychological and physical health. Bariatric surgery has been selected as the treatment of choice for this chronic disease, despite the controversial impact of the surgery on psychosocial health. The objective of this study was to describe candidates for bariatric surgery and analyze changes in weight, psychopathology, personality, and health problems and complaints at 6- and 12- month follow-up assessments. METHODS: Thirty obese patients (20 women and 10 men with a mean age of 39.17±8.81 years were evaluated in different dimensions before surgery and 6 and 12 months after the procedure. RESULTS: Six and 12 months after bariatric surgery, patients reported significant weight loss and a significant reduction in the number of health problems and complaints. The rates of self-reported psychopathology were low before surgery, and there were no statistically significant changes over time. The conscientiousness, extraversion, and agreeableness dimensions increased, but neuroticism and openness remained unchanged. All changes had a medium effect size. CONCLUSIONS: Our results suggest that patients experience significant health improvements and some positive personality changes after bariatric surgery. Even though these findings underscore the role of bariatric surgery as a relevant treatment for morbid obesity, more in-depth longitudinal studies are needed to elucidate the evolution of patients after the procedure.

  19. Systematic prophylactic oxytocin injection and the incidence of postpartum hemorrhage: A before-and-after study.

    Science.gov (United States)

    Garabedian, C; Simon, M; Closset, E; Ducloy-Bouthors, A-S; Schaffar, A; Deruelle, P; Gautier, S; Depret, S; Subtil, D

    2016-02-01

    Assess the impact of routine injection of 5 units of oxytocin as soon as the anterior shoulder is delivered on the incidence of postpartum haemorrhage (PPH) in a context of daily practice. Single-centre before-and-after study evaluating the effect of a change in the protocol for PPH prevention as applied in our obstetrical unit. During the first period, oxytocin (5 units) was to be injected only in case of PPH risk factors. During the second period, the injection was systematic. In the "before" study period, there were 1953 patients vaginal deliveries and 843 (43%) oxytocin injections, with a protocol compliance of 85%. In the "after" study period, 2018 women had vaginal deliveries and 1911 (95%) had an oxytocin injection (protocol compliance: 95%). The whole study period was associated with a reduced risk of moderate haemorrhage (13.4% vs. 9.2%, Phaemorrhage was observed (2.1% vs. 2.0%, P=0.79). After logistic regression, the study period remained associated with a significant reduction in the risk of moderate PPH (OR=0.72 [0.58-0.89]). Routine injection of 5 units of oxytocin makes it possible to reduce the risk of moderate PPH, but it does not affect the risk of severe PPH. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Before Copernico and after Copernico

    Science.gov (United States)

    Dalmastri, Elena

    2016-04-01

    This work is addressed to young people, 13 -14 years old. Requirements: - Experience with the concept of force, balance and speed - Experience of measure - Knowledge on direct and inverse proportionality - Abstractive abilities - Dialectical ability - Dynamic balance - Solar System - Reference System The purpose of this work is: 1) Looking at the Starry Sky, ask questions and search for answers. Someone before us has been asking the same questions and has been trying to find answers: going through the history of science, experiencing the same queries and contrasts. 2) Each student embodies a particular scientist, and fights to support their theory. In this way the student acquires the concepts of the theory they are supporting. 3) The debate amongst the students will lead to an outcome that will be perceived as a personal victory, rather than taken for granted. 4) A certainty will produce new queries and ways forward. Theory of Relativity (Albert Einstein, Power Point presentation) 5) We will demonstrate that the way to knowledge has no limits one must never feel satisfied. 6) Finally, there is a comparison between Copernican Revolution and Darwinian Revolution. For each student to embody a particular scientist, they will need to be familiar with the basic contents of the theory they are supposed to support. - Therefore, pupils will be provided with some forms about every scientist (Tolomeo, Aristarco di Samo, Copernico, Galileo, Keplero, Newton). - It will be necessary to consult some museum sites on line (for example "Collana - Gli strumenti della scienza" where you can find a session for each instrument used by Galileo (binoculars, compass), using interactive tools, PDF, videos). - Pupils are also recommended to watch the movie "Agorà" that tells the story of the philosopher and scientist of Ancient Greece, Aristarco of Samo. - To achieve a better understanding of the concept of ellipse, a prototype will be made with paper, pencil and rope (confirming elliptic

  1. HMB-45 Study Before and After Narrow-Band (311 nm Ultraviolet B Treatment in Vitiligo

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    Moosavi

    2015-06-01

    Full Text Available Background Vitiligo is an acquired disease in which the loss of functional melanocytes results in depigmented macules and patches. Over the years, wide arrays of markers for melanocytes have been described, including human melanoma black 45 (HMB-45. Narrow-band ultraviolet B (NB-UVB therapy is one of the therapeutic modalities for vitiligo. Objectives We sought to detect HMB-45 staining after 30 sessions of NB-UVB therapy in vitiligo and perivitiliginous skin. Patients and Methods All the participants were planned to have 30 sessions of NB-UVB therapy with 724 lamps (FS, 72 T, 12-HO Daavlin MED at 311 nm wavelengths. The patients underwent skin sampling from lesional and perilesional area before and after 30 sessions of treatment. The skin biopsies were sent to the laboratory for light microscopy and immunohistochemical study. The evaluation of HMB-45 was based on the quantitative method, measuring the number of positive stained cells. Clinical response was defined as repigmentation in three categories: more than 75%; between 40% and 75%; and less than 40%. The data were analyzed using SPSS (version 17. Results Twenty-nine patients completed the study. The Wilcoxon test showed a meaningful relation between HMB-45 staining before and after NB-UVB treatment in perilesional skin. We did not find a meaningful relation between HMB-45 staining before and after treatment regarding the mean age, gender, mean duration of disease, and initial lesional area (P = 0.55, P = 0.41, P = 0.55, and P = 0.87, respectively. After 30 sessions of NB-UVB therapy, repigmentation was less than 40% in 8 (27.6%, 40 - 75% in 7 (24.1%, and more than 75% in 6 patients. Conclusions The HMB-45 stain strength significantly changed after treatment in perilesional skin.

  2. Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study.

    Science.gov (United States)

    Vercellini, Paolo; Bracco, Benedetta; Mosconi, Paola; Roberto, Anna; Alberico, Daniela; Dhouha, Dridi; Somigliana, Edgardo

    2016-03-01

    To assess the proportion of patients satisfied with their treatment before and after a systematic change from norethindrone acetate to dienogest as the first-line progestin for symptomatic endometriosis. Before and after study. Academic department. The last 90 new consecutive endometriosis patients in whom norethindrone acetate was used, and the first 90 new consecutive endometriosis patients in whom dienogest was used. Norethindrone acetate at the oral dose of 2.5 mg once a day until June 6, 2013, then dienogest at the oral dose of 2 mg once a day thereafter. Degree of satisfaction with treatment after 6 months of progestin therapy and assessment of any variations in pain symptoms, psychological status, sexual function, or health-related quality of life associated with the introduction of dienogest. The proportion of satisfied plus very satisfied women after 6 months of treatment was 71% in the "before" period (norethindrone acetate) and 72% in the "after" period (dienogest). The implementation of dienogest was not associated with statistically significant ameliorations in overall pain relief, psychological status, sexual functioning, or health-related quality of life. Treatment was well tolerated by 58% of norethindrone acetate users compared with 80% of dienogest users. After dienogest implementation, the absolute risk reduction in the occurrence of any side effect was 13.9% (95% confidence interval, 0.8%-28.6%). Considering the large difference in the cost of the two drugs, dienogest should be suggested selectively in women who do not tolerate norethindrone acetate. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Sleep Problems Before and After Acute Myocardial Infarction: A Comparative Study

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    Belguzar Kara

    2012-12-01

    Full Text Available AIM: The purpose of this study was to compare patients’ sleep problems before and after acute myocardial infarction (AMI and also to determine factors affecting sleep problems in patients undergoing AMI. METHOD: This cross-sectional study was conducted at the Coronary Intensive Care Unit in a training hospital between January 1 and April 30, 2007. The sample of the study was composed of 26 patients with a first-ever AMI. Data were collected by using a questionnaire to determine the patient and illness-related descriptive characteristics and the Post Sleep Inventory Scale (PSIS. The Shapiro-Wilks test, descriptive statistics, paired samples t test, Mann Whitney U test, Wilcoxon test, reliability analysis and correlation analysis were used to analyze the data. RESULTS: The mean age of the study group was 53.2 ± 12.6 years and approximately 81% were males. The patients’ mean bedtime (t= -3.422, p= 0.001, quality of nocturnal sleep (t= -3.221, p= 0.001, awakening (t =-3.533, p<0.001 and total PSIS scores (t= -5.652, p<0.001 were significantly higher after AMI compared to before AMI. The mean PSIS scores of patients undergoing AMI were statistically significant different by gender (z= -2.164, p= 0.030 and working status (z= -2.171, p= 0.030. There was a negative correlation between the PSIS score and haemoglobin and haematocrit values (r= -0.503, p<0.01; r= -0.473, p<0.05; respectively. CONCLUSION: There were differences in the patients’ reported sleep problems between before and after AMI. The results of this study showed that sleep problems were more common among women, patients not working and those with anemia. Nurses should be aware of the sleep problems and factors that affect to sleep problems. [TAF Prev Med Bull 2012; 11(6.000: 687-694

  4. Mathematical ability of first year undergraduate paramedic students-A before and after study.

    Science.gov (United States)

    Eastwood, Kathryn; Boyle, Malcolm; Kim, Visal; Stam, Nathan; Williams, Brett

    2015-11-01

    An ability to accurately perform drug calculations unassisted is an essential skill for all health professionals, with various occupational-specific stressors exacerbating mathematical deficiencies. The objective of this study was to determine the unaided mathematic ability of first year undergraduate paramedic students before and after mathematical and drug calculation tutorials. Students were administered a questionnaire containing demographic, drug calculation and arithmetic questions during week one of the semester before the tutorials. During the semester students participated in three 2-hour tutorials which included both mathematical and drug calculation questions without assistance of computational devices. At the end of semester was a summative drug calculation examination of which five key questions were compared to similar questions from the first questionnaire. Descriptive statistics describe the demographic data with a paired t-test comparing the questionnaire and exam results. Drug calculation and mathematical ability was markedly improved following the tutorials, mean score of correct answers before 1.74 (SD 1.4) and after 4.14 (SD 0.93), pability to complete mathematical and drug calculations without the assistance of computational devices. This improved significantly following appropriate education and practice. Further research is required to determine the retention of this ability over time. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Prospective Study on Salivary Evening Melatonin and Sleep before and after Pinealectomy in Humans.

    Science.gov (United States)

    Slawik, Helen; Stoffel, Michael; Riedl, Lina; Veselý, Zdenko; Behr, Michael; Lehmberg, Jens; Pohl, Corina; Meyer, Bernhard; Wiegand, Michael; Krieg, Sandro M

    2016-02-01

    Melatonin is secreted systemically from the pineal gland maximally at night but is also produced locally in many tissues. Its chronobiological function is mainly exerted by pineal melatonin. It is a feedback regulator of the main circadian pacemaker in the hypothalamic suprachiasmatic nuclei and of many peripheral oscillators. Although exogenous melatonin is approved for circadian rhythm sleep disorders and old-age insomnia, research on endogenous melatonin in humans is hindered by the great interindividual variability of its amount and circadian rhythm. Single case studies on pinealectomized patients report on disrupted but also hypersomnic sleep. This is the first systematic prospective report on sleep with respect to pinealectomy due to pinealocytoma World Health Organization grade I without chemo- or radiotherapy. Before and after pinealectomy, 8 patients completed questionnaires on sleep quality and circadian rhythm (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Morningness-Eveningness Questionnaire), 2 nights of polysomnography, salivary evening melatonin profiles, and qualitative assessment of 2 weeks of actigraphy and sleep logs. Six patients were assessed retrospectively up to 4 years after pinealectomy. Before pinealectomy, all but 1 patient showed an evening melatonin rise typical for indifferent chronotypes. After pinealectomy, evening saliva melatonin was markedly diminished, mostly below the detection limit of the assay (0.09 pg/mL). No systematic change in subjective sleep quality or standard measures of polysomnography was found. Mean pre- and postoperative sleep efficiency was 94% and 95%, and mean sleep-onset latency was 21 and 17 min, respectively. Sleep-wake rhythm during normal daily life did not change. Retrospective patients had a reduced sleep efficiency (90%) and more stage changes, although this was not significantly different from prospective patients. In conclusion, melatonin does seem to have a modulatory, not a

  6. Case Study: Physical Capacity and Nutritional Status Before and After a Single-Handed Yacht Race.

    Science.gov (United States)

    Ghiani, Giovanna; Magnani, Sara; Doneddu, Azzurra; Sainas, Gianmarco; Pinna, Virginia; Caboi, Marco; Palazzolo, Girolamo; Tocco, Filippo; Crisafulli, Antonio

    2017-12-18

    During solitary sailing the sailor is exposed to sleep deprivation and difficulties in consuming regular meals. Sailor weight loss is often reported. In the present case study we describe changes in the physical capacity and the nutritional status of an athlete attempting a single-handed yacht race around the globe. An Italian male ocean racer (GM) asked for our help to reach an optimum level of physical and nutritional preparation. We planned his diet after assessing his anthropometric parameters and body composition as well as his usual energy intake and nutritional expenditure. The diet consisted in 120 meals stored in sealed plastic bags. Before his departure, GM performed two incremental exercise tests (cycle- and arm crank- ergometry) to assess his physical capacity. Cardiac functions were also estimated by Doppler echocardiography. All measures and exercise tests were repeated 10 days after GM finished the race, which lasted 64 days. Anthropometric measures did not change significantly, with the exception of Arm Fat Area and Thigh Muscle area, which decreased. There were evident increments in maximum oxygen intake and maximum workload during arm cranking after the race. On the contrary, maximum oxygen uptake and maximum workload decreased during cycling. Finally, End Diastolic and Stroke Volume decreased after the race. It was concluded that nutritional counseling was useful to avoid excessive changes in the nutritional status and body composition due to 64 days of solitary navigation. However, a reduction in physical leg capacity and cardiovascular functions secondary to legs disuse were present.

  7. [Study of SCE frequency before and after tubal sterilization with phenol mucilage].

    Science.gov (United States)

    Tang, F Q

    1991-05-01

    SCE frequency was compared in the chromosomes of lymphocytes before and after chemical occlusive tubal sterilization with phenol mucilage compound made by 2 manufacturers. 88 women were recruited in the study, 50% of the cases were injected with either of the 2 compounds. Blood samples were drawn both before and from 7-490 days the sterilization procedures. SCE frequencies were counted from lymphocyte cell cultures by 7 chromosome groupings. The results showed that differences in the mean and range of SCE frequency in each cell before and after sterilization were not statistically significant. The difference of SCE frequencies for different time spans between the 2 blood tests was not statistically significant either, nor were significant differences observed between the cases using the 2 different compounds. It was concluded that the dosage of phenol mucilage compound used for chemical occlusive sterilization did not induce any increase in SCE frequency. Therefore, these compounds did not cause damage to DNA primary structure in human lymphocytes. If the sterilization procedures are done properly, few complications or failures would occur. This procedure could, hopefully, become a widely used permanent method of contraception among rural women.

  8. Predictors of Headache Before, During, and After Pregnancy: A Cohort Study

    Science.gov (United States)

    Turner, Dana P.; Smitherman, Todd A.; Eisenach, James C.; Penzien, Donald B.; Houle, Timothy T.

    2011-01-01

    Objective The present study endeavored to identify predictors of headache during pregnancy, shortly after delivery, and at 8-week follow-up. Background Many women suffer from headaches during pregnancy and the postpartum period. However, little is known about factors that predict headache surrounding childbirth. Methods Secondary analysis of longitudinal cohort study of 2434 parturients hospitalized for cesarean or vaginal delivery in four university hospitals in the United States and Europe. Data were gathered from interviews and review of medical records shortly after delivery; 972 of the women were contacted 8 weeks later to assess persistent headache. The primary outcome measures were experiencing headache during pregnancy, headache within 72 hours after delivery, and headache at 8 weeks after delivery. Results Of the parturients, 10% experienced headache during pregnancy, 3.7% within 72 hours after delivery, and 3.6% at 8 weeks post delivery. Compared to those without a history of headache, a history of headache prior to pregnancy was the strongest predictor of headache during pregnancy (9.8% versus 23.5%; RR 2.4; 95% CI: 1.4 to 4.0). Experiencing headache during pregnancy (adjusted HR 3.8; 95% CI: 2.4 to 6.2) and receiving needle-based regional anesthesia for pain treatment (adjusted HR 2.2; 95% CI: 1.1 to 4.5) were independently associated with headache within 72 hours after delivery with event rates of 11.1% and 10.5%, respectively. Compared to those without such a history, headache before pregnancy was significantly associated with experiencing headache 8 weeks after delivery (4.0% versus 23.8%; RR = 6.0; 95% CI: 2.0 to 8.0), but headache during pregnancy or shortly after delivery was not. Several other psychosocial predictors (e.g., somatization, smoking before pregnancy) were statistically associated with at least one headache outcome. Conclusions A history of headache prior to pregnancy is a strong predictor of headache during and after pregnancy, the

  9. Predictors of headache before, during, and after pregnancy: a cohort study.

    Science.gov (United States)

    Turner, Dana P; Smitherman, Todd A; Eisenach, James C; Penzien, Donald B; Houle, Timothy T

    2012-03-01

    The present study endeavored to identify predictors of headache during pregnancy, shortly after delivery, and at 8-week follow-up. Many women suffer from headaches during pregnancy and the post-partum period. However, little is known about factors that predict headache surrounding childbirth. Secondary analysis of longitudinal cohort study of 2434 parturients hospitalized for cesarean or vaginal delivery in 4 university hospitals in the United States and Europe. Data were gathered from interviews and review of medical records shortly after delivery; 972 of the women were contacted 8 weeks later to assess persistent headache. The primary outcome measures were experiencing headache during pregnancy, headache within 72 hours after delivery, and headache at 8 weeks after delivery. Of the parturients, 10% experienced headache during pregnancy, 3.7% within 72 hours after delivery, and 3.6% at 8 weeks postdelivery. Compared to those without a history of headache, a history of headache prior to pregnancy was the strongest predictor of headache during pregnancy (9.8% vs 23.5%; risk ratio 2.4; 95% confidence interval [CI]: 1.4 to 4.0). Experiencing headache during pregnancy (adjusted hazard ratio HR 3.8; 95% CI: 2.4 to 6.2) and receiving needle-based regional anesthesia for pain treatment (adjusted hazard ratio 2.2; 95% CI: 1.1 to 4.5) were independently associated with headache within 72 hours after delivery with event rates of 11.1% and 10.5%, respectively. Compared to those without such a history, headache before pregnancy was significantly associated with experiencing headache 8 weeks after delivery (4.0% vs 23.8%; risk ratio = 6.0; 95% CI: 2.0 to 8.0), but headache during pregnancy or shortly after delivery was not. Several other psychosocial predictors (eg, somatization, smoking before pregnancy) were statistically associated with at least 1 headache outcome. A history of headache prior to pregnancy is a strong predictor of headache during and after pregnancy, the

  10. Electronic medical record interventions and recurrent perioperative antibiotic administration: a before-and-after study.

    Science.gov (United States)

    Hincker, Alexander; Ben Abdallah, Arbi; Avidan, Michael; Candelario, Penka; Helsten, Daniel

    2017-07-01

    Perioperative antibiotics decrease rates of surgical-site infections. Numerous interventions have improved administration of the first antibiotic dose; however, failures in the administration of subsequent doses frequently occur. We hypothesized that modifications to the electronic medical record (EMR) would improve the administration of the second antibiotic dose and that such improvements would be sustained over time. This historical cohort before-and-after study of multipronged alerts in the EMR analyzed 1,348 operations on adult patients. The operations lasted ≥ 240 min, utilized cefazolin as the perioperative antibiotic-constituting 1,348 second and 182 third intraoperative antibiotic doses-and did not involve cardiopulmonary bypass. A decision support intervention provided dosing recommendations when clinicians documented antibiotics. The reminder intervention displayed a continuous bar in the EMR, starting at the time the antibiotics were dosed and ending 15 min before subsequent doses were indicated. The primary endpoints of the study were the change in the proportion of correctly administered second dose of cefazolin, given in accordance with hospital guidelines in the month after implementing the intervention, and whether any improvements declined by three to seven months after implementation. Pre-intervention, 51.4% of second doses of cefazolin were correctly administered. In the immediate post-intervention period, 68.5% were correctly administered, representing a significant absolute improvement of 17.1% (95% confidence interval, 8.1 to 26.1; P pre-intervention). These inexpensive nonintrusive interventions to the EMR provided modest lasting improvements in proper administration of repeated doses of cefazolin. The fact that only approximately 70% compliance was reached highlights the difficulty in addressing this deficiency.

  11. Study of Metal-Humic Catalysts before and After the Gas Desulphurization Process Using Thermal Analysis

    Science.gov (United States)

    Szyszka, Danuta; Wieckowska, Jadwiga

    2017-12-01

    The study of metal-humic catalysts before and after the SO2 conversion has been carried out using thermal analysis. The thermogravimetric analysis and differential thermal analysis has been carried out using Perkin-Elmer TGA 7 and DTA 7 equipment in an argonic atmosphere. The heating rate of samples in the DTA was 10 °C/min., and in the TGA 40 °C/min. The following catalysts have been chosen for analysis: H-Pb2+/450 °C, H-B/450 °C, H-Sn2+/450 °C, H-Ce 4+. The study of metal-humic catalysts using thermal analysis has shown that, in the DTA curves of studied catalysts before SO2 conversion, endothermic peaks related to decomposition of metal carbonates, melting of metals or decomposition of metal-humic bonding. In the DTA curves after the SO2 conversion process, there are additional endothermic peaks related to the presence of sulphur in the metal-humic compounds and to thermal decomposition of those bonds.

  12. Study of sexual functioning and disorder in women before and after tubal sterilization (tubectomy)

    Science.gov (United States)

    Kunkeri, Shweta Patil; Sathyanarayana Rao, T. S.; Andrade, Chittaranjan

    2017-01-01

    Introduction: Sexual relationship is a basis for mental health and continuity of the healthy generation. There are very few studies on the female sexual functioning, especially in India. Sterilization being the most common contraceptive method, sexual functioning in women undergoing this surgical intervention has not been adequately explored. Available studies have found conflicting results; some have reported that sterilization has positive effects on sexual functioning since anxiety of getting pregnant is abolished. However, few Indian studies have reported a decline in sexual functioning following the sterilization procedure as women lack interest and perceive sexual function only for the purpose of procreation. The cultural differences and lack of sex education among Indian women are thought to be the reason for such a difference. Materials and Methods: A total of sixty married women above 18 years, who were consulting Family Planning Association, Mysore, for the purpose of undergoing tubal sterilization, and who gave a written consent were interviewed twice; before the sterilization procedure and 6 months post-sterilization. These women were assessed for sexual functioning using female sexual function index and sexual functioning index. Results: The prevalence of sexual dysfunction in the study population was 36.7% before the tubal sterilization. This rate increased to 71.7% after the procedure which was statistically significant. The common disorders were orgasm, arousal, and desire. Pain disorder was least common. This dysfunction exists across all the ages, education level, occupation, and residence. Conclusion: The study shows that whatever may be the attribution, tubal sterilization impairs the sexual functioning among women. A proper education and counseling need to be incorporated to prevent the problems. PMID:28529362

  13. Quantitive study for retinal function before and after photocoagulation in patients with diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Rui-Xue Sun

    2017-03-01

    Full Text Available AIM: To study the retinal function in patients with diabetic macular edema after photocoagulation. METHODS: A total of 30 eyes in 19 patients with diabetic macular edema(DME, who were diagnosed through fundus fluorescein angiography, consecutively recruited from March 2010 to March 2014 and were treated with macular grid pattern photocoagulation. Multifocal electroretinogram(mfERGsystem(version 3.15was performed before and after photocoagulation therapy for 3mo. All data were statistically analyzed. RESULTS: The amplitude densities of a-ware and b-ware for the fovea increased after macular grid pattern photocoagulation therapy, and there were significantly changes relative to its preoperation(t=-3.7683, Pt=-3.6570, Pt=1.7103, P>0.05; t=1.5623, P>0.05 . Compared with pretreatment, the amplitude densities of a-ware and b-ware at macular were statistically larger(t=4.8337, Pt=-2.0376, Pt=-2.1892, Pt=-3.5024, Pt=-1.4387, P>0.05; t=-0.1766, P>0.05. It was significant longer in the latency of a-wave and b-wave at paramacular after photocoagulation(t=-2.0905, Pt=-2.5646, PCONCLUSION: The laser photocoagulation treatment for DME can improve the retinal function at fovea, which benefits the vision acuity. Unfortunately,it induces extensively damaging effects on the macula and paramacular.

  14. Antibiotics prescribed before, during and after pregnancy in the Netherlands : a drug utilization study

    NARCIS (Netherlands)

    de Jonge, Linda; Bos, H Jens; van Langen, Irene M; de Jong-van den Berg, Lolkje T W; Bakker, Marian K

    2014-01-01

    PurposeTo describe the prescription of antibiotics before, during and after pregnancy, and the trends over a 16-year period in the Netherlands, and to determine whether they were prescribed according to national guidelines. MethodsThe IADB (http://iadb.nl) contains prescriptions dispensed by

  15. [Incidence of unplanned extubations in a neonatal intensive care unit. A before and after study].

    Science.gov (United States)

    Utrera Torres, M I; Moral Pumarega, M T; García Lara, N R; Melgar Bonís, A; Frías García, M E; Pallás Alonso, C R

    2014-05-01

    Unplanned extubations (UE) of mechanically ventilated newborns involves an undesirable increase in morbidity and mortality. A 2-stage study compared the frequency of UE in a Neonatal Intensive Care Unit before and after the implementation of a program of preventive measures to decrease UE. A before and after prospective study included all mechanically ventilated newborns participating in the 2 stage study from May-December 2011 and June-December 2012. In stage 1, the rate of UE per 100 intubated patient days was calculated and the characteristics of unplanned extubated newborns, circumstances of UE occurrence and need for re-intubation were studied. Consequently, a program of preventive measures for UE was designed and implemented, with the same variables being analysed in stage 2. No differences were found in patient characteristics during the two stages. Stage 1, incidence of UE was 5/100 intubated patient days; Stage 2, 4.5 UE/100 intubated patient days (P=.657). In both stages, most UE occurred during patient handling with re-intubation incidence at 77.4% and 67.7%, respectively. The combined rate of both stages during summer months of July, August and September was 6.2 UE/100 intubation days, in contrast with the remaining months of both stages: UE incidence rate, 3.4 UE/100 intubation days (p=.043). The implementation of a preventive measures program did not significantly reduce the incidence of UE. The summer period showed the highest incidence of UE. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. A comparative study on OCT before and after the operation for vitreomacular traction syndrome

    Directory of Open Access Journals (Sweden)

    Shu-Qi Song

    2017-07-01

    Full Text Available AIM: To make a contrast and then analyze the difference of optical coherence tomography(OCTbefore and after vitreomacular traction syndrome(VTSwas performed. METHODS: The clinical date of 11 evaluable eyes of 11 patients with VTS who were diagnosed by OCT and underwent 25G vitreous surgery from January 2013 to January 2014 were retrospectively analyzed. Patients were followed up for an average of 6mo, to observe the visual acuity and OCT examination of the patient before and after operation. We compared the changes of retinal thickness and local morphology before and after operation.RESULTS: After vitreous retraction, 6 eyes improved, 2 eyes do not improve. One eye received macular membrane traction, in the operation the macular epiretinal membrane peeling, retrial membrane stripping and the triamcinolone acetonide intravitreal injection were given, but after the operation, the vision does not improve. Two eyes received vitreous combined with retinal macular membrane traction. In the operation, macular epiretinal membrane stripping was given, after the operation, visual acuity improved. The proportion of those with visual acuity of 0.1 or more increased from 46% before to 73% after the operation. Before operations, the mean central macular thickness was 619.27±195.13μm, 239.12±143.84μm after, which decreased significantly(PCONCLUSION: Vitrectomy can effectively relieve the vitreous traction of the macula, and can prevent further decline in visual acuity and reduce macular edema as well as improve the visual acuity of some patients. So, OCT has important guiding significance on the diagnosis and prognosis of this group.

  17. Prescribing of Antidiabetic Medicines before, during and after Pregnancy : A Study in Seven European Regions

    NARCIS (Netherlands)

    Charlton, Rachel A.; Klungsoyr, Kari; Neville, Amanda J.; Jordan, Sue; Pierini, Anna; de Jong-van den Berg, Lolkje T. W.; Bos, H. Jens; Puccini, Aurora; Engeland, Anders; Gini, Rosa; Davies, Gareth; Thayer, Daniel; Hansen, Anne V.; Morgan, Margery; Wang, Hao; McGrogan, Anita; Andersen, Anne-Marie Nybo; Dolk, Helen; Garne, Ester

    2016-01-01

    Aim To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. Methods A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women with

  18. Parkinsonism and AIDS: a clinical comparative study before and after HAART

    Directory of Open Access Journals (Sweden)

    Ana Lucia Zuma de Rosso

    2009-09-01

    Full Text Available In 2002, after analyzing 28 HIV-positive patients with movement disorders we emphasized the decreasing not only of Parkinsonism but also of other involuntary movements in HIV patients in the last few years. The objective of this study is to compare the clinical results between HIV-positive patients with Parkinsonism before and after HAART. In 14 years (1986-1999 2,460 HIV-positive patients were seen in our Hospital 14 (0.6% of which presented with Parkinsonism. Eight years after (2000-2007 970 HIV positive patients were seen and only two (0.2% had Parkinsonism. We conclude that after the introduction of HAART there was an evident decrease in AIDS-related Parkinsonism.No ano de 2002, após analisarmos 28 pacientes HIV-positivos que apresentavam distúrbios do movimento, enfatizamos o declínio, não só do parkinsonismo, como também de outros movimentos involuntários em pacientes infectados pelo HIV nos últimos anos. O objetivo deste estudo é comparar os resultados clínicos entre pacientes HIV-positivos com parkinsonismo antes e depois da introdução do esquema HAART. Em 14 anos (1986-1999, 2.460 pacientes HIV-positivos foram avaliados em nosso Hospital dos quais 14 (0,6% apresentaram parkinsonismo. Nos oito anos seguintes (2000-2007, 970 pacientes HIV-positivos foram avaliados e somente dois (0,2% tinham parkinsonismo. Concluímos que após a introdução do esquema HAART houve evidente declínio do parkinsonismo secundário à AIDS.

  19. Paediatric resuscitation training: is e-learning the answer? A before and after pilot study.

    Science.gov (United States)

    O'Leary, Fenton M

    2012-06-01

    To determine whether an e-learning resuscitation programme was able to improve the knowledge and competence of doctors and nurses in providing cardiopulmonary resuscitation to children in a simulated cardiac arrest. A prospective before and after pilot study comprising of a simulated paediatric resuscitation before and after participants undertook an e-learning programme. Participants were emergency department doctors and new graduate nurses from The Children's Hospital at Westmead, Australia. Primary outcome measures were the ability to perform successful basic life support (BLS) and advanced life support (ALS) according to published guidelines. Secondary outcome measures were the individual steps in performing the overall resuscitation and subjective feedback from participants. Fifty-six clinicians were enrolled in the study (29 doctors and 27 nurses). Thirty-seven were re-tested (25 doctors and 12 nurses). The mean time between tests was 49 days (17 standard deviation). The e-learning module led to an improvement in participants' ability to perform BLS by 51% (P < 0.001) and ALS by 57% (P= 0.001) overall resulting in an overall competence of 89% (BLS) and 65% (ALS). There were also significant improvements in time to rhythm recognition (P= 0.006), time to first defibrillation (P= 0.009) and participants' self-reported knowledge and confidence in BLS and ALS (P < 0.001). E-learning does improve both the knowledge and competence of doctors and nurses in providing cardiopulmonary resuscitation to children in the simulation environment. © 2011 The Author. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  20. VOICE QUALITY BEFORE AND AFTER THYROIDECTOMY

    Directory of Open Access Journals (Sweden)

    Dora CVELBAR

    2016-04-01

    Full Text Available Introduction: Voice disorders are a well-known complication which is often associated with thyroid gland diseases and because voice is still the basic mean of communication it is very important to maintain its quality healthy. Objectives: The aim of this study referred to questions whether there is a statistically significant difference between results of voice self-assessment, perceptual voice assessment and acoustic voice analysis before and after thyroidectomy and whether there are statistically significant correlations between variables of voice self-assessment, perceptual assessment and acoustic analysis before and after thyroidectomy. Methods: This scientific research included 12 participants aged between 41 and 76. Voice self-assessment was conducted with the help of Croatian version of Voice Handicap Index (VHI. Recorded reading samples were used for perceptual assessment and later evaluated by two clinical speech and language therapists. Recorded samples of phonation were used for acoustic analysis which was conducted with the help of acoustic program Praat. All of the data was processed through descriptive statistics and nonparametric statistical methods. Results: Results showed that there are statistically significant differences between results of voice self-assessments and results of acoustic analysis before and after thyroidectomy. Statistically significant correlations were found between variables of perceptual assessment and acoustic analysis. Conclusion: Obtained results indicate the importance of multidimensional, preoperative and postoperative assessment. This kind of assessment allows the clinician to describe all of the voice features and provides appropriate recommendation for further rehabilitation to the patient in order to optimize voice outcomes.

  1. Empowering Post-Surgical Patients to Improve Opioid Disposal: A Before and After Quality Improvement Study.

    Science.gov (United States)

    Hasak, Jessica M; Roth Bettlach, Carrie L; Santosa, Katherine B; Larson, Ellen L; Stroud, Jean; Mackinnon, Susan E

    2018-03-01

    Our country is in the midst of an opioid epidemic. Although the problem is multifactorial, one issue is the presence of excess prescription opioid medications circulating in our communities. Our objective was to determine whether dissemination of an educational brochure would improve the disposal of unused opioids after surgery. Eligible surgery patients from an upper extremity/peripheral nerve clinic were enrolled into this prospective before and after study between February 2017 and September 2017. Patients who reported opioid use preoperatively were excluded from this study. The same survey was administered to the group of patients who did not receive the intervention and to those who did receive the intervention. Our primary endpoint was the proportion of patients who disposed of unused opioid medications. A total of 334 patients were studied: 164 who did not receive the brochure and 170 who received the brochure. Seventy-six patients were excluded for preoperative opioid use. After dissemination of the brochure, there was a significant increase in the proportion of patients who disposed of their unused opioids (11% vs 22%, p = 0.02). Of those who disposed of their opioids, there was no significant difference in the proportion of patients from each group who disposed in a manner that was recommended by the brochure (43% vs 64%, p = 0.19). Dissemination of the educational brochure improved disposal of unused opioids after surgery. This low-cost, easily implemented intervention can improve disposal of unused opioids and ultimately, decrease the amount of excess opioids circulating in our communities. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Sleep Patterns Before and After Weight Restoration in Females with Anorexia Nervosa: A Longitudinal Controlled Study.

    Science.gov (United States)

    El Ghoch, Marwan; Calugi, Simona; Bernabè, Jasmine; Pellegrini, Massimo; Milanese, Chiara; Chignola, Elisa; Dalle Grave, Riccardo

    2016-09-01

    To assess sleep patterns in female patients with anorexia nervosa before and after weight restoration. Sleep patterns were measured objectively using a Sense Wear Armband before and after weight restoration in 50 female patients with anorexia nervosa, and in 25 healthy females. At baseline, patients with anorexia nervosa exhibited lower total sleep time and sleep onset latency than controls, the former apparently associated with baseline BMI, duration of illness and age. However, after weight restoration, total sleep time and sleep onset latency were similar to controls, despite the persistence of longer periods of wake after sleep onset. In patients with anorexia nervosa, total sleep time and sleep onset latency appears to be reduced. This sleep disturbance seems to be influenced by the duration and severity of malnutrition, and appears to normalize with weight restoration. Even though a discontinuous sleep pattern seems to persist, this finding should be discussed with patients. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. Prescribing of Antidiabetic Medicines before, during and after Pregnancy: A Study in Seven European Regions.

    Directory of Open Access Journals (Sweden)

    Rachel A Charlton

    Full Text Available To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe.A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany, Wales and the rest of the UK. Women with a pregnancy starting and ending between 2004 and 2010, (Denmark, 2004-2009; Norway, 2005-2010; Emilia Romagna, 2008-2010, which ended in a live or stillbirth, were identified. Prescriptions for antidiabetic medicines issued (UK or dispensed (non-UK during pregnancy and/or the year before or year after pregnancy were identified. Prescribing patterns were compared across databases and over calendar time.1,082,673 live/stillbirths were identified. Pregestational insulin prescribing during the year before pregnancy ranged from 0.27% (CI95 0.25-0.30 in Tuscany to 0.45% (CI95 0.43-0.47 in Norway, and increased between 2004 and 2009 in all countries. During pregnancy, insulin prescribing peaked during the third trimester and increased over time; third trimester prescribing was highest in Tuscany (2.2% and lowest in Denmark (0.5%. Of those prescribed an insulin during pregnancy, between 50.5% in Denmark and 88.8% in the Netherlands received an insulin analogue alone or in combination with human insulin, this proportion increasing over time. Oral products were mainly metformin and prescribing was highest in the 3 months before pregnancy. Metformin use during pregnancy increased in some countries.Pregestational diabetes is increasing in many areas of Europe. There is considerable variation between and within countries in the choice of medication for treating pregestational diabetes in pregnancy, including choice of insulin analogues and oral antidiabetics, and very large variation in the treatment of gestational diabetes despite international guidelines.

  4. Happiness: before and after the kids.

    Science.gov (United States)

    Myrskylä, Mikko; Margolis, Rachel

    2014-10-01

    Understanding how having children influences parents' subjective well-being ("happiness") has great potential to explain fertility behavior. We study parental happiness trajectories before and after the birth of a child, using large British and German longitudinal data sets. We account for unobserved parental characteristics using fixed-effects models and study how sociodemographic factors modify the parental happiness trajectories. Consistent with existing work, we find that happiness increases in the years around the birth of a first child and then decreases to before-child levels. Moreover, happiness increases before birth, suggesting that the trajectories may capture not only the effect of the birth but also the broader process of childbearing, which may include partnership formation and quality. Sociodemographic factors strongly modify this pattern. Those who have children at older ages or who have more education have a particularly positive happiness response to a first birth; and although having the first two children increases happiness, having a third child does not. The results, which are similar in Britain and Germany, suggest that having up to two children increases happiness, and mostly for those who have postponed childbearing. This pattern is consistent with the fertility behavior that emerged during the second demographic transition and provides new insights into low and late fertility.

  5. Cadaveric validation study of computational fluid dynamics model of sinus irrigations before and after sinus surgery.

    Science.gov (United States)

    Craig, John R; Zhao, Kai; Doan, Ngoc; Khalili, Sammy; Lee, John Y K; Adappa, Nithin D; Palmer, James N

    2016-04-01

    Investigations into the distribution of sinus irrigations have been limited by labor-intensive methodologies that do not capture the full dynamics of irrigation flow. The purpose of this study was to validate the accuracy of a computational fluid dynamics (CFD) model for sinonasal irrigations through a cadaveric experiment. Endoscopic sinus surgery was performed on 2 fresh cadavers to open all 8 sinuses, including a Draf III procedure for cadaver 1, and Draf IIb frontal sinusotomies for cadaver 2. Computed tomography maxillofacial scans were obtained preoperatively and postoperatively, from which CFD models were created. Blue-dyed saline in a 240-mL squeeze bottle was used to irrigate cadaver sinuses at 60 mL/second (120 mL per side, over 2 seconds). These parameters were replicated in CFD simulations. Endoscopes were placed through trephinations drilled through the anterior walls of the maxillary and frontal sinuses, and sphenoid roofs. Irrigation flow into the maxillary, frontal, and sphenoid sinuses was graded both ipsilateral and contralateral to the side of nasal irrigation, and then compared with the CFD simulations. In both cadavers, preoperative and postoperative irrigation flow into maxillary, frontal, and sphenoid sinuses matched extremely well when comparing the CFD models and cadaver endoscopic videos. For cadaver 1, there was 100% concordance between the CFD model and cadaver videos, and 83% concordance for cadaver 2. This cadaveric experiment provided potential validation of the CFD model for simulating saline irrigation flow into the maxillary, frontal, and sphenoid sinuses before and after sinus surgery. © 2016 ARS-AAOA, LLC.

  6. Coronary artery calcium before and after hospitalization with pneumonia: The MESA study.

    Science.gov (United States)

    Corrales-Medina, Vicente F; Dwivedi, Girish; Taljaard, Monica; Petrcich, William; Lima, Joao A; Yende, Sachin; Kronmal, Richard A; Chirinos, Julio A

    2018-01-01

    Epidemiological analyses demonstrate that pneumonia survivors have a higher risk of myocardial infarction than people with similar load of risk factors for atherosclerotic cardiovascular disease (ASCVD) but without pneumonia. This may be due to a higher baseline burden of ASCVD in patients with pneumonia that is not captured by the accounting of known ASCVD risk factors in epidemiological analyses or to unfavorable accelerating effects of pneumonia on atherosclerosis. We analyzed data from the Multi-Ethnic Study of Atherosclerosis. We identified 54 participants that were hospitalized for pneumonia during study follow-up and that also had assessment of coronary artery calcium (CAC, an objective marker of coronary atherosclerotic burden) before and after this hospitalization. We matched them to 54 participants who were not hospitalized for pneumonia but that had CAC assessments at the same study visits as the pneumonia cases. We compared baseline CAC scores and their progression between groups. Baseline CAC scores were similar in both groups (median [IQR]; 6.3 [0-356.8] in pneumonia participants vs. 10.8 [0-178.3] in controls; p = 0.25). After a median of 4.8 years, the direction and magnitude of CAC score change, and the slope of CAC score progression between groups was also similar (median change [IQR], 21.8 [0 to 287.29] in participants with pneumonia versus 15.8 [0 to 140.94] in controls, p = 0.28; difference in slope, 7.7, 95% CI -9.0 to 24.6, p = 0.18). However, among participants with high baseline ASCVD risk (i.e. ACC/AHA 10-year risk estimate ≥7.5%), participants with pneumonia showed a larger increase in CAC scores (median change [IQR]; 159.10 [38.55-407.34] versus 48.72 [0.97-246.99] in controls; p = 0.02) and a trend towards a steeper slope of CAC score progression (difference in slope, 19.7, 95% CI -6.6 to 45.6, p = 0.07). Pneumonia may accelerate the progression of atherosclerosis in people with high baseline ASCVD risk.

  7. A genetic study of cortisol measured before and after endurance training: the HERITAGE Family Study.

    Science.gov (United States)

    Feitosa, Mary F; Rice, Treva; Rosmond, Roland; Borecki, Ingrid B; An, Ping; Gagnon, Jacques; Leon, Arthur S; Skinner, James S; Wilmore, Jack H; Bouchard, Claude; Rao, D C

    2002-03-01

    The aim of this study was to investigate whether there are familial influences on cortisol levels at baseline and in response to endurance exercise training and, if so, whether there is evidence for a major gene effect. There were 476 white individuals in 99 nuclear families and 247 black individuals in 105 families with valid cortisol data in the HERITAGE Family Study. Data adjustments were carried out separately in each of 8 sex by generation by race groups, using stepwise multiple regression procedures. The familial factors underling the variability in baseline cortisol (log-transformed and adjusted for age and baseline body mass index [BMI]) and its training response (post-training minus baseline, adjusted for age, baseline BMI, and the baseline cortisol value) were assessed by estimating familial correlations and carrying out segregation analysis. In the white sample, significant familial resemblance was detected for both baseline cortisol and the training response, with maximal heritabilities of 38% and 32%, respectively. However, significant familial correlations were not detected for either cortisol phenotype in the black sample, perhaps owing, in part, to the much smaller family sizes. Results of segregation analysis of the white sample provided evidence for Mendelian additive genes influencing baseline cortisol and its training response. The major genes accounted for 33% and 31% of the variance for baseline cortisol and the training response with 48% and 5% of the sample homozygous for the genotype leading to high values, respectively. In conclusion, we found significant familial effects influencing levels of baseline cortisol and its training response in the white sample. The putative major gene effects appear to explain most of the observed familial resemblance, this will motivate further linkage and association studies. Copyright 2002 by W.B. Saunders Company

  8. Before and After the Tax Administration Act

    African Journals Online (AJOL)

    NWUuser

    "PAY NOW, ARGUE LATER" RULE – BEFORE AND AFTER THE TAX. ADMINISTRATION ACT. C Keulder*. 1 Introduction. The levying of taxes is imperative for a government to ensure that it achieves its economic objectives1 which, amongst others, include the economic development of the country and regulating the levels ...

  9. [Correlation studies between MRI and the symptom scores of patients with LDH before and after manipulative therapy].

    Science.gov (United States)

    Guo, Wei; Zhao, Ping; Zhou, Wei; Wei, Jie; Li, Xi-de; Zhou, Hua; Liu, Liang; Yan, Xiao-bin

    2010-01-01

    To study the correlation between the MRI and some symptom scores of the patients with lumbar disc herniation (LDH), such as VAS (visual analogue scale), JOA (Japanese orthopedic association scale),and SLR (straight leg raising test) before and after manipulative therapy. From June to December in 2007, 70 patients with LDH were selected in the study. Among the patients, 40 patients were male and 30 patients were female, ranging in age from 21 to 56 years (averaged 39 years). MRI was used to measure the size and position of the protruded nucleus pulposus (size of disc protrution, the angle between nerve root canal and disc protrution). Correlation study was conducted between the MRI and VAS, JOA, and SLR before and after therapy. The correlation between the changes of MRI and that of the quantified clinical indexes of LDH patients was also analyzed. There were significant differences before and after therapy in some quantified indexes for the clinical manifestation of the patients, such as VAS, JOA,and SLR. There were no significant changes in the shape and size of protrude nucleus pulposus after 20 days' therapy by CT or MR recheck. Correlation study between the quantified indexes of clinical manifestation (JOA) and MRI before and after the treatment showed that there was no significant correlation. The study proves again that the shape and size of protrude nucleus pulposus has no paralleled relation with the patient's clinical manifestation,which is demonstrated by the recheck of MRI after a successful spinal manipulative treatment in the study.

  10. Secondary care intervals before and after the introduction of urgent referral guidelines for suspected cancer in Denmark: a comparative before-after study

    DEFF Research Database (Denmark)

    Larsen, M. B.; Hansen, R. P.; Hansen, D. G.

    2013-01-01

    the association between the secondary care interval and urgent referral remains scarce. The aim of this study was to analyse how the secondary care interval changed after the introduction of urgent referral. Methods: This was a retrospective population-based study of 6,518 incident cancer patients based...

  11. Cytological Study of Breast Carcinoma Before and After Oncotherapy with Special Reference to Morphometry and Proliferative Activity.

    Science.gov (United States)

    Koley, Sananda; Chakrabarti, Srabani; Pathak, Swapan; Manna, Asim Kumar; Basu, Siddhartha

    2015-12-01

    Our study was done to assess the cytological changes due to oncotherapy in breast carcinoma especially on morphometry and proliferative activity. Cytological aspirates were collected from a total of 32 cases of invasive ductal carcinoma both before and after oncotherapy. Morphometry was done on the stained cytological smears to assess the different morphological parameters of cell dimension by using the ocular morphometer and the software AutoCAD 2007. Staining was done with Ki-67 and proliferating cell nuclear antigen (PCNA) as proliferative markers. Different morphological parameters were compared before and after oncotherapy by unpaired Student's t test. Statistically significant differences were found in morphometric parameters, e.g., mean nuclear diameter, mean nuclear area, mean cell diameter, and mean cell area, and in the expression of proliferative markers (Ki-67 and PCNA). Statistical analysis was done by obtaining p values. There are statistically significant differences between morphological parameter of breast carcinoma cells before and after oncotherapy.

  12. Urinary infection before and after prostatectomy

    Directory of Open Access Journals (Sweden)

    Pourmand Gholamreza

    2010-01-01

    Full Text Available To determine the prevalence of pre and post prostatectomy related urinary tract in-fection and its correlation with peri-operative events, we studied 120 patients who underwent pros-tatectomy due to benign prostatic hypertrophy from September 2005 to September 2006. Urine cultures were performed before the operations, after a week, and three months later. Data including prostate volume, prostatic specific antigen (PSA, post voiding residue (PVR and histopathological reports as well as the duration of urinary leak, bladder irrigation, hospitalization, and catheterization were studied. The mean age of the studied patients was 70.5 ± 8 years. Significant preoperative bac-teriuria was revealed in 18 (15% patients of whom 14(77% patients developed negative cultures following the operation. Postoperative bacteriuria was detected in 9(7.5% patients who negative urine cultures preoperatively. Pre and post operative micro-organisms were different in the majority of the cases. The mean PSA was higher in patients with a positive history of infection. Following prostatectomy, patients with positive urine cultures had significantly longer urinary leakage, cathe-terization, and hospital stays compared with those who remained culture negative. We conclude that the incidence of positive urine culture pri-prostatectomy for BPH can be improved by appropriate antibiotic therapy, and the risk factors for postoperative urinary infection include preoperative infec-tion, prolonged urinary leakage, catheterization, and hospital stay. The elevated PSA may be a risk factor.

  13. Psychosocial Functioning Before and After Laparoscopic Adjustable Gastric Banding: a Cross-Sectional Study

    NARCIS (Netherlands)

    Larsen, J.K.; Geenen, R.; Ramshorst, B. van; Brand, N.; Wit, P. de; Stroebe, W.; Doornen, L.J.P. van

    2003-01-01

    Background: The aim of this cross-sectional study was to examine short and long-term physical, mental and, particularly, social quality of life (QoL) of patients with severe obesity after laparoscopic adjustable gastric banding (LAGB). Methods: 250 patients (221 female, 29 male, mean age 39.6 years,

  14. Plasma adiponectin before and after kidney transplantation

    DEFF Research Database (Denmark)

    Idorn, Thomas; Hornum, Mads; Bjerre, Mette

    2012-01-01

    The role of plasma adiponectin (ADPN) in patients with impaired kidney function and following kidney transplantation (Tx) is debated. We aimed to: (i) determine whether pretransplant ADPN level is an independent risk factor for deterioration of glucose tolerance including development of new......-onset diabetes mellitus after Tx, (ii) describe which parameters that influence the ADPN concentration before and after Tx. Fifty-seven nondiabetic kidney allograft recipients and 40 nondiabetic uraemic patients were included. The Tx group was examined at baseline and 3 and 12 months after Tx. The uraemic...... analysis, whereas an ordinal logistic regression analysis revealed no predictive characteristic of ADPN for aggravation of the glucose tolerance after Tx. In conclusion, kidney transplantation is accompanied by a significant reduction in ADPN concentration. Several factors determine the ADPN concentration...

  15. Rotavirus epidemiology before and after vaccine introduction.

    Science.gov (United States)

    Assis, Andrêssa S F; Valle, Daniel A; Antunes, Gustavo R; Tibiriça, Sandra H C; Assis, Rosane Maria S de; Leite, José Paulo G; Carvalho, Iná P de; Rosa e Silva, Maria Luzia da

    2013-01-01

    To evaluate the prevalence and circulation of rotavirus genotypes before and after the introduction of oral vaccine against human rotavirus, and to check for a possible change in the age of occurence of the infection by RV-A. This was a cross-sectional study conducted between 2002-2011, in the city of Juiz de Fora, state of Minas Gerais, Brazil. A total of 1,144 diarrheal stool specimens were obtained from nonhospitalized children aged between 0 and 5 years, and analyzed by polyacrylamide gel electrophoresis and reverse-transcription polymerase chain reaction for genotype characterization. Data on prevalence and age distribution of rotavirus cases were analyzed through the chi-squared test (p < 0.05), using SPSS, release 13.0. Rotavirus infection was detected in 9.35% (107/1,144) samples, with prevalence rates ranging from 11.12% (90/809) in the pre-vaccine to 5.07% (17/335) in the post-vaccine period (p = 0.001). Among the samples tested, the most frequently detected genotypes were G1P[6] (6/33 = 18.2%) in the period between 2002 and 2005 and G2P[4] in 2006 (11/33 = 33.3%) and in the period between 2007 and 2011 (5/33 = 15.2%). There was also a significant reduction in the number of cases of rotavirus disease in children aged between 0 and 36 months after the vaccine introduction. The study evidenced a significant decrease in the prevalence of rotavirus, mainly in children aged between 0 and 36 months in the 2007-2011 period, as well as a reduction in G1 genotype circulation. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  16. Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban.

    Science.gov (United States)

    Gorini, G; Moshammer, H; Sbrogiò, L; Gasparrini, A; Nebot, M; Neuberger, M; Tamang, E; Lopez, M J; Galeone, D; Serrahima, E

    2008-08-01

    The aim of this paper was to compare nicotine concentration in 28 hospitality premises (HPs) in Florence and Belluno, Italy, where a smoking ban was introduced in 2005, and in 19 HPs in Vienna, Austria, where no anti-smoking law entered into force up to now. Airborne nicotine concentrations were measured in the same HPs in winter 2002 or 2004 (pre-ban measurements) and winter 2007 (post-ban measurements). In Florence and Belluno, medians decreased significantly (P hospitality workers of 11.81 and 14.67 per 10,000, respectively. Lifetime excess lung cancer mortality risks for bar and disco-pub workers were 10-20 times higher than that calculated for restaurant workers, both in Italy and Austria. In winter 2007, it dropped to 0.01 per 10,000 in Italy, whereas in Austria it remained at the same levels. The drop of second-hand smoke exposure indicates a substantial improvement in air quality in Italian HPs even after 2 years from the ban. The nation-wide smoking ban introduced in Italy on January 10, 2005, resulted in a drop in second-hand smoke exposure in hospitality premises, whereas in Austria, where there is no similar nation-wide smoking ban, the exposure to second-hand smoke in hospitality premises remains high. Given that second-hand smoke is considered a group 1 carcinogen according to the International Agency for Research on Cancer classification, the World Health Organization Framework Convention on Tobacco Control strongly recommends the implementation of nation-wide smoke-free policies in order to improve the indoor air quality of hospitality premises and workplaces. Results from our study strongly supports this recommendation.

  17. Relationships between college settings and student alcohol use before, during and after events: a multi-level study.

    Science.gov (United States)

    Paschall, Mallie J; Saltz, Robert F

    2007-11-01

    We examined how alcohol risk is distributed based on college students' drinking before, during and after they go to certain settings. Students attending 14 California public universities (N=10,152) completed a web-based or mailed survey in the fall 2003 semester, which included questions about how many drinks they consumed before, during and after the last time they went to six settings/events: fraternity or sorority party, residence hall party, campus event (e.g. football game), off-campus party, bar/restaurant and outdoor setting (referent). Multi-level analyses were conducted in hierarchical linear modeling (HLM) to examine relationships between type of setting and level of alcohol use before, during and after going to the setting, and possible age and gender differences in these relationships. Drinking episodes (N=24,207) were level 1 units, students were level 2 units and colleges were level 3 units. The highest drinking levels were observed during all settings/events except campus events, with the highest number of drinks being consumed at off-campus parties, followed by residence hall and fraternity/sorority parties. The number of drinks consumed before a fraternity/sorority party was higher than other settings/events. Age group and gender differences in relationships between type of setting/event and 'before,''during' and 'after' drinking levels also were observed. For example, going to a bar/restaurant (relative to an outdoor setting) was positively associated with 'during' drinks among students of legal drinking age while no relationship was observed for underage students. Findings of this study indicate differences in the extent to which college settings are associated with student drinking levels before, during and after related events, and may have implications for intervention strategies targeting different types of settings.

  18. Before, During, and After a Wildfire

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    More and more people are making their homes in woodland settings – in or near forests, rural areas, or remote mountain sites - areas in which wildfires are more likely to occur. Wildfires often begin unnoticed. They spread quickly, igniting brush, trees, and homes. CDC recommends taking steps before, during, and after local wildfires to reduce the effect they have on your life.  Created: 11/1/2007 by Emergency Communications System.   Date Released: 11/1/2007.

  19. DSA study of the effect of vasopressin on the small-bowel circulation before and after embolization

    International Nuclear Information System (INIS)

    Li Xueqin; Wang Qiaoxi; Guo Yuxin; Yang Xinhong; Hu Hongyao

    2001-01-01

    Objective: To study the effect of vasopressin (VS) on the small-bowel circulation and the safety of embolotherapy for the small intestinal hemorrhage by DSA. Methods: Ten dogs were divided into three groups. Vasa recta were ligated 30 min after VS infusion ended in group A (n = 4), and 2h after VS infusion ended in group B (n = 4), they were ligated without VS infusion in control group (n = 2). DSA were performed before and after VS infusion, before and after the ligation. The tested parts of intestine were resected to make the pathologic examination a week late. Results: All branches of mesenteric arteries contracted and the contrast developed light in the intestinal wall after VS infusion. Branches contraction recovered but the contrast developed still slight in the intestinal wall about 30 min after infusion ended. All manifestation of DSA recovered to normal 2h after infusion ended. In all groups, the blood vessel net can be seen but is fewer and scattered in the area of ligation. The collocate presented soon after the ligation. The pathologic examination proved that there was only mind mucosal ischemia in all groups. Conclusion: The repressive effect of VS to the circulation of intestine weakened and then disappeared rapidly after the infusion ended. VS infusion had no significant effect on the safety of embolotherapy for small intestinal bleeding when the infusion has been finished for more than 2hr. DSA can demonstrated the circulation state of the intestine before and after embolization

  20. Portal vein thrombosis before and after transjugular intrahepatic portosystemic shunt placement: An observational study (STROBE compliant).

    Science.gov (United States)

    Wan, Yue-Meng; Li, Yu-Hua; Wu, Hua-Mei; Xu, Zhi-Yuan; Xu, Ying; Yang, Li-Hong; Wu, Xi-Nan; Yang, Jin-Hui

    2017-11-01

    Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS. All patients received warfarin (1.5-3.0 mg/day) or aspirin (100 mg/day) or clopidogrel (75 mg/day) post-TIPS. Results of patients with and without PVT (baseline and de novo) were compared.White blood cell (WBC) counts (odds ratio (OR): 0.430, 95% confidence interval (CI): 0.251-0.739, P = .002) and Child-Turcotte-Pugh (CTP) score (OR: 2.377, 95% CI: 1.045-5.409, P = .039) were significant baseline predictors for PVT in TIPS-treated patients with cirrhosis. Warfarin resulted in markedly greater rates of complete recanalization than aspirin or clopidogrel (P < .05) in patients with PVT. Patients with PVT had markedly higher 2-year cumulative rates of variceal rebleeding, shunt dysfunction, hepatic encephalopathy, and hepatocellular carcinoma, and prominently lower overall survival than those without PVT (P < .05).In TIPS-treated patients with cirrhosis, lower WBC count and higher CTP score were independent baseline predictors for PVT; patients with PVT had worse clinical outcomes than those without; warfarin may be more effective in recanalizing PVT than aspirin or clopidogrel.

  1. Quality of life before and after sinonasal surgery: a population-based matched cohort study.

    Science.gov (United States)

    Alakärppä, Antti I; Koskenkorva, Timo J; Koivunen, Petri T; Alho, Olli-Pekka

    2017-02-01

    A population-based matched cohort study was conducted to explore how the quality of life (QoL) changes in patients with septal deviation or recurrent/chronic rhinosinusitis after septoplasty (SP) and endoscopic sinus surgery (ESS). We also compared the QoL of the surgical cohort with that of a concurrently collected healthy cohort. We collected data on QoL in a population-based surgical cohort of 160 patients residing in one health care district (population 405,000) in Northern Finland, and in a control cohort comprised of 206 age- and sex-matched randomly selected subjects residing in Finland (population 5,470,000). QoL was assessed at entry and 12 months later with the Sino-Nasal Outcome Test-22 (SNOT-22) and the RAND-36 generic instruments. Seventy-six SP and 84 ESS patients and 206 controls were enrolled. At entry, the mean SNOT-22 scores of the SP and ESS groups were similar (34.9 and 35.1, respectively) and both were significantly worse than the control group (17.7). At 12 months, the mean SNOT-22 score had improved after SP [change 15.7, 95 % confidence interval (CI) 11.4-19.9] and ESS (change 18.0, 95 % CI 12.4-20.9) and almost reached that of the control group, which remained unchanged. The benefit was similar regardless of the surgical indication. At 12 months, mean RAND-36 scores had improved in most domains in both patient groups and remained unchanged in the controls. After appropriate surgical criteria, both SP and ESS are effective in enhancing QoL on the population level, and postoperative QoL almost reaches the level of the control population.

  2. Sleep quality of German soldiers before, during and after deployment in Afghanistan-a prospective study.

    Science.gov (United States)

    Danker-Hopfe, Heidi; Sauter, Cornelia; Kowalski, Jens T; Kropp, Stefan; Ströhle, Andreas; Wesemann, Ulrich; Zimmermann, Peter L

    2017-06-01

    In this prospective study, subjective sleep quality and excessive daytime sleepiness prior to, during and after deployment of German soldiers in Afghanistan were examined. Sleep quality (Pittsburgh Sleep Quality Index; PSQI) and daytime sleepiness (Epworth Sleepiness Scale; ESS) were assessed in 118 soldiers of the German army, who were deployed in Afghanistan for 6 months (deployment group: DG) and in 146 soldiers of a non-deployed control group (CG) at baseline. Results of the longitudinal analysis are reported, based on assessments conducted prior to, during the deployment and afterwards in the DG, and in the CG in parallel. Sleep quality and daytime sleepiness in the DG were already impaired during the predeployment training phase and remained at that level during the deployment phase, which clearly indicates the need for more attention on sleep in young soldiers, already at this early stage. The percentage of impaired sleepers decreased significantly after deployment. Programmes to teach techniques to improve sleep and reduce stress should be implemented prior to deployment to reduce sleep difficulties and excessive daytime sleepiness and subsequent psychiatric disorders. © 2017 European Sleep Research Society.

  3. Patterns of facial trauma before and after legalization of marijuana in Denver, Colorado: A joint study between two Denver hospitals.

    Science.gov (United States)

    Sokoya, Mofiyinfolu; Eagles, Justin; Okland, Tyler; Coughlin, Dylan; Dauber, Hannah; Greenlee, Christopher; Winkler, Andrew A

    2017-10-07

    The effect of marijuana on human health has been studied extensively. Marijuana intoxication has been shown to affect performance, attention span, and reaction time. The public health relationship between trauma and cannabis use has also been studied, with mixed conclusions. In this report, the effect of marijuana legalization on many aspects of facial trauma at two hospitals in Denver, Colorado is examined. A retrospective review of the electronic medical records was undertaken. Mann-Whitney U tests were used to compare age of patients before and after legalization, and chi squared analyses were used to compare mechanism of injury, and fracture types before and after recreational marijuana legalization in Denver, Colorado. Geographical location of patients was also considered. No significant increase was found in race before and after marijuana legalization (p=0.19). A significant increase in age was found before (M=39.54,SD=16.37), and after (M=41.38,SD=16.66) legalization (plegalization (plegalization (p>0.05). Public health efforts should be directed towards educating residents and visitors of Colorado on the effects and toxicology of marijuana. More epidemiologic studies are needed for further assessment of the long-term effects of the legalization of marijuana on the population. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Comparative Study Of Focal Mechanisms In South Central Chile Before And After The 2010 Maule Earthquake

    Science.gov (United States)

    Agurto, H.; Rietbrock, A.; Ryder, I. M.; Haberland, C. A.

    2011-12-01

    On 27 February 2010, a Mw=8.8 earthquake occurred off the coast of south central Chile rupturing nearly 500 km of the subduction zone plate interface. The earthquake also generated a tsunami and caused more than 500 fatalities. The largest earthquakes recorded have taken place along subduction margins (e.g. Chile 1960, 2010, Andaman-Sumatra 2004, Japan 2011) and understanding their rupture mechanisms and deformation regimes is therefore of vital importance. From November 2004 to October 2005, the TIPTEQ project ("From The Incoming Plate to megaThrust EarthQuake"; Rietbrock et al., 2007; Haberland et al., 2009) maintained a network of 120 seismic stations inland and 10 stations at sea between 37 and 39° lat. S., continuously-recording and monitoring the seismicity occurring in the area before the 2010 Maule earthquake. By using first motion polarities and moment tensor inversion we have computed and analyzed focal mechanisms for a subset of data from these records. We found thrust faulting along the subduction interface down to a depth of ~30 km, followed by a gap in the seismicity and then deeper earthquakes showing diverse faulting mechanisms more sparsely distributed within the subducting plate. We also see strike-slip crustal faulting occurring down to ~12 km depth within the area of the Lanalhue fault. The most striking observation is the presence of deep (40 km) normal faulting seismicity in the fore-arc, close to the trench. We have now started to analyze the International Maule Aftershocks Dataset (IMAD) of the 2010 earthquake in the southern rupture region. Again we observe thrust faulting in the subduction interface and a seismic gap between an upper and lower zone of seismicity along the interface. By comparison of the pre- and post-earthquake datasets we are investigating whether the Maule earthquake caused any changes in the style of deformation in this part of Chile. References Haberland, C., A. Rietbrock, D. Lange, K. Bataille, and T. Dahm (2009

  5. A Comparative Study of Pre-Service Teachers' Teaching Efficacy Beliefs before and after Work-Integrated Learning: Part Two

    Science.gov (United States)

    Junqueira, K. E.; Matoti, S. N.

    2013-01-01

    The study, which is grounded in Bandura's concept of self-efficacy, assessed the teaching efficacy beliefs of student teachers before and after completing six months of work-integrated learning. This was necessitated by research which shows that self-efficacy is an important aspect which influences a teacher's ability to teach as well as the…

  6. A Comparative Study of Pre-Service Teachers' Self-Efficacy Beliefs before and after Work-Integrated Learning

    Science.gov (United States)

    Matoti, S. N.; Junqueira, K. E.; Odora, R. J.

    2011-01-01

    The purpose of the study was to compare the teaching efficacy beliefs of pre-service teachers before and after work-integrated learning (WIL) in a South African University of Technology. The comparison groups were formed based on the criterion of WIL. Pre-service teachers in their third year of the B.Ed. (FET) programme participated in the study…

  7. Application of Small Punch Test Method in Studies of the 14MoV63 Steel Before and After Revitalisation

    Directory of Open Access Journals (Sweden)

    Kłaput J.

    2015-04-01

    Full Text Available The paper presents the results of studies of the chromium-molybdenum-vanadium steel designed for operation at elevated temperatures. The material was examined after long-term operation and after the revitalising heat treatment. Studies were performed by conventional methods and small punch test. Curves of ductile-brittle transition were plotted from the Charpy V-notch impact tests and were next compared with the curves of sudden loss of ductility obtained in the small punch test. Additionally, for the material before and after revitalisation, the values of temperatures Tpk and Tnuc were calculated using the method of inflection point.

  8. Psychosocial challenges before and after organ transplantation

    Directory of Open Access Journals (Sweden)

    Schulz KH

    2015-08-01

    Full Text Available Karl-Heinz Schulz,1,2 Sylvia Kroencke,1,2 1Department of Medical Psychology, 2University Transplant Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Abstract: This review addresses psychosocial challenges before and after solid organ transplantation. Stressors, corresponding psychosocial changes of the recipient, and psychological interventions in the different phases of the transplant process are described. Furthermore, important aspects of the preoperative psychosocial evaluation are presented with a special focus on living donors and patients with alcoholic liver disease. For the postoperative period, adherence, quality of life, and return to work are highlighted. Finally, research and clinical implications are presented. Keywords: adherence, alcoholic liver disease, evaluation, living donation, quality of life, return to work

  9. Study of surface carbohydrates in Galba truncatula tissues before and after infection with Fasciola hepatica.

    Science.gov (United States)

    Georgieva, Katya; Georgieva, Liliya; Mizinska-Boevska, Yana; Stoitsova, Stoyanka R

    2016-07-04

    The presence and distribution of surface carbohydrates in the tissues of Galba truncatula snails uninfected or after infection with Fasciola hepatica as well as on the surface of the snail-pathogenic larval stages of the parasite were studied by lectin labelling assay. This is an attempt to find similarities that indicate possible mimicry, utilised by the parasite as an evasion strategy in this snail-trematode system. Different binding patterns were identified on head-foot-mantle, hepatopancreas, genital glands, renopericardial complex of the host as well as of the snail-pathogenic larval stages of F. hepatica. The infection with F. hepatica leads to changes of labelling with Glycine max in the head-mantle cells and Arachis hypogaea in the tubular epithelium of the hepatopancreas. The lectin binding on the other snail tissues is not changed by the development of the larvae. Our data clearly demonstrated the similarity in labelling of G. truncatula tissues and the surface of the snail-pathogenic larval stages of F. hepatica. The role of glycosylation of the contact surfaces of both organisms in relation to the host-parasite interactions is also discussed.

  10. Absorption studies in patients with parasitic infestation before and after treatment

    International Nuclear Information System (INIS)

    Gheorghescu, B.; Gherman, I.; Jovin, G.; Suseanu, I.; Merculiev, E.; Nedea, M.

    1975-06-01

    This investigation has attempted to explore intestinal morphology and function, particularly the absorptive process, in a group of subjects infested with intestinal parasites, and to examine the effects thereon of treatment for the infestation. The study group consisted of 40 adults, 18 male and 22 females, who on admission to hospital showed various intestinal disorders apparently not associated with organic digestive diseases, and in addition, as deduced by various standard methods, intestinal parasitic infestation. All patients were infested with Giardia lamblia; 6 were additionally infested with Strongyloides and 3 with Taenia. Investigations included various blood tests (serum proteins, electrophoresis, blood cell counts), assay of fecal fats, test of iron absorption by whole-body counting, test of vitamin B 12 absorption by Schilling test, radiographic examination of stomach and small intestine, and histological examination of biopsy samples of mucosa from duodenum and jejunum. These investigations were performed prior to treatment, and 6 months and again one year later. Only 15 of the patients, including all 9 with Strongyloides or Taenia, showed recognizable morphological abnormalities in the biopsy specimens. Six of these (all with dual infestation) had abnormally low iron absorption, 5 (all with Giardia infestation only) showed abnormally low vitamin B 12 absorption, 2 (both with dual infestation) showed moderate steatorrhea, and all showed, by x-ray, dyskinetic disturbances of the intestine. Of the remaining 25 patients, 13 showed dyskinesias of varying intensities but none yielded abnormal results from any of the other tests. At 6 months after treatment the abnormalities were greatly reduced, and at one year all were gone except for 5 cases of minor morphological changes in the biopsy specimens. The investigators concluded that malabsorption in patients with intestinal parasitic infestation is a reality and that it is associated with morphological

  11. Study of sexual functioning and disorder in women before and after tubal sterilization (tubectomy)

    OpenAIRE

    Kunkeri, Shweta Patil; Sathyanarayana Rao, T. S.; Andrade, Chittaranjan

    2017-01-01

    Introduction: Sexual relationship is a basis for mental health and continuity of the healthy generation. There are very few studies on the female sexual functioning, especially in India. Sterilization being the most common contraceptive method, sexual functioning in women undergoing this surgical intervention has not been adequately explored. Available studies have found conflicting results; some have reported that sterilization has positive effects on sexual functioning since anxiety of gett...

  12. Glioneuronal tumors in childhood - Before and after surgery. A long-term follow-up study.

    Science.gov (United States)

    Ehrstedt, Christoffer; Moreira, Nuno Canto; Casar-Borota, Olivera; Strömberg, Bo; Ahlsten, Gunnar

    2017-07-01

    To give a detailed description of the long-term outcome of a cohort of children with glioneuronal tumors regarding pre- and postsurgical factors, including "dual" and "double" pathology, seizure freedom, and psychosocial outcome. During a fifteen-year period (1995-2009), all patients (age 0-17.99years) with a glioneuronal brain tumor diagnosed and treated at Uppsala University Children's Hospital were identified from the National Brain Tumor Registry and the National Epilepsy Surgery Registry. Hospital medical records were reviewed and neuroradiological and neuropathological findings were re-evaluated. A cross-sectional long-term follow-up prospective evaluation, including an interview, neurologic examination, and electroencephalogram, was accomplished in patients accepting participants in the study. A total of 25 out of 28 (89%) eligible patients were included. The M:F ratio was 1.5:1. Mean follow-up time after surgery was 12.1years (range 5.0-19.3). Twenty patients were adults (>18years) at follow-up. Seizure freedom was achieved in 64%. Gross total resection (GTR) was the only preoperative factor significantly correlating to seizure freedom (p=0.027). Thirty-eight percent were at some time postoperatively admitted for a psychiatric evaluation. There was a trend towards both higher educational level and employment status in adults who became seizure free. Long-term outcome is good regarding seizure freedom if GTR can be achieved, but late seizure recurrence can occur. "Dual" and "double" pathology is uncommon and does not influence seizure outcome. Obtaining seizure freedom seems to be important for psychosocial outcome, but there is a risk for psychiatric comorbidities and long-term follow-up by a multi-professional team is advisable. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Protein and amino acid status before and after bariatric surgery: a 12-month follow-up study.

    Science.gov (United States)

    Nicoletti, Carolina Ferreira; Morandi Junqueira-Franco, Marcia Varella; dos Santos, Jose Ernesto; Marchini, Julio Sergio; Salgado, Wilson; Nonino, Carla Barbosa

    2013-01-01

    Patients with obesity submitted to bariatric surgery present altered ingestion of macronutrient and micronutrient levels and nutrients deficiency. The objective of this study was to evaluate the protein and amino acid nutritional status of obese adults before and after bariatric surgery, with emphasis on plasma free amino acids. Thirty obese women were submitted to Roux-en-Y gastric shunt (bariatric surgery). Food and protein intake, anthropometric and bioimpedance data (body composition analysis), and serum total protein, albumin, and plasma amino acids levels were collected before the surgery (preoperative) and 3, 6, and 12 months after the surgical procedure. The mean protein intake was 47±2 g/day. The total weight loss during the study period was 39±8 kg; the fat-free mass decreased 7±5 kg. The amino acid profile showed increased concentrations of most amino acids 3 months after surgery; at 6 months, glutamic acid, serine, arginine, alanine, methionine, valine, phenylalanine, isoleucine, and tyrosine concentrations decreased. The total protein and albumin concentrations dropped along the 12-month follow-up. The amino acid profile changes after RYGB are evidence that total protein and albumin levels may not be good indicators of protein profile after the surgery. © 2013 Published by American Society for Metabolic and Bariatric Surgery on behalf of American Society for Bariatric Surgery.

  14. A comparative study of the intracranial environment before and after cranioplasty in decompressive craniectamized cases

    International Nuclear Information System (INIS)

    Utsugi, Osamu; Saito, Fumio; Inaba, Izumi; Takeda, Yasuaki; Miki, Tamotsu; Miwa, Tetsurou

    1990-01-01

    The external decompression is performed as a secondary method for the surgical treatment of increased intracranial pressure due to trauma or cerebrovascular disease. We have had the experience that, if patients are kept in a decompressed state for a prolonged period, they often complain of various minor neurological disorders; cranioplasty done on such patients improves those disorders. In this investigation, the authors made a plan to elucidate this mechanism. The subjects were 30 cases of non-progressive diseases, such as postoperative lesions of ruptured aneurysms, and intracerebral hematomas. We proved that the cerebral function improves after the cranioplasty by an average score of 5.7 on Hasegawa's simple intelligent evaluation scale and by 88.9% in EEG. The morphological change was observed by a CT scan, which showed as a compressive deformity of the lateral ventricle, subdural fluid collection, and a prolonged residue of brain edema. These findings were rapidly and greatly improved after the cranioplasty. It was also found, by the measurement of the regional cerebral blood flow by means of SPECT, that the hemicerebral blood flow rate on the side of the decompressive craniectomy was significantly improved after the cranioplasty compared with the control group. From the above data, it was presumed that the persistence of neurological disorders in decompressive craniectomy is caused largely by a regional cerebral blood flow disorder. Therefore, the authors considered that, when external decompression is done, it is essential to perform cranioplasty as soon as possible after the intracranial pressure has been relieved. (author)

  15. Comparision of overweight and obesity in medical cadets before and after 6 months studying at Phramongkutklao College.

    Science.gov (United States)

    Suwan, Kijja; Hatthachote, Panadda; Panichkul, Suthee; Phromphetcharat, Varee

    2012-05-01

    To evaluate prevalence of overweight and obesity in second-year medical cadets and to determine risk behaviors before and after 6 months studying at Phramongkutklao College of Medicine (PCM). MATERIAL AMD METHOD: Data on self-report behavioral questionnaires was collected from 92 medical cadets before and after 6 months studying at PCM in 2008. Body weight, height, waist circumference, blood pressure and body fat were measured according to standard protocols. Overall, prevalence of overweight and obese medical cadets before studying at PCM was 16.30% and 15.22% according to BMI and 27.17% and 15.22% by percent body fat. After 6 months of study, overall mean of body fat and systolic blood pressure were significantly reduced. For males, the mean of weight, BMI and waist circumference were reduced significantly. In contrast, the mean of body weight and BMI of females were significantly increased. The prevalence of overweight in total participants determined by body fat was significantly reduced from 27.17% to 15.22%. Determination by BMI, obesity was significantly reduced from 34.29% to 14.29% only in males. Behaviors that were found to be significantly increased (p watching TV or using a computer, and duration of sleep was also determined. The present study indicated that overweight, obesity, waist circumference and body fat of medical cadets were decreased after study at PCM which is possibly due to increasing exercise. Nevertheless, behavioral risks for obesity were also increasing, therefore, it might result in increased the prevalence of obesity in the future.

  16. Observational study of 1-year mortality rates before and after a major earthquake among Chinese nonagenarians.

    Science.gov (United States)

    Flaherty, Joseph H; Dong, Birong; Wu, Hongmei; Zhang, Yanling; Guralnik, Jack M; Malmstrom, Theodore K; Morley, John E

    2011-03-01

    Little is known about mortality among nonagenarians after an earthquake. Using secondary data analyses from the 2005 study called the Project of Longevity and Aging in Dujiangyan(n = 870), 1-year mortality rates were compared among a pre-earthquake group and a post-earthquake group of nonagenarians. All participants were from Dujiangyan, 50 km from the epicenter of the May 12, 2008 earthquake, in China. The pre-earthquake group was a subset of the 870 Project of Longevity and Aging in Dujiangyan participants, ages 93-95 years at the beginning of "Time Frame 1" (July 2005 through June 2006; n = 228). The post-earthquake group was a different subset of the 870 Project of Longevity and Aging in Dujiangyan participants, ages 93-95 years and alive at the beginning of Time Frame 2 (July 2008 through June 2009; n = 235). Time Frame 2 excluded a 7-week period following the earthquake in order to account for deaths due to trauma. Pre-earthquake health assessment data from the 2005 Project of Longevity and Aging in Dujiangyan study were used to calculate unadjusted/adjusted hazard ratios (HRs) for mortality. One-year mortality rates were 8.3% (19/228) and 16.2% (38/235) in the pre-earthquake group and the post-earthquake group, respectively (p =.01). In unadjusted analyses, only "being in the post-earthquake group" was associated with death (HR = 2.04; 95% confidence interval [CI], 1.17-3.53; p = .011). In the multivariable Cox regression model, being in the post-earthquake group continued to be the strongest risk factor associated with mortality (HR = 2.47; 95% CI, 1.39-4.40; p = .002). Other significant risk factors included impaired cognition (HR = 1.97; 95% CI, 1.10-3.53; p = .024), serum albumin (HR = 0.90; 95% CI, 0.82-0.98; p earthquake in Wenchuan, China, was associated with a twofold increase in the 1-year mortality among a group of nonagenarians who lived nearby.

  17. Obstructive sleep apnea: a polysomnographic study of sleep apnea before and after tonsillectomy and adenoidectomy.

    Science.gov (United States)

    Weninger, M; Saletu, B; Popow, C; Götz, M; Haschke, F

    1988-11-01

    We report about polysomnographic studies including EEG, EOG, EMG, ECG, measurement of oropharyngeal airflow, recording of chest wall movements and transcutaneous measurements of pO2 and pCO2 in a 4-year-old girl with severe obstructive sleep apnea. Her sleep profile was characterized by a disturbed cyclic pattern of sleep stages with onset of sleep at stage 4, shortening of REM-sleep periods and of sleep stages 1 and 2, and an increased quantity of sleep stage 4. The total time spent in apneic episodes was 11.3% of the total sleep period (only obstructive events). Apneic attacks were recorded mainly in REM and light NREM sleep states. Tonsillectomy and adenoidectomy resulted in marked improvement without further evidence of abnormal sleeping pattern or of sleep apneas.

  18. Before and after the earthquake: a case study of attrition from the HIV antiretroviral therapy program in Haiti

    Science.gov (United States)

    Puttkammer, Nancy H.; Zeliadt, Steven B.; Balan, Jean Gabriel; Baseman, Janet G.; Destiné, Rodney; Domerçant, Jean Wysler; Duvilaire, Jean Marie; Raphael, Nernst Atwood; Sherr, Kenneth; Yuhas, Krista; Barnhart, Scott

    2014-01-01

    Background On January 12, 2010, a devastating 7.0 magnitude earthquake struck the West Department of Haiti, killing more than 200,000 people and injuring or displacing many more. This disaster threatened continuity of HIV care and treatment services. Objectives This case study examined the effect of the devastating 2010 earthquake in Haiti on attrition from the HIV antiretroviral therapy (ART) program. Design The study triangulated retrospective data from existing sources, including: 1) individual-level longitudinal patient data from an electronic medical record for ART patients at two large public sector departmental hospitals differently affected by the earthquake; and 2) aggregate data on the volume of HIV-related services delivered at the two hospitals before and after the earthquake. Methods The study compared ART attrition and service delivery in Jacmel, a site in the ‘very strong’ zone of earthquake impact, and in Jérémie, a site in the ‘light’ zone of earthquake impact. The analysis used time-to-event analysis methods for the individual-level patient data, and descriptive statistical methods for the aggregate service delivery data. Results Adjusted ART attrition risk was lower at the hospital in Jacmel after vs. before the earthquake (HR=0.51; p=0.03), and was lower in Jacmel vs. Jérémie both before (HR=0.55; p=0.01) and after the earthquake (HR=0.35; p=0.001). The number of new ART patient enrollments, new HIV patient registrations, and HIV clinical visits dropped notably in Jacmel immediately after the earthquake, but then rapidly rebounded. On average, there was no change in new ART enrollments per month after vs. before the earthquake at either site. Conclusion These findings underscore the resilience of Haitian ART providers and patients, and contribute evidence that it is possible to maintain continuity of ART services even in the context of a complex humanitarian crisis. PMID:25103146

  19. Before and after the earthquake: a case study of attrition from the HIV antiretroviral therapy program in Haiti

    Directory of Open Access Journals (Sweden)

    Nancy H. Puttkammer

    2014-08-01

    Full Text Available Background: On January 12, 2010, a devastating 7.0 magnitude earthquake struck the West Department of Haiti, killing more than 200,000 people and injuring or displacing many more. This disaster threatened continuity of HIV care and treatment services. Objectives: This case study examined the effect of the devastating 2010 earthquake in Haiti on attrition from the HIV antiretroviral therapy (ART program. Design: The study triangulated retrospective data from existing sources, including: 1 individual-level longitudinal patient data from an electronic medical record for ART patients at two large public sector departmental hospitals differently affected by the earthquake; and 2 aggregate data on the volume of HIV-related services delivered at the two hospitals before and after the earthquake. Methods: The study compared ART attrition and service delivery in Jacmel, a site in the ‘very strong’ zone of earthquake impact, and in Jérémie, a site in the ‘light’ zone of earthquake impact. The analysis used time-to-event analysis methods for the individual-level patient data, and descriptive statistical methods for the aggregate service delivery data. Results: Adjusted ART attrition risk was lower at the hospital in Jacmel after vs. before the earthquake (HR=0.51; p=0.03, and was lower in Jacmel vs. Jérémie both before (HR=0.55; p=0.01 and after the earthquake (HR=0.35; p=0.001. The number of new ART patient enrollments, new HIV patient registrations, and HIV clinical visits dropped notably in Jacmel immediately after the earthquake, but then rapidly rebounded. On average, there was no change in new ART enrollments per month after vs. before the earthquake at either site. Conclusion: These findings underscore the resilience of Haitian ART providers and patients, and contribute evidence that it is possible to maintain continuity of ART services even in the context of a complex humanitarian crisis.

  20. Before and after the earthquake: a case study of attrition from the HIV antiretroviral therapy program in Haiti.

    Science.gov (United States)

    Puttkammer, Nancy H; Zeliadt, Steven B; Balan, Jean Gabriel; Baseman, Janet G; Destiné, Rodney; Domerçant, Jean Wysler; Duvilaire, Jean Marie; Raphael, Nernst Atwood; Sherr, Kenneth; Yuhas, Krista; Barnhart, Scott

    2014-01-01

    On January 12, 2010, a devastating 7.0 magnitude earthquake struck the West Department of Haiti, killing more than 200,000 people and injuring or displacing many more. This disaster threatened continuity of HIV care and treatment services. This case study examined the effect of the devastating 2010 earthquake in Haiti on attrition from the HIV antiretroviral therapy (ART) program. The study triangulated retrospective data from existing sources, including: 1) individual-level longitudinal patient data from an electronic medical record for ART patients at two large public sector departmental hospitals differently affected by the earthquake; and 2) aggregate data on the volume of HIV-related services delivered at the two hospitals before and after the earthquake. The study compared ART attrition and service delivery in Jacmel, a site in the 'very strong' zone of earthquake impact, and in Jérémie, a site in the 'light' zone of earthquake impact. The analysis used time-to-event analysis methods for the individual-level patient data, and descriptive statistical methods for the aggregate service delivery data. Adjusted ART attrition risk was lower at the hospital in Jacmel after vs. before the earthquake (HR=0.51; p=0.03), and was lower in Jacmel vs. Jérémie both before (HR=0.55; p=0.01) and after the earthquake (HR=0.35; p=0.001). The number of new ART patient enrollments, new HIV patient registrations, and HIV clinical visits dropped notably in Jacmel immediately after the earthquake, but then rapidly rebounded. On average, there was no change in new ART enrollments per month after vs. before the earthquake at either site. These findings underscore the resilience of Haitian ART providers and patients, and contribute evidence that it is possible to maintain continuity of ART services even in the context of a complex humanitarian crisis.

  1. A Study of Stranding of Juvenile Salmon by Ship Wakes Along the Lower Columbia River Using a Before-and-After Design: Before-Phase Results

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, Walter H.; Skalski, J R.; Sobocinski, Kathryn L.; Miller, Martin C.; Johnson, Gary E.; Williams, Greg D.; Southard, John A.; Buchanan, Rebecca A.

    2006-02-01

    Ship wakes produced by deep-draft vessels transiting the lower Columbia River have been observed to cause stranding of juvenile salmon. Proposed deepening of the Columbia River navigation channel has raised concerns about the potential impact of the deepening project on juvenile salmon stranding. The Portland District of the U.S. Army Corps of Engineers requested that the Pacific Northwest National Laboratory design and conduct a study to assess stranding impacts that may be associated with channel deepening. The basic study design was a multivariate analysis of covariance of field observations and measurements under a statistical design for a before and after impact comparison. We have summarized field activities and statistical analyses for the ?before? component of the study here. Stranding occurred at all three sampling sites and during all three sampling seasons (Summer 2004, Winter 2005, and Spring 2005), for a total of 46 stranding events during 126 observed vessel passages. The highest occurrence of stranding occurred at Barlow Point, WA, where 53% of the observed events resulted in stranding. Other sites included Sauvie Island, OR (37%) and County Line Park, WA (15%). To develop an appropriate impact assessment model that accounted for relevant covariates, regression analyses were conducted to determine the relationships between stranding probability and other factors. Nineteen independent variables were considered as potential factors affecting the incidence of juvenile salmon stranding, including tidal stage, tidal height, river flow, current velocity, ship type, ship direction, ship condition (loaded/unloaded), ship speed, ship size, and a proxy variable for ship kinetic energy. In addition to the ambient and ship characteristics listed above, site, season, and fish density were also considered. Although no single factor appears as the primary factor for stranding, statistical analyses of the covariates resulted in the following equations: (1) Stranding

  2. Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after study

    DEFF Research Database (Denmark)

    Johansson, P I; Stensballe, J

    2009-01-01

    BACKGROUND AND OBJECTIVES: Evidence supporting the use of platelets and plasma in resuscitation of massive bleedings is questionable. Current consensus guidelines recommend restrictive use. Our aim was to determine the effect of changing the transfusion practice on 30-day survival in massively...... bleeding patients. MATERIALS AND METHODS: Consecutive adult patients receiving more than 10 units of red blood cells (RBC) within 24 h 2 years prior to (2002-2003) and 2 years after (2005-2006) a change in transfusion practice were included. In 2004, we implemented Haemostatic Control Resuscitation (HCR......) with preemptive use of platelets and plasma, administered in transfusion packages, comprising 5 units of RBCs, 5 units of fresh-frozen plasma and 2 units of platelet concentrates (PC), when massive bleeding occurred or upon arrival at the emergency room and thereafter directed by thrombelastography throughout...

  3. Examining College Students' Culture Learning before and after Summer Study Abroad in Japan

    Science.gov (United States)

    Paik, Chie Matsuzawa; Anzai, Shinobu; Zimmerman, Erica

    2011-01-01

    With study abroad becoming an integral part of the American higher-education curriculum, home-institution instructors face the challenge of understanding the type and content of learning taking place abroad. We report on a study conducted at a service academy on the U.S. East Coast to examine American college students' cultural learning in the…

  4. Analysis by NASA's VESGEN Software of Retinal Blood Vessels Before and After 70-Day Bed Rest: A Retrospective Study

    Science.gov (United States)

    Raghunandan, Sneha; Vyas, Ruchi J.; Vizzeri, Gianmarco; Taibbi, Giovanni; Zanello, Susana B.; Ploutz-Snyder, Robert; Parsons-Wingerter, Patricia A.

    2016-01-01

    Significant risks for visual impairment associated with increased intracranial pressure (VIIP) are incurred by microgravity spaceflight, especially long-duration missions. Impairments include decreased near visual acuity, posterior globe flattening, choroidal folds, optic disc edema and cotton wool spots. We hypothesize that microgravity-induced fluid shifts result in pathological changes within the retinal blood vessels that precede development of visual and other ocular impairments. Potential contributions of retinal vascular remodeling to VIIP etiology are therefore being investigated by NASAs innovative VESsel GENeration Analysis (VESGEN) software for two studies: (1) head-down tilt in human subjects before and after 70 days of bed rest, and (2) U.S. crew members before and after ISS missions. VESGEN analysis in previous research supported by the US National Institutes of Health identified surprising new opportunities to regenerate retinal vessels during early-stage, potentially reversible progression of the visually impairing and blinding disease, diabetic retinopathy.

  5. Sick leave in patients with ankylosing spondylitis before and after anti-TNF therapy: a population-based cohort study.

    Science.gov (United States)

    Kristensen, Lars E; Petersson, Ingemar F; Geborek, Pierre; Jöud, Anna; Saxne, Tore; Jacobsson, Lennart T H; Englund, Martin

    2012-02-01

    To study levels of sick leave and disability pension before and after TNF-antagonist therapy in AS patients. Using the population-based South Swedish Arthritis Treatment Group register, we identified 139 AS patients (aged 18-58 years, 78% men), who between January 2002 and December 2008 started their first treatment with adalimumab, etanercept or infliximab. We linked data to the payment register by the Swedish Social Insurance Agency and calculated the proportion on sick leave in 30-day intervals from 12 months before treatment start until 12 months after. For each AS patient, we randomly selected four subjects from the general population matched for age, sex and area of residence. One to 3 months before treatment, an average of 24% of AS patients were on sick leave. During the first 6 months after treatment start, this fraction dropped to 15%, and further declined to 12% at 12 months (P patients with the general population, the relative risk of being on sick leave 3 months before treatment, treatment start and 12 months after treatment start was 8.0 (95% CI 4.6, 13.9), 9.2 (95% CI 5.4, 15.7) and 4.0 (95% CI 2.1, 6.3), respectively. The decrease in sick leave was not substantially offset by changes in disability pension. There is a decline in sick leave during the first 12 months after initiation of TNF-antagonist treatment in AS patients not explained by societal factors or secular trends. The proportion of AS patients on disability pension remained unchanged during the observation period.

  6. Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study

    Directory of Open Access Journals (Sweden)

    Jeongmin Kim

    2014-11-01

    CONCLUSIONS: Repeated education led by a multidisciplinary team and interdisciplinary communication improved the compliance rate of the 6-h resuscitation bundle in severe sepsis and septic shock patients. Compliance with the sepsis resuscitation bundle was associated with improved 28-day mortality in the study population.

  7. Ultra-structural study of Egyptian Buffalo oocytes before and after in ...

    African Journals Online (AJOL)

    The oocytes examined in this study showed normal ultra-structure of mitochondria, smooth endoplasmic reticulum (SER), zona pellucida (ZP), lipid droplets, vesicles and Golgi in the good type meanwhile, some differences and abnormalities in denuded oocytes were recorded. The most remarkable changes observed in the ...

  8. Executive functioning before and after onset of alcohol use disorder in adolescence. A TRAILS study

    NARCIS (Netherlands)

    Boelema, Sarai R.; Harakeh, Zeena; van Zandvoort, Martine J. E.; Reijneveld, Sijmen A.; Verhulst, Frank C.; Ormel, Johan; Vollebergh, Wilma A. M.

    Introduction: The aim of the present study was to investigate whether executive functioning (EF) in early adolescence predicted alcohol use disorder (AUD) in late adolescence and whether adolescents with AUD differed in maturation of EF from controls without a diagnosis. Methods: We used the data

  9. A register-based study of long-term healthcare use before and after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    2014-01-01

    hospitals (P long-term period, patients who completed psychotherapeutic......Abstract Background: Psychotherapeutic treatment for non-psychotic disorders is associated with significant reduction in patients' symptoms, and therefore it is believed that treatment improves health and decreases the need for additional healthcare. However, little is known about long-term changes...... in utilization of healthcare services. Aim: To investigate long-term changes in utilization of public healthcare services for patients referred to psychotherapeutic treatment. Methods: A pre-post study with 761 consecutive patients and 15,220 matched individuals in a matched population reference group. Data from...

  10. A register-based study of long-term healthcare use before and after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten; Mortensen, Erik Lykke; Poulsen, Stig

    2014-01-01

    in contacts with psychiatric hospitals (P long-term period, patients who......UNLABELLED: Abstract Background: Psychotherapeutic treatment for non-psychotic disorders is associated with significant reduction in patients' symptoms, and therefore it is believed that treatment improves health and decreases the need for additional healthcare. However, little is known about long-term...... changes in utilization of healthcare services. AIM: To investigate long-term changes in utilization of public healthcare services for patients referred to psychotherapeutic treatment. METHODS: A pre-post study with 761 consecutive patients and 15,220 matched individuals in a matched population reference...

  11. Home smoking restrictions before, during and after pregnancy-a qualitative study in rural China.

    Science.gov (United States)

    Mao, Aimei; Robinson, Jude

    2016-09-01

    Worldwide, many nonsmokers (often women and children) are exposed to second-hand smoke (SHS) in home settings, as men retain their traditional power and control within their family and women and children have limited agency to intervene. This study, set up to explore home smoking management in rural China, found that some women were able to positively intervene to restrict men's smoking at three key stages: prior to conception, during their pregnancy and at the early years of their children's lives. By utilizing dominant social, health and political narratives about the importance of raising a healthy child supported by the One-Child Policy in China, combined with the fear of health risks of SHS to young children, the women were able to use their elevated status as bearer and carers of the only children to subvert the pre-eminence of men in domestic environments, enabling them to positively influence home smoking. While this study highlights the possibility for future smoking cessation initiatives in China by incorporating family carers' elevated awareness of protection of children's health in key stages of childhood, there is also a need for further health education, as family members were unsure why they needed to keep children smoke-free, which may partially explain why few households were smoke-free. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Radioisotopic studies in renovascular hypertension before and after surgery or percutaneous transluminal renal angioplasty

    International Nuclear Information System (INIS)

    Mantero, F.; Fallo, F.; Scaroni, C.; Ridolfi, P.; Sicolo, M.; Varotta, L.; Bui, F.

    1987-01-01

    Over the past few years, radioisotopic studies have emerged as reliable diagnostic procedures in the screening for renovascular hypertension. More specifically, dynamic reno-scintigraphy (DRS) has been proved to be very sensitive in revealing hypoperfusion due to renal artery stenosis, although it cannot compete with the accuracy of arteriography, which only may provide a definitive diagnosis. Moreover, DRS appears to be a convenient test in clinical routine investigation because of its simplicity, low dose of tracer and high margin of safety for the patients

  13. [Comparson study of two types of constituents in seeds of Cassia obtusifolia before and after roasted].

    Science.gov (United States)

    Li, Guiliu; Xiao, Yongqing; Zhang, Cun; Li, Li; Pang, Zhen

    2009-06-01

    To establish methods of RP-HPLC respectively for content-determination of two types of constituents in the Cassia obtusifolia respectively, and tp determine the constituents between the raw and roasted seeds of C. obtusifolia in order to distinguish the difference of those seeds. HPLC systems consisted of Alltima C18 (4.6 mm x 150 mm, 5 microm), column temperature at 30 degrees C, flow rate of 1.0 mL x min(-1). Two different mobile phases and detection wavelengths: I , ACN-THF-0.1% H3 PO4 (17 : 3:80), 278 nm; II , MeOH-0.1% H3PO4 (79:21), 254 nm. Analyzed and compared the content of the two types of constituents between the raw and roasted seeds of C. obtusifolia. The calibrate curves of 5 constituents were linear (r > 0.999 7). The precision and repeatability were perfect (RSD < 1.6%, 1.8%). The samples were stabile during 24 h. The study provide a better universal reference for evaluating and controlling the quality of C. obtusifolia pieces.

  14. A review of epidemiologic studies on suicide before, during, and after the Holocaust.

    Science.gov (United States)

    Levav, Itzhak; Klomek, Anat Brunstein

    2018-03-01

    The available literature on the risk of suicides related to the Holocaust (1939-1945) and its aftermath differs in its time periods, in the countries investigated, and in the robustness of its sources. Reliable information seems to indicate that the risk of suicide for Jews in Nazi Germany and Austria during the pre-war period (1933-1939) was elevated, while information on suicide during the internment in the concentration camps is fraught with problems. The latter derives from the Nazis' decision to hide the statistics on the inmates' causes of death, and from the prevailing life conditions that impeded separation between self-inflicted death and murder. Reliable studies conducted in Israel among refugees who entered pre-state Israel, 1939-1945, and post-World War II survivors reaching Israel (1948 on), show a mixed picture: suicide rates among the former were higher than comparison groups, while the latter group shows evidence of resilience. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Liberal Glucose Control in ICU Patients With Diabetes: A Before-and-After Study.

    Science.gov (United States)

    Luethi, Nora; Cioccari, Luca; Biesenbach, Peter; Lucchetta, Luca; Kagaya, Hidetoshi; Morgan, Rhys; Di Muzio, Francesca; Presello, Barbara; Gaafar, Duaa; Hay, Alison; Crisman, Marco; Toohey, Roisin; Russell, Hollie; Glassford, Neil J; Eastwood, Glenn M; Ekinci, Elif I; Deane, Adam M; Bellomo, Rinaldo; Mårtensson, Johan

    2018-03-03

    To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes. Prospective, open-label, sequential period study. A 22-bed mixed ICU of a tertiary hospital in Australia. We compared 350 consecutive patients with diabetes admitted over 15 months who received liberal glucose control with a preintervention control population of 350 consecutive patients with diabetes who received conventional glucose control. Liberal control patients received insulin therapy if glucose was greater than 14 mmol/L (target: 10-14 mmol/L [180-252 mg/dL]). Conventional control patients received insulin therapy if glucose was greater than 10 mmol/L (target: 6-10 mmol/L [108-180 mg/dL]). We assessed separation in blood glucose, insulin requirements, occurrence of hypoglycemia (blood glucose ≤ 3.9 mmol/L [70 mg/dL]), creatinine and white cell count levels, and clinical outcomes. The median (interquartile range) time-weighted average blood glucose concentration was significantly higher in the liberal control group (11.0 mmol/L [8.7-12.0 mmol/L]; 198 mg/dL [157-216 mg/dL]) than in the conventional control group (9.6 mmol/L [8.5-11.0 mmol/L]; 173 mg/dL [153-198 mg/dL]; p liberal control patients (37.7%) and 188 conventional control patients (53.7%) received insulin in ICU (p liberal glucose control, insulin administration, and among patients with hemoglobin A1c greater than or equal to 7%, the prevalence of hypoglycemia was reduced, without negatively affecting serum creatinine, the white cell count response, or other clinical outcomes. (Trial Registration: Australian New Zealand Clinical Trials Registry; ACTRN12615000216516).

  16. [Deformations of acetabulum with load before and after prosthetic implantation. An experimental study by extensometry].

    Science.gov (United States)

    Massin, P; Landjerit, B; Roy-Camille, R; Thourot, M; Jacquard-Simon, N

    1993-01-01

    Using fresh cadavers pelves, an experimental model of unipodal stance was performed. The skeleton (femurs, pelvis and 2 lumbar vertebrae) was connected to the machine by non constrained junctions. Muscles (gluteus, iliacus and rectus abdominis) were simulated. Using this model, monopodal stance could be maintained under load. Strain measurements were performed on the periphery of the acetabulum. Results showed that periacetabular strains were dependent on the mobility of the lower lumbar intervertebral discs as well as on the type equilibrium (uni or bipodal). It was remarkable that the blockage of intervertebral rotations (experimental lombo-sacral arthrodesis) increased acetabular stiffness. The influence of total hip replacement was also studied. Periacetabular strains remained important around cementless press-fit cups. This would plead for a non weight bearing postoperative period in clinical practice of cementless arthroplasty. Important deformations also persisted around conventional cemented cups, justifying further research to limit periacetabular deformations around total hip prostheses, in the hope of limiting the rate of late acetabular loosening.

  17. A Patient Portal With Electronic Messaging: Controlled Before-and-After Study.

    Science.gov (United States)

    Riippa, Iiris; Linna, Miika; Rönkkö, Ilona

    2015-11-09

    willingness to pay for increased patient activation, whereas in the adjusted sample, the probability of the portal being more cost-effective than care as usual exceeded 50% probability at a willingness to pay €700 per clinically significant increase in patient activation score. There was no marked short-term impact on health status based on the SF-36v2 measure. Offering the possibility to substitute health care visits with less costly contacts using self-management tools did not seem to compromise the health status or treatment of chronic care patients. Patient activation increased, and this could be achieved with moderate costs in a short-term experiment. In the long term, increased activation is proposed to lead to better health outcomes and eventually cut down resource use. Future studies should assess the long-term effects of patient portals on patients' health status and cost of care.

  18. Comparative study of D2 receptors and content of DA in striatum before and after electro-acupuncture treatment

    International Nuclear Information System (INIS)

    Lin Yansong; Lin Xiangtong

    1999-01-01

    Objective: To evaluate the change of D 2 receptors and its relationship with DA content in experimental hemi-parkinsonism rats before and after electron-acupuncture treatment. Methods: 125 I-IBZM D 2 receptor cerebral autoradiographic analysis, HPLC-ECD DA and its metabolites, homovanillic acid (HVA), 3,4-di-hydroxyphenylacetic acid (DOPAC) content detection were used to study in striatum in before treatment, electro-acupuncture treatment and treatment control group. Results: 1) The DA, HVA and DOPAC level in striatum of lesioned side in electro-acupuncture group was increased comparing with the before treatment and treatment control group (P 125 I-IBZM uptake ratio was 8.04 +- 0.71, (29.34 +- 4.83)% more than that of the contralateral side, but no significant difference was observed as compared with that of the pretreatment group [(8.09 +- 0.52), P>0.05]; however it was much lower than that of the treatment control group (8.61 +- 0.63), P 2 receptors' up regulation in rats with experimental hemi-parkinsonism

  19. Selective serotonin reuptake inhibitorprescribing before, during and after pregnancy

    DEFF Research Database (Denmark)

    Charlton, Ra; Jordan, S; Pierini, A

    2015-01-01

    OBJECTIVE: To explore the prescribing patterns of selective serotonin reuptake inhibitors (SSRIs) before, during and after pregnancy in six European population-based databases. DESIGN: Descriptive drug utilisation study. SETTING: Six electronic healthcare databases in Denmark, the Netherlands...

  20. A Register-Based Study of Occupational Functioning in Non-Psychotic Patients Before and After Psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Poulsen, Stig Bernt; Mortensen, Erik Lykke

    2013-01-01

    . Method: We recruited 747 consecutive patients and 14,940 matched control subjects. Data on days on sick leave, unemployment and disability pension were collected for 2002-2007 from central registries and analyzed. Results: Of the 747 patients, 216 did not show up for treatment and 531 completed treatment....... Patients who completed treatment (completer patients) had, on average, 15.7 days on sick leave two years before treatment and 23.1 days on sick leave two years after treatment, while the control group had 5.4 and 7.5 days, respectively. Regarding disability pension, completer patients had 7.6 days before......Abstract: Background: Mental disorders are an important cause of occupational impairments. Little is known about whether psychotherapeutic treatment helps patients function in their jobs. This study investigated long-term changes in occupational functioning for patients referred to treatment...

  1. Ice Harbor Spillway Dissolved Gas Field Studies: Before and After Spillway Deflectors

    Science.gov (United States)

    2016-07-01

    environmental challenges. ERDC develops innovative solutions in civil and military engineering, geospatial sciences, water resources, and environmental...Dissolved oxygen Hydraulic structures Spillways Stilling basins Water--Air entrainment Tailwater ecology Ice Harbor Dam

  2. LONGITUDINAL STUDY ON LIVER FUNCTIONS IN PATIENTS WITH THALASSEMIA MAJOR BEFORE AND AFTER DEFERASIROX (DFX THERAPY

    Directory of Open Access Journals (Sweden)

    Ashraf Tawfik Soliman

    2014-04-01

    Conclusions: Some impairment of liver function can occur in hepatitis negative BMT patients with iron overload. The use of DFX was associated with mild but significant reduction of ALT, AST and ALP and increase in IGF-I levels. The negative correlation between IGF-I and ALT concentrations suggest that preventing hepatic dysfunction may improve the growth potential in these patients.

  3. Ultra-structural study of Egyptian Buffalo oocytes before and after in ...

    African Journals Online (AJOL)

    Yomi

    2012-04-12

    Apr 12, 2012 ... In vitro maturation (IVM) of oocytes from small antral follicles could reduce the need for exogenous ... [mouse (Merchant and Chang, 1971), human (Zamboni and Thomson, 1972), cattle (Hyttel et al., 1997) and .... appeared as a flocculent layer easily differentiated from zona pellucida. The cumulus cells had ...

  4. Changes in Rotavirus Genotypes before and after Vaccine Introduction: a Multicenter, Prospective Observational Study in Three Areas of Japan.

    Science.gov (United States)

    Tanaka, Takaaki; Kamiya, Hajime; Asada, Kazutoyo; Suga, Shigeru; Ido, Masaru; Umemoto, Masakazu; Ouchi, Kazunobu; Ito, Hiroaki; Kuroki, Haruo; Nakano, Takashi; Taniguchi, Koki

    2017-07-24

    In Japan, monovalent and pentavalent rotavirus (RV) vaccines were approved in 2011 and 2012, respectively. To monitor changes in the RV genotypes before and after vaccine introduction, we performed a prospective observational study among children (< 5 years) with gastroenteritis who tested RV-positive on antigen rapid tests. Stool samples were collected from 3 different sites in Japan: Tsu City, Mie Prefecture; Kurashiki City, Okayama Prefecture; and Isumi City, Chiba Prefecture. RV genotypes were determined using reverse transcription-polymerase chain reaction. In Tsu City, G3P[8] was dominant (61.0-77.1%) before vaccine introduction, but decreased after introduction. Meanwhile, in an inverse proportion to the decrease in G3P[8], G1P[8] increased until the 2013/14 season, when a sudden predominance of G2P[4] (100%) occurred. A similar trend was observed in Kurashiki City in terms of the extent of reduction in G3P[8] and the emergence of G2P[4]. In Isumi City, G1P[8] was dominant (70.3%) before vaccine introduction, and G9P[8] became predominant (83.3%) in the 2013/14 season. To determine whether the genotype changes are attributable to vaccines or natural epidemiological changes, ongoing continuous monitoring of the RV genotypes is required.

  5. Vulnerability before, during, and after a major depressive episode - A 3-wave population-based study

    NARCIS (Netherlands)

    Ormel, J; Oldehinkel, AJ; Vollebergh, W

    2004-01-01

    Background: Vulnerability as defined by high levels of neuroticism, low self-esteem, and poor coping skills characterizes individuals with a history of major depressive episodes (MDEs). Objective: To separate postmorbid vulnerability into (1) trait effects (ie, the continuation of premorbid

  6. Vulnerability Before, During, and After a Major Depressive Episode : A 3-Wave Population-Based Study

    NARCIS (Netherlands)

    Ormel, J.; Oldehinkel, A.J.; Vollebergh, W.A.M.

    2004-01-01

    Background Vulnerability as defined by high levels of neuroticism, low self-esteem, and poor coping skills characterizes individuals with a history of major depressive episodes (MDEs). Objective To separate postmorbid vulnerability into (1) trait effects (ie, the continuation of premorbid

  7. How Military Families Respond Before, During and After Deployment: Findings from the RAND Deployment Life Study

    Science.gov (United States)

    2016-01-01

    of separation may be important for avoiding the longer-term impairments caused by these problems, such as increased morbidity, homelessness ...effects are produced. This brief describes work done jointly in the RAND Arroyo Center and the RAND National Defense Research Institute documented

  8. Health problems of victims before and after disaster: a longitudinal study in general practice.

    NARCIS (Netherlands)

    Yzermans, C.J.; Donker, G.A.; Kerssens, J.J.; Dirkzwager, A.J.E.; Soeteman, R.J.H.; Veen, P.M.H. ten

    2005-01-01

    BACKGROUND: We aimed to quantify the health problems and to assess the possible risk factors for developing health problems in persons affected by the explosion of a firework depot at Enschede, The Netherlands, on May 13, 2000. The explosion considerably damaged buildings in the local neighbourhood

  9. A Case Study of Letters to Shareholders in Annual Reports Before, During and After the Financial Crisis

    DEFF Research Database (Denmark)

    Dragsted, Barbara

    2014-01-01

    The present study investigates changes in themes and linguistic strategies in letters to shareholders from a large Danish bank’s annual reports published before, during and after the financial crisis. It draws mainly on genre theory and uses corpus linguistics as the primary method for collecting...... the first (pre-crisis) and second (during crisis) periods differ from each other mainly with respect to the themes discussed in light of the developments in external circumstances and the bank’s financial performance, the latter (post-crisis) period reflects a more fundamental shift in genre, manifested...

  10. PET Study in a Patient with Spinocerebellar Degeneration before and after Long-Term Administration of Thyrotropin Releasing Hormone

    Directory of Open Access Journals (Sweden)

    H. Tanji

    1996-01-01

    Full Text Available We studied the chronic effect of thyrotropin releasing hormone (TRH in a patient with spinocerebellar degeneration by measuring cerebral metabolic rate for glucose (CMRG1c using 2-[18F]fluoro-2-deoxy-D-glucose (18FDG and positron emission tomography (PET. A 56-year-old female, who had suffered from progressive ataxia for 2 years, was treated by intravenous administration of 2 mg TRH for 3 weeks, and CMRG1c of the brain was measured before and after treatment. CMRG1c was markedly decreased in the cerebellum and there was no significant difference before and after the treatment, i.e. mean CMRG1c values were 4.92 and 4.90 mg/100 g/min, and the ratios of the cerebellum versus the frontal cortex were 0.50 and 0.51, respectively. The degree of disequilibrium of her body examined with stabilography became better by the 19th day and further improved by the 26th day after the start of TRH treatment. Based on the present study we conclude that long-term administration of TRH did not improve CMRG1c in the cerebellum, but evidently improved the sway of gravity center by stabilography. We speculate that the chronic effect of TRH was not necessarily due to an improvement of cerebellar function, because TRH receptors are widely distributed throughout the central nervous system.

  11. Nutrient deficiencies before and after sleeve gastrectomy.

    Science.gov (United States)

    van Rutte, P W J; Aarts, E O; Smulders, J F; Nienhuijs, S W

    2014-10-01

    Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year. Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found. Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %. In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.

  12. Societal costs and patients' experience of health inequities before and after diagnosis of psoriatic arthritis: a Danish cohort study.

    Science.gov (United States)

    Kristensen, Lars Erik; Jørgensen, Tanja S; Christensen, Robin; Gudbergsen, Henrik; Dreyer, Lene; Ballegaard, Christine; Jacobsson, Lennart T H; Strand, Vibeke; Mease, Philip J; Kjellberg, Jakob

    2017-09-01

    To comprehensively study the comorbidities, healthcare and public transfer (allowance) costs in patients with psoriatic arthritis (PsA) before and after diagnosis. Nationwide cohort study, using data from Danish registries from January 1998 through December 2014. A total of 10 525 patients with PsA and 20 777 matched general population comparator (GPC) subjects were included. Societal costs, employment status and occurrence of comorbidities in patients with PsA both before and after diagnosis were compared with GPC subjects. At baseline, patients with PsA had significantly more comorbidities, including cardiovascular disease (OR 1 . 70 95% CI 1 . 55 to 1 . 86), respiratory diseases (OR 1 . 73 95% CI 1 . 54 to 1 . 96) and infectious diseases (OR 2 . 03 95% CI 1 . 69 to 2 . 42) compared with GPC subjects. At all time points, patients with PsA had higher total healthcare and public transfer costs; they also had lower income (psocietal cost of €10 641 per patient-year compared with GPC subjects following diagnosis. The relative risk (RR) for being on disability pension 5 years prior to PsA diagnosis was 1 . 36 (95% CI 1 . 24 to 1 . 49) compared with GPC subjects. The RR increased to 1 . 60 (95% CI 1 . 49 to 1 . 72) at the time of diagnosis and was 2 . 69 (95% CI 2 . 40 to 3 . 02) 10 years after diagnosis, where 21 . 8% of the patients with PsA received disability pension. Our findings are suggestive of health inequity for patients with PsA and call for individual preventive measures and societal action. 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/.

  13. Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study.

    Science.gov (United States)

    Zhu, Chunyan; Geng, Qingshan; Yang, Hongling; Chen, Li; Fu, Xianhua; Jiang, Wei

    2013-07-23

    Rural-to-urban female migrant workers have a lower quality of life compared to the general population. Improving these conditions remains highly challenging. This paper reports the health-related quality of life (HRQoL) of the female migrant workers in an educational project. In this before-and-after study, a community-based health education intervention was developed to improve female migrant workers' HRQoL and job satisfaction. A factory was selected as the location to implement the trial, using a before-and-after design. The education intervention included distribution and free access to study materials, monthly lectures, and counseling. The primary endpoint was HRQoL, and gynecological disease and job satisfaction were secondary endpoints. We assessed HRQoL at baseline and at 6-month follow-up using the Health Survey Short Form (SF-36). Compared to the baseline assessment, the participants at the 6-month survey reported higher General Health scores (standardized-β coefficients (Betas) of β = 0.056; P migrant workers, appears effective in improving HRQoL and job satisfaction.

  14. Type and Extent of Somatic Morbidity before and after the Diagnosis of Hypothyroidism. A Nationwide Register Study

    Science.gov (United States)

    Thvilum, Marianne; Brandt, Frans; Almind, Dorthe; Christensen, Kaare; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2013-01-01

    Background Hypothyroidism has been linked with an increased risk of other morbidities, such as cardiovascular diseases and diabetes mellitus. However, the temporal relationship between these diseases and the diagnosis of hypothyroidism is not well illuminated. Such information may provide insight into causal relationships between hypothyroidism and other morbidities. Aim To investigate the type and extent of somatic morbidity before and after a diagnosis of hypothyroidism. Methods Observational cohort study. From official Danish health registers, 2822 hypothyroid singletons were identified and matched 1:4 with non-hypothyroid controls and observed over a mean period of 6 years. Frequency of different morbidities was obtained by person-to-person linking in the registers. Logistic and Cox regression models were used to assess the risk of morbidity before and after the diagnosis of hypothyroidism, respectively. Results Prior to the diagnosis of hypothyroidism there was a significantly increased risk of being diagnosed with cardiovascular diseases (odds ratio (OR) 1.37; 95% confidence interval (CI): 1.19–1.58), lung diseases (OR 1.25; 95% CI: 1.13–1.39), diabetes mellitus (OR 1.92; 95% CI: 1.61–2.29), as well as malignant diseases (OR 1.24; 95% CI: 1.06–1.45). Following the diagnosis of hypothyroidism there was a significantly increased risk of being diagnosed with cardiovascular diseases (hazard ratio (HR) 1.36; 95% CI: 1.15–1.60); lung diseases (HR 1.51; 95% CI: 1.30–1.75); and diabetes mellitus (HR 1.40; 95% CI: 1.11–1.77). Conclusions Prior to the diagnosis of hypothyroidism there is an excess risk of being diagnosed with cardiovascular diseases, lung diseases, diabetes mellitus, and malignant diseases. Following the diagnosis of hypothyroidism we demonstrate an increased frequency of cardiovascular diseases, lung diseases, and diabetes mellitus. PMID:24066186

  15. New method for retrospective study of hemodynamic changes before and after aneurysm formation in patients with ruptured or unruptured aneurysms

    Science.gov (United States)

    2013-01-01

    Background Prospective observation of hemodynamic changes before and after formation of brain aneurysms is often difficult. We used a vessel surface repair method to carry out a retrospective hemodynamic study before and after aneurysm formation in a ruptured aneurysm of the posterior communicating artery (RPcomAA) and an unruptured aneurysm of the posterior communicating artery (URPcomAA). Methods Arterial geometries obtained from three-dimensional digital subtraction angiography of cerebral angiograms were used for flow simulation by employing finite-volume modeling. Hemodynamic parameters such as wall shear stress (WSS), blood-flow velocity, streamlines, pressure, and wall shear stress gradient (WSSG) in the aneurysm sac and at the site of aneurysm formation were analyzed in each model. Results At “aneurysm” status, hemodynamic analyses at the neck, body, and dome of the aneurysm revealed the distal aneurysm neck to be subjected to the highest WSS and blood-flow velocity, whereas the aneurysm dome presented the lowest WSS and blood-flow velocity in both model types. More apparent changes in WSSG at the aneurysm dome with an inflow jet and narrowed impaction zone were revealed only in the RPcomAA. At “pre-aneurysm” status, hemodynamic analyses in both models showed that the region of aneurysm formation was subjected to extremely elevated WSS, WSSG, and blood-flow velocity. Conclusions These data suggest that hemodynamic analyses in patients with ruptured or unruptured aneurysms using the vessel surface repair method are feasible, economical, and simple. Our preliminary results indicated that the arterial wall was subjected to elevated WSS, WSSG and blood-flow velocity before aneurysm generation. However, more complicated flow patterns (often with an inflow jet or narrowed impaction zone) were more likely to be observed in ruptured aneurysm. PMID:24195732

  16. A Longitudinal Study of Motivations Before and Psychosexual Outcomes After Genital Gender-Confirming Surgery in Transmen.

    Science.gov (United States)

    van de Grift, Tim C; Pigot, Garry L S; Boudhan, Siham; Elfering, Lian; Kreukels, Baudewijntje P C; Gijs, Luk A C L; Buncamper, Marlon E; Özer, Müjde; van der Sluis, Wouter; Meuleman, Eric J H; Bouman, Mark-Bram; Mullender, Margriet G

    2017-12-01

    Genital dissatisfaction is an important reason for transmen to undergo genital gender-confirming surgery (GCS; phalloplasty or metoidioplasty). However, little is known about motives for choosing specific techniques, how transmen benefit postoperatively, and whether psychosexual outcomes improve. To evaluate motivations for and psychosexual outcomes after GCS. A longitudinal study of 21 transmen at least 1 year after GCS was conducted. Participants were recruited through their surgeon. Data were collected when they applied for surgery and at least 1 year after surgery. Data collection included semistructured questionnaires on motivations for surgery, postoperative experiences, and standardized measures of psychological symptoms, body image, self-esteem, sexuality, and quality of life (pre- and postoperative). Information on surgical complications and corrections was retrieved from medical records. Most participants underwent phalloplasty with urethral lengthening using a radial forearm flap. Although problematic voiding symptoms were prevalent, many participants were satisfied with their penile function. The strongest motivations to pursue penile surgery were confirmation of one's identity (100%), enabling sexual intercourse (78%), and voiding while standing (74%). No significant differences between postoperative and reference values were observed for standardized measures. After surgery, transmen were more sexually active (masturbation and with a partner) and used their genitals more frequently during sex compared with before surgery (31-78%). The present study provides input for preoperative decision making: (i) main motives for surgery include identity confirmation, voiding, and sexuality, (ii) surgery can result in more sexual activity and genital involvement during sex, although some distress can remain, but (iii) complications and voiding symptoms are prevalent. Study strengths include its longitudinal design and the novelty of the studied outcomes. The main

  17. Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study.

    Science.gov (United States)

    Vermaete, Nele; Wolter, Pascal; Verhoef, Gregor; Gosselink, Rik

    2014-03-01

    Fatigue is a common and distressing symptom in cancer patients, especially in lymphoma patients. One hypothesized mechanism in the etiology of fatigue is a vicious circle between fatigue, physical inactivity, and deconditioning. However, the natural evolution of physical activity and physical fitness over the course of treatment is unknown. Therefore, the aim of this longitudinal study was to assess fatigue, physical activity, and physical fitness in lymphoma patients before, during, and after treatment. Fatigue was measured with the EORTC-QLQ-C30, physical activity with an accelerometer, and physical fitness with a maximal incremental cycle ergometer test, 6-min walking distance test, and muscle strength measurements. Differences between the three measurement moments and baseline differences between Hodgkin lymphoma and non-Hodgkin lymphoma, early and advanced disease, were analyzed. Twenty-nine patients were included. Functional exercise capacity and quadriceps force were impaired before the start of treatment (86 ± 15 and 82 ± 16 % of predicted value, respectively). Over the course of treatment, significant declines were found in hemoglobin, quadriceps force, handgrip force, and maximal oxygen uptake, while patients reported more fatigue (p values physical activity (r = 0.81), and physical functioning (r = -0.44). Large interindividual variations were found. The present study partially confirmed the hypothesized vicious circle between fatigue, physical inactivity, and deconditioning. Further research with larger samples and longer follow-up is needed to identify factors associated with individual variation in the evolution of fatigue, physical activity, and physical fitness.

  18. Imaging before and after uterine artery embolization

    International Nuclear Information System (INIS)

    Kroencke, T.J.

    2008-01-01

    Percutaneous catheter-based embolization treatment of symptomatic uterine fibroids has evolved into the most widely used alternative therapeutic approach to surgical treatment worldwide. Uterine artery embolization (UAE) induces infarction of leiomyomas, resulting in ischemic necrosis, hyaline degeneration, and size reduction with resolution of associated symptoms. Published experience suggests that UAE is an effective and reliable option for treating uterine fibroids with high patient satisfaction. Magnetic resonance imaging (MRI) is superior to ultrasonography for determining the site, size and number of fibroids, which is important for establishing the indication for UAE. Other potential advantages of MRI include the option of performing MR angiography (MRA) and obtaining contrast-enhanced images for monitoring the outcome of UAE and assessing possible complications after UAE. (orig.) [de

  19. Diffusion- and Perfusion-weighted MRI Studies Just Before and After Removal of Hypertensive Putaminal Hematoma: Case Report

    OpenAIRE

    木下, 良正; 安河内, 秀興; 原田, 篤邦; 津留, 英智; 奥寺, 利男; 横田, 晃; Yoshimasa, KINOSHITA; Hideoki, YASUKOUCHI; Atsukuni, HARADA; Eichi, TSURU; Toshio, OKUDERA; Akira, YOKOTA; 宗像水光会総合病院 脳神経外科; 宗像水光会総合病院 脳神経外科; 宗像水光会総合病院 脳神経外科

    2007-01-01

    It has been suspected that a zone of perihematomal ischemia analogous to an ischemic penumbra exists in patients with subacute putaminal hemorrhage who showed transient neurological improvement with hyperbaric oxygenation therapy (HBO). A 54-year-old woman, who suffered from left putaminal hemorrhage, was examined for regional hemodynamics in the perihematomal region just before and just after the removal of putaminal hematoma in the subacute period by diffusion and perfusion MRI. The pyramid...

  20. Trees and networks before and after Darwin

    Directory of Open Access Journals (Sweden)

    Ragan Mark A

    2009-11-01

    Full Text Available Abstract It is well-known that Charles Darwin sketched abstract trees of relationship in his 1837 notebook, and depicted a tree in the Origin of Species (1859. Here I attempt to place Darwin's trees in historical context. By the mid-Eighteenth century the Great Chain of Being was increasingly seen to be an inadequate description of order in nature, and by about 1780 it had been largely abandoned without a satisfactory alternative having been agreed upon. In 1750 Donati described aquatic and terrestrial organisms as forming a network, and a few years later Buffon depicted a network of genealogical relationships among breeds of dogs. In 1764 Bonnet asked whether the Chain might actually branch at certain points, and in 1766 Pallas proposed that the gradations among organisms resemble a tree with a compound trunk, perhaps not unlike the tree of animal life later depicted by Eichwald. Other trees were presented by Augier in 1801 and by Lamarck in 1809 and 1815, the latter two assuming a transmutation of species over time. Elaborate networks of affinities among plants and among animals were depicted in the late Eighteenth and very early Nineteenth centuries. In the two decades immediately prior to 1837, so-called affinities and/or analogies among organisms were represented by diverse geometric figures. Series of plant and animal fossils in successive geological strata were represented as trees in a popular textbook from 1840, while in 1858 Bronn presented a system of animals, as evidenced by the fossil record, in a form of a tree. Darwin's 1859 tree and its subsequent elaborations by Haeckel came to be accepted in many but not all areas of biological sciences, while network diagrams were used in others. Beginning in the early 1960s trees were inferred from protein and nucleic acid sequences, but networks were re-introduced in the mid-1990s to represent lateral genetic transfer, increasingly regarded as a fundamental mode of evolution at least for

  1. Using the glucometrics website to benchmark ICU glucose control before and after the NICE-SUGAR study.

    Science.gov (United States)

    Lleva, Ranee R; Thomas, Prem; Bozzo, Janis E; Hendrickson, Karrie C; Inzucchi, Silvio E

    2014-09-01

    Prior to 2009, intensive glycemic control was the standard in main intensive care units (ICUs). Glucose targets have been recalibrated after publication of the NICE-SUGAR study in that year, followed by updated guidelines that endorsed more moderated control. We sought to determine if the prevalence of hyperglycemia in US ICUs had increased after the NICE-SUGAR study's results were reported. We used data from hospitals submitted to the Yale Glucometrics™ website to assess mean blood glucose values, percentage of blood glucose within various ranges, and the prevalence of hypo- and hyperglycemic excursions, based on the patient-day method, comparing the pre- to post-NICE-SUGAR time period. Among more than a total of 2 million blood glucose determinations, comprising 408 790 patient-days, median patient-day blood glucose decreased from 144 mg/dL to 141 mg/dL (P SUGAR time period. The percentage of patient days with a mean blood glucose of 110-179 mg/dl increased from 58.3 to 63.6%. The percentage of patient-days with either hypoglycemia (control in US ICUs has improved when comparing time periods before versus after publication of the NICE-SUGAR study. We found no evidence that fewer hypoglycemic events were achieved at the expense of more hyperglycemia. © 2014 Diabetes Technology Society.

  2. Mitral stenosis before, during and after pregnancy

    Directory of Open Access Journals (Sweden)

    JW Roos-Hesselink

    2007-07-01

    Full Text Available Mitral stenosis is the most common cardiac valvular problem in pregnant women with rheumatic heart disease being the most important cause. As a result of hemodynamic changes associated with pregnancy, previously asymptomatic patients develop symptoms or complications during pregnancy. Pregnancy in women with mitral stenosis is associated with a marked increase in maternal morbidity and adverse fetal outcome. Treatment of symptomatic mitral stenosis during pregnancy consists of bedrest, beta-blockers and diuretics. If symptoms persist despite optimal medical treatment, percutaneous mitral valvulotomy should be considered. If possible, surgery should be postponed until after delivery. It is recommended to treat women with symptomatic mitral stenosis in a tertiary centre with interventional possibilities.

  3. Trends in Diagnosis-Specific Work Disability Before and After Stroke: A Longitudinal Population-Based Study in Sweden.

    Science.gov (United States)

    Lallukka, Tea; Ervasti, Jenni; Lundström, Erik; Mittendorfer-Rutz, Ellenor; Friberg, Emilie; Virtanen, Marianna; Alexanderson, Kristina

    2018-01-04

    Although a stroke event often leads to work disability, diagnoses behind work disability before and after stroke are largely unknown. We examined the pre-event and postevent trends in diagnosis-specific work disability among patients of working age. We included all new nonfatal stroke events in 2006-2008 from population-based hospital registers in Sweden among women and men aged 25 to 60 years (n=12 972). Annual days of diagnosis-specific work disability were followed for 4 years before and after stroke. Repeated measures negative binomial regression models using the generalized estimating equations method were fitted to examine trends in diagnosis-specific work disability before and after the event. Already during the 4 pre-event years, work disability attributed to circulatory diseases increased among women (rate ratio, 1.99; 95% confidence interval, 1.68-2.36) and men (rate ratio, 2.20; 95% confidence interval, 1.88-2.57). Increasing trends before stroke were also found for work disability attributed to mental disorders, musculoskeletal diseases, neoplasms, diseases of the nervous, respiratory, and digestive systems, injuries, and diabetes mellitus. As expected, a sharp increase in work disability days attributed to circulatory diseases was found during the first year after the event among both sexes. Overall, during 4 years after the stroke, there was a decreasing trend for circulatory diseases and injuries, whereas the trend was increasing for nervous diseases and diabetes mellitus. Work disability attributed to several mental and somatic diagnoses is higher already before a stroke event. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  4. Nursing care of the family before and after a death in the ICU--an exploratory pilot study.

    Science.gov (United States)

    Bloomer, Melissa J; Morphet, Julia; O'Connor, Margaret; Lee, Susan; Griffiths, Debra

    2013-02-01

    This qualitative descriptive study was undertaken in two metropolitan ICUs utilising focus groups to describe the ways in which ICU nurses care for the families of dying patients during and after the death. Participants shared their perspectives on how they care for families, their concerns about care, and detailed the strategies they use to provide timely and person-centred family care. Participants identified that their ICU training was inadequate in equipping them to address the complex care needs of families leading up to and following patient deaths, and they relied on peer mentoring and role-modelling to improve their care. Organisational constraints, practices and pressures impacting on the nurse made 'ideal' family care difficult. They also identified that a lack of access to pastoral care and social work after hours contributed to their concerns about family care. Participants reported that they valued the time nurses spent with families, and the importance of ensuring families spent time with the patient, before and after death. Copyright © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Evolution of agricultural production of Zaire before and after 1960

    Directory of Open Access Journals (Sweden)

    Sabiti, K.

    1991-01-01

    Full Text Available This study presents the evolution of agricultural production of Zaire before and after 1960 with the help of variable quantifies of products, the cultured area and the exported quantifies of products. A comparative analysis of quantifies of studied products shows that after 1960, the agricultural production of basis foodstuffs of the Zairian population has fallen of the order of 91 % in comparison with the first period. This study shows that the system of peasantry introduced in 1936 by the INEAC, the rationalization of cultural methods connected to the governmental explain the agricultural expansion of Zaire before 1960.

  6. Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism.

    Science.gov (United States)

    Yajima, Y; Oshima, M; Iwai, T; Kitajima, H; Omura, S; Tohnai, I

    2017-07-01

    The purpose of this study was to investigate the relationship between the pressure drop in the pharyngeal airway space (ΔP PAS ) and the minimum cross-sectional area (minCSA) of the pharyngeal airway before and after mandibular setback surgery using computational fluid dynamics, in order to prevent iatrogenic obstructive sleep apnoea. Eleven patients with mandibular prognathism underwent bilateral sagittal split osteotomy for mandibular setback. Three-dimensional models of the upper airway were reconstructed from preoperative and postoperative computed tomography images, and simulations were performed using computational fluid dynamics. ΔP PAS and the minCSA of the pharyngeal airway were calculated, and the relationship between them was evaluated by non-linear regression analysis. In all cases, the minCSA was found at the level of the velopharynx. After surgery, ΔP PAS increased significantly and the minCSA decreased significantly. The non-linear regression equation expressing the relationship between these variables was ΔP PAS =3.73×minCSA -2.06 . When the minCSA was <1cm 2 , ΔP PAS increased greatly. The results of this study suggest that surgeons should consider bimaxillary orthognathic surgery rather than mandibular setback surgery to prevent the development of iatrogenic obstructive sleep apnoea when correcting a skeletal class III malocclusion. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Imaging language networks before and after anterior temporal lobe resection: results of a longitudinal fMRI study.

    Science.gov (United States)

    Bonelli, Silvia B; Thompson, Pamela J; Yogarajah, Mahinda; Vollmar, Christian; Powell, Robert H W; Symms, Mark R; McEvoy, Andrew W; Micallef, Caroline; Koepp, Matthias J; Duncan, John S

    2012-04-01

    Anterior temporal lobe resection (ATLR) controls seizures in up to 70% of patients with intractable temporal lobe epilepsy (TLE) but, in the language dominant hemisphere, may impair language function, particularly naming. Functional reorganization can occur within the ipsilateral and contralateral hemispheres. We investigated reorganization of language in left-hemisphere-dominant patients before and after ATLR; whether preoperative functional magnetic resonance imaging (fMRI) predicts postoperative naming decline; and efficiency of postoperative language networks. We studied 44 patients with TLE due to unilateral hippocampal sclerosis (24 left) on a 3T GE-MRI scanner. All subjects performed language fMRI and neuropsychological testing preoperatively and again 4 months after left or right ATLR. Postoperatively, individuals with left TLE had greater bilateral middle/inferior frontal fMRI activation and stronger functional connectivity from the left inferior/middle frontal gyri to the contralateral frontal lobe than preoperatively, and this was not observed in individuals with right TLE. Preoperatively, in left and right TLE, better naming correlated with greater preoperative left hippocampal and left frontal activation for verbal fluency (VF). In left TLE, stronger preoperative left middle frontal activation for VF was predictive of greater decline in naming after ATLR. Postoperatively, in left TLE with clinically significant naming decline, greater right middle frontal VF activation correlated with better postoperative naming. In patients without postoperative naming decline, better naming correlated with greater activation in the remaining left posterior hippocampus. In right TLE, naming ability correlated with left hippocampal and left and right frontal VF activation postoperatively. In left TLE, early postoperative reorganization to the contralateral frontal lobe suggests multiple systems support language function. Postoperatively, ipsilateral recruitment

  8. A controlled before and after study to evaluate a patient and health professional partnership model towards effective medication reconciliation.

    Science.gov (United States)

    Lingaratnam, Senthil; Aranda, Sanchia; Pearce, Tracy; Kirsa, Sue

    2013-03-01

    Preventable medication errors impact substantially on the Australian healthcare system. Where 'poor communication of medical information at transition points is responsible for as many as 50% of all medication errors', a leading contributor for this type of medication error is lack of consumer knowledge about medicines information. This study was aimed at designing and testing the effectiveness of a consumer-healthcare professional partnership model towards effective medication reconciliation. This model aims to empower consumers about their medicines information, so that they would contribute more effectively to medication reconciliation and thereby minimise medication errors occurring at transition points. Components of this model were informed by qualitative data gleaned from patient opinion surveys, focus group sessions involving nurses, doctors and pharmacists working at the hospital and results of a literature search of medication safety tools. Programme development was informed by health improvement approaches centred on a Plan-Do-Study-Act cycle. Evaluation for effectiveness was conducted within a framework of a controlled before and after study. revealed that there was a 1.4-fold increase in the reporting rate of pharmacists intervention. The study could not demonstrate that the designed intervention was effective in minimising near-misses. However, there is statistically insignificant reduction in errors for patients that were correctly exposed to the intervention. Anecdotal evidence suggests there is utility for a patient population keen to claim greater ownership of their medicines information. Further, we advocate that patient education about medicines and the establishment of a consumer-healthcare professional model occur prior to ward admission.

  9. Maternal and neonatal health impact of obstetrical risk insurance scheme in Mauritania: a quasi experimental before-and-after study.

    Science.gov (United States)

    Philibert, Aline; Ravit, Marion; Ridde, Valéry; Dossa, Inès; Bonnet, Emmanuel; Bedecarrats, Florent; Dumont, Alexandre

    2017-04-01

    A variety of health financing schemes shaped on pre-payment scheme have been implemented across Sub-Saharan Africa (SSA) to address the Millennium Development Goals (MDGs). In Mauritania, the Obstetric Risk Insurance package (ORI) focusing on maternal and perinatal health has been progressively implemented at the health district level since 2002. Here, our main objective was to assess the effectiveness of the ORI in increasing facility-based delivery rates, as well as increases in family planning, antenatal and postnatal care, caesarean delivery and neonatal health, from demographic and health survey data between 2002 and 2011. We also examined whether the effects of the ORI varied between strata of the population. The study was based on a quasi-experimental before-and-after design to assess the causal link between availability of ORI and increase in use of maternal health services and neonatal mortality. In combination with geographical information system, difference-in-differences and odd ratio approaches were used to address our objectives. Indicators of access to care for pregnant women and neonatal health and improved in both non-intervention and intervention groups during the study period. There was no global effect of the availability of ORI on facility-based delivery rates, nor on the use of antenatal and postnatal care services, except for qualified antenatal services. However, delivery rates in local health centres with ORI increased more rapidly than in those with no ORI, the contrary was shown for hospitals. Caesarean delivery and family planning decreased with ORI. Although late neonatal mortality rates remained low in the country, a significant decrease was seen in districts without ORI. Except for some strata of the population, ORI has not really met its objective of attracting more pregnant women towards facility-based health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical

  10. The Experience of Pleasure before and after Hearing Rehabilitation

    Science.gov (United States)

    Rey, Gwladys

    2010-01-01

    Hearing loss may lead to major changes in the social and emotional aspects of daily life. This follow-up study investigated the effect of hearing-aid use on emotional experience in adults with hearing impairment. Thirteen individuals with impaired hearing were tested before and after 6 months of hearing-aid use, and were compared with 19…

  11. Evaluation of serum nitric oxide before and after local ...

    African Journals Online (AJOL)

    Hoda Aly Abd-El Moety

    2012-10-06

    Oct 6, 2012 ... Objectives: Evaluation of serum nitric oxide before and after local radiofrequency thermal ablation for hepatocellular carcinoma. Subjects: Twenty patients with proven hepatocellular carcinoma and 15 healthy patients as controls were enrolled in the study. Abbreviations: NO, nitrous oxide; HCC, ...

  12. Lessons from before and after nanotech

    Science.gov (United States)

    Toumey, Chris

    2012-10-01

    Ethical questions arising from biotechnology first, then nanotechnology, and synthetic biology now, present common features, but as Chris Toumey explains, the scientific and ethical issues arising in each case should be treated individually.

  13. Effectiveness and Safety of an Extended ICU Visitation Model for Delirium Prevention: A Before and After Study.

    Science.gov (United States)

    Rosa, Regis Goulart; Tonietto, Tulio Frederico; da Silva, Daiana Barbosa; Gutierres, Franciele Aparecida; Ascoli, Aline Maria; Madeira, Laura Cordeiro; Rutzen, William; Falavigna, Maicon; Robinson, Caroline Cabral; Salluh, Jorge Ibrain; Cavalcanti, Alexandre Biasi; Azevedo, Luciano Cesar; Cremonese, Rafael Viegas; Haack, Tarissa Ribeiro; Eugênio, Cláudia Severgnini; Dornelles, Aline; Bessel, Marina; Teles, José Mario Meira; Skrobik, Yoanna; Teixeira, Cassiano

    2017-10-01

    To evaluate the effect of an extended visitation model compared with a restricted visitation model on the occurrence of delirium among ICU patients. Prospective single-center before and after study. Thirty-one-bed medical-surgical ICU. All patients greater than or equal to 18 years old with expected length of stay greater than or equal to 24 hours consecutively admitted to the ICU from May 2015 to November 2015. Change of visitation policy from a restricted visitation model (4.5 hr/d) to an extended visitation model (12 hr/d). Two hundred eighty-six patients were enrolled (141 restricted visitation model, 145 extended visitation model). The primary outcome was the cumulative incidence of delirium, assessed bid using the confusion assessment method for the ICU. Predefined secondary outcomes included duration of delirium/coma; any ICU-acquired infection; ICU-acquired bloodstream infection, pneumonia, and urinary tract infection; all-cause ICU mortality; and length of ICU stay. The median duration of visits increased from 133 minutes (interquartile range, 97.7-162.0) in restricted visitation model to 245 minutes (interquartile range, 175.0-272.0) in extended visitation model (p interquartile range, 1.0-3.0] vs 3.0 d [interquartile range, 2.5-5.0]; p = 0.03) and ICU stay (3.0 d [interquartile range, 2.0-4.0] vs 4.0 d [interquartile range, 2.0-6.0]; p = 0.04). The rate of ICU-acquired infections and all-cause ICU mortality did not differ significantly between the two study groups. In this medical-surgical ICU, an extended visitation model was associated with reduced occurrence of delirium and shorter length of delirium/coma and ICU stay.

  14. Before, after, in and beyond Teacher Education

    Science.gov (United States)

    Garrett, H. James

    2013-01-01

    The author uses a trip to a Holocaust museum to explain and illustrate psychoanalytic concepts from Freud to Lacan in order to re-imagine persistent dilemmas in teacher education. The author suggests that psychoanalytic vocabularies provide an additional and productive lens to conceptualize productive possibilities in teacher education.

  15. Laryngeal Sensation Before and After Clearing Behaviors

    Science.gov (United States)

    Bonilha, Heather Shaw; Gerlach, Terri Treman; Sutton, Lori Ellen; Dawson, Amy Elizabeth; Nietert, Paul J

    2013-01-01

    Purpose People frequently present to voice clinics with complaints of irritating laryngeal sensations. Clinicians attempt to reduce the irritating sensations and their common sequela, coughing and throat clearing, by advocating for techniques that remove the irritation with less harm to the vocal fold tissue. Despite the prevalence of patients with these complaints, it is not known if the less harmful techniques recommended by clinicians are effective at clearing irritating laryngeal sensations or that irritating laryngeal sensations are, in fact, more frequent in people with voice disorders than people without voice disorders. Method Assessments of participant reported laryngeal sensation, pre- and post- clearing task, were obtained from 22 people with and 24 people without a voice disorder. Six clearing tasks were used to preliminarily evaluate the differing effects of tasks believed to be deleterious and ameliorative. Results People with and without voice disorders reported pre-clear laryngeal sensation at a similar rate. Post-clear sensation was less likely to be completely or partially removed in people with voice disorders than in the non-voice disordered group. Hard throat clear and swallow with water were the most effective techniques at removing laryngeal sensation. Conclusions The findings provide initial evidence for some of the clinical practices common to treating patients with voice disorders and chronic clearing such as advocating for swallowing a sip of water as a replacement behavior instead of coughing or throat clearing. However, the findings raise questions about other practices such as associating irritating laryngeal sensation with a voice disorder. PMID:22717491

  16. Understanding civil society before and after 1989

    Directory of Open Access Journals (Sweden)

    Ferenc Miszlivetz

    2012-02-01

    Full Text Available Entrapped in the ambiguities of the Realpolitik of the Yalta system, East and Central European societies had to proceed on a long path of learning in order to find the right modes of self-organization and articulation to defend their values and identities vis-à-vis dictatorship and authoritarian rule. These bitter lessons contributed to the emergence of a new «strategy», a new vision which materialized in the emerging political philosophy and the political and social practice of civil society. This development would not have been possible without a gradual and fundamental change in political thinking and goal-setting, expressed in the development of a new concept of civil society.Atrapados en las ambigüedades de la Realpolitik del sistema de Yalta, las sociedades del Centro y Este de Europea han tenido que proceder a un largo camino de aprendizaje a fin de encontrar formas correctas de autoorganización y la articulación de la defensa de sus valores e identidades vis-à- vis con una dictadura y una administración autoritaria. Estas amargas lecciones contribuyeron a la emergencia de una nueva «estrategia», una nueva visión materializada en la emergente filosofía política y la práctica social y política de la sociedad civil. Este desarrollo no hubiera sido posible sin el gradual y fundamental cambio en el pensamiento político y el establecimiento de metas, expresadas en el desarrollo de un nuevo concepto de sociedad civil. 

  17. Saliva in relation to dental erosion before and after radiotherapy.

    Science.gov (United States)

    Jensdottir, Thorbjörg; Buchwald, Christian; Nauntofte, Birgitte; Hansen, Hanne Sand; Bardow, Allan

    2013-01-01

    Low saliva flow and abnormal saliva composition are common conditions after radiotherapy for oral cavity and pharyngeal cancer. Both conditions increase the susceptibility to dental caries and erosion, which may be further accelerated by changes in food preferences. The aim of this study was to determine changes in saliva flow and susceptibility to erosive challenges in pharyngeal cancer patients before and after radiotherapy to the head and neck. The erosive potential of sucking acidic candies with and without calcium was determined in nine patients (50-68 years) before and after receiving a radiation dose of 66 Gy to the head and neck area. The erosive potential was evaluated from saliva degree of saturation with respect to hydroxyapatite (HAp) and by dissolution of HAp in candy-stimulated saliva. Sucking acidic candies increased saliva flow rates ≈ 17-fold before as well as after radiotherapy (p HAp during (p HAp dissolution was significantly lower with the candy containing calcium compared with the control candy, both before and after radiotherapy (p < 0.001 and p < 0.05). Radiotherapy to the head and neck area significantly reduced saliva flow and altered saliva composition in a way that may increase the susceptibility to dental disease. However, saliva could be stimulated by acidic candies, which could be made nearly non-erosive even in irradiated patients.

  18. Plasma adiponectin before and after kidney transplantation

    DEFF Research Database (Denmark)

    Idorn, Thomas; Hornum, Mads; Bjerre, Mette

    2012-01-01

    The role of plasma adiponectin (ADPN) in patients with impaired kidney function and following kidney transplantation (Tx) is debated. We aimed to: (i) determine whether pretransplant ADPN level is an independent risk factor for deterioration of glucose tolerance including development of new...

  19. Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease

    OpenAIRE

    McDonnell, Lucy M; Hogg, Lauren; McDonnell, Lynn; White, Patrick

    2014-01-01

    Background: Poor sleep quality is common in chronic obstructive pulmonary disease (COPD). It is associated with poor quality of life. Pulmonary rehabilitation (PR) improves quality of life, exercise capacity, and anxiety and depression. Its effect on sleep quality is uncertain. Aim: To determine whether PR improves sleep quality in COPD. Methods: A prospective controlled ‘before and after’ study of sleep quality in COPD patients attending a community PR programme was conducted. Sleep quality ...

  20. Pulmonary rehabilitation and sleep quality: a before and after controlled study of patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    McDonnell, Lucy M; Hogg, Lauren; McDonnell, Lynn; White, Patrick

    2014-07-10

    Poor sleep quality is common in chronic obstructive pulmonary disease (COPD). It is associated with poor quality of life. Pulmonary rehabilitation (PR) improves quality of life, exercise capacity, and anxiety and depression. Its effect on sleep quality is uncertain. To determine whether PR improves sleep quality in COPD. A prospective controlled 'before and after' study of sleep quality in COPD patients attending a community PR programme was conducted. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Lung function, disease-specific quality of life (COPD assessment test--CAT), exercise capacity (incremental shuttle walk test--ISWT), and anxiety and depression (Hospital Anxiety and Depression Scale--HADS) were measured. Change in sleep quality was compared with a COPD control group. Twenty-eight participants completed PR. The control group comprised 24 patients. Prevalence of poor sleep quality (PSQI ≥5) was 78%. There were no differences between observation and control groups in sleep quality, age or severity. Quality of life was strongly correlated with quality of sleep (r=0.64, Pimproved the quality of life (CAT change 3.0; 95% CI, 0.7-5.3), exercise capacity (ISWT change (metres) 81.0; 15.3-146.6), anxiety (HADS score ≥8: change 2.33; 0.45-4.22), and depression (HADS score ≥8: change 2.90; 1.92-3.88). PR did not improve sleep quality (PSQI mean change 0.79; -0.35 to 1.93). PR did not improve sleep quality in COPD despite improving quality of life, exercise capacity, anxiety and depression. New strategies, independent of PR, are required to improve sleep quality in COPD.

  1. Health-related quality of life before and after management in adults referred to otolaryngology: rospective national study

    Science.gov (United States)

    Swan, IRC; Guy, FH; Akeroyd, MA

    2012-01-01

    Objective An assessment of the effect of otolaryngological management on the health-related quality of life of patients. Design Application of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment. Setting Six otolaryngological departments around Scotland. Participants A 9005 adult patients referred to outpatient clinics. Main outcome measures Complete HUI-3 data was collected from 4422 patients; complete GBI data from 4235; complete HUI-3 and GBI data from 3884. Results The overall change in health related quality of life from before to after management was just +0.02. In the majority of subgroups of data (classified by type of management) there was essentially no change in HUI-3 score. The major exceptions were those patients provided with a hearing aid (mean change 0.08) and those whose problem was managed surgically (mean change 0.04). The mean GBI score was 5.3 which is low. Those managed surgically reported a higher GBI score of 13.0. Conclusion We found that patients treated surgically or given a hearing aid reported a significant improvement in their health related quality of life after treatment in otolaryngology departments. In general, patients treated in other ways reported no significant improvement. We argue that future research should look carefully at patient groups where there is unexpectedly little benefit from current treatment methods and consider more effective methods of management. PMID:22212609

  2. Health-related quality of life before and after management in adults referred to otolaryngology: a prospective national study.

    Science.gov (United States)

    Swan, I R C; Guy, F H; Akeroyd, M A

    2012-02-01

    An assessment of the effect of otolaryngological management on the health-related quality of life of patients. Application of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment. Six otolaryngological departments around Scotland. A 9005 adult patients referred to outpatient clinics. Complete HUI-3 data was collected from 4422 patients; complete GBI data from 4235; complete HUI-3 and GBI data from 3884. The overall change in health related quality of life from before to after management was just +0.02. In the majority of subgroups of data (classified by type of management) there was essentially no change in HUI-3 score. The major exceptions were those patients provided with a hearing aid (mean change 0.08) and those whose problem was managed surgically (mean change 0.04). The mean GBI score was 5.3 which is low. Those managed surgically reported a higher GBI score of 13.0. We found that patients treated surgically or given a hearing aid reported a significant improvement in their health related quality of life after treatment in otolaryngology departments. In general, patients treated in other ways reported no significant improvement. We argue that future research should look carefully at patient groups where there is unexpectedly little benefit from current treatment methods and consider more effective methods of management. © 2011 Blackwell Publishing Ltd.

  3. Study on the change of hepatic fibrosis indicators in serum before and after I-131 treatment in Graves' Patients

    International Nuclear Information System (INIS)

    Li, L.

    2007-01-01

    Full text: Objective: To explore the change of hepatic fibrosis indicators, i.e., PC-III (type III procollagen), IV-C (type IV collagen), HA (hyaluronic acid), LN (laminin) levels in serum of Graves' patients before and after I-131 treatment. Methods: Control group were 40 healthy cases (female 25, male 15, aged 18-60 years) with normal serum levels of those indicators by medical examination in our hospital. Fifty-five Graves' patients (female 32, male 23, aged 17-58) were diagnosed by thyroid function indicators (TT3, TT4, FT3, FT4, TSH) tests, thyroid iodine intake and clinical symptoms and signs, with normal hepatic function indicators and without combined history of hepatic disease, cardiac disease, diabetes, and rheumatic disease. Three to six months after I-131 treatment these were completely recovered (back to normal thyroid function, shrunken thyroid gland volume from swelling, and disappeared clinical symptoms and signs). In both controls and Graves' patients, 2 ml venous blood was taken at early morning from each case with limosis respectively before and after I- 131 treatment. RIA method was adopted for detection of each serum indicator with reagents kit. Data were analyzed by t test in the SPSS statistical software pack. Results: 1. In Graves' patients, before treatment PC- III (type III procollagen) levels were statistically higher than that in controls (p 0.05). 2. In Graves' patients, PC-III significantly decreased to a lower level after treatment than before (p 05). 3. In Graves' patients, after treatment there is no significant difference of indicator levels when compared with controls (p>0.05). Conclusion: Graves' patients had certain degree of hyperplasia of hepatic connective tissue, and this pathogenesis recovered with healing of Graves' disease. PC-III positive rate and thyroid function indicator positive rate may be better in accordance with the disease process than IV-C, Ha and LN indicators. These data showed that of four serum hepatic

  4. Analysis of metabolomic patterns in thoroughbreds before and after exercise

    Directory of Open Access Journals (Sweden)

    Hyun-Jun Jang

    2017-11-01

    Full Text Available Objective Evaluation of exercise effects in racehorses is important in horseracing industry and animal health care. In this study, we compared metabolic patterns between before and after exercise to screen metabolic biomarkers for exercise effects in thoroughbreds. Methods The concentration of metabolites in muscle, plasma, and urine was measured by 1H nuclear magnetic resonance (NMR spectroscopy analysis and the relative metabolite levels in the three samples were compared between before and after exercise. Subsequently, multivariate data analysis based on the metabolic profiles was performed using orthogonal partial least square discriminant analysis (OPLS-DA and variable important plots and t-test was used for basic statistical analysis. Results From 1H NMR spectroscopy analysis, 35, 25, and 34 metabolites were detected in the muscle, plasma, and urine. Aspartate, betaine, choline, cysteine, ethanol, and threonine were increased over 2-fold in the muscle; propionate and trimethylamine were increased over 2-fold in the plasma; and alanine, glycerol, inosine, lactate, and pyruvate were increased over 2-fold whereas acetoacetate, arginine, citrulline, creatine, glutamine, glutarate, hippurate, lysine, methionine, phenylacetylglycine, taurine, trigonelline, trimethylamine, and trimethylamine N-oxide were decreased below 0.5-fold in the urine. The OPLS-DA showed clear separation of the metabolic patterns before and after exercise in the muscle, plasma, and urine. Statistical analysis showed that after exercise, acetoacetate, arginine, glutamine, hippurate, phenylacetylglycine trimethylamine, trimethylamine N-oxide, and trigonelline were significantly decreased and alanine, glycerol, inosine, lactate, and pyruvate were significantly increased in the urine (p<0.05. Conclusion In conclusion, we analyzed integrated metabolic patterns in the muscle, plasma, and urine before and after exercise in racehorses. We found changed patterns of metabolites in

  5. Trends in the geographic distribution of nursing staff before and after the Great East Japan Earthquake: a longitudinal study.

    Science.gov (United States)

    Morioka, Noriko; Tomio, Jun; Seto, Toshikazu; Kobayashi, Yasuki

    2015-08-25

    Medical care systems in Iwate, Miyagi and Fukushima prefectures were greatly damaged by the Great East Japan Earthquake (GEJE), which struck on 11 March 2011. The shortage of nurses in this area was concerning; however, temporal trends have not been investigated. This study aimed to investigate the trends in the geographic distribution of total nursing staff per population in the secondary medical areas (SMAs) of these prefectures before and after the GEJE. We also aimed to qualify the above trends. We conducted a longitudinal study at four time points (July 2007, 2010, 2011 and 2013) over 6 years using reports of basic hospitalization charges from all hospitals within Iwate, Miyagi and Fukushima prefectures that experienced severe damage from the GEJE. We calculated the number of total nursing staff per population in the SMAs and compiled descriptive statistics. Changes from 2010 to 2013 were qualified and mapped. In coastal SMAs, the ratios of total nursing staff per population decreased immediately after the GEJE. In most SMAs in 2013, the ratios increased and exceeded the pre-GEJE level. However, the changes in total nursing staff per population from 2010 to 2013 were negative in Ryouban (-4.0%), Ishinomaki-Tome-Kesennuma (-1.9%), Sousou (-47.7%) and Iwaki (-1.9%). In Sousou, which is closest to the Fukushima Daiichi Nuclear Power Plant, the changes in total nursing staff per population qualified by job role were -33.7% for nurses, -57.7% for associate nurses and -63.2% for nursing aides. Our study indicated that the temporal trends in the number of total nursing staff per population due to the GEJE differed between the physically damaged areas and those affected by radiation. We also found the difference in the trend by qualifications: the reduction in total nursing staff per population was larger in Sousou, the area most affected by radiation, than in any other SMAs. Moreover, the number of nursing aides was most affected among the three types of staff. To

  6. Characterization and photoluminescence studies of CdTe nanoparticles before and after transfer from liquid phase to polystyrene

    International Nuclear Information System (INIS)

    Wang, Shugang; Li, Yaoxian; Bai, Jie; Yang, Qingbiao; Song, Yan; Zhang, Chaoqun

    2009-01-01

    The major objective of this work was to detect the change of photoluminescence (PL) intensity of CdTe nanoparticles (NPs) before and after transfer from liquid phase to polystyrene (PS) matrix by electrospinning technique. Thio-stabilized CdTe NPs were first synthesized in aqueous, then enwrapped by cetyl-trimethylammonium bromide (CTAB), and finally, transferred into PS matrix to form CdTe/PS nanofibres by electrospinning. Then, CdTe/PS nanofibres were characterized by scanning electron microscope (SEM) and transmission electron microscope (TEM) to observe their morphology and distribution, respectively. The selective area electronic diffraction (SAED) pattern proved that the CdTe NPs were cubic lattice. The PL spectrum indicated that CdTe NPs have been transferred into PS nanofibres, and the PL intensity of CdTe NPs in the nanofibres was even higher than that before CdTe NPs were introduced into PS nanofibres. Moreover, X-ray photoelectron spectra (XPS) revealed that thiol-stabilized CdTe NPs were enwrapped by CTAB, and PS acted as a dispersant in the process of electrospinning. (author)

  7. Financial Services Advertising before and after the Crash of 1987.

    Science.gov (United States)

    Everett, Stephen E.

    1988-01-01

    Examines institutional changes in advertising before and after the stock market "crash" of 1987 as represented in the "Wall Street Journal." Finds that financial institutions increased the frequency and size of ads after the crash. (RS)

  8. The effect of an e-learning course on nursing staff's knowledge of delirium: a before-and-after study.

    Science.gov (United States)

    van de Steeg, Lotte; IJkema, Roelie; Wagner, Cordula; Langelaan, Maaike

    2015-02-05

    Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which might be due to a lack of knowledge of delirium diagnosis and treatment. The objective of the study was to test the effectiveness of an e-learning course on nurses' delirium knowledge, describe nursing staff's baseline knowledge about delirium, and describe demographic factors associated with baseline delirium knowledge and the effectiveness of the e-learning course. A before-and-after study design, using an e-learning course on delirium. The course was introduced to all nursing staff of internal medicine and surgical wards of 17 Dutch hospitals. 1,196 invitations for the e-learning course were sent to nursing staff, which included nurses, nursing students and healthcare assistants. Test scores on the final knowledge test (mean 87.4, 95% CI 86.7 to 88.2) were significantly higher than those on baseline (mean 79.3, 95% CI 78.5 to 80.1). At baseline, nursing staff had the most difficulty with questions related to the definition of delirium: what are its symptoms, course, consequences and which patients are at risk. The mean score for this category was 74.3 (95% CI 73.1 to 75.5). The e-learning course significantly improved nursing staff's knowledge of delirium in all subgroups of participants and for all question categories. Contrary to other studies, the baseline knowledge assessment showed that, overall, nursing staff was relatively knowledgeable regarding delirium. The Netherlands National Trial Register (NTR). NTR 2885 , 19 April 2011.

  9. Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

    Directory of Open Access Journals (Sweden)

    Chelsea Leonard

    2017-10-01

    Full Text Available Abstract Background Adapting promising health care interventions to local settings is a critical component in the dissemination and implementation process. The Veterans Health Administration (VHA rural transitions nurse program (TNP is a nurse-led, Veteran-centered intervention designed to improve transitional care for rural Veterans funded by VA national offices for dissemination to other VA sites serving a predominantly rural Veteran population. Here, we describe our novel approach to the implementation and evaluation = the TNP. Methods This is a controlled before and after study that assesses both implementation and intervention outcomes. During pre-implementation, we assessed site context using a mixed method approach with data from diverse sources including facility-level quantitative data, key informant and Veteran interviews, observations of the discharge process, and a group brainstorming activity. We used the Practical Robust Implementation and Sustainability Model (PRISM to inform our inquiries, to integrate data from all sources, and to identify factors that may affect implementation. In the implementation phase, we will use internal and external facilitation, paired with audit and feedback, to encourage appropriate contextual adaptations. We will use a modified Stirman framework to document adaptations. During the evaluation phase, we will measure intervention and implementation outcomes at each site using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance. We will conduct a difference-in-differences analysis with propensity-matched Veterans and VA facilities as a control. Our primary intervention outcome is 30-day readmission and Emergency Department visit rates. We will use our findings to develop an implementation toolkit that will inform the larger scale-up of the TNP across the VA. Discussion The use of PRISM to inform pre-implementation evaluation and synthesize data from multiple sources

  10. Saliva in relation to dental erosion before and after radiotherapy

    DEFF Research Database (Denmark)

    Jensdottir, Thorbjorg; von Buchwald, Christian; Nauntofte, Birgitte

    2013-01-01

    Abstract Objective. Low saliva flow and abnormal saliva composition are common conditions after radiotherapy for oral cavity and pharyngeal cancer. Both conditions increase the susceptibility to dental caries and erosion, which may be further accelerated by changes in food preferences. The aim...... of this study was to determine changes in saliva flow and susceptibility to erosive challenges in pharyngeal cancer patients before and after radiotherapy to the head and neck. Materials and methods: The erosive potential of sucking acidic candies with and without calcium was determined in nine patients (50...... rates ∼ 17-fold before as well as after radiotherapy (p radiotherapy. Also, saliva became more under-saturated with respect to HAp during (p

  11. Educational outreach visits to improve venous thromboembolism prevention in hospitalised medical patients: a prospective before-and-after intervention study.

    Science.gov (United States)

    Duff, Jed; Omari, Abdullah; Middleton, Sandy; McInnes, Elizabeth; Walker, Kim

    2013-10-08

    Despite the availability of evidence-based guidelines on venous thromboembolism (VTE) prevention clinical audit and research reveals that hospitalised medical patients frequently receive suboptimal prophylaxis. The aim of this study was to evaluate the acceptability, utility and clinical impact of an educational outreach visit (EOV) on the provision of VTE prophylaxis to hospitalised medical patients in a 270 bed acute care private hospital in metropolitan Australia. The study used an uncontrolled before-and-after design with accompanying process evaluation. The acceptability of the intervention to participants was measured with a post intervention survey; descriptive data on resource use was collected as a measure of utility; and clinical impact (prophylaxis rate) was assessed by pre and post intervention clinical audits. Doctors who admit >40 medical patients each year were targeted to receive the intervention which consisted of a one-to-one educational visit on VTE prevention from a trained peer facilitator. The EOV protocol was designed by a multidisciplinary group of healthcare professionals using social marketing theory. Nineteen (73%) of 26 eligible participants received an EOV. The majority (n = 16, 85%) felt the EOV was effective or extremely effective at increasing their knowledge about VTE prophylaxis and 15 (78%) gave a verbal commitment to provide evidence-based prophylaxis. The average length of each visit was 15 minutes (IQ range 15 to 20) and the average time spent arranging and conducting each visit was 92 minutes (IQ range 78 to 129). There was a significant improvement in the proportion of medical patients receiving appropriate pharmacological VTE prophylaxis following the intervention (54% to 70%, 16% improvement, 95% CI 5 to 26, p = 0.004). EOV is effective at improving doctors' provision of pharmacological VTE prophylaxis to hospitalised medical patients. It was also found to be an acceptable implementation strategy by the majority

  12. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    The objective of the study was to measure vaginal pressure during various daily activities in patients before and after vaginal surgery for pelvic organ prolapse, searching data for evidence-based activity guidelines. Vaginal pressure (VP) was studied in 23 patients during activities such as rest...... was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities....

  13. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study.

    Science.gov (United States)

    Muldoon, Kathryn; Gallagher, Louise; McGuinness, Denise; Smith, Valerie

    2017-11-13

    Controversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables. To determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia. A prospective before and after cohort study was conducted. Following ethical approval, two self-reported questionnaires were administered to women whose infants were undergoing frenotomy at seven healthcare clinics in the Republic of Ireland. Data on breastfeeding variables prior to the frenotomy procedure and at 1-month post-frenotomy were collected and compared. Descriptive statistics (frequencies and proportions) were used to analyse, separately, the pre- and post-frenotomy data. Inferential statistics (z-test scores for differences between proportions (alpha frenotomy comparative analyses. Ninety-eight women returned the baseline questionnaire, and, of these, 89 returned the follow-up questionnaire. The most common reason for seeking a frenotomy was difficulty with latch (38%). Private lactation consultants were the main person recommending a frenotomy (31%). Rates of exclusive breastfeeding remained similar pre- and post-frenotomy (58% versus 58%), although rates of formula feeding increased two-fold at follow-up. Infants' ability to extend their tongues to the lower lip after frenotomy was significantly increased (p frenotomy. Pain on breastfeeding was significantly reduced post-frenotomy (MD 2.90, 95% CI 3.75 to 2.05) and overall LATCH scale scores were significantly increased (MD -0.50, 95% CI -0.67 to -0.33). This study supports the hypothesis that frenotomy has a positive effect on

  14. Changes over time in mental well-being, fruit and vegetable consumption and physical activity in a community-based lifestyle intervention: a before and after study

    OpenAIRE

    Johnson, R.; Robertson, W.; Towey, M.; Stewart-Brown, S.; Clarke, A.

    2017-01-01

    Objectives: There is a theoretical basis for believing that healthy lifestyle interventions can improve mental well-being and evidence to show that mental well-being is protective of future health. This study contributes to the evidence base by examining changes in mental well-being associated with the One Body One Life (OBOL) healthy lifestyle programme in a community setting in the West Midlands. Study design: Quantitative, before and after the evaluation. Methods: We conducted a before and...

  15. Evaluating the Subjective Straight Ahead Before and After Spaceflight

    Science.gov (United States)

    Campbell, D. J.; Wood, S. J.; Reschke, M. F.; Clement, G.

    2017-01-01

    This joint European Space Agency (ESA) - NASA study will address adaptive changes in spatial orientation related to the subjective straight ahead and the use of a vibrotactile sensory aid to reduce perceptual errors. The study will be conducted before and after long duration expeditions to the International Space Station (ISS) to examine how spatial processing of target location is altered following exposure to microgravity. This study addresses the sensorimotor research gap to "determine the changes in sensorimotor function over the course of a mission and during recovery after landing."

  16. Psychological distress in men with prostate cancer and their partners before and after cancer diagnosis: a longitudinal study.

    Science.gov (United States)

    Oba, Akira; Nakaya, Naoki; Saito-Nakaya, Kumi; Hasumi, Masaru; Takechi, Hiroyuki; Arai, Seiji; Shimizu, Nobuaki

    2017-08-01

    To examine the relative risk of psychological distress of men with prostate cancer and their partners during the period before and after prostate cancer diagnosis compared with men without prostate cancer and their partners. The participants reported questionnaires on psychological distress at four time points: before prostate cancer biopsy, and at 1, 3 and 6 months following prostate cancer diagnosis. We performed multiple logistic regression analyses to examine the relative risk of psychological distress. A total of 115 couples answered the questionnaires at all four time points. Men with prostate cancer showed a significantly higher risk of psychological distress compared to men without prostate cancer at 1 (odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.9-13.1), 3 (OR = 3.2, 95% CI = 1.1-10.2) and 6 months following prostate cancer diagnosis (OR = 6.9, 95% CI = 2.3-25.7). Their partners showed a significantly higher risk of psychological distress compared to the partners of men without prostate cancer at 1 month following prostate cancer diagnosis (OR = 2.6, 95% CI = 1.1-6.6). Men with prostate cancer showed psychological distress during the 6 months following the cancer diagnosis. Their partners also showed psychological distress at 1 month following the cancer diagnosis. Inviting both men with prostate cancer and their partners to speak to their concerns, empathizing with them, finding the solutions together and monitoring of their psychological status regularly should be regarded as important following prostate cancer diagnosis. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  17. Studying of some physical properties for natural polymers (hemoglobin) for cancer patients before and after exposure to gamma irradiation

    International Nuclear Information System (INIS)

    Farooh, H.A.A.

    2010-01-01

    The effect of radiotherapy on hemoglobin (Hb) polymer, obtained from patients (cases) before and after two periods of local gamma irradiation was studied. The results were compared with healthy volunteer. The patients were classified into two main groups. The first group represents cases that suffer from breast cancer, while, the second group represents cases that suffer from pelvic cancer. The total doses for breast cancer were ranged from 45 to 50 Gy, divided into 25 fractions for 5 weeks. While the total doses for pelvic irradiation were ranged from 20 to 66 Gy; divided into 10-25 fraction for 2-5 weeks. The physical properties of Hb have been studied via several characterization techniques, such as X-ray diffraction, viscosity, Fourier Transform Infra-red spectroscopy (FTIR), Electron Spin Resonance (ESR) and UV-visible spectra. The resultant effects of radiotherapy can be summarized as follows: X-ray diffraction pattern of Hb polymer, for control and cancer breast before and after exposure to accumulated gamma irradiation, were characterized by halo consisting of two adjacent peaks with maximum intensity observed at 2θ = 9.549 and 21.222, respectively. By increasing the gamma doses, a decrease in crystalline phase (disordering character) were obtained. Also, the halos width at half of maximal intensity (δW) shows a decrease followed by an increase with increasing the accumulative gamma dose up to 50 Gy, but still below + ve and -ve control values. The viscosity were measured for Hb solutions of concentration 4.1x10 -5 Mol on the base of heme-heme interaction and at different shear rates (10-400 sec -1 ). The plastic viscosity for every hemoglobin samples was calculated by Bingham equation using specific software of the viscometer. There was an increase in the plastic viscosity of Hb cancer patients compared to -ve control. On irradiation the viscosity shows an increase with increasing the accumulative gamma dose. Fourier transform infra-red spectra (FTIR

  18. Cognitive Function Before and After Intensity-Modulated Radiation Therapy in Patients With Nasopharyngeal Carcinoma: A Prospective Study

    International Nuclear Information System (INIS)

    Hsiao, Kuan-Yin; Yeh, Shyh-An; Chang, Chiung-Chih

    2010-01-01

    Purpose: To evaluate the effects of radiation therapy (RT) on neurocognitive function in patients with nasopharyngeal carcinoma (NPC). Methods and Materials: Thirty patients with NPC treated with intensity-modulated RT were included. Dose-volume histograms of the temporal lobes were obtained in every patient. Neurocognitive tests were administered individually to each patient 1 day before initiation of RT and at least 12 months after completion of RT. Cognitive functioning status was evaluated as change in scores over time. Results: Among the total of 30 patients, 23 patients (76.7%) had significantly lower post-RT cognitive functioning scores compared with their pre-RT scores (p = 0.033). The cognitive functioning scores had significantly declined in the domains of short-term memory, language abilities, and list-generating fluency (p = 0.020, 0.023, and 0.001, respectively). Compared with patients with a mean dose to the temporal lobes of 36 Gy or less, patients with a mean dose of greater than 36 Gy had a significantly greater reduction in cognitive functioning scores (p = 0.017). Patients in whom V60 of the temporal lobes (i.e., the percentage of the temporal lobe volume that had received >60 Gy) was greater than 10% also had a greater reduction in cognitive functioning scores than those in whom V60 was 10% or less (p = 0.039). Conclusions: The results of our study indicated that RT could have deleterious effects on cognitive function in patients with NPC. Efforts should be made to reduce the radiation dose and irradiated volume of temporal lobes without compromising the coverage of target volume.

  19. Oral manifestations of allograft recipients before and after renal transplantation

    Directory of Open Access Journals (Sweden)

    Gita Rezvani

    2014-01-01

    Full Text Available Renal transplantation is considered the best treatment option for patients with end-stage renal disease. In this study, the prevalence of oral lesions was studied in a cohort of renal transplant recipients before and after transplantation. Fifty-nine kidney transplant recipients were examined one week before and four months after transplantation. The information gathered included age, sex, smoking history, duration on dialysis, drugs and their doses. There were 41 males (69.5% and 18 females (30.5% with a mean age of 37 years. Before surgery, two patients had non-specific lesions and two other patients had leukoedema. Following transplantation, 24 patients (40.7% did not have any specific lesion. In six patients, we observed non-specific erythematous lesions (10.2%. Other recorded observations are as follows: Gingival hyperplasia in five patients (8.5%, oral candidiasis of the erythematous type in five patients (8.5%, hairy leukoplakia in four patients (6.8% and leukoedema in seven patients (11.9%. In our study patients, the prevalence of oral lesions increased after transplantation, although it was lower than that reported in other studies. This could be due to the differences in sample size, differences between Iranian race and other races and different pharmaceutical formulation of the drug produced in Iran.

  20. Antioxidant status in neonatal jaundice before and after phototherapy

    Directory of Open Access Journals (Sweden)

    S Ayyappan

    2015-01-01

    Full Text Available Background: Neonatal jaundice refers to yellow coloration of the skin and the sclera (whites of the eyes of newborn babies that result from the accumulation of bilirubin in the skin and mucous membranes. Because bilirubin is potentially toxic to the central nervous system. Genetic disorders of bilirubin conjugation, particularly the common Gilbert′s syndrome, can also contribute to neonatal hyperbilirubinemia. Objective: The aim of this study was to evaluate the lipid per-oxidation and antioxidant enzyme activities in patients with neonatal jaundice before and after phototherapy. Materials and Methods: The study includes 50 neonatal jaundice patients with average age 2-15 days. All patients of neonatal jaundice receiving phototherapy except feeding, cleaning. Subjects selected were from the patients attending Pediatrics Department. Plasma malondialdehyde (MDA, erythrocyte glutathione peroxidase (GPX, superoxide dismutase and catalase (CAT to monitor the bilirubin level. Results: The results show increased levels of bilirubin compared with controls (P < 0.001 shows the level of plasma MDA in control, before and after phototherapy. Represents the level of GPX was significantly increased in after the phototherapy group when compared with before phototherapy and control SPSS soft ware: (P < 0.001. Shows the reduced glutathione (GSH level in plasma was significantly decreased in the after phototherapy group when compared with before phototherapy and control (P < 0.001. And finally with ascorbic acid and CAT. Conclusion: It is evident from the study that increased oxidative stress in neonatal jaundice babies leads to decrease in the levels of antioxidants like GSH and ascorbic acid and disturb their metabolism, that weaken their ability to fight the growing stress. Intense oxidative stress and decreased antioxidants may contribute to neural cell death and alter the erythrocytomembrane structure processing in neonatal jaundice.

  1. Micronutrient and physiologic parameters before and 6 months after RYGB.

    Science.gov (United States)

    Gobato, Renata Cristina; Seixas Chaves, Daniela Fojo; Chaim, Elinton Adami

    2014-01-01

    Bariatric surgery is considered an effective method for sustained weight loss, but may cause various nutritional complications. The aim of this study was to evaluate the nutritional status of minerals and vitamins, food consumption, and to monitor physiologic parameters in patients with obesity before and 6 months after Roux-en-Y gastric bypass surgery (RYGB). Thirty-six patients who had undergone RYGB were prospectively evaluated before and 6 months after surgery. At each phase their weight, height, body mass index (BMI), Electro Sensor Complex (ES Complex) data, food consumption, and total protein serum levels, albumin, prealbumin, parathyroid hormone (PTH), zinc (Zn), B12 vitamin (VitB12), iron (Fe), ferritin, copper (Cu), ionic calcium (CaI), magnesium (Mg), and folic acid were assessed. The mean weight loss from baseline to 6 months after surgery was 35.34±4.82%. Markers of autonomic nervous system balance (Pmicronutrients measured, 34 patients demonstrated some kind of deficiency. There was a high percentage of Zn deficiency in both pre- (55.55%) and postoperative (61.11%) patients, and 33.33% of the patients were deficient in prealbumin postoperatively. The protein intake after 6 months of surgery was below the recommended intake (deficiencies for Mg (Pprevalence of hypozincemia at 6 months post-RYGB. Furthermore, protein supplements were needed to maintain an adequate protein intake up to 6 months postsurgery. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  2. Relations between depressed mood and vocal parameters before, during and after sleep deprivation : a circadian rhythm study

    NARCIS (Netherlands)

    BOUHUYS, AL; SCHUTTE, HK; BEERSMA, DGM; NIEBOER, GLJ

    The mechanism underlying improvement after total sleep deprivation (TSD) was studied in 14 major depressed patients. The suggestions that (1) circadian processes and/or (2) dimensions of arousal may play a role in the response to TSD were investigated. Diurnal variation of depressed mood and of

  3. Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study

    Directory of Open Access Journals (Sweden)

    Rowe Heather J

    2010-07-01

    Full Text Available Abstract Background Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. Methods A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. Results In total 399/646 (62% women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91% were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%, 36/125 (29% were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group

  4. A Study on the Alterations in Skin Viscoelasticity before and after an Intradermal Administration of Growth Factor

    Science.gov (United States)

    Ono, Ichiro

    2011-01-01

    Background: While photo-aging is believed to be preventable by the complete blockage of ultraviolet rays, there is no epoch-making method except sing fillers or autologous fat injection, for rejuvenating the skin once it has aged. Objective: Our group developed a new method for rejuvenating aged skin by the direct intradermal injection of basic fibroblast growth factor, the first method of its kind in the world. In this paper we report the results of long-term follow-up observations and alterations in skin viscoelasticity before and after this treatment. Materials and Methods: A single dose of growth factor was injected directly into aged skin of the dorsal surface of the hand intradermally. The skin viscoelasticity of 50 treated cases was measured by a cutometer just before the treatment and at 1, 3, 6, and 9 months after treatment, respectively. Results: We observed the following rejuvenating effects: improved skin softness, gradual improvement of turgor, improved thickness of atrophied skin, and greatly improved viscoelasticity which reveals the improvement of biomechanical properties of the treated aged skin. According to the comparisons of viscoelasticity between pre- and post-treatment, the rejuvenated changes of R2 and R7 values were comparable to an age difference of more than 20 years. Conclusion: This method was confirmed to have excellent effects in rejuvenating aged skin safely and reliably including biomechanical properties. With this advance, we expect conventional non-physiological skin rejuvenating treatments to be replaced by a much more fundamental method using one-time injections of the growth factor. PMID:21976900

  5. Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study

    Directory of Open Access Journals (Sweden)

    Lovarini Meryl

    2005-12-01

    Full Text Available Abstract Background Many health professionals lack the skills to find and appraise published research. This lack of skills and associated knowledge needs to be addressed, and practice habits need to change, for evidence-based practice to occur. The aim of this before and after study was to evaluate the effect of a multifaceted intervention on the knowledge, skills, attitudes and behaviour of allied health professionals. Methods 114 self-selected occupational therapists were recruited. The intervention included a 2-day workshop combined with outreach support for eight months. Support involved email and telephone contact and a workplace visit. Measures were collected at baseline, post-workshop, and eight months later. The primary outcome was knowledge, measured using the Adapted Fresno Test of Evidence-Based Practice (total score 0 to 156. Secondary outcomes were attitude to evidence-based practice (% reporting improved skills and confidence; % reporting barriers, and behaviour measured using an activity diary (% engaging/not engaging in search and appraisal activities, and assignment completion. Results Post-workshop, there were significant gains in knowledge which were maintained at follow-up. The mean difference in the Adapted Fresno Test total score was 20.6 points (95% CI, 15.6 to 25.5. The change from post-workshop to follow-up was small and non-significant (mean difference 1.2 points, 95% CI, -6.0 to 8.5. Fewer participants reported lack of searching and appraisal skills as barriers to evidence-based practice over time (searching = 61%, 53%, 24%; appraisal 60%, 65%, 41%. These differences were statistically significant (p = 0.0001 and 0.010 respectively. Behaviour changed little. Pre-workshop, 6% engaged in critical appraisal increasing to 18% post-workshop and 18% at follow-up. Nearly two thirds (60% were not reading any research literature at follow-up. Twenty-three participants (20.2% completed their assignment. Conclusion Evidence

  6. Household Portfolio Choice Before and After House Purchase

    DEFF Research Database (Denmark)

    Lyng, Ran Sun; Zhou, Jie

    2017-01-01

    around 61% of them to down payments when buying a house. Liquid wealth stay low after a house purchase and start to increase 3 years later; (ii) the risky asset participation rate drops 2 percentage points – a 6.2% decline – at the year of house purchase. The drop is larger for households with wealth......We study the temporal patterns of household portfolio choice of liquid wealth over a 7-year period around house purchase, using unique administrative panel data from Denmark. We find that (i) households accumulate significantly more liquid wealth in a few years before a house purchase and convert...... above the median level; and (iii) conditional on participation, the risky asset share decreases and reaches the lowest point 1 year before a house purchase, but it jumps immediately after. This suggests that of the three channels identified in the literature that could affect the conditional risky share...

  7. Respiratory function in iron deficiency anaemia before and after treatment.

    Science.gov (United States)

    Osmanliev, P; Tzanev, B; Prokopov, V; Gigova, D

    1975-01-01

    The present studies concern the basic ventilatory indices, the arterial blood gases, the indices of the acid-base balance and the indices of the alveolar-capillary diffusion (DLCO, SS, Dm, theta Vc) in anemia before and after treatment. Substantial changes are recorded after treatment mainly in DLCO, SS and theta Vc. These changes are predominantly due to changes in the concentration of Hb. An evaluation of both methods for the standardization of DLCO at 14,6 g Hb/100 ml blood is also presented.

  8. Sex Differences in Medication and Primary Healthcare Use before and after Spousal Bereavement at Older Ages in Denmark: Nationwide Register Study of over 6000 Bereavements

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Jacobsen, Rune; Glaser, Karen

    2011-01-01

    Background. The study aimed to examine sex differences in healthcare use before and after widowhood to investigate whether reduced healthcare use among widowers compared with widows may partially explain excess mortality and more adverse health outcomes among men than women after spousal loss...... use and the average annual number of visits to general physicians (GPs). Results. The average daily use of all-cause and major system-specific medications, as well as the number of GP visits increased over the period from 1 year before and up to 5 years after a spouse's death, but there were no sex...

  9. Consumers' price knowledge before, during, and after store visit

    DEFF Research Database (Denmark)

    Jensen, Birger Boutrup

    Many attempts have been made to measure consumers' price knowledge for frequently purchased goods. However, the results have varied considerably and conflict with the results of reference price studies. This is the first study to examine consumers' price knowledge before, during, and after store...... visit, thus enabling a study of what consumers learn about prices during the store visit, and consequently the relationship between reference prices and episodic price knowledge. The project applies three measures of consumers' price knowledge corresponding to different levels of price information...... processing, which furthermore allows us to examine whether consumers' price memory is one- or multidimensional....

  10. Asthma medication prescribing before, during and after pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari

    2016-01-01

    OBJECTIVES: To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN: A descriptive drug utilisation study. SETTING: 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia...... Romagna and Tuscany), Wales, and the Clinical Practice Research Datalink representing the rest of the UK. PARTICIPANTS: All women with a pregnancy ending in a delivery that started and ended between 2004 and 2010, who had been present in the database for the year before, throughout and the year following...... for 3-month time periods and the choice of asthma medicine and changes in prescribing over the study period were evaluated in each database. RESULTS: In total, 1 165 435 deliveries were identified. The prevalence of asthma medication prescribing during pregnancy was highest in the UK and Wales databases...

  11. Before and After Photos: Treatment of Hypertrophic Scars

    Science.gov (United States)

    ... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Before and after photos: Treatment of hypertrophic scars ...

  12. Symptoms and personality problems before, during and after long-term psychoanalytic treatment: A multiple-cohort study

    NARCIS (Netherlands)

    Berghout, C.C.; Zevalkink, D.J.; de Jong, J.T.V.M.

    2010-01-01

    Using a multiple cohort design, we compared symptoms and personality functioning (SCL-90, BDI-II, STAI, IIP-64, MMPI-2) of patients (N= 231) in different phases of long-term psychoanalytic treatment (before, during, end, follow-up). Our results confirmed findings from earlier meta-analyses that

  13. Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction: a longitudinal follow-up study.

    Science.gov (United States)

    Borneskog, Catrin; Lampic, Claudia; Sydsjö, Gunilla; Bladh, Marie; Svanberg, Agneta Skoog

    2014-12-12

    More and more lesbian couples are planning parenthood through donor insemination and IVF and the number of planned lesbian families is growing in Sweden and other western countries. Research has shown that lesbian couples report as much overall satisfaction in their relationships as do heterosexual couples. However, although parenthood is highly desired, many parents are unaware of the demands of parenthood and the strain on their relationship that the arrival of the baby might bring. The aim of this study was to compare lesbian and heterosexual couples' perceptions of relationship satisfaction at a three-year follow up after assisted reproduction. The present study is a part of the Swedish study on gamete donation, a prospective longitudinal cohort study. The present study constitutes a three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden, were recruited consecutively during 2005-2008. A total of 114 lesbian women (57 treated women and 57 partners) and 126 heterosexual women and men (63 women and 63 men) participated. Participants responded to the ENRICH inventory at two time points during 2005-2011; at the commencement of treatment (time point 1) and about three years after treatment termination (time point 3). To evaluate the bivariate relationships between the groups (heterosexual and lesbian) and socio-demographic factors Pearson's Chi- square test was used. Kolmogorov-Smirnov test was used for testing of normality, Mann-Whitney U- test to examine differences in ENRICH between the groups and paired samples t-test to examine scores over time. Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples satisfaction with relationship quality was not low. Both lesbian and heterosexual couples would be classified accordingly to ENRICH-typology as vitalized or

  14. Childhood IQ and all-cause mortality before and after age 65: prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies.

    Science.gov (United States)

    Hart, C L; Taylor, M D; Smith, G Davey; Whalley, L J; Starr, J M; Hole, D J; Wilson, V; Deary, I J

    2005-05-01

    The objective was to investigate how childhood IQ related to all-cause mortality before and after age 65. The Midspan prospective cohort studies, followed-up for mortality for 25 years, were linked to individuals' childhood IQ from the Scottish Mental Survey 1932. The Midspan studies collected data on risk factors for cardiorespiratory disease from a questionnaire and at a screening examination, and were conducted on adults in Scotland in the 1970s. An age 11 IQ from the Scottish Mental Survey 1932, a cognitive ability test conducted on 1921-born children attending schools in Scotland, was found for 938 Midspan participants. The relationship between childhood IQ and mortality risk, adjusting for adulthood socio-economic confounders, was analysed. The effect of adjustment for childhood IQ on the relationship between established risk factors (blood pressure, smoking, height and respiratory function) and mortality was also investigated. For deaths occurring up to age 65, there was a 36% increased risk per standard deviation decrease (15 points) in childhood IQ which was reduced to 29% after adjusting for social class and deprivation category. There was no statistically significant relationship between childhood IQ and deaths occurring after the age of 65. Adjustment for childhood IQ attenuated the risk factor-mortality relationship in deaths occurring up to age 65, but had no effect in deaths occurring after age 65. Childhood IQ was significantly related to deaths occurring up to age 65, but not to deaths occurring after age 65.

  15. Opioid prescriptions before and after high-energy trauma

    DEFF Research Database (Denmark)

    Zwisler, Stine T; Hallas, Jesper; Larsen, Morten S

    2015-01-01

    OBJECTIVE: To describe the legal use of opioids in adult patients before and after high-energy trauma. DESIGN: The study was a retrospective database study. SETTING: Clinical care outside hospitals. PATIENTS: All patients who suffered high-energy trauma and were brought to Odense University...... Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database. In all, 938 patients were included. MAIN OUTCOME MEASURE: Redemption of opioid prescription during the 6 months prior...

  16. Phosphorus Spectroscopy of Calf Muscles before and after Exercise

    International Nuclear Information System (INIS)

    Wcisło, Bożena; Cichocka, Monika; Urbanik, Andrzej

    2014-01-01

    The aim of this study was to determine 31 PMRS reference spectrum and intracellular pH of calf muscles in the dominant limb of healthy, young, male volunteers before and after intense physical effort. Examinations were performed with a 1.5 T MR system. FID CSI (Free Induction Decay Chemical Shift Imaging) sequence was used with the following parameters: TR=4000 ms, FA=90°, NEX=2 and VOI (Volume Of Interest)=8×8×8 cm 3 (512 cm 3 ) involving in calf muscles. Raw data was preprocessed using SAGE (GE) software. Authors analyzed relative concentrations ratios of selected metabolites: PCr/ATP and PCr/P i . Intracellular pH and relative concentrations ratios of each metabolite (P i , PCr, α-ATP, β-ATP, γ-ATP, ATP) were also calculated relative to the sum of concentrations of all metabolites. Results were compared with a t-test. Based on statistical analysis of results significant differences (p<0.05) were demonstrated for some of the studied metabolites and for intracellular pH. Increase in PCr concentration in relation to the sum of concentrations of all metabolites and to ATP concentration was noted. However, β-ATP, α-ATP and ATP concentrations relative to the sum of concentrations of all metabolites become reduced. Decrease in pH after physical effort was demonstrated. There were no significant differences (p<0.05) in concentrations of remaining metabolites before and after exercise. Increase in PCr concentration relative to P i concentration and decrease of P i and γ-ATP concentration relative to the sum of concentrations of all metabolites were demonstrated. The 31 PMRS method enables assessment of concentrations of phosphorus-containing metabolites as well as intercellular pH before and after exercise. This method is still under examination, but it has already shown promise as a diagnostic tool for the future

  17. Variations over time in the effects of age and sex on hospitalization rates before and after admission to a nursing home: A German cohort study.

    Science.gov (United States)

    Hoffmann, Falk; Allers, Katharina

    2017-08-01

    We examined hospitalization rates for nursing home residents before and after their entry to the home, stratified by sex and age. A cohort study was conducted using data from a large health insurance fund on 127,227 residents aged 65 years and over newly admitted to a nursing home between January 1, 2010, and December 31, 2014. We assessed hospitalization rates and proportions being hospitalized in 6-month intervals one year before nursing home placement and up to 5 years thereafter. Multiple Poisson regression models were fitted to calculate relative risks (RR). Mean age was 84.0 years and 74.6% of the cohort were females. Hospitalization rates were 194.4 per 100 person-years (PY) in the 12 months before entry to the nursing home and 120.0 per 100 PY thereafter. Rates were highest immediately before entry in both sexes. The influence of age was most pronounced in the 12-7 months before entry (RR: 2.37 for 65-74 vs. 95+ years) and declined thereafter (1.29-1.38 up to month 24 after entry). In contrast, the influence of sex was greater after entry (RR: 1.13 for males vs. females in the 12-7 months before and 1.23-1.31 up to month 24 after entry). Hospitalization rates of nursing home residents are much higher in Germany than in other Western countries. We have provided some insight into the influence of age and sex on hospitalization rates, which varied over the period (time before and after entry to the nursing home) analyzed. We urgently recommend that future studies on the hospitalization of residents stratify their analyses by sex, age and period. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Anemia and iron deficiency before and after bariatric surgery.

    Science.gov (United States)

    Salgado, Wilson; Modotti, Caue; Nonino, Carla Barbosa; Ceneviva, Reginaldo

    2014-01-01

    Iron deficiency and anemia are changes often associated with obesity. Bariatric surgery is responsible for increasing the iron loss and reducing its absorption. The objective of this study was to evaluate anemia and iron deficiency before and after bariatric surgery and to relate them to possible predisposing factors. A retrospective study was conducted on obese patients submitted to open Roux-en-Y gastric bypass, in which clinical and laboratory data were obtained up to 48 months postoperatively. Patients were divided into groups according to the presence or absence of anemia and to the presence or absence of iron deficiency (even without anemia), and all data were compared between these groups. Preoperatively, 21.5% of patients had anemia and 20% had iron deficiency. The number of patients with anemia did not vary through the 4 years of the study, but ferritin levels significantly decreased with time (Pdeficiency. Anemia and iron deficiency are frequent in obese patients and must be treated before surgery. Medical and nutritional surveillance is important in the postoperative period of bariatric surgery. Management of each condition must be directed at correcting the 2 major sources of iron deficiency and anemia: food intolerance (mostly meat intolerance) and losses (frequently due to menstruation). These are the factors more related to iron deficient anemia. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Reduction of anti-malarial consumption after rapid diagnostic tests implementation in Dar es Salaam: a before-after and cluster randomized controlled study

    Directory of Open Access Journals (Sweden)

    Swai Ndeniria

    2011-04-01

    Full Text Available Abstract Background Presumptive treatment of all febrile patients with anti-malarials leads to massive over-treatment. The aim was to assess the effect of implementing malaria rapid diagnostic tests (mRDTs on prescription of anti-malarials in urban Tanzania. Methods The design was a prospective collection of routine statistics from ledger books and cross-sectional surveys before and after intervention in randomly selected health facilities (HF in Dar es Salaam, Tanzania. The participants were all clinicians and their patients in the above health facilities. The intervention consisted of training and introduction of mRDTs in all three hospitals and in six HF. Three HF without mRDTs were selected as matched controls. The use of routine mRDT and treatment upon result was advised for all patients complaining of fever, including children under five years of age. The main outcome measures were: (1 anti-malarial consumption recorded from routine statistics in ledger books of all HF before and after intervention; (2 anti-malarial prescription recorded during observed consultations in cross-sectional surveys conducted in all HF before and 18 months after mRDT implementation. Results Based on routine statistics, the amount of artemether-lumefantrine blisters used post-intervention was reduced by 68% (95%CI 57-80 in intervention and 32% (9-54 in control HF. For quinine vials, the reduction was 63% (54-72 in intervention and an increase of 2.49 times (1.62-3.35 in control HF. Before-and-after cross-sectional surveys showed a similar decrease from 75% to 20% in the proportion of patients receiving anti-malarial treatment (Risk ratio 0.23, 95%CI 0.20-0.26. The cluster randomized analysis showed a considerable difference of anti-malarial prescription between intervention HF (22% and control HF (60% (Risk ratio 0.30, 95%CI 0.14-0.70. Adherence to test result was excellent since only 7% of negative patients received an anti-malarial. However, antibiotic

  20. Retinal oxygen saturation before and after glaucoma surgery.

    Science.gov (United States)

    Nitta, Eri; Hirooka, Kazuyuki; Shimazaki, Takeru; Sato, Shino; Ukegawa, Kaori; Nakano, Yuki; Tsujikawa, Akitaka

    2017-08-01

    This study compared retinal vessel oxygen saturation before and after glaucoma surgery. Retinal oxygen saturation in glaucoma patients was measured using a non-invasive spectrophotometric retinal oximeter. Adequate image quality was found in 49 of the 108 consecutive glaucoma patients recruited, with 30 undergoing trabeculectomy, 11 EX-PRESS and eight trabeculotomy. Retinal oxygen saturation measurements in the retinal arterioles and venules were performed at 1 day prior to and at approximately 10 days after surgery. Statistical analysis was performed using a Student's t-test. After glaucoma surgery, intraocular pressure (IOP) decreased from 19.8 ± 7.7 mmHg to 9.0 ± 5.7 mmHg (p glaucoma surgery had an effect on the retinal venous oxygen saturation. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Anirudh Rao

    Full Text Available The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature.Systematic literature review.European and North American, Pre-dialysis Chronic Kidney Disease (CKD cohort studies.Studies assessing the association between CKD and mortality in the elderly (>65 years published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE.Time period before and after the publication of the STROBE statement.Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS, Scottish Intercollegiate Guidelines Network (SIGN and Critical Appraisal Skills Programme (CASP tools.37 papers (11 Pre & 26 Post STROBE were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0 vs 83% (IQR, 78.4-84.9, p = 0.05. There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9, SIGN (Manuscript SIGN score 83.3 and CASP (Manuscript CASP score 91.7 tools.Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting.This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort

  2. Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

    Science.gov (United States)

    Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S; Jager, Kitty J; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

    2016-01-01

    The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature. Systematic literature review. European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Time period before and after the publication of the STROBE statement. Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0) vs 83% (IQR, 78.4-84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting. This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort

  3. SMS reminders improve re-screening in women and heterosexual men with chlamydia infection at Sydney Sexual Health Centre: a before-and-after study.

    Science.gov (United States)

    Guy, Rebecca; Wand, Handan; Knight, Vickie; Kenigsberg, Aurelie; Read, Phillip; McNulty, Anna M

    2013-02-01

    In 2009, Sydney Sexual Health Centre implemented a short message service (SMS) reminder system to improve re-screening after chlamydia infection. SMS reminders were sent at 3 months recommending the patient make an appointment for a re-screen. Using a before-and-after study, the authors compared the proportion re-screened within 1-4 months of chlamydia infection in women and heterosexual men who were sent an SMS in January to December 2009 (intervention period) with a 18-month period before the SMS was introduced (before period). The authors used a χ(2) test and multivariate regression. Visitors and sex workers were excluded. In the intervention period, 141 of 343 (41%) patients were diagnosed with chlamydia and sent the SMS reminder. In the before period, 338 patients were diagnosed as having chlamydia and none received a reminder. The following baseline characteristics were significantly different between those sent the SMS in the intervention period and the before period: new patients (82% vs 72%, p=0.02), aged SMS (30%) than the before period (21%), p=0.04, and after adjusting for baseline differences, the OR was 1.57 (95% CI 1.01 to 2.46). SMS reminders increased re-screening in patients diagnosed as having chlamydia at a sexual health clinic. The clinic now plans to introduce electronic prompts to maximise the uptake of the initiative and consider strategies to further increase re-screening.

  4. Kidney recipients experiences before during and after kidney transplantation

    DEFF Research Database (Denmark)

    Nielsen, Charlotte

    lives. After the transplant, there is often a need for less medication and the possible side effects of the immunosuppressant treatment are outweighed by the increased quality of life. The transplant is a milestone, but the whole process is based on close contact with the health services, before...... and after the kidney transplant, through outpatient visits and during possible hospitalization, which can occur due to complications or disease progression. Objective To explore the coherence of the kidney transplant process in order to explain the lived experiences of kidney recipients before, during...... and after kidney transplantation. Method Participant observation and semi-structured individual interviews was conducted with kidney recipients before, during and after kidney transplantation. Data analysis is inspired by Ricoeur's interpretation theory on three levels: Naive reading; structural analysis...

  5. Food satisfaction: Integrating feelings before, during and after food intake

    DEFF Research Database (Denmark)

    Andersen, Barbara Vad; Hyldig, Grethe

    2015-01-01

    Consumers' satisfaction is important for the food industry to ensure product success. Determinants to food satisfaction are multifactorial and a method approaching the multiple determinants would provide a detailed picture of determinant behind consumers' hedonic food appreciation. The aims...... of this study were (1) to develop a method that could give detailed information about sensory- and food satisfaction (2) to study differences in sensory satisfaction in a case study, and (3) to study the factors related to food satisfaction. Focus group interviews and a literature study provided an overview...... of factors with potential to affect food satisfaction. A total of four questionnaires, covering factors before-, during- and after intake as well as demographics, were developed to measure factors related to satisfaction. The questionnaires were utilised in a cross-over consumer study with 79 subjects...

  6. Comparative study of portal hemodynamics and regional hepatic blood flow before and after hepatic resection by 133Xe-scintiphotosplenoportography

    International Nuclear Information System (INIS)

    Yasuda, Tadashi; Sasaki, Yo; Imaoka, Shingi; Shibata, Takashi; Wada, Hisashi; Nagano, Hiroaki; Iwanaga, Takeshi; Nakano, Shunichi; Hasegawa, Yoshihisa.

    1990-01-01

    Changes in the portal circulatory pattern and regional hepatic blood flow (rHBF) after surgical liver resection were studied by 133 Xe-scintiphotosplenoportography (SSP). The visual patterns of pre- and postoperative portal circulation were compared. Different patterns were observed after the operation in five of 27 patients (porto-systemic shunt formation 3, progression 1, regression 1). The patients with porto-systemic shunt showed postopertive complications (massive ascites, jaundice, cardiopulmonary failure) more frequently than those without it. The ratio of rHBF increase (post-/pre-operative rHBF) was 1.36±0.63 on average. The ratio was higher in patients with good liver function or without liver cirrhosis. The ratio also correlated with the weight of the liver resected. But operation time, blood loss or whether hepatic blood supply was clamped off during the operation did not affect the ratio. Resection in the right lobe, however, caused a greater rHBF increase in the residual liver than the same degree of resection in the left lobe. SSP could be a useful method for investigating the effect of hepatic resection on portal hemodynamics and it is suggested that existence of portosystemic shunt influences the postoperative course. (author)

  7. Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization

    Directory of Open Access Journals (Sweden)

    Deborah Campos Telles

    2013-12-01

    Full Text Available The aim of the present study was the morphometric evaluation of the epithelial lining and fibrous capsule in histological specimens of keratocystic odontogenic tumors (KOTs before and after marsupialization. Histological sections from six KOTs that had undergone marsupialization followed by enucleation were photographed. The thickness and features of the capsule and of the epithelial lining of the tumor were evaluated upon marsupialization and upon subsequent enucleation using Axion Vision software. The histological specimens taken upon marsupialization presented an epithelial lining that is typical of KOTs. After marsupialization, the enucleated specimens had a modified epithelial lining and a fibrous capsule that both presented a greater median thickness (p = 0.0277 and p = 0.0212, respectively, morphological changes, and significant enlargement. These modifications can facilitate full surgical treatment and may well be related to a low KOT recurrence rate.

  8. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use-A One Year Study from Vietnam.

    Science.gov (United States)

    Lien, La Thi Quynh; Hoa, Nguyen Quynh; Chuc, Nguyen Thi Kim; Thoa, Nguyen Thi Minh; Phuc, Ho Dang; Diwan, Vishal; Dat, Nguyen Thanh; Tamhankar, Ashok J; Lundborg, Cecilia Stålsby

    2016-06-14

    Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital's wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital's wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001).

  9. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam

    Science.gov (United States)

    Lien, La Thi Quynh; Hoa, Nguyen Quynh; Chuc, Nguyen Thi Kim; Thoa, Nguyen Thi Minh; Phuc, Ho Dang; Diwan, Vishal; Dat, Nguyen Thanh; Tamhankar, Ashok J.; Lundborg, Cecilia Stålsby

    2016-01-01

    Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital’s wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital’s wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001). PMID:27314366

  10. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam

    Directory of Open Access Journals (Sweden)

    La Thi Quynh Lien

    2016-06-01

    Full Text Available Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi and in an urban hospital (in the center of Hanoi in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital’s wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L. Metronidazole was detected at the highest concentrations in the urban hospital’s wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L. A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01 and metronidazole (r = 0.99; p < 0.001.

  11. Kinematic analysis of mandibular motion before and after orthognathic surgery for skeletal Class III malocclusion: A pilot study.

    Science.gov (United States)

    Ugolini, Alessandro; Mapelli, Andrea; Segù, Marzia; Galante, Domenico; Sidequersky, Fernanda V; Sforza, Chiarella

    2017-03-01

    The aim of the study was to detect the changes in 3D mandibular motion after orthognathic surgery for skeletal Class III malocclusion. Using a 3D motion analyzer, free mandibular border movements were recorded in nine patients successfully treated for skeletal Class III malocclusion and in nine patients scheduled for orthognathic surgery. Data were compared using Mann-Whitney non-parametric U-test. The results showed no differences between the groups in the total amount of mouth opening, protrusion, and in lateral excursions, but the percentage of mandibular movement explained by condylar translation was significantly increased after surgery (20% vs. 23.6%). During opening, the post-surgery patients showed a more symmetrical mandibular interincisal point and condylar path than pre-surgery patients (p < 0.01). Patients treated with orthognathic surgery for skeletal Class III malocclusion recover a good and symmetric temporomandibular joint function.

  12. Medication and nutritional supplement use before and after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Charline Fernanda Backes

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5 per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%, antilipemic (77% and antihypertensive drugs (49.5%. On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction.

  13. Genital endometriosis rate dynamics before and after Chernobyl accident

    International Nuclear Information System (INIS)

    Al-Shbul', I.; Suprun, L.Ya.

    2000-01-01

    The necessity of endometriosis dynamics evaluation is caused by worse ecological situation on the area of Belarus. Genital endometriosis frequency was studied considering the outcomes of surgeries fulfilled in hospitals of Gomel, Mogilev and Vitebsk in 1981-1995. At this time 1254 women underwent an operation and 19% of patients (235 persons) were operated before the Chernobyl accident. In the first 5 years after the accident endometriosis frequency increased nearly 2 times. The next 5 years (1991-1995) the number of operated patients was 565, i.e. 45% from the whole number. Uterus was extirpated or amputated in 898 patients, ovaries at both sides were removed in 36 ones. As the analysis showed the endometriosis frequency grew in 2,5 times for last 15 years, the most significant increase of this pathology was observed during the first five years after the accident

  14. Bacterial Contamination of Endodontic Materials before and after Clinical Storage.

    Science.gov (United States)

    Saeed, Media; Koller, Garrit; Niazi, Sadia; Patel, Shanon; Mannocci, Francesco; Bruce, Kenneth; Foschi, Federico

    2017-11-01

    The aim of this study was to evaluate the bacterial contamination in endodontic consumables (gutta-percha points, rubber dams, paper mixing pads, caulking agents, and endodontic instrument sponges [EISs]) before and after clinical use and storage. Materials were randomly sampled in triplicates at 3 time points (t 0 , at package opening; t 1 , at 7 days; and t 2 , at 14 days) during their clinical usage. The gutta-percha points and caulking agent (25 mg) were added to 1 mL phosphate-buffered saline (PBS). The rubber dam, paper mixing pad, and EIS were added to 25 mL PBS. After vortexing, centrifuging, and removing the supernatant, the pellet was resuspended in 1 mL PBS, plated on fastidious anaerobic agar, and incubated aerobically and anaerobically. The grown colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The total bacterial load was calculated in the remaining volume (800 μL) from each sample by quantitative polymerase chain reaction after DNA extraction. All tested materials showed a varied number of contaminated samples at the 3 time points (except EIS at t 0 ) using MALDI-TOF MS. The most isolated genera were Propionibacterium (42%) and Staphylococcus (32%). By using non-culture-based approaches, all tested materials at the 3 time points (except gutta-percha at t 0 and the caulking agent at t 0, t 1, and t 2 ) carried bacterial DNA. The majority of the tested materials harbored bacteria in their samples before and after clinical storage. Nosocomial infection derived from commonly used consumables could have an impact on the outcome of endodontic treatment. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Spousal similarity in life satisfaction before and after divorce.

    Science.gov (United States)

    Wortman, Jessica; Lucas, Richard E

    2016-04-01

    Previous research has explored possible origins of individual differences in subjective well-being, focusing largely on stable, internal characteristics of traits as predictors of life satisfaction (Diener & Lucas, 1999). Although past work has demonstrated that life satisfaction is largely stable over the life span, other evidence has also demonstrated the lasting impact of life events. In this study, we use married couples as a test of the impact of life circumstances on life satisfaction, focusing on similarity in life satisfaction before and after divorce. If life satisfaction is impacted by shared life circumstances, married couples (who share life circumstances) should show greater similarity in life satisfaction before divorce than after. We tested this possibility using a dyadic latent-state-trait model that examined cross-spouse similarity in the stable and changing components of life satisfaction. Using a nationally representative panel study from Germany (Wagner, Frick & Schupp, 2007), we showed that similarity declined substantially following divorce. This suggests that life satisfaction is related to shared life circumstances. (c) 2016 APA, all rights reserved).

  16. Harvested rainwater quality before and after treatment in six ...

    Science.gov (United States)

    Rainwater harvesting (RWH) is an alternative method of providing water for indoor domestic use, but the water quality after treatment and distribution at individual residences is not well documented. In this study, water quality parameters were measured at the cistern and indoor cold-water taps of six residential RWH systems that use various treatment processes. Potential human pathogens (Mycobacterium avium, Mycobacterium intracellulare, Aspergillus flavus, Aspergillus fumigatus, and Aspergillus niger) were found frequently in cisterns and in treated rainwater delivered at the tap; Legionella pneumophila was not detected as frequently, but it persisted in a system after its first detection. The observed decreases in bacterial concentrations from the cistern to the tap after filtration/ ultraviolet (UV) treatment and distribution were less than expected; this suggests deficiencies in the effectiveness of the filtration/UV processes employed and/or degradation in water quality in the distribution system due to the absence of a disinfectant residual. Determination of the disinfection efficiency occuring in home treatment processes. Molecular analysis of rainwater before and after treatment. First study to include the monitoring of opportunistic fungal pathogens.

  17. A before and after study on personality assessment in adolescents exposed to the 2009 earthquake in L'Aquila, Italy: influence of sports practice.

    Science.gov (United States)

    Valenti, Marco; Vinciguerra, Maria Giulia; Masedu, Francesco; Tiberti, Sergio; Sconci, Vittorio

    2012-01-01

    To assess and estimate the personality changes that occurred before and after the 2009 earthquake in L'Aquila and to model the ways that the earthquake affected adolescents according to gender and sport practice. The consequences of earthquakes on psychological health are long lasting for portions of the population, depending on age, gender, social conditions and individual experiences. Sports activities are considered a factor with which to test the overall earthquake impact on individual and social psychological changes in adolescents. Before and after design. Population-based study conducted in L'Aquila, Italy, before and after the 2009 earthquake. Before the earthquake, a random sample of 179 adolescent subjects who either practised or did not practise sports (71 vs 108, respectively). After the earthquake, of the original 179 subjects, 149 were assessed a second time. Minnesota Multiphasic Personality Inventory-Adolescents (MMPI-A) questionnaire scores, in a supervised environment. An unbalanced split plot design, at a 0.05 significance level, was carried out using a linear mixed model with quake, sex and sports practice as predictive factors. Although the overall scores indicated no deviant behaviours in the adolescents tested, changes were detected in many individual content scale scores, including depression (A-dep score mean ± SEM: before quake =47.54±0.73; after quake =52.67±0.86) and social discomfort (A-sod score mean ± SEM: before quake =49.91±0.65; after quake =51.72±0.81). The MMPI-A profiles show different impacts of the earthquake on adolescents according to gender and sport practice. The differences detected in MMPI-A scores raise issues about social policies required to address the psychological changes in adolescents. The current study supports the idea that sport should be considered part of a coping strategy to assist adolescents in dealing with the psychological effects of the earthquakes on their personalities.

  18. Algorithm for lamotrigine dose adjustment before, during, and after pregnancy

    DEFF Research Database (Denmark)

    Sabers, A

    2012-01-01

    Sabers A. Algorithm for lamotrigine dose adjustment before, during, and after pregnancy. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01627.x. © 2011 John Wiley & Sons A/S. Background -  Treatment with lamotrigine (LTG) during pregnancy is associated with a pronounced risk of seizure deterior......Sabers A. Algorithm for lamotrigine dose adjustment before, during, and after pregnancy. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01627.x. © 2011 John Wiley & Sons A/S. Background -  Treatment with lamotrigine (LTG) during pregnancy is associated with a pronounced risk of seizure...

  19. Pediatric fluoroquinolone prescription in South Korea before and after a regulatory intervention: A nationwide study, 2007-2015.

    Directory of Open Access Journals (Sweden)

    Seung Yeon Song

    Full Text Available To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents.Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred.A total of 505,859 children received systemic fluoroquinolone during the study period-297,054 ciprofloxacin, and 208,805 levofloxacin. After implementation of the drug utilization review program, the annual prescription rate for ciprofloxacin declined by 97.5% (from 840 to 21 per 100,000 person-years, P < 0.001, and for levofloxacin by 96.4% (from 598 to 11 per 100,000 person-years, P < 0.001. The decline was more dramatic in the outpatient setting than in the inpatient setting for both drugs.The dramatic and sustained decline in prescription number and change in prescription pattern after the regulatory action suggests that the implementation under drug utilization review program was successful in controlling excessive and inappropriate use of fluoroquinolones in children, possibly guiding towards more judicious and selective prescription behavior.

  20. Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty.

    Science.gov (United States)

    Vainrib, Michael; Reyblat, Polina; Ginsberg, David A

    2013-03-01

    To evaluate urodynamic parameters in myelomeningocele patients with native bladders and after augmentation, continence rates and check the longevity of these parameters after lower urinary tract (LUT) reconstruction. A retrospective review of adult myelomeningocele patients with UDS. 118 adult patients with NGB secondary to myelomeningocele were identified. 58/118 (49.1%) had UDS performed in our clinic: 18/58 (31%) after prior reconstruction ("Augment" group) and 40/58 (69%) during annual urologic follow up ("NoSx" group). Urodyanmic findings after augmentation included: Pdet@MCC 31.1 (1-95) cmH(2)O, MCC 495.9 ml, NDO in 3/18 (16.7%), mean DLPP 54.0 (48-60) cmH(2)O and mean ALPP 39.6 (20-110) cmH(2)O in 5/18 with an incompetent sphincter. Patients in "NoSx" group had the following findings: Pdet@MCC of 39.6 (1-60) cmH(2)O, MCC 407.5 ml, 18/40 (45%) had NDO, mean DLPP of 48.1 (15-95) cmH(2)O and mean ALPP = 51 (17-78) cmH(2)O in 10/40 with incompetent sphincter. In the "NoSx" group, 19/40 (47.5%) had normal bladder compliance. Mean time from the surgery to UDS was 10.4 years. Continent patients in the "NoSx" group had a significantly higher MCC than incontinent patients in the same group (475 vs. 352 ml, P = 0.029). 8/17 (47.1%) continent patients in "NoSx" group had normal UDS. Most patients after augmentation maintain low bladder pressures for more than 10 years. Close long-term follow up should be maintained, especially in those patients that have not had prior augmentation. Urinary incontinence may be secondary to poor sphincteric function in patients with and without prior augmentation. Moreover, we should continue to follow patients after reconstruction as elevated detrusor pressures can still be seen. Strict follow up after LUT reconstruction still continues to be important. Copyright © 2012 Wiley Periodicals, Inc.

  1. Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

    Science.gov (United States)

    Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

    2010-01-01

    Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

  2. Prescribing of Antidiabetic Medicines before, during and after Pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel A.; Klungsøyr, Kari; Neville, Amanda J.

    2016-01-01

    and 88.8% in the Netherlands received an insulin analogue alone or in combination with human insulin, this proportion increasing over time. Oral products were mainly metformin and prescribing was highest in the 3 months before pregnancy. Metformin use during pregnancy increased in some countries......Aim: To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. Methods: A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women...... with a pregnancy starting and ending between 2004 and 2010, (Denmark, 2004–2009; Norway, 2005–2010; Emilia Romagna, 2008–2010), which ended in a live or stillbirth, were identified. Prescriptions for antidiabetic medicines issued (UK) or dispensed (non-UK) during pregnancy and/or the year before or year after...

  3. How a nuclear power plant accident influences acceptance of nuclear power: results of a longitudinal study before and after the Fukushima disaster.

    Science.gov (United States)

    Visschers, Vivianne H M; Siegrist, Michael

    2013-02-01

    Major nuclear accidents, such as the recent accident in Fukushima, Japan, have been shown to decrease the public's acceptance of nuclear power. However, little is known about how a serious accident affects people's acceptance of nuclear power and the determinants of acceptance. We conducted a longitudinal study (N= 790) in Switzerland: one survey was done five months before and one directly after the accident in Fukushima. We assessed acceptance, perceived risks, perceived benefits, and trust related to nuclear power stations. In our model, we assumed that both benefit and risk perceptions determine acceptance of nuclear power. We further hypothesized that trust influences benefit and risk perceptions and that trust before a disaster relates to trust after a disaster. Results showed that the acceptance and perceptions of nuclear power as well as its trust were more negative after the accident. In our model, perceived benefits and risks determined the acceptance of nuclear power stations both before and after Fukushima. Trust had strong effects on perceived benefits and risks, at both times. People's trust before Fukushima strongly influenced their trust after the accident. In addition, perceived benefits before Fukushima correlated with perceived benefits after the accident. Thus, the nuclear accident did not seem to have changed the relations between the determinants of acceptance. Even after a severe accident, the public may still consider the benefits as relevant, and trust remains important for determining their risk and benefit perceptions. A discussion of the benefits of nuclear power seems most likely to affect the public's acceptance of nuclear power, even after a nuclear accident. © 2012 Society for Risk Analysis.

  4. Feasibility of bioelectrical impedance spectroscopy measurement before and after thoracentesis.

    Science.gov (United States)

    Zink, Matthias Daniel; Weyer, Sören; Pauly, Karolin; Napp, Andreas; Dreher, Michael; Leonhardt, Steffen; Marx, Nikolaus; Schauerte, Patrick; Mischke, Karl

    2015-01-01

    Bioelectrical impedance spectroscopy is applied to measure changes in tissue composition. The aim of this study was to evaluate its feasibility in measuring the fluid shift after thoracentesis in patients with pleural effusion. 45 participants (21 with pleural effusion and 24 healthy subjects) were included. Bioelectrical impedance was analyzed for "Transthoracic," "Foot to Foot," "Foot to Hand," and "Hand to Hand" vectors in low and high frequency domain before and after thoracentesis. Healthy subjects were measured at a single time point. The mean volume of removed pleural effusion was 1169 ± 513 mL. The "Foot to Foot," "Hand to Hand," and "Foot to Hand" vector indicated a trend for increased bioelectrical impedance after thoracentesis. Values for the low frequency domain in the "Transthoracic" vector increased significantly (P impedance change in the low frequency domain using the "Foot to Hand" vector (r = -0.7). Bioelectrical impedance changes in correlation with the thoracic fluid level. It was feasible to monitor significant fluid shifts and loss after thoracentesis in the "Transthoracic" vector by means of bioelectrical impedance spectroscopy. The trial is registered with Registration Numbers IRB EK206/11 and NCT01778270.

  5. Personality traits of children before and after epilepsy surgery.

    Science.gov (United States)

    Braams, Olga; Schappin, Renske; Meekes, Joost; van Rijen, Peter C; van Nieuwenhuizen, Onno; Braun, Kees P; Jennekens-Schinkel, Aag

    2017-07-01

    We studied how children with epilepsy (CWE) who are candidates for epilepsy surgery, perceive themselves with respect to overarching personality traits and whether the traits change after surgery. We explored influences of demographic and illness variables. A total of 23 CWE [mean age at inclusion 12.8 (sd 2.3); 12 girls] participated. Using the Dutch Personality Questionnaire Juniors (DPQ-J), we assessed 20 of the CWE shortly before epilepsy surgery and compared the results to those of 39 age- and gender-matched healthy controls. Furthermore, we obtained follow-up scores 6, 12 and 24 months after epilepsy surgery from the clinical group. CWE who were candidates for epilepsy surgery scored above average in inadequacy, perseverance, social inadequacy and recalcitrance, whereas healthy peers scored average. Over the two years' period after epilepsy surgery we found no changes, apart from a decrease of social inadequacy. Sporadic illness and demographic variables were related to some personality traits. However, neither post-surgical seizure freedom nor cessation of AEDs did noticeably change the self-evaluations of CWE. Asking CWE to evaluate their personality themselves may offer a shared basis for individually tailored behavior intervention in order to help them adapting to their ameliorated circumstances after surgery. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Statistical Analysis of Pakistani Currency Regime before and after Floatation

    Directory of Open Access Journals (Sweden)

    Shahid ALI

    2011-05-01

    Full Text Available In this paper the trends of exchange rates for the foreign currency are studied yearly for Pakistan rupee. In 2000 State bank of Pakistan officially floated the rupee. In this studies the trends of the exchange rate before floating and after floating and then checks its impact on the GDP per capita of the country. Here we consider the daily data of exchange rates of Pakistani currency from 1995 to 2009. Data was analyzed from 1995 to 2000 in the first step. In the second step data from 2001 to 2009 was analyzed. The result shows that if one wants to fl oat currency he must keep in mind that the political condition or stable and that the economy is also stable so that the system of fl oat can perform its functions completely.

  7. CBF before and after extracranial-intracranial bypass surgery in patients with ischemic cerebrovascular disease studied with 133Xe-inhalation tomography

    DEFF Research Database (Denmark)

    Vorstrup, S; Lassen, N A; Henriksen, L

    1985-01-01

    Cerebral blood flow (CBF) was studied by 133Xenon inhalation tomography in 22 patients with symptoms of ischemic cerebrovascular disease before and after establishment of an extracranial-intracranial bypass shunt. Selection of patients for shunting was based on angiographically demonstrated...

  8. Metamorphopsia assessment before and after vitrectomy for macular hole

    DEFF Research Database (Denmark)

    Krøyer, Kristian; Christensen, Ulrik; la Cour, Morten

    2009-01-01

    PURPOSE: To evaluate the degree of metamorphopsia in 42 patients before and 6 months after vitrectomy for idiopathic unilateral macular hole. METHODS: Semicircular test and reference stimuli of variable diameters were applied in a binocular test that measured interocular size disparity in patient...

  9. Ocular torsion before and after 1 hour centrifugation

    NARCIS (Netherlands)

    Groen, E.; Graaf, B. de; Bles, W.; Bos, J.E.

    1996-01-01

    To assess a possible otolith contribution to effects observed following prolonged expo-sure to hyper gravity, we used video-oculography to measure ocular torsion during static and dynamic conditions of lateral body tilt (roll) before and after one hour of centrifugation with a Gx-load of 3G. Static

  10. Ocular torsion before and after 1 hour centrifugation

    NARCIS (Netherlands)

    Groen, Eric; De Graaf, Bernd; Bles, Willem; Bos, Jelte E.

    1996-01-01

    To assess a possible otolith contribution to effects observed following prolonged exposure to hypergravity, we used video oculography to measure ocular torsion during static and dynamic conditions of lateral body tilt (roll) before and after t h of centrifugation with a G(x)-load of 3 G. Static tilt

  11. Medication Use before, during, and after Pregnancy among Women with Eating Disorders: A Study from the Norwegian Mother and Child Cohort Study.

    Directory of Open Access Journals (Sweden)

    Angela Lupattelli

    Full Text Available Little is known about medication use among women with eating disorders in relation to pregnancy.To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy.This study is based on the Norwegian Mother and Child Cohort Study (MoBa. A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN, bulimia nervosa (BN, binge eating disorder (BED and recurrent self-induced purging in the absence of binge eating (EDNOS-P, along with self-reported use of medication six months before, during, and 0-6 months after pregnancy.The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54, 0.94% BN (n = 585, 0.10% EDNOS-P (n = 61 and 5.00% BED (n = 3104. The highest over-time prevalence of psychotropic use was within the AN (3.7-22.2% and EDNOS-P (3.3-9.8% groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17-4.32. Having AN (adjusted RR: 5.11, 99% CI: 1.53-17.01 or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41-32.53 was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED and laxatives (all eating disorders subtypes were high at all time periods investigated.Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum.

  12. Medication Use before, during, and after Pregnancy among Women with Eating Disorders: A Study from the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Lupattelli, Angela; Spigset, Olav; Torgersen, Leila; Zerwas, Stephanie; Hatle, Marianne; Reichborn-Kjennerud, Ted; Bulik, Cynthia M; Nordeng, Hedvig

    2015-01-01

    Little is known about medication use among women with eating disorders in relation to pregnancy. To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy. This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0-6 months after pregnancy. The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5.00% BED (n = 3104). The highest over-time prevalence of psychotropic use was within the AN (3.7-22.2%) and EDNOS-P (3.3-9.8%) groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17-4.32). Having AN (adjusted RR: 5.11, 99% CI: 1.53-17.01) or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41-32.53) was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED) and laxatives (all eating disorders subtypes) were high at all time periods investigated. Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum.

  13. Medication Use before, during, and after Pregnancy among Women with Eating Disorders: A Study from the Norwegian Mother and Child Cohort Study

    Science.gov (United States)

    Lupattelli, Angela; Spigset, Olav; Torgersen, Leila; Zerwas, Stephanie; Hatle, Marianne; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.; Nordeng, Hedvig

    2015-01-01

    Introduction Little is known about medication use among women with eating disorders in relation to pregnancy. Aims To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0–6 months after pregnancy. Results The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5.00% BED (n = 3104). The highest over-time prevalence of psychotropic use was within the AN (3.7–22.2%) and EDNOS-P (3.3–9.8%) groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17–4.32). Having AN (adjusted RR: 5.11, 99% CI: 1.53–17.01) or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41–32.53) was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED) and laxatives (all eating disorders subtypes) were high at all time periods investigated. Conclusions Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum. PMID:26200658

  14. Pediatric fluoroquinolone prescription in South Korea before and after a regulatory intervention: A nationwide study, 2007-2015

    Science.gov (United States)

    Hyeon, Su Yeong; Kim, Donguk; Kang, Won Ku; Choi, Soo-Han; Kim, Yae-Jean

    2017-01-01

    Objective To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents. Methods Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred. Results A total of 505,859 children received systemic fluoroquinolone during the study period—297,054 ciprofloxacin, and 208,805 levofloxacin. After implementation of the drug utilization review program, the annual prescription rate for ciprofloxacin declined by 97.5% (from 840 to 21 per 100,000 person-years, P fluoroquinolones in children, possibly guiding towards more judicious and selective prescription behavior. PMID:28520738

  15. Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

    Directory of Open Access Journals (Sweden)

    Mohammed Amood AL-Kamarany

    2016-01-01

    Full Text Available The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™ ® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA. The incidence of rotavirus hospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%, followed by G1P[8] (15.0%, while in postvaccination period G1P[8] (31% was the predominant genotype, followed by G9P[8] (27.5%. In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

  16. Nursing students' conception of clinical skills training before and after their first clinical placement: A quantitative, evaluative study.

    Science.gov (United States)

    Struksnes, Solveig; Engelien, Ragna Ingeborg

    2016-01-01

    Education institution and practice field have a joint responsibility with regard to facilitating a learning environment for the nursing students that provides learning outcomes in accordance with the National Curriculum. Using simulated patient situations is about ensuring a safe learning environment where mistakes are not putting real patients' lives in danger. To compare nursing students' experiences with a skills training situation immediately after the training and after their ten weeks clinical placement in nursing homes. Quantitative, cross-sectional and evaluative. Full- and part-time students in their first year of a Bachelor of Nursing degree. The students answered a questionnaire on two different occasions, immediately after skills training and after internship in a nursing home. Being a "patient" and a "nurse" in simulation was experienced as useful to clinical practice. Students with previous experience had a significantly higher perception of mastering the procedure after the internship, while unexperienced fellow students did not report any significant increase with regard to a sense of coping during their clinical practice. The findings raise questions if there are aspects with the education institution or the practice field that should be improved to help facilitate a better learning process for students without any previous experience. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Medication before and after a spinal cord lesion

    DEFF Research Database (Denmark)

    Jensen, Elmo K; Biering-Sørensen, F

    2014-01-01

    for each Anatomical Therapeutic Chemical (ATC) Classification System group were registered for all patients, who were discharged from Department for Spinal Cord Injuries during 2010. The changes in medication per se were calculated for different parts of the population: non-traumatic, traumatic patients......OBJECTIVE: To map the impact of spinal cord lesion (SCL) on medication. STUDY DESIGN: Registration of medication for 72 patients before SCL and at discharge from the Department for Spinal Cord Injuries. SETTING: Department for Spinal Cord Injuries, East Denmark. METHODS: The changes in medication......, men, women, paraplegia, tetraplegia, American Spinal Injury Association Impairment Scale (AIS) A, B or C, AIS D, age 0-45, 46-60 and 60+. In addition, comparisons of changes in medication were made between complementary parts of the population. RESULTS: The overall increase in medication after SCL...

  18. Forward lunge knee biomechanics before and after partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Nielsen, Jonas Høberg; Holsgaard-Larsen, Anders

    2015-01-01

    partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM. METHODS: Twenty-two patients (35-55years old...... strenuous tasks following APM, patients used less knee flexion, a strategy that may limit excessive patellar loads during forward lunge in the recently operated leg....

  19. Pregnancy-Induced Hypertensive Disorders before and after a National Economic Collapse: A Population Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Védís Helga Eiríksdóttir

    Full Text Available Data on the potential influence of macroeconomic recessions on maternal diseases during pregnancy are scarce. We aimed to assess potential change in prevalence of pregnancy-induced hypertensive disorders (preeclampsia and gestational hypertension during the first years of the major national economic recession in Iceland, which started abruptly in October 2008.Women whose pregnancies resulted in live singleton births in Iceland in 2005-2012 constituted the study population (N = 35,211. Data on pregnancy-induced hypertensive disorders were obtained from the Icelandic Medical Birth Register and use of antihypertensive drugs during pregnancy, including β-blockers and calcium channel blockers, from the Icelandic Medicines Register. With the pre-collapse period as reference, we used logistic regression analysis to assess change in pregnancy-induced hypertensive disorders and use of antihypertensives during the first four years after the economic collapse, adjusting for demographic and pregnancy characteristics, taking aggregate economic indicators into account. Compared with the pre-collapse period, we observed an increased prevalence of gestational hypertension in the first year following the economic collapse (2.4% vs. 3.9%; adjusted odds ratio [aOR] 1.47; 95 percent confidence interval [95%CI] 1.13-1.91 but not in the subsequent years. The association disappeared completely when we adjusted for aggregate unemployment rate (aOR 1.04; 95% CI 0.74-1.47. Similarly, there was an increase in prescription fills of β-blockers in the first year following the collapse (1.9% vs.3.1%; aOR 1.43; 95% CI 1.07-1.90, which disappeared after adjusting for aggregate unemployment rate (aOR 1.05; 95% CI 0.72-1.54. No changes were observed for preeclampsia or use of calcium channel blockers between the pre- and post-collapse periods.Our data suggest a transient increased risk of gestational hypertension and use of β-blockers among pregnant women in Iceland in the

  20. Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study.

    Science.gov (United States)

    Cartier, Vanessa; Inan, Cigdem; Zingg, Walter; Delhumeau, Cecile; Walder, Bernard; Savoldelli, Georges L

    2016-08-01

    Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion. To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion. Before and after intervention study. University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012. Residents in anaesthesiology aware of the Seldinger technique for vascular puncture. Participants attended a half-day course on CVC insertion. Learning objectives included work organization, aseptic technique and prevention of CVC complications. CVC insertion competency was tested pretraining, posttraining and then more than 2 years after training (sustainability phase). The primary study outcome was competency as measured by a global rating scale of technical skills, a hand hygiene compliance score and a checklist compliance score. Secondary outcome was knowledge as measured by a standardised pretraining and posttraining multiple-choice questionnaire. Statistical analyses were performed using paired Student's t test or Wilcoxon signed-rank test. Thirty-seven residents were included; 18 were tested in the sustainability phase (on average 34 months after training). The average global rating of skills was 23.4 points (±SD 4.08) before training, 32.2 (±4.51) after training (P Simulation-based medical education training was effective in improving short and long-term competency in, and knowledge of CVC insertion.

  1. MRI findings before and after abdominal radical trachelectomy (ART) for cervical cancer: a prospective study and review of the literature.

    Science.gov (United States)

    Bourgioti, C; Koutoulidis, V; Chatoupis, K; Rodolakis, A; Koureas, A; Thomakos, N; Moulopoulos, L A

    2014-07-01

    To report the authors' experience with dedicated pelvic magnetic resonance imaging (MRI) in young women with early-stage cervical cancer treated with abdominal radical trachelectomy (ART). During a 5-year period, 21 patients, with biopsy-confirmed cervical carcinoma, International Federation of Gynaecology and Obstetrics (FIGO) stage ≤IB1, were considered for trachelectomy. All patients underwent pelvic MRI within 30 days prior to surgery. Tumour size, endocervical extension, extrauterine spread, and nodal status were noted. Postoperative MRI findings were reviewed in 16 patients. Nineteen of the 21 patients were treated with ART. In two patients, trachelectomy was aborted intraoperatively and radical hysterectomy was performed; preoperative MRI findings were consistent with surgicopathological examination in both patients. MRI correctly assessed tumour size in 18/21 patients, coming within 5 mm of the surgical specimen. Tumour size was underestimated in two cases because of circumferential growth (n = 1) or technical difficulties (n = 1). False-positive MRI result was due to post-biopsy inflammation (n = 1). MRI accurately identified absence of internal os involvement in 17/19 ART patients; false-positive MRI for internal os involvement were due to endocervical polyp (n = 1) and coexisting Nabothian cysts (n = 1). No trachelectomy patient had extrauterine disease or malignant nodes at MRI or final histology. Post-trachelectomy complications included hydrosalpinges (n = 3), lymphocysts (n = 2), isthmic stenosis (n = 1), and tumour relapse (n = 2). Dedicated pelvic MRI is helpful in assessing tumour size and endocervical extension in young women, candidates for ART. Hydrosalpinx may occur after ART and it may influence fertility potential. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Testicular cancer : a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy

    NARCIS (Netherlands)

    Tuinman, Marrit A.; Hoekstra, Harald J.; Sleijfer, Dirk Th.; Fleer, Joke; Vidrine, Damon J.; Gritz, Ellen R.; Hoekstra-Weebers, Josette E. H. M.

    Goals of work: The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment

  3. Role of endoscopic retrograde cholangiopancreatography before and after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Sbeih, F.; Aljohani, M.; Altraif, I.; Khan, H.

    1998-01-01

    While the role of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) in the diagnosis and management of choledocholithiasis is well established, this study evaluates the usefulness of ERCP and EST patients with symptomatic cholecystolithiasis and suspected choledocholithiasis before undergoing laparoscopic cholecystectomy (LC), and the role of ERCP-EST in the management of complications resulting from LC. This paper reviews retrospectively our experience from 1992 to 1995. A total of 1221 LCs and 717 ERCPs were performed on 225 patients who underwent LC (230 ERCPs before and 27 after). The age range was 10-85 years (mean 43.5. The study group comprised 148 (66%) females and 77 males (34%). The overall success rate for ERCP was 92% (96% for diagnostic and 88% for therapeutic). Choledocholithiasis was found at preoperative ERCP in 45% cases. Prediction of cholecoledocholithiasis was accurate in 46%, based on abnormal liver chemistry, and 70% when based on a combination of abnormal liver tests and dilated main bile duct (>7 mm) by ultrasound. In 40 cases of acute biliary pancreatitis, choledocholithiasis was found at ERCP in eight cases (20%). In the post LC-group, all eight cases with residual stones and seven of eight cases with bile leaks were successfully treated endoscopically. There were four cases with major duct injuries that required surgical management. The complications related to ERCP-EST included two cases of bleeding post-EST (one was controlled with injection therapy and the second one was managed surgically) and three cases of mild pancreatitis. ERCP and EST are effective and safe in the diagnosis and management of choledocholithiasis and facilitate LC for symptomatic cholelithiasis. The procedures are also valuable in the diagnosis and management of most complications resulting from LC. (author)

  4. Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study.

    Science.gov (United States)

    Mehta, Rajnikant L; Baxendale, Bryn; Roth, Katie; Caswell, Victoria; Le Jeune, Ivan; Hawkins, Jack; Zedan, Haya; Avery, Anthony J

    2017-09-05

    Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p communication.

  5. Evaluating the impact of an evidence-based medicine educational intervention on primary care doctors' attitudes, knowledge and clinical behaviour: a controlled trial and before and after study.

    Science.gov (United States)

    Shuval, Kerem; Berkovits, Eldar; Netzer, Doron; Hekselman, Igal; Linn, Shai; Brezis, Mayer; Reis, Shmuel

    2007-08-01

    Traditional continuing medical education programmes that offer passive learning have been shown to be poorly effective at changing doctors' clinical behaviour. A multifaceted evidence-based medicine (EBM) intervention was conducted at the largest health maintenance organization (HMO) in Israel, attempting to facilitate a change in doctors' attitudes, knowledge and clinical behaviour. No study thus far has examined the association between the teaching of EBM principles and doctors' clinical behaviour. This study evaluated the intervention programme through a controlled trial and before and after study. The objective of the evaluation is binary: first, to examine the impact of an educational intervention on family doctors' test ordering performance and drug utilization by their patients; and second, to assess the impact of the intervention on attitudes towards evidence-based practice and knowledge. Controlled trial and before and after study. Primary care clinics comprising similar patient characteristics were randomly allocated to the experimental or to the control group. Doctors in the experimental group participated in an EBM educational intervention, while the control group did not take part in the intervention. Clinicians' test ordering performance and their patients' drug utilization were derived from the HMO's database before intervention, after workshops and after intervention. Participants in the controlled trial consisted of 75 doctors and their 106 349 patients. The before and after study evaluated intervention doctors' (n = 70) EBM attitudes and knowledge through a validated questionnaire before and after workshops. EBM workshops enhanced intervention doctors' EBM knowledge scores from 22.4/100 before workshops to 40.8/100 after workshops (P = 0.000). Doctors improved their ability to formulate clinical questions while enhancing their search strategy using Medline. In a linear regression model, two covariates, specialization (B = 12.59; P = 0.001) and

  6. Monitoring of Deformation in Ground Before and After Tunnel Excavation

    Science.gov (United States)

    Eren, Mehmet; Hilmi Erkoç, Muharrem

    2017-04-01

    As population increase in metropolitan city, we need transportation and transmission tunnel. In this context, the engineers and administors attach impotance to building and planning underground-tunnel. Moreover, we must at regular intervals monitoring to deformation in underground-tunnel for quality and safety. Firstly, a deformation monitoring network is designed as perpendicular to the tunnel main axis. Secondly, the prescribed number of deformation measurements must be made. Finally, the deformation analysis is evaluated and its results is interpreted. This study investigates how deformation in monitoring network during and after tunnel excavate change.For this purpose, a deformation monitoring network of 18 object point and 4 reference point was established. Object points networks was designed steeply to the tunnel main axis as 3 cross section. Each cross section consisted of 3 point left, 2 point right and 1 point at the flowing line. Initial conditional measurement was made before tunnel excavation. Then the deformation measurement was made 5 period (1 period measured after tunnel excavate). All data sets were adjusted according to free adjustment method. The results from the investigation considering the tunnel line, a symmetrical subsidence was observed. The following day of tunnel excavation, we were observed %68 per of the total deformation. At the end of the last period measurements, %99 per of the total deformation was detected. Keywords: Tunnel, Deformation, Subsidence, Excavation

  7. Human bartonellosis: before and after Daniel Alcides Carrion

    OpenAIRE

    Takano Morón, Juan; Facultad de Medicina. Universidad Nacional Mayor de San Marcos. Lima, Perú. Médico patólogo, doctor en Medina, profesor emérito.

    2014-01-01

    This is a review of bibliographic aspects associated to the knowledge about human bartonelosis before and after the death of Daniel Alcides Carrion. Emphasis is placed on stimulus in the development of medical research in Peru by the self-inoculation and subsequent death of Carrion especially in relation to human bartonellosis, conducted by Peruvian researchers and others around the world. The review includes the basic area of knowledge about the bacteria that causes the illness, the host res...

  8. Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study

    International Nuclear Information System (INIS)

    Sarubbo, Silvio; Latini, Francesco; Cavallo, Michele; Ceruti, Stefano; Chieregato, Arturo; D'Esterre, Christopher; Western Ontario Univ., London, ON; Lee, Ting-Yim; Western Ontario Univ., London, ON; Fainardi, Enrico; Azienda Ospedaliera Univ., Ferrara

    2014-01-01

    Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty. We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in multiple cortical circular regions positioned in cranioplasty-treated and contralateral hemispheres. Neither complications associated with cranioplasty nor changes in outcome were observed. On the treated side, CBF and CBV values were higher before and 7 days after cranioplasty than at 3 months after surgery, whereas MTT values were lower at 7 days than at 3 months after surgical treatment. Our results indicate that cortical perfusion progressively declines in the cranioplasty treated hemisphere but remains stable in the contralateral hemisphere after surgery and suggest that CTP can represent a promising tool for a longitudinal analysis of hemodynamic abnormalities occurring in TBI patients after cranioplasty. In addition, these data imply a possible role of cranioplasty in restoring flow to meet the prevailing metabolic demand. (orig.)

  9. Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Sarubbo, Silvio [' ' S. Chiara' ' Hospital, Neurosurgery Unit, Department of Neurosciences, Trento (Italy); ' ' S. Anna' ' University Hospital, Department of Medical and Surgical Sciences of Communication and Behavior, Clinics of Neurology, Ferrara (Italy); Latini, Francesco; Cavallo, Michele [' ' S. Anna' ' University Hospital, Neurosurgery Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Ceruti, Stefano [' ' S. Anna' ' University Hospital, Neuroradiology Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Chieregato, Arturo [' ' Careggi' ' University Hospital, Neurocritical Care Unit, Department of Neuroscience, Firenze (Italy); D' Esterre, Christopher [Calgary Univ., Calgary, AB (Canada). Foothills Medical Centre; Western Ontario Univ., London, ON (Canada). Imaging Research Lab.; Lee, Ting-Yim [Western Ontario Univ., London, ON (Canada). Imaging Research Lab.; Western Ontario Univ., London, ON (Canada). Imaging Program; Fainardi, Enrico [' ' S. Anna' ' University Hospital, Neuroradiology Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Azienda Ospedaliera Univ., Ferrara (Italy). Unita Operativa di Neuroradiologia

    2014-03-15

    Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty. We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in multiple cortical circular regions positioned in cranioplasty-treated and contralateral hemispheres. Neither complications associated with cranioplasty nor changes in outcome were observed. On the treated side, CBF and CBV values were higher before and 7 days after cranioplasty than at 3 months after surgery, whereas MTT values were lower at 7 days than at 3 months after surgical treatment. Our results indicate that cortical perfusion progressively declines in the cranioplasty treated hemisphere but remains stable in the contralateral hemisphere after surgery and suggest that CTP can represent a promising tool for a longitudinal analysis of hemodynamic abnormalities occurring in TBI patients after cranioplasty. In addition, these data imply a possible role of cranioplasty in restoring flow to meet the prevailing metabolic demand. (orig.)

  10. Effectiveness of education in point-of-care ultrasound-assisted physical examinations in an emergency department: A before-and-after study.

    Science.gov (United States)

    Choi, Yoo Jin; Jung, Jae Yun; Kwon, Hyuksool

    2017-06-01

    Implementation of point-of-care ultrasonography (POCUS)-assisted physical examination (PE) in emergency departments (EDs) was conducted in the ED of an urban tertiary teaching hospital. This study examines the effect of POCUS implementation in emergency medicine departments by using a systematic education program on image acquisition to analyze decision making.Educating staff on POCUS involved a technique related to image acquisition and then accurately diagnosing subsequent POCUS results. The quasi-experimental, uncontrolled before-and-after study was performed to evaluate the education effect. POCUS orders for eligible patients, length of stay (LOS) in ED, and return visits (RVs) to ED between the "before" period (March 1, 2015 to February 28, 2016) and the "after" period (March 1, 2016 to February 28, 2017) were compared. Piecewise regression was used to assess trend differences of LOS and RVs between the periods.A total of 16,942 and 16,287 patients were included in the before and after periods of education, respectively. During the study periods, 966 (6%) and 2801 (18%) POCUS were ordered, respectively (rate difference  =  12%; P education, the median LOS was 6.55 (interquartile rage [IQR]: 6.2-6.75) and the trend slope of LOS was -0.01. After the education, the median LOS was 5.25 (IQR: 4.85-5.45) and the trend slope (the change of which was considered significant, at a P value of .012) was -0.15. Before the education, the median RV rate was 6.4% (IQR: 6.15-6.65) and the trend slope of RVs was -0.01. After the education, the median RVs was 5.25% (IQR: 4.95-5.35) and the trend slope of RVs was also significant, at -0.11.The education of POCUS-PE in ED successfully increased use of POCUS, and reduced the LOS and RV rate in ED.

  11. The effect of hypertension and diabetes management in Southwest China: a before- and after-intervention study.

    Directory of Open Access Journals (Sweden)

    Xiaohua Liang

    Full Text Available BACKGROUND: Non-communicable diseases are leading causes of disease burden in middle income countries. Little evidence exists to determine if the primary healthcare system can effectively manage non-communicable diseases. The purpose of this study was to examine the effectiveness of hypertension and diabetes management by the primary healthcare system. METHODS: We used individual level data from the 2009 National Basic Public Health Services System to assess the effectiveness of hypertension and diabetes interventions on fasting plasma glucose, and blood pressure. We analyzed the associations between fasting plasma glucose, systolic or diastolic blood pressure and risk factors. The estimated average intervention effect on data balanced with confounding variables was assessed. RESULTS: 9543 individuals who had data for fasting plasma glucose, systolic blood pressure and diastolic blood pressure were included in this analysis. This study included 6681 patients with hypertension and 2222 with diabetes. The intervention lowered mean fasting plasma glucose by 0.5 mmol/L (0.4-0.6, lowered mean systolic blood pressure by 3.5 mm Hg (3.2-3.7, and lowered diastolic blood pressure by 2.9 mm Hg (2.7-3.2. Individuals who received medicinal treatment had 1.3 mmHg (0.8 to 1.8, P<0.01 lower diastolic blood pressure and 0.6 mmol/L (0.5-0.8, P<0.01 lower fasting plasma glucose than those who did not receive medicine. Generalized linear model indicated that medicinal treatment and baseline systolic blood pressure were significant positive predictors of change in systolic blood pressure. Age, living in urban areas and diabetic complications were significant negative predictors of change for systolic blood pressure. CONCLUSION: The National Basic Public Health Services System in China using trained community healthcare workers and well-established guidelines can be effectively implement non-communicable disease prevention and management care paradigms.

  12. Portfolio Choice of Homeowners: Before and After the Crisis

    DEFF Research Database (Denmark)

    Lyng, Ran Sun

    2017-01-01

    the period 2004 – 2012, two-stage least squares estimates show that: (i) The extensive margin: increases in mortgage debt reduce risky asset participation. A DKK 100,000 increase in property value, holding home equity fixed, reduces the risky market participation rate by 0.925 percentage points before...... the crisis (a 2.17% relative decrease) and by 0.588 percentage points after the crisis (1.32% relative decrease). The reduction is larger for lower wealth households. (ii) Risky asset shares decision: before the crisis, a DKK 100,000 increase in mortgage debt decreases risky asset shares by 0.328 percentage...... points - a DKK 1,014 decrease in value, and a 2.61% relative decrease. After the crisis, a DKK 100,000 increase in mortgage debt decreases risky asset shares by 0.269 percentage points - a DKK 1,009 decrease in value, and a 2.47% relative decrease....

  13. Bicycle injury documentation before and after charting intervention.

    Science.gov (United States)

    Monroe, Kathy; Nichols, Michele; Bates, Robin; Meredith, Mark; Hunter, John; King, William D

    2008-07-01

    Previous studies have shown that routinely completed free-text emergency department medical records contain limited information necessary for injury surveillance. We instituted an injury documentation sheet into our emergency department records to evaluate the impact on completeness of bicycle injury documentation rates. The pretest/posttest study design used E-codes to identify bicycle-related injuries. A standardized data collection tool was utilized to review these charts. Time periods before (January 1 to December 31, 2004) and after (January 1 to June 30, 2005) institution of a standardized documentation sheet were reviewed. Data were entered into the computer program, Epistat, and scores were used for comparison. Initial review (n = 667) revealed mean age of patients 8.6 years, with 46% African American and 67% male. Helmet usage was documented in 49% of the charts (81 were wearing helmets; 245 were not wearing helmets). Mechanism of injury was documented as bicycle alone in 587, bicycle versus car in 13, and bicycle versus stationary object in 64. After implementation of an injury data sheet (n = 205), it was found that the mean age was 9.24 years, with 51% African American and 43% male. Helmet use was documented in 77% of cases (26 wearing helmets; 132 not wearing). Mechanism was documented as bicycle alone in 125, bicycle versus car in 66, and bicycle versus stationary object in 14. Helmet use was much more frequently documented after the initiation of an injury documentation reminder sheet (z = 6.97; P < 0.001; 95% confidence interval, 20.2-35.8). The use of standard injury documentation prompts increased completeness of documentation. With improved documentation, more accurate injury surveillance can be performed.

  14. Use of prescribed opioid analgesics and co-medication with benzodiazepines in women before, during, and after pregnancy: a population-based cohort study.

    Science.gov (United States)

    Handal, Marte; Engeland, Anders; Rønning, Marit; Skurtveit, Svetlana; Furu, Kari

    2011-09-01

    The aim of the study was to describe the use of prescribed opioid analgesics for noncancer pain and the degree of possible concurrent co-medication with benzodiazepines to women in Norway before, during, and after pregnancy. This was a population-based cohort study based on linkage of two nationwide registries: the Medical Birth Registry of Norway, and the Norwegian Prescription Database. Prescribed opioid analgesics and benzodiazepines issued to women 3 months prior to, during, and 3 months after pregnancies were identified. The study population consisted of 194,937 singleton pregnancies beginning in March 2004 or later and ending before January 2009. About 6% of the women were dispensed opioid analgesics before, during, or after pregnancy. Almost all these women received weak opioids (99%) with short-acting codeine in combination with paracetamol (acetaminophen) as the most frequently dispensed drug. The dispensing of codeine was reduced from 24/1,000 women before pregnancy to 10/1,000 in the last trimester, increasing to 17/1,000 during the breastfeeding period. Most women were dispensed codeine once, and treatment was of short duration (about 1 week). A small group of women (n = 271) were dispensed opioids in all trimesters. Increasing benzodiazepine use was observed as the number of opioid prescriptions increased. The use of opioid analgesics in pregnant women in Norway was dominated by treatment of short duration of the weak opioid codeine. As pregnancy proceeded, opioid use was reduced. However, the increase in opioid use during the nursing period has the potential for serious adverse effects.

  15. CHANGES AND PERSPECTIVES OF SLOVENIAN PIG PRODUCTION BEFORE AND AFTER ACCESSION TO THE EU: THE CASE STUDY

    Directory of Open Access Journals (Sweden)

    M. Kastelić

    2007-06-01

    Full Text Available The changes in pig production during the last six to ten years were studied in case of Farme Ihan d. d., the Slovenian pig producer. At the beginning of the period, the company produced 70 to 75 thousand slaughtering pigs per year. At the end of the period the production increased to 150 thousand. As expected, the prices of pigs were reduced during that period. According to the new legislation, the large part of facilities was reconstructed and some environment protection investments were done. The production was improved: the number of weaned pigs per sow per year increased from 19.2 in 1996 to 25.48 in 2006 and reached the Danish average. The percentage of meat was increased in the same period from 52.7 % to 58.6 %. The progress in daily gain and in feed conversion ratio was moderate. To secure the access to the market, the own slaughter facility was bought and reconstructed. For the same reason, the company became shareholder of two meat processing companies. The transition period has not been finished yet. Production results may improve faster than in old EU member countries. Investment cycle has also not been finished yet. More investments, especially in environment protection are needed.

  16. Changes over time in mental well-being, fruit and vegetable consumption and physical activity in a community-based lifestyle intervention: a before and after study.

    Science.gov (United States)

    Johnson, R; Robertson, W; Towey, M; Stewart-Brown, S; Clarke, A

    2017-05-01

    There is a theoretical basis for believing that healthy lifestyle interventions can improve mental well-being and evidence to show that mental well-being is protective of future health. This study contributes to the evidence base by examining changes in mental well-being associated with the One Body One Life (OBOL) healthy lifestyle programme in a community setting in the West Midlands. Quantitative, before and after the evaluation. We conducted a before and after study of the lifestyle intervention 'OBOL', a multi component intervention that includes exercise and healthy eating education. Mental well-being was measured with the Warwick-Edinburgh Mental Well-being Scale. Physical activity and fruit and vegetable consumption were self-reported. Measures were collected before and after the 12-week intervention and three months post completion. Non-parametric tests were used to assess differences between groups, and linear mixed models were used to assess change over time. Four hundred and eighty-one (81% of attendees) adult participants completed a valid Warwick-Edinburgh Mental Well-being Scale before starting OBOL; of whom, 63.8% completed the Warwick-Edinburgh Mental Well-being Scale immediately post intervention and 25.2% at three months. Mental well-being levels increased significantly (P Warwick-Edinburgh Mental Well-being Scale score = 48 [interquartile range 41-55], completion = 53 [interquartile range 46-57], 3-month follow-up = 52 [interquartile range 46-56]). Change in mental well-being was clinically significant after accounting for age and gender. Changes in both fruit and vegetable consumption and physical activity appeared to explain some but not all of the variation in mental well-being. We found significant improvements in mental well-being among participants directly after the intervention which were sustained at the three-month follow-up. These findings contribute to a growing body of knowledge on the contribution of lifestyle interventions

  17. Commercial sexual practices before and after legalization in Australia.

    Science.gov (United States)

    Seib, Charrlotte; Dunne, Michael P; Fischer, Jane; Najman, Jackob M

    2010-08-01

    The nature of sex work changes over time for many reasons. In recent decades around the world, there has been movement toward legalization and control of sex economies. Studies of the possible impact of legalization mainly have focused on sexually transmitted infections and violence, with little attention to change in the diversity of sexual services provided. This study examined the practices of sex workers before and after legalization of prostitution. Cross-sectional surveys of comparable samples of female sex workers were conducted in 1991 (N = 200, aged 16-46 years) and 2003 (N = 247, aged 18-57 years) in Queensland, Australia, spanning a period of major change in regulation of the local industry. In 2003, male clients at brothels and private sole operators (N = 161; aged 19-72 years) were also interviewed. Over time, there was a clear increase in the provision of "exotic" sexual services, including bondage and discipline, submission, fantasy, use of sex toys, golden showers, fisting, and lesbian double acts, while "traditional" services mostly remained at similar levels (with substantial decrease in oral sex without a condom). Based on comparisons of self-reports of clients and workers, the demand for anal intercourse, anal play, and urination during sex apparently exceeded supply, especially in licensed brothels. Within this population, legalization of sex work coincided with a substantial increase in diversity of services, but it appears that in the regulated working environments, clients who prefer high risk practices might not dictate what is available to them.

  18. Circulating chemokine ligand levels before and after successful kidney transplantation

    Directory of Open Access Journals (Sweden)

    Hamdi Elmoselhi

    2016-10-01

    Full Text Available Abstract Background Chemokine ligands (CCLs play a pivotal role in tissue injury before and after kidney transplantation. Meanwhile, transplantation improves patient’s survival and diminishes morbidity. It is hypothesized, then, that kidney transplantation diminishes pre-transplant (pre-TX levels of circulating inflammatory CCLs. This retrospective study compared circulating levels and profiles of CCLs before transplantation (pre-TX and after transplantation (post-TX. Methods Nineteen CCLs (1, 2, 3, 4, 5, 8, 11, 13, 15, 17, 21, 24, 26, 27, CXCL 5, 8, 10, 12 and 13 were measured in 47 stable post-TX recipients, and their stored pre-TX plasma was analyzed by multiplexed fluorescent bead-based immunoassay. Twenty normal controls were included for comparisons. Normalized data was presented as mean ± SD and non-normalized data as median (5–95 % CI. Significance was measured at p < 0.01. Arbitrary upper and lower margins for each CCL at the 95 % CI or 2SD levels in each group were chosen to calculate the percentile of patients in the other group who exceeded these limits. Significant CCL levels present in more than 75 % of patients in a group that exceeded the arbitrary upper or lower set margins in the other two groups were labeled as preferentially characteristic for the respective group. Results More than 75 % of pre- and post-TX patients had levels that exceeded the upper control for CCL1, 11, 15 and CCL15, CCL26 and CXCL13 levels, respectively. More than 75 % of pre- and post-TX patients exceeded the lower control for CCL3, 21, and CCL5 limits, respectively. More than 75 % of post-TX patients demonstrated elevated levels of CCL2, 3, 21, 26 and CXCL13 above the upper pre-TX cut offs. Meanwhile, more than 75 % of post-TX patients exceeded the lower pre-TX levels for CCL1, 4, 5, 8, 13, 15, 17, 24 and CXCL8 and10. Pre-TX was preferentially characterized by elevated CCL1 and 15 and diminished CCL3 and 21. Post-TX was preferentially

  19. Hearing disability before and after radiotherapy for nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Low, W.K.; Fong, K.W. [Singapore General Hospital (Singapore)

    1996-02-01

    This paper evaluates post-irradiation hearing changes in patients with nasopharyngeal carcinoma (NPC) from a disability orientated approach, which takes into account binaural hearing. Newly diagnosed patients with NPC were studied before radiotherapy, and at four months (mean 9.2 months) after radiotherapy, provided they remained disease-free. Each patient was examined clinically and with pure tone audiograms. Tympanometry was used to confirm middle ear effusion. Averaged hearing thresholds over 0.5, 1 and 2 kHz were evaluated. If abnormal (> 30 dB), the resultant hearing disability was illustrated by a modified Glasgow Plot. Twenty-three males and 10 females completed the study. Middle ear effusions resulted in 39.3 per cent (binaural in two patients) and 33.3 per cent (binaural in five patients) of patients having hearing disability pre- and post-irradiation respectively. No patient had hearing disability as a result of a sensoineural loss. It is recommended that future reporting of post-irradiation hearing changes in patients with NPC, as in middle ear surgery, be considered from a disability-orientated approach. (author).

  20. Hearing disability before and after radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Low, W.K.; Fong, K.W.

    1996-01-01

    This paper evaluates post-irradiation hearing changes in patients with nasopharyngeal carcinoma (NPC) from a disability orientated approach, which takes into account binaural hearing. Newly diagnosed patients with NPC were studied before radiotherapy, and at four months (mean 9.2 months) after radiotherapy, provided they remained disease-free. Each patient was examined clinically and with pure tone audiograms. Tympanometry was used to confirm middle ear effusion. Averaged hearing thresholds over 0.5, 1 and 2 kHz were evaluated. If abnormal (> 30 dB), the resultant hearing disability was illustrated by a modified Glasgow Plot. Twenty-three males and 10 females completed the study. Middle ear effusions resulted in 39.3 per cent (binaural in two patients) and 33.3 per cent (binaural in five patients) of patients having hearing disability pre- and post-irradiation respectively. No patient had hearing disability as a result of a sensoineural loss. It is recommended that future reporting of post-irradiation hearing changes in patients with NPC, as in middle ear surgery, be considered from a disability-orientated approach. (author)

  1. Time and flow study results before and after installation of a hospital information system and radiology information system and before clinical use of a picture archiving and communication system.

    Science.gov (United States)

    Inamura, K; Umeda, T; Harauchi, H; Kondoh, H; Hasegawa, T; Kozuka, T; Takeda, H; Inoue, M

    1997-02-01

    The effectiveness of a hospital information system (HIS) and a radiological information system (RIS) was evaluated to optimize preparation for the planned full clinical operation of a picture archiving and communication system (PACS), which is now linked experimentally to the HIS and the RIS. One thousand IC (integrated circuit) cards were used for time studies and flow studies in the hospital. Measurements were performed on image examination order entry, image examination, reporting, and image delivery times. Even though after the HIS and the RIS operation only a small amount of time savings were realized in each time fraction component, such as in the patient movement time, examination time, and film delivery time, the total turn-around time was shortened markedly, by more than 23 hours on average. It was verified that the HIS and the RIS was beneficial in the outpatient clinics of the orthopedic department. Our method of measurement employing IC cards before and after HIS and RIS operations can be applied in other hospitals.

  2. A comparative study of the effect of stress on the cognitive parameters in women with increased body mass index before and after menopause.

    Science.gov (United States)

    Ramesh, M B; Ammu, S; Nayanatara, A K; Vinodini, N A; Pratik, K C; Anupama, N; Bhagyalakshmi, K

    2018-03-23

    The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions is a hallmark of Alzheimer's disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. A total of 142 female subjects constituting women before menopause between the ages of 18 and 44 years and women after menopause between the ages of 45 and 60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The major tool perceived stress scale was used for measuring the perception of stress. On the basis of the stress scale measurement, each group was classified into with stress and without stress. Addenbrooke's Cognitive Examination-III was used for measuring the cognitive functions. Premenopausal women with stress showed a significant (pstressed women, all the cognitive functions except fluency showed a significant (pStress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of yoga and encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the hypothalamic-pituitary-adrenal axis in relation to cognition and stress.

  3. Evaluation and comparison of the internal fit and marginal accuracy of base metal (nickelchromium) and zirconia copings before and after ceramic veneering: a sem study.

    Science.gov (United States)

    Regish, K M; Sharma, D; Prithviraj, D R; Nair, A; Raghavan, R

    2013-03-01

    This study compares the internal fit and marginal adaptation of copy milled Zirconia copings with Nickel-Chromium (Ni-Cr) copings fabricated using a lost wax technique before and after ceramic veneering. A standardized metal master die simulating a prepared crown was fabricated and twenty impressions of the metal die were made and poured with die stone. Wax patterns were made on ten dies and cast while light cure resin patterns were made on the other ten dies for copy milling the Zirconia copings. Five specimens from each group were subjected to ceramic veneering. All the test specimens were luted on to the fresh dies, embedded in dental plaster, sectioned and image analysis done using scanning electron microscopy. Thereafter statistical analysis is done using student t-test. The linear measurements for internal fit and marginal discrepancy were increased for Zirconia compared with Ni-Cr copings. The difference in the values of all the specimens of all the groups were not statistically significant (P > 0.05) except the values comparing the internal fit of Zirconia and Ni-Cr copings before ceramic veneering (P Zirconia copings but internal fit and marginal adaptability deteriorated after ceramic veneering.

  4. Studying the Physical Function and Quality of Life Before and After Surgery in Patients With Stage I Cervical Cancer

    Science.gov (United States)

    2018-02-14

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Lymphedema; Sexual Dysfunction and Infertility; Stage IA1 Cervical Cancer AJCC v6 and v7; Stage IA2 Cervical Cancer AJCC v6 and v7; Stage IB1 Cervical Cancer AJCC v6 and v7

  5. Understanding Nutrition: A Study of Greek Primary School Children Dietary Habits, before and after Classroom Nutrition Intervention

    Science.gov (United States)

    Piperakis, Stylianos M.; Sotiriou, Apostolos; Georgiou, Evanthia; Thanou, Ageliki; Zafiropoulou, Maria

    2004-01-01

    The purpose of this study was first to assess and then to improve the diet of Greek primary school children teaching them healthy dietary habits and instructing them to face critically advertisements and media projected dietary models using a program which included intervention on cognitive, emotional, and social level. The results show that our…

  6. Effect of a Patient-Repositioning Device in an Intensive Care Unit On Hospital-Acquired Pressure Injury Occurences and Cost: A Before-After Study.

    Science.gov (United States)

    Edger, Melinda

    The principal aim of this study was to determine the hospital-acquired pressure injury (HAPI) rate before and after introduction of a repositioning device, measure staff-perceived level of exertion with device use, and assess return on investment. 1 group, before-and-after study. The sample comprised 717 patients cared for in a 17-bed intensive care unit. The study setting was the neonatal intensive care unit at Bon Secours Maryview Medical Center located in the mid-Atlantic United States (Portsmouth, Virginia). A safe patient-handling intervention was implemented as part of a quality improvement initiative. The effect of this system was measured using several outcome measures: (1) HAPI occurrences on the sacral area and buttocks, (2) perceived effort of use by staff, and (3) cost analysis. We used the validated Borg Scale to measure perceived exertion that was ranked on a scale from 6 to 20, where higher scores indicate greater exertion. Cost comparisons were completed before and after introduction of the patient-repositioning system. Cost analysis was determined using internal dollar amounts calculated for each stage of pressure injury. The return on investment was calculated by comparing the cost of HAPIs and the product after the intervention with the costs of HAPIs before the intervention. Analysis revealed a statistically significant reduction in HAPI occurrence from 1.3% to 0% (P = .004) when baseline manual repositioning (standard of care) was compared with use of the repositioning system. Caregivers reported significantly less exertion when using the repositioning device as compared with standard of care repositioning (P return on investment was estimated to be $16,911. Use of a repositioning device resulted in significantly reduced HAPIs. Perceived exertion for repositioning the patient with a repositioning device was significantly less than repositioning with standard of care. A cost analysis estimated a return on investment as a result of the

  7. PHARMACOEPIDEMIOLOGICAL STUDY OF NON-STEROID ANTIINFLAMMATORY MEDICINE USE IN THE IN-PATIENT DEPARTMENT BEFORE AND AFTER THE FORMULAR SYSTEM ADOPTION

    Directory of Open Access Journals (Sweden)

    V.A. Baturin

    2008-03-01

    Full Text Available We studied the use ofnon-steroid anti-inflammatorydrugs (NSAID at the in-patient department ofcentral district hospitalwith the application ofDDD-techniques before and after the formular system adoption. After introduction of drug formular and treatment standards the use of NSAID was reduced; the physicians began to use modern drugs. Non-indicated and contraindicated NSAID were prescribed more seldom. Itwas determined that reduction of antihypertensive drugs efficiency in hypertensive patients was the main side effect of NSAID use. NSAID gastropathy occurred more seldom, and mainly in the patients receiving several NSAIDs simultaneously.

  8. The learning environment in the obstetrics and gynecology clerkship: an exploratory study of students' perceptions before and after the clerkship

    Directory of Open Access Journals (Sweden)

    Laura E. Baecher-Lind

    2015-06-01

    Full Text Available For reasons that remain not entirely clear, Obstetrics and Gynecology (Ob/Gyn clerkships often exhibit comparatively higher rates of medical student mistreatment. To explore perceptions of our local learning environment, focus groups were held with students yet to start (pre-students and students having completed (post-students their Ob/Gyn clerkship. Topics of discussion included learning expectations and experiences, perceptions of mistreatment, and suggestions for improving the learning environment and student treatment. Using a naturalistic approach, we conducted a conventional content analysis to identify emergent themes. Nine pre-students and nine post-students participated. While pre-students anticipated being actively engaged, they also expected – based on peer accounts – to be subject to an unwelcoming learning environment on the Ob/Gyn clerkship, despite working hard to become team members. Due to patient advocacy and protection concerns, post-students reported low levels of student involvement and, subsequently, an overall passive learning experience. Students from both groups offered valuable suggestions for improving the learning environment and student treatment. The sensitive nature of Ob/Gyn clinical encounters may lead to overprotective behaviors that contribute to students feeling mistreated and excluded from patient care and team membership. Students’ experiences during Ob/Gyn clerkships could be improved by better balancing patient advocacy and student involvement. Practical implications to address these issues are offered.

  9. The learning environment in the obstetrics and gynecology clerkship: an exploratory study of students' perceptions before and after the clerkship.

    Science.gov (United States)

    Baecher-Lind, Laura E; Chang, Katherine; Blanco, Maria A

    2015-01-01

    For reasons that remain not entirely clear, Obstetrics and Gynecology (Ob/Gyn) clerkships often exhibit comparatively higher rates of medical student mistreatment. To explore perceptions of our local learning environment, focus groups were held with students yet to start (pre-students) and students having completed (post-students) their Ob/Gyn clerkship. Topics of discussion included learning expectations and experiences, perceptions of mistreatment, and suggestions for improving the learning environment and student treatment. Using a naturalistic approach, we conducted a conventional content analysis to identify emergent themes. Nine pre-students and nine post-students participated. While pre-students anticipated being actively engaged, they also expected - based on peer accounts - to be subject to an unwelcoming learning environment on the Ob/Gyn clerkship, despite working hard to become team members. Due to patient advocacy and protection concerns, post-students reported low levels of student involvement and, subsequently, an overall passive learning experience. Students from both groups offered valuable suggestions for improving the learning environment and student treatment. The sensitive nature of Ob/Gyn clinical encounters may lead to overprotective behaviors that contribute to students feeling mistreated and excluded from patient care and team membership. Students' experiences during Ob/Gyn clerkships could be improved by better balancing patient advocacy and student involvement. Practical implications to address these issues are offered.

  10. The impact of type of manual medication cart filling method on the frequency of medication administration errors: a prospective before and after study.

    Science.gov (United States)

    Schimmel, Anneliene M; Becker, Matthijs L; van den Bout, Tilly; Taxis, Katja; van den Bemt, Patricia M L A

    2011-07-01

    The medication cart can be filled using an automated system or a manual method and when using a manual method the medication can be arranged either by round time or by medication name. For the manual methods, it is hypothesized that the latter method would result in a lower frequency of medication administration errors because nurses are forced to read the medication labels, but evidence for this hypothesis is lacking. The aim of this study was to compare the frequency of medication administration errors of two different manual medication cart filling methods, namely arranging medication by round time or by medication name. A prospective, observational study with a before-after design. Eighty-six patients who stayed on an orthopaedic ward in one university medical centre in the Netherlands were included. Disguised observation was used to detect medication administration errors. The medication cart filling method in usual care was to fill the cart with medication arranged by round time. The intervention was the implementation of the second medication cart filling method, where the medication cart was filled by arranging medicines by their names. The primary outcome was the frequency of medication administrations with one or more error(s) after the intervention compared with before the intervention. The secondary outcome was the frequency of subtypes of medication administration errors. After the intervention 170 of 740 (23.0%) medication administrations with one or more medication administration error(s) were observed compared to 114 of 589 (19.4%) before the intervention (odds ratio 1.24 [95% confidence interval 0.95-1.62]). The distribution of subtypes of medication administration errors before and after the intervention was statistically significantly different (p<0.001). Analysis of subtypes revealed more omissions and wrong time errors after the intervention than before the intervention. Unauthorized medication errors were detected more frequently before the

  11. Quality of life before and after TVT, a prospective multicentre cohort study, results from the Netherlands TVT database

    NARCIS (Netherlands)

    Koops, SES; Bisseling, TM; Heintz, APM; Vervest, HAM

    Objective To asses the long term outcome of tension-free vaginal tape procedure in women with isolated stress urinary incontinence (SUI). Design Prospective cohort study. Setting Twenty-eight teaching hospitals and 13 local hospitals, with 54 gynaecologists and urologists performing the surgery.

  12. Patients' self-esteem before and after chemical peeling procedure.

    Science.gov (United States)

    Kouris, Anargyros; Platsidaki, Eftychia; Christodoulou, Christos; Efstathiou, Vasiliki; Markantoni, Vasiliki; Armyra, Kalliopi; Potouridou, Irene; Rigopoulos, Dimitrios; Kontochristopoulos, Georgios

    2017-12-29

    Chemical peeling is a safe method, widely used to treat a variety of skin conditions and reduce the aging effects. This study aims to evaluate self-esteem among adolescents who undergo chemical peelings. One hundred and twenty six patients constituted the study group. Sixty seven individuals had undergone chemical peeling for therapeutic reasons and 59 individuals for cosmetic reasons. To assess patients' self-esteem, the Rosenberg's Self-esteem Scale (RSES) was used before and after treatment. The control group included 71 healthy, age- and sex-matched volunteers from the general population. They were also asked to complete the RSES, after the same time interval as the patients. The healthy controls (23.01 ± 3.12) presented statistically significantly higher self-esteem than both the groups of individuals who would be submitted to chemical peeling. Furthermore, patients who would undergo peeling for therapeutic reasons (21.58 ± 3.20) had statistically significantly higher self-esteem than those who would undergo the procedure for cosmetic reasons (18.97 ± 3.36). After the chemical peeling sessions, the self-esteem of patients treated for therapeutic reasons (23.48 ± 2.43) and of patients treated for cosmetic reasons (22.83 ± 3.34) improved statistically significantly, while the self-esteem of the healthy controls remained stable, as expected. Patients who undergo chemical peelings tend to have low levels of self-esteem. Although facial lesions in skin diseases such as acne, acne scars, rosacea, and melasma seem to have negative effect on individuals' self-consciousness, patients who would be submitted to chemical peeling in order to treat wrinkles, loss of radiance, and skin tone clarity have even lower self-esteem. Chemical peelings were shown to favorably affect patient's self-esteem since all patients showed an increase in self-esteem after treatment, while the control group experienced no change.

  13. Public debt management before, during and after the crisis

    Directory of Open Access Journals (Sweden)

    Ana Andabaka Badurina

    2012-03-01

    Full Text Available During the financial and economic crisis, the public debt ratio in the European Union increased significantly, and public debt management had to be carried out in a completely new and unfavorable environment. The authors of this paper explore the changes in public debt management during and after the crisis. They describe the way in which three members of the Union – the Netherlands, Ireland and Hungary – dealt with the challenge of government financing during the crisis. These three countries were chosen because they all had a comparatively welldeveloped public debt management system before the crisis, and also due to the fact that during the crisis those responsible for public debt management pursued a policy of active accommodation to current market circumstances. Therefore, these case studies can illustrate the capacity of public debt management to contribute to the prevention of a sovereign debt crisis. In the conclusion, the authors give an overview of public debt management in Croatia in the period of the crisis and compare it with public debt management in the three countries whose experiences are presented in the paper.

  14. Comparative evaluation of shear bond strengths of veneering porcelain to base metal alloy and zirconia substructures before and after aging – An in vitro study

    Science.gov (United States)

    Sreekala, Laju; Narayanan, Mahesh; Eerali, Sunil M.; Eerali, Susil M.; Varghese, Joju; Zainaba Fathima, A. l.

    2015-01-01

    Objective: The aim of this study was to evaluate and compare the shear bond strength of veneering porcelain to base metal alloy and zirconia substructures before and after aging. Scanning electron microscopy (SEM) was used to determine the failure pattern. Materials and Methods: Twenty rectangular blocks (9 mm length × 4 mm height × 4 mm width) of base metal alloy (Bellabond plus, Bego, Germany) and zirconia (Will ceramZ zirconia K block) were fabricated for shear bond strength test. Surface of the base metal alloy block (4 mm × 4 mm area) was veneered with corresponding veneering porcelain (Ivoclar, IPS classic, vivadent). Similarly, surface of the zirconia rectangular block (4 mm × 4 mm) was veneered with corresponding veneering ceramic (Cercon ceram kiss, Degudent). Out of forty rectangular porcelain veneered core specimen, ten porcelain veneered base metal alloy specimen and ten porcelain veneered zirconia specimen were immersed in water at 37°C for one month to simulate the oral environment. Results: On comparison, the highest shear bond strength value was obtained in porcelain veneered base metal alloy before aging group followed by porcelain veneered base metal alloy after aging group, Porcelain veneered zirconia before aging group, porcelain veneered zirconia after aging group. SEM analysis revealed predominantly cohesive failure of veneering ceramic in all groups. Conclusion: Porcelain veneered base metal alloy samples showed highest shear bond strength than porcelain veneered zirconia samples. Study concluded that aging had an influence on shear bond strength. Shear bond strength was found to be decreasing after aging. SEM analysis revealed cohesive failure of veneering ceramic in all groups suggestive of higher bond strength of the interface than cohesive strength of ceramic. Hence, it was concluded that veneering ceramic was the weakest link. PMID:26942121

  15. Comparative evaluation of shear bond strengths of veneering porcelain to base metal alloy and zirconia substructures before and after aging - An in vitro study.

    Science.gov (United States)

    Sreekala, Laju; Narayanan, Mahesh; Eerali, Sunil M; Eerali, Susil M; Varghese, Joju; Zainaba Fathima, A L

    2015-12-01

    The aim of this study was to evaluate and compare the shear bond strength of veneering porcelain to base metal alloy and zirconia substructures before and after aging. Scanning electron microscopy (SEM) was used to determine the failure pattern. Twenty rectangular blocks (9 mm length × 4 mm height × 4 mm width) of base metal alloy (Bellabond plus, Bego, Germany) and zirconia (Will ceramZ zirconia K block) were fabricated for shear bond strength test. Surface of the base metal alloy block (4 mm × 4 mm area) was veneered with corresponding veneering porcelain (Ivoclar, IPS classic, vivadent). Similarly, surface of the zirconia rectangular block (4 mm × 4 mm) was veneered with corresponding veneering ceramic (Cercon ceram kiss, Degudent). Out of forty rectangular porcelain veneered core specimen, ten porcelain veneered base metal alloy specimen and ten porcelain veneered zirconia specimen were immersed in water at 37°C for one month to simulate the oral environment. On comparison, the highest shear bond strength value was obtained in porcelain veneered base metal alloy before aging group followed by porcelain veneered base metal alloy after aging group, Porcelain veneered zirconia before aging group, porcelain veneered zirconia after aging group. SEM analysis revealed predominantly cohesive failure of veneering ceramic in all groups. Porcelain veneered base metal alloy samples showed highest shear bond strength than porcelain veneered zirconia samples. Study concluded that aging had an influence on shear bond strength. Shear bond strength was found to be decreasing after aging. SEM analysis revealed cohesive failure of veneering ceramic in all groups suggestive of higher bond strength of the interface than cohesive strength of ceramic. Hence, it was concluded that veneering ceramic was the weakest link.

  16. Evaluation of quality of life in PKU before and after introducing tetrahydrobiopterin (BH4); a prospective multi-center cohort study.

    Science.gov (United States)

    Demirdas, Serwet; Maurice-Stam, Heleen; Boelen, Carolien C A; Hofstede, Floris C; Janssen, Mirian C H; Langendonk, Janneke G; Mulder, Margot F; Rubio-Gozalbo, M Estela; van Spronsen, Francjan J; de Vries, Maaike; Grootenhuis, Martha A; Bosch, Annet M

    2013-01-01

    Phenylketonuria (PKU) is a rare inborn error of metabolism caused by phenylalanine hydroxylase enzyme (PAH) deficiency. Treatment constitutes a strict Phe restricted diet with unpalatable amino acid supplements. Residual PAH activity enhancement with its cofactor tetrahydrobiopterin (BH4) is a novel treatment which increases dietary tolerance in some patients and permits dietary relaxation. Relaxation of diet may improve health related quality of life (HRQoL). This prospective cohort study aims to evaluate HRQoL of patients with PKU and effects of BH4 treatment on HRQoL. Patients aged 4years and older, diagnosed through newborn screening and early and continuously treated, were recruited from eight metabolic centers. Patients and mothers completed validated generic and chronic health-conditions HRQoL questionnaires (PedsQL, TAAQOL, and DISABKIDS) twice: before and after testing BH4 responsivity. Baseline results were compared to the general population. Data collected after BH4 testing was used to find differences in HRQoL between BH4 unresponsive patients and BH4 responsive patients after one year of treatment with BH4. Also a within patient comparison was performed to find differences in HRQoL before and after treatment with BH4. 69/81 (85%) patients completed the questionnaires before BH4 responsivity testing, and 45/69 (65%) participated again after testing. Overall PKU patients demonstrated normal HRQoL. However, some significant differences were found when compared to the general population. A significantly higher (thus better) score on the PedsQL was reported by children 8-12 years on physical functioning and by children 13-17 years on total and psychosocial functioning. Furthermore, adult patients reported significantly lower (thus worse) scores in the TAAQOL cognitive domain. 10 patients proved to be responsive to BH4 treatment; however improvement in their HRQoL after relaxation of diet could not be demonstrated. © 2013.

  17. ANALYSIS OF CORNEAL ASTIGMATISM BEFORE AND AFTER PTERYGIUM SURGERY- A PROSPECTIVE STUDY IN PATIENTS ATTENDING KIMS, HUBLI

    Directory of Open Access Journals (Sweden)

    Y. B. Bajantri

    2017-10-01

    Full Text Available BACKGROUND Pterygium is a very common degenerative condition seen in Indian subcontinent. It is a wing-shaped fibrovascular encroaching up on the cornea from either sides. The prevalence rate is 5.2%. Pterygium is known to affect refractive astigmatism. The induced astigmatism may become significant to cause visual distortion, even though the pterygium remains distant from visual axis induced astigmatism maybe either “with-the-rule” or “against-the-rule.” The aim of the study is to- 1. Compare preoperative with postoperative astigmatism in case of pterygium. 2. Assess the amount of astigmatism in case of pterygia of different lengths measured from the limbus over the cornea. MATERIALS AND METHODS The study included 70 eyes of 70 patients with primary pterygium. Preoperative evaluation included pterygium size, visual acuity, keratometry and refraction with subjective correction. Patients included in the study were divided into three groups based on length of pterygium encroaching on cornea (1 to 2 mm, 2 to 3 mm, >3 mm. Each eye underwent bare sclera pterygium excision. Postoperative visual acuity, keratometry and refraction were evaluated on 1st day, at the end of 1st week, 4 th week and 9th week. The pre and postoperative results were compared and analysed. RESULTS An average of all 70 cases with mean pterygium length 3.2 mm had a mean keratometry astigmatism of 1.84 ± 0.89D preoperatively and 0.514 ± 0.52D postoperatively indicating a reduction of pterygium-induced corneal astigmatism by 1.45 ± 0.77D (p value <0.0001, which was statistically significant. CONCLUSION Pterygium-induced corneal astigmatism is directly proportional to the size of the pterygium. Thus, early surgical excision reduces the corneal astigmatism, and hence, improves the visual acuity.

  18. Cesium-137 accumulation in higher plants before and after Chernobyl

    International Nuclear Information System (INIS)

    Sawidis, T.; Drossos, E.; Papastefanou, C.; Heinrick, G.

    1990-01-01

    Cesium-137 concentrations in plant species of three biotypes of northern Greece, differing in location as well as in vegetation, are reported following the Chernobyl reactor accident. The cesium uptake by plants was due to the foliar deposition rather than the root uptake. The highest level of cesium in plants was found in Ranunculus sardous, a pubescent plant. The 137 Cs concentration was about 22kBq kg -1 d.w. A high level of cesium was also found in Salix alba ( 137 Cs: 19.6 kBq kg -1 d.w.), a deciduous tree showing that hairy leaves or leaves having rough and large surfaces can absorb greater amounts of radioactivity (surface effect). A comparison is also made between the results of measurements of the present study and the results of measurements of some herbarium plants collected one year before the accident as well as the results of measurements of some new plants grown and collected one year after the accident resulting in a natural removal rate of 137 Cs in plants varying from 14 to 130 days

  19. [Human bartonellosis: before and after Daniel Alcides Carrion].

    Science.gov (United States)

    Takano Morón, Juan

    2014-04-01

    This is a review of bibliographic aspects associated to the knowledge about human bartonelosis before and after the death of Daniel Alcides Carrion. Emphasis is placed on stimulus in the development of medical research in Peru by the self-inoculation and subsequent death of Carrion especially in relation to human bartonellosis, conducted by Peruvian researchers and others around the world. The review includes the basic area of knowledge about the bacteria that causes the illness, the host response to infection as well as the biphasic behavior of the disease. The revised bibliography includes contributions to the knowledge of the disease in the last 100 years, now known with the eponym "Carrion's disease".

  20. A before and after study of medical students' and house staff members' knowledge of ACOVE quality of pharmacologic care standards on an acute care for elders unit.

    Science.gov (United States)

    Jellinek, Samantha P; Cohen, Victor; Nelson, Marcia; Likourezos, Antonios; Goldman, William; Paris, Barbara

    2008-06-01

    The Assessing Care of Vulnerable Elders (ACOVE) comprehensive set of quality assessment tools for ill older persons is a standard designed to measure overall care delivered to vulnerable elders (ie, those aged > or =65 years) at the level of a health care system or plan. The goal of this research was to quantify the pretest and posttest results of medical students and house staff participating in a pharmacotherapist-led educational intervention that focused on the ACOVE quality of pharmacologic care standards. This was a before and after study assessing the knowledge ofACOVE standards following exposure to an educational intervention led by a pharmacotherapist. It was conducted at the 29-bed Acute Care for Elders (ACE) unit of Maimonides Medical Center, a 705-bed, independent teaching hospital located in Brooklyn, New York. Participants included all medical students and house staff completing a rotation on the ACE unit from August 2004 through May 2005 who completed both the pre-and posttests. A pharmacotherapist provided a 1-hour active learning session reviewing the evidence supporting the quality indicators and reviewed case-based questions with the medical students and house staff. Educational interventions also occurred daily through pharmacotherapeutic consultations and during work rounds. Medical students and house staff were administered the same 15-question, patient-specific, case-based, multiple-choice pre-and posttest to assess knowledge of the standards before and after receiving the intervention. A total of 54 medical students and house staff (median age, 28.58 years; 40 men, 14 women) completed the study. Significantly higher median scores were achieved on the multiple-choice test after the intervention than before (median scores, 14/15 [93.3%] vs 12/15 [80.0%], respectively; P = 0.001). A pharmacotherapist-led educational intervention improved the scores of medical students and house staff on a test evaluating knowledge of evidence

  1. Sun exposure before and after a diagnosis of cutaneous malignant melanoma

    DEFF Research Database (Denmark)

    Idorn, L W; Philipsen, P A; Wulf, H C

    2011-01-01

    Previous studies on ultraviolet radiation (UVR) exposure before and after a diagnosis of cutaneous malignant melanoma (CMM) have been based primarily on questionnaires. Objective measures are needed....

  2. Vaginal pressure during daily activities before and after vaginal repair

    DEFF Research Database (Denmark)

    Mouritsen, L; Hulbaek, M; Brostrøm, S

    2007-01-01

    , pelvic floor contraction (PFC), coughing, Valsalva, rising from sitting to standing and lifting 2 and 5 kg with four different lifting techniques. VP was measured before, 1-5 days and 4-6 weeks after vaginal repair. Mean VP was four to five times higher during coughing and Valsalva compared to PFC...... and lifting 2 and 5 kg. Lifting in the walking position created a slightly higher VP compared to other lifting techniques, which did not differ. The VP did not increase when lifting 5 kg compared to 2 kg. Mean VP during coughing and Valsalva were significantly lower 1-5 days after the operation. VP...... was not related to the type of vaginal repair. The results imply that post-operative counselling should concentrate more on treating chronic cough and constipation than restrictions of moderate physical activities....

  3. Impact of the PROCESS guideline on the reporting of surgical case series: A before and after study.

    Science.gov (United States)

    Agha, R A; Borrelli, M R; Farwana, R; Kusu-Orkar, T; Millip, M C; Thavayogan, R; Garner, J; Darhouse, N; Orgill, D P

    2017-09-01

    The PROCESS guideline was developed in 2016 through expert Delphi consensus. It aimed to improve the quality of reporting of surgical case series. This study assessed the impact of the introduction of the PROCESS guideline on reporting for surgical case series submitted to three journals. 20 case series published in the International Journal of Surgery Case Reports (IJSCR), the International Journal of Surgery (IJS) or the Annals of Medicine and Surgery (AMS) in September to December 2016, prior to the introduction of the PROCESS guideline (the pre-PROCESS period), were randomly identified and scored against the PROCESS criteria. Two authors independently scored each article a total score out of 29, the 'PROCESS score' (expressed as a percentage). Scores for the two researchers were compared and consensus was reached to achieve a final score set. The process was repeated for the January 2017 to April 2017 issues of the three journals, post PROCESS implementation (the post-PROCESS period). The mean PROCESS score was 80% (range 66-90%) for the pre-PROCESS period and 84% (range 72-95%) for the post-PROCESS period, a 4% relative increase [STATS]. The Cohen's Kappa score between researchers was 0.907 implying very substantial agreement. Implementation of the PROCESS guideline resulted in a 5% improvement in the reporting quality of surgical case series published in three journals. Further research is needed to identify and successfully navigate existing barriers to greater compliance. Authors, reviewers and editors should adhere to the guidelines to boost reporting quality. Journals should develop their policies and guide for authors to incorporate the guideline and mandate compliance. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Evaluating the Subjective Straight Ahead Before and After Spaceflight

    Science.gov (United States)

    Campbell, D. J.; Wood, S. J.; Reschke, M. F.; Clement, G.

    2017-01-01

    Introduction. This joint European Space Agency/NASA pre- and post-flight study investigates the influence of exposure to microgravity on the subjective straight ahead (SSA) in crewmembers returning from long-duration expeditions to the International Space Station (ISS). The SSA is a measure of the internal representation of body orientation and to be influenced by stimulation of sensory systems involved in postural control. The use of a vibrotactile sensory aid to correct the representation of body tilted relative to gravity is also tested as a countermeasure. This study addresses the sensorimotor research gap to "determine the changes in sensorimotor function over the course of a mission and during recovery after landing." Research Plans. The ISS study will involve eight crewmembers who will participate in three pre-flight sessions (between 120 and 60 days before launch) and then three post-flight sessions on R plus 0/1 day, R plus 4 days, and R plus 8 days. Sixteen control subjects were also tested during three sessions to evaluate the effects of repeated testing and to establish normative values. The experimental protocol includes measurements of gaze and arm movements during the following tasks: (1) Near & Far Fixation: The subject is asked to look at actual targets in the true straight-ahead direction or to imagine these targets in the dark. Targets are located at near distance (arm's length) and far distance (beyond 2 meters). This task is successively performed with the subject's body aligned with the gravitational vertical, and with the subject's body tilted in pitch relative to the gravitational vertical using a tilt chair. Measures are then compared with and without a vibrotactile sensory aid that indicates how far one has tilted relative to the vertical; (2) Eye and Arm Movements: The subject is asked to look and point in the SSA direction in darkness and then make horizontal and vertical eye or arm movements, relative to Earth coordinates (allocentric

  5. Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.

    Science.gov (United States)

    Ervasti, Jenni; Virtanen, Marianna; Lallukka, Tea; Friberg, Emilie; Mittendorfer-Rutz, Ellenor; Lundström, Erik; Alexanderson, Kristina

    2017-09-29

    We examined the risk of disability pension before and after ischaemic heart disease (IHD) or stroke event, the burden of stroke compared with IHD and which factors predicted disability pension after either event. A population-based cohort study with follow-up 5 years before and after the event. Register data were analysed with general linear modelling with binary and Poisson distributions including interaction tests for event type (IHD/stroke). All people living in Sweden, aged 25‒60 years at the first event year, who had been living in Sweden for 5 years before the event and had no indication of IHD or stroke prior to the index event in 2006‒2008 were included, except for cases in which death occurred within 30 days of the event. People with both IHD and stroke were excluded, resulting in 18 480 cases of IHD (65%) and 9750 stroke cases (35%). Disability pension. Of those going to suffer IHD or stroke event, 25% were already on disability pension a year before the event. The adjusted OR for disability pension at first postevent year was 2.64-fold (95% CI 2.25 to 3.11) for people with stroke compared with IHD. Economic inactivity predicted disability pension regardless of event type (OR=3.40; 95% CI 2.85 to 4.04). Comorbid mental disorder was associated with the greatest risk (OR=3.60; 95% CI 2.69 to 4.83) after an IHD event. Regarding stroke, medical procedure, a proxy for event severity, was the largest contributor (OR=2.27, 95% CI 1.43 to 3.60). While IHD event was more common, stroke involved more permanent work disability. Demographic, socioeconomic and comorbidity-related factors were associated with disability pension both before and after the event. The results help occupational and other healthcare professionals to identify vulnerable groups at risk for permanent labour market exclusion after such an event. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  6. Comparison of Hemoglobin Levels Before and After Hemodialysis and Their Effects on Erythropoietin Dosing and Cost

    OpenAIRE

    Sagheb; Fallahzadeh; Moaref; Fallahzadeh; Dormanesh

    2016-01-01

    Background Hemoglobin levels measured after hemodialysis, as compared to hemoglobin levels measured before hemodialysis, are suggested to be a more accurate reflection of the hemoglobin levels between hemodialysis sessions, and to be a better reference point for adjusting erythropoietin dosing. Objectives The aim of this study was to compare the hemoglobin levels before and after hemodialysis, to calculate the required erythropoie...

  7. Impact of STROBE Statement Publication on Quality of Observational Study Reporting: Interrupted Time Series versus Before-After Analysis

    OpenAIRE

    Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence; Bouwes Bavinck, Jan Nico; Coenraads, Pieter-Jan; Diepgen, T.L.; Elsner, Peter; Garcia-Doval, Ignacio; Grob, J.J.; Langan, Sinead; Naldi, L.

    2013-01-01

    textabstractBackground:In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series.Methods:For this quasi-experimental study, original articles reporting...

  8. Use of general practice before and after mild traumatic brain injury: a nationwide population-based cohort study in Denmark

    DEFF Research Database (Denmark)

    Galili, Stine Fjendbo; Bech, Bodil Hammer; Vestergaard, Claus Høstrup

    2017-01-01

    Milde hovedtraumer ses hyppigt i de danske akutafdelinger, og følgevirkningerne af milde hovedtraumer er stærkt omdiskuterede. Formålet med dette nationale studie var at beskrive brugen af almen praksis før og efter et mildt hovedtraume og bruge antallet af kontakter som en proxy variabel...

  9. What Students Think About (Nuclear) Radiation - Before and After Fukushima

    Science.gov (United States)

    Neumann, S.

    2014-06-01

    Preparing successful science lessons is very demanding. One important aspect a teacher has to consider is the students' previous knowledge about the specific topic. This is why research about students' preconceptions has been, and continues to be, a major field in science education research. Following a constructivistic approach [R. Duit et al., International handbook of research on conceptual change, p. 629 (2008)], helping students learn is only possible if teachers know about students' ideas beforehand. Studies about students' conceptions regarding the major topics in physics education (e.g. mechanics, electrodynamics, optics, thermodynamics), are numerous and well-documented. The topic radiation, however, has seen very little empirical research about students' ideas and misconceptions. Some research was conducted after the events of Chernobyl [P. Lijnse et al., International Journal of Science Education 12, 67 (1990); B. Verplanken, Environment and Behavior 21, 7 (1989)] and provided interesting insight into some of the students' preconceptions about radiation. In order to contribute empirical findings to this field of research, our workgroup has been investigating the conceptions students have about the topic radiation for several years [S. Neumann et al., Journal of Science Education and Technology 21, 826 (2012)]. We used children's drawings and conducted short follow-up interviews with students (9 - 12 years old) and more detailed interviews with 15-year-old students. Both studies were originally done before the events in Fukushima and replicated a year later. We not only asked students about their general associations and emotions regarding the term radiation, but also examined the students' risk perceptions of different types of radiation. Through the use of open-ended questions we were able to examine students' conceptions about different types of radiation (including nuclear) that could be a hindrance to student learning. Our results show that students

  10. Operation IVY, Pacific Proving Grounds, November 1952. Project 11.5. Radiobiological Studies at Eniwetok before and after Mike Shot

    Science.gov (United States)

    1953-06-01

    plants that were to be used for autoradlograph? or as herbarium specimens were dried and pressed in the field. All plankton samples, as wei’ vs fish...nature. To further investigate the type of distribution, two series of counts of 100 samples each of unashed posttest Engebi sand were made. Sand, in a...various types of organisms and tissues closely resembled the sand curve, and, of the two curves, the data for the sand curve were more extensive and

  11. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study

    OpenAIRE

    Muldoon, Kathryn; Gallagher, Louise; McGuinness, Denise; Smith, Valerie

    2017-01-01

    Background Controversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables. Objective To de...

  12. Poverty Levels and Debt Indicators among Low-Income Households before and after the Great Recession

    Science.gov (United States)

    Kim, Kyoung Tae; Wilmarth, Melissa J.; Henager, Robin

    2017-01-01

    This study analyzed the debt profile of low-income households before and after the Great Recession using the 2007, 2010, and 2013 Survey of Consumer Finances (SCF). We used Heckman selection models to investigate three debt characteristics: (a) the amount of debt, (b) debt-to-income ratio, and (c) debt delinquency. Before and after the Great…

  13. The effect of a clinical pharmacist-led training programme on intravenous medication errors : a controlled before and after study

    NARCIS (Netherlands)

    Nguyen, Huong; Pham, Hong-Tham; Vo, Dang-Khoa; Nguyen, Tuan-Dung; van den Heuvel, Edwin R.; Haaijer-Ruskamp, Flora M.; Taxis, Katja

    Background Little is known about interventions to reduce intravenous medication administration errors in hospitals, especially in low-and middle-income countries. Objective To assess the effect of a clinical pharmacist-led training programme on clinically relevant errors during intravenous

  14. The effect of an e-learning course on nursing staff's knowledge of delirium: A before-and-after study

    NARCIS (Netherlands)

    L. Van De Steeg (Lotte); R.I. Jkema (Roelie I); C. Wagner (Cordula); M. Langelaan (Maaike)

    2015-01-01

    textabstractBackground: Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized

  15. The effect of an e-learning course on nursing staff's knowledge of delirium: a before-and-after study

    NARCIS (Netherlands)

    van de Steeg, L.; Ijkema, R.; Wagner, C.; Langelaan, M.

    2015-01-01

    Background: Delirium is a common condition in hospitalized patients, associated with adverse outcomes such as longer hospital stay, functional decline and higher mortality, as well as higher rates of nursing home placement. Nurses often fail to recognize delirium in hospitalized patients, which

  16. Does gender matter? Differences in social-emotional behavior among infants and toddlers before and after mild traumatic brain injury: a preliminary study.

    Science.gov (United States)

    Kaldoja, Mari-Liis; Kolk, Anneli

    2015-06-01

    Traumatic brain injury is a common cause of acquired disability in childhood. While much is known about cognitive sequelae of brain trauma, gender-specific social-emotional problems in children with mild traumatic brain injury is far less understood. The aims of the study were to investigate gender differences in social-emotional behavior before and after mild traumatic brain injury. Thirty-five 3- to 65-month-old children with mild traumatic brain injury and 70 controls were assessed with Ages and Stages Questionnaires: Social-Emotional. Nine months later, 27 of 35 patients and 54 of 70 controls were reassessed. We found that before injury, boys had more self-regulation and autonomy difficulties and girls had problems with adaptive functioning. Nine months after injury, boys continued to struggle with self-regulation and autonomy and new difficulties with interaction had emerged, whereas in girls, problems in interaction had evolved. Even mild traumatic brain injury in early childhood disrupts normal social-emotional development having especially devastating influence on interaction skills. © The Author(s) 2014.

  17. Sexual Function before and after Total Hip Replacement: Narrative Review

    Directory of Open Access Journals (Sweden)

    Rotem Meiri, BPT

    2014-12-01

    Conclusions: The ability to move comfortably is included among the many physical and psychosocial factors influencing sexual functioning. Practitioners should be encouraged to question their THR patients about sexual concerns and to provide counseling related to physical and functional aspects of sexual activity. Rehabilitation that focuses specifically on activities of daily living of sex should include sexual counseling, therapeutic exercise, and advice regarding sexual positions. Rehabilitation provided by physical therapists may help decrease pain, and facilitate greater self‐awareness, self‐confidence, and improved body image, all of which encourage and affirm optimal sexual health. Meiri R, Rosenbaum TY, and Kalichman L. Sexual function before and after total hip replacement: Narrative review. Sex Med 2014;2:159–167.

  18. Comparison of Children With Onset of Juvenile Dermatomyositis Symptoms Before or After Their Fifth Birthday in a UK and Ireland Juvenile Dermatomyositis Cohort Study

    Science.gov (United States)

    Martin, N; Krol, P; Smith, S; Beard, L; Pilkington, C A; Davidson, J; Wedderburn, L R

    2012-01-01

    Objective To compare 2 groups of children with juvenile dermatomyositis (DM), those with onset of symptoms before their fifth birthday versus those whose disease begins either on or after their fifth birthday, and to assess whether age at onset is associated with differences in disease presentation, treatments received, or outcomes 2 years after diagnosis. Methods Data were analyzed on children recruited to a UK juvenile DM cohort study with a diagnosis of probable or definite juvenile DM and less than 12 months between diagnosis and recruitment. Results Fifty-five (35%) of 157 children had onset of symptoms before their fifth birthday. At diagnosis, cutaneous ulceration was found in 32.7% of the younger group versus 11.8% of the older group (P = 0.003). Facial or body swelling was reported more often in the younger group, whereas headaches, alopecia, and Raynaud's phenomenon were all more frequently reported in the older group. At followup 2 years later, there were no important differences in outcomes between the groups. More than 90% of patients in both groups received both methotrexate and steroids. Twenty-three percent of both groups remained on steroids 2 years after diagnosis. Conclusion Our study showed that children with juvenile DM with disease onset at age <5 years are more likely to present with ulcerative skin disease and edema. There were no clinically significant differences in outcomes between the 2 groups. PMID:22674907

  19. Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2014-01-01

    Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders......-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox...... regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Results: Prior to the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (Odds ratio, OR, 1.51; 95% confidence...

  20. Aroma Constituents in Shanxi Aged Vinegar before and after Aging.

    Science.gov (United States)

    Liang, Jingjing; Xie, Jianchun; Hou, Li; Zhao, Mengyao; Zhao, Jian; Cheng, Jie; Wang, Shi; Sun, Bao-Guo

    2016-10-12

    Shanxi aged vinegar is one of the most famous Chinese traditional cereal vinegars produced by spontaneous solid-state fermentation. However, the aroma composition of Shanxi aged vinegar is still ambiguous. The Shanxi vinegars before and after aging were both analyzed by solvent-assisted flavor evaporation combined with gas chromatography-mass spectrometry (GC-MS) as well as gas chromatography-olfactometry (GC-O) in aroma extract dilution analysis. A total of 87 odor-active regions were found by GC-O, and 80 odor-active compounds were identified. By GC-MS/MS, in selected reaction monitoring mode, 30 important identifications were quantitated using authentic standards. In comparison, the aroma molecules for the vinegars before and after aging were almost the same; only their levels were altered, with mostly the esters and some compounds that produce pungent smells being lost and the levels of those from the Maillard reaction, especially the pyrazines (e.g., tetramethylpyrazine), being greatly increased. As for the aged vinegar, the compounds found to have high flavor dilution factors (>128) were 3-(methylthio)propanal, vanillin, 2,3-butanedione, tetramethylpyrazine, 3-methylbutanoic acid, γ-nonalactone, guaiacol, 3-(methylthio)propyl acetate, dimethyl trisulfide, phenylacetaldehyde, 2-ethyl-6-methylpyrazine, 2-acetylpyrazine, 2,3-dimethylpyrazine, furfural, and 3-hydroxy-2-butanone. However, the aroma compounds found at high concentrations (>25 μg/L) in the aged vinegar were acetic acid, followed by 2,3-butanedione, furfural, 3-hydroxy-2-butanone, tetramethylpyrazine, furfuryl alcohol, and 3-methylbutanoic acid.

  1. Lifecourse influences on women's smoking before, during and after pregnancy.

    Science.gov (United States)

    Graham, Hilary; Hawkins, Summer Sherburne; Law, Catherine

    2010-02-01

    The concept of the socioeconomic lifecourse is increasingly informing understanding of the social patterning of cigarette smoking. We investigated lifecourse influences on (i) women's smoking status (smoker/non-smoker) before pregnancy and (ii) quitting in pregnancy in the UK Millennium Cohort study. Our analyses included conventional measures of the socioeconomic lifecourse (woman's childhood circumstances, education, current socioeconomic circumstances) and measures of her domestic lifecourse (age of becoming a mother, current cohabitation status), as well as parity (first/subsequent child). In analyses of quitting, we also included pre-pregnancy cigarette consumption. Our study underlined, firstly, the importance of lifecourse disadvantage. Those experiencing greater disadvantage with respect to their childhood circumstances, education and current circumstances were at greater risk of being a smoker before pregnancy. A disadvantaged domestic lifecourse - earlier entry into motherhood and lone motherhood-further increased the risk. Poorer childhood circumstances, educational disadvantage, poorer current circumstances and early motherhood also significantly increased the odds of quitting in pregnancy. Secondly, parity was a major predictor of smoking behaviour. First-time mothers had higher odds both of smoking before pregnancy and quitting in pregnancy. The effects of parity were independent of women's lifecourse. Our study supports tobacco control policies which recognise and address inequalities across the lifecourse. However, our study suggests that the dye is not irrevocably cast by social disadvantage: first pregnancy uniformly increases the chances of quitting. Interventions which help smokers having their first baby to quit have an important part to play in promoting maternal and child health. Copyright 2009 Elsevier Ltd. All rights reserved.

  2. Comparision of uroflow parameters before and after hypospadias ...

    African Journals Online (AJOL)

    Aim: Uroflow investigation is used to identify whether stenosis has developed in the constituted neourethra after hypospadias repair. It is not clear whether a functional partial stenosis in the urethra in hypospadias cases is related to surgery or is present before the surgery. We aimed to investigate whether the obstructive ...

  3. Aqueous Humor Levels of Vascular Endothelial Growth Factor Before and After Intravitreal Bevacizumab in Type 3 Versus Type 1 and 2 Neovascularization. A Prospective, Case-Control Study

    NARCIS (Netherlands)

    Dell'Omo, Roberto; Cassetta, Marilluccia; Dell'Omo, Ermanno; di Salvatore, Angela; Hughes, John M.; Aceto, Fabiana; Porcellini, Antonio; Costagliola, Ciro

    2012-01-01

    PURPOSE: To determine the aqueous levels of vascular endothelial growth factor (VEGF) in patients with type 3 neovascularization (NV) secondary to age-related macular degeneration (AMD) and to compare the levels of those with type 1 and 2 NV secondary to AMD before and after administration of

  4. Organizing medical oncology care at a regional level and its subsequent impact on the quality of early breast cancer management: a before-after study.

    Science.gov (United States)

    Voidey, Aline; Pivot, Xavier; Woronoff, Anne-Sophie; Nallet, Gilles; Cals, Laurent; Schwetterle, Francis; Limat, Samuel

    2014-07-28

    One of the main measures of the French national cancer plan is to encourage physicians to work collectively, and to minimize territorial inequities in access to care by rethinking the geographical distribution of oncologists. For this reason, cancer care services are currently being reorganized at national level. A new infrastructure for multidisciplinary cancer care delivery has been put in place in our region. Patients can receive multidisciplinary health care services nearer their homes, thanks to a mobile team of oncologists. The objective of our study was to assess, using a quality approach, the impact on medical management and on the costs of treating early breast cancer, of the new regional structure for cancer care delivery. Before-and-after study performed from 2007 to 2010, including patients treated for early breast cancer in three hospitals in the region of Franche-Comté in Eastern France. The main outcome measures were quality criteria, namely delayed treatment (>12 weeks), dose-intensity and assessment of adjuvant chemotherapy. Other outcomes were 24-month progression-free survival (PFS) and economic evaluation. This study included 667 patients. The rate of chemotherapy tended to decrease, but not significantly (49.3% before versus 42.2% after, p=0.07), while the use of taxanes increased by 38% across all centres (59.6% before versus 98.0% after, p 3.0 weeks before versus 5.6 ± 3.6 weeks after, p=0.11). Dose-dense chemotherapy improved slightly, albeit non significantly (86.3% versus 91.1% p=0.22) and time to treatment tended to decrease. The new regional infrastructure did not change 24-month PFS, which remained at about 96%. The average cost of treatment was estimated at € 7000, with no difference between the two periods. Despite a shortage of oncologists, the new organization put in place in our region for the provision of care for early breast cancer makes it possible to maintain local community-based treatment, without negative economic

  5. Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia K

    2012-12-01

    Full Text Available Abstract Background Current studies comparing musculoskeletal pain levels between the genders focus on a single point in time rather than measuring change over time. The purpose of this study is to compare pain levels between males and females before and after treatment. Methods Eleven different patient cohorts (3,900 patients included in two prospective outcome databases collected pain data at baseline and 1 month after treatment. Treatments were either imaging-guided therapeutic injections or chiropractic therapy. The Mann–Whitney U test was used to calculate differences in numerical rating scale (NRS median scores between the genders for both time points in all 11 cohorts. Results Females reported significantly higher baseline pain scores at 4 of the 11 sites evaluated (glenohumeral (p = 0.015, subacromial (p = 0.002, knee (p = 0.023 injections sites and chiropractic low back pain (LBP patients (p = 0.041. However, at 1 month after treatment there were no significant gender differences in pain scores at any of the extremity sites. Only the chiropractic LBP patients continued to show higher pain levels in females at 1 month. Conclusions In these 11 musculoskeletal sites evaluated before and after treatment, only 3 extremity sites and the chiropractic LBP patients showed significantly higher baseline pain levels in females. At 1 month after treatment only the LBP patients had significant gender differences in pain levels. Gender evaluation of change in pain over time is likely to be more clinically important than an isolated pain measurement for certain anatomical sites.

  6. Description of the cascade of care and factors associated with attrition before and after initiating antiretroviral therapy of HIV infected children in a cohort study in India

    Directory of Open Access Journals (Sweden)

    Gerardo Alvarez-Uria

    2014-03-01

    Full Text Available In low- and middle-income countries, the attrition across the continuum of care of HIV infected children is not well known. The aim of this study was to investigate predictors of mortality and loss to follow up (LTFU in HIV infected children from a cohort study in India and to describe the cascade of care from HIV diagnosis to virological suppression after antiretroviral therapy (ART initiation. Multivariable analysis was performed using competing risk regression. The cumulative incidence of attrition due to mortality or LTFU after five year of follow-up was 16% from entry into care to ART initiation and 24.9% after ART initiation. Of all children diagnosed with HIV, it was estimated that 91.9% entered into care, 77.2% were retained until ART initiation, 58% stayed in care after ART initiation, and 43.4% achieved virological suppression on ART. Approximately half of the attrition occurred before ART initiation, and the other half after starting ART. Belonging to socially disadvantaged communities and living >90 min from the hospital were associated with a higher risk of attrition. Being >10 years old and having higher 12-month risk of AIDS (calculated using the absolute CD4 lymphocyte count and the age were associated with an increased risk of mortality. These findings indicate that we should consider placing more emphasis on promoting research and implementing interventions to improve the engagement of HIV infected children in pre-ART care. The results of this study can be used by HIV programmes to design interventions aimed at reducing the attrition across the continuum of care of HIV infected children in India.

  7. A before and after study of the impact of academic detailing on the use of diagnostic imaging for shoulder complaints in general practice

    Directory of Open Access Journals (Sweden)

    Gialamas Angela

    2007-03-01

    Full Text Available Abstract Background The aim of this study was to assess the impact that Academic Detailing (AD had on General Practitioners' use of diagnostic imaging for shoulder complaints in general practice and their knowledge and confidence to manage shoulder pain. Methods One-to-one Academic Detailing (AD for management of shoulder pain was delivered to 87 General Practitioners (GPs in metropolitan Adelaide, South Australia, together with locally developed clinical guidelines and a video/DVD on how to examine the shoulder. Three months after the initial AD a further small group or an individual follow up session was offered. A 10-item questionnaire to assess knowledge about the shoulders was administered before, immediately after, and 3 months after AD, together with questions to assess confidence to manage shoulder complaints. The number of requests for plain film (X-ray and ultrasound (US imaging of the shoulder was obtained for the intervention group as well as a random comparison group of 90 GP's from the same two Divisions. The change in the rate of requests was assessed using a log Poisson GEE with adjustment for clustering at the practice level. A linear mixed effects model was used to analyse changes in knowledge. Results In an average week 54% of GPs reported seeing fewer than 6 patients with shoulder problems. Mean (SD GP knowledge score before, immediately after and 3-months after AD, was 6.2/10 (1.5; 8.6/10 (0.96 and; 7.2/10 (1.5 respectively (p Conclusion These results provide evidence that AD together with education materials and guidelines can improve GPs' knowledge and confidence to manage shoulder problems and reduce the use of imaging, at least in the short term.

  8. Community and health system intervention to reduce disrespect and abuse during childbirth in Tanga Region, Tanzania: A comparative before-and-after study.

    Directory of Open Access Journals (Sweden)

    Stephanie A Kujawski

    2017-07-01

    Full Text Available Abusive treatment of women during childbirth has been documented in low-resource countries and is a deterrent to facility utilization for delivery. Evidence for interventions to address women's poor experience is scant. We assessed a participatory community and health system intervention to reduce the prevalence of disrespect and abuse during childbirth in Tanzania.We used a comparative before-and-after evaluation design to test the combined intervention to reduce disrespect and abuse. Two hospitals in Tanga Region, Tanzania were included in the study, 1 randomly assigned to receive the intervention. Women who delivered at the study facilities were eligible to participate and were recruited upon discharge. Surveys were conducted at baseline (December 2011 through May 2012 and after the intervention (March through September 2015. The intervention consisted of a client service charter and a facility-based, quality-improvement process aimed to redefine norms and practices for respectful maternity care. The primary outcome was any self-reported experiences of disrespect and abuse during childbirth. We used multivariable logistic regression to estimate a difference-in-difference model. At baseline, 2,085 women at the 2 study hospitals who had been discharged from the maternity ward after delivery were invited to participate in the survey. Of these, 1,388 (66.57% agreed to participate. At endline, 1,680 women participated in the survey (72.29% of those approached. The intervention was associated with a 66% reduced odds of a woman experiencing disrespect and abuse during childbirth (odds ratio [OR]: 0.34, 95% CI: 0.21-0.58, p < 0.0001. The biggest reductions were for physical abuse (OR: 0.22, 95% CI: 0.05-0.97, p = 0.045 and neglect (OR: 0.36, 95% CI: 0.19-0.71, p = 0.003. The study involved only 2 hospitals in Tanzania and is thus a proof-of-concept study. Future, larger-scale research should be undertaken to evaluate the applicability of this

  9. Effect of “Gol-e-ghand”, a mixture of rose petals and honey, on migraine attacks: a before-after pilot study

    Directory of Open Access Journals (Sweden)

    A. Maddahian

    2017-10-01

    Full Text Available Background and objectives: Migraine is the seventh most common cause of disability among all ailments according to the World Health Organization. Despite the availability of some medicines for prevention of migraine, their complications are a cause for concern. Traditional system of medicine and use of medicinal herbs can be beneficial in management of migraine. “Gol-e-ghand” is one of the most commonly prescribed products for the management of headaches in the Iranian traditional medicine. The present study was designed to evaluate the effect of “Ghol-e-ghand” on decreasing the frequency of migraine attacks. Methods: Nineteen migraine patients, who met the eligibility criteria, according to the International Headache Society diagnostic criteria were assigned to the intervention. The study was conducted as a before-after clinical trial and included two phases of drug administration. Propranolol was given during the first phase, while “Ghol-e-ghand” was administered along with propranolol in the second phase. The severity, duration, and frequency of headaches were measured before and after the intervention. Results: The analysis showed that “Ghol-e-ghand” decreased the frequency of migraine (20%, p=0.04, but it was not effective in decreasing the duration and severity of the attacks. Conclusion: “Ghol-e-ghand”can be suggested in migraine patients for reducing frequency of attacks.

  10. Ocular components before and after acquired, nonaccommodative esotropia.

    Science.gov (United States)

    Frane, S L; Sholtz, R I; Lin, W K; Mutti, D O

    2000-12-01

    Acquired nonaccommodative esotropia describes the sudden onset of a constant, comitant strabismus of idiopathic origin in children >6 months of age. We present a case of acquired nonaccommodative esotropia at 20 months of age in a subject participating in the Berkeley Infant Biometry Study, a longitudinal study of emmetropization and ocular component development in infants between 3 months and 3 years of age. Ocular components for this child were normal before the onset of strabismus (within 2 SD's of the mean for orthotropic study participants) for refractive error, corneal power, lens radii, lens power, and ocular axial dimensions. Refractive error postsurgically was significantly more hyperopic and crystalline lens power lower than average at +2.38 D and 37.2 D, respectively. The lack of abnormal ocular parameters is consistent with the idiopathic etiology of acute onset esotropia. This case suggests that ocular component values may not be useful for assessing the risk of acquired nonaccommodative esotropia.

  11. A matched case-control study comparing udder health, production and fertility parameters in dairy farms before and after the eradication of Bovine Virus Diarrhoea in Switzerland.

    Science.gov (United States)

    Tschopp, A; Deiss, R; Rotzer, M; Wanda, S; Thomann, B; Schüpbach-Regula, G; Meylan, M

    2017-09-01

    An obligatory eradication programme for Bovine Virus Diarrhoea (BVD) was implemented in Switzerland in 2008. Between 2008 and 2012, all bovines were tested for antigen or antibodies against BVDV. By the year 2012, eradication was completed in the majority of farms. A decrease of the prevalence of persistently infected (PI) newborn calves was observed from 1.4% in 2008 to study was to assess the effects of BVD eradication on different parameters of animal health, production and fertility in Swiss dairy herds which had completed the eradication programme. A matched case-control study was carried out using data from two periods, before (Period 1) and after (Period 2) the active phase of eradication. Case farms had at least two PI animals detected before or during the eradication; controls were BVD-free and matched for region, herd size and use of alpine pasture. A total of 110 farmers (55 pairs) were recruited. During a phone interview, a questionnaire about farm characteristics, animal health and appreciation of the BVD eradication programme was filled in. Breeding data and milk test day records were also analyzed. Parameters were first compared between (i) case and control herds before eradication, and (ii) Period 1 and Period 2 for case herds only. Milk yield (MY), bulk milk somatic cell count (BMSCC), prevalence of subclinical mastitis (SCM), and non-return rate (NRR) showed a p-valuecase-control) was created (IA). Except for MY, the IA was significant for all parameters modelled. Despite an overall p-value of 0.27, case herds tended to have a higher MY after eradication (β=0.53, p=0.050). For BMSCC and SCM, case herds had higher values than controls in both periods; udder health was significantly improved in control herds and it remained stable in case herds, with a slight decrease of BMSCC (β=-0.19, p=0.010). Finally, among fertility parameters, NRR showed a general improvement but it was significant only in control herds (β=0.29, p=0.019). Even though the

  12. Community and health system intervention to reduce disrespect and abuse during childbirth in Tanga Region, Tanzania: A comparative before-and-after study.

    Science.gov (United States)

    Kujawski, Stephanie A; Freedman, Lynn P; Ramsey, Kate; Mbaruku, Godfrey; Mbuyita, Selemani; Moyo, Wema; Kruk, Margaret E

    2017-07-01

    Abusive treatment of women during childbirth has been documented in low-resource countries and is a deterrent to facility utilization for delivery. Evidence for interventions to address women's poor experience is scant. We assessed a participatory community and health system intervention to reduce the prevalence of disrespect and abuse during childbirth in Tanzania. We used a comparative before-and-after evaluation design to test the combined intervention to reduce disrespect and abuse. Two hospitals in Tanga Region, Tanzania were included in the study, 1 randomly assigned to receive the intervention. Women who delivered at the study facilities were eligible to participate and were recruited upon discharge. Surveys were conducted at baseline (December 2011 through May 2012) and after the intervention (March through September 2015). The intervention consisted of a client service charter and a facility-based, quality-improvement process aimed to redefine norms and practices for respectful maternity care. The primary outcome was any self-reported experiences of disrespect and abuse during childbirth. We used multivariable logistic regression to estimate a difference-in-difference model. At baseline, 2,085 women at the 2 study hospitals who had been discharged from the maternity ward after delivery were invited to participate in the survey. Of these, 1,388 (66.57%) agreed to participate. At endline, 1,680 women participated in the survey (72.29% of those approached). The intervention was associated with a 66% reduced odds of a woman experiencing disrespect and abuse during childbirth (odds ratio [OR]: 0.34, 95% CI: 0.21-0.58, p Tanzania and is thus a proof-of-concept study. Future, larger-scale research should be undertaken to evaluate the applicability of this approach to other settings. After implementation of the combined intervention, the likelihood of women's reports of disrespectful treatment during childbirth was substantially reduced. These results were

  13. Hemodynamics before and after bleb formation in cerebral aneurysms

    Science.gov (United States)

    Cebral, Juan R.; Radaelli, Alessandro; Frangi, Alejandro; Putman, Christopher M.

    2007-03-01

    We investigate whether blebs in cerebral aneurysms form in regions of low or high wall shear stress (WSS), and how the intraaneurysmal hemodynamic pattern changes after bleb formation. Seven intracranial aneurysms harboring well defined blebs were selected from our database and subject-specific computational models were constructed from 3D rotational angiography. For each patient, a second anatomical model representing the aneurysm before bleb formation was constructed by smoothing out the bleb. Computational fluid dynamics simulations were performed under pulsatile flow conditions for both models of each aneurysm. In six of the seven aneurysms, the blebs formed in a region of elevated WSS associated to the inflow jet impaction zone. In one, the bleb formed in a region of low WSS associated to the outflow zone. In this case, the inflow jet maintained a fairly concentrated structure all the way to the outflow zone, while in the other six aneurysms it dispersed after impacting the aneurysm wall. In all aneurysms, once the blebs formed, new flow recirculation regions were formed inside the blebs and the blebs progressed to a state of low WSS. Assuming that blebs form due to a focally damaged arterial wall, these results seem to indicate that the localized injury of the vessel wall may be caused by elevated WSS associated with the inflow jet. However, the final shape of the aneurysm is probably also influenced by the peri-aneurysmal environment that can provide extra structural support via contact with structures such as bone or dura matter.

  14. Faith after an Earthquake: A Longitudinal Study of Religion and Perceived Health before and after the 2011 Christchurch New Zealand Earthquake

    Science.gov (United States)

    Sibley, Chris G.; Bulbulia, Joseph

    2012-01-01

    On 22 February 2011, Christchurch New Zealand (population 367,700) experienced a devastating earthquake, causing extensive damage and killing one hundred and eighty-five people. The earthquake and aftershocks occurred between the 2009 and 2011 waves of a longitudinal probability sample conducted in New Zealand, enabling us to examine how a natural disaster of this magnitude affected deeply held commitments and global ratings of personal health, depending on earthquake exposure. We first investigated whether the earthquake-affected were more likely to believe in God. Consistent with the Religious Comfort Hypothesis, religious faith increased among the earthquake-affected, despite an overall decline in religious faith elsewhere. This result offers the first population-level demonstration that secular people turn to religion at times of natural crisis. We then examined whether religious affiliation was associated with differences in subjective ratings of personal health. We found no evidence for superior buffering from having religious faith. Among those affected by the earthquake, however, a loss of faith was associated with significant subjective health declines. Those who lost faith elsewhere in the country did not experience similar health declines. Our findings suggest that religious conversion after a natural disaster is unlikely to improve subjective well-being, yet upholding faith might be an important step on the road to recovery. PMID:23227147

  15. Faith after an earthquake: a longitudinal study of religion and perceived health before and after the 2011 Christchurch New Zealand Earthquake.

    Science.gov (United States)

    Sibley, Chris G; Bulbulia, Joseph

    2012-01-01

    On 22 February 2011, Christchurch New Zealand (population 367,700) experienced a devastating earthquake, causing extensive damage and killing one hundred and eighty-five people. The earthquake and aftershocks occurred between the 2009 and 2011 waves of a longitudinal probability sample conducted in New Zealand, enabling us to examine how a natural disaster of this magnitude affected deeply held commitments and global ratings of personal health, depending on earthquake exposure. We first investigated whether the earthquake-affected were more likely to believe in God. Consistent with the Religious Comfort Hypothesis, religious faith increased among the earthquake-affected, despite an overall decline in religious faith elsewhere. This result offers the first population-level demonstration that secular people turn to religion at times of natural crisis. We then examined whether religious affiliation was associated with differences in subjective ratings of personal health. We found no evidence for superior buffering from having religious faith. Among those affected by the earthquake, however, a loss of faith was associated with significant subjective health declines. Those who lost faith elsewhere in the country did not experience similar health declines. Our findings suggest that religious conversion after a natural disaster is unlikely to improve subjective well-being, yet upholding faith might be an important step on the road to recovery.

  16. Faith after an earthquake: a longitudinal study of religion and perceived health before and after the 2011 Christchurch New Zealand Earthquake.

    Directory of Open Access Journals (Sweden)

    Chris G Sibley

    Full Text Available On 22 February 2011, Christchurch New Zealand (population 367,700 experienced a devastating earthquake, causing extensive damage and killing one hundred and eighty-five people. The earthquake and aftershocks occurred between the 2009 and 2011 waves of a longitudinal probability sample conducted in New Zealand, enabling us to examine how a natural disaster of this magnitude affected deeply held commitments and global ratings of personal health, depending on earthquake exposure. We first investigated whether the earthquake-affected were more likely to believe in God. Consistent with the Religious Comfort Hypothesis, religious faith increased among the earthquake-affected, despite an overall decline in religious faith elsewhere. This result offers the first population-level demonstration that secular people turn to religion at times of natural crisis. We then examined whether religious affiliation was associated with differences in subjective ratings of personal health. We found no evidence for superior buffering from having religious faith. Among those affected by the earthquake, however, a loss of faith was associated with significant subjective health declines. Those who lost faith elsewhere in the country did not experience similar health declines. Our findings suggest that religious conversion after a natural disaster is unlikely to improve subjective well-being, yet upholding faith might be an important step on the road to recovery.

  17. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study.

    Science.gov (United States)

    Fanning, Laura; Jones, Nick; Manias, Elizabeth

    2016-04-01

    The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital. Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377-bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity. A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor. The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting. © 2015 John Wiley & Sons, Ltd.

  18. Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: Controlled before and after study

    Science.gov (United States)

    de Lusignan, Simon; Chan, Tom; Tejerina Arreal, Maria C.; Parry, Glenys; Dent-Brown, Kim; Kendrick, Tony

    2013-01-01

    Background Referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in people with long term conditions (LTCs) is not known. Method Routinely collected primary care, psychological therapy clinic and hospital data were extracted for the registered population of 20 practices (N = 121199). These data were linked using the SAPREL (Secure and Private Record Linkage) method. We linked the 1118 people referred to psychological therapies with 6711 controls, matched for age, gender and practice. We compared utilisation of healthcare resources by people with LTCs, 6 months before and after referral, and conducted a controlled before and after study to compare health utilisation with controls. We made the assumption that collection of a greater number of repeat prescriptions for antidepressants was associated with greater adherence. Results Overall 21.8% of people with an LTC had CMHP vs. 18.8% without (p test p < 0.001). Cases with LTCs showed referral to the psychological therapies clinic was associated with increased antidepressant medication prescribing (mean differences 0.62, p < 0.001) and less use of emergency department than controls (mean difference −0.21, p = 0.003). Conclusions Referral to improved access to psychological therapies (IAPT) services appears of value to people with LTC. It is associated with the issue of a greater number of prescriptions for anti-depressant medicines and less use of emergency services. Further studies are needed to explore bed occupancy and outpatient attendance. PMID:23639304

  19. Vulnerability and livelihoods before and after the Haiti earthquake

    OpenAIRE

    Echevin, Damien

    2011-01-01

    This paper examines the dynamics of poverty and vulnerability in Haiti using various data sets. As living conditions survey data are not comparable in this country, we first propose to use the three rounds of the Demographic Health Survey (DHS) available before the earthquake. Decomposing household assets changes into age and cohort effects, we use repeated cross-section data to identify a...

  20. Reproducibility of lymphoscintigraphy before and after excisional biopsy of primary breast lesions: a study using superficial peri-areolar injection of the radiotracer.

    Science.gov (United States)

    Asadi, M; Shobeiri, H; Aliakbarian, M; Jangjoo, A; Dabbagh Kakhki, V R; Sadeghi, R; Keshtgar, M

    2013-01-01

    A major controversial issue in the sentinel node biopsy of the breast is the applicability of sentinel node mapping in patients with the history of previous excisional biopsy of the breast lesions. In the current study, we evaluated the reproducibility of lymphoscintigraphy before and after excisional biopsy of the primary breast lesions using superficial peri-areolar injection of the radiotracer. Eighteen patients scheduled for excisional biopsy of breast lesions were included into the study. The patients received intra-dermal injection of the radiotracer in the peri-areolar area of the index quadrant 1 to 2h before surgery. Imaging was performed the day after surgery. Immediately after completion of the first imaging, the patients received another injection of the radiotracer with the same technique, dose, and location. Other sets of lymphoscintigraphy imaging were taken immediately and 4h post second injection. The two sets of lymphoscintigraphy images were compared. In 2 patients, sentinel node could not be identified in either set of images. In the remaining 16 patients, one sentinel node was detected in both lymphoscintigraphy image sets. The sentinel nodes of the second image sets were all in the same location of the first sets with at least 5 times higher count. Excisional biopsy of the primary breast lesions does not seem to change the superficial lymphatic drainage pattern from the areola of the breast and sentinel node mapping can be performed after this procedure using superficial periareolar technique. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  1. Effect of palliative care nurse champions on the quality of dying in the hospital according to bereaved relatives: A controlled before-and-after study.

    Science.gov (United States)

    Witkamp, Frederika Erica; van Zuylen, Lia; van der Rijt, Carin C D; van der Heide, Agnes

    2016-02-01

    To improve the quality of end-of-life care, hospitals increasingly appoint palliative care nurse champions. We investigated the effect of nurse champions on the quality of life during the last 3 days of life and the quality of dying as experienced by bereaved relatives. A controlled before-and-after study (June 2009-July 2012). Halfway, in each of seven intervention wards, two nurse champions were appointed; 11 wards served as control wards. The quality of life during the last 3 days of life, quality of dying and multiple dimensions of quality of dying were compared before and after the introduction of nurse champions. In a university hospital, each death at non-intensive care units was followed up by an invitation to relatives (10-13 weeks later) to answer a questionnaire. For the two periods, data were collected on 86 and 84 patients in intervention wards and on 108 and 118 patients in control wards (overall response: 52%). In the intervention wards, no differences were found in the quality of life during the last 3 days of life and the quality of dying scores: in both periods, median score for the quality of life during the last 3 days of life was 3.0 and for the quality of dying 7.0. No differences were found in multiple quality of dying dimensions. In control wards, the median quality of dying score was 7.0 pre-intervention and 6.0 post-intervention (p = 0.04). Other scores were comparable with those in intervention wards. Performing a complex intervention study in palliative care proved to be feasible. This study showed no differences in the experiences of bereaved relatives after introduction of nurse champions. The complexity of palliative care in the hospital might require more intensive and longer training of nurse champions. © The Author(s) 2015.

  2. Health care costs before and after diagnosis of depression in patients with unexplained pain: a retrospective cohort study using the United Kingdom General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Reed C

    2013-01-01

    Full Text Available Catherine Reed,1 Jihyung Hong,2 Diego Novick,1 Alan Lenox-Smith,3 Michael Happich41Global Health Outcomes, Eli Lilly and Company, Windlesham, Surrey, UK; 2Personal Social Services Research Unit, London School of Economics and Political Science, London, UK; 3Eli Lilly UK, Basingstoke, UK; 4Eli Lilly and Company, Bad Homburg, GermanyPurpose: To assess the impact of pain severity and time to diagnosis of depression on health care costs for primary care patients with pre-existing unexplained pain symptoms who subsequently received a diagnosis of depression.Patients and methods: This retrospective cohort study analyzed 4000 adults with unexplained pain (defined as painful physical symptoms [PPS] without any probable organic cause and a subsequent diagnosis of depression, identified from the UK General Practice Research Database using diagnostic codes. Patients were categorized into four groups based on pain severity (milder or more severe; based on number of pain-relief medications and use of opioids and time to diagnosis of depression (≤1 year or >1 year from PPS index date. Annual health care costs were calculated (2009 values and included general practitioner (GP consultations, secondary care referrals, and prescriptions for pain-relief medications for the 12 months before depression diagnosis and in the subsequent 2 years. Multivariate models of cost included time period as a main independent variable, and adjusted for age, gender, and comorbidities.Results: Total annual health care costs before and after depression diagnosis for the four patient groups were higher for the groups with more severe pain (£819–£988 versus £565–£628; P < 0.001 for all pairwise comparisons and highest for the group with more severe pain and longer time to depression diagnosis in the subsequent 2 years (P < 0.05. Total GP costs were highest in the group with more severe pain and longer time to depression diagnosis both before and after depression diagnosis (P

  3. Impact of an implicit social skills training group in children with autism spectrum disorder without intellectual disability: A before-and-after study.

    Science.gov (United States)

    Guivarch, Jokthan; Murdymootoo, Veena; Elissalde, Sara-Nora; Salle-Collemiche, Xavier; Tardieu, Sophie; Jouve, Elisabeth; Poinso, François

    2017-01-01

    Children with Autism Spectrum Disorders (ASDs) have problems with social skills. Social skills training groups are among the proposed therapeutic strategies, but their efficacy still needs to be evaluated. To evaluate the efficacy of an implicit social skills training group in children with ASDs without intellectual disability. A before-and-after study of children with ASD without intellectual disability was conducted in a child psychiatry day hospital, where they participated in an implicit group with cooperative games. Their social skills were assessed using the Social-Emotional Profile (SEP), the Childhood Autism Rating Scale (CARS), and the empathy quotient (EQ) before and after 22 weeks. Six patients aged 9 to 10 years old were evaluated. A significant increase in overall adaptation and social skills (median 8 and 7.7 points) in the SEP was demonstrated in addition to a significant reduction in the CARS score (median: 4 points), including in the field of social relationships. The EQ increased two-fold. This implicit group improved the children's social skills. It would be interesting to evaluate the maintenance of these skills over time, examine more widespread results, and compare implicit and explicit groups.

  4. Impact of an implicit social skills training group in children with autism spectrum disorder without intellectual disability: A before-and-after study

    Science.gov (United States)

    Murdymootoo, Veena; Elissalde, Sara-Nora; Salle-Collemiche, Xavier; Tardieu, Sophie; Jouve, Elisabeth; Poinso, François

    2017-01-01

    Introduction Children with Autism Spectrum Disorders (ASDs) have problems with social skills. Social skills training groups are among the proposed therapeutic strategies, but their efficacy still needs to be evaluated. Objective To evaluate the efficacy of an implicit social skills training group in children with ASDs without intellectual disability. Methods A before-and-after study of children with ASD without intellectual disability was conducted in a child psychiatry day hospital, where they participated in an implicit group with cooperative games. Their social skills were assessed using the Social-Emotional Profile (SEP), the Childhood Autism Rating Scale (CARS), and the empathy quotient (EQ) before and after 22 weeks. Results Six patients aged 9 to 10 years old were evaluated. A significant increase in overall adaptation and social skills (median 8 and 7.7 points) in the SEP was demonstrated in addition to a significant reduction in the CARS score (median: 4 points), including in the field of social relationships. The EQ increased two-fold. Discussion—Conclusion This implicit group improved the children’s social skills. It would be interesting to evaluate the maintenance of these skills over time, examine more widespread results, and compare implicit and explicit groups. PMID:28715464

  5. Impact of an implicit social skills training group in children with autism spectrum disorder without intellectual disability: A before-and-after study.

    Directory of Open Access Journals (Sweden)

    Jokthan Guivarch

    Full Text Available Children with Autism Spectrum Disorders (ASDs have problems with social skills. Social skills training groups are among the proposed therapeutic strategies, but their efficacy still needs to be evaluated.To evaluate the efficacy of an implicit social skills training group in children with ASDs without intellectual disability.A before-and-after study of children with ASD without intellectual disability was conducted in a child psychiatry day hospital, where they participated in an implicit group with cooperative games. Their social skills were assessed using the Social-Emotional Profile (SEP, the Childhood Autism Rating Scale (CARS, and the empathy quotient (EQ before and after 22 weeks.Six patients aged 9 to 10 years old were evaluated. A significant increase in overall adaptation and social skills (median 8 and 7.7 points in the SEP was demonstrated in addition to a significant reduction in the CARS score (median: 4 points, including in the field of social relationships. The EQ increased two-fold.This implicit group improved the children's social skills. It would be interesting to evaluate the maintenance of these skills over time, examine more widespread results, and compare implicit and explicit groups.

  6. A clinical study to compare between resting and stimulated whole salivary flow rate and pH before and after complete denture placement in different age groups

    Directory of Open Access Journals (Sweden)

    B C Muddugangadhar

    2015-01-01

    Conclusion: Stimulated whole salivary flow rates and pH were significantly higher than resting (unstimulated whole salivary flow rates and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No age related variations in whole salivary flow rate and pH were observed in healthy, non-medicated individuals. Clinical Implications: The assessment of salivary flow rate, pH in different age groups is of prognostic value, which is an important aspect to be considered in the practice of removable prosthodontics.

  7. Attitudes of Brazilian Medical Students Towards Psychiatric Patients and Mental Illness: A Quantitative Study Before and After Completing the Psychiatric Clerkship.

    Science.gov (United States)

    da Rocha Neto, Helio Gomes; Rosenheck, Robert A; Stefanovics, Elina A; Cavalcanti, Maria Tavares

    2017-06-01

    The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.

  8. [A psychopathological study on three-dimensional computer graphics (3DCGs): special reference to pictures made by a schizophrenic patient before and after the onset].

    Science.gov (United States)

    Ashizawa, Yuko; Tachikawa, Hirokazu; Hori, Masashi; Hori, Takafumi; Mizukami, Katsuyoshi; Asada, Takashi

    2004-01-01

    A patient with catatonic type schizophrenia drawing 3-dimensional computer graphics (3DCGs) before and after the onset is reported. His 3DCGs are discussed from the view of psychopathology. A 21-year-old male was admitted to our hospital. He was an art student. For three months before admission, he had been absorbed in drawing 3DCGs. When he was asked to draw handmade pictures by his teacher, he experienced a bizarre mood and took an overdose of aspirin. At the time of admission, he was in a stupor state, and was diagnosed with catatonic type schizophrenia. After admission, he exhibited excitement and disorganized speech. These symptoms disappeared after administration of neuroleptics, and he was discharged. The 3DCGs he drew before and after the onset revealed several special characteristics. First, the compositions of his pictures were too geometric and too precise. Secondly, the themes of his pictures changed from romantic before the onset to symbolic after it, and the styles changed from realistic to abstractive after the onset. Finally, histograms of the 3DCGs revealed many colors before onset, which converged to simple colors after. Therefore, it was suggested that the latent pathological process at the beginning of schizophrenia might be reflected in his 3DCGs. 3DCGs are a new type of fine art. They can express beautiful and cool images more simply than handmade pictures. Due to these features, artists can create images of their innerworld, with less effort and talent than picture drawings, by computer assistance. This case suggests that the geometric working space, change-free viewpoints, and computer assistance, which are characteristics of the methods in making 3DCGs may be suitable for schizophrenic artists to create images of their innerworld. However, being absorbed in making 3DCGs could also promote the latent schizophrenic process to the onset.

  9. Association between smoking and respiratory function before and after menopause.

    Science.gov (United States)

    Hayatbakhsh, Mohammad R; Najman, Jake M; O'Callaghan, Michael J; Williams, Gail M; Paydar, Anita; Clavarino, Alexandra

    2011-02-01

    There is a lack of evidence about whether menopausal status influences the effect of smoking on lung function. This study examined the association between smoking and menopausal status and lung function independent of each other. Data were from a cohort of women attending the 21-year follow-up of the Mater University of Queensland Study of Pregnancy. The study was based on 2020 women who provided data on respiratory function, smoking, and menopausal status. A Spirobank G spirometer system was used to measure forced vital capacity (FVC), forced expiratory volume in first second (FEV(1)), and forced expiratory flow between 25 and 75% of forced vital capacity (FEF(25-75)). Smoking and menopausal status were assessed by self-report. Respiratory function was associated with cigarette smoking, menopausal status, and hormone replacement therapy. Regardless of smoking status, postmenopausal women had poorer lung function when compared with premenopausal women. In multivariate analysis, cigarette smoking was associated with lower FVC, FEV(1), and FEF(25-75), with the magnitude of effect being stronger for women who were postmenopausal. The data suggest that the impact of smoking intensifies after menopause. It seems plausible that effective quit-smoking programs, particularly after menopause, may lead to better lung function and reduced morbidity and mortality in women.

  10. Medication before and after a spinal cord lesion.

    Science.gov (United States)

    Jensen, E K; Biering-Sørensen, F

    2014-05-01

    To map the impact of spinal cord lesion (SCL) on medication. Registration of medication for 72 patients before SCL and at discharge from the Department for Spinal Cord Injuries. Department for Spinal Cord Injuries, East Denmark. The changes in medication for each Anatomical Therapeutic Chemical (ATC) Classification System group were registered for all patients, who were discharged from Department for Spinal Cord Injuries during 2010. The changes in medication per se were calculated for different parts of the population: non-traumatic, traumatic patients, men, women, paraplegia, tetraplegia, American Spinal Injury Association Impairment Scale (AIS) A, B or C, AIS D, age 0-45, 46-60 and 60+. In addition, comparisons of changes in medication were made between complementary parts of the population. The overall increase in medication after SCL was 3.29 times (Ppopulation, the increase was most constantly seen for the medicine in the groups 'Alimentary tract and metabolism' and 'Nervous system'. The highest overall increases were seen in patients with AIS A, B and C compared with AIS D (P<0.05). There was no difference between traumatic and non-traumatic SCL, men and women, and younger compared with older patients. SCL elicits a general massive need for medicine. The relative increase is most pronounced for the more severely injured (AIS A, B and C). The increase in medication may have implications for side effects and for the economy of all involved.

  11. Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services

    Directory of Open Access Journals (Sweden)

    Lin Chienhung

    2012-09-01

    Full Text Available Abstract Background The Taiwan government adopted National Health Insurance (NHI in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.

  12. Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-east Nigeria: a before and after study.

    Science.gov (United States)

    Mbachu, Chinyere; Dim, Cyril; Ezeoke, Uche

    2017-06-09

    Effective female education on cervical cancer prevention has been shown to increase awareness and uptake of screening. However, sustaining increase in uptake poses a challenge to control efforts. Peer health education has been used as an effective tool for ensuring sustained behavior change. This study was undertaken to assess the effectiveness of peer health education on perception, willingness to screen and uptake of cervical cancer screening by women. A before and after intervention study was undertaken in 2 urban cities in Enugu state, Nigeria among women of reproductive age attending women's meeting in Anglican churches. Multistage sampling was used to select 300 women. Peer health education was provided once monthly for 3 consecutive sessions over a period of 3 months. Data was collected at baseline and after the intervention using pre-tested questionnaires. Descriptive statistics and tests of significance of observed differences and associations were done at p-value of education, employment status and parity (p education is an effective strategy for increasing women's perception of benefits of early detection of cervical cancer through screening. It is also effective for increasing their practice of screening for cervical cancer.

  13. Trends in unprotected intercourse among heterosexual men before and after brothel ban in Siem Reap, Cambodia: a serial cross-sectional study (2003-2012).

    Science.gov (United States)

    Wong, Mee Lian; Teo, Alvin Kuo Jing; Tai, Bee Choo; Ng, Alwyn Mao Tong; Lim, Raymond Boon Tar; Tham, Dede Kam Tyng; Kaur, Nashwinder; Tan, Rayner Kay Jin; Kros, Sarath; Touch, Savun; Chhit, Maryan; Lubek, Ian

    2018-03-27

    Following Cambodia's implementation of the 100% condom use program with enforcement of condom use and STI treatment services for sex workers in 2001, sexually transmitted infection and HIV declined markedly. In 2008, Cambodia implemented a law to ban brothel-based sex work. We reported trends in unprotected vaginal intercourse with sex workers among heterosexual men buying sex before (2003-2008) and after (2009-2012) the brothel ban in Cambodia. We also determined the association of brothel ban with these men's reports of unprotected intercourse with sex workers. In this serial cross-sectional study, we collected yearly behavioural data on random cross-sectional samples of heterosexual men buying sex who attended the only government health centre in Siem Reap for voluntary confidential counselling and testing (VCCT) between 2003 and 2012. We used multivariable Poisson regression analysis on the 10-year data of 976 men to obtain the adjusted prevalence ratio (aPR) of unprotected intercourse in the last 6 months by brothel closure. Men buying sex from non-brothel-based sex workers increased almost 3-fold from 17% in 2007-2008 before brothel closure to 55% in 2011-2012 after brothel closure (p < 0.001). Unprotected intercourse with sex workers in the last week increased significantly from 37% (2003-2004) before brothel closure to 65% (2011-2012) after brothel closure. This increase corresponded closely with the increase in self-reported unprotected intercourse from 35% to 61% by the sex workers (n = 1805) attending the same clinic for VCCT. Brothel closure was associated with an increased risk (aPR: 1.65; 95% CI: 1.40-1.94) of unprotected intercourse with sex workers. HIV prevalence in the heterosexual men declined significantly from 26% in 2003-2004 to 4.8% in 2007-2008 and 0 case in 2009-2010 before increasing to 5.6% in 2011-2012. Our findings suggest that the brothel ban had led to an increase in unprotected intercourse with all sex workers for men buying

  14. Outcomes of road traffic injuries before and after the implementation of a camera ticketing system: a retrospective study from a large trauma center in Saudi Arabia.

    Science.gov (United States)

    Alghnam, Suliman; Alkelya, Muhamad; Alfraidy, Moath; Al-Bedah, Khalid; Albabtain, Ibrahim Tawfiq; Alshenqeety, Omar

    2017-01-01

    Road traffic injuries (RTIs) are the third leading cause of death in Saudi Arabia. Because speed is a major risk factor for severe crash-related injuries, a camera ticketing system was implemented countrywide in mid-2010 by the traffic police in an effort to improve traffic safety. There are no published studies on the effects of the system in Saudi Arabia. To examine injury severity and associated mortality at a large trauma center before and after the implementation of the ticketing system. Retrospective, analytical. Trauma center of a tertiary care center in Riyadh. The study included all trauma registry patients seen in the emergency department for a crash-related injury (automobile occupants, pedestrians, or motorcyclists) between January 2005 and December 2014. Associations with outcome measures were assessed by univariate and multivariate methods. Injury severity score (ISS), Glasgow coma scale (GCS) and mortality. The study included all trauma registry patients seen in the emergency department for a crash-related injury. All health outcomes improved in the period following implementation of the ticketing system. Following implementation, ISS scores decreased (-3.1, 95% CI -4.6, -1.6) and GCS increased (0.47, 95% CI 0.08, 0.87) after adjusting for other covariates. The odds of death were 46% lower following implementation than before implementation. When the data were log-transformed to account for skewed data distributions, the results remained statistically significant. This study suggests positive health implications following the implementation of the camera ticketing system. Further investment in public health interventions is warranted to reduce preventable RTIs. The study findings represent a trauma center at a single hospital in Riyadh, which may not generalize to the Saudi population.

  15. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT.

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    Full Text Available BACKGROUND/AIMS: The 256-slice CT enables the entire brain to be scanned in a single examination. We evaluated the application of 256-slice whole-brain CT perfusion (CTP in determining graft patency as well as investigating cerebral hemodynamic changes in Moyamoya disease before and after surgical revascularization. METHODS: Thirty-nine cases of Moyamoya disease were evaluated before and after surgical revascularization with 256-slice CT. Whole-brain perfusion images and dynamic 3D CT angiographic images generated from perfusion source data were obtained in all patients. Cerebral blood flow (CBF, cerebral blood volume (CBV, time to peak (TTP and mean transit time (MTT of one hemisphere in the region of middle cerebral artery (MCA distribution and contralateral mirroring areas were measured. Relative CTP values (rCBF, rCBV, rTTP, rMTT were also obtained. Differences in pre- and post- operation perfusion CT values were assessed with paired t test or matched-pairs signed-ranks test. RESULTS: Preoperative CBF, MTT and TTP of potential surgical side were significantly different from those of contralateral side (P<0.01 for all. All graft patencies were displayed using the 3D-CTA images. Postoperative CBF, rCBF and rCBV values of surgical side in the region of MCA were significantly higher than those before operation (P<0.01 for all. Postoperative MTT, TTP, rMTT and rTTP values of the surgical side in the region of MCA were significantly lower than those before operation (P<0.05 for all. CONCLUSION: The 256-slice whole-brain CTP can be used to evaluate cerebral hemodynamic changes in Moyamoya disease before and after surgery and the 3D-CTA is useful for assessing the abnormalities of intracranial arteries and graft patencies.

  16. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT.

    Science.gov (United States)

    Zhang, Jun; Wang, Jianhong; Geng, Daoying; Li, Yuxin; Song, Donglei; Gu, Yuxiang

    2013-01-01

    The 256-slice CT enables the entire brain to be scanned in a single examination. We evaluated the application of 256-slice whole-brain CT perfusion (CTP) in determining graft patency as well as investigating cerebral hemodynamic changes in Moyamoya disease before and after surgical revascularization. Thirty-nine cases of Moyamoya disease were evaluated before and after surgical revascularization with 256-slice CT. Whole-brain perfusion images and dynamic 3D CT angiographic images generated from perfusion source data were obtained in all patients. Cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP) and mean transit time (MTT) of one hemisphere in the region of middle cerebral artery (MCA) distribution and contralateral mirroring areas were measured. Relative CTP values (rCBF, rCBV, rTTP, rMTT) were also obtained. Differences in pre- and post- operation perfusion CT values were assessed with paired t test or matched-pairs signed-ranks test. Preoperative CBF, MTT and TTP of potential surgical side were significantly different from those of contralateral side (P<0.01 for all). All graft patencies were displayed using the 3D-CTA images. Postoperative CBF, rCBF and rCBV values of surgical side in the region of MCA were significantly higher than those before operation (P<0.01 for all). Postoperative MTT, TTP, rMTT and rTTP values of the surgical side in the region of MCA were significantly lower than those before operation (P<0.05 for all). The 256-slice whole-brain CTP can be used to evaluate cerebral hemodynamic changes in Moyamoya disease before and after surgery and the 3D-CTA is useful for assessing the abnormalities of intracranial arteries and graft patencies.

  17. Measurement of deuteron beam polarization before and after acceleration

    Directory of Open Access Journals (Sweden)

    A Ramazani Moghaddam Arani

    2017-02-01

    Full Text Available Beam polarization measurement in scattering experiments with a high accuracy and the lowest possible cost is an important issue. In this regard, deuteron beam polarization was measured in the low-energy beam line easily with a relatively low cost procedure and in a very short time by Lamb Shift Polarimeter (LSP. Also, the beam polarization has been measured in high-energy beam line with BINA. In low-energy line, a polarized beam of deuterons delivered by POLIS was decelerated and focused on LSP detection system. Three resonances between 52mT and 63mT show the distribution of different spin states of polarized deuteron beam. In high-energy beam line, polarization can be measured employing BINA via the H(d,dp reaction. The asymmetry ratio, was obtained as a function of azimuthal angle, φ, for several polar scattering angles. Knowing values of the analyzing powers, the ratio has been used to extract the polarization results. The obtained results show that polarization of deuteron beam that is accelerated up to the energy of 130 MeV is almost the same before and after acceleration

  18. Impact of STROBE Statement Publication on Quality of Observational Study Reporting: Interrupted Time Series versus Before-After Analysis

    NARCIS (Netherlands)

    S. Bastuji-Garin (Sylvie); E. Sbidian (Emilie); C. Gaudy-Marqueste (Caroline); E. Ferrat (Emilie); J.C. Roujeau (Jean-Claude); M.A. Richard (Marie-Aleth); F. Canoui-Poitrine (Florence); J.N. Bouwes Bavinck (Jan Nico); P.J. Coenraads (Pieter-Jan); T.L. Diepgen; P. Elsner (Peter); I. Garcia-Doval (Ignacio); J.J. Grob; S. Langan (Sinead); L. Naldi; T.E.C. Nijsten (Tamar); J. Schmitt (Julien); Å. Svensson (Åke); H. Williams

    2013-01-01

    textabstractBackground:In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement

  19. Sequential kidney scintiscanning before and after vascular reconstruction

    International Nuclear Information System (INIS)

    Siems, H.H.; Allenberg, J.R.; Hupp, T.; Clorius, J.H.

    1985-01-01

    In this follow-up study sequential scintigraphy was performed on 20 of selected patients up to 3.4 years after operation, the results are compared with the pre-operative examinations and with the surgical effect on the increased blood pressure. (orig./MG) [de

  20. The effect of participatory women's groups on infant feeding and child health knowledge, behaviour and outcomes in rural Bangladesh: a controlled before-and-after study.

    Science.gov (United States)

    Younes, Leila; Houweling, Tanja A J; Azad, Kishwar; Kuddus, Abdul; Shaha, Sanjit; Haq, Bedowra; Nahar, Tasmin; Hossen, Munir; Beard, James; Copas, Andrew; Prost, Audrey; Costello, Anthony; Fottrell, Edward

    2015-04-01

    Despite efforts to reduce under-5 mortality rates worldwide, an estimated 6.6 million under-5 children die every year. Community mobilisation through participatory women's groups has been shown to improve maternal and newborn health in rural settings, but little is known about the potential of this approach to improve care and health in children after the newborn period. Following on from a cluster-randomised controlled trial to assess the effect of participatory women's groups on maternal and neonatal health outcomes in rural Bangladesh, 162 women's groups continued to meet between April 2010 and December 2011 to identify, prioritise and address issues that affect the health of children under 5 years. A controlled before-and-after study design and difference-in-difference analysis was used to assess morbidity outcomes and changes in knowledge and practices related to child feeding, hygiene and care-seeking behaviour. Significant improvements were measured in mothers' knowledge of disease prevention and management, danger signs and hand washing at critical times. Significant increases were seen in exclusive breast feeding for at least 6 months (15.3% (4.2% to 26.5%)), and mean duration of breast feeding (37.9 days (17.4 to 58.3)). Maternal reports of under-5 morbidities fell in intervention compared with control areas, including reports of fever (-10.5% (-15.1% to -6.0%)) and acute respiratory infections (-12.2% (-15.6% to -8.8%)). No differences were observed in dietary diversity scores or immunisation uptake. Community mobilisation through participatory women's groups can be successfully adapted to address health knowledge and practice in relation to child's health, leading to improvements in a number of child health indicators and behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy: a population-based regional cohort study from southern Sweden.

    Science.gov (United States)

    Wallman, Johan K; Jöud, Anna; Olofsson, Tor; Jacobsson, Lennart T H; Bliddal, Henning; Kristensen, Lars E

    2017-05-01

    The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA). Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends. The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout. Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study.

    Science.gov (United States)

    Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

    2015-07-16

    To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. Prelaw and postlaw design study. 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having 'unhealthy' air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to 'good'. The differences were statistically significant (prestaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Depressive Symptoms Before, During, and After Delirium: A Literature Review.

    Science.gov (United States)

    Nelson, Scott; Rustad, James K; Catalano, Glenn; Stern, Theodore A; Kozel, F Andrew

    2016-01-01

    Delirium and depression are often thought of as mutually exclusive conditions. However, several studies cite depression as a risk factor for delirium whereas others note that patients with delirium often manifest depressive symptoms. Whether these depressive symptoms persist after delirium resolves remains unclear. This article reviews published studies that have investigated the relationship between depression and delirium. Literature searches on PubMed, CINAHL, Cochrane Library, and PsycInfo were conducted using search criteria "delirium" AND "depress⁎" as keywords or MeSH terms. Of 722 search results, 10 prospective cohort studies were identified for inclusion. These studies were categorized regarding the time of assessment for depressive symptoms. Included studies varied greatly (regarding their index population, their methods of assessment, and their timing of assessments). Of the studies, 3 involved patients undergoing hip fracture repair. They demonstrated more severe depressive symptoms both during delirium and after delirium ended. Conversely, the other studies did not find any statistically significant correlations between the 2 conditions. The literature suggests a correlation between depression and delirium in patients with hip fracture. Whether other specific populations have higher comorbidity is unclear. Unfortunately, studies varied widely in their methods, precluding a meta-analysis. Nonetheless, our review provides a foundation for future research. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

  4. Effects of a 12-month multi-faceted mentoring intervention on knowledge, quality, and usage of spirometry in primary care: a before-and-after study.

    Science.gov (United States)

    Gupta, Samir; Moosa, Dilshad; MacPherson, Ana; Allen, Christopher; Tamari, Itamar E

    2016-04-21

    Asthma is among the most common chronic diseases in adults. International guidelines have emphasized the importance of regular spirometry for asthma control evaluation. However, spirometry use in primary care remains low across jurisdictions. We sought to design and evaluate a knowledge translation intervention to address both the poor quality of spirometry and the underuse of spirometry in primary care. We designed a 1-year intervention consisting of initial interactive education and hands-on training followed by unstructured peer expert mentoring (through an online portal, email, telephone, videoconference, fax, and/or in-person). We recruited physician and allied health mentees from across primary care sites in Ontario, Canada. We compared spirometry-related knowledge immediately before and after the 1-year intervention period and the quality of spirometry testing and the usage of spirometry in patients with asthma in the year before and the year of the intervention. Seven of 10 (70 %) invited sites participated, including 25/90 (28 %) invited allied health mentees and 23/68 (34 %) invited physician mentees. We recruited 7 physician mentors and 4 allied health mentors to form 3 mentor-mentee pods. Spirometry knowledge scores increased from 21.4 +/- 3.1 pre- to 27.3 +/- 3.5 (out of 35) (p Spirometry acceptability and repeatability criteria were met by 59/191 (30.9 %) spirometries and 86/193 (44.6 %) spirometries [odds ratio 1.7 (1.0, 3.0)], in the pre-intervention and intervention periods, respectively. Spirometry was ordered in 75/512 (14.6 %) and 129/336 (38.4 %) respiratory visits (p spirometry in real world primary care settings. A future controlled study should assess the impact of this intervention on patient outcomes, its cost-effectiveness, and its sustainability.

  5. Plasma Osteoprotegerin Levels Before and After Treatment of Thyroid Dysfunctions

    Directory of Open Access Journals (Sweden)

    Didem Özdemir

    2013-12-01

    Full Text Available Purpose: Osteoprotegerin (OPG is a soluble decoy receptor for the receptor activator of nuclear factor kappaB ligand, thereby inhibiting bone resorption. In this study, we aimed to evaluate plasma OPG levels in patients with thyroid dysfunctions and determine whether its levels change after restoration of euthyroidism. Material and Method: OPG levels were studied at the time of diagnosis and after the restoration of euthyroidism at least for 8 weeks in patients diagnosed with overt thyrotoxicosis and hypothyroidism. Results: Seventeen hypothyroid, 17 thyrotoxic patients and 17 age-, sex- and body mass index-matched healthy controls were analyzed. Mean basal plasma OPG levels were 5.42±2.66, 5.04±1.62 and 5.24±0.93 pmol/l in thyrotoxic, hypothyroid and healthy controls, respectively (p=0.844. After restoration of euthyroidism, OPG was 5.52±2.37 pmol/l in thyrotoxic and 4.33±1.37 pmol/l in hypothyroid patients, indicating no significant difference compared to baseline values (p=0.846 and p=0.109, respectively. We also did not observe any correlation between basal OPG levels and basal thyrotropin and thyroid hormone levels. Discussion: Thyroid dysfunctions seem to affect bone functions by mechanisms other than OPG, however, more clinical studies with larger sample sizes are needed to clarify the underlying mechanisms of thyroid dysfunction-related changes in bone metabolism. Turk Jem 2013; 17: 102-7

  6. Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

    Science.gov (United States)

    Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

    2016-09-01

    To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

  7. Aqueous humor levels of vascular endothelial growth factor before and after intravitreal bevacizumab in type 3 versus type 1 and 2 neovascularization. A prospective, case-control study.

    Science.gov (United States)

    dell'Omo, Roberto; Cassetta, Marilluccia; dell'Omo, Ermanno; di Salvatore, Angela; Hughes, John M; Aceto, Fabiana; Porcellini, Antonio; Costagliola, Ciro

    2012-01-01

    To determine the aqueous levels of vascular endothelial growth factor (VEGF) in patients with type 3 neovascularization (NV) secondary to age-related macular degeneration (AMD) and to compare the levels of those with type 1 and 2 NV secondary to AMD before and after administration of intravitreal bevacizumab (IVB). Prospective, case-control study. Aqueous samples were collected from 29 eyes of 29 patients with untreated wet AMD at baseline (day of the first IVB), month 1 (day of the second IVB), and month 2 (day of the third IVB). Among them, 10 eyes presented with type 1, 9 with type 2, and 10 with type 3 NV. A group of 14 aqueous samples from 14 patients who underwent cataract surgery without other ocular or systemic disease comprised the controls. Main outcome measures were concentration of VEGF at baseline and after IVB in the 3 NV groups; secondary outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes after IVB. Levels of VEGF were determined by commercially available enzyme-linked immunosorbent assay kits. VEGF concentrations in aqueous humor at baseline were higher in patients with type 3 NV when compared to controls (P = .0001) and type 1 and 2 NV patients (P = .002 and P = .0001 respectively). At month 1, levels of VEGF were significantly reduced compared to baseline (P < .05) and significantly lower compared to the controls (P < .005) in each NV group. These low levels were maintained at the 2-month interval. BCVA significantly improved in type 1 and 2 NV groups (P < .05). CMT significantly reduced in each NV group compared to baseline (P < .05). In eyes with untreated wet AMD, aqueous levels of VEGF are significantly higher in type 3 NV than in type 1 or 2 NV. Regardless of the type of NV, aqueous VEGF levels significantly reduce 1 month after IVB as compared to both the baseline measurements and the values recorded in age-matched controls. These decreases are maintained at 2 months after administering

  8. Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it.

    Science.gov (United States)

    Simon, S; Higginson, I J

    2009-01-01

    Hospital palliative care teams (HPCTs) are well established as multi-professional services to provide palliative care in an acute hospital setting and are increasing in number. However, there is still limited evaluation of them, in terms of efficacy and effectiveness. The gold standard method of evaluation is a randomised control trial, but because of methodological (e.g., randomisation), ethical and practical difficulties such trials are often not possible. HPCT is a complex intervention, and the specific situation in palliative care makes it challenging to evaluate (e.g., distress and cognitive impairment of patients). The quasi-experimental before-after study design has the advantage of enabling an experimental character without randomisation. But this has other weaknesses and is prone to bias, for example, temporal trends and selection bias. As for every study design, avoidance and minimisation of bias is important to improve validity. Therefore, strategies of selecting an appropriate control group or time series and applying valid outcomes and measurement tools help reducing bias and strengthen the methods. Special attention is needed to plan and define the design and applied method.

  9. Dynamic double-echo perfusion study of cervix-carcinomas before and after radiation at a 0.5T routine scanner

    International Nuclear Information System (INIS)

    Neumann, U.; Klengel, S.; Kaulen, F.; Schorcht, J.

    1997-01-01

    There is an increasing interest in non-invasive measurement of hemodynamic parameters in tumors. MRI is a valuable method for the evaluation and morphological staging of cervix carcinomas. The sensitivity to radiation should correlate with the pathoanatomical grade of vascularization. We tested the value of perfusion imaging in cervix tumors before and after radiation to optimize therapy. In 38 patients with cervix carcinoma (stage T2-T4) we simultaneously measured dynamic T 1 and T 2 * signal changes after bolus application of the paramagnetic contrast medium Gd-DTPA. We detected 3 patterns of uncorrected simultaneous dynamic T 1 and T 2 * signal changes in cervix tumors, which allows the differentiation of high, reduced and no T 2 * signal loss. Most tumors with a strong perfusion effect showed good regression during and after radiation therapy. More than 60% of cervix carcinomas with low or no perfusion effects were characterized by incomplete tumor reduction. Further study is necessary to prove the statistical significance allowing prospective differentiation of cervix tumors into therapy-responders and non-responders. (orig.)

  10. Protocol for the evaluation of a free health insurance card scheme for poor pregnant women in Mbeya region in Tanzania: a controlled-before and after study.

    Science.gov (United States)

    Borghi, Josephine; Ramsey, Kate; Kuwawenaruwa, August; Baraka, Jitihada; Patouillard, Edith; Bellows, Ben; Binyaruka, Peter; Manzi, Fatuma

    2015-07-04

    The use of demand-side financing mechanisms to increase health service utilisation among target groups and enhance service quality is gaining momentum in many low- and middle-income countries. However, there is limited evidence on the effects of such schemes on equity, financial protection, quality of care, and cost-effectiveness. A scheme providing free health insurance cards to poor pregnant women and their households was first introduced in two regions of Tanzania in 2011 and gradually expanded in 2012. A controlled before and after study will examine in one district the effect of the scheme on utilization, quality, and cost of healthcare services accessed by poor pregnant women and their households in Tanzania. Data will be collected 4 months before implementation of the scheme and 17 months after the start of implementation from a survey of 24 health facilities, 288 patients exiting consultations and 1500 households of women who delivered in the previous year in one intervention district (Mbarali). 288 observations of provider-client interactions will also be carried out. The same data will be collected from a comparison district in a nearby region. A process evaluation will ascertain how the scheme is implemented in practice and the level of implementation fidelity and potential moderators. The process evaluation will draw from impact evaluation data and from three rounds of data collection at the national, regional, district, facility and community levels. An economic evaluation will measure the cost-effectiveness of the scheme relative to current practice from a societal perspective. This evaluation will generate evidence on the impact and cost-effectiveness of targeted health insurance for pregnant women in a low income setting, as well as building a better understanding of the implementation process and challenges for programs of this nature.

  11. [Smoking, alcohol and caffeine consumption of mothers before, during and after pregnancy--results of the study 'breast-feeding habits in Bavaria'].

    Science.gov (United States)

    Rebhan, B; Kohlhuber, M; Schwegler, U; Koletzko, B; Fromme, H

    2009-07-01

    The aim of this analysis of the study 'Breast-feeding habits in Bavaria' is to describe the smoking habits, alcohol and caffeine consumption of mothers in Bavaria before, during and after pregnancy. Furthermore, we asked about the environmental tabacco smoke exposition of pregnant women and infants. The influence of consumption habits on breast-feeding is quantified and the distribution of the risky habits in the population is characterised. The study 'Breast-feeding habits in Bavaria' is a prospective cohort study which was carried out from April 2005 to January 2006. Some 3 822 mothers throughout Bavaria who had delivered a baby in April 2005 participated in the basic survey. Methods and first results have already been published. The participants were asked in 4 follow-up questionnaires about breast-feeding habits, smoking habits, and alcohol and caffeine consumption. The follow-up rate was 82%. Only participants with a complete follow-up were included into this analysis (n=3 103). Some 23.7% of the mothers smoked before pregnancy. The percentage of women reporting any smoking during pregnancy was 9.8%. More than half (53%) of the ex-smokers started to smoke again up to the end of month 9 after delivery. 25.3% of the mothers reported any alcohol consumption during pregnancy, 69.0% of pregnant women were drinking caffeine-containing beverages. The consumption rates were reduced clearly during pregnancy. Smoking had a higher prevalence in the group of young women with low school education, alcohol consumption in the group of elder women with high school education. Mothers born in Germany smoked significantly more than mothers with a migration background. Smoking had a significant, dose-dependent negative influence on a breast-feeding duration of 5 cigarettes/day, OR 2.54, 95% CI 1.42-4.54). Caffeine consumption also had a significant negative influence on the breast-feeding duration (OR 1.49, 95% CI 1.25-1.79), whereas alcohol consumption did not. Alcohol

  12. Quality of life before and after cosmetic surgery.

    Science.gov (United States)

    Bensoussan, Jean-Charles; Bolton, Michael A; Pi, Sarah; Powell-Hicks, Allycin L; Postolova, Anna; Razani, Bahram; Reyes, Kevin; IsHak, Waguih William

    2014-08-01

    This article reviews the literature regarding the impact of cosmetic surgery on health-related quality of life (QOL). Studies were identified through PubMed/Medline and PsycINFO searches from January 1960 to December 2011. Twenty-eight studies were included in this review, according to specific selection criteria. The procedures and tools employed in cosmetic surgery research studies were remarkably diverse, thus yielding difficulties with data analysis. However, data indicate that individuals undergoing cosmetic surgery began with lower values on aspects of QOL than control subjects, and experienced significant QOL improvement post-procedurally, an effect that appeared to plateau with time. Despite the complexity of measuring QOL in cosmetic surgery patients, most studies showed an improvement in QOL after cosmetic surgery procedures. However, this finding was clouded by measurement precision as well as heterogeneity of procedures and study populations. Future research needs to focus on refining measurement techniques, including developing cosmetic surgery-specific QOL measures.

  13. About furniture. Before and after Ptolomaeus Philadelphos' pavilion

    Directory of Open Access Journals (Sweden)

    Elena Calandra

    2010-07-01

    Full Text Available The furniture is of primary importance towards the canopies definition, more than the architectonic structure: they  contribute, in fact, in creating and organizing the spaces, so that there is almost no distinction between furniture and structure, as it is possible to observe in the ancient sources of different periods (Herodotus, Euripides, Julius Caesar, Plutarchus, Athenaeus: the pavilions of Xerxes at Plataia, of Ion at Delphi, of Alexander after the Issa battle and at Susa, of Pompey at Pharsalos, as well as the Ptolomaeus's canopy at Alexandria. At the same time, the furniture language is studied, signifying the power and the force of the sovereign through the luxurious materials and surprising the spectators.      At the end, some hypotheses on the final destination of the furniture, after dismantling the Ptolomaeus' canopy, equiped for one year.

  14. Free Secondary Education in France before and after the Revolution

    Science.gov (United States)

    Palmer, R. R.

    1974-01-01

    Before the French Revolution, in 1789, 46 percent of the pupils in public secondary schools received free instruction compared to 13 percent of the pupils in 1842. The article examines the means by which the conclusion is arrived at, assesses its validity, and comments on some of its implications. (Author/SM)

  15. The influence of achievement before, during and after medical school on physician job satisfaction

    NARCIS (Netherlands)

    Schmit Jongbloed, Lodewijk J.; Schonrock-Adema, Johanna; Borleffs, Jan C. C.; Stewart, Roy E.; Cohen-Schotanus, Janke

    2014-01-01

    In this longitudinal study, we investigated the relationship between physicians' prior achievements (before, during and after medical school) and job satisfaction, and tested the two lines of reasoning that prior achievements influence job satisfaction positively or negatively, respectively. The

  16. Assessment of patient-reported measures of bowel function before and after pelvic radiotherapy: an ancillary study of the North Central Cancer Treatment Group study N00CA.

    Science.gov (United States)

    Atherton, Pamela J; Halyard, Michele Y; Sloan, Jeff A; Miller, Robert C; Deming, Richard L; Tai, T H Patricia; Stien, Kathy J; Martenson, James A

    2013-04-01

    The Bowel Function Questionnaire (BFQ) has been used in clinical trials to assess symptoms during and after pelvic radiotherapy (RT). This study evaluated the importance of symptoms in the BFQ from a patient perspective. Patients reported presence or absence of symptoms and rated importance of symptoms at baseline, 4 weeks after completion of pelvic RT, and 12 and 24 months after RT. The BFQ measured overall quality of life (QOL) and symptoms of nocturnal bowel movements, incontinence, clustering, need for protective clothing, inability to differentiate stool from gas, liquid bowel movements, urgency, cramping, and bleeding. Bowel movement frequency also was recorded. A content validity questionnaire (CVQ) was used to rate symptoms as "not very important," "moderately unimportant," "neutral," "moderately important," or "very important." Most of the 125 participating patients rated all symptoms as moderately or very important. Generally, patients gave similar ratings for symptom importance at all study points, and ratings were independent of whether the patient experienced the symptom. Measures of greatest importance (moderately or very important) at baseline were ability to control bowel movements (94 %), not having to wear protective clothing (90 %), and not having rectal bleeding (94 %). With the exception of need for protective clothing, the presence of a symptom at 4 weeks was associated with significantly worse QOL (P < .01 for all). The BFQ has excellent content validity. Patients rated most symptoms as moderately or very important, indicating the BFQ is an appropriate tool for symptom assessment during and after pelvic RT.

  17. Low back pain in women before and after menopause

    OpenAIRE

    Kozinoga, Mateusz; Majchrzycki, Marian; Piotrowska, Sylwia

    2015-01-01

    Low back pain is a massive problem in modern population, both in social and economic terms. It affects large numbers of women, especially those aged 45-60. Going through a perimenopausal period is associated with many symptoms, including low back pain. This paper is a review of published research on the association between the perimenopausal age and low back pain. PubMed databases were investigated. After the search was narrowed to “menopausal status, back pain”, 35 studies were found. Se...

  18. Case study : a unified technique with perforation, well test before and after stimulation, ground cross linked acid fracturing, foreign fluid recovery in 1 downhole pipe string

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, T. [China Univ. of Geosciences, Beijing (China); Ding, Y.; Xu, Y.; Cai, B.; Yan, X.; Duan, Y. [PetroChina, Langfang (China). RIPED

    2009-07-01

    This paper outlined a unified technique in which perforation well tests were conducted both before and after well stimulation using a single downhole pipestring. The perforation, testing, pump drainage, and tubing implements were assembled on a test string and run into the well. The well was shut-in for a period of 4 hours after fracturing procedures in order to allow the acid to react with the formation. Natural fracture processes were identified by combining geology data with data obtained during the acidizing pumping process. Ground cross-linked acid was applied above the pipestring in order to link natural fractures and achieve greater penetration depths and higher conductivity. Paraffin remover was used to prevent paraffin coagulation during fracturing fluid recovery processes. A cleanup agent with a lower surface tension was used to ensure stable fluid recovery. The study showed that use of the ground cross-linked acid improved well performance and reduced costs. Post-acid fracturing rates were 226 m{sup 3} per day with no water. 6 refs., 1 tab., 9 figs.

  19. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Pre-hospital midazolam for benzodiazepine-treated seizures before and after the Rapid Anticonvulsant Medication Prior to Arrival Trial: A national observational cohort study.

    Science.gov (United States)

    Shtull-Leber, Eytan; Silbergleit, Robert; Meurer, William J

    2017-01-01

    Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014. We compared the rates and odds of midazolam use as first-line treatment among all adult and pediatric benzodiazepine-treated seizures before and after RAMPART publication (February 2012). Secondary analyses were conducted for rates of airway interventions and rescue therapy, as proxies for safety and efficacy of seizure termination. 156,539 benzodiazepine-treated seizures were identified. Midazolam use increased from 26.1% in January 2010 to 61.7% in December 2014 (difference +35.6%, 95% CI, 32.7%-38.4%). The annual rate of midazolam adoption increased significantly from 5.9% per year to 8.9% per year after the publication of RAMPART (difference +3.0% per year; 95%CI, 1.6%-4.5% per year; adjusted OR 1.24; 95%CI, 1.17-1.32). Overall frequency of rescue therapy and airway interventions changed little after the publication of RAMPART. These data are consistent with effective, ongoing, but incomplete clinical translation of the RAMPART results. The effects of the trial, however, cannot be isolated. The study was limited by broad inclusion of all benzodiazepine-treated seizures as well as a lack of information on route of drug of administration. The safety and effectiveness of midazolam for benzodiazepine-treated seizures in prehospital clinical practice appear consistent with trial data, which should encourage

  1. Do kidney transplantations save money? A study using a before-after design and multiple register-based data from Sweden.

    Science.gov (United States)

    Jarl, Johan; Desatnik, Peter; Peetz Hansson, Ulrika; Prütz, Karl Göran; Gerdtham, Ulf-G

    2018-04-01

    The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. A before-after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression. Altogether 66-79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample. Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy.

  2. Inception of the 'endocarditis team' is associated with improved survival in patients with infective endocarditis who are managed medically: findings from a before-and-after study.

    Science.gov (United States)

    Kaura, Amit; Byrne, Jonathan; Fife, Amanda; Deshpande, Ranjit; Baghai, Max; Gunning, Margaret; Whitaker, Donald; Monaghan, Mark; MacCarthy, Philip A; Wendler, Olaf; Dworakowski, Rafal

    2017-01-01

    Despite improvements in its management, infective endocarditis (IE) is associated with poor survival. The aim of this study was to evaluate the impact of a multidisciplinary endocarditis team (ET), including a cardiologist, microbiologist and a cardiac surgeon, on the outcome of patients with acute IE according to medical or surgical treatment strategies. We conducted an observational before-and-after study of 196 consecutive patients with definite IE, who were treated at a tertiary reference centre between 2009 and 2015. The study was divided into two periods: period 1, before the formation of the ET (n=101), and period 2, after the formation of the ET (n=95). The role of the ET included regular multidisciplinary team meetings to confirm diagnosis, inform the type and duration of antibiotic therapy and recommend early surgery, when indicated, according to European guidelines. The patient demographics and predisposing conditions for IE were comparable between the two study periods. In the time period following the introduction of the ET, there was a reduction in both the time to commencement of IE-specific antibiotic therapy (4.0±4.0 days vs 2.5±3.2 days; P=0.004) and the time from suspected IE to surgery (7.8±7.3 days vs 5.3±4.2 days; P=0.004). A 12-month Kaplan-Meier survival for patients managed medically was 42.9% in the pre-ET period and 66.7% in the post-ET period (P=0.03). The involvement of the ET was a significant independent predictor of 1-year survival in patients managed medically (HR 0.24, 95% CI 0.07 to 0.87; P=0.03). A standardised multidisciplinary team approach may lead to earlier diagnosis of IE, more appropriate individualised management strategies, expedited surgery, where indicated, and improved survival in those patients chosen for medical management, supporting the recent change in guidelines to recommend the use of a multidisciplinary team in the care of patients with IE.

  3. Impact of the Spanish smoking law on exposure to secondhand smoke in offices and hospitality venues: before-and-after study.

    Science.gov (United States)

    Nebot, Manel; López, Maria J; Ariza, Carles; Pérez-Ríos, Mónica; Fu, Marcela; Schiaffino, Anna; Muñoz, Gloria; Saltó, Esteve; Fernández, Esteve

    2009-03-01

    A smoking law was passed by the Spanish Parliament in December 2005 and was enforced by 1 January 2006. The law bans smoking in all indoor workplaces but only in some hospitality venues, because owners are allowed to establish a smoking zone (venues>100 m2) or to allow smoking without restrictions (venueslaw on exposure to secondhand smoke (SHS) in enclosed workplaces, including hospitality venues. The study design is a before-and-after evaluation. We studied workplaces and hospitality venues from eight different regions of Spain. We took repeated samples of vapor-phase nicotine concentration in 398 premises, including private offices (162), public administration offices (90), university premises (43), bars and restaurants (79), and discotheques and pubs (24). In the follow-up period, SHS levels were markedly reduced in indoor offices. The median decrease in nicotine concentration ranged from 60.0% in public premises to 97.4% in private areas. Nicotine concentrations were also markedly reduced in bars and restaurants that became smoke-free (96.7%) and in the no-smoking zones of venues with separate spaces for smokers (88.9%). We found no significant changes in smoking zones or in premises allowing smoking, including discotheques and pubs. Overall, this study shows the positive impact of the law on reducing SHS in indoor workplaces. However, SHS was substantially reduced only in bars and restaurants that became smoke-free. Most hospitality workers continue to be exposed to very high levels of SHS. Therefore, a 100% smoke-free policy for all hospitality venues is required.

  4. Cerebral blood flow study with 3D-SSP and neuropsychological evaluation by mini-mental state examination (MMSE) before and after clipping of unruptured cerebral aneurysm

    International Nuclear Information System (INIS)

    Takada, Hidekazu; Sasaki, Takehiko; Osato, Toshiaki

    2006-01-01

    We evaluate the influence of surgery for unruptured aneurysms on cerebral blood flow and neuropsychological estimate. We evaluated the cases of 28 consecutive patients with unruptured cerebral aneurysm treated with direct surgery accompanied by craniotomy. Before and after surgery, MRI, 123 I-IMP-SPECT with 3D-SSP analysis and MMSE were performed. There was not a significant decrease in MMSE. In 123 I-IMP-SPECT, it was recognized that the cerebral blood flow was decreased at the frontal operculum of operative site. These results indicate that careful neuropsychological evaluation is essential to make a favorable treatment plan for unruptured aneulysms. (author)

  5. [Hospitality workers' exposure to environmental tobacco smoke before and after implementation of smoking ban in public places: a review of epidemiological studies].

    Science.gov (United States)

    Polańska, Kinga; Hanke, Wojciech; Konieczko, Katarzyna

    2011-01-01

    Environmental tobacco smoke (ETS) exposure induces serious negative health consequences, of which the increased risk of cardiovascular diseases, cancer, respiratory symptoms and poor pregnancy outcomes appear to be most important. Taking into account those health consequences of ETS exposure most countries have introduced legislation to ban or restrict smoking in public places. In this paper the effectiveness of the introduced legislation was analyzed with regard to the protection of hospitality workers from ETS exposure in the workplace. The analysis of 12 papers published after 2000 covered the year of publication, type of legislation, study population, hospitality venue (pub, bar, restaurant, disco) and type of markers or self-reported perception of exposure to ETS. The analysis indicates that the legislation to ban smoking in hospitality venues protects workers from ETS exposure when the venues are 100% tobacco smoke free. The reduction of the cotinine level in biological samples after the implementation of smoke free law was 57-89%, comparing to the biomarker level in the samples taken before the new law was introduced. About 90% of reduction in nicotine and PM levels was also noted. In addition, the positive self perception reported by workers proved the effectiveness of new legislation protecting them from ETS exposure.

  6. Hemodynamic evaluation before and after the STA-MCA anastomosis

    International Nuclear Information System (INIS)

    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Yamada, Keisuke; Shibamoto, Keiji

    1990-01-01

    Twenty-seven patients with minor completed and major stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The regional cerebral blood flow (rCBF), using inhalation of stable xenon and computed tomographic scanning (Xe s CT-CBF study), and the mode of transit time (MTT) in the MCA territory using intra-arterial digital aortography were measured. Activated rCBF and MTT was measured 20 minutes after the administration of acetazolamide (10 mg/kg) in 14 patients. Nineteen of the 23 patients with minor stroke (Group 1) showed immediate improvement in their neurological state within a few days of the operation, while four patients with minor stroke (Group 2) and four patients with major stroke (Group 3) showed no improvement. Based on the rCBF obtained with the Xe s CT-CBF study, affected side rCBF/unaffected side rCBF and %f [(peak DSA number/affected side MTT)/(peak DSA number/unaffected side MTT)] were compared. There was a significant positive correlation. Affected side MTT in Group 1 was 6.41±1.16 sec, preoperatively, and significantly decreased to 5.13±0.91 sec after the operation. On the other hand, preoperative MTT in Group 2 was 4.40±0.81 sec and 4.76±0.89 sec, postoperatively. Preoperative %f in Group 1 was 0.514±0.143 and significantly increased to 0.739±0.154, postoperatively. Group 2 showed no change. Vasodilatory capacity with acetazolamide showed a marked improvement in Group 1, postoperativery. Our study indicated that if MTT is moderately lengthened, %f is moderately decreased, and vasodilatory capacity is impaired, in patients with minor ischemic stroke will benefit from STA-MCA anastomosis. (author)

  7. Quality of Life in Patients with Chronic Rhinosinusitis with Nasal Polyposis Before and After Functional Endoscopic Sinus Surgery: A Study Based on SINO-NASAL OUTCOME TEST

    Directory of Open Access Journals (Sweden)

    Mehrnoosh Musavi Aghdas

    2018-02-01

    Full Text Available Background: Chronic rhinosinusitis is one of the most common diseases in the world. The high prevalence and chronicity of disease increasing burden of disease. Burden of this disease, productivity and the quality of life of patients decreased. The aim of this study was to evaluate the effect of endoscopic sinus surgery on the quality of life of patients with chronic rhinosinusitis with nasal polyposis. Method: This prospective study was performed on 59 patients suffering chronic rhinosinusitis with nasal polyposis referring to ENT clinic of educational hospital of Tabriz University of medical sciences during 2015 to 2017. These patients underwent Endoscopic Sinus Surgery as treatment. For all patients, SINO-NASAL OUTCOME (TEST (SNOT-22 was completed before and twelve months after surgery. Results:  Fifty-nine patients were enrolled in this study. 21 were female (35.6% and 38 were male (64.40%. The mean age of the studied population was 40.88 ± 16.11 years. The mean score of the preoperative score was 59.38 ± 5.84 and the mean score of the postoperative score was 24.01 ± 10.48. The results of the statistical analysis showed that endoscopic surgery reduced The SNOT-22 questionnaire score is significant. (P < 0.000. The results of the test showed that the increase in preoperative score increases the gain after surgery. (Spearman correlation coefficient: 0.419 and P: 0.001 Conclusion: Endoscopic sinus surgery seems to improve the symptoms and quality of Life in patients with chronic rhinosinusitis.

  8. Does access to a demand-led evidence briefing service improve uptake and use of research evidence by health service commissioners? A controlled before and after study.

    Science.gov (United States)

    Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S

    2017-02-14

    The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on

  9. Intracranial tuberculosis in children : CT findings before and after treatment

    International Nuclear Information System (INIS)

    Jung, Hye Weon; Kim, In One; Kim, Woo Sun; Hwang, Yong Seong; Yeon, Kyung Mo

    1996-01-01

    To analyze the CT findings of intracranial tuberculosis in children at initial stage and during follow-up after treatment. We evaluated 25 patients who were diagnosed by CSF analysis or response to anti-tuberculous medication as suffering from intracranial tuberculosis. There were 13 boys and 12 girls aged between 4 months and 14 years. Twenty-five initial and sixty-three follow-up CT scans were retrospectively analyzed. We evaluated the pattern of cisternal enhancement, the locations of infarction, and the presence of calcification and parenchymal granuloma. The changes of hydrocephalus and related complications, as well as cisternal abnormality during anti-tuberculous medication were also evaluated. The initial findings on CT scan were hydrocephalus(75%), cisternal obliteration in precontrast study(64%), thick-line or ring-shaped cisternal enhancement on postcontrast study(44%), infarctions(32%), calcifications(32%), periventricular edema(28%), and parenchymal granulomas(16%). On follow-up CT scan, hydrocephalus and cisternal enhancement had decreased to 35% and 82%, respectively, and the granulomas had changed to calcified nodules(100%). Ventriculo-peritoneal shunt or external ventricular drainage was needed in nine patient, and ventriculitis or complication of shunt procedure developed in four. Intracranial tuberculosis in children presented predominantly as meningitis involving basal cisterns and was associated with hydrocephalus. Infarction and calcification may be seen as parenchymal lesion. In spite of medical treatment, drainage was needed in about half the patients. During this treatment, the resolution of hydrocephalus, decreased cisternal enhancement, and calcification of the granlomas were seen

  10. The Creative Industries: Before and After the Crisis

    Directory of Open Access Journals (Sweden)

    Fanea-Ivanovici Mina

    2014-12-01

    Full Text Available Creative industries clearly proved their potential for economic growth in the period before the crisis in Europe as well as across the world. However, the crisis has significantly changed the way of doing business and many sectors have been affected – some businesses managed to survive while others have been forced to close down. The present paper aims to examine whether creative industries have undergone a downturn as a result of the economic crisis or they managed to preserve their revitalising effect on countries, regions and cities.

  11. The effectiveness of a nurse-initiated intervention to reduce catheter-associated bloodstream infections in an urban acute hospital: an intervention study with before and after comparison.

    Science.gov (United States)

    Tsuchida, Toshie; Makimoto, Kiyoko; Toki, Masayo; Sakai, Keiko; Onaka, Emiko; Otani, Yoshiko

    2007-11-01

    Catheter care is considered to be important for prevention of catheter-associated bloodstream infections (CABSIs) although epidemiological evidence is sparse. To identify problems associated with catheter care and evaluate the effectiveness of nurse-initiated interventions to reduce CABSIs. An intervention study with before and after comparison. CABSI surveillance was conducted in a 560-bed acute hospital located in a major urban area in Japan. Patients were enrolled in this study from April 2000 to December 2002 based on the following criteria: (1) adult inpatients; and (2) those in whom central venous lines or Swan-Ganz catheters were inserted for 2 days or longer. In the first year, risk factors for CABSI and problems associated with catheter care were identified by inspection of the infection control nurse (ICN) or four trained link nurses, and the laboratory results. In the subsequent 2 years, the following interventions based on the surveillance results were implemented: (1) enhanced skin preparation by scrubbing with regular bathing soap and tap water; (2) a new method for stabilisation of the catheter inserted into the internal jugular vein, where additional dressing was placed over the sterilised dressing; (3) educating the staff on maximal sterile precautions by teaching staff members at their section meetings and displaying posters; (4) use of a check list and observation of catheter insertion by link nurses to monitor compliance; and (5) selection of a disinfectant that requires shorter contact time and has longer residual effect. After these interventions were implemented, the overall bloodstream infection (BSI) rate declined from 4.0/1000 device-days to 1.1/1000 device-days (p<0.005). We identified four problems-those related to skin preparation, dressing, sterile precautions and disinfectant. We implemented a series of interventions to reduce CABSIs; the overall CABSI rate decreased significantly.

  12. Influences on immunization rates: Vaccination coverage of mumps, measles, rubella and varicella before and after the STIKO intervention 2011 - A retrospective study.

    Science.gov (United States)

    Sanftenberg, Linda; Schrörs, Hans-Jürgen; Schelling, Jörg

    2016-07-25

    In September 2011, the German Standing Committee on Vaccinations (STIKO) changed their recommendation regarding the mumps-measles-rubella-varicella vaccination (MMRV). We compared the immunization rates against MMRV in Germany before and after the STIKO intervention. We recorded the immunization status of children born between 09/2008 and 08/2012 in 35 selected doctor's surgeries in Germany. After the STIKO intervention, the ratio of the combined MMRV vaccine as the first dose immunization was reduced to approximately 25% of the initial value. A slight increase in the number of children not sufficiently vaccinated against varicella (1.2%) was observed, but the immunization rates against measles, mumps, rubella and varicella did not significantly decrease. The STIKO intervention led to a significant change in physicians' vaccination procedures. The separate administration MMR+V vaccination may be a helpful option to improve the immunization rates in general. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Randomised clinical trial: the burden of illness of uninvestigated dyspepsia before and after treatment with esomeprazole - results from the STARS II study

    DEFF Research Database (Denmark)

    Veldhuyzen van Zanten, S; Wahlqvist, P; Talley, N J

    2011-01-01

    Aliment Pharmacol Ther 2011; 34: 714-723 SUMMARY: Background  Patients with dyspepsia often experience troublesome symptoms. Aim  To assess the burden of uninvestigated dyspepsia (symptoms, health-related quality of life [HRQL] and work productivity) before and after 8 weeks' esomeprazole treatment....... Methods  Patients (n = 1250) with uninvestigated dyspepsia (no endoscopy within 6 months and ≤2 endoscopies within 10 years) underwent a 1-week esomeprazole acid-suppression test before randomisation to 7 weeks' esomeprazole or placebo. The Reflux Disease Questionnaire (RDQ), Quality of Life in Reflux...... work productivity improvement vs. placebo. Conclusions  Uninvestigated dyspepsia is associated with high symptom load and impacts on HRQL and work productivity. Esomeprazole improves HRQL among such patients, and improves work productivity among 1-week acid-suppression trial responders. Clinical...

  14. Incidence of cardiovascular complications in knee arthroplasty patients before and after implementation of a ropivacaine local infiltration analgesia protocol: A retrospective study.

    Science.gov (United States)

    Lameijer, Joost R C; Verboom, Frederik; Grefkens, Joost; Jansen, Joris

    2016-10-01

    Local infiltration analgesia (LIA) during total knee arthroplasty has been shown to give statistically significant reduction in post-operative pain. The effects of using high volumes of ropivacaine combined with adrenaline as LIA on cardiovascular parameters in knee replacement have not been described before. The objective of this study was to investigate the cardiovascular safety of ropivacaine as part of high volume local infiltration analgesia (LIA) in total knee replacement surgery. This is a retrospective observational comparative cohort study conducted in two independent cohorts, one treated without and one treated with a local infiltration analgesia protocol, containing a total of 744 patients with a mean age of 68years (42 to 89) and 68years (21 to 88) respectively with a follow-up of 12months. No statistical difference in bradycardia during surgery, post-operative cardiovascular complications, and mortality was found after use of LIA. A statistically significant lower incidence of hypotension was found in the LIA group (Plocal infiltration analgesia during total knee replacement surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Histopathological and immunohistochemical aspects of American cutaneous leishmaniasis before and after different treatments*

    Science.gov (United States)

    Viana, Agostinho Gonçalves; Mayrink, Wilson; Fraga, Carlos Alberto de Carvalho; Silva, Luciana Maria; Domingos, Patrícia Luciana Batista; Bonan, Paulo Rogério Ferreti; de Paula, Alfredo Maurício Batista; Botelho, Ana Cristina de Carvalho

    2013-01-01

    BACKGROUND The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied. OBJECTIVES This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods. METHODS We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4. RESULTS Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference. CONCLUSION We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence. PMID:23539001

  16. Histopathological and immunohistochemical aspects of American cutaneous leishmaniasis before and after different treatments.

    Science.gov (United States)

    Viana, Agostinho Gonçalves; Mayrink, Wilson; Fraga, Carlos Alberto de Carvalho; Silva, Luciana Maria; Domingos, Patrícia Luciana Batista; Bonan, Paulo Rogério Ferreti; Paula, Alfredo Maurício Batista de; Botelho, Ana Cristina de Carvalho

    2013-01-01

    The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied. This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods. We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4. Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference. We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence.

  17. Effect of a printed reminder in the waiting room to turn off mobile phones during consultation: a before and after study

    Directory of Open Access Journals (Sweden)

    de Aguiar Sylvia

    2009-03-01

    Full Text Available Abstract Background Telephone interruptions during consultations are one cause of work-related stress amongst general practitioners. Many health care centers recommend that patients turn off any mobile phones to avoid interruptions to the discussion with the physicians. Methods The purpose of this before and after study was to determine whether a printed reminder for turning off the mobile phone in the waiting room is helpful in decreasing the number of interruptions during consultation. A visual phone off sign utilizing the International "No" symbol of a diagonal line through a circle, along with a "please turn off your phone during consultation" reminder was used in the waiting room in the "after" period. Results A significant difference was found in the proportion of patients receiving or making a call during the consultation (8.8% vs. 13.5%, RR = 0.66; 95%CI 0.46–0.94; p = 0.021 and in the total number of calls (10.4% vs. 17.3%, RR = 0.60; 95%CI 0.44–0.83, p = 0.003 between the exposed and the non-exposed groups. However, no significant differences were found in the total time or the median time spent talking during consultation. The duration of the calls had median times of 20.5 seconds and 22.3 seconds in the exposed and the non-exposed groups respectively. Women from both groups who received a call during consultation answered significantly more when compared to men (70% vs. 52%; p = 0.05; Conclusion Our findings suggest that a printed reminder in the waiting room is helpful in decreasing the number of interruptions by mobile phone during consultation in our settings. The study provides the basis for further quantitative and qualitative research on this topic

  18. Media Agenda Setting Regarding Gun Violence before and after a Mass Shooting.

    Science.gov (United States)

    Jashinsky, Jared Michael; Magnusson, Brianna; Hanson, Carl; Barnes, Michael

    2016-01-01

    Gun violence is related to substantial morbidity and mortality with surrounding discussions framed and shaped by the media. This study's objective was to explore national news media's reporting of gun violence around a mass shooting. National news pieces were coded according to categories of gun violence, media frames, entities held responsible, responses, and reporting of the public heath approach. Individuals were held responsible for gun violence in 63% of pieces before and 32% after the shooting. Lawmakers were held responsible in 30% of pieces before and 66% after. Background checks were a proposed gun violence prevention method in 18% of pieces before and 55% after Sandy Hook, and lethality reduction of firearms was in 9% before and 57% after. Following a mass shooting, the media tended to hold government, not individuals, primarily responsible. The media often misrepresented the real picture of gun violence and key public health roles.

  19. The short-term health and psychosocial impacts of domestic energy efficiency investments in low-income areas: a controlled before and after study

    Directory of Open Access Journals (Sweden)

    Charlotte N. B. Grey

    2017-01-01

    Full Text Available Abstract Background Research suggests that living in fuel poverty and cold homes contributes to poor physical and mental health, and that interventions targeted at those living in poor quality housing may lead to health improvements. However, little is known about the socio-economic intermediaries and processes that contribute to better health. This study examined the relationship between energy efficiency investments to homes in low-income areas and mental and physical health of residents, as well as a number of psychosocial outcomes likely to be part of the complex relationship between energy efficiency measures and health outcomes. Methods A quasi-experimental field study with a controlled pretest-posttest design was conducted (intervention n = 364; control n = 418 to investigate the short-term health and psychosocial impacts of a domestic energy efficiency programme that took place across Wales between 2013 and 2015. Survey data were collected in the winters before and after installation of energy efficiency measures, including external wall insulation. The study used a multilevel modelling repeated measures approach to analyse the data. Results The energy efficiency programme was not associated with improvements in physical and mental health (using the SF-12v2 physical and mental health composite scales or reductions in self-reported respiratory and asthma symptoms. However, the programme was associated with improved subjective wellbeing (B = 0.38, 95% CI 0.12 to 0.65, as well as improvements in a number of psychosocial outcomes, including increased thermal satisfaction (OR = 3.83, 95% CI 2.40 to 5.90, reduced reports of putting up with feeling cold to save heating costs (OR = 0.49, CI = 0.25 to 0.94, fewer financial difficulties (B = −0.15, 95% CI -0.25 to -0.05, and reduced social isolation (OR = 0.32, 95% CI 0.13 to 0.77. Conclusion The study showed that investing in energy efficiency in low

  20. The short-term health and psychosocial impacts of domestic energy efficiency investments in low-income areas: a controlled before and after study.

    Science.gov (United States)

    Grey, Charlotte N B; Jiang, Shiyu; Nascimento, Christina; Rodgers, Sarah E; Johnson, Rhodri; Lyons, Ronan A; Poortinga, Wouter

    2017-01-31

    Research suggests that living in fuel poverty and cold homes contributes to poor physical and mental health, and that interventions targeted at those living in poor quality housing may lead to health improvements. However, little is known about the socio-economic intermediaries and processes that contribute to better health. This study examined the relationship between energy efficiency investments to homes in low-income areas and mental and physical health of residents, as well as a number of psychosocial outcomes likely to be part of the complex relationship between energy efficiency measures and health outcomes. A quasi-experimental field study with a controlled pretest-posttest design was conducted (intervention n = 364; control n = 418) to investigate the short-term health and psychosocial impacts of a domestic energy efficiency programme that took place across Wales between 2013 and 2015. Survey data were collected in the winters before and after installation of energy efficiency measures, including external wall insulation. The study used a multilevel modelling repeated measures approach to analyse the data. The energy efficiency programme was not associated with improvements in physical and mental health (using the SF-12v2 physical and mental health composite scales) or reductions in self-reported respiratory and asthma symptoms. However, the programme was associated with improved subjective wellbeing (B = 0.38, 95% CI 0.12 to 0.65), as well as improvements in a number of psychosocial outcomes, including increased thermal satisfaction (OR = 3.83, 95% CI 2.40 to 5.90), reduced reports of putting up with feeling cold to save heating costs (OR = 0.49, CI = 0.25 to 0.94), fewer financial difficulties (B = -0.15, 95% CI -0.25 to -0.05), and reduced social isolation (OR = 0.32, 95% CI 0.13 to 0.77). The study showed that investing in energy efficiency in low-income communities does not lead to self-reported health improvements in the

  1. Myasthaenia Gravis : Clinical management issues before, during and after pregnancy

    Directory of Open Access Journals (Sweden)

    Ali Hassan

    2017-08-01

    Full Text Available Myasthaenia gravis (MG is an autoimmune neuromuscular disorder which is twice as common among women, often presenting in the second and third decades of life. Typically, the first trimester of pregnancy and first month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are not recommended because of the delayed beneficial effects and possible risks associated with the surgery. Assisted vaginal delivery—either vacuum-assisted or with forceps—may be required during labour, although a Caesarean section under epidural anaesthesia should be reserved only for standard obstetric indications. Myasthaenic women should not be discouraged from attempting to conceive, provided that they seek comprehensive counselling and ensure that the disease is under good control before the start of the pregnancy.

  2. Pulse changes in patients with cervical spondylosis before and after acupuncture treatment.

    Science.gov (United States)

    Zhang, Huiyu; Guo, Minfang; Lu, Xiaozuo

    2016-02-01

    To study changes in pulse diagram parameters (PDP) in patients with cervical spondylosis (CS) before and after acupuncture treatment, explore the characteristics of PDP and the relationship between PDP changes and therapeutic effectiveness, and provide evidence for outcome prediction and objective evaluation of CS treatment before and after acupuncture treatment. Patients with CS were treated with acupuncture and measured with a pulse acquisition device based on image (PADBI) before the first and after the tenth acupuncture sessions. Changes in PDP from before until after the acupuncture sessions and patient impressions were analyzed to judge the effect of acupuncture treatment for. The PDP values in effective patients were closer to normal values. This indicated that Qi stagnation and blood stasis of the patients was improved. The PDP changes from before to after the first acupuncture treatment were more obvious than those from before to after the tenth acupuncture treatment. This result indicates that the speed of symptom improvement decreased significantly after several acupuncture courses. Analysis of correlation between efficacy and PDP showed that the changes in PDP in five patients was abnormal, which mainly manifested as values of h1, u, p, Pp, and t1, and no significant changes or differences were increased with standard values. This indicated that the symptoms of CS were not improved in these patients. PADBI can provide evidence for outcome prediction of acupuncture treatment in patients with CS. PADBI can provide evidence for objective evaluation of acupuncture treatment of CS.

  3. The calcium endocrine system of adolescent rhesus monkeys and controls before and after spaceflight

    Science.gov (United States)

    Arnaud, Sara B.; Navidi, Meena; Deftos, Leonard; Thierry-Palmer, Myrtle; Dotsenko, Rita; Bigbee, Allison; Grindeland, Richard E.

    2002-01-01

    The calcium endocrine system of nonhuman primates can be influenced by chairing for safety and the weightless environment of spaceflight. The serum of two rhesus monkeys flown on the Bion 11 mission was assayed pre- and postflight for vitamin D metabolites, parathyroid hormone, calcitonin, parameters of calcium homeostasis, cortisol, and indexes of renal function. Results were compared with the same measures from five monkeys before and after chairing for a flight simulation study. Concentrations of 1,25-dihydroxyvitamin D were 72% lower after the flight than before, and more than after chairing on the ground (57%, P parathyroid hormone did not reach significance. Calcitonin showed modest decreases postflight (P animals.

  4. Effect of a comprehensive programme to provide universal access to care for sputum-smear-positive multidrug-resistant tuberculosis in China: a before-and-after study.

    Science.gov (United States)

    Li, Renzhong; Ruan, Yunzhou; Sun, Qiang; Wang, Xiexiu; Chen, Mingting; Zhang, Hui; Zhao, Yanlin; Zhao, Jin; Chen, Cheng; Xu, Caihong; Su, Wei; Pang, Yu; Cheng, Jun; Chi, Junying; Wang, Qian; Fu, Yunting; Huan, Shitong; Wang, Lixia; Wang, Yu; Chin, Daniel P

    2015-04-01

    China has a quarter of all patients with multidrug-resistant tuberculosis (MDRTB) worldwide, but less than 5% are in quality treatment programmes. In a before-and-after study we aimed to assess the effect of a comprehensive programme to provide universal access to diagnosis, treatment, and follow-up for MDRTB in four Chinese cities (population 18 million). We designated city-level hospitals in each city to diagnose and treat MDRTB. All patients with smear-positive pulmonary tuberculosis diagnosed in Center for Disease Control (CDC) clinics and hospitals were tested for MDRTB with molecular and conventional drug susceptibility tests. Patients were treated with a 24 month treatment package for MDRTB based on WHO guidelines. Outpatients were referred to the CDC for directly observed therapy. We capped total treatment package cost at US$4644. Insurance reimbursement and project subsidies limited patients' expenses to 10% of charges for services within the package. We compared data from a 12 month programme period (2011) to those from a retrospective survey of all patients with MDRTB diagnosed in the same cities during a baseline period (2006-09). 243 patients were diagnosed with MDRTB or rifampicin-resistant tuberculosis during the 12 month programme period compared with 92 patients (equivalent to 24 per year) during the baseline period. 172 (71%) of 243 individuals were enrolled in the programme. Time from specimen collection for resistance testing to treatment initiation decreased by 90% (from median 139 days [IQR 69-207] to 14 days [10-21]), the proportion of patients who started on appropriate drug regimen increased 2·7 times (from nine [35%] of 26 patients treated to 166 [97%] of 172), and follow-up by the CDC after initial hospitalisation increased 24 times (from one [4%] of 23 patients to 163 [99%] of 164 patients). 6 months after starting treatment, the proportion of patients remaining on treatment increased ten times (from two [8%] of 26 patients to 137 [80

  5. The effect of complete integration of HIV and TB services on time to initiation of antiretroviral therapy: a before-after study.

    Directory of Open Access Journals (Sweden)

    Bernhard Kerschberger

    Full Text Available Studies have shown that early ART initiation in TB/HIV co-infected patients lowers mortality. One way to implement earlier ART commencement could be through integration of TB and HIV services, a more efficient model of care than separate, vertical programs. We present a model of full TB/HIV integration and estimate its effect on time to initiation of ART.We retrospectively reviewed TB registers and clinical notes of 209 TB/HIV co-infected adults with a CD4 count <250 cells/µl and registered for TB treatment at one primary care clinic in a South African township between June 2008 and May 2009. Using Kaplan-Meier and Cox proportional hazard analysis, we compared time between initiation of TB treatment and ART for the periods before and after full, "one-stop shop" integration of TB and HIV services (in December 2009. Potential confounders were determined a priori through directed acyclic graphs. Robustness of assumptions was investigated by sensitivity analyses. The analysis included 188 patients (100 pre- and 88 post-integration, yielding 56 person-years of observation. Baseline characteristics of the two groups were similar. Median time to ART initiation decreased from 147 days (95% confidence interval [CI] 85-188 before integration of services to 75 days (95% CI 52-119 post-integration. In adjusted analyses, patients attending the clinic post-integration were 1.60 times (95% CI 1.11-2.29 more likely to have started ART relative to the pre-integration period. Sensitivity analyses supported these findings.Full TB/HIV care integration is feasible and led to a 60% increased chance of co-infected patients starting ART, while reducing time to ART initiation by an average of 72 days. Although these estimates should be confirmed through larger studies, they suggest that scale-up of full TB/HIV service integration in high TB/HIV prevalence settings may shorten time to ART initiation, which might reduce excess mortality and morbidity.

  6. Longitudinal on-farm study of the development of antimicrobial resistance in Campylobacter coli from pigs before and after danofloxacin and tylosin treatments.

    Science.gov (United States)

    Juntunen, Pekka; Olkkola, Satu; Hänninen, Marja-Liisa

    2011-06-02

    Effects of danofloxacin or consecutive fluoroquinolone and macrolide treatments on resistance development in Campylobacter have remained uncharacterised. Therefore we analysed the development of resistance in porcine Campylobacter coli before and after danofloxacin and tylosin treatments at a farrowing farm. Danofloxacin-treated (n=12, group A) and control pigs (n=15, group B) were subsequently treated with tylosin and sampled longitudinally. C. coli were isolated and susceptibilities to ciprofloxacin and erythromycin were assessed, isolates were genotyped with PFGE and resistance-related mutations were identified. Isolates from the danofloxacin-treated pigs had more frequently non-wild type MICs (above the epidemiological cut-off value (ECOFF)) for ciprofloxacin (Ptylosin treatment increased proportion of isolates with non-wild type MICs for erythromycin in both groups A and B (Ptylosin treatment isolates had even higher MICs for ciprofloxacin and erythromycin than before the treatment. Therefore, controlled use of antimicrobials in food animal production is essential. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Relationship of locus of control with plaque and gingival status before and after oral health education in a group of college students - an experimental study.

    Science.gov (United States)

    Potdar, S; Lakshminarayan, N; Goud Reddy, S

    2015-02-01

    In health psychology, several models are being constructed to understand human behaviour. Multidimensional health locus of control (MHLC) is one among them. We sought to know the relationship of MHLC with dental plaque and gingival status before and after oral health education programme among 286 college students, aged 18-21 years in Davangere city. Multidimensional health locus of control questionnaire consisting of questions measuring internal health locus of control (IHLC), powerful others health locus of control (PHLC) and chance health locus of control (CHLC) was administered to students. Dental plaque and gingival health status were recorded using Plaque Index (PLI) and Gingival Index (GI), 1967. Oral health education was provided using power point presentation after the baseline oral examination. After 10 weeks of intervention, the students were given the same proforma followed by the assessment of plaque and gingival status. A negative correlation was observed between PHLC and IHLC with PLI and GI and positive correlation of CHLC with PLI and GI at a level of P education was found to be effective and this could change the behaviour of individuals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Central bank independence before and after the crisis

    NARCIS (Netherlands)

    de Haan, J.; Bodea, Christina; Hicks, Raymond; Eijffinger, Sylvester

    This paper discusses whether central bank independence (CBI) has changed since the financial crisis. Central banks’ quasi-fiscal policies during and after the crisis, and macro-prudential and unconventional monetary policies, which are more redistributive than traditional monetary policy, have led

  9. Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and after intervention study of carbapenem-use stewardship.

    Directory of Open Access Journals (Sweden)

    Young Kyung Yoon

    Full Text Available OBJECTIVE: Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. METHODS: A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18; Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36; and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54. RESULTS: During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD: 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028 and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; P<0.001. The use of autoregressive-error models showed that in contrast with ertapenem use, the use of Group 2 carbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB (P = 0.031. CONCLUSIONS: Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.

  10. Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and after intervention study of carbapenem-use stewardship.

    Science.gov (United States)

    Yoon, Young Kyung; Yang, Kyung Sook; Lee, Seung Eun; Kim, Hyun Jeong; Sohn, Jang Wook; Kim, Min Ja

    2014-01-01

    Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18); Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36); and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54). During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD): 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028) and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; Pcarbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB) (P = 0.031). Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.

  11. Physiological parameter values in greyhounds before and after high ...

    African Journals Online (AJOL)

    Heart rate (HR), blood lactate (BL) and rectal temperature (RT) are relevant physiological parameters to determine the dogs response to effort. ... in greyhounds have reported the effect of high-intensity exercise on many physiological parameters immediately after completing different racing distances and recovery times.

  12. A full Bayes before-after study accounting for temporal and spatial effects: Evaluating the safety impact of new signal installations.

    Science.gov (United States)

    Sacchi, Emanuele; Sayed, Tarek; El-Basyouny, Karim

    2016-09-01

    Recently, important advances in road safety statistics have been brought about by methods able to address issues other than the choice of the best error structure for modeling crash data. In particular, accounting for spatial and temporal interdependence, i.e., the notion that the collision occurrence of a site or unit times depend on those of others, has become an important issue that needs further research. Overall, autoregressive models can be used for this purpose as they can specify that the output variable depends on its own previous values and on a stochastic term. Spatial effects have been investigated and applied mostly in the context of developing safety performance functions (SPFs) to relate crash occurrence to highway characteristics. Hence, there is a need for studies that attempt to estimate the effectiveness of safety countermeasures by including the spatial interdependence of road sites within the context of an observational before-after (BA) study. Moreover, the combination of temporal dynamics and spatial effects on crash frequency has not been explored in depth for SPF development. Therefore, the main goal of this research was to carry out a BA study accounting for spatial effects and temporal dynamics in evaluating the effectiveness of a road safety treatment. The countermeasure analyzed was the installation of traffic signals at unsignalized urban/suburban intersections in British Columbia (Canada). The full Bayes approach was selected as the statistical framework to develop the models. The results demonstrated that zone variation was a major component of total crash variability and that spatial effects were alleviated by clustering intersections together. Finally, the methodology used also allowed estimation of the treatment's effectiveness in the form of crash modification factors and functions with time trends. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Effect of a control project on clinical profiles and outcomes in buruli ulcer: a before/after study in Bas-Congo, Democratic Republic of Congo.

    Directory of Open Access Journals (Sweden)

    Delphin Mavinga Phanzu

    2011-12-01

    Full Text Available BACKGROUND: Buruli ulcer (BU is a necrotizing bacterial infection of skin, subcutaneous tissue and bone caused by Mycobacterium ulcerans. Although the functional impairment caused by BU results in severe suffering and in socio-economic problems, the disease remains largely neglected in Africa. The province of Bas-Congo in Democratic Republic of Congo contains one of the most important BU foci of the country, i.e. the Songololo Territory in the District of Cataractes. This study aims to assess the impact of a BU control project launched in 2004 in the Songololo Territory. METHODS: We used a comparative non-randomized study design, comparing clinical profiles and outcomes of the group of patients admitted at the General Reference Hospital (GRH of the "Institut Médical Evangélique" (IME of Kimpese 3 years before the start of the project (2002-2004 with those admitted during the 3 years after the start of the project (2005-2007. RESULTS: The BU control project was associated with a strong increase in the number of admitted BU cases at the GRH of IME/Kimpese and a fundamental change in the profile of those patients; more female patients presented with BU, the proportion of relapse cases amongst all admissions reduced, the proportion of early lesions and simple ulcerative forms increased, more patients healed without complications and the case fatality rate decreased substantially. The median duration since the onset of first symptoms however remained high, as well as the proportion of patients with osteomyelitis or limitations of joint movement, suggesting that the diagnostic delay remains substantial. CONCLUSION: Implementing a specialized program for BU may be effective in improving clinical profiles and outcomes in BU. Despite these encouraging results, our study highlights the need of considering new strategies to better improve BU control in a low resources setting.

  14. Role of uroflowmetry before and after hypospadias repair

    Directory of Open Access Journals (Sweden)

    Rajat Piplani

    2018-01-01

    Conclusions: Abnormal uroflow is an inherent aspect of hypospadias in 50% of the cases. Both preoperative and postoperative uroflow evaluation is necessary for meaningful conclusion. Patients with preoperative normal flow rates but obstructed postoperative flow rates need clinical evaluation. Obstructive flow rates are more common after TIP (Snodgrass repair. The urinary flow rates improve with time.

  15. Before-after field study of effects of wind turbine noise on polysomnographic sleep parameters.

    Science.gov (United States)

    Jalali, Leila; Bigelow, Philip; Nezhad-Ahmadi, Mohammad-Reza; Gohari, Mahmood; Williams, Diane; McColl, Steve

    2016-01-01

    Wind is considered one of the most advantageous alternatives to fossil energy because of its low operating cost and extensive availability. However, alleged health-related effects of exposure to wind turbine (WT) noise have attracted much public attention and various symptoms, such as sleep disturbance, have been reported by residents living close to wind developments. Prospective cohort study with synchronous measurement of noise and sleep physiologic signals was conducted to explore the possibility of sleep disturbance in people hosting new industrial WTs in Ontario, Canada, using a pre and post-exposure design. Objective and subjective sleep data were collected through polysomnography (PSG), the gold standard diagnostic test, and sleep diary. Sixteen participants were studied before and after WT installation during two consecutive nights in their own bedrooms. Both audible and infrasound noises were also concurrently measured inside the bedroom of each participant. Different noise exposure parameters were calculated (LAeq, LZeq) and analyzed in relation to whole-night sleep parameters. Results obtained from PSG show that sleep parameters were not significantly changed after exposure. However, reported sleep qualities were significantly (P = 0.008) worsened after exposure. Average noise levels during the exposure period were low to moderate and the mean of inside noise levels did not significantly change after exposure. The result of this study based on advanced sleep recording methodology together with extensive noise measurements in an ecologically valid setting cautiously suggests that there are no major changes in the sleep of participants who host new industrial WTs in their community. Further studies with a larger sample size and including comprehensive single-event analyses are warranted.

  16. A Comparison of Questions and Tasks in Geography Textbooks before and after Curriculum Reform in China

    Science.gov (United States)

    Yang, Daihu; Wang, Ziying; Xu, Di

    2015-01-01

    This study centres on the questions and tasks in geography textbooks written before and after the curriculum reform in China. The aim of the study is to reveal the recent changes in amount, learning outcomes and types of questions and tasks in geography textbooks as well as the extent to which the ideas and intentions advocated by the curriculum…

  17. Breast Cancer Patients’ Cognitive Functioning Before and After Chemotherapy

    DEFF Research Database (Denmark)

    Andersen, Christina Maar; Pedersen, Anette Fischer; Mehlsen, Mimi Yung

    patients who were to receive chemotherapy scored higher on executive function than the controls (effect size (ES)=-0.202, p=0.011), but significantly lower on overall cognitive functioning as well as on the specific domains of attention, working memory, verbal learning and memory, motor function, visual...... learning and memory and visuospatial function (ES=0.248 to 0.407, p=0.000 to 0.010). Post-treatment, the patients who had received chemotherapy continued to score significantly lower than the controls on overall cognitive functioning and on the same specific domains as before treatment (ES=0.189 to 0.......430, p=0.000 to 0.038), but the between-group difference was reduced. The chemotherapy-treated patients also scored significantly lower on processing speed (ES=0.195, p=0.014) and there was no longer a difference between the groups with regards to executive function (ES=-0.109, p=0.173) and attention (ES...

  18. Grief and loss for patients before and after heart transplant.

    Science.gov (United States)

    Poole, Jennifer; Ward, Jennifer; DeLuca, Enza; Shildrick, Margrit; Abbey, Susan; Mauthner, Oliver; Ross, Heather

    2016-01-01

    The purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts. There is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience. Part of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants. Patients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned. Loss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Medical Advice for Sick-reported Students (MASS in intermediate vocational education schools: design of a controlled before-and-after study

    Directory of Open Access Journals (Sweden)

    Madelon K Van der Vlis

    2017-06-01

    Full Text Available Abstract Background School absenteeism, including medical absenteeism, is associated with early school dropout and may result in physical, mental, social and work-related problems in later life. Especially at intermediate vocational education schools, high rates of medical absenteeism are found. In 2012 the Dutch intervention ‘Medical Advice for Sick-reported Students’ (MASS, previously developed for pre-vocational secondary education, was adjusted for intermediate vocational education schools. The aim of the study outlined in this paper is to evaluate the effectiveness of the MASS intervention at intermediate vocational education schools in terms of reducing students’ medical absenteeism and early dropping out of school. Additionally, the extent to which biopsychosocial and other factors moderate the effectiveness of the intervention will be assessed. Methods A controlled before-and-after study will be conducted within Intermediate Vocational Education schools. Schools are allocated to be an intervention or control school based on whether the schools have implemented the MASS intervention (intervention schools or not (control schools. Intervention schools apply the MASS intervention consisting of active support for students with medical absenteeism provided by the school including a consultation with the Youth Health Care (YHC professional if needed. Control schools provide care as usual. Data will be collected by questionnaires among students in both groups meeting the criteria for extensive medical absenteeism (i.e. ‘reported sick four times in 12 school weeks or for more than six consecutive school days’ at baseline and at 6 months follow-up. Additionally, in the intervention group a questionnaire is completed after each consultation with a YHC professional, by both the student and the YHC professional. Primary outcome measures are duration and cumulative incidence of absenteeism and academic performances. Secondary outcome

  20. Medical Advice for Sick-reported Students (MASS) in intermediate vocational education schools: design of a controlled before-and-after study.

    Science.gov (United States)

    Van der Vlis, Madelon K; Lugtenberg, Marjolein; Vanneste, Yvonne T M; Berends, Wenda; Mulder, Wico; Bannink, Rienke; Van Grieken, Amy; Raat, Hein; de Kroon, Marlou L A

    2017-06-29

    School absenteeism, including medical absenteeism, is associated with early school dropout and may result in physical, mental, social and work-related problems in later life. Especially at intermediate vocational education schools, high rates of medical absenteeism are found. In 2012 the Dutch intervention 'Medical Advice for Sick-reported Students' (MASS), previously developed for pre-vocational secondary education, was adjusted for intermediate vocational education schools. The aim of the study outlined in this paper is to evaluate the effectiveness of the MASS intervention at intermediate vocational education schools in terms of reducing students' medical absenteeism and early dropping out of school. Additionally, the extent to which biopsychosocial and other factors moderate the effectiveness of the intervention will be assessed. A controlled before-and-after study will be conducted within Intermediate Vocational Education schools. Schools are allocated to be an intervention or control school based on whether the schools have implemented the MASS intervention (intervention schools) or not (control schools). Intervention schools apply the MASS intervention consisting of active support for students with medical absenteeism provided by the school including a consultation with the Youth Health Care (YHC) professional if needed. Control schools provide care as usual. Data will be collected by questionnaires among students in both groups meeting the criteria for extensive medical absenteeism (i.e. 'reported sick four times in 12 school weeks or for more than six consecutive school days' at baseline and at 6 months follow-up). Additionally, in the intervention group a questionnaire is completed after each consultation with a YHC professional, by both the student and the YHC professional. Primary outcome measures are duration and cumulative incidence of absenteeism and academic performances. Secondary outcome measures are biopsychosocial outcomes of the students. It

  1. Prenatal care and childbirth assistance in Amazonian women before and after the Pacific Highway Construction (2003-2011): a cross-sectional study.

    Science.gov (United States)

    Guimarães, Andréia S; Mantovani, Saulo A S; Oliart-Guzmán, Humberto; Martins, Antonio C; Filgueira-Júnior, José Alcântara; Santos, Ana Paula; Braña, Athos Muniz; Branco, Fernando Luís Cunha Castelo; Pereira, Thasciany Moraes; Delfino, Breno Matos; Ramalho, Alanderson A; Oliveira, Cristieli S M; Araújo, Thiago S; de Lara Estrada, Carlos Hermogenes Manrique; Arróspide, Nancy; Muniz, Pascoal T; Codeço, Cláudia T; da Silva-Nunes, Mônica

    2016-07-13

    Attention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. In 2003 both Brazilian and Peru governments have finished paving an international road connecting remotes areas in the Brazilian Amazon to the Pacific coast in Peru. The situation of prenatal care and child delivery with mothers of children under 5 years old living in the urban area of Assis Brasil, Acre was assessed in two cross-sectional studies performed in 2003 and 2011, corresponding to the period before and after the Pacific highway construction. In 2003, most mothers were of black/Afro-American ethnicity, or "pardos" (the offspring of a Caucasian with a African descendant) (77.69 %), had more than 4 years of schooling (73.40 %) and had a mean age of 22.18 years. In 2011, the number of as a migration of indigenous women increased from 0 to 14.40 % of the respondents, because of migration from communities along the rivers to urban areas, with no other significant changes in maternal characteristics. No significant improvement in childbirth assistance was noticed between 1997 and 2011; only the percentage of in-hospital vaginal deliveries performed by doctors increased from 17.89 to 66.26 % (p prenatal care was associated with white ethnicity in 2003, and higher socioeconomic level and white ethnicity in 2011, while the higher number of prenatal visits was associated with higher maternal education and higher socioeconomic levels in 2011. Vaginal child delivery at a hospital facility was associated with maternal age in 2003, and year of birth, being of white ethnicity and higher level of education in 2011. The indicators of prenatal care and child delivery were below the national average, showing that geographical isolation still affects women's health care in the Amazon, despite the construction of the highway and governmental health protocols

  2. Comparative study of regulated and unregulated air pollutant emissions before and after conversion of automobiles from gasoline power to liquefied petroleum gas/gasoline dual-fuel retrofits.

    Science.gov (United States)

    Yang, Hsi-Hsien; Chien, Shu-Mei; Cheng, Man-Ting; Peng, Chiung-Yu

    2007-12-15

    Liquefied petroleum gas (LPG) is increasingly being examined as an alternative to gasoline use in automobiles as interest grows in reducing air pollutant emissions. In this study, emissions of regulated (CO, THC, NO(x)) and unregulated air pollutants, including CO2, particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), and BTEX (acronym for benzene, toluene, ethylbenzene, xylene), were measured before and after conversion of nine gasoline-powered automobiles to LPG/ gasoline dual-fuel retrofits. The tests were conducted on a standard chassis dynamometer in accordance with the United States Environmental Protection Agency FTP-75 test procedure, with the exception that all tests were conducted under hot-start driving conditions. The influences of LPG on air pollutant emission levels and carcinogenic potency were investigated and compared with gasoline. The results showed average emission factors of 0.14 g/km, 0.33 mg/km, 0.09 g/km, 0.44 g/km, and 197 g/km for CO, THC, NO(x), PM, and CO2, respectively, for LPG/ gasoline dual-fuel retrofits. Paired-sample t-test results indicated that the emissions of CO (p = 0.03), THC (p = 0.04), and CO2 (p = 4.6 x 10(-8)) were significantly reduced with the retrofit in comparison with gasoline-powered automobiles. The reduction percentages were 71%, 89%, and 14% for CO, THC, and CO2, respectively. The average total PAH emission factor for LPG was 217 microg/km, which is significantly lower than gasoline (863 microg/km; p = 0.05). The PAH corresponding carcinogenicities (BaP(eq)) were calculated via toxic equivalencies based on benzo(a)pyrene (BaP). Paired-sample t-test results fortotal BaP(eq) emissions showed no significant difference between gasoline (30.0 microg/km) and LPG (24.8 microg/km) at a confidence level of 95%. The discrepancy between PAH and BaP(eq) emissions resulted from the higher emission percentages of high molecular weight PAHs for LPG, which might be from lubricant oil. The average emission factors of

  3. Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review

    NARCIS (Netherlands)

    Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S.; Jager, Kitty J.; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

    2016-01-01

    The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study

  4. Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study.

    Science.gov (United States)

    Hohwü, Lena; Li, Jiong; Olsen, Jørn; Sørensen, Thorkild I A; Obel, Carsten

    2014-01-01

    Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group). Median body mass index (BMI) and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) were estimated by logistic regression analysis adjusted for maternal educational level. Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02) and obesity (9.8% versus 8.5%, p = 0.06) was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI): 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively). Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31). There was no elevated risk in those who experienced maternal bereavement postnatally. Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

  5. Epithelial healing and visual outcomes of patients using omega-3 oral nutritional supplements before and after photorefractive keratectomy: a pilot study.

    Science.gov (United States)

    Ong, Nikki Heidi; Purcell, Tracy L; Roch-Levecq, Anne-Catherine; Wang, Dorothy; Isidro, Marichelle A; Bottos, Katia M; Heichel, Christopher W; Schanzlin, David J

    2013-06-01

    To investigate the effect of omega-3 oral nutritional supplementation on corneal reepithelialization, visual acuity, and tear stability after photorefractive keratectomy (PRK). This is a prospective, randomized, single-blinded controlled therapeutic trial using omega-3 oral nutritional supplements (TheraTears Nutrition for Dry Eyes; Advanced Vision Research-Akorn, Ann Arbor, MI) conducted at our center. Eighteen healthy patients with refractive error between -1 and -8 diopters were recruited and had bilateral PRK. The treatment group (n = 9 subjects) received omega-3 2 weeks before surgery through 1 month after PRK. The control group (n = 9 subjects) was not given omega-3. Epithelial defects were photographed on postoperative days 0 to 5. Reepithelialization (area in square millimeters) was assessed by fluorescein staining until healing. Tear breakup time (TBUT) and uncorrected distance visual acuity were measured at 1 week, and 1 and 3 months postoperatively. Epithelial defect in the treatment group eyes healed faster compared with that of the controls (P = 0.04). The treatment group eyes healed at an average rate of 1.19% [SD = 0.002; 95% confidence interval (CI), 1.04%-1.34%] per hour, versus 0.83% (SD = 0.0008; 95% CI, 0.77%-0.89%) for controls (Mann-Whitney rank-sum test, P oral nutritional supplements decreased the average time for epithelial healing, and improved TBUT and visual acuity recovery in PRK. These findings suggested that omega-3 oral nutritional supplementation may be a beneficial adjunct therapy for PRK patients.

  6. Quality of reporting and study design of CKD cohort studies assessing mortality in the elderly before and after STROBE : A systematic review

    NARCIS (Netherlands)

    Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S.; Jager, Kitty J.; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

    2016-01-01

    Background: The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and

  7. Analysis of artery blood flow before and after angioplasty

    Science.gov (United States)

    Tomaszewski, Michał; Baranowski, Paweł; Małachowski, Jerzy; Damaziak, Krzysztof; Bukała, Jakub

    2018-01-01

    The study presents a comparison of results obtained from numerical simulations of blood flow in two different arteries. One of them was considered to be narrowed in order to simulate an arteriosclerosis obstructing the blood flow in the vessel, whereas the second simulates the vessel after angioplasty treatment. During the treatment, a biodegradable stent is inserted into the artery, which prevents the vessel walls from collapsing. The treatment was simulated through the use of numerical simulation using the finite element method. The final mesh geometry obtained from the analysis was exported to the dedicated software in order to create geometry in which a flow domain inside the artery with the stent was created. The flow analysis was conducted in ANSYS Fluent software with non-deformable vessel walls.

  8. Bradykinin and cysteinyl leukotriene concentrations in cell-salvaged blood before and after passage through negatively charged filters during clinical use in cancer patients: a pilot study.

    Science.gov (United States)

    Catling, S J; Thornton, C A; Russell, I T

    2015-09-01

    It has been suggested that giving cell-salvaged blood through a leucocyte depletion filter can cause hypotension due to bradykinin released when factor XII and platelets are activated by the negatively charged surface of the filter. We measured the concentration of bradykinin and cysteinyl leukotrienes in cell-salvaged blood sampled before and after passage through a negatively charged leucodepletion filter in 24 consecutive patients with gynaecological or bowel cancer undergoing elective surgery with cell salvage. In no case was an increase in bradykinin concentration observed after passage through the filter; in 23 patients the post-filtration bradykinin concentration was zero (p = 0.007). The change in the concentration of cysteinyl leukotrienes detected during passage across the filter was not statistically significant (p = 0.1). Our findings do not support the suggestion that either bradykinin or cysteinyl leukotrienes are generated in cell-salvaged blood during passage through leucodepletion filters. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  9. Positive and negative memories in Danish soldiers – before, during, and after deployment

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Bohn, Annette; Staugaard, Søren Risløv

    This study compares the characteristics of positive and negative memories in 610 Danish soldiers across three measurement points (before, during and after deployment). Participants were asked to report the most positive and most negative memory from their lives before deployment, and to report...... the most positive and most negative memories concerning their deployment (during deployment and right after deployment). The memory narratives were coded by two independent raters for specificity, coherence, and degree of desorganisation. For all three time points, these ratings were compared across time...

  10. Venice Film Festival before, during and after Pontecorvo

    Directory of Open Access Journals (Sweden)

    Roberto Donati

    2016-07-01

    Full Text Available A brief historical introduction to Venice Film Festival. The reasons that led Gillo Pontecorvo to become Director in 1992. Pontecorvo’s programmatic standpoint, successes and first false steps: the Unforgiven case. The five Pontecorvo editions in detail: titles, directors, discoveries, reassessments. His initiatives aimed to repopulate the Lido of common moviegoers, specifically young spectators, after years when the Mostra had become an insiders’ exclusive destination. Gillo’s comeback as a former Director, again as a filmmaker, with the short movie Nostalgia di protezione. Pontecorvo’ aftermath: from Felice Laudadio to Alberto Barbera, from Moritz de Hadeln to Marco Müller, until Barbera’s comeback.

  11. Adherence of trials of operative intervention to the CONSORT statement extension for non-pharmacological treatments: a comparative before and after study.

    Science.gov (United States)

    Gray, R; Sullivan, M; Altman, D G; Gordon-Weeks, A N

    2012-09-01

    Use of the Consolidated Standards of Reporting Trials (CONSORT) statement has been shown to improve the reporting of randomised controlled trials and it is endorsed by leading surgical journals. The CONSORT statement for non-pharmacological treatment (CONSORT-NPT) provides specific items to aid in the reporting of trials of operative intervention. This study compares the reporting practice of trials of operative intervention published in time periods before and after publication of the CONSORT-NPT statement. A 30-point checklist containing the salient CONSORT-NPT items was designed and the adherence of trials meeting the inclusion criteria determined independently by two authors. There was a significant improvement of 3.95 points in the mean CONSORT-NPT score from 2004 to 2010 (95% confidence interval: 3.61-4.29, pCONSORT statement rather than to CONSORT-NPT items, which remained poorly reported in 2010. The mean CONSORT-NPT score was 17.5 (standard deviation [SD]: 4.5) for trials published in CONSORT endorsing journals compared with 15.6 (SD: 4.0) for those that did not mention endorsement of the CONSORT statement although this was not a significant difference (p=0.064). Although there has been a significant improvement in the reporting of trials of operative intervention published in the surgical literature since 2004, items specific to the CONSORT-NPT extension remain underreported. Improved awareness of this important addition to the CONSORT statement throughout the surgical community and its endorsement by surgical journals will help to improve the reporting practice of trials of operative intervention.

  12. Antiepileptic drug prescribing before, during and after pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel; Garne, Ester; Wang, Hao

    2015-01-01

    pregnancy were co-prescribed with high-dose folic acid: ranging from 1.0% (CI95 0.3-1.8%) in Emilia Romagna to 33.5% (CI95 28.7-38.4%) in Wales. CONCLUSION: The country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co...... and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated. RESULTS: In total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy......-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care. © 2015 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd....

  13. Assessment of asymmetric leg loading before and after total hip arthroplasty using instrumented shoes.

    Science.gov (United States)

    Martínez-Ramírez, Alicia; Weenk, Dirk; Lecumberri, Pablo; Verdonschot, Nico; Pakvis, Dean; Veltink, Peter H

    2014-02-28

    Total hip arthroplasty is a successful surgical treatment in patients with osteoarthritis of the hip. Different questionnaires are used by the clinicians to assess functional capacity and the patient's pain, despite these questionnaires are known to be subjective. Furthermore, many studies agree that kinematic and kinetic parameters are crucial to evaluate and to provide useful information about the patient's evolution for clinicians and rehabilitation specialists. However, these quantities can currently only be obtained in a fully equipped gait laboratory. Instrumented shoes can quantify gait velocity, kinetic, kinematic and symmetry parameters. The aim of this study was to investigate whether the instrumented shoes is a sufficiently sensitive instrument to show differences in mobility performance before and after total hip arthroplasty. In this study, patients undergoing total hip arthroplasty were measured before and 6-8 months after total hip arthroplasty. Both measurement sessions include 2 functional mobility tasks while the subject was wearing instrumented shoes. Before each measurement the Harris Hip Score and the Traditional Western Ontario and McMaster Universities osteoarthritis index were administered as well. The stance time and the average vertical ground reaction force measured with the instrumented shoes during walking, and their symmetry index, showed significant differences before and after total hip arthroplasty. However, the data obtained with the sit to stand test did not reveal this improvement after surgery. Our results show that inter-limb asymmetry during a walking activity can be evaluated with the instrumented shoes before and after total hip arthroplasty in an outpatient clinical setting.

  14. Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study.

    Science.gov (United States)

    Detroyer, Elke; Dobbels, Fabienne; Teodorczuk, Andrew; Deschodt, Mieke; Depaifve, Yves; Joosten, Etienne; Milisen, Koen

    2018-01-19

    Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium. A before-after study in a sample of patients enrolled pre-intervention (non-intervention cohort (NIC); n = 81) and post-intervention (intervention cohort (IC); n = 79), and nurses (n = 17) of a geriatric ward (university hospital). The intervention included an information session about using the e-learning tool, which consisted of 11 e-modules incorporating development of knowledge and skills in the prevention, detection and management of delirium, and the completion of a delirium e-learning tool during a three-month period. Key patient outcomes included in-hospital prevalence and duration of delirium (Confusion Assessment Method), delirium severity (Delirium Index) and mortality (in-hospital; 12 months post-admission); key nurse outcomes included delirium knowledge (Delirium Knowledge Questionnaire) and recognition (Case vignettes). Logistic regression and linear mixed models were used to analyse patient data; Wilcoxon Signed Rank tests, McNemar's or paired t-tests for nursing data. No significant difference was found between the IC and NIC for in-hospital prevalence (21.5% versus 25.9%; p = 0.51) and duration of delirium (mean 4.2 ± SD 4.8 days versus 4.9 ± SD 4.8 days; p = 0.38). A trend towards a statistically significant lower delirium severity (IC versus NIC: difference estimate

  15. Transpulmonary thermodilution (TPTD) before, during and after Sustained Low Efficiency Dialysis (SLED). A Prospective Study on Feasibility of TPTD and Prediction of Successful Fluid Removal.

    Science.gov (United States)

    Huber, Wolfgang; Fuchs, Stephan; Minning, Andreas; Küchle, Claudius; Braun, Marlena; Beitz, Analena; Schultheiss, Caroline; Mair, Sebastian; Phillip, Veit; Schmid, Sebastian; Schmid, Roland M; Lahmer, Tobias

    2016-01-01

    Acute kidney injury (AKI) is common in critically ill patients. AKI requires renal replacement therapy (RRT) in up to 10% of patients. Particularly during connection and fluid removal, RRT frequently impairs haemodyamics which impedes recovery from AKI. Therefore, "acute" connection with prefilled tubing and prolonged periods of RRT including sustained low efficiency dialysis (SLED) has been suggested. Furthermore, advanced haemodynamic monitoring using trans-pulmonary thermodilution (TPTD) and pulse contour analysis (PCA) might help to define appropriate fluid removal goals. Since data on TPTD to guide RRT are scarce, we investigated the capabilities of TPTD- and PCA-derived parameters to predict feasibility of fluid removal in 51 SLED-sessions (Genius; Fresenius, Germany; blood-flow 150 mL/min) in 32 patients with PiCCO-monitoring (Pulsion Medical Systems, Germany). Furthermore, we sought to validate the reliability of TPTD during RRT and investigated the impact of "acute" connection and of disconnection with re-transfusion on haemodynamics. TPTDs were performed immediately before and after connection as well as disconnection. Comparison of cardiac index derived from TPTD (CItd) and PCA (CIpc) before, during and after RRT did not give hints for confounding of TPTD by ongoing RRT. Connection to RRT did not result in relevant changes in haemodynamic parameters including CItd. However, disconnection with re-transfusion of the tubing volume resulted in significant increases in CItd, CIpc, CVP, global end-diastolic volume index GEDVI and cardiac power index CPI. Feasibility of the pre-defined ultrafiltration goal without increasing catecholamines by >10% (primary endpoint) was significantly predicted by baseline CPI (ROC-AUC 0.712; p = 0.010) and CItd (ROC-AUC 0.662; p = 0.049). TPTD is feasible during SLED. "Acute" connection does not substantially impair haemodynamics. Disconnection with re-transfusion increases preload, CI and CPI. The extent of these changes might

  16. Transpulmonary thermodilution (TPTD before, during and after Sustained Low Efficiency Dialysis (SLED. A Prospective Study on Feasibility of TPTD and Prediction of Successful Fluid Removal.

    Directory of Open Access Journals (Sweden)

    Wolfgang Huber

    Full Text Available Acute kidney injury (AKI is common in critically ill patients. AKI requires renal replacement therapy (RRT in up to 10% of patients. Particularly during connection and fluid removal, RRT frequently impairs haemodyamics which impedes recovery from AKI. Therefore, "acute" connection with prefilled tubing and prolonged periods of RRT including sustained low efficiency dialysis (SLED has been suggested. Furthermore, advanced haemodynamic monitoring using trans-pulmonary thermodilution (TPTD and pulse contour analysis (PCA might help to define appropriate fluid removal goals.Since data on TPTD to guide RRT are scarce, we investigated the capabilities of TPTD- and PCA-derived parameters to predict feasibility of fluid removal in 51 SLED-sessions (Genius; Fresenius, Germany; blood-flow 150 mL/min in 32 patients with PiCCO-monitoring (Pulsion Medical Systems, Germany. Furthermore, we sought to validate the reliability of TPTD during RRT and investigated the impact of "acute" connection and of disconnection with re-transfusion on haemodynamics. TPTDs were performed immediately before and after connection as well as disconnection.Comparison of cardiac index derived from TPTD (CItd and PCA (CIpc before, during and after RRT did not give hints for confounding of TPTD by ongoing RRT. Connection to RRT did not result in relevant changes in haemodynamic parameters including CItd. However, disconnection with re-transfusion of the tubing volume resulted in significant increases in CItd, CIpc, CVP, global end-diastolic volume index GEDVI and cardiac power index CPI. Feasibility of the pre-defined ultrafiltration goal without increasing catecholamines by >10% (primary endpoint was significantly predicted by baseline CPI (ROC-AUC 0.712; p = 0.010 and CItd (ROC-AUC 0.662; p = 0.049.TPTD is feasible during SLED. "Acute" connection does not substantially impair haemodynamics. Disconnection with re-transfusion increases preload, CI and CPI. The extent of these changes

  17. Politics and School Desegregation before and after "Parents Involved"

    Science.gov (United States)

    Brown, Frank; Hunter, Richard C.

    2009-01-01

    The authors attempt to tell the story of "Brown" and "Parents Involved" on educational inequality and connect these topics to economic competition globally. "Brown" came about in the 1950s in a much different environment: America was less diverse racially and ethnically, and economic competition on a global scale was…

  18. HIV stigma experiences and stigmatisation before and after a HIV ...

    African Journals Online (AJOL)

    reduction community “hub” intervention would change the HIV stigma experiences of people living with HIV (PLWH) and the stigmatisation by the community in an urban area in South Africa. A convergent parallel mixed-method design with a ...

  19. Understorey bird abundance and diversity before and after a forest ...

    African Journals Online (AJOL)

    layer and canopy cover. In the Eastern Arc Mountains, the effects of forest fires on avifauna, especially on forest interior bird species, have received little attention. In the Ulugurus the author has reported the negative affects of fire on understorey forest birds in the lower alti- tude Kimboza Forest Reserve (Werema 2014), but ...

  20. Multifaceted intervention to curb in-hospital over-prescription of proton pump inhibitors: A longitudinal multicenter quasi-experimental before-and-after study.

    Science.gov (United States)

    Del Giorno, Rosaria; Ceschi, Alessandro; Pironi, Michela; Zasa, Anna; Greco, Angela; Gabutti, Luca

    2017-12-20

    Proton pump inhibitors (PPIs) are indicated for a restricted number of clinical conditions, and their misuse can lead to several adverse effects. Despite that, the proportion of overuse is alarmingly high. To test the efficacy of a multifaceted strategy in order to achieve a significant reduction of new PPI prescriptions at discharge in hospitalized patients. Multicenter longitudinal quasi-experimental before-and-after study conducted from July 1st, 2014 to June 30th, 2017. 44,973 admissions in a network of 5 public teaching hospitals of the Italian-speaking region of Switzerland. Multifaceted strategy consisting in a continuous transparent monitoring-benchmarking and in capillary educational interventions applied in the internal medicine departments. To confirm the causality of the results we monitored the trend of new PPI prescriptions in the, not exposed to the intervention, surgery departments of the same hospital network. New PPI prescriptions at hospital discharge. Over the 36month study period 44,973 patient files were analyzed. At admission, comparing internal medicine vs. surgery departments, 44.9% vs. 23.3% of patients were already being treated with a PPI. The annual rate of new PPI prescriptions, for internal medicine showed a decreasing trend: 19, 19, 18, 16% in years 2014, 2015, 2016, 2017, respectively (p<0.001, 2014 vs. 2017; p-for-trend <0.001), while an increasing rate was found in the surgery departments in the same years: 30, 29, 36, 36%, respectively (p<0.001, 2014 vs. 2017; p-for-trend <0.001). The case mix was significantly associated with the probability of new PPI prescriptions in both departments (OR1.35, 95% CI 1.26-1.44 for internal medicine and 1.24, 95% CI 1.19-1.30 for surgery). The introduction of a multifaceted intervention significantly reduced the time trend of PPI prescriptions at hospital discharge in internal medicine departments. Further studies are needed to confirm whether the strategy proposed could contribute to optimize

  1. Comparision of uroflow parameters before and after hypospadias ...

    African Journals Online (AJOL)

    Hematology Oncology Training and Research Hospital's. Pediatric Surgery Clinic between January 2010 and June. 2013 and a control group of 32 healthy children without symptoms of hypospadias or other urinary system problems were included in the study. Uroflowmetric investigations. (maximum urine flow rate, mean ...

  2. Successful Erasmus Experience: Analysing Perceptions Before, during and after Erasmus

    Science.gov (United States)

    Asoodar, Maryam; Atai, Mahmood Reza; Baten, Lut

    2017-01-01

    This study explored the expectations, perceptions and experiences of students involved in Erasmus programs. The objective was to achieve a better understanding of students' cultural and intercultural needs in order to underpin the development of teaching materials in Intercultural Education Resources for Erasmus Students and their Teachers…

  3. Vandellos 1 decommissioning project. Safety before, during and after

    International Nuclear Information System (INIS)

    Rodriguez, A.

    2002-01-01

    The Nuclear Power Plant of Vandellos 1, a gas-graphite reactor (GCR), started operation in the 70's after 17 years running the decommissioning process began in 1998, and is expected to finish at the end of 2002 with the level 2 of decommissioning with a practically total scope reached, except the concrete reactor vessel and its internals that will remain for another 25 years in surveillance state (dormancy) until their total dismantling. During the last four years the activities related to decontamination and disassembly of the power plant system as well as the management of all this material have been carried out. One of the last phases of the project that will be performed this year, without doubt, one of the most representative of the operative difficulty of the task is the disassembly of some buildings which are more than 80 meters high and with some structures weighing more than 3.000 t, an operation, which is spectacular in terms of volume and mass involved. However one has to keep in mind that it has been preceded by the of clearance process of all these structures to be disassembled this summer. Hundred of thousands of radiological measures will confirm with guarantee that the destination of the dismantled materials is the correct one, assuring the protection of people and the environment. This is a process which has to integrate the principles of radiological safety and industrial safety. First, it has to be guaranteed that structures and components are below the values authorised by authorities for their free release, and, secondly, that the planned sequence of the process and manoeuvres in the disassembly of these colossal structures assures safety. (author)

  4. RUSSIAN-ARAB COOPERATION BEFORE AND AFTER THE "ARAB SPRING"

    Directory of Open Access Journals (Sweden)

    Marina Anatolievna Sapronova

    2014-01-01

    Full Text Available The article considers the main stages of the Russian- Arab economic cooperation since the beginning of the 1990s up to the present time and changing the «Middle Eastern vector» of Russian foreign policy. Analyzes the problems faced by Russia in the development of foreign policy doctrine in the region of the Arab East, becoming the successor of the Soviet Union; difficulty in building bilateral relations with Iraq, Syria, Libya, and Russia's role as a co-sponsor of the Middle East settlement. Next is considered the foreign policy in 2000 and the return of Russia to the «Greater Middle East», analyzes the problems impeding effective Russian- Arab cooperation. Special attention is paid to the strengthening of bilateral relations with the countries of the Arabian Peninsula, the implementation of joint projects in various fields and to establish a constructive dialogue with the new government of Iraq and the establishment of a sound legal framework of mutual relations. Another important direction of Russian foreign policy in the 2000s, becoming the establishment of relations with the Organization of the Islamic Conference. Simultaneously being established permanent contacts with groups «Hamas» and «Hezbollah». In the last part of the article explores the specificity of modern political, trade and economic cooperation after the events of the «Arab Spring» of 2011. Particular attention is paid to the position of Russia in relation to processes taking place in Tunisia, Egypt, Libya, Syria. The crisis in Syria has demonstrated a fundamentally different approaches to its solution by Russia and the West. Ultimately, the firm position of Russia on the Syrian issue secured her role as an important political player in the Middle East. In general, regional transformation in 2011, despite their negative consequences for the Russian-Arab economic cooperation and opened new opportunities to promote the Russian Federation for Arab markets.

  5. Russian-Arab Cooperation Before And After The "Arab Spring"

    Directory of Open Access Journals (Sweden)

    Marina Anatolievna Sapronova

    2014-01-01

    Full Text Available The article considers the main stages of the Russian- Arab economic cooperation since the beginning of the 1990s up to the present time and changing the «Middle Eastern vector» of Russian foreign policy. Analyzes the problems faced by Russia in the development of foreign policy doctrine in the region of the Arab East, becoming the successor of the Soviet Union; difficulty in building bilateral relations with Iraq, Syria, Libya, and Russia's role as a co-sponsor of the Middle East settlement. Next is considered the foreign policy in 2000 and the return of Russia to the «Greater Middle East», analyzes the problems impeding effective Russian- Arab cooperation. Special attention is paid to the strengthening of bilateral relations with the countries of the Arabian Peninsula, the implementation of joint projects in various fields and to establish a constructive dialogue with the new government of Iraq and the establishment of a sound legal framework of mutual relations. Another important direction of Russian foreign policy in the 2000s, becoming the establishment of relations with the Organization of the Islamic Conference. Simultaneously being established permanent contacts with groups «Hamas» and «Hezbollah». In the last part of the article explores the specificity of modern political, trade and economic cooperation after the events of the «Arab Spring» of 2011. Particular attention is paid to the position of Russia in relation to processes taking place in Tunisia, Egypt, Libya, Syria. The crisis in Syria has demonstrated a fundamentally different approaches to its solution by Russia and the West. Ultimately, the firm position of Russia on the Syrian issue secured her role as an important political player in the Middle East. In general, regional transformation in 2011, despite their negative consequences for the Russian-Arab economic cooperation and opened new opportunities to promote the Russian Federation for Arab markets.

  6. Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study.

    Science.gov (United States)

    Benjamins, S Janine; Damen, Maurice L W; van Stel, Henk F

    2015-01-01

    In the Netherlands a need is felt for more flexible Child Health Care services, both efficient and tailored to needs. We set up a study on impact and feasibility of task delegation to child health care nurses performing all regular checkups on children aged 2 months to 4 years. Abnormal findings were discussed with the attending child health care doctor. This article describes impact and feasibility of this task delegation from four viewpoints: competences of nurses; percentage of children assigned to the nurse; change in abnormal findings and referrals; experiences of professionals and parents. Two experiment teams and two control teams were compared before and after starting task delegation. Nurses in the experiment teams were trained to carry out regular checkups on healthy children. Assignment to the experiment schedule was a joint decision by doctor and nurse. Nursing competences were measured by means of questionnaires. Percentage of children assigned to the nurse and screening results of eyes, heart, hips, growth and development were extracted from the electronic health record. Difference in change was compared between experiment and control teams. Mann-Whitney tests and logistic generalized estimating equations were used to test for significance. Experiences of professionals and parents were evaluated through focus group interviews, which were subjected to a qualitative analysis. Nurses in the experiment regions showed improvement in medical screening skills. No difference in change was perceived in general nursing competences. In the experiment group, 69% of all children were assigned to the nurse. There were no significant differences in change in the percentages of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips. Interviews showed that both doctors and nurses thought positively of the new working method, yet made some recommendations for improvements. Parents felt well-informed and experienced an

  7. Feasibility and Impact of Doctor-Nurse Task Delegation in Preventive Child Health Care in the Netherlands, a Controlled Before-After Study.

    Directory of Open Access Journals (Sweden)

    S Janine Benjamins

    Full Text Available In the Netherlands a need is felt for more flexible Child Health Care services, both efficient and tailored to needs. We set up a study on impact and feasibility of task delegation to child health care nurses performing all regular checkups on children aged 2 months to 4 years. Abnormal findings were discussed with the attending child health care doctor. This article describes impact and feasibility of this task delegation from four viewpoints: competences of nurses; percentage of children assigned to the nurse; change in abnormal findings and referrals; experiences of professionals and parents.Two experiment teams and two control teams were compared before and after starting task delegation. Nurses in the experiment teams were trained to carry out regular checkups on healthy children. Assignment to the experiment schedule was a joint decision by doctor and nurse. Nursing competences were measured by means of questionnaires. Percentage of children assigned to the nurse and screening results of eyes, heart, hips, growth and development were extracted from the electronic health record. Difference in change was compared between experiment and control teams. Mann-Whitney tests and logistic generalized estimating equations were used to test for significance. Experiences of professionals and parents were evaluated through focus group interviews, which were subjected to a qualitative analysis.Nurses in the experiment regions showed improvement in medical screening skills. No difference in change was perceived in general nursing competences. In the experiment group, 69% of all children were assigned to the nurse. There were no significant differences in change in the percentages of abnormal findings or referrals in the experiment teams compared to the control teams, except for hips. Interviews showed that both doctors and nurses thought positively of the new working method, yet made some recommendations for improvements. Parents felt well-informed and

  8. Trends in Community Pharmacy Counts and Closures before and after the Implementation of Medicare Part D

    Science.gov (United States)

    Klepser, Donald G.; Xu, Liyan; Ullrich, Fred; Mueller, Keith J.

    2011-01-01

    Purpose: Medicare Part D provided 3.4 million American seniors with prescription drug insurance. It may also have had an unintended effect on pharmacy viability. This study compares trends in the number of pharmacies and rate of pharmacy closures before and after the implementation of Medicare Part D. Methods: This retrospective observational…

  9. Health problems in children and adolescents before and after a man-made disaster.

    NARCIS (Netherlands)

    Dirkzwager, A.J.E.; Kerssens, J.J.; Yzermans, C.J.

    2006-01-01

    OBJECTIVE:: The aims of this study were to examine health problems of children (4-12 years old at the time of the disaster) and adolescents (13-18 years old at the time of the disaster) before and after exposure to a fireworks disaster in the Netherlands (May 2000), to compare these health problems

  10. Oxygen Delivery to the Brain before and after Birth

    Science.gov (United States)

    Jones, M. Douglas; Rosenberg, Adam A.; Simmons, Michael A.; Molteni, Richard A.; Koehler, Raymond C.; Traystman, Richard J.

    1982-04-01

    We studied the relationship between cerebral oxygen consumption and cerebral oxygen delivery (cerebral blood flow× arterial oxygen content) in fetal, newborn, and adult sheep. Relative to the amount of oxygen consumed, cerebral oxygen delivery in the fetus exceeds that in the lamb and adult by 70 percent. This may represent a protective advantage for the fetus or simply a necessary adaptation to the low arterial oxygen pressure in the intrauterine environment.

  11. Children's Drawings about "Radiation"--Before and after Fukushima

    Science.gov (United States)

    Neumann, Susanne; Hopf, Martin

    2013-01-01

    Although the term "radiation" has a fixed place in everyday life as well as in the media, there is very little empirical research on students' conceptions about this topic. In our study we wanted to find out what students associate with this term. In 2009, we asked 509 students (between grade 4 and grade 6) from seven different schools…

  12. Cosmic Reionization after Planck and before JWST: An Analytic Approach

    Science.gov (United States)

    Madau, Piero

    2017-12-01

    The reionization of cosmic hydrogen marks a critical juncture in the history of structure formation. Here we present a new formulation of the standard reionization equation for the evolution of the volume-averaged H II fraction that is more consistent with the accepted conceptual model of inhomogeneous intergalactic absorption. The revised equation explicitly accounts for the presence of the optically thick “Lyman-limit systems” that are known to determine the mean-free path of ionizing radiation after overlap. Integration of this equation provides a better characterization of the timing of reionization by smoothly linking the pre-overlap with the post-overlap phases of such a process. We confirm the validity of the quasi-instantaneous approximation as a predictor of reionization completion/maintenance and discuss new insights on the sources of cosmic reionization using the improved formalism. A constant emission rate into the intergalactic medium (IGM) of three Lyman continuum (LyC) photons per atom per gigayear leads to a reionization history that is consistent with a number of observational constraints on the ionization state of the z = 5–9 universe. While star-forming galaxies can dominate the reionization process if the luminosity-weighted fraction of LyC photons that escape into the IGM, {f}{esc}, exceeds 15% (for a faint magnitude cut-off of the galaxy UV luminosity function of {M}{lim}=-13 and a LyC photon yield per unit 1500 Å luminosity of {ξ }{ion}={10}25.3 {{erg}}-1 {Hz}), simple models where the product of the two unknowns {f}{esc}{ξ }{ion} is not evolving with redshift fail to reproduce the changing neutrality of the IGM observed at these epochs.

  13. The Minimum Price Guarantee Policy before and after Real Plan

    Directory of Open Access Journals (Sweden)

    Jackelline Favro

    2014-12-01

    Full Text Available This study aims to analyze the performance of the Minimum Price Guarantee Policy - MPGPin Brazil for the main agricultural products, during the 1980s and 1990s, and especially the post-Real Plan period. The research has a bibliographic and descriptive nature. The main results showed that the MPGP remains an important tool for ensuring income to farmers and the supply of selected crops in the analyzed period, but there was a reduction of public action for the new MPGP and new private instruments has revealed efficiency

  14. Comparision of uroflow parameters before and after hypospadias ...

    African Journals Online (AJOL)

    9 Marte A, Iouio GD, Pasquale AM. Functional evaluation of tubularized- incised plate repair of midshaft-proximal hypospadias using uroflowmetry. BJU Int 2001; 87:540–543. 10 Hammouda HM, El-Ghoneimi A, Baglı DJ, Mclorıe GA, Khoury AE. Tubularized incised plate repair: functional outcome after intermediate.

  15. Refugee children's play: Before and after migration to Australia.

    Science.gov (United States)

    MacMillan, Kelli K; Ohan, Jeneva; Cherian, Sarah; Mutch, Raewyn C

    2015-08-01

    Play is vital to children's development, health and resilience. Play modulates cognitive, emotional and social well-being. Children constitute approximately half of all humanitarian refugee entrants resettled in Australia. Refugee children are commonly victims and witnesses of war and persecution, living across resource-poor environs during transit. Little is known about the effects of refugee migration on play. This study explores how refugee children engaged in play pre-migration (in their home country) and post-migration (Australia). Refugee children attending the Refugee Health Clinic of a tertiary children's hospital were invited to complete a qualitative descriptive study of play. The children were asked to draw how they played pre- and post-migration. Drawings were analysed for (i) the presence of play; (ii) location of play; and (iii) drawing detail. Nineteen refugee children were recruited (mean age 8.5 years ± standard deviation 6.4 months). Significantly fewer children drew play pre- versus post-migration (11/19, 58% vs. 18/19, 95% P migration (pre: 2/8, 25% vs. post: 7/8, 87%, P = 0.06), trending to significance. Of those children who drew play, almost all drew playing outside (pre-migration: 10/11, 90.9%; post-migration: 17/18, 94.4%). Drawings showed equivalent detail pre- and post-migration. Resettled refugee children, especially girls, demonstrated limited play pre-migration, with higher levels of engagement post-resettlement. Facilitating opportunities for variety of play may strengthen positive resettlement outcomes for children and parents. Larger longitudinal studies examining play in refugee children and associations with physical, development and psychological well-being are warranted. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  16. Genotoxicity studies in the ST cross of the Drosophila wing spot test of sunflower and soybean oils before and after frying and boiling procedures.

    Science.gov (United States)

    Demir, Eşref; Marcos, Ricard; Kaya, Bülent

    2012-10-01

    Sunflower and soybean oils were tested for genotoxicity in the Drosophila wing somatic mutation and recombination assay. Results indicate that both oils produce genotoxic effects when tested without any previous frying or boiling processes. Boiling sunflower oil during fifteen, thirty and sixty minutes significantly increased its genotoxic response; nevertheless, after frying potatoes this oil showed a significant decrease in the genotoxic activity. On the other hand, boiling and frying soybean oil in the same conditions results in a decrease of its genotoxic potential. We have also detected that the amount of total polar materials increases significantly in oils submitted to frying or boiling process. Nevertheless, in oils obtained after frying potatoes, the amount of TPM was higher than after boiling. It is suggested that this effect is probably due to the amount of non-volatile TPM, the fatty acid composition of the oils, the types of frying oil, the high frying temperature and time, and the number of boiling and frying. This is the first study reporting genotoxicity data in Drosophila for the boiling and frying of both sunflower and soybean oils. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Experiences of Turkish University Students on Academic Mobility: Before and after Academic Mobility Factors

    Science.gov (United States)

    Erden, Hale

    2016-01-01

    Student academic mobility is described as the movement of students from one country to another for studying undergraduate and/or graduate degrees. Students' academic mobility involves two factors: before academic mobility factors and after academic mobility factors. The current study aims at identifying the perceptions of Turkish university…

  18. Employment and sick leave in patients with prostate cancer before, during and after radiotherapy.

    Science.gov (United States)

    Sveistrup, Joen; Mortensen, Ole S; Rosenschöld, Per M; Engelholm, Svend A; Petersen, Peter M

    2016-06-01

    The aim of this study was to determine employment outcomes after radiotherapy (RT) for prostate cancer (PCa). The Danish DREAM database contains information about social benefits paid to Danish citizens. Data are recorded prospectively every week. From the database, it is possible to assess whether a patient is working, on sick leave or retired at a certain time. Data on 417 Danish citizens treated with RT for PCa at Rigshospitalet, Copenhagen, between 1 January 2005 and 1 May 2010 were obtained from the database. The data were collected during a 2 year period from 1 year before RT to 1 year after RT. Among patients of working age, 75% were still available for work 1 year after RT. The degree of sick leave increased almost continuously in the year before the start of RT and reached a maximum of 56% during RT. After RT it gradually declined. There was no significant difference between the number of patients on sick leave 1 year after RT compared to 1 year before RT (p = 0.23). Patients spent a significantly higher number of weeks on sick leave in the year after the start of RT compared to the year before RT (p = 0.001). Except for a transient increase in sick leave during treatment, RT did not seem to affect the working lives of patients with PCa significantly.

  19. Misconceptions in Astronomy: Before and After a Constructivist Learning Environment

    Science.gov (United States)

    Ruzhitskaya, Lanika; Speck, A.

    2009-01-01

    We present results of a pilot study on college students’ misconceptions in astronomy. The study was conducted on the campus of a Midwestern university among 43 non-science major students enrolled in an introductory astronomy laboratory course. The laboratory course was based on a constructivist learning environment where students learned astronomy by doing astronomy. During the course, students worked with educational simulations created by Project CLEA team and RedShift College Education Astronomy Workbook by Bill Walker as well as were involved in think-pair-share discussions based on Lecture-Tutorials (Prather et al 2008). Several laboratories were prompted by an instructor's brief presentations. On the first and last days of the course students were surveyed on what their beliefs were about causes of the seasons, the moon's apparent size in the sky and its phases, planetary orbits, structure of the solar system, the sun, distant stars, and the nature of light. The majority of the surveys’ questions were based on Neil Comins’ 50 most commonly cited misconceptions. The outcome of the study showed that while students constructed correct understanding of a number of phenomena, they also created a set of new misconceptions. For example, if on the first day of the course, nine out of 43 students knew what caused the seasons on Earth; on the last day of the course, 20 students gained the similar understanding. However, by the end of the course more students believed that smaller planets must rotate faster based on the conservation of angular momentum and Kepler's laws. Our findings suggest that misconceptions pointed out by Neil Comins over a decade ago are still relevant today; and that learning based exclusively on simulations and collaborative group discussions does not necessarily produce the best results, but may set a ground for creating new misconceptions.

  20. Hospitalisation of older people before and after long-term care entry in Auckland, New Zealand.

    Science.gov (United States)

    Boyd, Michal; Broad, Joanna B; Zhang, Tony Xian; Kerse, Ngaire; Gott, Merryn; Connolly, Martin J

    2016-07-01

    global population projections forecast large growth in demand for long-term care (LTC) and acute hospital services for older people. Few studies report changes in hospitalisation rates before and after entry into LTC. This study compares hospitalisation rates 1 year before and after LTC entry. the Older Persons' Ability Level (OPAL) study was a 2008 census-type survey of LTC facilities in Auckland, New Zealand. OPAL resident hospital admissions and deaths were obtained from routinely collected national databases. all 2,244 residents (66% = female) who entered LTC within 12 months prior to OPAL were included. There were 3,363 hospitalisations, 2,424 in 12 months before and 939 in 12 months after entry, and 364 deaths. In the 6 to 12 months before LTC entry, the hospitalisation rate/100 person-years was 67.3 (95% confidence interval [CI] 62.5-72.1). Weekly rates then rose steeply to over 450/100 person-years in the 6 months immediately before LTC entry. In the 6 months after LTC entry, the rate fell to 49.1 (CI 44.9-53.3; RR 0.73 (CI 0.65-0.82, P < 0.0001)) and decreased further 6 to 12 months after entry to 41.1 (CI 37.1-45.1; rate ratio [RR] 0.61 (CI 0.54-0.69, P < 0.0001)). increased hospitalisations a few months before LTC entry suggest functional and medical instability precipitates LTC entry. New residents utilise hospital beds less frequently than when at home before that unstable period. Further research is needed to determine effective interventions to avoid some hospitalisations and possibly also LTC entry. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Liver volume, portal vein flow, and clearance of indocyanine green and antipyrine in hyperthyroidism before and after antithyroid treatment

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Sonne, J; Court-Payen, M

    1999-01-01

    The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment.......The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment....

  2. The effect of music on pain and vital signs of children before and after endoscopy.

    Science.gov (United States)

    Sabzevari, Alireza; Kianifar, Hamidreza; Jafari, Seyed Ali; Saeidi, Masumeh; Ahanchian, Hamid; Kiani, Mohammad Ali; Jarahi, Lida

    2017-07-01

    Gentle music has relaxing and pain reducing effects. In this study, the effect of music on patients' vital signs and pain was investigated before and after endoscopy. This clinical trial study was conducted on 100 children from seven to fourteen years of age in Gha'em Hospital, Mashhad in 2015. Children were divided into two equal groups (case group=50 and control group=50). The control group received endoscopy according to the standards, without any other procedure. For the case group, a classic musical piece by Clayderman was played during endoscopy (from the time of entering the endoscopy room to the end of the process). After conducting endoscopy, FALCC scale and Baker-Wong pain scale were filled for both groups. In addition, children's vital signs including: heart rate (pulse), diastolic and systolic blood pressure were measured before and after endoscopy for both groups. Data analysis was conducted using SPSS16 with the help of Mann-Whitney and Chi-square tests. No significant difference was found in age, gender distribution of case or control groups (p>0.05). Heart rate and diastolic blood pressure was significantly lower in the music (case) group compared to the control group before endoscopy (p=0.012). In addition, pain score in patients of the music group was lower than the control group (pmusic for children during endoscopy can reduce pain and anxiety in patients before and after endoscopy.

  3. Serum alanine aminotransferase levels, hematocrit rate and body weight correlations before and after hemodialysis session

    Directory of Open Access Journals (Sweden)

    Edmundo Pessoa Lopes

    2009-01-01

    Full Text Available PURPOSE: To evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis. PATIENTS AND METHODS: The serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients. RESULTS: The mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001. The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001 and hematocrit rate (r = 0.5; p < 0.001. A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001. Based on the ROC curve, the upper limit of the normal alanine aminotransferase level should be reduced by 40% relative to the upper limit of normal if the blood samples are collected before the hemodialysis session or by 60% if blood samples are collected after the session. CONCLUSION: In the present study, significant elevations in the serum alanine aminotransferase levels and hematocrit rates occurred in parallel to a reduction in body weight after the hemodialysis session. These findings suggest that one of the factors for low alanine aminotransferase levels prior to hemodialysis could be hemodilution in patients with chronic renal failure.

  4. Flotation performances and surface properties of chalcopyrite with xanthate collector added before and after grinding

    Science.gov (United States)

    Peng, Huiqing; Wu, Di; Abdelmonem, Mohamed

    In this study, effects of the collector added before grinding and after grinding on the subsequent flotation and mineral surface properties were investigated. The pH was controlled at 10 during the grinding and flotation processes opened to the atmosphere. With enough amounts of sodium butyl xanthate addition, adding the collector before grinding recovered more chalcopyrite than adding it after grinding in single mineral flotation. The Eh of each ground pulp before and after conditioning were measured and it was found that adding collector before grinding obtained higher and relatively suitable pulp potential for chalcopyrite flotation. Particle size analyses of the flotation products indicate that the different flotation recoveries occurred due to the different flotation losses in fine particles (<20 μm). XPS analyses focused on the fine particles of flotation feedings and found that more carbon and oxygen, and less iron were remained on mineral surfaces when the collector was added before grinding, due to the higher collector adsorption capacity, larger free oxygen adsorbance and less iron oxide/hydroxide species.

  5. Flicker electroretinograms of eyes with cataract recorded with RETeval system before and after mydriasis.

    Science.gov (United States)

    Miura, Gen; Baba, Takayuki; Oshitari, Toshiyuki; Yamamoto, Shuichi

    2018-01-01

    The aim of this study is to determine the effect of pupil size of eyes with cataracts on the flicker electroretinograms (ERGs) elicited and recorded with the RETeval system. Forty-one eyes of 41 patients (mean age, 76.5±7.3 years) that had grade 2 nuclear or