Environmental impact assessment. Investigation of marine mammals in relation to the establishment of a marine wind farm on Horns Reef

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-02-15

Elsamproject has decided to carry out an environmental impact assessment with the aim to investigate whether the establishment of a marine wind farm on Horns Reef may impact on breeding and non-breeding marine mammals, particularly harbour porpoise Phocoena phocoena and common seal Phoca vitulina. The marine mammals of the northern part of the German Bight can be characterised by a regular occurrence of harbour porpoise and common seal throughout the year, an irregular occurrence of grey seal Halichoerus grypus and white-beaked dolphin Lagenorhynchus albirostris and rare occurrences of white-sided dolphin Lagenorhynchus acutus, minke whale Balaenoptera acutorostrata, sperm whale Physeter macrocephalus, long-finned pilot whale Globicephala melas and killer whale Orcinus orca. The environment impact assessment therefore focuses on the evaluation of the possible effects on harbour porpoise and common seal. The investigation constitutes the first phase of a before-after-control-impact (BACI) analysis of the occurrence of harbour porpoise before, during and after the construction of the wind farm. (au)

Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis.

Directory of Open Access Journals (Sweden)

Sylvie Bastuji-Garin

Full Text Available 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.For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4 were selected. We compared the proportions of STROBE items (STROBE score adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007 and one post STROBE period (2008-2010. Segmented regression analysis of interrupted time series was also performed.Of the 456 included articles, 187 (41% reported cohort studies, 166 (36.4% cross-sectional studies, and 103 (22.6% case-control studies. The median STROBE score was 57% (range, 18%-98%. Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001 but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42. In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016. By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64 in the post STROBE statement publication.The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after

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.

Effect of a dam on epilithic algal communities of a mountain stream: before-after dam construction comparison

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Luciana Cibils Martina

2013-02-01

Full Text Available In this study we evaluated the effect of a dam on epilithic algal communities by analyzing community response after dam construction and by comparing community composition, structure and biomass upstream and downstream of the dam. Samples of epilithic algae and environmental data were collected at each site during high and low water periods before and after dam construction in Achiras Stream (Córdoba, Argentina. Ordinations showed modifications in algal assemblages after dam construction and downstream of the dam. Ordinations also suggested a loss of seasonality at the downstream site since the assemblages were similar between hydrological periods after dam construction. Indicator species, obtained by the Indicator Value method, showed that, after dam construction, there could have been an increase in nutrient concentration and a release of plankton from the impoundment. Abundance, richness and diversity were altered after dam construction as assessed by ANOVAs derived from a modified BACI Design. Proportion of early-successional species was higher at the upstream site while late-successional species were dominant at the downstream site, as predicted. Lower fluctuations in discharge downstream of the dam may have helped succession advance, whereas at the upstream site, mainly during the high water period, floods could have caused sloughing of life forms from the outer layers of the biofilm, resetting the algal community to early successional stages. It may be concluded that the dam affected algal community and favored succession advance mainly by reducing current velocity and flow fluctuations.

Ecosystem scale declines in elk recruitment and population growth with wolf colonization: a before-after-control-impact approach.

Science.gov (United States)

Christianson, David; Creel, Scott

2014-01-01

The reintroduction of wolves (Canis lupus) to Yellowstone provided the unusual opportunity for a quasi-experimental test of the effects of wolf predation on their primary prey (elk--Cervus elaphus) in a system where top-down, bottom-up, and abiotic forces on prey population dynamics were closely and consistently monitored before and after reintroduction. Here, we examined data from 33 years for 12 elk population segments spread across southwestern Montana and northwestern Wyoming in a large scale before-after-control-impact analysis of the effects of wolves on elk recruitment and population dynamics. Recruitment, as measured by the midwinter juvenile∶female ratio, was a strong determinant of elk dynamics, and declined by 35% in elk herds colonized by wolves as annual population growth shifted from increasing to decreasing. Negative effects of population density and winter severity on recruitment, long recognized as important for elk dynamics, were detected in uncolonized elk herds and in wolf-colonized elk herds prior to wolf colonization, but not after wolf colonization. Growing season precipitation and harvest had no detectable effect on recruitment in either wolf treatment or colonization period, although harvest rates of juveniles∶females declined by 37% in wolf-colonized herds. Even if it is assumed that mortality due to predation is completely additive, liberal estimates of wolf predation rates on juvenile elk could explain no more than 52% of the total decline in juvenile∶female ratios in wolf-colonized herds, after accounting for the effects of other limiting factors. Collectively, these long-term, large-scale patterns align well with prior studies that have reported substantial decrease in elk numbers immediately after wolf recolonization, relatively weak additive effects of direct wolf predation on elk survival, and decreased reproduction and recruitment with exposure to predation risk from wolves.

Ecosystem scale declines in elk recruitment and population growth with wolf colonization: a before-after-control-impact approach.

Directory of Open Access Journals (Sweden)

David Christianson

Full Text Available The reintroduction of wolves (Canis lupus to Yellowstone provided the unusual opportunity for a quasi-experimental test of the effects of wolf predation on their primary prey (elk--Cervus elaphus in a system where top-down, bottom-up, and abiotic forces on prey population dynamics were closely and consistently monitored before and after reintroduction. Here, we examined data from 33 years for 12 elk population segments spread across southwestern Montana and northwestern Wyoming in a large scale before-after-control-impact analysis of the effects of wolves on elk recruitment and population dynamics. Recruitment, as measured by the midwinter juvenile∶female ratio, was a strong determinant of elk dynamics, and declined by 35% in elk herds colonized by wolves as annual population growth shifted from increasing to decreasing. Negative effects of population density and winter severity on recruitment, long recognized as important for elk dynamics, were detected in uncolonized elk herds and in wolf-colonized elk herds prior to wolf colonization, but not after wolf colonization. Growing season precipitation and harvest had no detectable effect on recruitment in either wolf treatment or colonization period, although harvest rates of juveniles∶females declined by 37% in wolf-colonized herds. Even if it is assumed that mortality due to predation is completely additive, liberal estimates of wolf predation rates on juvenile elk could explain no more than 52% of the total decline in juvenile∶female ratios in wolf-colonized herds, after accounting for the effects of other limiting factors. Collectively, these long-term, large-scale patterns align well with prior studies that have reported substantial decrease in elk numbers immediately after wolf recolonization, relatively weak additive effects of direct wolf predation on elk survival, and decreased reproduction and recruitment with exposure to predation risk from wolves.

Effects of Gear Restriction on the Abundance of Juvenile Fishes along Sandy Beaches in Hawai'i.

Science.gov (United States)

Donovan, Mary K; Friedlander, Alan M; Usseglio, Paolo; Goodell, Whitney; Iglesias, Ily; Schemmel, Eva M; Stamoulis, Kostantinos A; Filous, Alexander; Giddens, Jonatha; Kamikawa, Keith; Koike, Haruko; McCoy, Kaylyn; Wall, Christopher B

2016-01-01

In 2007, due to growing concerns of declines in nearshore fisheries in Hawai'i, a ban on gillnets was implemented in designated areas around the island of O'ahu in the main Hawaiian Islands. Utilizing a 17 year time-series of juvenile fish abundance beginning prior to the implementation of the gillnet ban, we examined the effects of the ban on the abundance of juveniles of soft-bottom associated fish species. Using a Before-After-Control-Impact (BACI) sampling design, we compared the abundance of targeted fishery species in a bay where gillnet fishing was banned (Kailua, O'ahu), and an adjacent bay where fishing is still permitted (Waimānalo, O'ahu). Our results show that when multiple juvenile fish species were combined, abundance declined over time in both locations, but the pattern varied for each of the four species groups examined. Bonefishes were the only species group with a significant BACI effect, with higher abundance in Kailua in the period after the gillnet ban. This study addressed a need for scientific assessment of a fisheries regulation that is rarely possible due to lack of quality data before enactment of such restrictions. Thus, we developed a baseline status of juveniles of an important fishery species, and found effects of a fishery management regulation in Hawai'i.

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

Earthworm short-term response to dairy wastewater applied to a Salix plantation

DEFF Research Database (Denmark)

Krogh, Paul Henning; Jørgensen, Uffe; Berg Olsen, Anne

Odour is one problem in the management of waste water from dairy, thus the organic Thise Dairy has developed an all year round solution releasing the waste water into underground tubes at 30 cm depth in a willow energy crop plantation established in 2013. The wastewater contains 0.3% dry matter...... in the untreated control willow area, were established in Oct. 2017 and considered (non-randomized) blocks. In other words this was a Before-After-Control-Impact (BACI) design. Plots were sampled to estimate earthworm abundance one week before and one week after treatment (map link: goo.gl/tvvMuF). The willow...... was surrounded by an agricultural field with a history of wastewater fertilisation subject to an exploratory sampling. - We found seven species of earthworms in the willow and five in the agricultural soil. Juveniles of A. tuberculata, A. caliginosa, L. herculeus, L. castaneus, are morphologically intrageneric...

Effects of wind-energy facilities on grassland bird distributions

Science.gov (United States)

Shaffer, Jill A.; Buhl, Deb

2016-01-01

The contribution of renewable energy to meet worldwide demand continues to grow. Wind energy is one of the fastest growing renewable sectors, but new wind facilities are often placed in prime wildlife habitat. Long-term studies that incorporate a rigorous statistical design to evaluate the effects of wind facilities on wildlife are rare. We conducted a before-after-control-impact (BACI) assessment to determine if wind facilities placed in native mixed-grass prairies displaced breeding grassland birds. During 2003–2012, we monitored changes in bird density in 3 study areas in North Dakota and South Dakota (U.S.A.). We examined whether displacement or attraction occurred 1 year after construction (immediate effect) and the average displacement or attraction 2–5 years after construction (delayed effect). We tested for these effects overall and within distance bands of 100, 200, 300, and >300 m from turbines. We observed displacement for 7 of 9 species. One species was unaffected by wind facilities and one species exhibited attraction. Displacement and attraction generally occurred within 100 m and often extended up to 300 m. In a few instances, displacement extended beyond 300 m. Displacement and attraction occurred 1 year after construction and persisted at least 5 years. Our research provides a framework for applying a BACI design to displacement studies and highlights the erroneous conclusions that can be made without the benefit of adopting such a design. More broadly, species-specific behaviors can be used to inform management decisions about turbine placement and the potential impact to individual species. Additionally, the avoidance distance metrics we estimated can facilitate future development of models evaluating impacts of wind facilities under differing land-use scenarios.

Chernobyl: before and after. Information sheet No. 1

Energy Technology Data Exchange (ETDEWEB)

Devine, J [comp.

1986-01-01

Complied in June 1986 the information sheet lists title, authors, and journal details and gives brief details of all relevant published articles. Part 1 concerns material relevant before the accident in April 1986 - the construction, design and safety of the Chernobyl RBMK nuclear power station (20 references). Part 2 lists articles published after the accident concerning the impact of the disaster on safety in the nuclear power industry (23 references).

Effects of wind-energy facilities on breeding grassland bird distributions.

Science.gov (United States)

Shaffer, Jill A; Buhl, Deborah A

2016-02-01

The contribution of renewable energy to meet worldwide demand continues to grow. Wind energy is one of the fastest growing renewable sectors, but new wind facilities are often placed in prime wildlife habitat. Long-term studies that incorporate a rigorous statistical design to evaluate the effects of wind facilities on wildlife are rare. We conducted a before-after-control-impact (BACI) assessment to determine if wind facilities placed in native mixed-grass prairies displaced breeding grassland birds. During 2003-2012, we monitored changes in bird density in 3 study areas in North Dakota and South Dakota (U.S.A.). We examined whether displacement or attraction occurred 1 year after construction (immediate effect) and the average displacement or attraction 2-5 years after construction (delayed effect). We tested for these effects overall and within distance bands of 100, 200, 300, and >300 m from turbines. We observed displacement for 7 of 9 species. One species was unaffected by wind facilities and one species exhibited attraction. Displacement and attraction generally occurred within 100 m and often extended up to 300 m. In a few instances, displacement extended beyond 300 m. Displacement and attraction occurred 1 year after construction and persisted at least 5 years. Our research provides a framework for applying a BACI design to displacement studies and highlights the erroneous conclusions that can be made without the benefit of adopting such a design. More broadly, species-specific behaviors can be used to inform management decisions about turbine placement and the potential impact to individual species. Additionally, the avoidance distance metrics we estimated can facilitate future development of models evaluating impacts of wind facilities under differing land-use scenarios. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Lasting impact of an implemented self-management programme for people with type 2 diabetes referred from primary care: a one-group, before-after design.

Science.gov (United States)

Fløde, Mari; Iversen, Marjolein M; Aarflot, Morten; Haltbakk, Johannes

2017-12-01

Research interventions in uniform clinical settings and in patients fulfilling well-defined inclusion criteria might show a more pronounced effect than implementing the same intervention in existing practice. Diabetes Self-Management Education (DSME) is complex, and should be assessed in existing practice as it is an intervention widely implemented. To examine the impact of an established group-based DSME in unselected people with type 2 diabetes referred from primary care. A one-group, before-after design was used for assessments before, immediately after, and 3 months after participation in a group-based DSME programme conducted at two Learning and Mastering Centres in Norway between November 2013 and June 2014. Participants completed a questionnaire before (n = 115), immediately after (n = 95) and 3 months after (n = 42) the DSME programme. Primary outcome measure was diabetes knowledge (Michigan Diabetes Knowledge Test). Also patient activation (Patient Activation Measure [PAM]) and self-efficacy (General Self-Efficacy scale [GSE]) were measured. Changes in outcome measures were analysed using paired t-tests for normally distributed data and Wilcoxon signed-rank test for skewed data. Mean knowledge improved significantly from baseline (p < 0.001). Changes persisted at the 3-month assessment. Mean PAM scores improved significantly from baseline (p < 0.001), and changes persisted for 3 months. Mean GSE scores improved from baseline (p = 0.022) and persisted for 3 months. However, when results were stratified for participants who responded at all three time points, GSE showed no change during the study period. The complexity self-management in the individual is challenging to reflect in DSME. This implemented DSME programme for people with type 2 diabetes improved levels of diabetes knowledge and patient activation, persisting for at least 3 months. Hence, the DSME programme appears to be robust beyond standardised research settings, in educating unselected

Effects of highway construction on stream water quality and macroinvertebrate condition in a mid-atlantic highlands watershed, USA.

Science.gov (United States)

Chen, Yushun; Viadero, Roger C; Wei, Xinchao; Fortney, Ronald; Hedrick, Lara B; Welsh, Stuart A; Anderson, James T; Lin, Lian-Shin

2009-01-01

Refining best management practices (BMPs) for future highway construction depends on a comprehensive understanding of environmental impacts from current construction methods. Based on a before-after-control impact (BACI) experimental design, long-term stream monitoring (1997-2006) was conducted at upstream (as control, n = 3) and downstream (as impact, n = 6) sites in the Lost River watershed of the Mid-Atlantic Highlands region, West Virginia. Monitoring data were analyzed to assess impacts of during and after highway construction on 15 water quality parameters and macroinvertebrate condition using the West Virginia stream condition index (WVSCI). Principal components analysis (PCA) identified regional primary water quality variances, and paired t tests and time series analysis detected seven highway construction-impacted water quality parameters which were mainly associated with the second principal component. In particular, impacts on turbidity, total suspended solids, and total iron during construction, impacts on chloride and sulfate during and after construction, and impacts on acidity and nitrate after construction were observed at the downstream sites. The construction had statistically significant impacts on macroinvertebrate index scores (i.e., WVSCI) after construction, but did not change the overall good biological condition. Implementing BMPs that address those construction-impacted water quality parameters can be an effective mitigation strategy for future highway construction in this highlands region.

Safety impacts of platform tram stops on pedestrians in mixed traffic operation: A comparison group before-after crash study.

Science.gov (United States)

Naznin, Farhana; Currie, Graham; Logan, David; Sarvi, Majid

2016-01-01

Tram stops in mixed traffic environments present a variety of safety, accessibility and transport efficiency challenges. In Melbourne, Australia the hundred year-old electric tram system is progressively being modernized to improve passenger accessibility. Platform stops, incorporating raised platforms for level entry into low floor trams, are being retro-fitted system-wide to replace older design stops. The aim of this study was to investigate the safety impacts of platform stops over older design stops (i.e. Melbourne safety zone tram stops) on pedestrians in the context of mixed traffic tram operation in Melbourne, using an advanced before-after crash analysis approach, the comparison group (CG) method. The CG method evaluates safety impacts by taking into account the general trends in safety and the unobserved factors at treatment and comparison sites that can alter the outcomes of a simple before-after analysis. The results showed that pedestrian-involved all injury crashes reduced by 43% after platform stop installation. This paper also explores a concern that the conventional CG method might underestimate safety impacts as a result of large differences in passenger stop use between treatment and comparison sites, suggesting differences in crash risk exposure. To adjust for this, a modified analysis explored crash rates (crash counts per 10,000 stop passengers) for each site. The adjusted results suggested greater reductions in pedestrian-involved crashes after platform stop installation: an 81% reduction in pedestrian-involved all injury crashes and 86% reduction in pedestrian-involved FSI crashes, both are significant at the 95% level. Overall, the results suggest that platform stops have considerable safety benefits for pedestrians. Implications for policy and areas for future research are explored. Copyright © 2015 Elsevier Ltd. All rights reserved.

A systematic review of the effectiveness of liming to mitigate impacts of river acidification on fish and macro-invertebrates

International Nuclear Information System (INIS)

Mant, Rebecca C.; Jones, David L.; Reynolds, Brian; Ormerod, Steve J.; Pullin, Andrew S.

2013-01-01

The addition of calcium carbonate to catchments or watercourses – liming – has been used widely to mitigate freshwater acidification but the abatement of acidifying emissions has led to questions about its effectiveness and necessity. We conducted a systematic review and meta-analysis of the impact of liming streams and rivers on two key groups of river organisms: fish and invertebrates. On average, liming increased the abundance and richness of acid-sensitive invertebrates and increased overall fish abundance, but benefits were variable and not guaranteed in all rivers. Where B-A-C-I designs (before-after-control-impact) were used to reduce bias, there was evidence that liming decreased overall invertebrate abundance. This systematic review indicates that liming has the potential to mitigate the symptoms of acidification in some instances, but effects are mixed. Future studies should use robust designs to isolate recovery due to liming from decreasing acid deposition, and assess factors affecting liming outcomes. -- Highlights: •In a systematic review and meta-analysis, we asked how river liming affected fish and invertebrates. •On average, liming increased fish abundance. •Liming also increased average abundance and richness of acid-sensitive invertebrates. •However, benefits were variable and not guaranteed in all acidified rivers. -- A systematic review showed lime application to acidified rivers increased average fish abundance, and abundance and richness in acid-sensitive invertebrates, but not always

LIDAR Correlation to Extreme Flapwise Moment : Gust Impact Prediction Time and Feedforward Control

DEFF Research Database (Denmark)

Meseguer Urban, Albert; Hansen, Morten Hartvig

A Conventional wind turbine controller uses feedback parameters reacting to wind disturbances after they have already impacted the rotor. LIDARs are able to measure the wind speed before it reaches the wind turbine rotor. These anticipated values can be used in control systems designed to reduce...

Satellite remote sensing reveals a positive impact of living oyster reefs on microalgal biofilm development

Science.gov (United States)

Echappé, Caroline; Gernez, Pierre; Méléder, Vona; Jesus, Bruno; Cognie, Bruno; Decottignies, Priscilla; Sabbe, Koen; Barillé, Laurent

2018-02-01

Satellite remote sensing (RS) is routinely used for the large-scale monitoring of microphytobenthos (MPB) biomass in intertidal mudflats and has greatly improved our knowledge of MPB spatio-temporal variability and its potential drivers. Processes operating on smaller scales however, such as the impact of benthic macrofauna on MPB development, to date remain underinvestigated. In this study, we analysed the influence of wild Crassostrea gigas oyster reefs on MPB biofilm development using multispectral RS. A 30-year time series (1985-2015) combining high-resolution (30 m) Landsat and SPOT data was built in order to explore the relationship between C. gigas reefs and MPB spatial distribution and seasonal dynamics, using the normalized difference vegetation index (NDVI). Emphasis was placed on the analysis of a before-after control-impact (BACI) experiment designed to assess the effect of oyster killing on the surrounding MPB biofilms. Our RS data reveal that the presence of oyster reefs positively affects MPB biofilm development. Analysis of the historical time series first showed the presence of persistent, highly concentrated MPB patches around oyster reefs. This observation was supported by the BACI experiment which showed that killing the oysters (while leaving the physical reef structure, i.e. oyster shells, intact) negatively affected both MPB biofilm biomass and spatial stability around the reef. As such, our results are consistent with the hypothesis of nutrient input as an explanation for the MPB growth-promoting effect of oysters, whereby organic and inorganic matter released through oyster excretion and biodeposition stimulates MPB biomass accumulation. MPB also showed marked seasonal variations in biomass and patch shape, size and degree of aggregation around the oyster reefs. Seasonal variations in biomass, with higher NDVI during spring and autumn, were consistent with those observed on broader scales in other European mudflats. Our study provides the

Understanding the hydrologic impacts of wastewater treatment plant discharge to shallow groundwater: Before and after plant shutdown

Science.gov (United States)

Hubbard, Laura E.; Keefe, Steffanie H.; Kolpin, Dana W.; Barber, Larry B.; Duris, Joseph W.; Hutchinson, Kasey J.; Bradley, Paul M.

2016-01-01

Effluent-impacted surface water has the potential to transport not only water, but wastewater-derived contaminants to shallow groundwater systems. To better understand the effects of effluent discharge on in-stream and near-stream hydrologic conditions in wastewater-impacted systems, water-level changes were monitored in hyporheic-zone and shallow-groundwater piezometers in a reach of Fourmile Creek adjacent to and downstream of the Ankeny (Iowa, USA) wastewater treatment plant (WWTP). Water-level changes were monitored from approximately 1.5 months before to 0.5 months after WWTP closure. Diurnal patterns in WWTP discharge were closely mirrored in stream and shallow-groundwater levels immediately upstream and up to 3 km downstream of the outfall, indicating that such discharge was the primary control on water levels before shutdown. The hydrologic response to WWTP shutdown was immediately observed throughout the study reach, verifying the far-reaching hydraulic connectivity and associated contaminant transport risk. The movement of WWTP effluent into alluvial aquifers has implications for potential WWTP-derived contamination of shallow groundwater far removed from the WWTP outfall.

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

Faunal and vegetation monitoring in response to harbor dredging in the Port of Miami

Science.gov (United States)

Daniels, Andre; Stevenson, Rachael; Smith, Erin; Robblee, Michael

2018-04-11

Seagrasses are highly productive ecosystems. A before-after-control-impact (BACI) design was used to examine effects of dredging on seagrasses and the animals that inhabit them. The control site North Biscayne Bay and the affected site Port of Miami had seagrass densities decrease during both the before, Fish and Invertebrate Assessment Network 2006-2011, and after, Faunal Monitoring in Response to Harbor Dredging 2014-2016, studies. Turbidity levels increased at North Biscayne Bay and Port of Miami basins during the Faunal Monitoring in Response to Harbor Dredging study, especially in 2016. Animal populations decreased significantly in North Biscayne Bay and Port of Miami in the Faunal Monitoring in Response to Harbor Dredging study compared to the Fish and Invertebrate Assessment Network study. Predictive modeling shows that numbers of animal populations will likely continue to decrease if the negative trends in seagrass densities continue unabated. There could be effects on several fisheries vital to the south Florida economy. Additional research could determine if animal populations and seagrass densities have rebounded or continued to decrease.

Hepatic encephalopathy before and neurological complications after liver transplantation have no impact on the employment status 1 year after transplantation

OpenAIRE

Pflugrad, Henning; Tryc, Anita B; Goldbecker, Annemarie; Strassburg, Christian P; Barg-Hock, Hannelore; Klempnauer, J?rgen; Weissenborn, Karin

2017-01-01

AIM To investigate the impact of hepatic encephalopathy before orthotopic liver transplantation (OLT) and neurological complications after OLT on employment after OLT. METHODS One hundred and fourteen patients with chronic liver disease aged 18-60 years underwent neurological examination to identify neurological complications, neuropsychological tests comprising the PSE-Syndrome-Test yielding the psychometric hepatic encephalopathy score, the critical flicker frequency and the Repeatable Batt...

Review of the effects of in-stream pipeline crossing construction on aquatic ecosystems and examination of Canadian methodologies for impact assessment.

Science.gov (United States)

Lévesque, Lucie M; Dubé, Monique G

2007-09-01

Pipeline crossing construction alters river and stream channels, hence may have detrimental effects on aquatic ecosystems. This review examines the effects of crossing construction on fish and fish habitat in rivers and streams, and recommends an approach to monitoring and assessment of impacts associated with these activities. Pipeline crossing construction is shown to not only compromise the integrity of the physical and chemical nature of fish habitat, but also to affect biological habitat (e.g., benthic invertebrates and invertebrate drift), and fish behavior and physiology. Indicators of effect include: water quality (total suspended solids TSS), physical habitat (substrate particle size, channel morphology), benthic invertebrate community structure and drift (abundance, species composition, diversity, standing crop), and fish behavior and physiology (hierarchy, feeding, respiration rate, loss of equilibrium, blood hematocrit and leukocrit levels, heart rate and stroke volume). The Before-After-Control-Impact (BACI) approach, which is often applied in Environmental Effects Monitoring (EEM), is recommended as a basis for impact assessment, as is consideration of site-specific sensitivities, assessment of significance, and cumulative effects.

Design of a multi-site multi-state clinical trial of home monitoring of chronic disease in the community in Australia.

Science.gov (United States)

Celler, Branko G; Sparks, Ross; Nepal, Surya; Alem, Leila; Varnfield, Marlien; Li, Jane; Jang-Jaccard, Julian; McBride, Simon J; Jayasena, Rajiv

2014-12-15

Telehealth services based on at-home monitoring of vital signs and the administration of clinical questionnaires are being increasingly used to manage chronic disease in the community, but few statistically robust studies are available in Australia to evaluate a wide range of health and socio-economic outcomes. The objectives of this study are to use robust statistical methods to research the impact of at home telemonitoring on health care outcomes, acceptability of telemonitoring to patients, carers and clinicians and to identify workplace cultural factors and capacity for organisational change management that will impact on large scale national deployment of telehealth services. Additionally, to develop advanced modelling and data analytics tools to risk stratify patients on a daily basis to automatically identify exacerbations of their chronic conditions. A clinical trial is proposed at five locations in five states and territories along the Eastern Seaboard of Australia. Each site will have 25 Test patients and 50 case matched control patients. All participants will be selected based on clinical criteria of at least two hospitalisations in the previous year or four or more admissions over the last five years for a range of one or more chronic conditions. Control patients are matched according to age, sex, major diagnosis and their Socio-Economic Indexes for Areas (SEIFA). The Trial Design is an Intervention control study based on the Before-After-Control-Impact (BACI) design. Our preliminary data indicates that most outcome variables before and after the intervention are not stationary, and accordingly we model this behaviour using linear mixed-effects (lme) models which can flexibly model within-group correlation often present in longitudinal data with repeated measures. We expect reduced incidence of unscheduled hospitalisation as well as improvement in the management of chronically ill patients, leading to better and more cost effective care. Advanced data

Response of benthic macroinvertebrate communities to highway construction in an Appalachian watershed

Science.gov (United States)

Hedrick, Lara B.; Welsh, S.A.; Anderson, James T.; Lin, L.-S.; Chen, Y.; Wei, X.

2010-01-01

Highway construction in mountainous areas can result in sedimentation of streams, negatively impacting stream habitat, water quality, and biotic communities. We assessed the impacts of construction of a segment of Corridor H, a four-lane highway, in the Lost River watershed, West Virginia, by monitoring benthic macroinvertebrate communities and water quality, before, during, and after highway construction and prior to highway use at upstream and downstream sites from 1997 through 2007. Data analysis of temporal impacts of highway construction followed a Before-After-Control-Impact (BACI) study design. Highway construction impacts included an increase in stream sedimentation during the construction phase. This was indicated by an increase in turbidity and total suspended solids. Benthic macroinvertebrate metrics indicated a community more tolerant during and after construction than in the period before construction. The percent of Chironomidae and the Hilsenhoff Biotic Index (HBI) increased, while percent of Ephemeroptera, Plecoptera, and Trichoptera (EPT) decreased. Our 10-year study addressed short-term impacts of highway construction and found that impacts were relatively minimal. A recovery of the number of EPT taxa collected after construction indicated that the benthic macroinvertebrate community may be recovering from impacts of highway construction. However, this study only addressed a period of 3 years before, 3 years during, and 4 years post construction. Inferences cannot be made concerning the long-term impacts of the highway, highway traffic, runoff, and other factors associated with highway use. Continual monitoring of the watershed is necessary to determine if the highway has a continual impact on stream habitat, water quality, and biotic integrity. ?? 2010 Springer Science+Business Media B.V.

Women's mental health before, during, and after pregnancy: a population-based controlled cohort study.

Science.gov (United States)

van Bussel, Johan C H; Spitz, Bernard; Demyttenaere, Koen

2006-12-01

Common mental health disorders like depressive and anxiety disorders are frequent in antenatal and postpartum women. However, no agreement about the prevalence of these disorders and the course of women's mental health during the transition to motherhood exists. This study compared women's mental health before, during, and after pregnancy with a control group of nonpregnant women. Three hundred and twenty-four women were assessed before, during, and after their pregnancy with the 12-item version of the General Health Questionnaire (GHQ-12). A control group of 324 women who did not deliver during 3 subsequent years was assessed with the GHQ-12 at corresponding time-points. No differences in GHQ-12 mean scores, prevalence, and incidence of common mental health disorders between the study and control groups were found. No differences in prevalence and incidence rates within each group were found. The presence of a common mental health disorder before pregnancy or in early pregnancy predicted common mental health disorders in the postpartum period. Common mental health disorders are frequent during pregnancy and the postpartum period, but pregnant or postpartum women are not more at risk than those who are not pregnant or who did not deliver.

The effects of run-of-river hydroelectric power schemes on invertebrate community composition in temperate streams and rivers.

Science.gov (United States)

Bilotta, Gary S; Burnside, Niall G; Turley, Matthew D; Gray, Jeremy C; Orr, Harriet G

2017-01-01

Run-of-river (ROR) hydroelectric power (HEP) schemes are often presumed to be less ecologically damaging than large-scale storage HEP schemes. However, there is currently limited scientific evidence on their ecological impact. The aim of this article is to investigate the effects of ROR HEP schemes on communities of invertebrates in temperate streams and rivers, using a multi-site Before-After, Control-Impact (BACI) study design. The study makes use of routine environmental surveillance data collected as part of long-term national and international monitoring programmes at 22 systematically-selected ROR HEP schemes and 22 systematically-selected paired control sites. Five widely-used family-level invertebrate metrics (richness, evenness, LIFE, E-PSI, WHPT) were analysed using a linear mixed effects model. The analyses showed that there was a statistically significant effect (p<0.05) of ROR HEP construction and operation on the evenness of the invertebrate community. However, no statistically significant effects were detected on the four other metrics of community composition. The implications of these findings are discussed in this article and recommendations are made for best-practice study design for future invertebrate community impact studies.

Using 'nudge' principles for order set design: a before and after evaluation of an electronic prescribing template in critical care.

Science.gov (United States)

Bourdeaux, Christopher P; Davies, Keith J; Thomas, Matthew J C; Bewley, Jeremy S; Gould, Timothy H

2014-05-01

Computerised order sets have the potential to reduce clinical variation and improve patient safety but the effect is variable. We sought to evaluate the impact of changes to the design of an order set on the delivery of chlorhexidine mouthwash and hydroxyethyl starch (HES) to patients in the intensive care unit. The study was conducted at University Hospitals Bristol NHS Foundation Trust, UK. Our intensive care unit uses a clinical information system (CIS). All drugs and fluids are prescribed with the CIS and drug and fluid charts are stored within a database. Chlorhexidine mouthwash was added as a default prescription to the prescribing template in January 2010. HES was removed from the prescribing template in April 2009. Both interventions were available to prescribe manually throughout the study period. We conducted a database review of all patients eligible for each intervention before and after changes to the configuration of choices within the prescribing system. 2231 ventilated patients were identified as appropriate for treatment with chlorhexidine, 591 before the intervention and 1640 after. 55.3% were prescribed chlorhexidine before the change and 90.4% after (p<0.001). 6199 patients were considered in the HES intervention, 2177 before the intervention and 4022 after. The mean volume of HES infused per patient fell from 630 mL to 20 mL after the change (p<0.001) and the percentage of patients receiving HES fell from 54.1% to 3.1% (p<0.001). These results were well sustained with time. The presentation of choices within an electronic prescribing system influenced the delivery of evidence-based interventions in a predictable way and the effect was well sustained. This approach has the potential to enhance the effectiveness of computerised order sets.

Extending the liaison psychiatry service in a large hospital in the UK: a before and after evaluation of the economic impact and patient care following ED attendances for self-harm

NARCIS (Netherlands)

Opmeer, Brent C.; Hollingworth, William; Marques, Elsa M. R.; Margelyte, Ruta; Gunnell, David

2017-01-01

Objectives To evaluate the impact of an expansion of liaison psychiatry services (LPS) on patient management, outcomes and treatment costs for emergency department (ED) attendances for self-harm. Design Retrospective before and after cohort study using routinely collected Self-Harm Surveillance

Impact of the PROVAUR stewardship programme on linezolid resistance in a tertiary university hospital: a before-and-after interventional study.

Science.gov (United States)

García-Martínez, Lucrecia; Gracia-Ahulfinger, Irene; Machuca, Isabel; Cantisán, Sara; De La Fuente, Soraya; Natera, Clara; Pérez-Nadales, Elena; Vidal, Elisa; Rivero, Antonio; Rodríguez-Lopez, Fernando; Del Prado, José Ramón; Torre-Cisneros, Julián

2016-09-01

There is little evidence of the impact of antimicrobial stewardship programmes on antimicrobial resistance. To study the efficacy and safety of a package of educational and interventional measures to optimize linezolid use and its impact on bacterial resistance. A quasi-experimental study was designed and carried out before and after implementation of a stewardship programme in hospitalized patients with Gram-positive infections treated with linezolid. The intervention reduced linezolid consumption by 76%. The risk of linezolid-resistant CoNS isolates (OR = 0.37; 95% CI = 0.27-0.49; P linezolid use can contribute to reducing the resistance rate of CoNS and E. faecalis to this antibiotic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Impact of exploratory offshore drilling on benthic communities in the Minerva gas field, Port Campbell, Australia

Energy Technology Data Exchange (ETDEWEB)

Currie, D.R.; Isaacs, L.R. [Central Queensland Univ., Gladstone (Australia). Centre for Environmental Management

2005-04-01

Changes to benthic infauna caused by exploratory gas drilling operations in the Minerva field were examined experimentally using a BACI (before, after, control, impact) design. Analysis of 72 x 0.1 m{sup 2} Smith-McIntyre grab samples obtained from one pre-drilling and three post-drilling periods yielded a diverse fauna consisting of 196 invertebrate species and 5035 individuals. Changes to benthic community structure were assessed using ANOVA and nonmetric multidimensional scaling (MDS). The abundances of two common species (Apseudes sp. 1 and Prionospio coorilla) decreased significantly at the well-head site immediately after drilling. The size of these reductions in abundance ranged between 71% and 88%, and persisted for less than 4 months after drilling. A third common species (Katlysia sp. 1) increased in abundance 200 m east of the well-head following drilling. Most species occurred at densities too low to be analysed individually and so were pooled at higher taxonomic levels. Changes in the abundance of species aggregated by phylum varied, but significant declines in the most abundant phyla (Crustaceans and Polychaetes) of 45-73% were observed at all sites within a 100 m radius of the well-head following drilling. In most cases these changes became undetectable four months after drilling following species recruitments. MDS ordinations confirm that drilling related changes to benthic community structure are most pronounced at stations located closest to the well-head. Additionally, the ordinations indicate that modified communities persist at the well-head for more than 11 months following exploratory drilling. (author)

Impact of cleft lip and/or palate in children on family quality of life before and after reconstructive surgery.

Science.gov (United States)

Macho, P; Bohac, M; Fedeles, J; Fekiacova, D; Fedeles, J

2017-01-01

The aim of the study was to evaluate the impact of cleft lip/palate children together with consequent treatment on quality of family life using standardized questionnaire. Different to previous studies the evaluation of quality of family life by questionnaire was realized twice in the same group of families (before the reconstructive surgery and several months after palatoplasty). The study was conducted in 40 families divided in two groups: 20 families with children with cleft lip (CL), 20 families with children with cleft lip and palate (CLP). The questionnaire of the Impact on Family Scale was used for evaluation of the influence of orofacial clefts on parent´s quality of life. Evaluations were made at the second month of child´s life and at one year of child´s life with reciprocally comparison. The higher impact of children with CLP on quality of family life was noted at 2 months and 1 year of child's age as compared to the impact of children with CL. The reduction of impact on quality of life after surgical correction was observed in families of children with CL at one year of child's age. This decrease of influence on family quality of life was due to significantly lower impact in strain and economic dimensions in families with CL children after operation. However, in the group of families with CLP children no significant changes in the impact on family quality of life were noted when compared to the values before and shortly after the reconstructive surgery. This study showed that orofacial clefts in children influence markedly the quality of their family life. The higher impact of children with CLP on quality of family life as compared to children with CL was noted and this impact in CLP group was not influenced shortly after reconstructive surgery. It is suggested that appropriate medical care in Cleft Centre with special psychological support may lead to improvement in quality of life for families with cleft lip and palate children (Tab. 2, Fig. 2, Ref

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

Serum endocan levels before and after surgery on low-grade gliomas.

Science.gov (United States)

Tanriverdi, Taner; Kemerdere, Rahsan; Inal, Berrin B; Yuksel, Odhan; Emre, Humeyra O; Ahmedov, Merdin; Baran, Oguz; Ates, Seda

2017-01-01

Endocan has been shown to be a marker for several cancers and may show degree of malignancy. The aim of this study is to assess serum levels of endocan before and after surgery on low-grade gliomas (LGGs). Endocan was assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits in a total of 19 patients and 12 controls. Serial serum samples were obtained before and after surgery (1 st day, 1 st week, and 1 st month of surgery). Control samples were collected from cord blood during cesarean section. The results were compared with control brain tissues. Controls showed significantly lower serum endocan levels compared to before and after surgery ( P < 0.05). There is a trend of increase in mean serum levels from before surgery and during the very early period after surgery (during first week); however, in the first month, mean serum levels became lower. Endocan, a vital molecule for angiogenesis, is highly expressed before and after surgery in LGGs, but long-term data is needed. Furthermore, future studies should include high-grade gliomas to discuss whether endocan is associated with recurrence and response to treatment.

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...

Water Quality Monitoring in the Execution of Canal Remediation Methods in the Florida Keys

Science.gov (United States)

Serna, A.; Briceno, H.

2016-02-01

Monitoring data indicate relatively high nutrient concentrations in waters close to shore along the Florida Keys, and corresponding responses from the system, such as higher phytoplankton biomass, turbidity and light attenuation as well as lower oxygenation and lower salinities of the water column. These changes, associated to human impact, have become more obvious near canal mouths. Waters close to shore show characteristics closely related to those in residential canals, affected by quick movement of infiltrated runoff and wastewaters (septic tanks), tides and high water table. Many canals do not meet the minimum water quality (WQ) criteria established by the State of Florida and are a potential source of contaminants to near shore waters designated as Outstanding Florida Waters. Canal remediation is being conducted by the Monroe County targeting poor circulation and organic matter accumulation. The restoration technologies include reduction in weed wrack, enhanced circulation, organic removal and partial backfilling. The objective of WQ monitoring is to measure the status and trends of WQ parameters to evaluate progress toward achieving and maintaining WQ standards and protecting/restoring the living marine resources. Monitoring followed a Before-and-After-Control-Impact scheme (BACI). Field measurements, included diel observations and vertical profiles of physical-chemical properties (salinity, DO, %DO saturation, temperature and turbidity) and nutrient analysis. Comparing profiles between remediated and control canals indicated similar patterns in physicochemical properties, and suggesting larger seasonal than spatial variability. BACI diel observations, in surface and bottom waters of remediated canals indicated little difference for surface waters, but significant improvements for bottom waters. Most surface waters are well oxygenated, while bottom waters show a significant increase in DO following culvert installation.

An Empirical Bayes before-after evaluation of road safety effects of a new motorway in Norway.

Science.gov (United States)

Elvik, Rune; Ulstein, Heidi; Wifstad, Kristina; Syrstad, Ragnhild S; Seeberg, Aase R; Gulbrandsen, Magnus U; Welde, Morten

2017-11-01

This paper presents an Empirical Bayes before-after evaluation of the road safety effects of a new motorway (freeway) in Østfold county, Norway. The before-period was 1996-2002. The after-period was 2009-2015. The road was rebuilt from an undivided two-lane road into a divided four-lane road. The number of killed or seriously injured road users was reduced by 75 percent, controlling for (downward) long-term trends and regression-to-the-mean (statistically significant at the 5 percent level; recorded numbers 71 before, 11 after). There were small changes in the number of injury accidents (185 before, 123 after; net effect -3%) and the number of slightly injured road users (403 before 279 after; net effect +5%). Motorways appear to mainly reduce injury severity, not the number of accidents. The paper discusses challenges in implementing the Empirical Bayes design when less than ideal data are available. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

Science.gov (United States)

Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak

2015-01-01

Background Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students’ motivation to study. Design and methods An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students’ academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS). Cronbach’s alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance. Results Students’ academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students’ self-esteem and feeling of self-worth (PAmotivation level declined significantly (P<0.001). The change of academic motivational constructs before and after the intervention was altogether significant (P=0.036, multivariate analysis of variance). Conclusion After experiencing a three-day intervention, the new students’ motivation advanced along the continuum of self-determination toward autonomous motivation. Therefore, it is considered to be worthwhile conducting an academic intervention to

Adrenal hormones before and after venography during adrenal venous sampling: a self-controlled study.

Science.gov (United States)

Koike, Yuya; Matsui, Seishi; Omura, Masao; Makita, Kohzoh; Obara, Alfonso W D; Moriya, Nobukazu; Nishikawa, Tetsuo

2017-03-01

A stress reaction involving increased adrenal hormone release occurs when starting adrenal venous sampling (AVS). The purpose of the present study was to investigate the effect of single shot venography on adrenal hormone production during AVS. This was a prospective self-controlled study. We enrolled 54 consecutive patients (21 men, 33 women; mean age 52 ± 11 years) with primary aldosteronism who underwent AVS from May 2014 to February 2015. Under non-stimulated conditions, blood samples were obtained from a common trunk of the left adrenal vein before and after single shot venography. The initial plasma aldosterone and cortisol concentration (PAC and PCC) were compared with those measured after venography for each patient. PAC and PCC were slightly but significantly decreased between before and after venography (after log transformation 2.12 ± 0.73 vs 2.07 ± 0.72, P = 0.00066, 1.89 ± 0.52 vs 1.83 ± 0.53, P = 0.00031, respectively). During non-stimulated left AVS, adrenal hormone secretion was slightly but significantly decreased after venography, similar to the normal time-related stress reaction. Venography did not increase the adrenal hormone secretion.

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.

Short-term responses to watershed logging on biomass mercury and methylmercury accumulation by periphyton in boreal lakes

Energy Technology Data Exchange (ETDEWEB)

Desrosiers, M.; Planas, D. [Quebec Univ., Montreal, PQ (Canada). Dept. de sciences biologiques; Mucci, A. [McGill Univ., Montreal, PQ (Canada). Dept. of Earth and Planetary Sciences

2006-08-15

Increased timber harvesting in the boreal regions of Quebec may have a significant impact on aquatic ecosystems. Watershed disturbances such as logging increase chemical loading to lakes. Soil in the Canadian Shield readily adsorbs and accumulates mercury (Hg) from atmospheric deposition. Forest watersheds serve as large reservoirs of Hg that shed their metal load when soil and land hydrology are disrupted. This paper presented the results of a study evaluating the impact of logging on periphyton algal biomass and dry mass. The study also evaluated the impact of total mercury (THG) and methylmercury (MeHg) accumulation in the littoral zone of the boreal lakes. A before-after control-impact (BACI) sample design was applied that required data from control and target sites sampled both before and after the disturbances. The study was carried out on 18 boreal lakes located in the Grenville geological province. Eight lakes had their watersheds logged over 15 to 79 per cent of their area. A further 10 lakes were used as control sites to document interannual variations. The project used water quality and physiographic data acquired by research groups within the Sustainable Forest Management Network. Fourteen study lakes were sampled once a year during 2 consecutive ice-free seasons before and after logging, and another 4 lakes were sampled 2 years after logging. Significant decreases in algal biomass and increases in MeHg concentrations in periphyton mats in a majority of the harvested watershed lakes were detected. The increases may have a significant impact on organisms of higher trophic levels as they are at the base of the food web. Results suggested that the observed decrease in periphyton biomass combined with the increase in MeHg accumulation may magnify the impact of logging activities on fish and other aquatic predators. Two years after logging, it was observed that MeHg concentrations were still increasing. It was concluded that further research is needed

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).

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...

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery.

Science.gov (United States)

Hooper, M M; Stellato, T A; Hallowell, P T; Seitz, B A; Moskowitz, R W

2007-01-01

To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Longitudinal, interventional, unblended. Forty-eight obese subjects (47 women, one man, mean age 44+/-9 years; mean body mass index (BMI) 51+/-8 kg/m(2)) recruited from an academic medical center bariatric surgery program. Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 for quality of life. Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. SUBJECTS completed the SF-36 and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 on the WOMAC pain subscale score was evaluated. SF-36 outcomes were compared to normal published controls. Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41+/-15 kg and the mean BMI decreased from 51+/-8 to 36+/-7 kg/m(2). Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Hye Bin; Park, Hee Chul; Park, Won [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

2012-09-15

Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

International Nuclear Information System (INIS)

Lee, Hye Bin; Park, Hee Chul; Park, Won

2012-01-01

Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

Before-and-After Study of Interruptions in a Pharmacy Department.

Science.gov (United States)

Guérin, Aurélie; Caron, Elaine; Lebel, Denis; Bussières, Jean-François

2013-01-01

Few data exist on interruptions in the drug-use process in hospital pharmacies and their effects on patient care. The primary objective was to compare the hourly number of stimuli received and emitted (i.e., generated) by pharmacists and pharmacy technicians before and after implementation of measures intended to reduce interruptions. The secondary objective was to evaluate the impact of the corrective measures on 4 specific stimuli. This before-and-after cross-sectional observational study was conducted in the main dispensing area of the pharmacy department of a Canadian university hospital centre. Stimuli received and emitted by pharmacists and pharmacy technicians were counted before (2010) and after (2012) implementation of corrective measures designed to limit interruptions. The effect of corrective measures on targeted stimuli was measured with a t test. Data were collected during a total of 93 randomly scheduled 30-min observation periods: 62 periods in 2010 (n = 2663 stimuli) and 31 periods in 2012 (n = 1217 stimuli). The average hourly stimulus rate (± standard deviation) was unchanged after implementation of corrective measures: 85.9 ± 22.2 in 2010 and 78.5 ± 20.1 in 2012 (p = 0.06). However, a significant decline was observed for many individual stimuli, including the number of face-to-face nonprofessional conversations among pharmacists (4.4 ± 4.2 in 2010 versus 1.2 ± 1.8 in 2012, p = 0.003). Despite the implementation of corrective measures, there was no statistically significant change in the hourly stimulus rates from 2010 to 2012. Other studies are needed to better characterize the nature and repercussions of stimuli, distractions, and interruptions.

Does human pressure affect the community structure of surf zone fish in sandy beaches?

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Costa, Leonardo Lopes; Landmann, Júlia G.; Gaelzer, Luiz R.; Zalmon, Ilana R.

2017-01-01

Intense tourism and human activities have resulted in habitat destruction in sandy beach ecosystems with negative impacts on the associated communities. To investigate whether urbanized beaches affect surf zone fish communities, fish and their benthic macrofaunal prey were collected during periods of low and high human pressure at two beaches on the Southeastern Brazilian coast. A BACI experimental design (Before-After-Control-Impact) was adapted for comparisons of tourism impact on fish community composition and structure in urbanized, intermediate and non-urbanized sectors of each beach. At the end of the summer season, we observed a significant reduction in fish richness, abundance, and diversity in the high tourist pressure areas. The negative association between visitors' abundance and the macrofaunal density suggests that urbanized beaches are avoided by surf zone fish due to higher human pressure and the reduction of food availability. Our results indicate that surf zone fish should be included in environmental impact studies in sandy beaches, including commercial species, e.g., the bluefish Pomatomus saltatrix. The comparative results from the less urbanized areas suggest that environmental zoning and visitation limits should be used as effective management and preservation strategies on beaches with high conservation potential.

Can Building Design Impact Physical Activity? A Natural Experiment.

Science.gov (United States)

Eyler, Amy A; Hipp, Aaron; Valko, Cheryl Ann; Ramadas, Ramya; Zwald, Marissa

2018-05-01

Workplace design can impact workday physical activity (PA) and sedentary time. The purpose of this study was to evaluate PA behavior among university employees before and after moving into a new building. A pre-post, experimental versus control group study design was used. PA data were collected using surveys and accelerometers from university faculty and staff. Accelerometry was used to compare those moving into the new building (MOVERS) and those remaining in existing buildings (NONMOVERS) and from a control group (CONTROLS). Survey results showed increased self-reported PA for MOVERS and NONMOVERS. All 3 groups significantly increased in objectively collected daily energy expenditure and steps per day. The greatest steps per day increase was in CONTROLS (29.8%) compared with MOVERS (27.5%) and NONMOVERS (15.9%), but there were no significant differences between groups at pretest or posttest. Self-reported and objectively measured PA increased from pretest to posttest in all groups; thus, the increase cannot be attributed to the new building. Confounding factors may include contamination bias due to proximity of control site to experimental site and introduction of a university PA tracking contest during postdata collection. Methodology and results can inform future studies on best design practices for increasing PA.

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

Science.gov (United States)

Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

2017-01-14

To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

The Effects of Run-of-River Hydroelectric Power Schemes on Fish Community Composition in Temperate Streams and Rivers.

Science.gov (United States)

Bilotta, Gary S; Burnside, Niall G; Gray, Jeremy C; Orr, Harriet G

2016-01-01

The potential environmental impacts of large-scale storage hydroelectric power (HEP) schemes have been well-documented in the literature. In Europe, awareness of these potential impacts and limited opportunities for politically-acceptable medium- to large-scale schemes, have caused attention to focus on smaller-scale HEP schemes, particularly run-of-river (ROR) schemes, to contribute to meeting renewable energy targets. Run-of-river HEP schemes are often presumed to be less environmentally damaging than large-scale storage HEP schemes. However, there is currently a lack of peer-reviewed studies on their physical and ecological impact. The aim of this article was to investigate the effects of ROR HEP schemes on communities of fish in temperate streams and rivers, using a Before-After, Control-Impact (BACI) study design. The study makes use of routine environmental surveillance data collected as part of long-term national and international monitoring programmes at 23 systematically-selected ROR HEP schemes and 23 systematically-selected paired control sites. Six area-normalised metrics of fish community composition were analysed using a linear mixed effects model (number of species, number of fish, number of Atlantic salmon-Salmo salar, number of >1 year old Atlantic salmon, number of brown trout-Salmo trutta, and number of >1 year old brown trout). The analyses showed that there was a statistically significant effect (pcomposition. The implications of these findings are discussed in this article and recommendations are made for best-practice study design for future fish community impact studies.

A Climate Change Adaptation Strategy for Management of ...

Science.gov (United States)

Sea level rise is causing shoreline erosion, increased coastal flooding, and marsh vulnerability to the impact of storms. Coastal marshes provide flood abatement, carbon and nutrient sequestration, water quality maintenance, and habitat for fish, shellfish, and wildlife, including species of concern, such as the saltmarsh sparrow (Ammodramus caudacutus). We present a climate change adaptation strategy (CCAS) adopted by scientific, management, and policy stakeholders for managing coastal marshes and enhancing system resiliency. A common adaptive management approach previously used for restoration projects was modified to identify climate-related vulnerabilities and plan climate change adaptive actions. As an example of implementation of the CCAS, we describe the stakeholder plans and management actions the US Fish and Wildlife Service and partners developed to build coastal resiliency in the Narrow River Estuary, RI, in the aftermath of Superstorm Sandy. When possible, an experimental BACI (before-after, control-impact) design, described as pre- and post-sampling at the impact site and one or more control sites, was incorporated into the climate change adaptation and implementation plans. Specific climate change adaptive actions and monitoring plans are described and include shoreline stabilization, restoring marsh drainage, increasing marsh elevation, and enabling upland marsh migration. The CCAS provides a framework and methodology for successfully managing coa

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.

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 < 0.001). People with LTCs before referral were more likely to use health care resources (2-tailed t-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

Cholescintigraphy in patients with acute cholecystitis before and after percutaneous gallbladder drainage

DEFF Research Database (Denmark)

Borly, L; Stage, J G; Grønvall, S

1995-01-01

gallbladder drainage. During the post-drainage cholescintigraphies, a cholecystokinin stimulation was performed to investigate gallbladder emptying in 12 selected patients. Gallbladder pressure and volume were measured before drainage in another group of 12 patients with acute cholecystitis. RESULTS......OBJECTIVE: To investigate gallbladder function by use of cholescintigraphy in patients with acute cholecystitis before and after percutaneous gallbladder drainage. DESIGN: A cholescintigraphy was performed in 40 patients with acute cholecystitis before and after the performance of percutaneous......: As expected, no gallbladder activity was observed in the cholescintigraphies before drainage, except in a patient with an occluding stone in the common bile duct. Cystic duct patency and gallbladder activity were seen in 80% of patients in cholescintigraphies performed after drainage but before any other...

Satellite remote sensing reveals a positive impact of living oyster reefs on microalgal biofilm development

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C. Echappé

2018-02-01

Full Text Available Satellite remote sensing (RS is routinely used for the large-scale monitoring of microphytobenthos (MPB biomass in intertidal mudflats and has greatly improved our knowledge of MPB spatio-temporal variability and its potential drivers. Processes operating on smaller scales however, such as the impact of benthic macrofauna on MPB development, to date remain underinvestigated. In this study, we analysed the influence of wild Crassostrea gigas oyster reefs on MPB biofilm development using multispectral RS. A 30-year time series (1985–2015 combining high-resolution (30 m Landsat and SPOT data was built in order to explore the relationship between C. gigas reefs and MPB spatial distribution and seasonal dynamics, using the normalized difference vegetation index (NDVI. Emphasis was placed on the analysis of a before–after control-impact (BACI experiment designed to assess the effect of oyster killing on the surrounding MPB biofilms. Our RS data reveal that the presence of oyster reefs positively affects MPB biofilm development. Analysis of the historical time series first showed the presence of persistent, highly concentrated MPB patches around oyster reefs. This observation was supported by the BACI experiment which showed that killing the oysters (while leaving the physical reef structure, i.e. oyster shells, intact negatively affected both MPB biofilm biomass and spatial stability around the reef. As such, our results are consistent with the hypothesis of nutrient input as an explanation for the MPB growth-promoting effect of oysters, whereby organic and inorganic matter released through oyster excretion and biodeposition stimulates MPB biomass accumulation. MPB also showed marked seasonal variations in biomass and patch shape, size and degree of aggregation around the oyster reefs. Seasonal variations in biomass, with higher NDVI during spring and autumn, were consistent with those observed on broader scales in other European mudflats. Our

A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique

Science.gov (United States)

Brown, Joe; Cumming, Oliver; Bartram, Jamie; Cairncross, Sandy; Ensink, Jeroen; Holcomb, David; Knee, Jackie; Kolsky, Peter; Liang, Kaida; Liang, Song; Nala, Rassul; Norman, Guy; Rheingans, Richard; Stewart, Jill; Zavale, Olimpio; Zuin, Valentina; Schmidt, Wolf-Peter

2015-01-01

Introduction Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access. Methods and analysis We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation. Ethics Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the

Assessment of preclinical students' academic motivation before and after a three-day academic affair program.

Science.gov (United States)

Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak

2015-01-01

Medical students' motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students' motivation to study. An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students' academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS). Cronbach's alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance. Students' academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students' self-esteem and feeling of self-worth (Pmotivation toward accomplishment increased significantly (Pacademic milestones, and a step ahead of autonomous motivation. Amotivation level declined significantly (Pacademic motivational constructs before and after the intervention was altogether significant (P=0.036, multivariate analysis of variance). After experiencing a three-day intervention, the new students' motivation advanced along the continuum of self-determination toward autonomous motivation. Therefore, it is considered to be worthwhile

Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

Science.gov (United States)

Oz, A Z; Ciger, S

2018-03-01

The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.

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

PHILOSOPHERS BEFORE AND AFTER SPACEFLIGHT

OpenAIRE

Fabio Grigenti

2011-01-01

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.

Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

Directory of Open Access Journals (Sweden)

Aung MN

2015-12-01

Full Text Available Myo Nyein Aung,1 Juraiporn Somboonwong,2 Vorapol Jaroonvanichkul,1 Pongsak Wannakrairot3 1Medical Education Unit, 2Quality Management Division and Department of Physiology, 3Academic Affairs Division, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandBackground: Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students’ motivation to study.Design and methods: An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students’ academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS. Cronbach’s alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance.Results: Students’ academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students’ self-esteem and feeling of self-worth (P<0.001. Moreover, intrinsic motivation toward accomplishment increased significantly (P<0.001. This is related to the enjoyment of passing academic milestones, and a step

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.

CREEK Project: RUI: the Role of Oyster Reefs in the Structure and Function of Tidal Creeks. A Project Overview: 1996-2000.

Data.gov (United States)

Baruch Institute for Marine and Coastal Sciences, Univ of South Carolina — A group of eight tidal creeks dominated by oysters, Crassostrea virginica, in North Inlet, South Carolina, USA were studied using a replicated BACI (Before - After...

Occurrence of Comorbidities before and after Soft Tissue Sarcoma Diagnosis

Directory of Open Access Journals (Sweden)

Myrthe P. P. van Herk-Sukel

2012-01-01

Full Text Available Background. Data is limited on the burden of common comorbidities, such as cardiovascular disease (CVD, respiratory disease and diabetes, or comorbidities related to cancer and its treatment, such as anemia and depression, in patients with soft tissue sarcoma (STS. Patients and Methods. From the Dutch Pathology Registry linked to the PHARMO database (including data on drug use and hospitalizations, 533 patients with STS were selected during 2000–2007 and matched 1 : 10 to cancer-free controls. The occurrences of comorbidities were assessed in the 12 months before and after STS diagnosis. Results. STS patients were 2–4 times more likely to have comorbidities at diagnosis compared with cancer-free controls. The incidence of CVD, anemia, and depression after STS diagnosis differed significantly from cancer-free controls and decreased during followup from 40–124 per 1,000 person-years (py during the first six months to 11–38 per 1,000 py more than 12 months after diagnosis. The incidence of respiratory disease and diabetes among STS patients remained stable during followup (5–21 per 1,000 py and did not differ significantly from cancer-free controls. Conclusions. STS patients were more likely to have comorbidities before cancer diagnosis and to develop CVD, anemia, and depression after diagnosis compared to cancer-free controls.

Effects of the Mediterranean Diet before and after Weight Loss on Eating Behavioral Traits in Men with Metabolic Syndrome.

Science.gov (United States)

Carbonneau, Élise; Royer, Marie-Michelle; Richard, Caroline; Couture, Patrick; Desroches, Sophie; Lemieux, Simone; Lamarche, Benoît

2017-03-19

The objective of this study was to investigate the impact of the Mediterranean diet (MedDiet) consumed before and after weight loss on eating behavioral traits as measured by the Three-Factor Eating Questionnaire (TFEQ) in men with metabolic syndrome (MetS). In this fixed sequence study, 19 men with MetS (National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria), aged between 24 and 62 years, first consumed a five-week standardized North American control diet followed by a five-week MedDiet, both under weight-maintaining controlled-feeding conditions. This was followed by a 20-week caloric restriction weight loss period in free-living conditions, without specific recommendations towards adhering to the principles of the MedDiet. Participants were finally subjected to a final five-week MedDiet phase under isoenergetic controlled-feeding conditions. The MedDiet before weight loss had no impact on eating behavioral traits. Body weight reduction by caloric restriction (-10.2% of initial weight) was associated with increased cognitive restraint ( p < 0.0001) and with reduced disinhibition ( p = 0.02) and susceptibility to hunger ( p = 0.01). Feeding the MedDiet for five weeks under isoenergetic conditions after the weight loss phase had no further impact on eating behavioral traits. Results of this controlled-feeding study suggest that consumption of the MedDiet per se has no effect on eating behavioral traits as measured by TFEQ, unless it is combined with significant weight loss.

Effects of the Mediterranean Diet before and after Weight Loss on Eating Behavioral Traits in Men with Metabolic Syndrome

Directory of Open Access Journals (Sweden)

Élise Carbonneau

2017-03-01

Full Text Available The objective of this study was to investigate the impact of the Mediterranean diet (MedDiet consumed before and after weight loss on eating behavioral traits as measured by the Three-Factor Eating Questionnaire (TFEQ in men with metabolic syndrome (MetS. In this fixed sequence study, 19 men with MetS (National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII criteria, aged between 24 and 62 years, first consumed a five-week standardized North American control diet followed by a five-week MedDiet, both under weight-maintaining controlled-feeding conditions. This was followed by a 20-week caloric restriction weight loss period in free-living conditions, without specific recommendations towards adhering to the principles of the MedDiet. Participants were finally subjected to a final five-week MedDiet phase under isoenergetic controlled-feeding conditions. The MedDiet before weight loss had no impact on eating behavioral traits. Body weight reduction by caloric restriction (−10.2% of initial weight was associated with increased cognitive restraint (p < 0.0001 and with reduced disinhibition (p = 0.02 and susceptibility to hunger (p = 0.01. Feeding the MedDiet for five weeks under isoenergetic conditions after the weight loss phase had no further impact on eating behavioral traits. Results of this controlled-feeding study suggest that consumption of the MedDiet per se has no effect on eating behavioral traits as measured by TFEQ, unless it is combined with significant weight loss.

A Comparative study on sexual dysfunctions before and after menopause

Science.gov (United States)

Beigi, Marjan; Fahami, Fariba

2012-01-01

Background: Sexual instinct which is the cause of numerous changes in an individual’s life could be influenced by different factors such as menopause and ageing. This study was designed to compare sexual dysfunction before and after menopause. Materials and Methods: This was a cross-sectional study. Participants were 174 menopausal women who referred to medical health centers of Isfahan, Iran. Data were collected through self constructed sexual dysfunctions questionnaire in relation to their sexual activities before and after menopause. The reliability and validity of this questionnaire was determined by content validity and Cronbach’s alpha coefficient. Findings: Findings showed that the relative frequency of sexual dysfunctions was 38% in the productive period and 72.4% in the menopause period. There was a significant association between sexual dysfunctions before and after the menopause period (p vaginismus, respectively. Conclusions: A considerable percentage of women experienced sexual dysfunctions in productive and menopause periods, and menopause could be a factor to maintain or intensify sexual dysfunctions. PMID:23833604

Improving discharge care: the potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before-after pilot study.

Science.gov (United States)

Cadilhac, Dominique A; Andrew, Nadine E; Stroil Salama, Enna; Hill, Kelvin; Middleton, Sandy; Horton, Eleanor; Meade, Ian; Kuhle, Sarah; Nelson, Mark R; Grimley, Rohan

2017-08-04

Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes. Clinicians from a 'top-ranked' hospital participated in a focus group to elicit their success factors. Two pilot hospitals then participated in the organisational intervention that was designed with experts and consumers. Hospital clinicians involved in discharge care for stroke and patients admitted with acute stroke or transient ischaemic attack. A four-stage, multifaceted organisational intervention that included data reviews, education and facilitated action planning. Three discharge processes collected in Queensland hospitals within the Australian Stroke Clinical Registry were used to select study hospitals: (1) discharge care plan; (2) antihypertensive medication prescription and (3) antiplatelet medication prescription (ischaemic events only). Primary measure: composite outcome. Secondary measures: individual adherence changes for each discharge process; sensitivity analyses. The performance outcomes were compared 3 months before the intervention (preintervention), 3 months postintervention and at 12 months (sustainability). Data from 1289 episodes of care from the two pilot hospitals were analysed. Improvements from preintervention adherence were: antiplatelet therapy (88%vs96%, p=0.02); antihypertensive prescription (61%vs79%, porganisational intervention. The intervention warrants further application and trialling on a larger scale. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

Experimental whole-lake dissolved organic carbon increase alters fish diet and density but not growth or productivity

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Koizumi, Shuntaro; Craig, Nicola; Zwart, Jacob A.; Kelly, Patrick T.; Ziegler, Jacob P.; Weidel, Brian C.; Jones, Stuart E.; Solomon, Christopher T.

2018-01-01

Negative relationships between dissolved organic carbon (DOC) concentration and fish productivity have been reported from correlative studies across lakes, but to date there have not been experimental tests of these relationships. We increased the DOC concentration in a lake by 3.4 mg L-1, using a before-after control-impact (BACI) design, to quantify the effects on the productivity and population structure of Largemouth Bass (Micropterus salmoides). Greater DOC reduced the volume of the epilimnion, the preferred habitat of Largemouth Bass, resulting in increased bass density. The likelihood that adult bass had empty diets decreased despite this increase in bass density; diet composition also changed. There was no apparent change in bass growth or condition. Overall, there was no net change in Largemouth Bass productivity. However, changes in YOY and juvenile recruitment and feeding success suggest the possibility that future effects could occur. Our results are the first to examine the effects of an increase in DOC on fish productivity through a five-year temporal lens, which demonstrates that the relationship between DOC and fish productivity is multi-dimensional and complex.

Medical Advice for Sick-reported Students (MASS in intermediate vocational education schools: design of a controlled before-and-after study

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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

CHEMICAL AND ENERGETIC CONTENT OF CORN BEFORE AND AFTER PRE-CLEANING

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Sandra Iara Furtado Costa Rodrigues

2015-04-01

Full Text Available The poultry industry normally has little control over the raw material that arrives at the processing plant. This experiment aimed to evaluate chemical and energetic quality of corn obtained in a feed mill before and after pre-cleaning. Twenty samples of 30 kg of corn each were taken from trucks delivering corn to the mill. The trucks were then unloaded and the material passed through a pre-cleaning process when another sample was taken. Samples were graded and physical properties evaluated: density (g/L, grain percentages of foreign material, impurities, fragments, broken, soft, insect damaged, fire-burnt, fermented, damaged, cracked and fine particles, as well as chemical composition analysis: Apparent metabolizable energy for poultry (AME, ether extract (EE, crude fiber (CF, starch (STA, water activity (WA, crude protein (CP, digestible and total lysine, methionine, cystine, threonine, tryptophan, valine, isoleucine, leucine, phenylalanine, histidine and arginine. The experiment was a randomized design with two treatments (before and after pre-cleaning and twenty replications. Data was analyzed using SAS ® and treatment differences obtained using F test. Correlations and principal components were calculated. There was a decrease in density after the pre-cleaning process, which was probably due to the removal of earth and stones rather than grain and its fractions. Significant increases were found for insect damage, fermented and damaged grain while fire-burn was significantly reduced after the pre-cleaning process. Starch increased after pre-cleaning which is a result of contaminants that normally are poor in this carbohydrate, but fiber levels increased too. Apparent metabolizable energy, aminoacids, digestible (P<0.05 and total (P<0.05 histidine, total lysine and methionine (P<0.1 levels were reduced after pre-cleaning. Density was higher when there were fewer impurities such as straw, husk or small grains. Broken corn was positively

Review of the effects of protection in marine protected areas: current knowledge and gaps

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Ojeda–Martínez, C.

2011-06-01

Full Text Available The effectiveness of marine protected areas (MPAs and the conservation of marine environments must be based on reliable information on the quality of the marine environment that can be obtained in a reasonable timeframe. We reviewed studies that evaluated all aspects related to the effectiveness of MPAs in order to describe how the studies were conducted and to detect fields in which research is lacking. Existing parameters used to evaluate the effectiveness of MPAs are summarised. Two-hundred and twenty-two publications were reviewed. We identified the most commonly used study subjects and methodological approaches. Most of the studies concentrated on biological parameters. Peer reviewed studies were based on control vs. impact design. BACI and mBACI designs were used in very few studies. Through this review, we have identified gaps in the objectives assigned to MPAs and the way in which they have been evaluated. We suggest some guidelines aimedat improving the assessment of the effects of protection in MPAs.

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

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Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

2016-07-25

BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (pwater exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

Indoor Air Quality of Residential Building Before and After Renovation

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Sánka, Imrich; Földváry, Veronika

2017-06-01

This study investigates the impact of energy renovation on the indoor air quality of an apartment building during the heating season. The study was performed in one residential building before and after its renovation. An evaluation of the indoor air quality was performed using objective measurements and a subjective survey. The concentration of CO2 was measured in the bedrooms, and a sampling of the total volatile compounds (TVOC) was performed in the living rooms of the selected apartments. Higher concentrations of CO2 and TVOC were observed in the residential building after its renovation. The concentrations of CO2, and TVOC in some of the cases exceeded the recommended maximum limits, especially after implementing energy-saving measures on the building. The average air exchange rate was visibly higher before the renovation of the building. The current study indicates that large-scale renovations may reduce the quality of an indoor environment in many apartments, especially in the winter season.

Medical Errors Management Before and After Implementation of Accreditation in Hospital

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Ghassem Abedi

2014-12-01

Full Text Available Background and purpose: This study aimed to manage medical errors before and after the implementation of accreditation in public, private, and social security hospitals of Mazandaran, Iran. Materials and Methods: This descriptive study has been done in 38 hospitals. Data were collected through documents reviewed relating to 2013 and 2014. The paired t-test and Friedman test were used by statistical software SPSS. Results: Results showed that the most and the least percent of reported errors, before accreditation, in sequence, were related to public clinical unit (55.9% and operating rooms (0.6%, and after accreditation in public clinical unit (46.6% and operating rooms (2.3% in teaching centers. The most errors (before accreditation occurred in the morning (62% and the least, in the evening (8.3% in teaching centers. Furthermore, after accreditation, the most errors occurred in the morning (64.8% and the least, in the night (17.3% in therapeutic hospitals. Paired t-test showed that there is no significant difference between medical errors before and after accreditation. Friedman test showed that structural/systemic errors reported were the most important medical errors in teaching centers after accreditation and therapeutic hospitals before accreditation (P < 0.05. Conclusion: There is no significant difference between the rate of reported errors before and after the implementation of accreditation. This illustrates that the role of management in controlling of medical errors has been poor, and stronger management should be applied in providing health care services.

A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique.

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Brown, Joe; Cumming, Oliver; Bartram, Jamie; Cairncross, Sandy; Ensink, Jeroen; Holcomb, David; Knee, Jackie; Kolsky, Peter; Liang, Kaida; Liang, Song; Nala, Rassul; Norman, Guy; Rheingans, Richard; Stewart, Jill; Zavale, Olimpio; Zuin, Valentina; Schmidt, Wolf-Peter

2015-06-18

Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access. We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation. Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the Georgia Institute of Technology, the University of

[Research on quality changes in ginseng stems and leaves before and after frost].

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Zhao, Yan; Ma, Shuang; Cai, En-Bo; Liu, Shuang-Li; Yang, He; Zhang, Lian-Xue; Wang, Shi-Jie

2014-08-01

The present study is to investigate the quality changes of ginseng stems and leaves before and after frost. The contents changes of ginsenoside, free amino acid, and total phenolic compounds, as well as DPPH radical scavenging effect before and after frost were measured. The content of 9 ginsenoside monomer in ginseng stems was decreased except for Rg, and Re after frost, but in ginseng leaves was all decreased. The total content of amino acids was decreased in ginseng stems after frost, while increased in ginseng leaves. The content of phenolic compounds in ginseng stems and leaves were both decreased after frost while the ability of DPPH radical scavenging was improved. The factor of frost has great impact on the quality of ginseng stems and leaves.

Pre-Acting Control for Shock and Impact Isolation Systems

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D.V. Balandin

2005-01-01

Full Text Available Pre-acting control in shock/impact isolation systems is studied. With pre-acting control, the isolation system begins to respond to an impact before this impact has been applied to the base. The limiting performance of the isolator with pre-acting control is investigated for a single-degree-of-freedom system subject to an instantaneous impact. The isolation performance index is defined as the maximum of the absolute value of the displacement of the object to be isolated relative to the base, provided that the magnitude of the control force transmitted to the object does not exceed a prescribed value. It is shown that there is a substantial advantage in the use of pre-acting isolators over isolators without pre-action. Particular attention is given to a pre-acting isolator based on a passive elastic element (a spring separating the object to be protected from the base. An example illustrates the calculation of the design parameters of such an isolator.

Impact of the goldspotted oak borer, Agrilus auroguttatus, on the health of coast live oak before and after treatment with two systemic insecticides

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Yigen Chen; Mary L. Flint; Tom W. Coleman; Joseph J. Doccola; Donald M. Grosman; David L. Wood; Steven J. Seybold

2015-01-01

BACKGROUND: The invasive goldspotted oak borer, Agrilus auroguttatus, is threatening the health and survival of oak trees in San Diego County, California. From two sites in the core area of the infestation, we report a 2.5 year investigation of the impact of A. auroguttatus on coast live oak, Quercus agrifolia, before and after treatment with two systemic...

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......, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. POPULATION: All women with a pregnancy ending in a live or stillbirth starting and ending between 2004 and 2010. METHODS: A common protocol was implemented across databases to identify SSRI prescriptions issued (UK) or dispensed (non......-UK) in the year before, during or in the year following pregnancy. MAIN OUTCOME MEASURES: The percentage of deliveries in which the woman received an SSRI prescription in the year before, during or in the year following pregnancy. We also compared the choice of SSRIs and changes in prescribing over the study...

Signature pathways identified from gene expression profiles in the human uterine cervix before and after spontaneous term parturition

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HASSAN, Sonia S.; ROMERO, Roberto; TARCA, Adi L.; DRAGHICI, Sorin; PINELES, Beth; BUGRIM, Andrej; KHALEK, Nahla; CAMACHO, Natalia; MITTAL, Pooja; YOON, Bo Hyun; ESPINOZA, Jimmy; KIM, Chong Jai; SOROKIN, Yoram; MALONE, John

2008-01-01

Objective This study aimed to discover ‘signature pathways’ characterizing biological processes based on genes differentially expressed in the uterine cervix before and after spontaneous labor. Study Design The cervical transcriptome was previously characterized from biopsies taken before and after term labor. Pathway analysis was used to study the differentially expressed genes based on two gene-to-pathway annotation databases (KEGG and Metacore™). Over-represented and highly impacted pathways and connectivity nodes were identified. Results Fifty-two pathways in the Metacore™ database were significantly enriched in differentially expressed genes. Three of the top 5 pathways were known to be involved in cervical remodeling.Two novel pathways were: plasmin signaling and plasminogen activator urokinase (PLAU) signaling. The same analysis in the KEGG database identified 4 significant pathways, of which impact analysis confirmed. Multiple nodes providing connectivity within the plasmin and PLAU signaling pathways were identified.. Conclusions Three strategies for pathway analysis were consistent in their identification of novel, unexpected as well as expected networks, suggesting that this approach is both valid and effective for the elucidation of biological mechanisms involved in cervical dilation and remodeling. PMID:17826407

Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland

OpenAIRE

Ebnöther, Corina; Tanner, Beate; Schmid, Flavia; Rocca, Vittoria La; Heinzer, Ivo; Bregenzer, Thomas

2017-01-01

Objective. To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center. Methods. Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared ...

Pelvic organ function before and after laparoscopic bowel resection for rectosigmoid endometriosis

DEFF Research Database (Denmark)

Riiskjaer, M; Greisen, S; Glavind-Kristensen, M

2016-01-01

OBJECTIVE: To assess urinary, sexual, and bowel function before and after laparoscopic bowel resection for rectosigmoid endometriosis. DESIGN: Prospectively collected data regarding the function of the pelvic organs. SETTING: Tertiary endometriosis referral unit, Aarhus University Hospital. SAMPLE......: A cohort of 128 patients who underwent laparoscopic bowel resection for endometriosis. METHODS: The International Consultation on Incontinence Questionnaire (ICIQ), Sexual Function-Vaginal Changes Questionnaire (SVQ), and the Low Anterior Resection Syndrome (LARS) questionnaire were answered before.......40; P = 0.002) of increased incontinence problems (I-score) 1 year after surgery. CONCLUSION: A significant and clinically relevant improvement in urinary and sexual function 1 year after laparoscopic bowel resection for endometriosis was found. Except for anastomotic leakage, this could be observed...

Iranian Medical Students’ Perception of Psychiatry: Before and After a Psychiatry Clerkship

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Nejatisafa, Ali-Akbar; Shoar, Saeed; Kaviani, Hosein; Samimi-Ardestani, Mehdi; Shabani, Amir; Esmaeili, Sara; Moghaddam, Yasaman

2013-01-01

Objective We aimed to compare the medical students’ attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics. Method In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences) were asked to participate anonymously in the study on the first and the last 3-days of their psychiatry clerkship. From 346 invited 4th-5th year medical students, 225 (65%) completed anonymous self-report questionnaires before and after a 4-week psychiatry clerkship. Results Positive response to choose psychiatry as a career was seen in 13.3% and 18.3% before and after psychiatry rotation, respectively. However, the difference was not statistically significant; about one-quarter of the students were turned on to psychiatry and 25% were discouraged during the clerkship. Individual pair wise comparisons revealed significant improvements only in two out of 13 measured aspects of psychiatry. Seventeen out of 38 (47.7%) students who identified psychiatry as the career of choice or strong possibility reported that one of their family members or close friends’ mental illness had an impact on their choice. Those students who considered psychiatry as the strong possibility claimed that they are more interested in humanities (OR = 2.96; 95% CI: 1.17, 7.49), and playing a musical instrument (OR = 2.53; 95% CI: 1.15, 5.57). Conclusion It may be concluded that exposure to psychiatry clerkship could influence medical students’ opinion about psychiatry positively, or negatively. Personal characteristics and individual interests of students may play an important role in choosing psychiatry as their future career. PMID:23682250

Iranian Medical Students’ Perception of Psychiatry: Before and After a Psychiatry Clerkship

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Homayoun Amini

2013-03-01

Full Text Available Objective: We aimed to compare the medical students’ attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics.Method: In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences were asked to participate anonymously in the study on the first and the last 3-days of their psychiatry clerkship. From 346 invited 4th-5th year medical students, 225 (65% completed anonymous self-report questionnaires before and after a 4-week psychiatry clerkship.Results: Positive response to choose psychiatry as a career was seen in 13.3 % and 18.3 % before and after psychiatry rotation, respectively. However, the difference was not statistically significant; about one-quarter of the students were turned on to psychiatry and 25% were discouraged during the clerkship. Individual pair wise comparisons revealed significant improvements only in two out of 13 measured aspects of psychiatry. Seventeen out of 38 (47.7% students who identified psychiatry as the career of choice or strong possibility reported that one of their family members or close friends’ mental illness had an impact on their choice. Those students who considered psychiatry as the strong possibility claimed that they are more interested in humanities (OR = 2.96; 95% CI: 1.17, 7.49, and playing a musical instrument (OR = 2.53; 95% CI: 1.15, 5.57.Conclusion: It may be concluded that exposure to psychiatry clerkship could influence medical students’ opinion about psychiatry positively, or negatively. Personal characteristics and individual interests of students may play an important role in choosing psychiatry as their future

Cytokine expression before and after aspirin desensitization therapy in aspirin-exacerbated respiratory disease.

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Aktas, Ayse; Kurt, Emel; Gulbas, Zafer

2013-12-01

Aspirin exacerbated respiratory disease (AERD) is induced by acetylsalicylic acid (ASA) and/or nonsteroidal antiinflammatory drugs (NSAIDs). Effects of desensitization on many mediators have been examined previously, but few studies addressed the influence of desensitization on T lymphocytes and T lymphocyte-derived cytokines. This study was performed to examine peripheral blood lymphocyte (PBL) cytokine expression in aspirin-sensitive patients who have asthma before and after aspirin desensitization. In this study, the release of interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-γ) by CD4+ T lymphocytes prior to aspirin desensitization were also measured at intracellular levels, and expression of these cytokines after 1 month aspirin desensitization was evaluated. Twelve patients with AERD were included in the study. Two different control groups were formed, one consisted of 15 healthy people and second 12 aspirin tolerant asthmatic (ATA) patients using aspirin. A blood sample was collected prior to desensitization, and the tests were repeated by taking a second blood sample 1 month after the 4-day desensitization treatment. The proportion of lymphocytes secreting IFN-γ in the study group was 15.61 ± 4.40 % before desensitization and 15.08 ± 5.89 % after desensitization. The rate of IFN-γ secreting CD4+ T lymphocytes was 20.51 ± 4.41 % in the normal control group and 16.07 ± 5.7 % in the ATA group (p = 0.021). The ratio of CD4+ T lymphocyte secreting IFN-γ was reduced in patients with AERD before desensitization compared to normal control group (p = 0.040). The levels of IL-2, IL-4, and the subsets of lymphocyte were not different before and after desensitization compared to control groups.

The calcium endocrine system of adolescent rhesus monkeys and controls before and after spaceflight

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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 endocrine system were similar to the effects of chairing on the ground, but were more pronounced. Reduced intestinal calcium absorption, losses in body weight, increases in cortisol, and higher postflight blood urea nitrogen were the changes in flight monkeys that distinguished them from the flight simulation study animals.

Cognitive Function Before and After Left Heart Catheterization.

Science.gov (United States)

Scott, David A; Evered, Lisbeth; Maruff, Paul; MacIsaac, Andrew; Maher, Sarah; Silbert, Brendan S

2018-03-10

Hospital procedures have been associated with cognitive change in older patients. This study aimed to document the prevalence of mild cognitive impairment in individuals undergoing left heart catheterization (LHC) before the procedure and the incidence of cognitive decline to 3 months afterwards. We conducted a prospective, observational, clinical investigation of elderly participants undergoing elective LHC. Cognition was assessed using a battery of written tests and a computerized cognitive battery before the LHC and then at 3 months afterwards. The computerized tests were also administered at 24 hours (or discharge) and 7 days after LHC. A control group of 51 community participants was recruited to calculate cognitive decline using the Reliable Change Index. Of 437 participants, mild cognitive impairment was identified in 226 (51.7%) before the procedure. Computerized tests detected an incidence of cognitive decline of 10.0% at 24 hours and 7.5% at 7 days. At 3 months, written tests detected an incidence of cognitive decline of 13.1% and computerized tests detected an incidence of 8.5%. Cognitive decline at 3 months using written tests was associated with increasing age, whereas computerized tests showed cognitive decline was associated with baseline amnestic mild cognitive impairment, diabetes mellitus, and prior coronary stenting. More than half the patients aged >60 years presenting for LHC have mild cognitive impairment. LHC is followed by cognitive decline in 8% to 13% of individuals at 3 months after the procedure. Subtle cognitive decline both before and after LHC is common and may have important clinical implications. URL: www.anzctr.org.au. Unique identifier: ACTRN12607000051448. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Stimulate feed intake before weaning and control intake after weaning to optimise health and growth performance

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Tehya Read

2015-09-01

Full Text Available Post-weaning feed restriction is a common practice in rabbit farming to reduce mortality, but results in lower growth performance and slaughter weights. This study aimed to assess the influence of 2 diets both rich in fibre and low in starch, with high or low digestible energy (DE and digestible protein (DP contents for a constant DP/DE ratio offered from 18 to 70 d of age, on the growth performance and health parameters of rabbits. Eight hundred rabbit kits were divided in 2 experimental groups differing in the feed offered from 18 to 70 d: a high concentrate diet (HC group; 10.37 MJ DE/kg DM and 102 g DP/kg DM or low concentrate diet (LC group; 9.63 MJ DE/kg DM and 95 g DP/kg DM. Feed was offered ad libitum before weaning (35 d and from 63 to 70 d, while feed offered from 35 to 63 d was controlled to obtain similar DE intake in both groups. Feed intake, animal weights and health status were recorded weekly. Mortality was recorded daily. Feed intake was similar in both groups before weaning (P=0.204, and consequently the DE intake was higher in the HC group compared to the LC group before weaning (3.91 vs. 3.39 MJ, respectively; P=0.017. Feed intake from 63 to 70 d was lower in the HC than in the LC group (229 vs. 239 g/d/kit, respectively; P<0.001.Total DE ingested after weaning was similar in both groups (45.44 MJ; P=0.143. Kits were heavier in the HC group throughout the study (P<0.05. A higher average daily gain during the periods of 18-28, 35-42 and 56-63 d was seen in the HC group (+8.1%, +16.8% and +4.5%, respectively; P<0.05. Mortality and morbidity rates were similar between groups throughout the study (P=1.0 and P=0.104, respectively. Our results suggest that when the feed intake after weaning is controlled, i the feeding strategy before weaning determines the weight at weaning and at slaughter age; and ii rabbits fed a diet more highly concentrated but rich in fibre increase their growth performance without negative

Impact of Leaf Removal, Applied Before and After Flowering, on Anthocyanin, Tannin, and Methoxypyrazine Concentrations in 'Merlot' (Vitis vinifera L.) Grapes and Wines.

Science.gov (United States)

Sivilotti, Paolo; Herrera, Jose Carlos; Lisjak, Klemen; Baša Česnik, Helena; Sabbatini, Paolo; Peterlunger, Enrico; Castellarin, Simone Diego

2016-06-08

The development and accumulation of secondary metabolites in grapes determine wine color, taste, and aroma. This study aimed to investigate the effect of leaf removal before flowering, a practice recently introduced to reduce cluster compactness and Botrytis rot, on anthocyanin, tannin, and methoxypyrazine concentrations in 'Merlot' grapes and wines. Leaf removal before flowering was compared with leaf removal after flowering and an untreated control. No effects on tannin and anthocyanin concentrations in grapes were observed. Both treatments reduced levels of 3-isobutyl-2-methoxypyrazine (IBMP) in the grapes and the derived wines, although the after-flowering treatment did so to a greater degree in the fruit specifically. Leaf removal before flowering can be used to reduce cluster compactness, Botrytis rot, and grape and wine IBMP concentration and to improve wine color intensity but at the expense of cluster weight and vine yield. Leaf removal after flowering accomplishes essentially the same results without loss of yield.

Comparing environmental issues in Cuba before and after the Special Period: balancing sustainable development and survival.

Science.gov (United States)

Maal-Bared, Rasha

2006-04-01

Following the Earth Summit in 1992, Cuba designed and implemented a variety of programs, administrative structures, and public awareness activities to promote sound environmental management and sustainable development. This came shortly after the fall of the Soviet Union and the strengthening of the US blockade in 1990, which resulted in a 35% drop in Cuban GDP. This period, referred to as the Special Period, witnessed a decrease in many environmentally damaging activities both by choice and by necessity, but also resulted in many decisions to resuscitate the Cuban economy. The purpose of this work was to compare and rank the environmental risks Cuba faced before and during the Special Period (1990-2000) using two Comparative environmental risk assessments (CERAs). To do so, an ecosystem integrity risk assessment matrix was constructed with 42 risk end points. The matrix assessed the risk posed by 17 problem areas including air pollution, water contamination, solid waste sites, pesticides and ecosystem degradation. The risks were calculated using five criteria: area affected, vulnerability of affected population, severity of impact, irreversibility of effect and uncertainty. To construct this matrix, both literature reviews and expert interviews in Cuba were conducted in 2000. The results showed a general decrease in risk scores during the Special Period. Before the Special Period, high risks were posed by: terrestrial degradation and industrial wastewater and sludge, followed by freshwater degradation, surface water stressors, and pesticides. After the Special Period, industrial wastewater and sludge and pesticides were no longer high-risk areas, but municipal wastewater and marine coastal degradation ranked higher than previously. Also, the risk endpoints most stressed after 1990 were affected by activities controlled by the government, such as mining and tourism, and lack of infrastructure. Therefore, the claims that public environmental education is the main

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.

Do patients with malocclusion have a higher prevalence of temporomandibular disorders than controls both before and after orthognathic surgery? A systematic review and meta-analysis.

Science.gov (United States)

Al-Moraissi, Essam Ahmed; Perez, Daniel; Ellis, Edward

2017-10-01

The aim of this study was to identify, through meta-analysis, whether patients who require orthognathic surgery have a higher prevalence of temporomandibular disorders (TMDs) than controls, both before treatment and after. A systematic review and meta-analysis were conducted based on PRISMA guidelines, to address the study purposes. A search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was performed to locate all pertinent articles published from inception to June 2016. Inclusion criteria were controlled clinical studies, either prospective or retrospective, and case-control studies comparing preoperative and postoperative signs and symptoms of TMDs in patients who undergo orthognathic surgery to those of a healthy volunteer population with no dentofacial deformities. The predictor variables were patients with dentofacial deformities who underwent orthognathic surgery and patients with no dentofacial deformities and with good maxillomandibular relations and normal occlusion. The outcomes variables were the weighted, prevalence rate (proportion) in signs and symptoms of TMDs in patients with dentofacial deformities and risk ratio (RR) of signs and symptoms of TMDs before and after orthognathic surgery, compared to the control group. A total of 542 patients enrolled in 6 studies were included in this analysis. The overall pooled weighted rate or prevalence of TMDs for orthognathic surgery patients preoperatively was 32.5% (95% CI = 26.7%-38.9%). There was a significant difference between the 2 groups with respect to TMDs before surgery, but no significant difference in TMDs after surgery. The RR for patients who had dentofacial deformities before orthognathic surgery compared with a control group was 1.634 (95% CI = 1.216-2.194; P = 0.001). The RR for patients after orthognathic surgery compared with a control group was 1.262 (0.718; 95% CI = 0.805-1.979; P = 0.311). The results of this study show that patients who are going to have a

Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

Science.gov (United States)

Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

2017-04-21

Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism.

Science.gov (United States)

Bilgir, Oktay; Bilgir, Ferda; Topcuoglu, Tuba; Calan, Mehmet; Calan, Ozlem

2014-03-01

This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment.

Acute effect of Ethanol and Taurine on frontal cortex absolute beta power before and after exercise

Science.gov (United States)

Cagy, Mauricio; Velasques, Bruna; Ribeiro, Pedro; Gongora, Mariana; Alvarenga, Renato; Alonso, Luciano; Pompeu, Fernando A. M. S.

2018-01-01

Ethanol (ET) is a substance that modulates the Central Nervous System (CNS). Frequently, ET intake occurs combined with energy drinks, which contain taurine (TA), an important amino acid found in the body (i.e brain and muscles). Although TA administration has been used in the improvement of physical performance, the impact of TA, ET and exercise remains unknown. This study aimed to analyze the acute effect of 6g of Taurine (TA), 0.6 mL∙kg-1 of Ethanol (ET), and Taurine combined with Ethanol (TA+ET) ingestion on the electrocortical activity before and after a moderate intensity exercise in 9 subjects, 5 women (counterbalanced experimental design). In each of the 4 treatments (Placebo—PL, TA, ET and TA+ET), electroencephalography (EEG) tests were conducted in order to analyze changes in absolute beta power (ABP) in the frontal lobe in 3 moments: baseline (before ingestion), peak (before exercise) and post-exercise. In the PL treatment, the frontal areas showed decrease in ABP after exercise. However, in the ET+TA treatment, ABP values were greater after exercise, except for Fp1. The ET treatment had no effect on the Superior Frontal Gyrus area (F3, Fz and F4) and ABP decreased after exercise in Fp1 and Fp2. In the TA treatment, ABP increased after exercise, while it decreased at the peak moment in most of the frontal regions, except for Fp1, F3 and Fz. We concluded that after a moderate intensity exercise, a decrease in cortical activity occurs in placebo treatment. Moreover, we found a inhibitory effect of TA on cortical activity before exercise and a increased in cortical activity after exercise. A small ET dose is not enough to alter ABP in all regions of the frontal cortex and, in combination with TA, it showed an increase in the frontal cortex activity at the post-exercise moment. PMID:29538445

Management of the ocular surface and tear film before, during, and after laser in situ keratomileusis.

Science.gov (United States)

Albietz, Julie M; Lenton, Lee M

2004-01-01

To identify evidence-based, best practice strategies for managing the ocular surface and tear film before, during, and after laser in situ keratomileusis (LASIK). After a comprehensive review of relevant published literature, evidence-based recommendations for best practice management strategies are presented. Symptoms of ocular irritation and signs of dysfunction of the integrated lacrimal gland/ocular surface functional gland unit are common before and after LASIK. The status of the ocular surface and tear film before LASIK can impact surgical outcomes in terms of potential complications during and after surgery, refractive outcome, optical quality, patient satisfaction, and the severity and duration of dry eye after LASIK. Before LASIK, the health of the ocular surface should be optimized and patients selected appropriately. Dry eye before surgery and female gender are risk factors for developing chronic dry eye after LASIK. Management of the ocular surface during LASIK can minimize ocular surface damage and the risk of adverse outcomes. Long-term management of the tear film and ocular surface after LASIK can reduce the severity and duration of dry eye symptoms and signs. Strategies to manage the integrated ocular surface/lacrimal gland functional unit before, during, and after LASIK can optimize outcomes. As problems with the ocular surface and tear film are relatively common, attention should focus on the use and improvement of evidence-based management strategies.

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices.

Science.gov (United States)

Broglio, Steven P; Williams, Richelle M; O'Connor, Kathryn L; Goldstick, Jason

2016-07-01

Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration. To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices. Cross-sectional study. High school football field. Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age = 16.2 ± 0.8 years, height = 179.6 ± 6.4 cm, weight = 81.9 ± 13.1 kg) participated. After the rule change, 24 athletes (age = 15.9 ± 0.8 years, height = 178.3 ± 6.5 cm, weight = 76.2 ± 11.6 kg) participated. Nine athletes participated in both years of the investigation. Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured. A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years. A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how

The Differences Cost of Equity Capital between Before and After Adoption of IFRS

Directory of Open Access Journals (Sweden)

I Putu Sugiartha Sanjaya

2017-11-01

Full Text Available The objective of this study was to analyze and compare between cost of equity capital between before and after adoption of IFRS on Statement of Financial Accounting Standard Financial Instrument (PSAK for banking companies listed in Indonesian Stock Exchange. The period on this study was 2008-2009 for before adoption and 2013-2014 for after adoption. Data on this study was secondary data such as annual financial reporting and share price. Cost of equity capital was measured using Ohlson Model. Sample in this study was banking companies listed in Indonesian Stock Exchange in 2008, 2009, 2013, and 2014. Selecting sample was by purposive sampling with specific criteria. Results of this study proved that cost of equity capital was lower for after adoption of IFRS on Statement of Financial Accounting Standard Financial Instrument for banking companies listed in Indonesian Stock Exchange than before adoption. It meant that adoption IFRS could reduce cost of equity capital. This result had an impact on reducing non performing loan, increasing loan to deposit ratio, and increasing net interest margin.

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...... to a multitrauma or redemption of two or more prescriptions for opioids 6 months or later after a multitrauma. RESULTS: Of the 938 patients brought to OUH with severe trauma within the study period, 61 patients died (7 percent) and six of these had redeemed prescriptions for opioids within 6 months prior...

Occupant satisfaction with the acoustical environment : green office buildings before and after treatment

Energy Technology Data Exchange (ETDEWEB)

Hodgson, M. [British Columbia Univ., Vancouver, BC (Canada). School of Occupational and Environmental Hygiene, Acoustics and Noise Research Group

2009-07-01

Sustainable architecture is meant to preserve the environment and conserve natural resources, as well as provide an environment for the occupants that promotes wellbeing and productivity. Occupants generally claim that the acoustical environment is the least satisfactory aspect of green office buildings. They are dissatisfied with excessive noise and poor speech privacy. This paper reported on the results of 2 studies of the acoustical environments in green office buildings before and after acoustical-control measures were installed. Acoustical quality was evaluated by occupant-satisfaction surveys and acoustical-parameter measurements. The first study, which involved 6 green office buildings, showed that buildings designed to obtain LEED ratings are unlikely to have satisfactory acoustical environments. A naturally-ventilated, green university building with a poor acoustical environment was examined in the second study. The results of this study suggest that improving acoustical environments in green buildings requires good acoustical design, with input from an acoustical specialist from the beginning of the design process. The design should consider site selection and building orientation; external envelope and penetrations in it; building layout and internal partitions; HVAC systems; appropriate dimensioning of spaces; and the amount and location of sound absorbing treatments. The study also showed that a building's energy efficiency, lighting, ventilation, air-quality and acoustics are interconnected, and that no aspect can be successfully designed in isolation. It was concluded that optimized engineering-control measures can improve poor acoustical environments. 11 refs., 1 tab., 1 fig.

Does selective logging stress tropical forest invertebrates? Using fat stores to examine sublethal responses in dung beetles.

Science.gov (United States)

França, Filipe; Barlow, Jos; Araújo, Bárbara; Louzada, Julio

2016-12-01

The increased global demand for tropical timber has driven vast expanses of tropical forests to be selectively logged worldwide. While logging impacts on wildlife are predicted to change species distribution and abundance, the underlying physiological responses are poorly understood. Although there is a growing consensus that selective logging impacts on natural populations start with individual stress-induced sublethal responses, this literature is dominated by investigations conducted with vertebrates from temperate zones. Moreover, the sublethal effects of human-induced forest disturbance on tropical invertebrates have never been examined. To help address this knowledge gap, we examined the body fat content and relative abundance of three dung beetle species (Coleoptera: Scarabaeinae) with minimum abundance of 40 individuals within each examined treatment level. These were sampled across 34 plots in a before-after control-impact design (BACI) in a timber concession area of the Brazilian Amazon. For the first time, we present evidence of logging-induced physiological stress responses in tropical invertebrates. Selective logging increased the individual levels of fat storage and reduced the relative abundance of two dung beetle species. Given this qualitative similarity, we support the measurement of body fat content as reliable biomarker to assess stress-induced sublethal effects on dung beetles. Understanding how environmental modification impacts the wildlife has never been more important. Our novel approach provides new insights into the mechanisms through which forest disturbances impose population-level impacts on tropical invertebrates.

Quantitative law describing market dynamics before and after interest-rate change

International Nuclear Information System (INIS)

Petersen, Alexander M.; Wang Fengzhong; Stanley, H. Eugene; Havlin, Shlomo

2010-01-01

We study the behavior of U.S. markets both before and after U.S. Federal Open Market Commission meetings and show that the announcement of a U.S. Federal Reserve rate change causes a financial shock, where the dynamics after the announcement is described by an analog of the Omori earthquake law. We quantify the rate n(t) of aftershocks following an interest-rate change at time T and find power-law decay which scales as n(t-T)∼(t-T) -Ω , with Ω positive. Surprisingly, we find that the same law describes the rate n ' (|t-T|) of 'preshocks' before the interest-rate change at time T. This study quantitatively relates the size of the market response to the news which caused the shock and uncovers the presence of quantifiable preshocks. We demonstrate that the news associated with interest-rate change is responsible for causing both the anticipation before the announcement and the surprise after the announcement. We estimate the magnitude of financial news using the relative difference between the U.S. Treasury Bill and the Federal Funds effective rate. Our results are consistent with the 'sign effect', in which 'bad news' has a larger impact than 'good news'. Furthermore, we observe significant volatility aftershocks, confirming a 'market under-reaction' that lasts at least one trading day.

Quantitative law describing market dynamics before and after interest-rate change.

Science.gov (United States)

Petersen, Alexander M; Wang, Fengzhong; Havlin, Shlomo; Stanley, H Eugene

2010-06-01

We study the behavior of U.S. markets both before and after U.S. Federal Open Market Commission meetings and show that the announcement of a U.S. Federal Reserve rate change causes a financial shock, where the dynamics after the announcement is described by an analog of the Omori earthquake law. We quantify the rate n(t) of aftershocks following an interest-rate change at time T and find power-law decay which scales as n(t-T)∼(t-T)(-Ω) , with Ω positive. Surprisingly, we find that the same law describes the rate n'(|t-T|) of "preshocks" before the interest-rate change at time T . This study quantitatively relates the size of the market response to the news which caused the shock and uncovers the presence of quantifiable preshocks. We demonstrate that the news associated with interest-rate change is responsible for causing both the anticipation before the announcement and the surprise after the announcement. We estimate the magnitude of financial news using the relative difference between the U.S. Treasury Bill and the Federal Funds effective rate. Our results are consistent with the "sign effect," in which "bad news" has a larger impact than "good news." Furthermore, we observe significant volatility aftershocks, confirming a "market under-reaction" that lasts at least one trading day.

Quantitative law describing market dynamics before and after interest-rate change

Science.gov (United States)

Petersen, Alexander M.; Wang, Fengzhong; Havlin, Shlomo; Stanley, H. Eugene

2010-06-01

We study the behavior of U.S. markets both before and after U.S. Federal Open Market Commission meetings and show that the announcement of a U.S. Federal Reserve rate change causes a financial shock, where the dynamics after the announcement is described by an analog of the Omori earthquake law. We quantify the rate n(t) of aftershocks following an interest-rate change at time T and find power-law decay which scales as n(t-T)˜(t-T)-Ω , with Ω positive. Surprisingly, we find that the same law describes the rate n'(|t-T|) of “preshocks” before the interest-rate change at time T . This study quantitatively relates the size of the market response to the news which caused the shock and uncovers the presence of quantifiable preshocks. We demonstrate that the news associated with interest-rate change is responsible for causing both the anticipation before the announcement and the surprise after the announcement. We estimate the magnitude of financial news using the relative difference between the U.S. Treasury Bill and the Federal Funds effective rate. Our results are consistent with the “sign effect,” in which “bad news” has a larger impact than “good news.” Furthermore, we observe significant volatility aftershocks, confirming a “market under-reaction” that lasts at least one trading day.

Whole-body fluid distribution in humans during dehydration and recovery, before and after humid-heat acclimation induced using controlled hyperthermia.

Science.gov (United States)

Patterson, M J; Stocks, J M; Taylor, N A S

2014-04-01

This experiment was designed to test the hypothesis that the plasma volume is not selectively defended during exercise- and heat-induced dehydration following humid-heat acclimation. Eight physically active males were heat acclimated (39.8 °C, relative humidity 59.2%) using 17 days of controlled hyperthermia (core temperature: 38.5 °C). Inter-compartmental fluid losses and movements were tracked (radioisotopes and Evans blue dye) during progressive dehydration (cycling) in these same conditions and also during a resting recovery without fluid replacement (28 °C), before (day 1), during (day 8) and after heat acclimation (day 22). On days 8 and 22, there were significant increases in total body water, interstitial fluid and plasma volume (P 0.05). The baseline plasma volume remained expanded throughout: 43.4 [±2.6 (day 1)], 49.1 [±2.4 (day 8); P recovery, plasma volume restoration commenced, with the intracellular fluid contribution becoming more pronounced as acclimation progressed. It is concluded that the plasma volume was not defended more vigorously following humid-heat acclimation. Indeed, a greater fluid loss may well underlie the mechanisms for enhancing plasma volume recovery when heat acclimation is induced using the controlled-hyperthermia technique. © 2013 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

MICROBIOTA URINE BEFORE AND AFTER LITHOTRIPSY FOR RENAL STONES

Directory of Open Access Journals (Sweden)

Y. L. Naboka

2013-01-01

Full Text Available Extracorporeal shock wave lithotripsy (ESWL in spite of the low invasiveness and high efficiency is accompanied by an infectious- inflammatory complications and renal parenchymal injury . Dynamics of microbial spectrum urine and the impact of postoperative antibiotic therapy currently remains unexplored. The study included 30 patients subjected to ESWL. Bacteriological study was midstream morning urine before ESWL, 1, 3 days after ESWL, and midstream urine in the first urination after ESWL. All patients were divided into 2 groups. Group I consisted of patients (46.7% with antibiotic therapy . Group II patients (53.3 % antibiotic therapy was performed. In most cases (97.8 % were bacteriuria , while in 75% of cases highlighted in the various options bacterial associations representation aerobic- anaerobic mixed infection, among which was dominated by non-clostridial anaerobic bacteria in all samples. Revealed that after ESWL microbial spectrum urine does not change in any case within 3 days , except for Enterobacteriaceae, but the frequency of occurrence and level of bacteriuria vary for different periods after surgery and fees or absence of antibiotic therapy.

Deficits in novelty exploration after controlled cortical impact.

Science.gov (United States)

Wagner, Amy K; Postal, Brett A; Darrah, Shaun D; Chen, Xiangbai; Khan, Amina S

2007-08-01

Experimental models of traumatic brain injury (TBI) have been utilized to characterize the behavioral derangements associated with brain trauma. Several studies exist characterizing motor function in the controlled cortical impact (CCI) injury model of TBI, but less research has focused on how CCI affects exploratory behavior. The goal of this study was to characterize deficits in three novelty exploration tasks after the CCI. Under anesthesia, 37 adult male Sprague Dawley rats received CCI (2.7 mm and 2.9 mm; 4 m/sec) over the right parietal cortex or sham surgery. For days 1-6 post-surgery, the beam balance and beam walking tasks were used to assess motor deficits. The Open Field, Y-Maze, and Free Choice Novelty (FCN) tasks were used to measure exploratory deficits from days 7-14 post-surgery. Injured rats displayed a significant, but transient, deficit on each motor task (p Open Field results showed that injured rats had lower activity levels than shams (p time in the novel arm versus the familiar arms when compared to shams (p time and had fewer interactions with objects in the novel environment compared to shams (p < 0.05). These results suggest that several ethological factors contribute to exploratory deficits after CCI and can be effectively characterized with the behavioral tasks described. Future work will utilize these tasks to evaluate the neural substrates underlying exploratory deficits after TBI.

Should we isolate human preantral follicles before or after cryopreservation of ovarian tissue?

Science.gov (United States)

Vanacker, Julie; Luyckx, Valérie; Amorim, Christiani; Dolmans, Marie-Madeleine; Van Langendonckt, Anne; Donnez, Jacques; Camboni, Alessandra

2013-04-01

To evaluate the survival and growth potential of human preantral follicles isolated before and after cryopreservation. Pilot study. Gynecology research unit in a university hospital. Six women aged 27 to 32 years. Six ovarian biopsy samples were cut into two equal parts, half subjected to slow-freezing followed by follicle isolation (cryo-iso group) and alginate-matrigel embedding, and half immediately processed for follicle isolation and alginate-matrigel embedding followed by slow-freezing (iso-cryo group) or used as fresh controls (fresh group). Follicle number, viability, diameter, and morphology. After 1,134 preantral follicles had been isolated from fresh biopsy samples and 1,132 from frozen specimens, the three groups were compared before and after 7 days of in vitro culture (IVC) in alginate-matrigel beads. No statistically significant differences in viability were found between the three groups before or after IVC, but follicle diameter increased in all three groups after IVC. Morphology analysis revealed well-preserved follicles in both the iso-cryo and cryo-iso groups after IVC. Human preantral follicles can be successfully cryopreserved before or after isolation without impairing their ability to survive and grow in vitro. This could lead to development of new protocols for follicle cryopreservation, IVC, and grafting in clinical and research settings for fertility preservation. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Australian smokers' support for plain or standardised packs before and after implementation: findings from the ITC Four Country Survey.

Science.gov (United States)

Swift, Elena; Borland, Ron; Cummings, K Michael; Fong, Geoffrey T; McNeill, Ann; Hammond, David; Thrasher, James F; Partos, Timea R; Yong, Hua-Hie

2015-11-01

Plain packaging (PP) for tobacco products was fully implemented in Australia on 1 December 2012 along with larger graphic health warnings. Using longitudinal data from the Australian arm of the ITC Four Country Survey, we examined attitudes to the new packs before and after implementation, predictors of attitudinal change, and the relationship between support and quitting activity. A population-based cohort study design, with some cross-sectional analyses. Surveys of Australian smokers assessed attitudes to PP at four time points prior to implementation (from 2007 to 2012) and one post-implementation wave collected (early/mid-2013). Trend analysis showed a slight rise in opposition to PP among smokers in the waves leading up to their implementation, but no change in support. Support for PP increased significantly after implementation (28.2% pre vs 49% post), such that post-PP more smokers were supportive than opposed (49% vs 34.7%). Multivariate analysis showed support either before or after implementation was predicted by belief in greater adverse health impacts of smoking, desire to quit and lower addiction. Among those not supportive before implementation, having no clear opinion about PP (versus being opposed) prior to the changes also predicted support post-implementation. Support for PP was prospectively associated with higher levels of quitting activity. Since implementation of PP along with larger warnings, support among Australian smokers has increased. Support is related to lower addiction, stronger beliefs in the negative health impacts of smoking, and higher levels of quitting activity. 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/

Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

Science.gov (United States)

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

2017-03-01

In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

Gallbladder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy

Energy Technology Data Exchange (ETDEWEB)

Lee, Myung Hea; Suk, Jae Dong; Moon, Dae Hyuk; Kim, Myung Hwan; Min, Young Il [Asian Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

1991-03-15

Extracorporeal shock wave lithotripsy (ESWI.) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, {sup 99m}Tc-DISIDA hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7 mCi of {sup 99m}Tc-DISIDA, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (I frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated, ESWL group were studied before, l day after and 2 weeks after ESWL, and UDCA group were studied before and 2 weeks after starting oral medication Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESlVL group, mean EF and mean ER at 1 day after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recovered to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

Sputum and serum microRNA-144 levels in patients with tuberculosis before and after treatment.

Science.gov (United States)

Lv, Yan; Guo, Shuai; Li, Xue-Gang; Chi, Jing-Yu; Qu, Yi-Qing; Zhong, Hai-Lai

2016-02-01

To measure the expression levels of sputum and serum microRNA-144 (miR-144) before and after the treatment of patients with tuberculosis (TB). Details of the cases of a total of 124 TB patients were collected at Qilu Hospital of Shandong University between April 2014 and April 2015. Fifty-three of these patients had sputum positive for bacteria and a cavity on imaging (group A), 20 patients had sputum negative for bacteria and a cavity on imaging (group B), and 51 patients had sputum negative for bacteria and no cavity on imaging (group C). One hundred seventeen healthy people who attended the hospital for a physical examination were recruited as controls. Quantitative real-time PCR (qRT-PCR) was used to measure the levels of sputum and serum miR-144 before anti-TB treatment and at 1 month after treatment. Before treatment, sputum and serum miR-144 expression levels in the TB patients were both higher than those of the controls (both p<0.05). After treatment, sputum and serum miR-144 levels in the TB patients were significantly lower than those measured before treatment (both p<0.05). The levels of sputum and serum miR-144 in the improved TB patients decreased significantly after treatment compared to those measured before treatment (both p<0.001). Significant differences were found in sputum and serum miR-144 levels in the TB patients, with or without improvement, compared with the healthy controls (all p<0.05). Sputum and serum miR-144 levels were significantly upregulated in the TB patients, but were found to decrease significantly after anti-TB treatment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial.

Science.gov (United States)

Stoller, Oliver; de Bruin, Eling D; Schuster-Amft, Corina; Schindelholz, Matthias; de Bie, Rob A; Hunt, Kenneth J

2013-09-22

After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (≤20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject's inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics

Localised Effects of a Mega-Disturbance: Spatiotemporal Responses of Intertidal Sandy Shore Communities to the 2010 Chilean Earthquake.

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Sepúlveda, Roger D; Valdivia, Nelson

2016-01-01

Determining the effects of unpredictable disturbances on dynamic ecological systems is challenged by the paucity of appropriate temporal and spatial coverage of data. On 27 February 2010, an 8.8 Mw mega-earthquake and tsunami struck central Chile and caused coastal land-level changes, massive damage to coastal infrastructure, and widespread mortality of coastal organisms. Wave-exposed sandy beaches showed significant changes of species abundances from before to after the earthquake, but the highly dynamic biotic and abiotic conditions of these habitats make difficult to draw clear-cut conclusions from these patterns. Here, we analysed a beyond-BACI (Before-After Control-Impact) sampling design to test whether the effects of the Maule earthquake on sandy-shore species diversity, abundance, and structure were heterogeneous along the shore. Invertebrate species abundances were quantified before (i.e. February 2010) and after (i.e. March 2010, September 2010, and March 2011) the earthquake at three sandy shores randomly located within the earthquake rupture area and three sites within a "control" area located >400 km southward from epicentre. Immediately after the earthquake took place, the three sites located in the rupture area showed anomalous beach-profile uplifts that did not comply with the erosion (i.e. "negative" uplifts) that regularly occurs during late summer in the region. Species richness, abundance, and community structure significantly varied from before to after the strike, but these patterns of change varied among sites within both areas. Only the site with the strongest and persistent beach-profile uplift within the rupture area showed significant concomitant changes in species richness and community structure; after 13 months, this community showed a similar multivariate structure to the before-disturbance state. This site, in particular, was located in the section of the rupture area that received most of the impact of the after-earthquake tsunami

Localised Effects of a Mega-Disturbance: Spatiotemporal Responses of Intertidal Sandy Shore Communities to the 2010 Chilean Earthquake.

Directory of Open Access Journals (Sweden)

Roger D Sepúlveda

Full Text Available Determining the effects of unpredictable disturbances on dynamic ecological systems is challenged by the paucity of appropriate temporal and spatial coverage of data. On 27 February 2010, an 8.8 Mw mega-earthquake and tsunami struck central Chile and caused coastal land-level changes, massive damage to coastal infrastructure, and widespread mortality of coastal organisms. Wave-exposed sandy beaches showed significant changes of species abundances from before to after the earthquake, but the highly dynamic biotic and abiotic conditions of these habitats make difficult to draw clear-cut conclusions from these patterns. Here, we analysed a beyond-BACI (Before-After Control-Impact sampling design to test whether the effects of the Maule earthquake on sandy-shore species diversity, abundance, and structure were heterogeneous along the shore. Invertebrate species abundances were quantified before (i.e. February 2010 and after (i.e. March 2010, September 2010, and March 2011 the earthquake at three sandy shores randomly located within the earthquake rupture area and three sites within a "control" area located >400 km southward from epicentre. Immediately after the earthquake took place, the three sites located in the rupture area showed anomalous beach-profile uplifts that did not comply with the erosion (i.e. "negative" uplifts that regularly occurs during late summer in the region. Species richness, abundance, and community structure significantly varied from before to after the strike, but these patterns of change varied among sites within both areas. Only the site with the strongest and persistent beach-profile uplift within the rupture area showed significant concomitant changes in species richness and community structure; after 13 months, this community showed a similar multivariate structure to the before-disturbance state. This site, in particular, was located in the section of the rupture area that received most of the impact of the after

Characterization of Chemical Composition in PM2.5 in Beijing Before, During, and After a Large-Scale International Event

Science.gov (United States)

Yang, X.; Cheng, S.; Li, J.

2017-12-01

To commemorate the 70th anniversary of the victory of the Chinese people's Anti-Japanese War and the World Anti-Fascist War, an international parade was held in Beijing in September 2015. In order to ensure satisfactory air quality during this event, a phased emission control measures were taken in Beijing and its surrounding provinces. The 24-h PM2.5 samples were collected in Beijing from August 1 to September 15, 2015 covering the period before, during and after this large-scale event. The observed PM2.5 data, meteorological data, emission reduction measures, and air mass trajectory simulation results were systematically analyzed to understand the pollution characteristics and chemical compositions of PM2.5 in Beijing. The results indicated that PM2.5 concentration during the two emission control phases was reduced by 61.7% comparing to the non-control period, but the regional transport of pollutants and meteorological conditions had a more prominent impact on PM2.5 than emission reduction during phase 2. The secondary water-soluble ions including SO42-, NO3-, and NH4+ were found as the main ions present in PM2.5. During the entire emission control period, organic carbon (OC) and elemental carbon (EC) mass concentrations were decreased by 53.1% and 57.9%. A PM2.5 mass balance was analyzed, and it was found that the organic matter accounted for 29.3, 37.6 and 28.5% of the PM2.5 mass before, during and after the emission control, while the contribution of mobile sources to PM2.5 was relatively outstanding after a series of emission control measures.

Terrestrial liming benefits birds in an acidified forest in the northeast.

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Pabian, Sarah E; Brittingham, Margaret C

2007-12-01

Studies in Europe have reported negative effects of acid deposition on forest birds, and research in North America has identified links between forest bird abundance and rates of acid deposition. We examined the bird community in an acidified forest in central Pennsylvania (USA) and evaluated the effects of terrestrial lime application on birds. We used a before-after control-impact (BACI) study design, with one year of observation before (2003) and three years after lime application (2004, 2005, and 2006). Between the 2003 and 2004 field seasons, 4500 kg/ha of dolomitic lime were applied to two of four 100-ha watersheds. Each year, we monitored bird abundance and Ovenbird (Seiurus aurocapilla) eggshell thickness and territory size. Soil and snail abundance data were also collected. The bird community and territory size results indicated that the study area may be providing low-quality habitat for forest birds, perhaps as a result of acid deposition. We found lower forest bird abundances than have been found in less acidified areas of Pennsylvania, and larger Ovenbird territory sizes than have been found in other studies. We found a significant positive relationship between soil calcium and bird abundance, indicating that soil calcium may affect bird abundance. Liming increased soil calcium and pH and led to increased snail and bird abundances. After liming, bird abundance was positively related to snail abundance. No significant changes occurred in Ovenbird territory size or eggshell thickness. Our results suggest that acid deposition could be responsible for reduced bird abundance, and that liming is a potential mitigation technique.

On the stability of preferences and attitudes before and after experiencing an electric vehicle

DEFF Research Database (Denmark)

Jensen, Anders Fjendbo; Cherchi, Elisabetta; Mabit, Stefan Lindhard

2013-01-01

-wave stated preference experiment where data was collected before and after the respondents experienced an electric vehicle for three months. We estimate a hybrid choice model using jointly the stated choices before and after the test period. The results show that individual preferences change significantly......In this study, we investigate the extent to which experience affects individual preferences for specific electric vehicle characteristics, individual attitudes toward the environment, and the impact of the attitudes on the choice between an electric and a conventional vehicle. We use a two...... after a real experience with an electric vehicle in the household. In particular, there are major changes in the preference for driving range, top speed, fuel cost, battery life and charging in city centres and train stations. In line with other studies, we find that environmental concern has a positive...

Straylight before and after hyperopic laser in situ keratomileusis or laser-assisted subepithelial keratectomy

NARCIS (Netherlands)

Lapid-Gortzak, Ruth; van der Linden, Jan Willem; van der Meulen, Ivanka J. E.; Nieuwendaal, Carla P.; Mourits, Maarten P.; van den Berg, Thomas J. T. P.

2010-01-01

PURPOSE To compare straylight values before and 3 months after hyperopic laser in situ keratomileusis (LASIK) or laser-assisted subepithelial keratectomy (LASEK) and determine the cause of any change SETTING Private refractive surgery clinic, Driebergen, The Netherlands DESIGN Comparative case

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 (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.

A CMOS matrix for extracting MOSFET parameters before and after irradiation

International Nuclear Information System (INIS)

Blaes, B.R.; Buehler, M.G.; Lin, Y.S.; Hicks, K.A.

1988-01-01

An addressable matrix of 16 n- and 16 p-MOSFETs has been designed to extract the DC MOSFET parameters for all dc gate bias conditions before and after irradiation. The matrix contains four sets of MOSFETs each with four different geometries that can be biased independently before and after irradiation. Thus the worst-case bias scenarios can be determined. The MOSFET matrix was fabricated at a silicon foundry using a radiation-soft CMOS p-well LOCOS process. Cobalt 60 irradiation results for the n-MOSFETs showed a very low threshold voltage shift of -3mV/krad(Si); whereas, the p-MOSFETs showed 21 mV/krad(Si). The worst-case threshold voltage shift occurred for the n-MOSFET with a gate bias of 5V during anneal, but for the p-MOSFETs, biasing did not affect the shift in the threshold voltage. A parasitic MOSFET dominated the leakage of the n-MOSFET biased with 5V on the gate during irradiation

Drug-Induced Hypothermia as Beneficial Treatment before and after Cerebral Ischemia

DEFF Research Database (Denmark)

Johansen, Flemming F; Hasseldam, Henrik; Rasmussen, Rune Skovgaard

2014-01-01

Objectives: Hypothermia is still unproven as beneficial treatment in human stroke, although in animal models, conditioning the brain with hypothermia has induced tolerance to insults. Here, we delineate the feasibility of drug-induced mild hypothermia in reducing ischemic brain damage when...... conditioning before (preconditioning) and after (postconditioning) experimental stroke. Methods: Hypothermia was induced in rats with a bolus of 6 mg/kg talipexole followed by 20 h continuous talipexole infusion of 6 mg/kg in total. Controls received similar treatment with saline. The core body temperature...... was continuously monitored. In preconditioning, hypothermia was terminated before either reversible occlusion of the middle cerebral artery (MCAO) for 60 min or global ischemia for 10 min with 2-vessel occlusion and hypotension. In postconditioning, rats experienced 60 min of MCAO before hypothermia was induced...

Endogenous hormones in postmenopausal females with breast cancer--before and after treatment.

Science.gov (United States)

Trehan, Aniljeet S; Arora, Megha K; Seth, Shashi; Chauhan, Ashok

2012-01-01

Breast cancer is usually present for many years (as long as 5-10 years) before it can be clinically diagnosed (theory of the 'dormant malignant cell'). This implies that breast cancer cells, during their subclinical period, are likely to have been exposed for a considerable time to endogenous sex hormones and endogenous hormonal milieu predicts the chances of breast cancer in females. So, we planned this study to evaluate the role of endogenous hormones in postmenopausal females excluding the patients on hormone replacement therapy as the relationship between breast cancer and hormone replacement therapy is well known. Hormone therapy is known to affect these hormone levels but whether treatment of breast cancer per se also decreases the hormone levels is not known. We planned the present study to determine hormone levels in patients before and after 4 months of treatment (chemotherapy/surgery and radiotherapy). Circulating hormone levels were measured using a chemiluminescence method. Their results were compared with a group of 25 age matched healthy controls. We found that serum prolactin, testosterone and estrogen levels were very significantly higher in patients before treatment (Group I) as compared to controls (Group III). Serum prolactin and serum estrogen levels were significantly higher and serum testosterone was very significantly higher in patients before treatment (Group I) when compared after 4 months of treatment (Group II). Only serum estrogen levels were significantly high in patients after treatment (Group II) as compared to controls (Group III). Serum progesterone levels showed no significant difference to any of the groups. We concluded that postmenopausal females with breast cancer have abnormalities in hormone levels. These abnormalities may be considered in the pathogenesis of the disease and should be taken into account in the treatment of patients of breast cancer. It might also be helpful to delay the onset of cancer by normalizing the

Before You Control Your Pest

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Rodenticides Other types of pesticides Disponible en español Before You Control Your Pest There are many require chemical control. There are many types of professionals who may offer assistance at different Control Company Pesticide Safe Use Practices Agency or Service How they may be able to help: NPIC We

Changing information needs of social impact of nuclear power plant siting. Through a comparison before and after the Fukushima Daiichi nuclear power plant accident

International Nuclear Information System (INIS)

Kashiwa, Takako; Kawamoto, Yoshimi

2013-01-01

In the light of the Fukushima Daiichi nuclear power plant accident, we need to consider a symbiosis method based on the diminution of the nuclear power industry. To find a region that does not excessively depend on the nuclear power industry, it is necessary to examine and discuss the social impact of nuclear-related industries. In this study, we compared people's changing information needs of social impact before and after the Fukushima Daiichi nuclear power plant accident. It was found that the need for information increased after the accident. In particular, there were three research areas where the need for information increased: the consideration of building nuclear power plants, the influence of harmful rumors on the region, and influence on the nuclear power industry. Next, attempts were made to understand whether there is a difference between information needs of social impact by attributes, such as age, sex and knowledge of nuclear power. The information needs of the following categories of people increased after the accident: people aged between 10 and 50 years, women, people who do not have a clear opinion about the use of a nuclear power plant, and people who do not have any knowledge of nuclear power. (author)

VOICE QUALITY BEFORE AND AFTER THYROIDECTOMY

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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.

To Compare Efficacy of Hypnosis and Intravenous Sedation in Controlling of Important Variables of Vital Signs and Evaluate the Patient Anxiety Before and after Topical Anesthesia in Ophthalmic Surgery

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Faranak Behnaz

2016-07-01

Full Text Available Background: Stress is one of the most important problems among preoperative patients. In order to reduce these signs and symptoms, some medications are used for patients. The aim of this study was to compare the efficacy of hypnosis to intravenous sedation on controlling the important variables of vital signs and to evaluate the patient anxiety before and after regional or topical anesthesia in ophthalmic surgery.Materials and Methods: This study was designed as a double-blind stratified randomized clinical trial.  Hypnotism was administered to hypnotism group, and midazolam, fentanyl, and propofol were given intravenously to the IV sedation group. The patients were monitored and the baseline variables consisted of mean arterial pressure, pulse rate, respiratory rate, and O2 saturation were registered every 15 minutes during surgery. Patient anxiety was measured via Spielbeger`s State Anxiety Index (STAI score before and after surgery.Results: 90 patients were participated in the study, with 50% (n=45 assigned to hypnosis group and 50% (N=45 assigned to IV sedation group. Patients characteristics, including age, gender, and body mass index (BMI duration of surgery were similar among the groups (P>0.05. Spielbeger`s State Anxiety Index (STAI score before and after surgery were not significantly different in both groups (P>0.05. Heart rate, respiratory rate, mean arterial pressure were lower among hypnosis group as well as this group had higher O2 saturation during surgery (P<0.05.Conclusion: Hypnosis can be an effective means of controlling vital signs at different intervals of starting the ophthalmic surgery compared to intravenous sedation. In the hypnosis group anxiety was similar to IV sedation group, but O2 saturation was more desirable. 

Efficacy of Biofeedback Therapy before and after Sphincteroplasty for Fecal Incontinence because of Obstetric Injury: A Randomized Controlled Trial

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Leila Ghahramani

2016-03-01

Full Text Available Fecal incontinence is a challenging condition in that it exerts various psychosocial impacts on daily life. Different treatment modalities have been suggested for fecal incontinence. The present study aimed to evaluate the efficacy of biofeedback therapy in combination with surgery in the management of fecal incontinence. The present randomized controlled trial was performed on 27 women with a complaint of fecal incontinence because of delivery trauma. The patients underwent sphincteroplasty and levatorplasty via the same method by 2 colorectal surgeons. In Group I, biofeedback therapy was performed 3 months before and 6 months after the surgery; in Group II, biofeedback therapy was applied only 6 months after the surgery; and in Group III, only surgical management was performed. The results revealed a significant difference between the preoperative and postoperative Wexner scores of incontinence in all the 3 groups. Additionally, the difference between the preoperative and postoperative scores was significant only in Group I and Group III, but not in Group II. The reduction in the Wexner score was significantly less in Group III. However, no significant difference was observed between the 3 groups concerning the mean difference of preoperative and postoperative manometry. The present study revealed no significant role for biofeedback therapy alone in the improvement of manometric evaluation. However, the Wexner score, which is an indicator of patient satisfaction, increased with biofeedback therapy following sphincteroplasty. In general, surgical treatment is now reserved for selected patients with fecal incontinence and has recently been developed with biofeedback therapy. Trial Registration Number: IRCT201206039936N1

Effects of low-level laser therapy applied before or after plyometric exercise on muscle damage markers: randomized, double-blind, placebo-controlled trial.

Science.gov (United States)

Fritsch, Carolina Gassen; Dornelles, Maurício Pinto; Severo-Silveira, Lucas; Marques, Vanessa Bernardes; Rosso, Isabele de Albuquerque; Baroni, Bruno Manfredini

2016-12-01

Promising effects of phototherapy on markers of exercise-induced muscle damage has been already demonstrated in constant load or isokinetic protocols. However, its effects on more functional situations, such as plyometric exercises, and when is the best moment to apply this treatment (pre- or post-exercise) remain unclear. Therefore, the purpose of this study was to investigate the effect of low-level laser therapy (LLLT) before or after plyometric exercise on quadriceps muscle damage markers. A randomized, double-blinded, placebo-controlled trial was conducted with 24 healthy men, 12 at pre-exercise treatment group and 12 at post-exercise treatment group. Placebo and LLLT (810 nm, 200 mW per diode, 6 J per diode, 240 J per leg) were randomly applied on right/left knee extensor muscles of each volunteer before/after a plyometric exercise protocol. Muscular echo intensity (ultrasonography images), soreness (visual analogue scale - VAS), and strength impairment (maximal voluntary contraction - MVC) were assessed at baseline, 24, 48, and 72 h post-exercise. Legs treated with LLLT before or after exercise presented significantly smaller increments of echo intensity (values up to 1 %) compared to placebo treatments (increased up to ∼7 %). No significant treatment effect was found for VAS and MVC, although a trend toward better results on LLLT legs have been found for VAS (mean values up to 30 % lesser than placebo leg). In conclusion, LLLT applied before or after plyometric exercise reduces the muscle echo intensity response and possibly attenuates the muscle soreness. However, these positive results were not observed on strength impairment.

Cycling before and after Exhaustion Differently Affects Cardiac Autonomic Control during Heart Rate Matched Exercise

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Matthias Weippert

2017-11-01

Full Text Available During cycling before (PRE and after exhaustion (POST different modes of autonomic cardiac control might occur due to different interoceptive input and altered influences from higher brain centers. We hypothesized that heart rate variability (HRV is significantly affected by an interaction of the experimental period (PRE vs. POST and exercise intensity (HIGH vs. LOW; HIGH = HR > HR at the lactate threshold (HRLT, LOW = HR ≤ HRLT despite identical average HR.Methods: Fifty healthy volunteers completed an incremental cycling test until exhaustion. Workload started with 30 W at a constant pedaling rate (60 revolutions · min−1 and was gradually increased by 30 W · 5 min−1. Five adjacent 60 s inter-beat (R-R interval segments from the immediate recovery period (POST 1–5 at 30 W and 60 rpm were each matched with their HR-corresponding 60 s-segments during the cycle test (PRE 1–5. An analysis of covariance was carried out with one repeated-measures factor (PRE vs. POST exhaustion, one between-subject factor (HIGH vs. LOW intensity and respiration rate as covariate to test for significant effects (p < 0.050 on the natural log-transformed root mean square of successive differences between adjacent R-R intervals (lnRMSSD60s.Results: LnRMSSD60s was significantly affected by the interaction of experimental period × intensity [F(1, 242 = 30.233, p < 0.001, ηp2 = 0.111]. LnRMSSD60s was higher during PRE compared to POST at LOW intensity (1.6 ± 0.6 vs. 1.4 ± 0.6 ms; p < 0.001. In contrast, at HIGH intensity lnRMSSD60s was lower during PRE compared to POST (1.0 ± 0.4 vs. 1.2 ± 0.4 ms; p < 0.001.Conclusion: Identical net HR during cycling can result from distinct autonomic modulation patterns. Results suggest a pronounced sympathetic-parasympathetic coactivation immediately after the cessation of peak workload compared to HR-matched cycling before exhaustion at HIGH intensity. On the opposite, at LOW intensity cycling, a stronger coactivational

Before-after environmental impact assessment of an artificial channel opening on a south-western Atlantic choked lagoon system.

Science.gov (United States)

Prestrelo, L; Monteiro-Neto, C

2016-07-01

This study aimed to evaluate the human induced impact of a channel opening in a choked lagoon and attempted to establish the cause-effect links for the observed changes. The same lagoon system was sampled before and after the channel opening event, and the differences in fish and crustacean assemblages and environmental variables between these periods analysed. The opening of the artificial channel resulted in salinity increases, leading to a shift in species composition, favouring marine species and reducing abundance and diversity of previously dominant freshwater species. Furthermore, saltwater entrance into the choked lagoon caused an unexpected decrease in species richness and biomass, plus deterioration of ecosystem processes, reducing fishing capacity. The effects of salinity on the ecosystem vary depending on the ecosystem's composition and capacity to overcome salinity changes, thus specific monitoring projects are important strategies for developing coastal lagoon conservation management. © 2016 The Fisheries Society of the British Isles.

Using a Before-During-After (BDA) Model to Plan Effective Secondary Mathematics Lessons

Science.gov (United States)

Wilburne, Jane Murphy; Peterson, Winnie

2007-01-01

Creating effective mathematics lessons can be a challenge for any teacher. One approach to design an effective lesson is using a before-during-after (BDA) format. This article describes what a BDA format is and provides two examples of how it is implemented in high school mathematics classes. (Contains 2 tables and 5 figures.)

NETosis before and after Hyperglycemic Control in Type 2 Diabetes Mellitus Patients.

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Agostina Carestia

Full Text Available Diabetes is characterized by chronic inflammation, endothelial dysfunction, increased risk of infections and early cardiovascular disease. By releasing neutrophil extracellular traps (NETs, neutrophils kill bacteria and exert pro-inflammatory and pro-thrombotic activities. Increased NETosis has been found in cross-sectional studies including treated type 2 diabetes mellitus (T2DM patients. In this study, we determined whether the ability of neutrophils to form NETs differs in diabetic patients pre- and post-hyperglycemic control versus healthy donors (HD, and the relationship between NETosis with pro-thrombotic, pro-inflammatory biomarkers and thrombotic clinical events.Diabetic patients recently diagnosed and after 6 and 12 months of treatment (N = 25 and HD (N = 25 were included. NET formation was studied by microscopy and fluorometry. Nucleosomes, HNE-DNA complexes, von Willebrand factor (vWF, IL6 and TNFα plasma levels were measured by ELISA and P-selectin on the platelet surface was assessed by cytometry.Basal levels of NETs in recently diagnosed T2DM patients were higher compared to HD. While TNFα stimulation of control neutrophils resulted in DNA release, patient neutrophils were not responsive. Although glycemia decreased after 6 months of metformin treatment, basal and TNFα and PMA-stimulated NETs reached normal values after 12 months. Compared to controls, nucleosomes, HNE-DNA complexes, IL-6 and TNFα levels were increased in recently diagnosed patients and decreased after 12 months of treatment. P-selectin and vWF levels were similar in both populations.Our data suggest that NETs could represent a biomarker for T2DM. Increased NETosis in T2DM patients does not appear to be the consequence of impaired glycemic control but rather due to pro-inflammatory cytokines and is not related to thrombotic events.

Categorization of questions posed before and after inquiry-based learning

Directory of Open Access Journals (Sweden)

Sandra Milena García González

2014-07-01

Full Text Available Posing research questions is the central ability of the scientific thought. This article examines the ability of sixth grade children to pose researchable questions before and after a three months’ work on a didactic sequence based on the inquiry school model. According to their purpose, the questions asked by children, after reading a text, were classified into researchable questions -susceptible to be empirically explored-, questions about a cause, and questions on a piece of data. The results show that the amount and the type of questions the students were able to pose during the intervention changed, from most of questions on data or information, to most of researchable questions, subsequently, the importance of designing teaching approaches to foster this ability was proved.

Impact of Angioscopic Evaluation for Femoropopliteal In-Stent Restenosis Before and After Excimer Laser Atherectomy.

Science.gov (United States)

Idemoto, Akiko; Okamoto, Naotaka; Tanaka, Akihiro; Mori, Naoki; Nakamura, Daisuke; Yano, Masamichi; Makino, Nobuhiko; Egami, Yasuyuki; Shutta, Ryu; Tanouchi, Jun; Nishino, Masami

2017-07-01

In-stent restenosis (ISR) is a prevalent problem following stenting of femoropopliteal lesions. A potential novel treatment modality for ISR including excimer laser atherectomy (ELA) has become available. We performed ELA for in-stent chronic total occlusion (CTO) of femoropopliteal lesions and evaluated lesion morphology before and after ELA by angioscopy in 2 patients. The angioscopic findings clearly showed removal of in-stent thrombi after ELA. Thus, ELA may be effective for in-stent CTO of femoropopliteal lesions. This is the first report describing the direct visualization of ELA effect for vaporization of thrombi in femoropopliteal in-stent lesions by angioscopy.

Impact of the Spanish smoking law on exposure to secondhand smoke in offices and hospitality venues: before-and-after study.

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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 (venueshospitality 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.

Bird Survey in Storruns windfarm in Jaemtland; Faagelundersoekning vid Storruns vindkraftanlaeggning Jaemtland

Energy Technology Data Exchange (ETDEWEB)

Falkdalen, Ulla; Falkdalen Lindahl, Lars; Nygaard, Torgeir

2013-08-15

A survey of the bird populations in Oldfjaellen in Jaemtland county, Sweden, was initiated in 2003 prior to the construction of a wind-farm on two adjacent hills, Storrun and Froesoerun by the lake Oevre Oldsjoen. After a gap in the surveys in 2004, comprehensive studies were continued during 2005 - 2008, prior to the construction. The construction-work started during autumn 2008, and the turbines were erected during 2009. Power production was started during the autumn of 2009. The post-construction bird studies were carried out in 2010 and 2011. This report summarizes all the studies that were performed before and after the construction of the wind-farm. Many of the separate studies were made using a BACI method (Before-After-Control-Impact) enabling comparisons of the situation before and after development, using a control area. In addition, a study of collision rates and scavenger removal rates is reported. As expected, the movement and migration of birds over Storrun was of rather limited magnitude. Although the majority of observations during the investigated periods spring and autumn are assumed to be migrating birds, larger flocks of birds are rare in the area. Ca. 20 % of all the birds that passed through or near the wind-farm area flew in heights comparable to the rotor-swept zone. However, more than 40 % of the raptors and waders passed through in that zone, which implies a collision risk. These two groups of birds have shown to be particularly prone to collisions with rotor blades in other studies.

Neuropsychological assessment before and after radiotherapy in a child with an intracranial tumor: case report

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Alessandra Pereira Lopes

2013-12-01

Full Text Available INTRODUCTION: Brain tumors are the most common solid tumors and the second largest group of neoplasms diagnosed in childhood. Treatment includes surgery, radiotherapy, and chemotherapy. However, radiotherapy can cause complications, e.g., cognitive deficits. CASE DESCRIPTION: We describe the case of a child diagnosed with a brain tumor evaluated before and after radiotherapy to investigate cognitive decline after treatment. The results showed a decline in Intelligence Quotient (IQ scores and reversal of the predominance of verbal and nonverbal skills. After radiotherapy, the subject showed slowness, academic deficits, and difficulties learning new information. COMMENTS: Even though the post-treatment evaluation showed scores compatible with the average, comparison between pre- and post-treatment evaluations demonstrated the impact of radiotherapy on the subject's cognitive profile. These results highlight the importance of evaluating patients who undergo radiotherapy before and after treatment and understanding neuropsychological scores associated with the subjects' complaints.

Impact of a point-of-sale tobacco display ban on smokers' spontaneous purchases: comparisons from postpurchase interviews before and after the ban in Western Australia.

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Carter, Owen B J; Phan, Tina; Mills, Brennen W

2015-03-01

To assess the impact of the Western Australian tobacco point-of-sale display ban on spontaneous purchase behaviours. Daily adult smokers (n=402) observed purchasing cigarettes were recruited via exit interviews either 2 months before or after the implementation of the display ban. Smokers were asked if they had intended to purchase cigarettes before entering the store to assess spontaneous purchase behaviours. Whether smokers had noticed the displays before their purchase and the extent to which this influenced their purchase decision was also assessed via non-prompting questions. When compared with before the ban, fewer smokers after the ban noticed the displays (27.1% vs 1.1%, pmaking spontaneous purchases (28.2% vs 19.8%, ppurchase decisions (free recall 5.0% vs 1.1%, ppurchasers were more likely than planned purchasers to suggest the displays influenced their purchase decisions (free recall 9.7% vs 3.2%, ppurchasers nominating the influence of displays fell substantially (free recall 9.7% vs 5.6%, p=NS; cued recall 40.0% vs 11.1%, ppurchasers (free recall 3.2% vs 0.0%, pmaking spontaneous tobacco purchases after implementation of the Western Australian tobacco display ban and between a fivefold and sixfold reduction in the proportion suggesting displays influenced their decision to purchase cigarettes. These data are consistent with previous research suggesting tobacco displays encourage spontaneous purchases and their removal corresponds to reductions in the same. 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.

A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

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Andrade Denise de

2000-01-01

Full Text Available In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1 040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%, 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.

A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

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Denise de Andrade

2000-03-01

Full Text Available In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1 040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%, 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.

Flow motion waves with high and low frequency in severe ischaemia before and after percutaneous transluminal angioplasty

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Hoffmann, Ulrich; Schneider, Ernst; Bollinger, Alfred

2017-01-01

Study of objective - The aim was to evaluate skin flux and prevalence of low and high frequency flow motion waves in patients with severe ischaemia due to peripheral arterial occlusive disease before and after percutaneous transluminal angioplasty (PTA) with and without local thrombolysis. Design - Flow motion was recorded by the laser Doppler technique at the dorsum of the foot before, one day, and one month after PTA. The results were separately analysed in patients with successful and unsu...

Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

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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.

Impact of regurgitation on health-related quality of life in gastro-oesophageal reflux disease before and after short-term potent acid suppression therapy.

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Kahrilas, Peter J; Jonsson, Andreas; Denison, Hans; Wernersson, Börje; Hughes, Nesta; Howden, Colin W

2014-05-01

Limited data exist on the impact of regurgitation on health-related quality of life (HRQOL) in gastro-oesophageal reflux disease (GORD). We assessed the relationship between regurgitation frequency and HRQOL before and after acid suppression therapy in GORD. We used data from two randomised trials of AZD0865 25-75 mg/day versus esomeprazole 20 or 40 mg/day in non-erosive reflux disease (NERD) (n=1415) or reflux oesophagitis (RO) (n=1460). The Reflux Disease Questionnaire was used to select patients with frequent and intense heartburn for inclusion and to assess treatment response. The Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire was used to assess HRQOL. At baseline, 93% of patients in both the NERD and RO groups experienced regurgitation. Mean QOLRAD scores were similar for NERD and RO at baseline and at week 4 and disclosed decremental HRQOL with increasing frequency of regurgitation; a clinically relevant difference of >0.5 in mean QOLRAD scores was seen with regurgitation ≥4 days/week versus <4 days/week. The prevalence of frequent, persistent regurgitation (≥4 days/week) at week 4 among heartburn responders (≤1 day/week of mild heartburn) was 28% in NERD and 23% in RO. QOLRAD scores were higher among heartburn responders. There was a similar pattern of impact related to regurgitation frequency in heartburn responders compared with the group as a whole. Frequent regurgitation was associated with a clinically relevant, incremental decline in HRQOL beyond that associated with heartburn before and after potent acid suppression in both NERD and RO. NCT00206284 and NCT00206245.

Detecting the Evolution of Deliberate Fertility Control before the Demographic Transition in Germany

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Aliaksandr Amialchuk

2012-10-01

Full Text Available BACKGROUND Pervious literature has established the existence of deliberate non-parity-specific fertility control in pre-transitional populations. However, less focus has been given to the timing of its onset. In addition, previous studies focused on the changes in fertility in response to the local prices of grains, which may be endogenous. OBJECTIVE This paper studies the emergence and evolution of deliberate fertility control by investigating the link between child mortality and economic stress on the one hand and non-parity-specific birth control on the other, in historic German villages between 1700 and 1900. METHODS Birth histories from fourteen German villages (1700-1900 and rye price series are used in a micro-level event history analysis. The fertility response of second and higher-order births to the mortality of children over age two and exogenous fluctuations in rye price are used as measures of the extent of deliberate non-parity-specific birth control. RESULTS Over the course of the demographic transition, the effect of the death of children generally increases after controlling for the effect of the death of children less than two years old. The negative fertility response to high rye prices before and in the year immediately following the price change occurred only after 1800. CONCLUSIONS The replacement and insurance effects associated with child mortality generally increased before the demographic transition. The emergence of the negative effect of high rye prices on fertility after 1800 further supports the presence and evolution of deliberate non-parity-specific fertility control before the demographic transition.

Biochemical Evaluation of Serum Adiponectin Level in Egyptian Breast Cancer Patients before and after Treatment

International Nuclear Information System (INIS)

El Shepiny, M.S.El.M.

2010-01-01

In this study, serum adiponectin level was evaluated in 35 primary breast cancer patients and 10 healthy females, before and after treatment to assess if there is a relation between it and breast cancer, and to find out if it has a prognostic value. Serum adiponectin level was significantly lower in all and postmenopausal breast cancer patients before taking any type of treatment, and non-significantly lower in locally advanced breast cancer patients after treatment by 4 cycles of neoadjuvant chemotherapy than healthy controls. Non-significant elevations was shown after treatment by surgery, and also after completing treatment by surgery followed by taking 2 cycles of adjuvant chemotherapy followed by treatment by radiotherapy in case of premenopausal locally advanced breast cancer patients. Triglycerides showed significantly higher level in all groups of patients. There was statistical negative correlation between serum adiponectin level and body mass index (BMI) in postmenopausal healthy controls, and between serum adiponectin level and BMI, triglycerides in all and postmenopausal breast cancer patients before taking any type of treatment. In conclusion, this study suggests that low serum adiponectin level is likely to be associated with increased breast cancer risk, particularly among postmenopausal women. The association between obesity and breast cancer risk might be partly explained by adiponectin

Indoor thermal environment, air exchange rates, and carbon dioxide concentrations before and after energy retro fits in Finnish and Lithuanian multi-family buildings.

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Leivo, Virpi; Prasauskas, Tadas; Du, Liuliu; Turunen, Mari; Kiviste, Mihkel; Aaltonen, Anu; Martuzevicius, Dainius; Haverinen-Shaughnessy, Ulla

2018-04-15

Impacts of energy retrofits on indoor thermal environment, i.e. temperature (T) and relative humidity (RH), as well as ventilation rates and carbon dioxide (CO 2 ) concentrations, were assessed in 46 Finnish and 20 Lithuanian multi-family buildings, including 39 retrofitted case buildings in Finland and 15 in Lithuania (the remaining buildings were control buildings with no retrofits). In the Finnish buildings, high indoor T along with low RH levels was commonly observed both before and after the retrofits. Ventilation rates (l/s per person) were higher after the retrofits in buildings with mechanical exhaust ventilation than the corresponding values before the retrofits. Measured CO 2 levels were low in vast majority of buildings. In Lithuania, average indoor T levels were low before the retrofits and there was a significant increase in the average T after the retrofits. In addition, average ventilation rate was lower and CO 2 levels were higher after the retrofits in the case buildings (N=15), both in apartments with natural and mixed ventilation. Based on the results, assessment of thermal conditions and ventilation rates after energy retrofits is crucial for optimal indoor environmental quality and energy use. Copyright © 2017 Elsevier B.V. All rights reserved.

18F-FDG PET imaging before and after capsulotomy in obsessive-compulsive disorder

International Nuclear Information System (INIS)

Guan Yihui; Sun Bomin; Zhang Haiying; Lin Xiangtong; Zuo Chuantao; Zhao Jun; Liu Yongchang

2001-01-01

Objective: To evaluate the therapeutic effect of surgery in obsessive-compulsive disorder (OCD) patients with 18 F-FDG PET imaging. Methods: 18 F-fluorodeoxyglucose (FDG)-PET images were obtained in 9 patients with OCD (6 male and 3 female) before and after 3 to 4 weeks of bilateral capsulotomy, PET images were also performed in 10 controls. Each OCD patient was also evaluated both before and after the surgery by various neuropsychiatric tests including Y-BOCS, HAMA and HAMD. Results: Compare with normal controls, 9 cases of OCD demonstrated high 18 F-FDG uptake in frontal, cingulate, orbital gyri, caudate and thalamus. After capsulotomy, 6 of 9 cases showed better results, the metabolic ratios were also significant decreased in the following areas: anterior cingule gyrus: right (P < 0.001) left (P < 0.05), caudate nuclei: right (P < 0.01) left (P < 0.05), anterolateral orbital frontal cortex: right (P < 0.01) left (P < 0.05), there is no significant changes in bilateral thalamus. Meanwhile, the OCD scales also have significant decreased values in Y-BOCS (P < 0.05) and HARS (P < 0.001). Conclusions: These results indicated that cingule-striatum-pallidum-thalamic circuit is closely related to OCD, and glucose metabolism in these areas decreases significantly after bilateral capsulotomy

Effects of peritoneal ropivacaine nebulization for pain control after laparoscopic gynecologic surgery.

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Somaini, Marta; Brambillasca, Pietro; Ingelmo, Pablo Mauricio; Lovisari, Federica; Catenacci, Stefano Scalia; Rossini, Valeria; Bucciero, Mario; Sahillioglu, Emre; Buda, Alessandro; Signorelli, Mauro; Gili, Mauro; Joshi, Girish; Fumagalli, Roberto; Ferland, Catherine E; Diemunsch, Pierre

2014-01-01

To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Tertiary care center. One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Patients were randomized to receive either nebulization of 30 mg ropivacaine before surgery (preoperative group), nebulization of 30 mg ropivacaine after surgery (postoperative group), instillation of 100 mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24 hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4 hours, 1-3 at 6 hours, and 0.7-3 at 24 hours; p = .01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7 mg; 95% CI, 0.7-13; p = .02). More patients who received nebulization walked without assistance within 12 hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p = .001). Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 - 2000.

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Friedman, Jed; Thomas, Duncan

The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being.

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.

Neural correlates of distraction in borderline personality disorder before and after dialectical behavior therapy.

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Winter, Dorina; Niedtfeld, Inga; Schmitt, Ruth; Bohus, Martin; Schmahl, Christian; Herpertz, Sabine C

2017-02-01

Neural underpinnings of emotion dysregulation in borderline personality disorder (BPD) are characterized by limbic hyperactivity and disturbed prefrontal activity. It is unknown whether neural correlates of emotion regulation change after a psychotherapy which has the goal to improve emotion dysregulation in BPD, such as dialectical behavioral therapy (DBT). We investigated distraction as a main emotion regulation strategy before and after DBT in female patients with BPD. Thirty-one BPD patients were instructed to either passively view or memorize letters before being confronted with negative or neutral pictures in a distraction task during functional magnetic resonance imaging. This paradigm was applied before and after a 12-week residential DBT-based treatment program. We compared the DBT group to 15 BPD control patients, who continued their usual, non-DBT-based treatment or did not have any treatment, and 22 healthy participants. Behaviorally, BPD groups and healthy participants did not differ significantly with respect to alterations over time. On the neural level, BPD patients who received DBT-based treatment showed an activity decrease in the right inferior parietal lobe/supramarginal gyrus during distraction from negative rather than neutral stimuli when compared to both control groups. This decrease was correlated with improvement in self-reported borderline symptom severity. DBT responders exhibited decreased right perigenual anterior cingulate activity when viewing negative (rather than neutral) pictures. In conclusion, our findings reveal changes in neural activity associated with distraction during emotion processing after DBT in patients with BPD. These changes point to lower emotional susceptibility during distraction after BPD symptom improvement.

Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study.

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Al-Salehi, S K; Horner, K

2016-10-01

The aim of this study was to evaluate the impact of limited volume CBCT upon diagnosis as part of endodontic management of posterior teeth. The null hypothesis that CBCT does not make any difference in endodontic diagnosis was tested. A single-centre "before-after" study was conducted in a secondary healthcare establishment. Eligible patients were all adults aged 18 years or over who were referred to a specialist endodontic unit. Further inclusion criteria were that the cases were either re-treatment or de novo root canal treatment where the anatomy was judged to be complex. Exclusion criteria included vulnerable groups and de novo endodontic treatment with uncomplicated root canal anatomy. As well as a full history and clinical examination, a high quality colour photographic intraoral image, two paralleling technique periapical radiographs and limited volume CBCT examination were carried out for each patient. All components, except the CBCT dataset, were combined into a Powerpoint presentation and assessed by 4 observers. A questionnaire was designed for the observers as part of the study. CBCT information only changed the radiological findings and the final diagnosis in a minority of cases. There was no clear evidence that CBCT increases the confidence of observers or that CBCT was helpful in making a diagnosis. Routine use of CBCT cannot not be justified on the basis of a change in diagnosis and carefully selected use is appropriate. CBCT is being increasingly used in the field of endodontics. The benefits gained from the use of CBCT must be carefully balanced against the increased radiation dosage. Determination of selection criteria for the use of CBCT in endodontics is, therefore, essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

Commercial sexual practices before and after legalization in Australia.

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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.

Muscle Activation During Landing Before and After Fatigue in Individuals With or Without Chronic Ankle Instability

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Webster, Kathryn A.; Pietrosimone, Brian G.; Gribble, Phillip A.

2016-01-01

Context: Ankle instability is a common condition in physically active individuals. It often occurs during a jump landing or lateral motion, particularly when participants are fatigued. Objective: To compare muscle activation during a lateral hop prefatigue and postfatigue in individuals with or without chronic ankle instability (CAI). Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: A total of 32 physically active participants volunteered for the study. Sixteen participants with CAI (8 men, 8 women; age = 20.50 ± 2.00 years, height = 172.25 ± 10.87 cm, mass = 69.13 ± 13.31 kg) were matched with 16 control participants without CAI (8 men, 8 women; age = 22.00 ± 3.30 years, height = 170.50 ± 9.94 cm, mass = 69.63 ± 14.82 kg) by age, height, mass, sex, and affected side. Intervention(s): Electromyography of the tibialis anterior, peroneus longus, gluteus medius, and gluteus maximus was measured before and after a functional fatigue protocol. Main Outcome Measure(s): Activation of 4 lower extremity muscles was measured 200 milliseconds before and after landing from a lateral hop. Results: We observed no interactions. The group main effects for the peroneus longus demonstrated higher muscle activation in the CAI group (52.89% ± 11.36%) than in the control group (41.12% ± 11.36%) just before landing the lateral hop (F1,30 = 8.58, P = .01), with a strong effect size (d = 1.01). The gluteus maximus also demonstrated higher muscle activation in the CAI group (45.55% ± 12.08%) than in the control group (36.81% ± 12.08%) just before landing the lateral hop (F1,30 = 4.19, P = .049), with a moderate effect size (d = 0.71). We observed a main effect for fatigue for the tibialis anterior, with postfatigue activation higher than prefatigue activation (F1,30 = 7.45, P = .01). No differences were present between groups for the gluteus medius. Conclusions: Our results support the presence of a centralized feed

HUMORAL AND CELLULAR IMMUNITY PARAMETERS IN CHILDREN BEFORE AND AFTER ADENOTONSILLECTOMY

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M. H. Baradaranfar

2007-08-01

Full Text Available Adenoids and tonsils are active lymphoid organs and play an important role ‎against invading antigens of upper aerodigestive tract in children. ‎The present study analyzes the changes in cellular and humoral immunity of children six ‎months after adenotonsillectomy. The study population consisted of 30 children whit chronic adenotonsillar hypertrophy and 30 age-matched healthy children. ‎In all children serum level of IgM and IgG, percentage of T lymphocytes (CD3, T ‎helper cells (CD4, T cytotoxic ‎cells (CD8 and B lymphocytes (CD20 were measured before surgery. These parameters were ‎remeasured in patients 6 months after adenotonsillectomy. ‎Before the operation, a reduction in percentage of T lymphocytes (CD3,TCD4,TC8 ‎and B CD20 was seen compared to control group. This reduction was only significant in T ‎lymphocytes (CD3.The serum IgM and IgG levels were not different in two groups. Six months after ‎operation, the percentage of lymphocytes T CD3, T CD8 and BCD20 was increased and ‎reached the control group. The IgM level was also significantly decreased in patients after ‎operation. ‎Our results indicate that cellular and humoral immunity decreases in children ‎with chronic adenotonsiller hypertrophy preoperatively and increases to healthy children ‎level, six months postoperatively. It means that chronic adenotosillar hypertrophy affect ‎some parameters of cellular and humoral immunity and adenotonsillectomy by removing ‎chronic stimulations and reverses these changes without any negative effect on immune ‎function of patients.

Serum chromogranin A concentration in hyperthyroidism before and after medical treatment.

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Al-Shoumer, Kamal A S; Vasanthy, Bagavathy A

2009-07-01

The aim was to evaluate changes in chromogranin A (CgA) concentration in hyperthyroidism and to assess its metabolic correlations. We studied CgA levels in hyperthyroidism. First, 38 hyperthyroid patients matched with 86 normal controls were studied after an overnight fast. Second, 30 if the 38 patients were followed up for 6 months with medical antithyroid drug therapy (carbimazole). In the first study, after 10-12 h overnight fasting, blood was collected for measurement of CgA, glucose, insulin, intact proinsulin, and thyroid function. These variables were remeasured in the second study for the patients after attainment of euthyroidism with the antithyroid drug carbimazole for 6 months. Pretreatment CgA level was significantly higher in patients compared with controls. CgA levels dropped significantly to levels similar to those of controls after antithyroid therapy. Although baseline and follow-up fasting glucose, insulin, and intact proinsulin demonstrated similar pattern of CgA changes before and after medical treatment, CgA did not correlate with any of them. However, CgA levels demonstrated a significant positive correlation with free T(3) and free T(4) only. These studies demonstrate that untreated hyperthyroidism is associated with elevated CgA level that changes in parallel to thyroid status. It is therefore possible to use CgA concentration as a potential marker of disease activity in hyperthyroidism.

Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats.

Science.gov (United States)

Combs, Hannah L; Jones, Theresa A; Kozlowski, Dorothy A; Adkins, DeAnna L

2016-04-15

Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI.

Headwater stream temperature: interpreting response after logging, with and without riparian buffers, Washington, USA

Science.gov (United States)

Jack E. Janisch; Steven M. Wondzell; William J. Ehinger

2012-01-01

We examined stream temperature response to forest harvest in small forested headwater catchments in western Washington, USA over a seven year period (2002-2008). These streams have very low discharge in late summer and many become spatially intermittent. We used a before-after, control-impact (BACl) study design to contrast the effect of clearcut logging with two...

Abortion Before & After Roe

Science.gov (United States)

Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu

2013-01-01

We use unique data on abortions performed in New York State from 1971–1975 to demonstrate that women travelled hundreds of miles for a legal abortion before Roe. A100- mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233

[Healthier after Psychotherapy? Analysis of Claims Data (Lower Saxony, Germany) on Sickness Absence Duration before and after Outpatient Psychotherapy].

Science.gov (United States)

Epping, Jelena; de Zwaan, Martina; Geyer, Siegfried

2017-11-17

Introduction In employed populations sickness absence can be used as a good indicator of health status. In the present study, it was examined how periods of sickness absence are developing within one year before and after psychotherapy under comparison of three types of psychotherapy (behavior therapy, psychodynamic psychotherapy, and psychoanalysis), all fully covered by statutory health insurance. Methods and data The analyses were performed with pseudonymized claims data from the AOK Niedersachsen, a statutory health insurance (N=2,900,065 insured). Certified sickness absences before and after psychotherapy were examined for 9,916 patients. Parallelized controls were used to build a comparison of the length of sickness absences. Analyses were performed separately for women and for men. Results Within one year before starting psychotherapy, patients had longer sickness absences than controls on average. There was a reduction in the length of sickness absence of 20 days (median) within one year before to 12 days (median) within one year after the psychotherapy. The obtained differences between types of psychotherapy were considerable. Discussion Differences in terms of sickness absences may in part be explained by socio-demographic differences. Patients who underwent psychoanalysis were younger and had higher educational levels. However, it remains unclear why the differences of sickness absence periods were that high. It has to be discussed whether self-selection of patients with better health into psychoanalysis had occurred. Conclusions Patients undergoing psychoanalysis differ from patients who underwent other types of psychotherapy in terms of their duration of sickness absence as well as socio-demographic profile. Thus, due to differences in the composition of patients future research in psychotherapy will have to differentiate by type of psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

A control center design revisited: learning from users’ appropriation

DEFF Research Database (Denmark)

Souza da Conceição, Carolina; Cordeiro, Cláudia

2014-01-01

This paper aims to present the lessons learned during a control center design project by revisiting another control center from the same company designed two and a half years before by the same project team. In light of the experience with the first project and its analysis, the designers and res...

Masticatory performance and oral health-related quality of life before and after complete denture treatment.

Science.gov (United States)

Yamamoto, Saori; Shiga, Hiroshi

2018-03-13

To clarify the relationship between masticatory performance and oral health-related quality of life (OHRQoL) before and after complete denture treatment. Thirty patients wearing complete dentures were asked to chew a gummy jelly on their habitual chewing side, and the amount of glucose extraction during chewing was measured as the parameter of masticatory performance. Subjects were asked to answer the Oral Health Impact Profile (OHIP-J49) questionnaire, which consists of 49 questions related to oral problems. The total score of 49 question items along with individual domain scores within the seven domains (functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability and handicap) were calculated and used as the parameters of OHRQoL. These records were obtained before treatment and 3 months after treatment. Each parameter of masticatory performance and OHRQoL was compared before treatment and after treatment. The relationship between masticatory performance and OHRQoL was investigated, and a stepwise multiple linear regression analysis was performed. Both masticatory performance and OHRQoL were significantly improved after treatment. Furthermore, masticatory performance was significantly correlated with some parameters of OHRQoL. The stepwise multiple linear regression analysis showed functional limitation and pain as important factors affecting masticatory performance before treatment and functional limitation as important factors affecting masticatory performance after treatment. These results suggested that masticatory performance and OHRQoL are significantly improved after treatment and that there is a close relationship between the two. Moreover, functional limitation was found to be the most important factor affecting masticatory performance. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

The Impact of Splenectomy in Myelofibrosis Patients before Allogeneic Hematopoietic Stem Cell Transplantation.

Science.gov (United States)

Robin, Marie; Zine, Maryem; Chevret, Sylvie; Meignin, Véronique; Munoz-Bongrand, Nicolas; Moatti, Hannah; Xhaard, Aliénor; Sicre de Fontbrune, Flore; Peffault de Latour, Régis; Sarfati, Emile; Socié, Gérard

2017-06-01

Performing a pretransplantation splenectomy in patients with myelofibrosis (MF) is a matter of debate, as while the procedure improves hematological recovery, it may lead to severe morbidities. We retrospectively analyzed data from 85 consecutive patients who underwent transplantation in our center for MF, including 39 patients who underwent splenectomy before their transplantation. A majority of them had primary MF (78%), were considered high-risk patients (84% dynamic international prognostic scoring system intermediate-2 or higher), and had received transplants from HLA-matched sibling donors (56%) after a reduced-intensity conditioning regimen (82%). One-half of all splenectomized patients presented surgical or postsurgical morbidities, most frequently thrombosis and hemorrhage. After adjustment using Cox models, pretransplantation splenectomy was not associated with nonrelapse mortality or post-transplantation relapse but with an improved overall survival (OS) and event-free survival (EFS). We conclude that some patients with huge splenomegaly may undergo pretransplantation splenectomy without a deleterious impact on post-transplantation outcomes. OS and EFS improvement should in confirmed in controlled study. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Regional fault deformation characteristics before and after the Menyuan Ms6.4 earthquake

Directory of Open Access Journals (Sweden)

Ning Li

2016-07-01

Full Text Available This study analyzes data regarding cross-fault deformations within the seismogenic zone of the 2016 Qinghai Menyuan Ms6.4 earthquake and its surrounding area. The results showed that the tendency anomaly sites near the epicenter had relatively long anomaly durations prior to the earthquake, while sudden-jumping anomaly sites started to increase in the middle eastern Qilian Mountains approximately a year before the earthquake and continued to increase and migrate towards the vicinity of the epicenter two to six months before the earthquake. Intensive observations a few days after the earthquake indicated that abnormal returns and turns before the earthquake were significant, but all had small amplitudes, and the coseismic effect was generally minor. In addition, the post-seismic tendency analysis of individual cross faults in the Qilian Mountain fault zone revealed an accelerating thrust tendency at all cross-fault sites in the middle Qilian Mountains after the 2008 Wenchuan Ms8.0 earthquake. This indicates that the Wenchuan mega-earthquake exerted a great impact on the dynamic environment of the northeastern margin of the Qinghai-Tibet plate and significantly enhanced the extrusion effect of the Indian plate on the middle Qilian Mountains, generating favorable conditions for the occurrence of Menyuan thrust earthquakes.

Stethoscope disinfection campaign in a Nigerian teaching hospital:results of a before-and-after study.

Science.gov (United States)

Uneke, Chigozie J; Ndukwe, Chinwendu D; Nwakpu, Kingsley O; Nnabu, Richard C; Ugwuoru, Cletus D; Prasopa-Plaizier, Nittita

2014-01-15

This study aimed to assess the impact of a stethoscope disinfection sensitization campaign among doctors and nurses in a Nigerian teaching hospital. The design was a before-and-after study. Pre-program measurements were used to provide a baseline against which the post-program results were compared. Interventions that promoted compliance with stethoscope disinfection practice that were implemented included training and education on stethoscope disinfection and introduction of 70% isopropyl alcohol disinfectant at points-of-care places. Microbiological assessment of stethoscopes used by health workers was conducted after the intervention and the outcome was compared with the pilot study results. After the intervention, of the 89 stethoscopes screened, 18 (20.2%) were contaminated with bacterial agents. A higher prevalence of stethoscope contamination was observed among stethoscopes from the intensive care unit (66.7%), the VIP unit (50%), and the antenatal unit (37.5%). The main isolates were Staphylococcus aureus (44.4%) and Escherichia coli (50%). The antibiotic sensitivity assessment indicated that the bacterial isolates were resistant to nearly all the antibiotics tested. All the 89 health workers whose stethoscopes were screened after the intervention admitted to cleaning their stethoscopes after seeing each patient, representing a compliance rate of 100%, unlike the 15% compliance at the pilot phase. The baseline stethoscope contamination rate was 78.5% versus 20.2% post-intervention. Training and education and introduction of alcohol-based disinfectants inexpensive but very effective methods to improve stethoscope disinfection compliance among health workers in low-income settings.

Sustainable Communication Practices in Management Control - Are Body and Mind in Conflict or Convertion?

DEFF Research Database (Denmark)

Nørreklit, Hanne; Wit, Camilla Kølsen de

2001-01-01

For the manager of a firm to gain success, good ideas and management control systems are probably important, but not sufficient elements. The manager also need to be able to communicate his/her ideas and plans convincingly to the employees as they have to execute the.(...) The bacis assumption made...

Analysis of computed tomography density of liver before and after amiodarone administration.

Science.gov (United States)

Matsuda, Masazumi; Otaka, Aoi; Tozawa, Tomoki; Asano, Tomoyuki; Ishiyama, Koichi; Hashimoto, Manabu

2018-05-01

To evaluate CT density of liver changes between before and after amiodarone administration. Twenty-five patients underwent non-enhanced CT including the liver before and after amiodarone administration. We set regions of interest (ROIs) at liver S8, spleen, paraspinal muscle, and calculated average CT density in these ROIs, then compared CT density between liver and other organs. Statistical differences between CT density of liver and various ratios before and after administration were determined, along with correlations between cumulative dose of amiodarone and liver density after administration, density change of liver, and various ratios after administration. Liver density, liver-to-spleen ratio, and liver-to-paraspinal muscle ratio differed significantly between before and after amiodarone administration. No significant correlations were found between cumulative doses of amiodarone and any of liver density after administration, density change of liver, or various ratios after administration. CT density of liver after amiodarone administration was significantly higher than that before administration. No correlations were identified between cumulative dose of amiodarone and either liver density after administration or density change of liver. Amiodarone usage should be checked when radiologists identify high density of the liver on CT.

Before, During, and After a Wildfire

Centers for Disease Control (CDC) Podcasts

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.

Radiological controls integrated into design

Energy Technology Data Exchange (ETDEWEB)

Kindred, G.W. [Cleveland Electric Illuminating Co., Perry, OH (United States)

1995-03-01

Radiological controls are required by law in the design of commercial nuclear power reactor facilities. These controls can be relatively minor or significant, relative to cost. To ensure that radiological controls are designed into a project, the health physicist (radiological engineer) must be involved from the beginning. This is especially true regarding keeping costs down. For every radiological engineer at a nuclear power plant there must be fifty engineers of other disciplines. The radiological engineer cannot be an expert on every discipline of engineering. However, he must be knowledgeable to the degree of how a design will impact the facility from a radiological perspective. This paper will address how to effectively perform radiological analyses with the goal of radiological controls integrated into the design package.

Comparative study of the congenital anomalies before and after Chernobyl disaster

International Nuclear Information System (INIS)

Zaprjanov, Z.; Porjazova, E.; Djambazova, S.; Hubavenska, I.; Velichkova, L.

2005-01-01

The aim of our study was a comparative examination of the congenital anomalies before and directly after the Chernobyl disaster in the early and later periods of time. For the study post mortem material of the Department of general and clinical pathology at the Medical University of Plovdiv was used. Eight hundred seventy eight cases of newborns with congenital anomalies for a 24-year period (1981-2004) were reviewed. The number of the congenital anomalies was compared quantitatively in general and in systems. Equal 5-year intervals of time were compared to a control 5-year period before the Chernobyl accident. The data were statistically processed using different statistical methods. The comparative study of the number of the congenital anomalies did not show a statistically significant increase in relation to the nuclear accident

The Impact of Supporting Family Caregivers Before Bereavement on Outcomes After Bereavement: Adequacy of End-of-Life Support and Achievement of Preferred Place of Death.

Science.gov (United States)

Aoun, Samar M; Ewing, Gail; Grande, Gunn; Toye, Chris; Bear, Natasha

2018-02-01

The investigation of the situation of bereaved family caregivers following caregiving during the end-of-life phase of illness has not received enough attention. This study investigated the extent to which using the Carer Support Needs Assessment Tool (CSNAT) intervention during the caregiving period has affected bereaved family caregivers' perceptions of adequacy of support, their grief and well-being, and achievement of their preferred place of death. All family caregivers who participated in a stepped-wedge cluster trial of the CSNAT intervention in Western Australia (2012-2014) and completed the pre-bereavement study (n = 322) were invited to take part in a caregiver survey by telephone four to six months after bereavement (2015). The survey measured the adequacy of end-of-life support, the level of grief, the current physical and mental health, and the achievement of the preferred place of death. The response rate was 66% (152, intervention; 60, control). The intervention group perceived that their pre-bereavement support needs had been adequately met to a significantly greater extent than the control group (d = 0.43, P death more often according to their caregivers (79.6% vs. 63.6%, P = 0.034). There was also a greater agreement on the preferred place of death between patients and their caregivers in the intervention group (P = 0.02). The results from this study provide evidence that the CSNAT intervention has a positive impact on perceived adequacy of support of bereaved family caregivers and achievement of preferred place of death according to caregivers. The benefits gained by caregivers in being engaged in early and direct assessment of their support needs before bereavement reinforce the need for palliative care services to effectively support caregivers well before the patient's death. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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.

Comparisons of mosquito populations before and after construction of a wetland for water quality improvement in Pitt County, North Carolina, and data-reliant vectorborne disease management.

Science.gov (United States)

Anderson, Alice L; O'Brien, Kevin; Hartwell, Megan

2007-04-01

Wetlands serve an important purpose in flood control and water quality, but constructed-wetland sites also provide habitats for mosquito breeding. Communities near constructed-wetland sites often raise a "mosquito" objection when constructed wetlands are proposed. Wildlife and wetland advocates can confuse the public by making unsubstantiated claims about natural predators eliminating or controlling mosquito problems in a constructed wetland. Management of constructed-wetland mosquito habitat, with adequate mosquito surveillance and data analysis, can help lead to a successful project and satisfied citizens. The cooperative project described in this paper, was conducted in the town of Simpson, North Carolina, and was designed to determine the mosquito population impact of wetland construction at Mill Branch Stream, a small tributary of the Tar River in Eastern North Carolina. In the authors' analysis of three years of mosquito surveillance data, month (time of year standing in for temperature and day length) was a significant factor in regression analysis for mosquito numbers, but rainfall was not. Numbers of mosquitoes were not found to be significantly higher after construction than before construction.

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.

Crew resource management training in the intensive care unit. A multisite controlled before-after study.

Science.gov (United States)

Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; So, Ralph L; Tangkau, Peter; Wagner, Cordula

2016-08-01

There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months). Three ICUs received CRM training and were compared with a matched control unit. The 2-day classroom-based training was delivered to multidisciplinary groups (ie, ICU physicians, nurses, managers). All levels of Kirkpatrick's evaluation framework were assessed using a mixed method design, including questionnaires, observations and routinely administered patient outcome data. Level I-reaction: participants were very positive directly after the training. Level II-learning: attitudes towards behaviour aimed at optimising situational awareness were relatively high at baseline and remained stable. Level III-behaviour: self-reported behaviour aimed at optimising situational awareness improved in the intervention group. No changes were found in observed explicit professional oral communication. Level IV-organisation: patient outcomes were unaffected. Error management culture and job satisfaction improved in the intervention group. Patient safety culture improved in both control and intervention units. We can conclude that CRM, as delivered in the present study, does not change behaviour or patient outcomes by itself, yet changes how participants think about errors and risks. This indicates that CRM requires a combination with other initiatives in order to improve clinical outcomes. 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/

Protective Effect of Whole and Fat-Free Fluoridated Milk, Applied before or after Acid Challenge, against Dental Erosion.

Science.gov (United States)

Cassiano, Luiza P S; Charone, Senda; Souza, Juliana G; Leizico, Ligia C; Pessan, Juliano P; Magalhães, Ana Carolina; Buzalaf, Marília Afonso Rabelo

2016-01-01

This study analysed in vitro the effect of milk against dental erosion, considering three factors: the type of milk (bovine whole/fat-free), the presence of different fluoride concentrations and the time of application (before/after erosive challenge). Bovine enamel (n = 15/group) and root dentine (n = 12/group) specimens were submitted to the following treatments: after the first erosive challenge - 0.9% NaCl solution (negative control), whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control); before the first erosive challenge - whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control). Specimens were submitted to demineralisation-remineralisation regimes 4 times/day for 5 days. The response variables were enamel and dentine loss (in micrometres). Data were analysed using Kruskal-Wallis/Dunn's test (p erosive challenge, was the most protective treatment, but with no significant difference compared with the same treatment carried out after the erosive challenge. For dentine, whole fluoridated milk (all concentrations, after), fat-free 10 ppm F milk (after, before) and whole milk with or without F (except 2.5 ppm F, all before) significantly reduced dentine erosion. It seems that the presence of fluoride, especially at 10 ppm, is the most important factor in reducing dental erosion. © 2016 S. Karger AG, Basel.

Influence of free water availability on a desert carnivore and herbivore.

Science.gov (United States)

Kluever, Bryan M; Gese, Eric M; Dempsey, Steven J

2017-04-01

Anthropogenic manipulation of finite resources on the landscape to benefit individual species or communities is commonly employed by conservation and management agencies. One such action in arid regions is the construction and maintenance of water developments (i.e., wildlife guzzlers) adding free water on the landscape to buttress local populations, influence animal movements, or affect distributions of certain species of interest. Despite their prevalence, the utility of wildlife guzzlers remains largely untested. We employed a before-after control-impact (BACI) design over a 4-year period on the US Army Dugway Proving Ground, Utah, USA, to determine whether water availability at wildlife guzzlers influenced relative abundance of black-tailed jackrabbits Lepus californicus and relative use of areas near that resource by coyotes Canis latrans , and whether coyote visitations to guzzlers would decrease following elimination of water. Eliminating water availability at guzzlers did not influence jackrabbit relative abundance. Coyote relative use was impacted by water availability, with elimination of water reducing use in areas associated with our treatment, but not with areas associated with our control. Visitations of radio-collared coyotes to guzzlers declined nearly 3-fold following elimination of water. Our study provides the first evidence of a potential direct effect of water sources on a mammalian carnivore in an arid environment, but the ecological relevance of our finding is debatable. Future investigations aimed at determining water effects on terrestrial mammals could expand on our findings by incorporating manipulations of water availability, obtaining absolute estimates of population parameters and vital rates and incorporating fine-scale spatiotemporal data.

Students’ Perception toward the Implementation of Peer-Assessment in Writing; Before and After Revision

Directory of Open Access Journals (Sweden)

Husni Mubarok

2017-10-01

Full Text Available This study was aimed at elaborating students’ perception toward the implementation of peer assessment in writing class either before or after revision. Writing becomes one of skills which should be mastered by students in order to get higher level of literacy. Writing is a productive skill which asks students to arrange words and organize them into good writing which could be understood by readers. The success of writing is determined by the writing process itself starting from planning, first draft writing, revising, and editing. One of the strategies used in teaching writing is by implementing peer assessment. Peer assessment strategy becomes one of important parts in the process of writing because there will be feedback or suggestion from peers in doing a review. The number of the subject of this research was students in second semester of the English Education Department of UNISNU Jepara. This research was conducted on even semester. The total number of the students, which became respondents, was 37 students of English Education Department. The research design used was qualitative research which measured students’ perceptions of the implementation of peer assessment in writing: before and after revision. The result showed that before revision, students had negative perception toward their own writing. After revision, they had positive perceptions toward peer assessment strategy. Those included usefulness and meaningfulness, nature of feedback, reality of feedback, precision, validity, fairness, and personal goal-setting. Besides that, the score after revision (7.9 was higher than the score before revision (6.62. It meant that the result showed the increasing of students’ score after revision.

Microbiomes of Endodontic-Periodontal Lesions before and after Chemomechanical Preparation.

Science.gov (United States)

Gomes, Brenda P F A; Berber, Vanessa B; Kokaras, Alexis S; Chen, Tsute; Paster, Bruce J

2015-12-01

This study was conducted to evaluate the microbiomes of endodontic-periodontal lesions before and after chemomechanical preparation (CMP). Clinical samples were taken from 15 root canals (RCs) with necrotic pulp tissues and from their associated periodontal pockets (PPs) (n = 15) of teeth with endodontic-periodontal lesions before and after CMP. The Human Oral Microbe Identification using Next Generation Sequencing (NGS) protocol and viable culture were used to analyze samples from RCs and PPs. The Mann-Whitney U test and Benjamini-Hochberg corrections were performed to correlate the clinical and radiographic findings with microbial findings (P Bacteria were detected in 100% of the samples in both sites (15/15) using NGS. Firmicutes was the most predominant phylum in both sites using both methods. The most frequently detected species in the RCs before and after CMP using NGS were Enterococcus faecalis, Parvimonas micra, Mogibacterium timidum, Filifactor alocis, and Fretibacterium fastidiosum. The species most frequently detected in the PPs before and after CMP using NGS were P. micra, E. faecalis, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia, and F. alocis. Associations were found between periapical lesions ≤ 2 mm and Desulfobulbus sp oral taxon 041 and with periodontal pockets ≥ 6 mm and Dialister invisius and Peptostreptococcus stomatis (all P periodontal lesions is complex and more diverse than previously reported. It is important to note that bacteria do survive in some root canals after CMP. Finally, the similarity between the microbiota of both sites, before and after CMP, suggests there may be a pathway of infection between the pulp and periodontium. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Psychological Health Before, During, and After an Economic Crisis: Results from Indonesia, 1993 – 2000

Science.gov (United States)

Friedman, Jed; Thomas, Duncan

2015-01-01

The 1997 Indonesian financial crisis resulted in severe economic dislocation and political upheaval, and the detrimental consequences for economic welfare, physical health, and child education have been established in several studies. The crisis also adversely impacted the psychological well-being of the Indonesian population. Comparing responses of the same individuals interviewed before and after the crisis, we document substantial increases in several different dimensions of psychological distress among male and female adults across the entire age distribution. In addition, the imprint of the crisis can be seen in the differential impacts of the crisis on low education groups, the rural landless, and residents in those provinces that were most affected by the crisis. Elevated levels of psychological distress persist even after indicators of economic well-being such as household consumption had returned to pre-crisis levels, suggesting the deleterious effects of the crisis on the psychological well-being of the Indonesian population may be longer lasting than the impacts on economic well-being. PMID:25892838

Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

International Nuclear Information System (INIS)

Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

2015-01-01

Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

The evaluation of gastroesophageal reflux before and after medical therapies

International Nuclear Information System (INIS)

Malmud, L.S.; Fisher, R.S.

1981-01-01

Gastroesophageal scintigraphy is a quantitative technique that can be employed to detect and quantitate gastroesophageal reflux before and after the application of therapeutic modalities, including change in body position, bethanechol, atropine, antacids, and antacid-alginate compounds. Five groups of 10-15 patients each were studied before and after using each therapeutic modality and before and after atropine. The results were compared to the patient's symptomatology and to the acid reflux test. Gastroesophageal scintigraphy was performed following oral administration of 300 microCi 99mTc-sulfur colloid in 300 ml acidified orange juice. Thirty-second gamma camera images were obtained as the gastroesophageal gradient was increased from approximately 10 to 35 mm Hg at 5 mm Hg increments using an inflatable abdominal binder. Data were processed using a digital computer. Reflux was reduced by change in position from recumbent to upright, and by the use of subcutaneous bethanechol, oral antacid, or oral antacidalginate compound. Atropine increased reflux. Gastroesophageal scintigraphy is more sensitive than fluoroscopy, correlates well with clinical symptomatology, and is a reliable and convenient technique for the quantitative estimation of reflux before and after therapy

Differences of protein profile before and after orthodontic treatment

Science.gov (United States)

Nasri, Farah Amirah Mohd; Wahab, Rohaya Megat Abdul; Karsani, Saiful Anuar; Ariffin, Shahrul Hisham Zainal

2016-11-01

Mechanical forces in orthodontic treatment used to treat malocclusion can cause inflamed gingival tissue and the process of tooth movement may resorb dental root. Root resorption is an iatrogenic effect of orthodontic treatment but it can be monitored using protein biomarker. This study aims to investigate the differences of protein profile before and after orthodontic treatment using different staining methods. Human gingival crevicular fluid and saliva were collected from orthodontic patients before and after treatment. Protein profile were observed using SDS-PAGE. Our study shows down regulation of proteins after 3 months of treatment. Hence, there are potential values from this study to aid in investigation for specific biomarkers for root resorption.

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......) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used...

Variations of streambed vertical hydraulic conductivity before and after a flood season

Science.gov (United States)

Wu, Guangdong; Shu, Longcang; Lu, Chengpeng; Chen, Xunhong; Zhang, Xiao; Appiah-Adjei, Emmanuel K.; Zhu, Jingsi

2015-11-01

The change of vertical hydraulic conductivity ( K v) before and after a flood season is crucial in understanding the long-term temporal variation of streambed permeability. Therefore, in this study, a detailed K v field investigation was conducted at an in-channel site within the Dawen River, China, before and after a flood season. In-situ falling-head permeameter tests were performed for the determination of K v. The tests were conducted using a 10 × 10 grid, at five different depths. In total, 871 valid K v values from layers 1-5 were obtained. The Kruskal-Wallis test on these K v values before and after the flood season shows they belonged to different populations. The sediments before the flood season primarily consisted of sand and gravel, whereas after the flood season, patchy distribution of silt/clay occurred in the sandy streambed and silt/clay content increased with the increasing depth; under the losing condition during flooding, downward movement of water brought fine particles into the coarse sediments, partially silting the pores. Accordingly, the K v values after the flood season had a smaller mean and median, and a higher level of heterogeneity, compared to those before the flood season. Additionally, the distribution pattern in K v across the stream differed before and after flood season; after the flood season, there was an increasing trend in K v from the south bank to the north bank. Overall, the contrasts of K v before and after the flood season were predominantly subject to the infiltration of fine particles.

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.

MR imaging of the knee in marathon runners before and after competition

International Nuclear Information System (INIS)

Krampla, W.; Mayrhofer, R.; Malcher, J.; Urban, M.; Hruby, W.; Kristen, K.H.

2001-01-01

Objective. To evaluate the findings in MRI-studies of the knee in recreational long-distance runners after competition and to assess the reversibility of the findings.Design and patients. Eight recreational long-distance runners underwent MRI studies of the knee before, immediately after and 6-8 weeks after taking part in the Vienna City Marathon. The studies were evaluated regarding alterations of pre-existing lesions and new pathological findings.Results. In six runners without major pre-existing alterations no negative effects were experienced. In one runner with pre-existing grade III alterations of the menisci, signs of progressive osteoarthritis were experienced 2 months after the competition. In all other cases increased meniscal signal alterations and minor signal changes in the bone marrow after the race were transitory.Conclusion. In healthy individuals no negative long-term-effects were experienced. Pre-existing high-grade lesions of the menisci might be a predisposing risk for osteoarthritis, triggered by the stress of long-distance running. (orig.)

The differences of saliva pH before and after application of Bis-GMA resin based-pit and fissure sealant

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Ayub Irmadani Anwar

2016-06-01

Full Text Available Pit and fissure sealant applications is one way to prevent caries. One of the effective ingredient as a pit and fissure sealant is a Bis-GMA resin. One of the active components  of  Bis-GMA  resin  is  sodium  fluoride,  which is capable  of releasing fluoride ions to the tooth surface and able to improve the repair and remineralization process through the replacement  of  calcium and phosphate ions found in saliva to increase the pH of saliva. This study was to determine the effect of pit and fissure sealant applications made from Bis-GMA resin to pH of saliva in children aged 6-12 years. The study design is pre and post test with control group design. Saliva samples were derived from 15 pediatric patients has met the criteria. The pH of saliva were taken before and after the application of pit and fissure sealant made from Bis-GMA and measured with pH meter. This study used a non-parametric test, the Wilcoxon Signed Rank test. The results of this study are also supported by the results of statistical tests showed p-: 0.005 (p<0.05 value, which means that there are significant differences in pH of saliva before and after the application of pit and fissure sealant made from Bis-GMA resin.

Leptin and ghrelin concentration in hyperthyroid cats before and after radioactive iodine therapy compared to euthyroid control cats.

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Marsilio, Sina; Glanemann, Barbara; Martin, Lucile; Szladovits, Balazs; Neiger, Reto

2017-04-19

Leptin and ghrelin, two peptide hormones with antagonistic effects on satiety and energy balance, could be involved in the pathogenesis of weight loss and polyphagia in cats with hyperthyroidism. Leptin generally decreases appetite and increases energy expenditure, while ghrelin exerts the opposite effects. Leptin and ghrelin were measured in 42 client owned hyperthyroid cats with a body condition score (BCS) ≤ 5/9 before (T0) and 4 weeks after radioactive iodine treatment (RAIT) (T1). Dependent on the serum total thyroxine concentration concentration at T1, cats were sub-classified as still hyperthyroid (ht-ht) (n = 4), euthyroid (ht-eu) (n = 10) or hypothyroid (ht-hypo) (n = 28). Results were compared to those of 22 healthy, euthyroid control cats with a comparable BCS (≤ 5/9) and age (≥ 8 years) to hyperthyroid cats. At T0, there were no significant differences between hyperthyroid and control cats for leptin (p = 0.06) or ghrelin concentrations (p = 0.27). At T1, leptin significantly decreased in ht-hypo cats compared to T0 (p = 0.0008) despite a significantly increased body weight in this group (p = 0.0001). Serum ghrelin concentrations did not differ between hyperthyroid cats with a history of polyphagia compared to non-polyphagic cats (p = 0.42). After RAIT, ghrelin concentration significantly increased in all hyperthyroid cats (p weight in different states of thyroid dysfunction; increasing ghrelin concentrations after RAIT suggest a ghrelin-independent mechanism for polyphagia in hyperthyroid cats.

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.

Analysis of metabolomic patterns in thoroughbreds before and after exercise

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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

Evaluation of Lambda-Cyhalothrin and Pyriproxyfen Barrier Treatments for Aedes albopictus (Diptera: Culicidae) Management in Urbanized Areas of New Jersey.

Science.gov (United States)

Unlu, Isik; Williams, Gregory M; Rochlin, Ilia; Suman, Devi; Wang, Yi; Chandel, Kshitij; Gaugler, Randy

2018-02-28

Mosquito control programs in the United States are still searching for best management practices to control the Asian tiger mosquito, Aedes albopictus (Skuse; Diptera: Culicidae). Most intervention methods for this species are either labor intensive (e.g., source reduction) or short-term (e.g., ultra-low-volume adulticiding). We investigated the effectiveness of barrier spray pesticide applications within urban and suburban residential yards in New Jersey as a control strategy using a before-after-control-impact (BACI) approach. Applications of Demand CSR pyrethroid (9.7% AI lambda-cyhalothrin) only or combined Demand CSR and Archer IGR insect growth regulator (1.3% AI pyriproxyfen) applications resulted in significant and similar decreases in adult mosquito abundance post-treatment ranging from 78 to 74% respectively, compared with the untreated control. Both insecticides exceeded the 70% reduction threshold considered as effective for Ae. albopictus control for 2 to 4 wk. However, applications of Archer IGR alone did not reduce adult mosquito abundance. The field study results were supported by laboratory no-choice bioassays using treated leaf foliage. Our study is the first data driven evidence of the residual efficacy of barrier pesticide applications in New Jersey with lambda-cyhalothrin that provided significant reductions in adult Ae. albopictus populations for an extended duration.

Quality of life in patients with primary axillary hyperhidrosis before and after treatment with fractionated microneedle radiofrequency

Directory of Open Access Journals (Sweden)

Bahareh Abtahi-Naeini

2015-01-01

Full Text Available Background: Primary axillary hyperhidrosis (PAH is a common condition with a great impact on the patient′s quality of life (QOL. It is associated with serious social, emotional, and occupational distress. The aim of this study was to investigate the QOL in patients with PAH before and after treatment with fractionated microneedle radiofrequency (FMR. Materials and Methods: We evaluated 25 patients with severe PAH. Each patient had three sessions of FMR treatment using a novel applicator at 3-week intervals. The study was based on Dermatology Life Quality Index (DLQI Questionnaires. Patients were evaluated at baseline and 3 months after the last session. Results: Our patients included 32% males and 68% females. The mean ± standard deviation (SD age of subjects was 30.2 ± 6.27 years. The mean ± SD of the DLQI before and after treatment was 12.96 ± 5.93, and 4.29 ± 2.21, respectively. There was a statistically significant difference between the before and after intervention (P < 0.001. No major, permanent adverse effects were shown. Conclusion: Treatment with FMR can improve the DLQI of patients with PAH.

Using an Individual Procedure Score Before and After the Advanced Surgical Skills Exposure for Trauma Course Training to Benchmark a Hemorrhage-Control Performance Metric.

Science.gov (United States)

Mackenzie, Colin F; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark

2015-01-01

Test with an individual procedure score (IPS) to assess whether an unpreserved cadaver trauma training course, including upper and lower limb vascular exposure, improves correct identification of surgical landmarks, underlying anatomy, and shortens time to vascular control. Prospective study of performance of 3 vascular exposure and control procedures (axillary, brachial, and femoral arteries) using IPS metrics by 2 colocated and trained evaluators before and after training with the Advanced Surgical Skills Exposure for Trauma (ASSET) course. IPS, including identification of anatomical landmarks, incisions, underlying structures, and time to completion of each procedure was compared before and after training using repeated measurement models. Audio-video instrumented cadaver laboratory at University of Maryland School of Medicine. A total of 41 second to sixth year surgical residents from surgical programs throughout Mid-Atlantic States who had not previously taken the ASSET course were enrolled, 40 completed the pre- and post-ASSET performance evaluations. After ASSET training, all components of IPS increased and time shortened for each of the 3 artery exposures. Procedure steps performed correctly increased 57%, anatomical knowledge increased 43% and skin incision to passage of a vessel loop twice around the correct vessel decreased by a mean of 2.5 minutes. An overall vascular trauma readiness index, a comprehensive IPS score for 3 procedures increased 28% with ASSET Training. Improved knowledge of surface landmarks and underlying anatomy is associated with increased IPS, faster procedures, more accurate incision placement, and successful vascular control. Structural recognition during specific procedural steps and anatomical knowledge were key points learned during the ASSET course. Such training may accelerate acquisition of specific trauma surgery skills to compensate for shortened training hours, infrequent exposure to major vascular injuries, or when just

A Pilot Study of Disparity Vergence and Near Dissociated Phoria in Convergence Insufficiency Patients Before versus After Vergence Therapy

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Tara L. Alvarez

2015-07-01

Full Text Available PURPOSE: This study examined the relationship between the near dissociated phoria and disparity vergence eye movements. Convergence insufficiency (CI patients before vergence therapy were compared to: 1 the same patients after vergence therapy and 2 binocularly normal controls (BNC. METHODS: Sixteen subjects were studied--twelve BNC and four with CI. Measurements from the CI subjects were obtained before and after 18 hours of vergence eye movement therapy. The near dissociated phoria was measured using the flashed Maddox rod technique. Vergence responses were stimulated from 4° symmetrical disparity vergence step stimuli. The peak velocity of the vergence response and the magnitude of the fusion initiating component (FIC from an independent component analysis were calculated. A linear regression analysis was conducted studying the vergence peak velocity as a function of the near dissociated phoria where the Pearson correlation coefficient was computed. RESULTS: Before vergence therapy, the average with one standard deviation FIC magnitude of convergence responses from CI subjects was 0.290.82 and significantly less than the FIC magnitude of 1.850.84 for BNC (p<0.02. A paired t-test reported that the FIC and near dissociated phoria before vergence therapy for CI subjects significantly increased to 1.490.57 (p<0.04 and became less exophoric to 3.5∆1.9 exo (p<0.02 after vergence therapy. A significant correlation (r=0.87; p<0.01 was observed between the near dissociated phoria and the vergence ratio of convergence peak velocity divided by divergence peak velocity. CONCLUSION: The results have clinical translational impact in understanding the mechanism by which vergence therapy may be changing the vergence system leading to a sustained reduction in visual symptoms.

Translucency of Zirconia Ceramics before and after Artificial Aging.

Science.gov (United States)

Walczak, Katarzyna; Meißner, Heike; Range, Ursula; Sakkas, Andreas; Boening, Klaus; Wieckiewicz, Mieszko; Konstantinidis, Ioannis

2018-03-11

The aging of zirconia ceramics (Y-TZP) is associated with tetragonal to monoclinic phase transformation. This change in microstructure may affect the optical properties of the ceramic. This study examines the effect of aging on the translucency of different zirconia materials. 120 disc-shaped specimens were fabricated from four zirconia materials: Cercon ht white, BruxZir Solid Zirconia, Zenostar T0, Lava Plus (n = 30 per group). Accelerated aging was performed in a steam autoclave (134°C, 0.2 MPa, 5 hours). CIELab coordinates (L*, a*, b*) and luminous reflectance (Y) were measured with a spectrophotometer before and after aging. Contrast ratio (CR) and translucency parameter (TP) were calculated from the L*, a*, b*, and Y tristimulus values. The general linear model (Bonferroni adjusted) was used to compare both parameters before and after aging, as well as between the different zirconia materials (p ≤ 0.05). CR and TP differed significantly before and after aging in all groups tested. Before aging, Zenostar T showed the highest and Lava Plus showed the lowest translucency. After aging, Cercon ht and Zenostar T showed the highest and BruxZir and Lava Plus the lowest translucency. Aging reduced the translucency in all specimens tested. Furthermore, translucency differed between the zirconia brands tested. Nevertheless, the differences were below the detectability threshold of the human eye. The aging process can influence the translucency and thus the esthetic outcome of zirconia restorations; however, the changes in translucency were minimal and probably undetectable by the human eye. © 2018 by the American College of Prosthodontists.

Kidney recipients experiences before during and after kidney transplantation

DEFF Research Database (Denmark)

Nielsen, Charlotte

Background Kidney transplantation is considered to be the best treatment for terminal renal insufficiency. Kidney transplant patients report higher quality of life because they avoid regular dialysis treatment that causes side effects, complications, restrictions and limitations in their daily...... 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...

Eating Hints: Before, During, and After Cancer Treatment

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... Publications Reports Eating Hints: Before, during, and after Cancer Treatment Eating Hints is for people who are having or are about to have cancer treatment. Family and friends may also want to read ...

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.

Diffusion tensor imaging detects early brain microstructure changes before and after ventriculoperitoneal shunt in children with high intracranial pressure hydrocephalus

Science.gov (United States)

Zhao, Cailei; Li, Yongxin; Cao, Weiguo; Xiang, Kui; Zhang, Heye; Yang, Jian; Gan, Yungen

2016-01-01

Abstract To explore the use of diffusion tensor imaging (DTI) parameters in the quantitative assessment of early brain microstructure changes before and after ventriculoperitoneal shunt in children with high intracranial pressure hydrocephalus. Ten patients with communicating hydrocephalus (age: 2–36 months) and 14 age-/gender-matched controls (age: 2–36 months) were enrolled in this study. All patients underwent the ventriculoperitoneal shunt procedure. The imaging data were collected before and 3 months after the operation. Regions of interests (ROIs) included the white matter near the frontal horn of the lateral ventricles (FHLV), the occipital horn of the lateral ventricles (OHLV), occipital subcortical (OS) area, frontal subcortical (FS) area, and thalamus. Fractional anisotropies (FA) and apparent diffusion coefficients (ADC) of the ROIs before and after ventriculoperitoneal shunt were compared between the patients and the controls. Three months after surgery, the patients recovered from the surgery with ameliorated intracranial pressure and slight improvement of clinical intelligence scale and motor scale. Before ventriculoperitoneal shunt, the FA values (except the right FHLV) were significantly decreased and the ADC values were significantly increased in the patients with hydrocephalus, compared with the controls. After the ventriculoperitoneal shunt, the FA values in the FHLV and OHLV of the patients were similar to the controls, but the FA values in other ROIs were still significantly lower than controls. The ADC values in the FS and OS white matter areas of the patients were similar to the controls; however, the ADC values in other ROIs were still significantly higher in patients. The increase of FA and the reduction in ADC in the ROIs preceded the clinical function improvement in patients with high intracranial pressure hydrocephalus and reflected the early changes in brain tissue microstructure, such as the compression of the white matter areas in

Ares I Flight Control System Design

Science.gov (United States)

Jang, Jiann-Woei; Alaniz, Abran; Hall, Robert; Bedrossian, Nazareth; Hall, Charles; Ryan, Stephen; Jackson, Mark

2010-01-01

The Ares I launch vehicle represents a challenging flex-body structural environment for flight control system design. This paper presents a design methodology for employing numerical optimization to develop the Ares I flight control system. The design objectives include attitude tracking accuracy and robust stability with respect to rigid body dynamics, propellant slosh, and flex. Under the assumption that the Ares I time-varying dynamics and control system can be frozen over a short period of time, the flight controllers are designed to stabilize all selected frozen-time launch control systems in the presence of parametric uncertainty. Flex filters in the flight control system are designed to minimize the flex components in the error signals before they are sent to the attitude controller. To ensure adequate response to guidance command, step response specifications are introduced as constraints in the optimization problem. Imposing these constraints minimizes performance degradation caused by the addition of the flex filters. The first stage bending filter design achieves stability by adding lag to the first structural frequency to phase stabilize the first flex mode while gain stabilizing the higher modes. The upper stage bending filter design gain stabilizes all the flex bending modes. The flight control system designs provided here have been demonstrated to provide stable first and second stage control systems in both Draper Ares Stability Analysis Tool (ASAT) and the MSFC 6DOF nonlinear time domain simulation.

Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

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Aurélie Bidet-Caulet

2009-11-01

Full Text Available For patients with pharmaco-resistant temporal epilepsy, unilateral anterior temporal lobectomy (ATL - i.e. the surgical resection of the hippocampus, the amygdala, the temporal pole and the most anterior part of the temporal gyri - is an efficient treatment. There is growing evidence that anterior regions of the temporal lobe are involved in the integration and short-term memorization of object-related sound properties. However, non-verbal auditory processing in patients with temporal lobe epilepsy (TLE has raised little attention. To assess non-verbal auditory cognition in patients with temporal epilepsy both before and after unilateral ATL, we developed a set of non-verbal auditory tests, including environmental sounds. We could evaluate auditory semantic identification, acoustic and object-related short-term memory, and sound extraction from a sound mixture. The performances of 26 TLE patients before and/or after ATL were compared to those of 18 healthy subjects. Patients before and after ATL were found to present with similar deficits in pitch retention, and in identification and short-term memorisation of environmental sounds, whereas not being impaired in basic acoustic processing compared to healthy subjects. It is most likely that the deficits observed before and after ATL are related to epileptic neuropathological processes. Therefore, in patients with drug-resistant TLE, ATL seems to significantly improve seizure control without producing additional auditory deficits.

Daily blood pressure profile in Cushing's syndrome before and after surgery

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Kreze A.

1999-01-01

Full Text Available No significant difference has been demonstrated in the altered circadian blood pressure pattern between the pituitary-dependent and adrenal forms of Cushing's syndrome before surgery. The effect of therapy, however, proved to be different. The mesor was normalized in the pituitary-dependent Cushing's syndrome more conspicuously for systolic than for diastolic blood pressure. In Cushing's syndrome due to adrenal adenoma, systolic and diastolic blood pressure mesors have been even significantly "overnormalized" after treatment, being 11 to 27 and 2 to 13 mmHg (95% confidence lower than corresponding mesors in controls. There was no difference between forms in the effect of treatment on blood pressure amplitudes, which remained significantly lower than in controls. Finally, acrophase patterns were partly normalized after treatment of the pituitary-dependent form only for diastolic blood pressure, while both systolic and diastolic blood pressure acrophases were normalized in the treated adrenal form. In conclusion, complete normalization of the pattern of daily blood pressure profile has not been achieved in either form of the syndrome. This may be one of the reasons for the reduced long-term survival after surgical cure of hypercortisolism, than expected.

Clinical significance of changes of serum vascular endothelial growth factor level before and after radiotherapy in patients with esophageal carcinoma

International Nuclear Information System (INIS)

Yu Jingping; Sun Zhiqiang; Ni Xinchu; Wang Jian; Li Yi; Hu Lijun; Li Dongqing; Sun Suping

2011-01-01

Objective: To investigate the changes and clinical value of serum vascular endothelial growth factor (VEGF) level before, during and after radiotherapy in patients with esophageal carcinoma. Methods: The sera of 67 esophageal carcinoma patients and 30 healthy control cases were collected. The VEGF level in serum samples were measured with enzyme-linked immunosorbent assay (ELISA) method. The relations among VEGF level changes,clinical stages and radiotherapy effect were analyzed. Results: The VEGF levels of patients with esophagus cancer before, during and after radiotherapy were significantly higher than those in control group (F=11.65, P<0.01). The VEGF level after radiotherapy was significant lower than that before radiotherapy (F=10.72, P<0.01). The average VEGF level of patients with T 3 and T 4 was significantly higher than that of control group (F=14.10, P<0.01). The average VEGF level of patients with N 1 and N 2 was significantly higher than that of control group (F=8.64, P<0.01). In 62 patients,the serum VEGF level increased in 21 cases but decreased in 41 cases after radiotherapy. With difference in radiotherapy efficiency of 61.90% and 90.24%, respectively (χ 2 =6.08, P<0.05). The average VEGF level during and after radiotherapy for 50 cases of CR + PR were significantly lower than that before radiotherapy (F=7.98, P<0.01). Conclusions: Monitoring the serum VEGF level of patients with esophagus cancer can help evaluate the radiosensitivity, which has a significance in predicting the prognosis of radiotherapy. (authors)

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.

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.

Sweet taste preferences before and after an intensive medical weight loss intervention.

Science.gov (United States)

Asao, K; Rothberg, A E; Arcori, L; Kaur, M; Fowler, C E; Herman, W H

2016-06-01

Medical weight loss could change sweet taste threshold and preferences. The decrease in sweet taste preferences may, in turn, help in the maintenance of weight loss. This study examined the association between sweet taste preferences at baseline and weight change during a medical weight management programme and the impact of diet-induced weight loss on sweet taste preferences. Adult patients with body mass index ≥32 kg m -2 were recruited from a medical weight management clinic. Sweet taste preference was assessed using a forced-choice, paired-comparison tracking method before and after a very-low-calorie diet (VLCD). Twenty participants were included in the analysis: mean age was 53.1 (standard deviation [SD]: 11.4) years, and 14 were female. The mean body mass index was 41.4 (SD: 7.5) kg m -2 . The median preferred sucrose concentration before VLCD was 0.45 M. Following VLCD, mean change in weight was -13.3 (SD: 6.6) kg, and percentage weight change was -11.3% (SD: 5.9%). Based on mixed models with and without adjustment for demographic factors, diabetes status and smoking history, preferred sucrose concentration at baseline did not predict change in longer-term body weight. The change of preferred sucrose concentration following 12 weeks of VLCD was not significant ( P -value 0.95). Change in weight during and after VLCD was not associated with sweet taste preferences at baseline. After diet-induced weight loss, sweet taste preferences did not change.

Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes

OpenAIRE

Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

2017-01-01

Background: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. Objectives: The primary objective of this study was to compare prescribing practices before and after the 2013 zo...

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.

Airborne exposure and biological monitoring of bar and restaurant workers before and after the introduction of a smoking ban.

Science.gov (United States)

Ellingsen, Dag G; Fladseth, Geir; Daae, Hanne L; Gjølstad, Merete; Kjaerheim, Kristina; Skogstad, Marit; Olsen, Raymond; Thorud, Syvert; Molander, Paal

2006-03-01

The aims were to assess the impact of a total smoking ban on the level of airborne contaminants and the urinary cotinine levels in the employees in bars and restaurants. In a follow up design, 13 bars and restaurants were visited before and after the implementation of a smoking ban. Ninety-three employees in the establishments were initially included into the study. The arithmetic mean concentration of nicotine and total dust declined from 28.3 microg m(-3) (range, 0.4-88.0) and 262 microg m(-3) (range, 52-662), respectively, to 0.6 microg m(-3) (range, not detected-3.7) and 77 microg m(-3) (range, not detected-261) after the smoking ban. The Pearson correlation coefficient between airborne nicotine and total dust was 0.86 (p introduction of a smoking ban in bars and restaurants. The urinary cotinine levels were reduced in non-smokers. The decline found in smokers may suggest a reduction in the amount of smoking after intervention. In non-smokers cotinine concentrations were higher based on urine sampled the morning after a shift than based on urine sampled immediately post-shift.

A community-based intervention for improving health-seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania

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Muzdalifat Abeid

2015-09-01

Full Text Available Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited. Objective: This study assessed the impact of a community-based intervention, focusing on improving the community's knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence. Design: The strategies used to create awareness included radio programs, information, education communication materials, and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012 and endline (2014 with men and women aged 18–49 years. Main outcome measures were number of reported rape cases at health facilities and the community's knowledge and attitudes toward sexual violence. Results: The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3 to 80.6% in the intervention area and from 55.5 to 71.9% in the comparison area; p<0.001, and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p=0.03. There was significant improvement in most of the attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect on the overall scores of acceptance attitudes in the final assessment when comparing the two areas (−2.4, 95% CI: −8.4 to 3.6, p=0.42. Conclusions: The intervention had an effect on some indicators on knowledge and attitudes toward sexual violence even after a short period of intervention. This finding informs the public health

Evaluation of genome-wide expression profiles of blood and sputum neutrophils in cystic fibrosis patients before and after antibiotic therapy.

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Massimo Conese

Full Text Available In seeking more specific biomarkers of the cystic fibrosis (CF lung inflammatory disease that would be sensitive to antibiotic therapy, we sought to evaluate the gene expression profiles of neutrophils in CF patients before treatment in comparison with non-CF healthy individuals and after antibiotic treatment. Genes involved in neutrophil-mediated inflammation, i.e. chemotaxis, respiratory burst, apoptosis, and granule exocytosis, were the targets of this study. Microarray analysis was carried out in blood and airway neutrophils from CF patients and in control subjects. A fold change (log threshold of 1.4 and a cut-off of p<0.05 were utilized to identify significant genes. Community networks and principal component analysis were used to distinguish the groups of controls, pre- and post-therapy patients. Control subjects and CF patients before therapy were readily separated, whereas a clear distinction between patients before and after antibiotic therapy was not possible. Blood neutrophils before therapy presented 269 genes down-regulated and 56 up-regulated as compared with control subjects. Comparison between the same patients before and after therapy showed instead 44 genes down-regulated and 72 up-regulated. Three genes appeared to be sensitive to therapy and returned to "healthy" condition: phorbol-12-myristate-13-acetate-induced protein 1 (PMAIP1, hydrogen voltage-gated channel 1 (HVCN1, and β-arrestin 1 (ARRB1. The up-regulation of these genes after therapy were confirmed by real time PCR. In airway neutrophils, 1029 genes were differentially expressed post- vs pre-therapy. Of these, 30 genes were up-regulated and 75 down-regulated following antibiotic treatment. However, biological plausibility determined that only down-regulated genes belonged to the gene classes studied for blood neutrophils. Finally, it was observed that commonly expressed genes showed a greater variability in airway neutrophils than that found in blood neutrophils

Evaluation of genome-wide expression profiles of blood and sputum neutrophils in cystic fibrosis patients before and after antibiotic therapy.

Science.gov (United States)

Conese, Massimo; Castellani, Stefano; Lepore, Silvia; Palumbo, Orazio; Manca, Antonio; Santostasi, Teresa; Polizzi, Angela Maria; Copetti, Massimiliano; Di Gioia, Sante; Casavola, Valeria; Guerra, Lorenzo; Diana, Anna; Montemurro, Pasqualina; Mariggiò, Maria Addolorata; Gallo, Crescenzio; Maffione, Angela Bruna; Carella, Massimo

2014-01-01

In seeking more specific biomarkers of the cystic fibrosis (CF) lung inflammatory disease that would be sensitive to antibiotic therapy, we sought to evaluate the gene expression profiles of neutrophils in CF patients before treatment in comparison with non-CF healthy individuals and after antibiotic treatment. Genes involved in neutrophil-mediated inflammation, i.e. chemotaxis, respiratory burst, apoptosis, and granule exocytosis, were the targets of this study. Microarray analysis was carried out in blood and airway neutrophils from CF patients and in control subjects. A fold change (log) threshold of 1.4 and a cut-off of p<0.05 were utilized to identify significant genes. Community networks and principal component analysis were used to distinguish the groups of controls, pre- and post-therapy patients. Control subjects and CF patients before therapy were readily separated, whereas a clear distinction between patients before and after antibiotic therapy was not possible. Blood neutrophils before therapy presented 269 genes down-regulated and 56 up-regulated as compared with control subjects. Comparison between the same patients before and after therapy showed instead 44 genes down-regulated and 72 up-regulated. Three genes appeared to be sensitive to therapy and returned to "healthy" condition: phorbol-12-myristate-13-acetate-induced protein 1 (PMAIP1), hydrogen voltage-gated channel 1 (HVCN1), and β-arrestin 1 (ARRB1). The up-regulation of these genes after therapy were confirmed by real time PCR. In airway neutrophils, 1029 genes were differentially expressed post- vs pre-therapy. Of these, 30 genes were up-regulated and 75 down-regulated following antibiotic treatment. However, biological plausibility determined that only down-regulated genes belonged to the gene classes studied for blood neutrophils. Finally, it was observed that commonly expressed genes showed a greater variability in airway neutrophils than that found in blood neutrophils, both before and

Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes.

Science.gov (United States)

Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

2017-01-01

Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change). Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release) or 6.25 mg (controlled release) daily or less. Documentation of potentially related serious adverse events within the patients' records was also evaluated. A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020). In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%-50%, p = 0.23), elderly men (34%-40%, p = 0.53), and elderly women (60%-74%, p = 0.14), but the change was only significant in young women (42%-70%, p = 0.0045). After Food and Drug Administration-mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health system, and specifically young women, with initial prescriptions for low

Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes

Directory of Open Access Journals (Sweden)

Jessica L Norman

2017-05-01

Full Text Available Background: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release or 6.25 mg (controlled release per night in women. Objectives: The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Methods: Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change. Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release or 6.25 mg (controlled release daily or less. Documentation of potentially related serious adverse events within the patients’ records was also evaluated. Results: A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020. In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%–50%, p = 0.23, elderly men (34%–40%, p = 0.53, and elderly women (60%–74%, p = 0.14, but the change was only significant in young women (42%–70%, p = 0.0045. Conclusion: After Food and Drug Administration–mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health

Excessive and addictive gaming control using counselling agent in online game design

Science.gov (United States)

Ididi, Italumeh O.; Hassan, Sa'adah; Ghani, Abdul Azim Abd; Ali, Norhayati Mohd

2017-10-01

In recent times, online game play has become a food for thought to concerned individuals, researchers and authorities of various countries due to its excessive and addictive usage. Although, various government have taken certain measures such as shutting down internet cafe at certain hours of the day, censoring the most brutal, offensive and aggressive sections of certain games before they are released. Researchers have advised developers on ways of limiting harm on players by suggesting design changes on time limit. Furthermore, researchers have also suggested that online game distributors ought to make available appropriate referral services. The impart of the above are yet to make any remarkable impact on players. In this paper, we have proposed a Counseling Agent model integrating informative and self-appraisal messages in online game design as a control measure. Informative and self-appraisal messaging in games have proven optimistic through making positive impact on player's thoughts and behavior towards gaming. These messages are expected to remind players about the negative impact of excessive and addictive gaming habits, as well as suggesting possible reductive solutions through message streaming.

The impact of socioeconomic and clinical factors on purchase of prescribed analgesics before and after hysterectomy on benign indication

DEFF Research Database (Denmark)

Daugbjerg, Signe Bennedbæk; Brandsborg, Birgitte; Ottesen, Bent Smedegaard

2014-01-01

OBJECTIVE:: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. METHODS:: Nearly...... socioeconomic factors and changes in analgesic purchase were assessed. RESULTS:: Analgesic purchase after hysterectomy was independently predicted by age below 35 or above 65 years, body mass index >29.9, high American Society of Anesthesiologists (ASA) score, uterus weight...

Short-term impacts of a 4-lane highway on black bears in eastern North Carolina

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Van Manen, Frank T.; McCollister, Matthew F.; Nicholson, Jeremy M.; Thompson, Laura M.; Kindall, Jason L.; Jones, Mark D.

2012-01-01

Among numerous anthropogenic impacts on terrestrial landscapes, expanding transportation networks represent one of the primary challenges to wildlife conservation worldwide. Larger mammals may be particularly vulnerable because of typically low densities, low reproductive rates, and extensive movements. Although numerous studies have been conducted to document impacts of road networks on wildlife, inference has been limited because of experimental design limitations. During the last decade, the North Carolina Department of Transportation (NCDOT) rerouted and upgraded sections of United States Highway 64 between Raleigh and the Outer Banks to a 4-lane, divided highway. A new route was selected for a 24.1-km section in Washington County. The new section of highway included 3 wildlife underpasses with adjacent wildlife fencing to mitigate the effects of the highway on wildlife, particularly American black bears (Ursus americanus). We assessed the short-term impacts of the new highway on spatial ecology, population size, survival, occupancy, and gene flow of black bears. We tested our research hypotheses using a before-after control-impact (BACI) study design. We collected data during 2000–2001 (preconstruction phase) and 2006–2007 (postconstruction phase) in the highway project area and a nearby control area (each approx. 11,000 ha), resulting in 4 groups of data (i.e., pre- or postconstruction study phase, treatment or control area). We captured and radiocollared 57 bears and collected 5,775 hourly locations and 4,998 daily locations. Using mixed-model analysis of variance and logistic regression, we detected no differences in home ranges, movement characteristics, proximity to the highway alignment, or habitat use between the 2 study phases, although minimum detectable effect sizes were large for several tests. However, after completion of the new highway, bears on the treatment area became less inactive in morning, when highway traffic was low, compared with

Patient and parental self-reports of executive functioning in a sample of young female adolescents with anorexia nervosa before and after cognitive remediation therapy.

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Dahlgren, Camilla Lindvall; Lask, Bryan; Landrø, Nils Inge; Rø, Øyvind

2014-01-01

Previous studies assessing the potency of cognitive remediation therapy (CRT) have largely focused on performance-based assessments and how these change during the course of the intervention. Little is known of behavioural manifestations of such changes, and no previous studies have studied parental reports before and after CRT. Patient and parental self-reports of executive function using the Behaviour Rating Inventory of Executive Function (BRIEF) were obtained for 17 adolescent patients in treatment for anorexia nervosa before and after CRT. Results indicated that patients scored significantly lower on the BRIEF shift subscale after CRT, whereas parental reports revealed significantly lower scores on the shift and emotional control subscales, and on the two composite indices Behavioural Regulation Index and Global Executive Composite. Case-wise comparisons support variations in executive functions in adolescents with anorexia nervosa. Changes are evaluated in light of the relationship between patients and parents and with regard to the limitations of the study design. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

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...

A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

OpenAIRE

Denise de Andrade; Emília L. S. Angerami; Carlos Roberto Padovani

2000-01-01

In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were se...

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.

Before and After Photos: Treatment of Hypertrophic Scars

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... 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 ...

MRI of cervical carcinoma: before and after chemotherapy

International Nuclear Information System (INIS)

Kim, Jung Sik; Suh, Soo Jhi; Choi, Tae Jin; Lee, Tae Sung; Suh, Young Wook

1992-01-01

To evaluate usefulness of MR in assessment of tumor response to the chemotherapy, we prospectively studied cases of cervical carcinoma with more than 2.5cm in diameter or stage IIb or more. Three courses of chemotherapy were performed with cisplatin and 5 F-U. MR images were obtained both before and after chemotherapy. Nine of 13 patients were undertaken radical hysterectomy after chemotherapy and MR amination. MR volumetry, stage and depth of stromal invasion were compared before and after chemotherapy. And in 9 patients who underwent radical hysterectomy, comparison of pathologic and MR imaging findings were also done. The results were following. 1) All tumors dectrased in volume (m = 80.5%). 2) Five tumors (38.5%) reduced in stage, IB → CIS (1); IIA → CIS (1), IIA → IB (2), IIB → IB (1). 3) Depth of stromal invasion in MRI correlated well with that of histopathologic specimen in 7 of the 9 patients. Conclusively MR imaging is useful in assessment of tumor response to chemotherapy

"The Day After": A Quasi-Experimental Study of Its Impact.

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Mayton, Daniel M., II

This study was designed to determine the effects of watching the television film, "The Day After," on the attitude toward nuclear warfare and arms reduction of 105 undergraduate students. Students participating chose whether or not to watch the film. All participants completed questionnaires before and after the showing of the film.…

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

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Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

Examining the Feasibility and Impact of a Graduate Public Administration Course in Evidence-Informed Policy

Science.gov (United States)

Ouimet, Mathieu; Lapointe, Luc; Léon, Grégory

2015-01-01

A pilot controlled before-and-after design was used to assess the impact of a new master-level course in evidence-informed policy making on students' basic knowledge in evidence-based practice. The primary outcome variable was the mean percentage of pre-post improvement on the knowledge test. In the treatment group, the mean percentage of pre-post…

Infectious episodes before and after a marathon race.

Science.gov (United States)

Ekblom, B; Ekblom, O; Malm, C

2006-08-01

The aim of this study was to investigate the incidence of self-reported infectious episodes (IE) during 3 weeks before (pre-IE) and 3 weeks after (post-IE) a marathon race and relate these figures to training status, running time, socioeconomic and demographic factors. Two questionnaires, including questions about important factors for IE incidence, were given to a representative cohort of 1694 runners (17% of all finishers) in the Stockholm Marathon 2000. Pre-IE incidence in the cohort was 17% with no difference between women and men. Post-IE incidence in the whole cohort was 19% with no significant (P>0.05) difference between women and men. The post-IE incidence in runners without a pre-IE was 16% (P>0.05 to pre-IE incidence). In the group of runners with pre-IE, 33% experienced an IE after the race also (Ptraining volume 6 months before the race, finishing time and socioeconomic and demographic factors and pre-IE or post-IE. This study does not support the theory of increased infection rate after exhaustive long-distance running ("The Open Window Theory") in recreational runners, but suggests that the sometimes experienced increased rate of infections among athletes can be caused by strenuous exercise too soon after an infection.

Impact of tamsulosin on urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy: a prospective randomized controlled trial.

Science.gov (United States)

Jeong, In Gab; You, Dalsan; Yoon, Jong Hyun; Hong, Sungwoo; Lim, Ju Hyun; Hong, Jun Hyuk; Choo, Myung-Soo; Ahn, Hanjong; Kim, Choung-Soo

2014-02-01

To examine the impact of tamsulosin on the rate of acute urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy. A total of 236 patients who underwent robot-assisted laparoscopic radical prostatectomy for prostate cancer carried out by a single surgeon were enrolled in this randomized study. Patients were randomly divided into two groups: treatment with tamsulosin (0.4 mg) from 1 day before to 14 days after surgery (tamsulosin group), or no tamsulosin treatment (control group). The urethral catheter was removed on the fifth postoperative day. The primary end-point was the acute urinary retention rate. Changes in each domain of the International Continence Society male short-form questionnaire and uroflowmetry parameters were secondary end-points. The primary end-point was assessed in 218 patients (92.4%; n = 109 in each group). It was not assessed in 18 patients because of cystographic leak from the vesicourethral anastomosis. The acute urinary retention rate was lower in the tamsulosin group (7.3%) than in the control group (17.4%, P = 0.018). Multivariate logistic regression analysis identified tamsulosin treatment and the operative experience of the surgeon as independent risk factors for acute urinary retention. Tamsulosin-treated patients had a 0.30-fold lower risk of developing acute urinary retention compared with control patients (95% confidence interval 0.12-0.76; P = 0.011). None of the International Continence Society male questionnaire domain scores showed significant changes between the groups. Perioperative treatment with tamsulosin in patients undergoing robot-assisted laparoscopic radical prostatectomy reduces the rate of acute urinary retention after early catheter removal, without aggravating urinary incontinence. © 2013 The Japanese Urological Association.

A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia: a controlled before-and-after study.

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Engel, M F; Bruns, A H W; Hulscher, M E J L; Gaillard, C A J M; Sankatsing, S U C; Teding van Berkhout, F; Emmelot-Vonk, M H; Kuck, E M; Steeghs, M H M; den Breeijen, J H; Stellato, R K; Hoepelman, A I M; Oosterheert, J J

2014-11-01

We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled before-and-after study, we evaluated the effect of an implementation strategy tailored to previously identified barriers to an early switch. In three Dutch hospitals, a protocol dictating a timely switch strategy was implemented using educational sessions, pocket reminders and active involvement of nursing staff. Primary outcomes were the proportion of patients switched timely and the duration of intravenous antibiotic therapy. Length of hospital stay (LOS), patient outcome, education effects 6 months after implementation and implementation costs were secondary outcomes. Statistical analysis was performed using mixed-effects models. Prior to implementation, 146 patients were included and, after implementation, 213 patients were included. The case mix was comparable. The implementation did not change the proportion of patients switched on time (66 %). The median duration of intravenous antibiotic administration decreased from 4 days [interquartile range (IQR) 2-5] to 3 days (IQR 2-4), a decrease of 21 % [95 % confidence interval (CI) 11 %; 30 %) in the multi-variable analysis. LOS and patient outcome were comparable before and after implementation. Forty-three percent (56/129) of physicians attended the educational sessions. After 6 months, 24 % (10/42) of the interviewed attendees remembered the protocol's main message. Cumulative implementation costs were 5,798 (20/reduced intravenous treatment day). An implementation strategy tailored to previously identified barriers reduced the duration of intravenous antibiotic administration in hospitalised CAP patients by 1 day, at minimal cost.

Malaria diagnostic testing and treatment practices in three different Plasmodium falciparum transmission settings in Tanzania: before and after a government policy change

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Bousema Teun

2011-04-01

Full Text Available Abstract Background Patterns of decreasing malaria transmission intensity make presumptive treatment of malaria an unjustifiable approach in many African settings. The controlled use of anti-malarials after laboratory confirmed diagnosis is preferable in low endemic areas. Diagnosis may be facilitated by malaria rapid diagnostic tests (RDTs. In this study, the impact of a government policy change, comprising the provision of RDTs and advice to restrict anti-malarial treatment to RDT-positive individuals, was assessed by describing diagnostic behaviour and treatment decision-making in febrile outpatients Methods Prospective data from Biharamulo and Rubya Designated District Hospital (DDH were collected before and after policy change, in Sumve DDH no new policy was implemented. Diagnosis of malaria was confirmed by RDT; transmission intensity was evaluated by a serological marker of malaria exposure in hospital attendees. Results Prior to policy change, there was no evident association between the actual level of transmission intensity and drug-prescribing behaviour. After policy change, there was a substantial decrease in anti-malarial prescription and an increase in prescription of antibiotics. The proportion of parasite-negative individuals who received anti-malarials decreased from 89.1% (244/274 to 38.7% (46/119 in Biharamulo and from 76.9% (190/247 to 10.0% (48/479 in Rubya after policy change. Conclusion This study shows that an official policy change, where RDTs were provided and healthcare providers were advised to adhere to RDT results in prescribing drugs can be followed by more rational drug-prescribing behaviour. The current findings are promising for improving treatment policy in Tanzanian hospitals.

Household Portfolio Choice Before and After House Purchase

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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...... 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......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...

[Visual functions' detailed evaluating in patients with Sjögren's syndrome before and after intracanalicular implants' (Smart Plug) insertion--(first results)].

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Hejcmanová, D; Nemcová, I; Slezák, R

2006-05-01

The aim of the study was to determine exact visual functions (log MAR [minimal angle of resolution] and CS [contrast sensitivity]) and to evaluate corneal topographic maps in patients with established (by means of laboratory and biopsy examinations) Sjogren's Syndrome, and to determine the difference in subjective symptoms before and after insertion of the intracanalicular implants as well. Twelve eyes (1 man, 6 women) with established Sjogren's syndrome were examined before and during two months after the insertion of the plugs. The best-corrected visual acuity (BCVA) was assessed on Landolt C rings optotypes. CS was measured on computer-controlled device (Neuroscientific Corp., U.S.A.) in 6 space-frequencies (0.74-29.55 c/deg). The corneal topographic changes (Keraton Opticon) were established by means of comparing total aberrations values before and after the intracanalicular implants' (Smart Plugs type) insertion. The control group for visual functions assessment consisted of 10 woman (20 eyes) of similar middle age. The BCVA on log MAR optotypes was 0.84 (0.69-0.95) before and 0.88 (0.52-1.23) after the insertion, on both occasions, it was lower than in the control group. The CS was before the insertion in all of the spatial frequencies lower, the largest differences were in the frequencies range 1.97-7.29 c/deg (p test, in 100% positive before the treatment, was after the insertion in 75% negative; the height of the tear-meniscus was positive in 100% before the procedure, and after that, its measurement improved to 1 mm in 91%; in 9% it was 1.5 mm. We also noticed changes of the ocular surface by means of lissamine green staining; this test was before the procedure positive in 100%, the improvement after that was in 63%. The regularity of the corneal surface is the determining factor of visual functions in "dry eyes". The measurement of the corneal topography is useful in differential diagnosis and helps to distinguish mild and more serious conditions of dry

Sexual Dysfunction before and after Cardiac Rehabilitation

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Jörg Schumann

2010-01-01

variables. Methods. Analysis of patients participating in a 12-week exercise-based outpatient cardiac rehabilitation program (OCR between April 1999 and December 2007. Exercise capacity (ExC and quality of life including sexual function were assessed before and after OCR. Results. Complete data were available in 896 male patients. No sexual activity at all was indicated by 23.1% at baseline and 21.8% after OCR, no problems with sexual activity by 40.8% at baseline and 38.6% after OCR. Patients showed an increase in specific problems (erectile dysfunction and lack of orgasm from 18% to 23% (<.0001 during OCR. We found the following independent positive and negative predictors of sexual problems after OCR: hyperlipidemia, age, CABG, baseline ExC and improvement of ExC, subjective physical and mental capacity, and sense of affiliation. Conclusions. Sexual dysfunction is present in over half of the patients undergoing OCR with no overall improvement during OCR. Age, CABG, low exercise capacity are independent predictors of sexual dysfunction after OCR.

New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016.

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Yang, Jingzhen; Comstock, R Dawn; Yi, Honggang; Harvey, Hosea H; Xun, Pengcheng

2017-12-01

To examine the trends of new and recurrent sports-related concussions in high-school athletes before and after youth sports traumatic brain injury laws. We used an interrupted time-series design and analyzed the concussion data (2005-2016) from High School Reporting Injury Online. We examined the trends of new or recurrent concussion rates among US representative high-school athletes participating in 9 sports across prelaw, immediate-postlaw, and postlaw periods by using general linear models. We defined 1 athlete exposure as attending 1 competition or practice. We included a total of 8043 reported concussions (88.7% new, 11.3% recurrent). The average annual concussion rate was 39.8 per 100 000 athlete exposures. We observed significantly increased trends of reported new and recurrent concussions from the prelaw, through immediate-postlaw, into the postlaw period. However, the recurrent concussion rate showed a significant decline 2.6 years after the laws went into effect. Football exhibited different trends compared with other boys' sports and girls' sports. Observed trends of increased concussion rates are likely attributable to increased identification and reporting. Additional research is needed to evaluate intended long-term impact of traumatic brain injury laws.

Protected area effectiveness against land development in Spain.

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Rodríguez-Rodríguez, David; Martínez-Vega, Javier

2018-06-01

Land use-land cover (LULC) changes towards artificial covers are one of the main global threats to biodiversity conservation. In this comprehensive study, we tested a number of methodological and research hypotheses, and a new covariate control technique in order to address common protected area (PA) assessment issues and accurately assess whether different PA networks have had an effect at preventing development of artificial LULCs in Spain, a highly biodiverse country that has experienced massive socioeconomic transformations in the past two decades. We used digital census data for four PA networks designated between 1990 and 2000: Nature Reserves (NRs), Nature Parks (NPs), Sites of Community Importance (SCIs) and Special Protection Areas (SPAs). We analysed the effect of explanatory variables on the ecological effectiveness of protected polygons (PPs): Legislation stringency, cummulative legal designations, management, size, age and bio-physical characteristics. A multiple Before-After-Control-Impact (BACI) semi-experimental research design was used whereby artificial land cover increase (ALCI) and proportional artificial land cover increase (PALCI) results were compared inside and outside PAs, using 1 km and 5 km buffer areas surrounding PAs as controls. LULC data were retrieved from Corine Land Cover (CLC) 1990 and 2006 data. Results from three spatial-statistical models using progressively restrictive criteria to select control areas increasingly more accurate and similar to the assessed PPs were compared. PAs were a generally effective territorial policy to prevent land development in Spain. NRs were the most effective PA category, with no new artificial land covers in the assessed period, although exact causality could not be attributed due to legal overlaps. SPAs were the least effective category, with worse ALCI data than their control areas. Legal protection was effective against land development, which was influenced by most bio-physical variables

Morbidity before and after the diagnosis of hyperthyroidism

DEFF Research Database (Denmark)

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

2013-01-01

Hyperthyroidism has been linked with different morbidities, like atrial fibrillation, stroke and diabetes mellitus. However, our knowledge regarding the extent and temporal relation between hyperthyroidism and other diseases is fragmented. Here, we aimed at evaluating various morbidities before...... and after the diagnosis of hyperthyroidism....

Air pollution in Boston bars before and after a smoking ban

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Hyde James N

2006-10-01

Full Text Available Abstract Background We quantified the air quality benefits of a smoke-free workplace law in Boston Massachusetts, U.S.A., by measuring air pollution from secondhand smoke (SHS in 7 pubs before and after the law, comparing actual ventilation practices to engineering society (ASHRAE recommendations, and assessing SHS levels using health and comfort indices. Methods We performed real-time measurements of respirable particle (RSP air pollution and particulate polycyclic aromatic hydrocarbons (PPAH, in 7 pubs and outdoors in a model-based design yielding air exchange rates for RSP removal. We also assessed ventilation rates from carbon dioxide concentrations. We compared RSP air pollution to the federal Air Quality Index (AQI and the National Ambient Air Quality Standard (NAAQS to assess health risks, and assessed odor and irritation levels using published SHS-RSP thresholds. Results Pre-smoking-ban RSP levels in 6 pubs (one pub with a non-SHS air quality problem was excluded averaged 179 μg/m3, 23 times higher than post-ban levels, which averaged 7.7 μg/m3, exceeding the NAAQS for fine particle pollution (PM2.5 by nearly 4-fold. Pre-smoking ban levels of fine particle air pollution in all 7 of the pubs were in the Unhealthy to Hazardous range of the AQI. In the same 6 pubs, pre-ban indoor carcinogenic PPAH averaged 61.7 ng/m3, nearly 10 times higher than post-ban levels of 6.32 ng/m3. Post-ban particulate air pollution levels were in the Good AQI range, except for 1 venue with a defective gas-fired deep-fat fryer, while post-ban carcinogen levels in all 7 pubs were lower than outdoors. Conclusion During smoking, although pub ventilation rates per occupant were within ASHRAE design parameters for the control of carbon dioxide levels for the number of occupants present, they failed to control SHS carcinogens or RSP. Nonsmokers' SHS odor and irritation sensory thresholds were massively exceeded. Post-ban air pollution measurements showed 90% to 95

Air pollution in Boston bars before and after a smoking ban.

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Repace, James L; Hyde, James N; Brugge, Doug

2006-10-27

We quantified the air quality benefits of a smoke-free workplace law in Boston Massachusetts, U.S.A., by measuring air pollution from secondhand smoke (SHS) in 7 pubs before and after the law, comparing actual ventilation practices to engineering society (ASHRAE) recommendations, and assessing SHS levels using health and comfort indices. We performed real-time measurements of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in 7 pubs and outdoors in a model-based design yielding air exchange rates for RSP removal. We also assessed ventilation rates from carbon dioxide concentrations. We compared RSP air pollution to the federal Air Quality Index (AQI) and the National Ambient Air Quality Standard (NAAQS) to assess health risks, and assessed odor and irritation levels using published SHS-RSP thresholds. Pre-smoking-ban RSP levels in 6 pubs (one pub with a non-SHS air quality problem was excluded) averaged 179 microg/m3, 23 times higher than post-ban levels, which averaged 7.7 microg/m3, exceeding the NAAQS for fine particle pollution (PM2.5) by nearly 4-fold. Pre-smoking ban levels of fine particle air pollution in all 7 of the pubs were in the Unhealthy to Hazardous range of the AQI. In the same 6 pubs, pre-ban indoor carcinogenic PPAH averaged 61.7 ng/m3, nearly 10 times higher than post-ban levels of 6.32 ng/m3. Post-ban particulate air pollution levels were in the Good AQI range, except for 1 venue with a defective gas-fired deep-fat fryer, while post-ban carcinogen levels in all 7 pubs were lower than outdoors. During smoking, although pub ventilation rates per occupant were within ASHRAE design parameters for the control of carbon dioxide levels for the number of occupants present, they failed to control SHS carcinogens or RSP. Nonsmokers' SHS odor and irritation sensory thresholds were massively exceeded. Post-ban air pollution measurements showed 90% to 95% reductions in PPAH and RSP respectively, differing

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

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van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-01-01

Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

Financial Services Advertising before and after the Crash of 1987.

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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)

Glucose in vaginal secretions before and after oral glucose tolerance testing in women with and without recurrent vulvovaginal candidiasis.

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Ehrström, Sophia; Yu, Anna; Rylander, Eva

2006-12-01

To measure the change of glucose in vaginal secretions during glucose tolerance testing in women with recurrent vulvovaginal candidiasis and in healthy control subjects. Thirty-eight women with recurrent vulvovaginal candidiasis and 45 healthy, age-matched controls completed a health questionnaire regarding general and gynecologic health and food and alcohol habits. They all underwent an oral glucose tolerance test and a vaginal examination. Vaginal secretion was collected from the proximal part of the vagina. Glucose in plasma and in vaginal secretions were measured at fasting and after 2 hours and analyzed with the hexokinase method. A sample size analysis showed that the number of subjects included in the study was sufficient for a beta value of 0.80, at the significance level of alpha=.05, at a difference in glucose in vaginal secretions of 30% after oral glucose tolerance test. In healthy women, the median level of glucose in vaginal secretions was 5.2 mM before and 3.7 mM after oral glucose tolerance test, and plasma glucose was 5.0 mM before and 5.8 mM after oral glucose tolerance test. No significant difference was seen regarding change of glucose level in vaginal secretions and plasma glucose after testing, compared with before oral glucose tolerance testing. There were no differences between women with recurrent vulvovaginal candidiasis and control subjects regarding change in glucose level in vaginal secretions or in plasma during oral glucose tolerance test. II-2.

Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery

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Adams, TD; Hammoud, AO; Davidson, LE; Laferrère, B; Fraser, A; Stanford, JB; Hashibe, M; Greenwood, JLJ; Kim, J; Taylor, D; Watson, AJ; Smith, KR; McKinlay, R; Simper, SC; Smith, SC; Hunt, SC

2016-01-01

BACKGROUND Interaction between maternal obesity, intrauterine environment and adverse clinical outcomes of newborns has been described. METHODS Using statewide birth certificate data, this retrospective, matched-control cohort study compared paired birth weights and complications of infants born to women before and after Roux-en-Y gastric bypass surgery (RYGB) and to matched obese non-operated women in several different groups. Women who had given birth to a child before and after RYGB (group 1; n = 295 matches) and women with pregnancies after RYGB (group 2; n = 764 matches) were matched to non-operated women based on age, body mass index (BMI) prior to both pregnancy and RYGB, mother’s race, year of mother/s birth, date of infant births and birth order. In addition, birth weights of 13 143 live births before and/or after RYGB of their mothers (n = 5819) were compared (group 3). RESULTS Odds ratios (ORs) for having a large-for-gestational-age (LGA) neonate were significantly less after RYGB than for non-surgical mothers: ORs for groups 1 and 2 were 0.19 (0.08–0.38) and 0.33 (0.21–0.51), respectively. In contrast, ORs in all three groups for risk of having a small for gestational age (SGA) neonate were greater for RYGB mothers compared to non-surgical mothers (ORs were 2.16 (1.00–5.04); 2.16 (1.43–3.32); and 2.25 (1.89–2.69), respectively). Neonatal complications were not different for group 1 RYGB and non-surgical women for the first pregnancy following RYGB. Pregnancy-induced hypertension and gestational diabetes were significantly lower for the first pregnancy of mothers following RYGB compared to matched pregnancies of non-surgical mothers. CONCLUSION Women who had undergone RYGB not only had lower risk for having an LGA neonate compared to BMI-matched mothers, but also had significantly higher risk for delivering an SGA neonate following RYGB. RYGB women were less likely than non-operated women to have pregnancy-related hypertension and diabetes

Vitrification of human germinal vesicle oocytes; before or after in vitro maturation?

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Evangelia Kasapi

2017-03-01

Full Text Available Background The use of immature oocytes derived from stimulated cycles could be of great importance, particularly for urgent fertility preservation cases. The current study aimed to determine whether in vitro maturation (IVM was more successful before or after vitrification of these oocytes. Materials and Methods This prospective study was performed in a private in vitro fertilization (IVF center. We collected 318 germinal vesicle (GV oocytes from 104 stimulated oocyte donation cycles. Oocytes were divided into two groups according to whether vitrification was applied at the GV stage (group 1 or in vitro matured to the metaphase II (MII stage and then vitrified (group 2. In the control group (group 3, oocytes were in vitro matured without vitrification. In all three groups, we assessed survival rate after warming, maturation rate, and MII-spindle/chromosome configurations. The chi-square test was used to compare rates between the three groups. Statistical significance was defined at P<0.05 and we used Bonferroni criterion to assess statistical significance regarding the various pairs of groups. The Statistical Package for the Social Sciences version 17.0 was used to perform statistical analysis. Results There was no significant difference in the survival rate after vitrification and warming of GV (93.5% and MII oocytes (90.8%. A significantly higher maturation rate occurred when IVM was performed before vitrification (82.9% compared to after vitrification (51%. There was no significant difference in the incidence of normal spindle/ chromosome configurations among warmed oocytes matured in vitro before (50.0% or after (41.2% vitrification. However, a higher incidence of normal spindle/chromosome configurations existed in the in vitro matured oocytes which were not subjected to vitrification (fresh oocytes, 77.9%. Conclusion In stimulated cycles, vitrification of in vitro matured MII oocytes rather than GV oocytes seems to be more efficient. This

Effects of implementing electronic medical records on primary care billings and payments: a before-after study.

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Jaakkimainen, R Liisa; Shultz, Susan E; Tu, Karen

2013-09-01

Several barriers to the adoption of electronic medical records (EMRs) by family physicians have been discussed, including the costs of implementation, impact on work flow and loss of productivity. We examined billings and payments received before and after implementation of EMRs among primary care physicians in the province of Ontario. We also examined billings and payments before and after switching from a fee-for-service to a capitation payment model, because EMR implementation coincided with primary care reform in the province. We used information from the Electronic Medical Record Administrative Data Linked Database (EMRALD) to conduct a retrospective before-after study. The EMRALD database includes EMR data extracted from 183 community-based family physicians in Ontario. We included EMRALD physicians who were eligible to bill the Ontario Health Insurance Plan at least 18 months before and after the date they started using EMRs and had completed a full 18-month period before Mar. 31, 2011, when the study stopped. The main outcome measures were physicians' monthly billings and payments for office visits and total annual payments received from all government sources. Two index dates were examined: the date physicians started using EMRs and were in a stable payment model (n = 64) and the date physicians switched from a fee-for-service to a capitation payment model (n = 42). Monthly billings and payments for office visits did not decrease after the implementation of EMRs. The overall weighted mean annual payment from all government sources increased by 27.7% after the start of EMRs among EMRALD physicians; an increase was also observed among all other primary care physicians in Ontario, but it was not as great (14.4%). There was a decline in monthly billings and payments for office visits after physicians changed payment models, but an increase in their overall annual government payments. Implementation of EMRs by primary care physicians did not result in decreased

Media Agenda Setting Regarding Gun Violence before and after a Mass Shooting

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Jashinsky, Jared Michael; Magnusson, Brianna; Hanson, Carl; Barnes, Michael

2017-01-01

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. PMID:28119907

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

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Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer

Science.gov (United States)

MacKenna, Antonio; Crosby, Javier; Huidobro, Cristián; Correa, Eduardo; Duque, Gonzalo

2017-01-01

Objective The main objective of this study was to assess semen characteristics of patients with testicular cancer before cryopreservation and after thawing, to evaluate the consequences of this technique on sperm quality in patients with testicular cancer. Methods Five hundred eighty-nine samples from 543 patients with testicular cancer were cryopreserved between 1995 and 2015, one aliquot per patient was used for a thawing test to assess the impact of cryopreservation on sperm motility; semen analysis was performed before cryo preservation and after thawing, the result interpretation was carried out using the 2010 World Health Organization (WHO) Laboratory Manual, and consent forms were signed by the patients for freezing and when sperm was used for reproductive purposes. Results Hypospermia was observed in 28.7% of samples, the median sperm concentration was 18 million/mL with 35% oligozoospermia; twenty-two patients (4.1%) had azoospermia and 12.7% had severe oligozoospermia, the median sperm count was 31.3 million and 261 semen samples (44.3%) were normal in all parameters according to the WHO; total motile sperm count before cryopreservation and after thawing was 12 (0-412.2) and 7 (0-303.9) million sperm, respectively (p < 0.00001, 95% CI 5.48-14.91), which represents a 32% reduction; concerning the utilization of cryopreserved semen samples, only twelve patients (2.2%) used their frozen sperm for reproductive purposes. Conclusions An impairment in semen quality was found in almost half of the samples from patients with testicular cancer, only few patients had azoospermia or severe oligozoospermia; sperm cryopreservation significantly reduces sperm motility and total motile sperm count and very few patients use their frozen sperm for reproductive purposes. PMID:28333030

A before and after comparison of the effects of forest walking on the sleep of a community-based sample of people with sleep complaints

Directory of Open Access Journals (Sweden)

Miyaura Tomiyasu

2011-10-01

Full Text Available Abstract Background Sleep disturbance is a major health issue in Japan. This before-after study aimed to evaluate the immediate effects of forest walking in a community-based population with sleep complaints. Methods Participants were 71 healthy volunteers (43 men and 28 women. Two-hour forest-walking sessions were conducted on 8 different weekend days from September through December 2005. Sleep conditions were compared between the nights before and after walking in a forest by self-administered questionnaire and actigraphy data. Results Two hours of forest walking improved sleep characteristics; impacting actual sleep time, immobile minutes, self-rated depth of sleep, and sleep quality. Mean actual sleep time estimated by actigraphy on the night after forest walking was 419.8 ± 128.7 (S.D. minutes whereas that the night before was 365.9 ± 89.4 minutes (n = 42. Forest walking in the afternoon improved actual sleep time and immobile minutes compared with forest walking in the forenoon. Mean actual sleep times did not increase after forenoon walks (n = 26 (the night before and after forenoon walks, 380.0 ± 99.6 and 385.6 ± 101.7 minutes, respectively, whereas afternoon walks (n = 16 increased mean actual sleep times from 342.9 ± 66.2 to 475.4 ± 150.5 minutes. The trend of mean immobile minutes was similar to the abovementioned trend of mean actual sleep times. Conclusions Forest walking improved nocturnal sleep conditions for individuals with sleep complaints, possibly as a result of exercise and emotional improvement. Furthermore, extension of sleep duration was greater after an afternoon walk compared to a forenoon walk. Further study of a forest-walking program in a randomized controlled trial is warranted to clarify its effect on people with insomnia.

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

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

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

Tamarisk (Tamarix spp.) water fluxes before, during and after episodic defoliation by the saltcedar leaf beetle

Science.gov (United States)

Hultine, K.R.; Nagler, P.L.; Dennison, P.E.; Bush, S.E.; Ehleringer, J.R.

2009-01-01

Tamarisk (Tamarix) species are among the most successful and economically costly plant invaders in the western United States, in part due to its potential to remove large amounts of water from shallow aquifers. Accordingly, local, state and federal agencies have released a new biological control - the saltcedar leaf beetle (Diorhabda elongata) along many watersheds in the western United States to reduce the spread of tamarisk. The beetle defoliates tamarisk for much of the growing season resulting in potentially large seasonal declines in productivity, fitness, and water loss from tamarisk stands. We measured sap flux density (Js) using heat dissipation sensors to investigate water use patterns of tamarisk before, during and after a single, six week beetle-induced defoliation event in southeastern, Utah, USA. Granier-style probes were installed on 20 dominant trees from May through September 2008, a period that covers almost the entire growing season. As the beetle emerged from dormancy in mid-June, daytime and nighttime Js measurably increased for approximately two weeks before declining to less than 20% of predicted values (predicted by modeling Js with atmospheric vapor pressure deficit in May and June before defoliation). Tamarisk trees in mid-August produced new leaves and Js returned to pre-defoliation levels. Total Js, summed over the duration of the study was 13% lower than predicted values. These data suggest that defoliation results in only small changes in seasonal water loss from tamarisk stands. Current research is focusing on long-term ecohydrological impacts of tamarisk defoliation over multiple growing seasons.

ACSYNT inner loop flight control design study

Science.gov (United States)

Bortins, Richard; Sorensen, John A.

1993-01-01

The NASA Ames Research Center developed the Aircraft Synthesis (ACSYNT) computer program to synthesize conceptual future aircraft designs and to evaluate critical performance metrics early in the design process before significant resources are committed and cost decisions made. ACSYNT uses steady-state performance metrics, such as aircraft range, payload, and fuel consumption, and static performance metrics, such as the control authority required for the takeoff rotation and for landing with an engine out, to evaluate conceptual aircraft designs. It can also optimize designs with respect to selected criteria and constraints. Many modern aircraft have stability provided by the flight control system rather than by the airframe. This may allow the aircraft designer to increase combat agility, or decrease trim drag, for increased range and payload. This strategy requires concurrent design of the airframe and the flight control system, making trade-offs of performance and dynamics during the earliest stages of design. ACSYNT presently lacks means to implement flight control system designs but research is being done to add methods for predicting rotational degrees of freedom and control effector performance. A software module to compute and analyze the dynamics of the aircraft and to compute feedback gains and analyze closed loop dynamics is required. The data gained from these analyses can then be fed back to the aircraft design process so that the effects of the flight control system and the airframe on aircraft performance can be included as design metrics. This report presents results of a feasibility study and the initial design work to add an inner loop flight control system (ILFCS) design capability to the stability and control module in ACSYNT. The overall objective is to provide a capability for concurrent design of the aircraft and its flight control system, and enable concept designers to improve performance by exploiting the interrelationships between

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

Use of Medicare services before and after introduction of the prospective payment system.

Science.gov (United States)

Manton, K G; Woodbury, M A; Vertrees, J C; Stallard, E

1993-08-01

The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 provide health and health service use data for 12-month periods before and after the introduction of PPS. Case-mix differences between pre- and post-periods are controlled by using the Grade of Membership model to identify health groups from the NLTCS data. Differences in timing (e.g., hospital length of stay) were controlled using life table models estimated for each health group, that is, service use patterns pre- and post-PPS are compared within groups. Hospital LOS and admission rates declined post-PPS. Changes in the timing and location of death occurred but, overall, mortality did not increase. Changes in post-acute care service use by elderly, chronically disabled Medicare beneficiaries were observed: home health service use increased overall and among the unmarried disabled population. PPS did not adversely affect quality of care as reflected in mortality or in hospital readmissions. Moreover, the differential use of post-acute care, and changes in hospital LOS by health group, indicate that the system responded, specific to marital status and age, to the severity of needs of chronically disabled persons.

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...

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.

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

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.

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 ...

Obstetric patients' health-related quality of life before and after intensive care.

Science.gov (United States)

Pia, Seppänen; Reijo, Sund; Tero, Ala-Kokko; Mervi, Roos; Jukka, Uotila; Mika, Helminen; Tarja, Suominen

2018-03-23

Intensive care admissions during pregnancy, childbirth, and postpartum period are relatively well investigated. However, very little is known about these obstetric patients' health-related quality of life (HRQoL) before and after critical care. The objective of this study was to assess obstetric patients' HRQoL before intensive care admission (baseline) and at 6 months after discharge (follow-up) DESIGN: This was a retrospective database study. In a 5-year period, the data of all women admitted to the intensive care unit (ICU) during pregnancy, delivery, or up to 42 days postpartum were analysed. Four multidisciplinary ICUs of Finnish University hospitals participated. The HRQoL was assessed using the EuroQol-5D (EQ-5D) instrument with utility score (EQsum) and visual analogue scale (EQ-VAS). A total of 283 obstetric patients were identified from the clinical information system. Of these, 99 (35%) completed the EQ-5D questionnaires both at baseline and follow-up, and 65 of them (23%) completed EQ-VAS. The comparison of patients' EQsum scores before intensive care admission and after discharge showed that patients' HRQoL remained good (0.970 vs 0.972) (max 1.0) or increased (0.788 vs 0.982) in 80.8% of the patients. Patients reported improved overall health on the EQ-VAS at 6 months follow-up (EQ-VAS mean, 71.86 vs 88.20; p ≤ 0.001) (max 100). However, 19.2% of the patients had lower HRQoL (EQsum mean 0.987 vs 0.798) at follow-up. Following intensive care, 15% of the patients had more pain/discomfort, and 11% expressed more depression/anxiety. Multiparous patients were more likely to suffer from worsened depression/anxiety (p = 0.024). In the majority of the obstetric patients, HRQoL at 6 months follow-up remained good or had increased from baseline. However, nearly one-fifth of the patients had impaired HRQoL after discharge. Thus, intensive care management should take in to consideration follow-up program after intensive care of ICU-admitted obstetric

The Impact of Laughter Yoga on the Stress of Cancer Patients before Chemotherapy

Science.gov (United States)

Farifteh, Shadi; Mohammadi-Aria, Alireza; Kiamanesh, Alireza; Mofid, Bahram

2014-01-01

Background Cancer is usually accompanied by considerable stress for the sufferer, and the stress has destructive effects on Chemotherapy treatment process. Therefore, the current research deals with the effect of yoga laughter on the cancer patients’ stress before chemotherapy. Methods In this research, as the first step, 37 cancer sufferers , who had been hospitalized in Shohada Tajrish Hospital (Behnam Daneshpoor Charity Organization) and had the requirements necessary for being taken as research samples, were selected for data collection. The mentioned patients were classified randomly in experimental and control groups. Collected data were analyzed by the multi-variable covariance analysis test. Results The results show there is a meaningful difference in the stress average before and after interference in the test group (p<0.05). Conclusion Laughter yoga can decrease the stress in cancer sufferers before chemotherapy. PMID:25628838

Capecitabine and Oxaliplatin Before, During, and After Radiotherapy for High-Risk Rectal Cancer

DEFF Research Database (Denmark)

Larsen, Finn Ole; Markussen, Alice; Jensen, Benny V

2017-01-01

PURPOSE: To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. PATIENTS AND METHODS: Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were...... accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT. The patients received radiotherapy...... as intensity-modulated radiotherapy. Total mesorectal excision was planned 8 weeks after CRT. The patients were evaluated with magnetic resonance imaging (MRI) before start of treatment, after 6 weeks of chemotherapy, and again just before the operation. The European Organization for Research and Treatment...

Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

Science.gov (United States)

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

The effect of professional-led guideline workshops on clinical practice for the management of patent ductus arteriosus in preterm neonates in Japan: a controlled before-and-after study.

Science.gov (United States)

Isayama, Tetsuya; Ye, Xiang Y; Tokumasu, Hironobu; Chiba, Hiroo; Mitsuhashi, Hideko; Shahrook, Sadequa; Kusuda, Satoshi; Fujimura, Masanori; Toyoshima, Katsuaki; Mori, Rintaro

2015-05-08

Clinical guidelines assist physicians to make decisions about suitable healthcare. We conducted a controlled before-and-after study to investigate the impact of professional-led guideline workshops for patent ductus arteriosus (PDA) management on physicians' clinical practices, discharge mortality, and associated morbid conditions among preterm neonates. We recruited physicians practicing at two neonatal intensive care units (NICUs) in Japan and used the data of all neonates weighing less than or equal to 1,500 g admitted to 90 NICUs (2 intervention NICUs and 88 control NICUs) in the Neonatal Research Network of Japan from April 2008 to March 2010. We held 1-day workshops for physicians on PDA clinical practice guidelines at the two intervention NICUs. Physicians' skills assessed by confidence rating (CR) scores and the Sheffield Peer Review Assessment Tool (SPRAT) were compared between pre- and post-workshop month at the intervention NICUs using Wilcoxon signed-rank tests. Neonatal discharge mortality and morbidity were compared between pre- and post-workshop year at both the intervention and control NICUs using multivariable regression analyses adjusting for potential confounders. Fifteen physicians were included in the study. Physicians' CR scores (2.14 vs. 2.47, p = 0.02) and SPRAT (4.14 vs. 4.50, p = 0.05) in PDA management improved after the workshops. The analyses of neonatal outcomes included 294 and 6,234 neonates in the intervention and control NICUs, respectively. Neonates' discharge mortality declined sharply at the intervention NICUs (from 15/146 to 5/148, relative risk reduction -0.67; adjusted odds ratio 0.30, 95% confidence interval 0.10 to 0.89) during the post-workshop period. The mortality reduction was much greater than that in the control NICUs (from 207/3,322 to 147/2,912, relative risk reduction -0.19; adjusted odds ratio 0.75, 95% confidence interval 0.59 to 0.95), although the difference between the intervention and control NICUs were not

Estimating the Impacts of Direct Load Control Programs Using GridPIQ, a Web-Based Screening Tool

Energy Technology Data Exchange (ETDEWEB)

Pal, Seemita; Thayer, Brandon L.; Barrett, Emily L.; Studarus, Karen E.

2017-11-13

In direct load control (DLC) programs, utilities can curtail the demand of participating loads to contractually agreed-upon levels during periods of critical peak load, thereby reducing stress on the system, generation cost, and required transmission and generation capacity. Participating customers receive financial incentives. The impacts of implementing DLC programs extend well beyond peak shaving. There may be a shift of load proportional to the interrupted load to the times before or after a DLC event, and different load shifts have different consequences. Tools that can quantify the impacts of such programs on load curves, peak demand, emissions, and fossil fuel costs are currently lacking. The Grid Project Impact Quantification (GridPIQ) screening tool includes a Direct Load Control module, which takes into account project-specific inputs as well as the larger system context in order to quantify the impacts of a given DLC program. This allows users (utilities, researchers, etc.) to test and compare different program specifications and their impacts.

Comparison of doses, before and after remedial action

International Nuclear Information System (INIS)

Wallo, A. III

1988-01-01

The Division of Facility and Site Decommissioning Projects at DOE-Headquarters is evaluating potential doses from vicinity properties before and after remedial action at several sites using the RESRAD computer code. A preliminary review was completed for nineteen Colonie vicinity properties. This review indicated potential doses before remedial action at these sites ranged from about 43 to 2 mrem/year and after remediation between 5 and 0 mrem/year. These estimates indicate the conservatism in the DOE-derived soil decontamination remedial action. Following remedial action, the potential doses are on the order of those being considered to be below regulatory concern by EPA and NRC. The estimates made for these sites are still conservative due to the method used to determine the source term. More realistic assessments of source terms are anticipate dot significantly affect the after-remedial-action doses, possibly lowering them all to below 1 mrem/year. This evaluation is being refined with more realistic estimates of the source term, for all of the Colonie vicinity properties. Once the Colonie vicinity properties are completed, at least three other sites will be evaluated. It is hoped that this information will provide added confidence in the remedial action guidelines and more general acceptance of the guidelines by the EPA and others

Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids.

Science.gov (United States)

Al-Janaby, Hala; El-Sakka, Haytham; Masood, Manal; Ashani W Mendis, Walimuni; M Slack-Smith, Linda; Parsons, Richard; M Frydrych, Agnieszka

2017-01-01

Oral lichen planus and mouth dryness are common pathoses, yet not entirely understood. These two conditions may be associated, with a few studies investigating the relationship between mouth dryness and oral lichen planus providing conflicting results. None of the studies have explored the specific impact of disease treatment on mouth dryness. The purpose of this observational before and after comparison study was to examine the effect of treatment of oral lichen planus with topical corticosteroids on mouth dryness. Nineteen subjects with oral lichen planus were evaluated for the severity of xerostomia using a xerostomia inventory and a visual analogue scale. Stimulated and unstimulated whole salivary flow rates, unstimulated salivary pH and buffering capacity were also measured. All subjects were evaluated before and after treatment with topical corticosteroids. All subjects reported xerostomia before treatment with topical corticosteroids, with 79% reporting a significant improvement ( P = 0.03) after treatment. Topical corticosteroid treatment was not associated with statistically significant differences in stimulated or unstimulated salivary flow rates, unstimulated salivary pH or buffering capacity. The results of this study suggest that treatment of oral lichen planus with topical corticosteroids may decrease the severity of dry mouth symptoms.

Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery.

Science.gov (United States)

Jiang, Rong-San; Lu, Fung-Jou; Liang, Kai-Li; Shiao, Jiun-Yi; Su, Mao-Chang; Hsin, Chung-Han; Chen, Wen-Kang

2008-01-01

The olfactory loss in patients with chronic rhinosinusitis has been measured by different methods. However, the results have been variable and it is not clear whether functional endoscopic sinus surgery (FESS) significantly improves olfactory function. This study was performed to evaluate the influences of FESS on olfactory function in patients with chronic rhinosinusitis using three different types of olfactory tests. Seventy patients with chronic rhinosinusitis were administered the University of Pennsylvania Smell Identification Test (UPSIT), a single staircase phenyl ethyl alcohol odor detection threshold test (STT), and a short-term odor memory/discrimination test a day before and 6 months after FESS. A questionnaire inquiring about the patients' self-perception of olfactory function was administered also. Independent ratings of the severity of chronic rhinosinusitis before FESS were established from CT scans. Fifty-two (74.3%) of the patients reported that their olfactory function was impaired before surgery, and 68.6% of the patients reported impaired olfactory function after surgery, a difference that was not significant. No meaningful changes in any of the olfactory test scores were noted 6 or more months after FESS. Preoperatively, small correlations between CT scores and the symptom scores (r = 0.278; p = 0.024), threshold scores (r = -0.27; p = 0.031), and UPSIT scores (r = -0.36; p = 0.003) were observed. In patients with severe rhinosinusitis, FESS had little impact on the ability to smell, regardless of the method for assessing smell function. Subtle associations between olfactory function and the severity of chronic rhinosinusitis determined by CT were observed, however, preoperatively. The olfactory test measures were correlated with one another both pre- and postoperatively.

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

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

Hamstring injury prevention in soccer: Before or after training?

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Lovell, R; Knox, M; Weston, M; Siegler, J C; Brennan, S; Marshall, P W M

2018-02-01

We examined the effects of a 12-week program of Nordic hamstring exercises (NHE), administered before or after football training, upon eccentric hamstring strength, muscle activity, and architectural adaptations. Amateur soccer players were randomized into three groups. The control group (CON; n=11) undertook core stability exercises, whereas a periodized NHE program was delivered either before (NHE BEF ; n=10) or after (NHE AFT ; n=14) biweekly training sessions. Outcome measures included peak torque and concomitant normalized peak surface electromyography signals (sEMG) of the biceps femoris (BF) and medial hamstring (MH) muscles during knee flexor maximal eccentric contractions, performed at 30°·s -1 . Ultrasonography was used to determine BF muscle thickness, muscle fiber pennation angle, and fascicle length. Performing the NHE derived likely moderate peak torque increases in both NHE BEF (+11.9%; 90% confidence interval: 3.6%-20.9%) and NHE AFT (+11.6%; 2.6%-21.5%) vs CON. Maximum sEMG increases were moderately greater in the BF of both NHE training groups vs CON. There were likely moderate increases in BF muscle thickness (+0.17 cm; 0.05-0.29 cm) and likely small pennation angle increases (+1.03°; -0.08° to 2.14°) in NHE AFT vs CON and NHE BEF . BF fascicle length increases were likely greater in NHE BEF (+1.58 cm; 0.48-2.68 cm; small effect) vs CON and NHE AFT . A 12-week eccentric hamstring strengthening program increased strength and sEMG to a similar magnitude irrespective of its scheduling relative to the football training session. However, architectural adaptations to support the strength gains differed according to the timing of the injury prevention program. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Levels of interleukin-6 in tears before and after excimer laser treatment

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Resan Mirko

2015-01-01

Full Text Available Background/Aim. Immune response and consequent inflammatory process which originate on ocular surface after a trauma are mediated by cytokines. Photoablation of corneal stroma performed by excimer laser causes surgically induced trauma. Interleukin-6 (IL-6 is mostly known as a proinflammatory cytokine. However, it also has regenerative and anti-inflammatory effects. It is supposed that this cytokine is likely to play a significant role in the process of corneal wound healing response after photoablation of stroma carried out by laser in situ keratomileusis (LASIK or photorefractive keratectomy (PRK methods. The aim of this study was to determine and compare the levels of IL-6 in tears before and after treatment with LASIK and PRK methods. Methods. The study included 68 shortsighted eyes up to -3.0 diopter sphere, i.e. 198 samples of tears (per three samples taken from each of the eyes, divided into two groups according to the kind of excimer laser intervention performed: the group 1 - eyes treated by LASIK method (n = 31, and the group 2 - eyes treated by the PRK method (n = 37. The samples of tears were taken from each eye at the following time points: before excimer laser treatment (0 h, the control group, 1 h after the treatment (1 h and 24 h after the treatment (24 h. The patients did not use anti-inflammatory therapy 24 h after the intervention. Tear samples were collected using microsurgical sponge. Level of IL-6 in tear fluid was determined by the flow cytometry method, applying a commercial test kit which allowed cytokine detection from a small sample volume. Results. The values of IL-6 were detectable in 16% of samples before LASIK treatment and in 30% of samples before PRK treatment. One h after the treatment IL-6 was detectable in 29% of samples for the LASIK group and 43% of samples for the PRK group, and 24 h after the treatment it was detectable in 19% of samples for the LASIK group and in 57% of samples for the PRK group. When we

Levels of interleukin-6 in tears before and after excimer laser treatment.

Science.gov (United States)

Resan, Mirko; Stanojević, Ivan; Petković, Aleksandra; Pajić, Bojan; Vojvodić, Danilo

2015-04-01

Immune response and consequent inflammatory process which originate on ocular surface after a trauma are mediated by cytokines. Photoablation of corneal stroma performed by excimer laser causes surgically induced trauma. Interleukin-6 (IL-6) is mostly known as a proinflammatory cytokine. However, it also has regenerative and anti-inflammatory effects. It is supposed that this cytokine is likely to play a significant role in the process of corneal wound healing response after photoablation of stroma carried out by laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) methods. The aim of this study was to determine and compare the levels of IL-6 in tears before and after treatment with LASIK and PRK methods. The study included 68 shortsighted eyes up to -3.0 diopter sphere, i.e. 198 samples of tears (per three samples taken from each of the eyes), divided into two groups according to the kind of excimer laser intervention performed: the group 1--eyes treated by LASIK method (n=31), and the group 2--eyes treated by the PRK method (n=37). The samples of tears were taken from each eye at the following time points: before excimer laser treatment (0 h, the control group), 1 h after the treatment (1 h) and 24 h after the treatment (24 h). The patients did not use anti-inflammatory therapy 24 h after the intervention. Tear samples were collected using microsurgical sponge. Level of IL-6 in tear fluid was determined by the flow cytometry method, applying a commercial test kit which allowed cytokine detection from a small sample volume. Results. The values of IL-6 were detectable in 16% of samples before LASIK treatment and in 30% of samples before PRK treatment. One h after the treatment IL-6 was detectable in 29% of samples for the LASIK group and 43% of samples for the PRK group, and 24 h after the treatment it was detectable in 19% of samples for the LASIK group and in 57% of samples for the PRK group. When we analyzed the dynamics of IL76 production

Constipation-Related Health Care Utilization in Children Before and After Hospitalization for Constipation.

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Stephens, John R; Steiner, Michael J; DeJong, Neal; Rodean, Jonathan; Hall, Matt; Richardson, Troy; Berry, Jay G

2018-01-01

We studied constipation-related health care among children before and after constipation admission. Index admissions for constipation in 2010-2011 were identified in the Truven Marketscan Database, which includes children receiving Medicaid in 10 states. We measured number of and spending for outpatient constipation visits 12 months before and after index hospitalizations. We also measured spending for constipation hospitalizations and rehospitalization rate. There were 780 index constipation admissions. The median number of outpatient constipation visits was 1 (interquartile range [IQR] = 0, 3) in the 12 months before and 2 (IQR [0, 4]) after admission ( P = .001). Median outpatient spending for constipation was $110 (IQR [0, 429]) before and $132 (IQR [0, 431]) after admission ( P = .2). Median spending for index constipation admissions was $5295 (IQR [2756, 8267]); 78 children (10%) were rehospitalized for constipation within 12 months. Constipation-related health care utilization increased after constipation admission. Median spending for one constipation admission was 50 times the median spending for 12 months of outpatient constipation visits.

Renal function and morphology in aged Beagle dogs before and after hydrocortisone administration.

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Pascale M Y Smets

Full Text Available Objectives of this study were to evaluate glomerular filtration rate (GFR, renal structural changes and proteinuria in aged Beagle dogs before and after hydrocortisone (HC administration. Eleven Beagle dogs ≥10 years old were treated with either hydrocortisone (HC group, n = 6 or placebo (control group, n = 5. Urinary markers, GFR and kidney biopsies were evaluated before (T0, during (T16 wks and after discontinuing HC administration (T24 wks. Results indicate that HC administration causes a significant increase in GFR. At all time points except T16 wks, proteinuria was higher in the control group than in the HC group, and there was no significant difference in urinary markers between groups. At T16 wks, proteinuria, urinary albumin-to-creatinine (c ratio, immunoglobulin G/c and retinol-binding protein/c were higher compared to baseline in the HC group. At T0, rare to mild renal lesions were detected in all HC dogs and rare to moderate changes in all control dogs. Glomerulosclerosis progressed in both groups until T24 wks. Tubular atrophy was detected in three HC dogs at T16 wks and T24 wks, but also in five control dogs throughout the study. At every time point, five HC dogs and all control dogs had rare to moderate interstitial inflammation. Rare to mild interstitial fibrosis was found in up to three HC dogs at T16 wks and T24 wks, and severe fibrosis in one HC dog at T24 wks. Up to four control dogs had rare to mild fibrosis at all time points. These findings indicate that clinically healthy, aged Beagle dogs may have considerable renal lesions and proteinuria, which could have implications for experimental or toxicological studies. Additional research is needed to elucidate glucocorticoid effects on renal structure, but functional changes such as hyperfiltration and proteinuria warrant attention to kidney function of canine patients with Cushing's syndrome or receiving exogenous glucocorticoids.

Doppler color flow analysis of the uterine arteries before and after intrauterine device insertion: a prospective study.

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de Souza, Marco Aurélio Martins; Geber, Selmo

2006-02-01

An intrauterine device (IUD) is one of the most frequently used methods of birth control around the world. Although a relationship between its use and menstrual disorders has been well documented, only a few studies have tried to show whether there are any vascular modifications. The aim of our study was to evaluate the influence of an IUD on uterine artery blood flow using Doppler assessment. A total of 100 patients selected for IUD use were prospectively evaluated with Doppler analysis before and 30 days after insertion. The resistive index (RI) and pulsatility index (PI) were used to evaluate uterine artery vascular resistance. Patients were allocated in 2 groups according to whether they were (group 2) or were not (group 1) lactating. The PI and RI of the patients in groups 1 and 2 before and after IUD insertion were not statistically significantly different (P = .298 and .23). When we compared uterine artery blood flow indices before and after IUD insertion for groups 1 and 2 separately, we observed in group 1 that the mean +/- SD PI values were 2.45 +/- 0.62 and 2.55 +/- 0.55 (P = .38) and the RI values were 0.87 +/- 0.08 and 0.87 +/- 0.06 (P = .88) before and after IUD insertion, respectively. In group 2, the PI values were 2.31 +/- 0.55 and 2.37 +/- 0.69 (P = .68) and the RI values were 0.85 +/- 0.07 and 0.86 +/- 0.07 (P = .44) before and after IUD insertion. Finally, we used the mean blood flow indices of the uterine arteries of all patients to compare the effect of IUD insertion. Results were also not statistically significant when we compared PI and RI before and after IUD insertion. The presence of an IUD does not interfere with the vascular resistance of the uterine arteries that can be shown by Doppler flow assessments 1 month after insertion.

Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention.

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Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi

2016-01-01

Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.

HIV stigma experiences and stigmatisation before and after an intervention

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H. C. Chidrawi

2016-10-01

Full Text Available This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in change-over-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisationbehaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.

HIV stigma experiences and stigmatisation before and after an intervention

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H. Christa Chidrawi

2016-12-01

Full Text Available This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in change-over-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisation behaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.

Design, modeling and control of nanopositioning systems

CERN Document Server

Fleming, Andrew J

2014-01-01

Covering the complete design cycle of nanopositioning systems, this is the first comprehensive text on the topic. The book first introduces concepts associated with nanopositioning stages and outlines their application in such tasks as scanning probe microscopy, nanofabrication, data storage, cell surgery and precision optics. Piezoelectric transducers, employed ubiquitously in nanopositioning applications are then discussed in detail including practical considerations and constraints on transducer response. The reader is then given an overview of the types of nanopositioner before the text turns to the in-depth coverage of mechanical design including flexures, materials, manufacturing techniques, and electronics. This process is illustrated by the example of a high-speed serial-kinematic nanopositioner. Position sensors are then catalogued and described and the text then focuses on control. Several forms of control are treated: shunt control, feedback control, force feedback control and feedforward control (...

Comparison of the Influence of Two Flap Designs on Periodontal Healing after Surgical Extraction of Impacted Third Molars

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Seyed Ahmad Arta

2011-03-01

Full Text Available Background and aims. Impacted lower third molar is found in 90% of the general population. Impacted lower third molar surgery may result in periodontal complications on the distal surface of the adjacent second molar. The aim of this study was to evaluate the effect of flap design on the periodontal status of the second molar after lower third molar surgery. Materials and methods. Twenty patients, with an age range of 18-26 years, participated in the present study. The inclusion criteria consisted of the presence of bilateral symmetrical impacted third molars on panoramic radiographs. The subjects were randomly divided into two groups. The impactions on the left and right sides were operated by Szmyd and triangular flaps, respectively. Postoperative management and medications were similar for both groups. The subjects were evaluated at two-week, one-month, and six-month postoperative intervals by a surgeon who was blind to the results. Data was analyzed by t-test using SPSS 11 software. Results. There were no significant differences in clinical attachment loss, pocket depth, bone level, plaque index, and free gingival margin between the two flaps (p>0.05. Conclusion. The results of the present study did not show any differences in pocket depth, clinical attachment level, bone level and FGM (free gingival margin between the two flap designs under study.

Evaluation of patients with Alzheimer's disease before and after dental treatment

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Thaís de Souza Rolim

2014-12-01

Full Text Available Oral infections may play a role in Alzheimer's disease (AD. Objective To describe the orofacial pain, dental characteristics and associated factors in patients with Alzheimer's Disease that underwent dental treatment. Method 29 patients with mild AD diagnosed by a neurologist were included. They fulfilled the Mini Mental State Exam and Pfeffer's questionnaire. A dentist performed a complete evaluation: clinical questionnaire; research diagnostic criteria for temporomandibular disorders; McGill pain questionnaire; oral health impact profile; decayed, missing and filled teeth index; and complete periodontal investigation. The protocol was applied before and after the dental treatment. Periodontal treatments (scaling, extractions and topic nystatin were the most frequent. Results There was a reduction in pain frequency (p=0.014, mandibular functional limitations (p=0.011 and periodontal indexes (p<0.05, and an improvement in quality of life (p=0.009 and functional impairment due to cognitive compromise (p<0.001 after the dental treatment. Orofacial complaints and intensity of pain also diminished. Conclusion The dental treatment contributed to reduce co-morbidities associated with AD and should be routinely included in the assessment of these patients.

The cytokine temporal profile in rat cortex after controlled cortical impact.

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Dalgard, Clifton L; Cole, Jeffrey T; Kean, William S; Lucky, Jessica J; Sukumar, Gauthaman; McMullen, David C; Pollard, Harvey B; Watson, William D

2012-01-01

Cerebral inflammatory responses may initiate secondary cascades following traumatic brain injury (TBI). Changes in the expression of both cytokines and chemokines may activate, regulate, and recruit innate and adaptive immune cells associated with secondary degeneration, as well as alter a host of other cellular processes. In this study, we quantified the temporal expression of a large set of inflammatory mediators in rat cortical tissue after brain injury. Following a controlled cortical impact (CCI) on young adult male rats, cortical and hippocampal tissue of the injured hemisphere and matching contralateral material was harvested at early (4, 12, and 24 hours) and extended (3 and 7 days) time points post-procedure. Naïve rats that received only anesthesia were used as controls. Processed brain homogenates were assayed for chemokine and cytokine levels utilizing an electrochemiluminescence-based multiplex ELISA platform. The temporal profile of cortical tissue samples revealed a multi-phasic injury response following brain injury. CXCL1, IFN-γ, TNF-α levels significantly peaked at four hours post-injury compared to levels found in naïve or contralateral tissue. CXCL1, IFN-γ, and TNF-α levels were then observed to decrease at least 3-fold by 12 hours post-injury. IL-1β, IL-4, and IL-13 levels were also significantly elevated at four hours post-injury although their expression did not decrease more than 3-fold for up to 24 hours post-injury. Additionally, IL-1β and IL-4 levels displayed a biphasic temporal profile in response to injury, which may suggest their involvement in adaptive immune responses. Interestingly, peak levels of CCL2 and CCL20 were not observed until after four hours post-injury. CCL2 levels in injured cortical tissue were significantly higher than peak levels of any other inflammatory mediator measured, thus suggesting a possible use as a biomarker. Fully elucidating chemokine and cytokine signaling properties after brain injury may

The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.

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Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

2007-08-01

To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (pMedical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; chi(2) test). A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

Use of complementary and alternative medicine before and after organ removal due to urologic cancer

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Mani, Jens; Juengel, Eva; Arslan, Ilhan; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

2015-01-01

Objective Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. Methods From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. Results From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. Conclusion The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling. PMID:26491269

Hydrological Regimes of Small Catchments in the High Tatra Mountains Before and After Extraordinary Wind-Induced Deforestation

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Holko, Ladislav; Hlavata, Helena; Kostka, Zdenek; Novak, Jan

2009-01-01

The paper presents the results of rainfall-runoff data analysis for small catchments of the upper Poprad River affected by wind-induced deforestation in November 2004. Before-event and afterevent measured data were compared in order to assess the impact of deforestation on hydrological regimes. Several characteristics were used including water balance, minimum and maximum runoff, runoff thresholds, number of runoff events, selected characteristics of events, runoff coefficients, and flashiness indices. Despite increased spring runoff minima, which in one catchment (Velick Creek) exceeded previously observed values after deforestation took place, it can be generally concluded that the impact of the deforestation was not clearly manifested in the analyzed hydrological data.

Negative rumination in social anxiety: A randomised trial investigating the effects of a brief intervention on cognitive processes before, during and after a social situation.

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Modini, Matthew; Abbott, Maree J

2017-06-01

According to cognitive models of Social Anxiety Disorder (SAD), negative rumination is a key maintaining factor in the vicious cycle of social anxiety. However, there is a scarcity of research investigating treatment effects on rumination in social anxiety, as well as other key cognitive variables. The current study aimed to determine the effectiveness of a brief intervention on a range of cognitive processes, most notably negative rumination. Additionally, predictors of negative rumination and state anxiety are also investigated. Participants with a diagnosis of SAD were randomly allocated to an intervention (n = 24) or control group (n = 23). Participant's initially completed trait and state based measures with the intervention group also completing a brief cognitive intervention. One-week later participants completed state anxiety and cognitive measures before and after a speech task. Finally, one-week post-speech task participants completed further trait and state based measures. While the brief cognitive intervention had positive effects on some of the cognitive processes measured at different time points of the study, levels of negative rumination remained stable. Predictors of negative rumination and state anxiety were consistent with cognitive models of SAD. The brief nature of the intervention and temporal stance of the intervention (delivered one-week before the speech) may have impacted outcomes. Cognitive technique can potentially impact a range of key processes that maintain SAD, however, more powerful and tailored interventions are needed that address the different processes at play before, during and after a social situation for socially anxious individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of temperature variation before and after gamma irradiation on the longevity and reproduction of Sitophilus zeamais Motschulsky, 1855 (Coleoptera, Curculionidae)

International Nuclear Information System (INIS)

Camargo, A.A.; Wiendl, F.M.; Bergamo, M.A.

1983-01-01

A basic study of radiobiology in order to verify the synergistic effects of the sudden variation of temperature on the longevity and reproduction of Sitophilus zeamais Mots., 1855 is done, before and after gamma irradiation, and to analyse such effects in the practical application of the irradiation system of stored grains for human consumption. Also to take advantage of the synergistic effects so as to reduce the dose rate necessary to control weevils attacking stored grains. The insects were irradiated at the rates of 0 (control), 2, 4, 8, 16, 32 and 64 krad, by using a 60-Cobalt source. In a first experiment, the insects were exposed to cooling at -8 0 C below zero for 15 minutes after irradiation; in a second experiment this treatment was done before irradiation. The countings of the insect birth and death rates were weekly done. From these data one can conclude that the adult longevity decreased and the mortality increased when the insects were cooled before irradiation, and also that cooling before irradiation induces a more deleterious effect on the insect than cooling after irradiation, resulting in a lower birth rate. (Author) [pt

Analysis and design of hybrid control systems

Energy Technology Data Exchange (ETDEWEB)

Malmborg, J.

1998-05-01

Different aspects of hybrid control systems are treated: analysis, simulation, design and implementation. A systematic methodology using extended Lyapunov theory for design of hybrid systems is developed. The methodology is based on conventional control designs in separate regions together with a switching strategy. Dynamics are not well defined if the control design methods lead to fast mode switching. The dynamics depend on the salient features of the implementation of the mode switches. A theorem for the stability of second order switching together with the resulting dynamics is derived. The dynamics on an intersection of two sliding sets are defined for two relays working on different time scales. The current simulation packages have problems modeling and simulating hybrid systems. It is shown how fast mode switches can be found before or during simulation. The necessary analysis work is a very small overhead for a modern simulation tool. To get some experience from practical problems with hybrid control the switching strategy is implemented in two different software environments. In one of them a time-optimal controller is added to an existing PID controller on a commercial control system. Successful experiments with this hybrid controller shows the practical use of the method 78 refs, 51 figs, 2 tabs

Consolidation and reconsolidation are impaired by oral propranolol administered before but not after memory (re)activation in humans.

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Thomas, Émilie; Saumier, Daniel; Pitman, Roger K; Tremblay, Jacques; Brunet, Alain

2017-07-01

Propranolol administered immediately after learning or after recall has been found to impair memory consolidation or reconsolidation (respectively) in animals, but less reliably so in humans. Since reconsolidation impairment has been proposed as a treatment for mental disorders that have at their core an emotional memory, it is desirable to understand how to reliably reduce the strength of pathogenic memories in humans. We postulated that since humans (unlike experimental animals) typically receive propranolol orally, this introduces a delay before this drug can exert its memory impairment effects, which may render it less effective. As a means to test this, in two double-blind placebo-controlled experiments, we examined the capacity of propranolol to impair consolidation and reconsolidation as a function of timing of ingestion in healthy subjects. In Experiment 1, (n=36), propranolol administered immediately after learning or recall failed to impair the consolidation or reconsolidation of the memory of a standardized slideshow with an accompanying emotional story. In Experiment 2 (n=50), propranolol given 60-75min before learning or recall successfully impaired memory consolidation and reconsolidation. These results suggest that it is possible to achieve reliable memory impairment in humans if propranolol is given before learning or before recall, but not after. Copyright © 2016 Elsevier Inc. All rights reserved.

The systemic inflammome of severe obesity before and after bariatric surgery.

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Ebymar Arismendi

Full Text Available Obesity is associated with low-grade systemic inflammation. The "inflammome" is a network layout of the inflammatory pattern. The systemic inflammome of obesity has not been described as yet. We hypothesized that it can be significantly worsened by smoking and other comorbidities frequently associated with obesity, and ameliorated by bariatric surgery (BS. Besides, whether or not these changes are mirrored in the lungs is unknown, but obesity is often associated with pulmonary inflammation and bronchial hyperresponsiveness.We sought to: (1 describe the systemic inflammome of morbid obesity; (2 investigate the effects of sex, smoking, sleep apnea syndrome, metabolic syndrome and BS upon this systemic inflammome; and, (3 determine their interplay with pulmonary inflammation.We studied 129 morbidly obese patients (96 females; age 46 ± 12 years; body mass index [BMI], 46 ± 6 kg/m2 before and one year after BS, and 20 healthy, never-smokers, (43 ± 7 years, with normal BMI and spirometry.Before BS, compared with controls, all obese subjects displayed a strong and coordinated (inflammome systemic inflammatory response (adiponectin, C-reactive protein, interleukin (IL-8, IL-10, leptin, soluble tumor necrosis factor-receptor 1(sTNF-R1, and 8-isoprostane. This inflammome was not modified by sex, smoking, or coexistence of obstructive sleep apnea and/or metabolic syndrome. By contrast, it was significantly ameliorated, albeit not completely abolished, after BS. Finally, obese subjects had evidence of pulmonary inflammation (exhaled condensate that also decreased after BS.The systemic inflammome of morbid obesity is independent of sex, smoking status and/or comorbidities, it is significantly reduced by BS and mirrored in the lungs.

Variations in enamel damage after debonding of two different bracket base designs: An in vitro study.

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Ahangar Atashi, Mohammad Hossein; Sadr Haghighi, Amir Hooman; Nastarin, Parastou; Ahangar Atashi, Sina

2018-01-01

Background. Bracket base design is a factor influencing shear bond strength. High shear bond strength leads to enamel crack formation during debonding. The aim of this study was to compare enamel damage variations, including the number and length of enamel cracks after debonding of two different base designs. Methods. Eighty-eight extracted human premolars were randomly divided into2 groups (n=44). The teeth in each group were bonded by two types of brackets with different base designs: 80-gauge mesh design versus anchor pylon design with pylons for adhesive retention. The number and length of enamel cracks before bonding and after debonding were evaluated under an optical stereomicroscope ×40 in both groups. Mann-Whitney U test was used to compare the number of cracks between the two groups. ANCOVA was used for comparison of crack lengths after and before debonding in each group and between the two groups. Results. There was a significant increase in enamel crack length and numbers in each group after debonding. There was no significant difference in enamel crack numbers after debonding between the two groups, whereas the length of enamel cracks was significantly greater in anchor pylon base design after debonding. Conclusion. Bracket bases with pylon design for adhesive retention caused more iatrogenic debonding damage to enamel surface.

Is It Necessary Managing Carnivores to Reverse the Decline of Endangered Prey Species? Insights from a Removal Experiment of Mesocarnivores to Benefit Demographic Parameters of the Pyrenean Capercaillie.

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Rubén Moreno-Opo

Full Text Available Mesopredator control has long been used to alleviate the effect of elevated predation pressure on vulnerable, threatened or valuable species. However, the convenience of using mesopredator controls is technically questionable and scientifically-sound research is therefore required to evaluate the impact of predation on prey case by case. In this study we evaluated the effect of the alteration of terrestrial mesopredator dynamics on the demographic parameters of a relict capercaillie Tetrao urogallus aquitanicus population currently in decline for which the impact of predation has not previously been assessed. We used a six-year mesocarnivore removal experiment (2008-2013 together with seven-years of previous demographic information on capercaillies (1999-2007 within a before-after control-impact (BACI design to evaluate the effect of mesocarnivore removal on capercaillie demographic parameters and on spatial behaviour of the most frequent predatory mesocarnivores of the capercaillie (Martes spp. and red fox Vulpes vulpes. Using a dynamic site-occupancy approach, the reduction of mesocarnivore population levels as a result of removal was clear for marten species, mainly during key months for capercaillie reproduction, but not for the red fox. Our results show that the breeding success of capercaillies was enhanced in areas where carnivores were removed and was inversely related to the occupation level of the studied mesocarnivores, although being only significant for Martes spp. Moreover, capercaillie predation rates were lower and adult survival seemingly higher in treatment during the removal phase. Cost-effective, long-term management interventions to ensure the recovery of this threatened capercaillie population are discussed in the light of the results. At our study area, the decision for implementing predation management should be included within a broader long-term conservation perspective. In this regard, a more feasible and sustainable

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

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study.

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Brusveen, Elin Marie Gravdal; Brudvik, Pongsri; Bøe, Olav Egil; Mavragani, Maria

2012-04-01

The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

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

Hand hygiene compliance before and after wearing gloves among intensive care unit nurses in Iran.

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Ghorbani, Azam; Sadeghi, Leila; Shahrokhi, Akram; Mohammadpour, Asghar; Addo, Mary; Khodadadi, Esmail

2016-11-01

Nosocomial infections are considered a major risk factor in hospital wards, and hand hygiene is the first step in their control. An observational study was conducted in 2015 with 200 nurses working in intensive care units in teaching hospitals of Tabriz, Iran. Data were collected by using the Hand Hygiene Observation Tool questionnaire. The researchers monitored nurses' opportunities for hand hygiene during the 8-week period from February 3-April 4, 2015. A total of 1,067 opportunities occurred for hand hygiene before and after wearing gloves. The results show that hand hygiene compliance before wearing gloves is poor among nurses who work in intensive care units (14.8%). Therefore it is necessary to conduct effective interventions through continuing education programs to improve hand hygiene compliance. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The impact of an urban sewerage system on childhood diarrhoea in Tehran, Iran: a concurrent control field trial.

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Kolahi, Ali-Asghar; Rastegarpour, Ali; Sohrabi, Mohammad-Reza

2009-05-01

The stepwise implementation of the Tehran Sewerage Project provided a convenient setting for which health impacts of an urban sewerage system could be examined with appropriate controls. In 2001, Tehran municipal districts 17 and 18 had no sewerage system connections, but areas within these districts had been planned to be connected by 2006. These areas were chosen as an intervention group. Neighbouring areas, with a similar socio-economic status, that had not been planned to connect to the sewerage system by 2006, were chosen as controls. Homes within designated areas were randomized and surveyed twice to determine diarrhoea incidences for children aged 6-60 months, once in 2001, before connection to the sewerage system, and once again in 2006, after the intervention. By 2006, 76% of the homes in the intervention zones were connected to the sewerage system. In the first stage of the study, diarrhoea incidences for intervention and control groups were 18.6 and 16.6%, respectively. In the second stage, incidences decreased to 10.1 and 10.5%, respectively. Data collected from 4179 children demonstrated that the diarrhoea incidence had decreased by 46% in the intervention group, whereas it had decreased by 37% in the controls.

Tobacco marketing awareness on youth smoking susceptibility and perceived prevalence before and after an advertising ban.

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Moodie, Crawford; MacKintosh, Anne Marie; Brown, Abraham; Hastings, Gerard B

2008-10-01

The Tobacco Advertising and Promotion Act (TAPA) was implemented in the United Kingdom in 2003. This study is the first to assess its impact on young people, examining smoking susceptibility (intention to smoke among never smokers) and perceived prevalence across three British cross-sectional samples (aged 11-16) before and after the introduction of the ban. Three in-home surveys (n = 1078, 1121 and 1121) were conducted before (1999 and 2002) and after (2004) the implementation of the TAPA. Significant declines in awareness of tobacco marketing and perceived prevalence occurred across the three waves. Higher levels of awareness and perceived prevalence were associated with increased susceptibility, but direct measures of susceptibility remained stable. The TAPA is protecting young people in United Kingdom from tobacco marketing and reducing perceived prevalence, both of which are linked to susceptibility. The stability of susceptibility across the three waves is probably best explained by both the partial implementation of TAPA at the final survey point and the time such effects take to emerge. The evidence from this and previous studies is, however, that, ultimately, they will appear.

Merits of exercise therapy before and after major surgery

NARCIS (Netherlands)

Hoogeboom, T.J.; Dronkers, J.J.; Hulzebos, E.H.J.; Meeteren, N.L.U. van

2014-01-01

PURPOSE OF REVIEW: Advances in medical care have led to an increasing elderly population. Elderly individuals should be able to participate in society as long as possible. However, with an increasing age their adaptive capacity gradually decreases, specially before and after major life events (like

Prescribing of Antidiabetic Medicines before, during and after Pregnancy

DEFF Research Database (Denmark)

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

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...

Gastric emptying studies in the morbidly obese before and after gastroplasty

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Christian, P.E.; Datz, F.L.; Moore, J.G.

1986-11-01

Dual isotope gastric emptying studies were performed on 16 morbidly obese patients before and after gastroplasty to determine the effect of this surgery on the rate of emptying. The solid and liquid phases of gastric emptying were compared with a normal control group. In the 900-g and 50-g meals there was a significant difference in the mean half emptying time between solid and liquid phases of emptying (p less than 0.05). Pre-operatively, the 900-g meal half emptying times of both solids and liquids and the 50-g liquid phase meal did not differ significantly between obese patients and the control group. However, in the solid phase of the 50-g meal obese patients differed significantly from a control group (p = 0.007). Three months after gastroplasty, gastric emptying of 50-g meals from the total stomach was not significantly changed from the pre-operative 50-g meal values in ten of 12 patients (p less than 0.05) and no change in total stomach emptying times were seen at 12 mo compared to the 3-mo study (p less than 0.05). Emptying of the pouch alone for both solids and liquids was significantly faster than the pre-operative and postoperative total stomach studies. Gastric emptying in the obese is normal with large meals, but is delayed in small meals. In most patients, gastroplasty does not result in slower emptying of meals.

Functional MRI of tongue motor tasks in patients with tongue cancer: observations before and after partial glossectomy

International Nuclear Information System (INIS)

Haupage, Samantha; Branski, Ryan C.; Kraus, Dennis; Peck, Kyung K.; Hsu, Meier; Holodny, Andrei

2010-01-01

The current study seeks to provide preliminary data regarding this central, adaptive response during tongue motor tasks utilizing functional magnetic resonance imaging (fMRI) before and after glossectomy. Six patients, with confirmed histological diagnoses of oral tongue cancer, underwent fMRI before and 6 months after partial glossectomy. These data were compared to nine healthy controls. All subjects performed three tongue motor tasks during fMRI: tongue tapping (TT), dry swallow (Dry), and wet swallow (Wet). Following surgery, increased activation was subjectively observed in the superior parietal lobule, supplementary motor area, and anterior cingulate. Region of interest (ROI) analysis of the precentral gyrus confirmed increased cortical activity following surgery. In addition, comparisons between pre-surgical scans and controls suggested the dry swallow task was sensitive to elicit tongue-related activation in the precentral gyrus (p ≤ 0.05). The adaptive changes in the cortex following partial glossectomy reflect recruitment of the parietal, frontal, and cingulate cortex during tongue motor tasks. In addition, post-operative activation patterns more closely approximated control levels than the pre-operative scans. Furthermore, the dry swallow task appears most specific to elicit tongue-related cortical activity. (orig.)

Functional MRI of tongue motor tasks in patients with tongue cancer: observations before and after partial glossectomy

Energy Technology Data Exchange (ETDEWEB)

Haupage, Samantha; Branski, Ryan C.; Kraus, Dennis [Memorial Sloan-Kettering Cancer Center, Head and Neck Surgery, New York, NY (United States); Peck, Kyung K. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Medical Physics, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Medical Physics and Radiology, New York, NY (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Holodny, Andrei [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States)

2010-12-15

The current study seeks to provide preliminary data regarding this central, adaptive response during tongue motor tasks utilizing functional magnetic resonance imaging (fMRI) before and after glossectomy. Six patients, with confirmed histological diagnoses of oral tongue cancer, underwent fMRI before and 6 months after partial glossectomy. These data were compared to nine healthy controls. All subjects performed three tongue motor tasks during fMRI: tongue tapping (TT), dry swallow (Dry), and wet swallow (Wet). Following surgery, increased activation was subjectively observed in the superior parietal lobule, supplementary motor area, and anterior cingulate. Region of interest (ROI) analysis of the precentral gyrus confirmed increased cortical activity following surgery. In addition, comparisons between pre-surgical scans and controls suggested the dry swallow task was sensitive to elicit tongue-related activation in the precentral gyrus (p {<=} 0.05). The adaptive changes in the cortex following partial glossectomy reflect recruitment of the parietal, frontal, and cingulate cortex during tongue motor tasks. In addition, post-operative activation patterns more closely approximated control levels than the pre-operative scans. Furthermore, the dry swallow task appears most specific to elicit tongue-related cortical activity. (orig.)

A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.

Science.gov (United States)

Fuller, Brian M; Ferguson, Ian T; Mohr, Nicholas M; Drewry, Anne M; Palmer, Christopher; Wessman, Brian T; Ablordeppey, Enyo; Keeperman, Jacob; Stephens, Robert J; Briscoe, Cristopher C; Kolomiets, Angelina A; Hotchkiss, Richard S; Kollef, Marin H

2017-04-01

To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. Quasi-experimental, before-after trial. Emergency department and ICUs of an academic center. Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU. An emergency department ventilator protocol which targeted variables in need of quality improvement, as identified by prior work: 1) lung-protective tidal volume, 2) appropriate setting of positive end-expiratory pressure, 3) oxygen weaning, and 4) head-of-bed elevation. A total of 229 patients (186 preintervention group, 43 intervention group) were studied. In the emergency department, the intervention was associated with significant changes (p protective ventilation from 11.1% to 61.5%, p value of less than 0.01. The intervention was associated with a reduction in mortality from 54.8% to 39.5% (odds ratio, 0.38; 95% CI, 0.17-0.83; p = 0.02) and a 3.9 day increase in ventilator-free days, p value equals to 0.01. This before-after study of mechanically ventilated patients with acute respiratory distress syndrome demonstrates that implementing a mechanical ventilator protocol in the emergency department is feasible and associated with improved clinical outcomes.

SELECTIVE EVALUATION OF TWO URINARY ENZYMES (NAG AND AAP BEFORE AND AFTER UNILATERAL SHOCK WAVE LITHOTRIPSY

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M. R. Nikoobakht

2006-09-01

Full Text Available Biological effects extracorporeal shock wave lithotripsy (ESWL is not precisely known. We have evaluated two urinary enzymes activity N-acetyl-B-D-glucosamine (NAG and alanine amino peptidase (AAP before and after unilateral ESWL as markers for renal parenchymal damage. Forty eight patients with kidney stones (mean age 39 who had presented for the first time or at least one year after their previous lithotripsy underwent ESWL. Urinary specimens were collected before and after first, third and seventh days of lithotripsy and NAG, AAP were evaluated. These enzymes displayed the greatest activity 24 hours after ESWL with significant difference compared to the control group, (P < 0.05 versus 0.02. Elevation of urinary enzymes activity correlated with stone size particularly stones larger than 2 cm. These data suggest that there is some tubular and parenchymal damage induced by ESWL that needs time to get improved. The higher urinary enzyme activity in patients with larger stones ( > 2 cm is probably related to injury resulting from passage of smaller stones, produced after lithotripsy of a large stone, and it is suggested that these patients are treated with a safer procedure.

Lung function studies before and after a work shift

Energy Technology Data Exchange (ETDEWEB)

Love, R G

1983-05-01

The lung function of 23 underground coal workers and eight surface workers at a Scottish colliery was measured immediately before and after a work shift. Changes in lung function were assessed in relation to the measured respirable dust exposure and the time of day in which the shift was worked. Large, and statistically significant, decrements of lung function during the shift were found in night-shift workers compared with workers on other shifts. Measurements derived from the forced expiratory manoeuvre, particularly FEV1, Vmax50, and Vmax25, after three vital capacity breaths of an 80% He/20% O2 mixture, showed large reductions in night-shift men, smaller reductions in afternoon-shift men, and small increases or decreases in morning-shift underground and surface workers. Within-shift changes for other tests, such as closing volume, N2 index, and volume of isoflow, did not differ significantly between shifts. No significant relationship was found between dust exposure and functional changes during a shift for any test. Lung function changes in a control group of 25 female workers not exposed to dust (hospital nurses) did not show the same large variations between day and night shifts. Examination of a further control group of 16 office workers did not show any difference in diurnal changes between smokers and non-smokers. It is concluded that these coal miners, even on permanent shift patterns, had widely different changes in their lung function cycle depending on which shift they were working. These changes did not appear to be related to dust exposure or cigarette smoking and were not consistent with other biological adaptations known to result from regular night-shift working.

Drug prescription patterns before, during and after pregnancy for chronic, occasional and pregnancy-related drugs in the Netherlands

NARCIS (Netherlands)

Bakker, Marian; Boersma - Jentink, Janneke; Vroom, Fokaline; van den Berg, Paulus; de Walle, Hermien; de Jong-van den Berg, L.T.W.

Objective To compare the prescription of drugs in women over a period from 2 years before until 3 months after pregnancy, regarding the type of drugs used and the fetal risk. Design A cohort study based on pharmacy records of women giving birth to a child between 1994 and 2003. Setting The study was

Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention

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Buratta Livia

2016-01-01

Full Text Available Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA and healthy nutrition (NUTR. Method. Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Results. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Conclusion. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.

Gene expression profiling in persons with multiple chemical sensitivity before and after a controlled n-butanol exposure session

DEFF Research Database (Denmark)

Dantoft, Thomas Meinertz; Skovbjerg, Sine; Andersson, Linus

2017-01-01

was that unexposed and symptom-free MCS participants have similar gene expression patterns to controls and a second hypothesis that MCS participants can be separated from controls based on differential gene expression upon a controlled n-butanol exposure. Participants were exposed to 3.7 ppm n-butanol while seated...... min after being exposed to and 4 hours after the exposure. Participants suffering from MCS and healthy controls were recruited through advertisement at public places and in a local newspaper. 36 participants who considered themselves sensitive were prescreened for eligibility. 18 sensitive persons...... displayed similar gene expression levels both at baseline and after the exposure and the computed AUC values were likewise comparable between the 2 groups. The intragroup variation in expression levels among MCS participants was noticeably greater than the controls. MCS participants and controls have...

Impact of an educational intervention designed to reduce unnecessary recall during screening mammography.

Science.gov (United States)

Carney, Patricia A; Abraham, Linn; Cook, Andrea; Feig, Stephen A; Sickles, Edward A; Miglioretti, Diana L; Geller, Berta M; Yankaskas, Bonnie C; Elmore, Joann G

2012-09-01

The aim of this study was to describe the impact of a tailored Web-based educational program designed to reduce excessive screening mammography recall. Radiologists enrolled in one of four mammography registries in the United States were invited to take part and were randomly assigned to receive the intervention or to serve as controls. The controls were offered the intervention at the end of the study, and data collection included an assessment of their clinical practice as well. The intervention provided each radiologist with individual audit data for his or her sensitivity, specificity, recall rate, positive predictive value, and cancer detection rate compared to national benchmarks and peer comparisons for the same measures; profiled breast cancer risk in each radiologist's respective patient populations to illustrate how low breast cancer risk is in population-based settings; and evaluated the possible impact of medical malpractice concerns on recall rates. Participants' recall rates from actual practice were evaluated for three time periods: the 9 months before the intervention was delivered to the intervention group (baseline period), the 9 months between the intervention and control groups (T1), and the 9 months after completion of the intervention by the controls (T2). Logistic regression models examining the probability that a mammogram was recalled included indication of intervention versus control and time period (baseline, T1, and T2). Interactions between the groups and time period were also included to determine if the association between time period and the probability of a positive result differed across groups. Thirty-one radiologists who completed the continuing medical education intervention were included in the adjusted model comparing radiologists in the intervention group (n = 22) to radiologists who completed the intervention in the control group (n = 9). At T1, the intervention group had 12% higher odds of positive mammographic results

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......, 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...... 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....

Quality of life in pediatric patients before and after cosmetic camouflage of visible skin conditions.

Science.gov (United States)

Ramien, Michele L; Ondrejchak, Sandra; Gendron, Roxanne; Hatami, Afshin; McCuaig, Catherine C; Powell, Julie; Marcoux, Danielle

2014-11-01

Visible vascular and pigmentary conditions have a negative impact on children's and adolescents' quality of life (QoL). We sought to quantitate the effect of visible skin anomalies and their camouflage on QoL. In all, 41 patients, 5 years of age and older, were taught to use cosmetic camouflage. QoL was assessed using the Children's Dermatology Life Quality Index (CDLQI) before and 6 months after the intervention. Satisfaction and use were evaluated after 1 and 6 months. Baseline QoL scores revealed a small impact of vascular anomalies (CDLQI score 4.2) and a small to moderate effect of pigmentary anomalies (CDLQI score 6.1). Six months after the intervention, QoL improved in the study population as a whole (CDLQI score 5.1 vs 2.1, Pcamouflage was well tolerated and patients with pigmentary anomalies were more likely to continue using the products. Limitations include small study population, few male patients, cultural influences not addressed, and limited range of conditions. Children and teenagers with visible vascular and pigmentary anomalies experience an impairment of QoL that is abrogated by introduction to use of cosmetic camouflage. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases

International Nuclear Information System (INIS)

Inoue, Yusuke; Momose, Toshimitsu; Machida, Kikuo; Honda, Norinari; Nishikawa, Junichi; Sasaki, Yasuhito.

1994-01-01

Cerebral blood volume before and after acetazolamide was measured by SPECT to evaluate cerebral vasodilatory capacity in eight patients with cerebrovascular disease and five control subjects. Two SPECT measurements were performed serially, and acetazolamide was administered between them. The ratio of increase in hemispheric blood volume was calculated, and it was compared with the results of cerebral blood flow and cerebral blood volume measurements. A cerebral vasodilatory capacity map, the image after acetazolamide minus the baseline image, was also produced. Acetazolamide increased hemispheric blood volume in all subjects. The ratio of increase was lower in the involved hemispheres of the patients with unilateral carotid disease than in the uninvolved hemispheres of the patients and control subjects. The ratio of concordance with blood flow and blood volume measurements was approximated at 80%. Cerebral vasodilatory capacity mapping revealed three defects compatible with the clinical data. SPECT measurements of cerebral blood volume after acetazolamide can be performed following baseline SPECT with no additional radiotracer, and may be helpful to assess hemodynamic status. (author)

Manual and Electroacupuncture for Labour Pain: Study Design of a Longitudinal Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Linda Vixner

2012-01-01

Full Text Available Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women’s experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov: NCT01197950.

Power Difference in Spectrum of Sound Radiation before and after Break of Phantom by Piezoelectric Extracorporeal Shock Wave Lithotriptor

Science.gov (United States)

Kanai, Hiroshi; Jang, Yun-Seok; Chubachi, Noriyoshi; Tanahashi, Yoshikatsu

1994-05-01

This paper investigates the difference in the spectrum of sound radiated before and after the break of a phantom at a focal point of the piezoelectric extracorporeal shock wave lithotriptor (ESWL) in order to identify the break time or to examine whether a calculus exists exactly at the focal point or not. From the preliminary experiments using a piece of chalk as a phantom of a calculus to measure the sound radiated when impact is applied to the chalk by an impact hammer, it is found that the bending vibration component of the vibration is exhibited in the spectrum of sound. However, for small-sized chalk shorter than 3 cm, the peak frequency of the bending vibration is higher than 20 kHz. From the experiments using a piezoeletric ESWL, it is found that there is clear difference in the power spectra among the sound radiated before the break, that radiated just after the break in the breaking process, and that radiated when the chalk does not exist at the focal point of the ESWL. These characteristics will be effective for the examination of the existence of the calculus at the focal point.

Investigation of the Change of Quality of Life and Depression in Lung Cancer Patients before and after Chemotherapy

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Jiancun CAO

2011-04-01

Full Text Available Background and objective Quality of life (QoL is an important end point in cancer patients, and depressive symptoms are significantly more frequent in lung cancer patients. The aim of this study is to observe the impact of chemotherapy on quality of life and emotion among lung cancer patients. Methods Fourty lung cancer patients were assessed with clinical outcomes, the EORTC QLQ-C30, SDS questionnaires before chemotherapy, one week after 2 cycles of chemotherapy, one week after 4 cycles of chemotherapy. Results Before chemotherapy, the scores of functioning scales were high, the rate of depression was 65%. After 2 cycles of chemotherapy, effective rate was 42.5%, the scores of cognitive function increase, the scores of role, emotional, social function decrease, the scores of dyspnoea decrease, the scores of pain, appetite loss, insomnia, constipation, diarrhea increase, the scores of Global quality of life decrease; the rate of depression was 70%. After 4 cycles of chemotherapy, effective rate was 23%, the scores of physical, role, emotional, social function decrease, the scores of symptom scales increase, the scores of dyspnoea, nausea and vomiting, appetite loss, financial impact increase, the scores of global quality of life decrease, the rate of depression was 87.5%. Conclusion Some patients have symptoms relieved, but during the chemotherapy, the patients have significant depression, the quality of life decrease. We should evaluate the quality of life and emotions of lung cancer patients, and give positive psychological intervention to improve the quality of life.

Genetic testing for hereditary cancer: effects of alexithymia and coping strategies on variations in anxiety before and after result disclosure.

Science.gov (United States)

Fantini-Hauwel, Carole; Dauvier, Bruno; Arciszewski, Thomas; Antoine, Pascal; Manouvrier, Sylvie

2011-07-01

This study assessed the impact of the results of genetic testing for hereditary cancer from a multifactorial health psychology perspective, considering that emotional expression plays a key role in psychological adjustment. Measures of dispositional and transactional coping strategies, anxiety and alexithymia were filled out by 77 participants in a longitudinal study design. Statistical analyses were performed using general linear models and partial least squares path modelling, low-constraint methods that are particularly useful in the behavioural sciences. While anxiety levels prior to the result announcement were predictive of the distress experienced by noncarriers, considerable variability was observed for mutation carriers. Some subjects who had lower anxiety levels before the test displayed greater anxiety afterwards, but others seemed to anticipate the distress they would experience with the result that they showed a decrease in anxiety. The mutation carriers behaved as though their adaptive functioning were reshaped by the test result, independent of their disposition and previous emotional state, except in the case of alexithymia. Difficulty expressing emotions prior to genetic testing contributed to a similar difficulty after receiving the result, adding to the latter's emotional impact by promoting emotion-focused coping strategies and increasing distress. © 2011 Taylor & Francis

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.

Assessment of Arterial Oxygen Saturation by Pulse Oximetry Before, During and After Electroconvulsive Therapy

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SH Tarig

2006-07-01

Full Text Available Introduction & Objective: Electroconvulsive therapy (ECT is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT. Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room, when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th and other stages (p<0.001. Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend

The Profitability Analysis of PT. Garuda Indonesia (Persero) Tbk. Before and After Privatization

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Nurasiah, I.; Anggara

2017-03-01

This study purposes to determine differences in the profitability of PT. Garuda Indonesia (Persero) Tbk. before and after privatization using Net Profit Margin (NPM), Return on Investmen (ROI) and Return on Equity (ROE). This research used a case study method with a qualitative approach. The data used are secondary data from official financial statements of PT. Garuda Indonesia (Persero) Tbk. periode 2008-2013, 3 years before privatization and 3 years after privatization. Data analysis was performed by reviewing the financial statement data, calculate & determine the value of profitability ratios before and after privatization, and determine the amount of the average difference before and after privatization. The result proved that the average ratio of profitability calculated by applying NPM, ROI and ROE in every year shows a decrease that caused imbalance components forming of NPM, ROI, ROE, where profit is getting down while the selling, total assets and equity increase more and more from the previous period. The implication for the next research is a research that focus on determine how long a company can emerged from the crisis by privatization decision.

Clinical significance of changes of serum IL-2, IL-6 and gastrin levels before and after treatment in patients with chronic eczema

International Nuclear Information System (INIS)

Mou Xudong; Ren Hong

2009-01-01

Objective: To explore the clinical significance of changes of serum IL-2, IL-6 and gastrin levels after treatment in patients with chronic eczema. Methods: Serum IL-2, IL-6 and gastin were detected with RIA both before and after treatment in 38 patients with chronic eczema and 35 controls. Results: Before treatment, serum IL-2 levels in the patients were significantly lower than those in the controls (P 0.05), however, the IL-2 levels were still significantly lower than those in controls (P>0.05). Conclusion: Serum IL-2, IL-6 and gastrin levels in the patients with chronic eczema were closely related to the severity of the diseases process and could be taken as indicator of treatment efficacy. (authors)

Changes in Serum TSH and T4 Levels after Switching the Levothyroxine Administration Time from before Breakfast to before Dinner

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S. Ala

2015-01-01

Full Text Available Background. Levothyroxine is commonly used in the treatment of patients with hypothyroidism. Levothyroxine is most often administered in the morning, on an empty stomach, in order to increase its oral absorption. However, many patients have difficulties taking levothyroxine in the morning. Aim. The aim of this study was evaluating the effect of changing levothyroxine administration time from before breakfast to before dinner on the serum levels of TSH and T4. Subjects and Methods. Fifty patients between 18 and 75 years old with hypothyroidism were included in the study and were randomly divided into two groups. Each group received two tablets per day (one levothyroxine tablet and one placebo tablet 30 minutes before breakfast and 1 hour before dinner. After two months, the administration time for the tablets was changed for each group, and the new schedule was continued for a further two-month period. The serum TSH and T4 levels were measured before and after treatment in each group. Results. Changing the levothyroxine administration time resulted in 1.47 ± 0.51 µIU/mL increase in TSH level (p=0.001 and 0.35 ± 1.05 µg/dL decrease in T4 level (p=0.3. Conclusions. Changing the levothyroxine administration time from before breakfast to before dinner reduced the therapeutic efficacy of levothyroxine.

High Accuracy Attitude Control System Design for Satellite with Flexible Appendages

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Wenya Zhou

2014-01-01

Full Text Available In order to realize the high accuracy attitude control of satellite with flexible appendages, attitude control system consisting of the controller and structural filter was designed. When the low order vibration frequency of flexible appendages is approximating the bandwidth of attitude control system, the vibration signal will enter the control system through measurement device to bring impact on the accuracy or even the stability. In order to reduce the impact of vibration of appendages on the attitude control system, the structural filter is designed in terms of rejecting the vibration of flexible appendages. Considering the potential problem of in-orbit frequency variation of the flexible appendages, the design method for the adaptive notch filter is proposed based on the in-orbit identification technology. Finally, the simulation results are given to demonstrate the feasibility and effectiveness of the proposed design techniques.

Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video.

Science.gov (United States)

Messina, Bruna; Fuentes, Daniel; Tavares, Hermano; Abdo, Carmita H N; Scanavino, Marco de T

2017-03-01

Despite the serious behavioral consequences faced by individuals with sexual compulsivity, related neuropsychological studies are sparse. To compare decision making and cognitive flexibility at baseline and after exposure to an erotic video in sexually compulsive participants and non-sexually compulsive controls. The sample consisted of 30 sexually compulsive men and 30 controls. Cognitive flexibility was investigated through the Wisconsin Card Sorting Test and decision making was examined through the Iowa Gambling Task. Wisconsin Card Sorting Test categories, correct responses, and perseverative errors and Iowa Gambling Task general trends and blocks. Sexually compulsive subjects and controls performed similarly at baseline. After watching an erotic video, controls performed better in block 1 of the Iowa Gambling Task (P = .01) and had more correct responses on the Wisconsin Card Sorting Test (P = .01). The controls presented fewer impulsive initial choices and better cognitive flexibility after exposure to erotic stimuli. Messina B, Fuentes D, Tavares H, et al. Executive Functioning of Sexually Compulsive and Non-Sexually Compulsive Men Before and After Watching an Erotic Video. J Sex Med 2017;14:347-354. Copyright © 2017. Published by Elsevier Inc.

Cine-MR imaging aqueductal CSF flow in normal pressure hydrocephalus syndrome before and after CSF shunt

International Nuclear Information System (INIS)

Mascalchi, M.; Arnetoli, G.; Inzitari, D.; Dal Pozzo, G.; Lolli, F.; Caramella, D.; Bartolozzi, C.

1993-01-01

Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction. (orig.)

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.

Effects of reduced-impact logging on fish assemblages in central Amazonia.

Science.gov (United States)

Dias, Murilo S; Magnusson, William E; Zuanon, Jansen

2010-02-01

In Amazonia reduced-impact logging, which is meant to reduce environmental disturbance by controlling stem-fall directions and minimizing construction of access roads, has been applied to large areas containing thousands of streams. We investigated the effects of reduced-impact logging on environmental variables and the composition of fish in forest streams in a commercial logging concession in central Amazonia, Amazonas State, Brazil. To evaluate short-term effects, we sampled 11 streams before and after logging in one harvest area. We evaluated medium-term effects by comparing streams in 11 harvest areas logged 1-8 years before the study with control streams in adjacent areas. Each sampling unit was a 50-m stream section. The tetras Pyrrhulina brevis and Hemigrammus cf. pretoensis had higher abundances in plots logged > or =3 years before compared with plots logged fish composition did not differ two months before and immediately after reduced-impact logging. Temperature and pH varied before and after logging, but those differences were compatible with normal seasonal variation. In the medium term, temperature and cover of logs were lower in logged plots. Differences in ordination scores on the basis of relative fish abundance between streams in control and logged areas changed with time since logging, mainly because some common species increased in abundance after logging. There was no evidence of species loss from the logging concession, but differences in log cover and ordination scores derived from relative abundance of fish species persisted even after 8 years. For Amazonian streams, reduced-impact logging appears to be a viable alternative to clear-cut practices, which severely affect aquatic communities. Nevertheless, detailed studies are necessary to evaluated subtle long-term effects.

[Evaluation of swallowing function with surface electromyography before and after tonsillectomy].

Science.gov (United States)

Gürkan, Emre; Veyseller, Bayram; Açıkalın, Reşit Murat; Elbistanlı, Suphi; Yurtsever, Serveren; Acar, Hürtan

2011-01-01

In this study, we evaluated the swallowing function with surface electromyography before and after tonsillectomy. Twenty patients (12 males, 8 females; mean age 23.8 years; range 17 to 30 years) who had tonsillectomy indication as study group, and 10 healthy individuals (8 males, 2 females; mean age 26 years; range 18 to 35 years) as control group were included in this prospective study between October 2008 and February 2009. Due to their significant role on oral and faringeal phases of swallowing; the surface electromyography prosedure is performed on the masseter muscle, the submental-submandibular muscle group and the infrahyoid muscles to measure their electrical activity and duration of contraction. For this purpose, single swallow and continuous drinking of 100 cc water tests were applied to each patient preoperatively and; in the postoperative 1st week and the 1st month. The preoperative duration of drinking periods were significanly longer in the study group compared to the control group (p<0.05). At the end of the first postoperative week the duration of drinking 100 cc water test was significantly longer than the preoperative mean of the study group (p<0.05). After one month single- swallow durations of study group were significantly shorter then the preoperative mean (p<0.05). The electrical activity of the masseter and infrahyoid muscles were significantly higher in study group compared with control group (p<0.05). The close proximity of the surgical area to the muscles affects swallowing after tonsillectomy. The surface electromyography is a simple, non-invasive and reliable method for postoperative evaluation of the swallowing functions of the throat muscles and thereby allows monitoring of the recovery and functional improvement of these muscles.

Validated measurements of microbial loads on environmental surfaces in intensive care units before and after disinfecting cleaning.

Science.gov (United States)

Frickmann, H; Bachert, S; Warnke, P; Podbielski, A

2018-03-01

Preanalytic aspects can make results of hygiene studies difficult to compare. Efficacy of surface disinfection was assessed with an evaluated swabbing procedure. A validated microbial screening of surfaces was performed in the patients' environment and from hands of healthcare workers on two intensive care units (ICUs) prior to and after a standardized disinfection procedure. From a pure culture, the recovery rate of the swabs for Staphylococcus aureus was 35%-64% and dropped to 0%-22% from a mixed culture with 10-times more Staphylococcus epidermidis than S. aureus. Microbial surface loads 30 min before and after the cleaning procedures were indistinguishable. The quality-ensured screening procedure proved that adequate hygiene procedures are associated with a low overall colonization of surfaces and skin of healthcare workers. Unchanged microbial loads before and after surface disinfection demonstrated the low additional impact of this procedure in the endemic situation when the pathogen load prior to surface disinfection is already low. Based on a validated screening system ensuring the interpretability and reliability of the results, the study confirms the efficiency of combined hand and surface hygiene procedures to guarantee low rates of bacterial colonization. © 2017 The Society for Applied Microbiology.

Quality of life in recipients before and after liver transplantation in Turkey.

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Ordin, Yaprak S; Dicle, Aklime; Wellard, Sally

2011-09-01

Liver transplantation has become the treatment of choice for patients with end-stage liver disease. Most studies show a positive effect on quality of life after liver transplantation, but most studies are based on data from Western countries and little is known about quality of life in liver transplant recipients in Turkey or other developing countries. To investigate liver transplant recipients' quality of life and factors affecting it, before and 3 months after transplantation in western Turkey. Descriptive and comparative, with data collected prospectively. Two medical centers in Western Turkey. Sixty-five adult recipients of a liver transplant between May 15 and December 31,2007. Quality of life was measured by using the Nottingham Health Profile Turkish version, and sociodemographic and clinical data were collected from patients' records. Scores on all subscales of the Nottingham Health Profile differed significantly from before to after liver transplantation. The differences between the mean scores for quality of life before and after transplantation varied significantly with the patients' sex and disease severity.

Prognostic significance of pleural lavage cytology after thoracotomy and before closure of the chest in lung cancer.

Science.gov (United States)

Taniguchi, Yuji; Nakamura, Hiroshige; Miwa, Ken; Adachi, Yoshin; Fujioka, Shinji; Haruki, Tomohiro; Horie, Yasushi

2009-07-01

Some reports have described pleural lavage cytology (PLC) to be a prognostic factor for non-small cell lung cancer (NSCLC) patients. However, there have only been a few reports describing the findings both immediately after thoracotomy (PLC after thoracotomy) and before the closure of the chest (PLC before closure). From April 2002 to April 2008, both PLC after thoracotomy and PLC before closure were performed in 296 consecutive patients who underwent resections for NSCLC. PLC after thoracotomy was positive in 14 patients. The survival rate in the PLC after thoracotomy positive cases was significantly poorer than in PLC after thoracotomy negative cases (P=0.047). In contrast, there were 26 PLC before closure positive cases. The survival rate in the PLC before closure positive cases was significantly poorer than in the PLC before closure negative cases (PPLC after thoracotomy is not an independent prognostic factor in our study. However, PLC before closure was an independent prognostic factor based on multivariate analyses. We conclude that PLC before closure was found to be a better prognostic factor than PLC after thoracotomy for NSCLC patients.

Designing for Change: Minimizing the Impact of Changing Requirements in the Later Stages of a Spaceflight Software Project

Science.gov (United States)

Allen, B. Danette

1998-01-01

In the traditional 'waterfall' model of the software project life cycle, the Requirements Phase ends and flows into the Design Phase, which ends and flows into the Development Phase. Unfortunately, the process rarely, if ever, works so smoothly in practice. Instead, software developers often receive new requirements, or modifications to the original requirements, well after the earlier project phases have been completed. In particular, projects with shorter than ideal schedules are highly susceptible to frequent requirements changes, as the software requirements analysis phase is often forced to begin before the overall system requirements and top-level design are complete. This results in later modifications to the software requirements, even though the software design and development phases may be complete. Requirements changes received in the later stages of a software project inevitably lead to modification of existing developed software. Presented here is a series of software design techniques that can greatly reduce the impact of last-minute requirements changes. These techniques were successfully used to add built-in flexibility to two complex software systems in which the requirements were expected to (and did) change frequently. These large, real-time systems were developed at NASA Langley Research Center (LaRC) to test and control the Lidar In-Space Technology Experiment (LITE) instrument which flew aboard the space shuttle Discovery as the primary payload on the STS-64 mission.

Postharvest biological control of brown rot in peaches after cold storage preceded by preharvest chemical control 1

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Elizandra Pivotto Pavanello

2015-12-01

Full Text Available ABSTRACT Pathogenic fungi cause skin darkening and peach quality depreciation in post harvest. Therefore, alternative techniques to chemical treatment are necessary in order to reduce risks to human health. The aim of this study was to evaluate the effect of the application of Trichoderma harzianum in association with different fungicides applied before harvest to 'Eldorado' peaches for brown rot control and other quality parameters during storage. The treatments consisted of five preharvest fungicide applications (control, captan, iprodione, iminoctadine and tebuconazole associated with postharvest application of T. harzianum, after cold storage (with and without application, in three evaluation times (zero, two and four days at 20 °C, resulting in a 5x2x3 factorial design. The application of T. harzianum only brought benefits to the control of brown rot when combined with the fungicide captan, at zero day shelf life. After two days, there was a greater skin darkening in peaches treated with T. harzianum compared with peaches without the treatment, except for peaches treated with the fungicide iprodione and T. harzianum The application of T. harzianum during postharvest showed no benefits for the control of brown rot, however, the association with fungicides reduced the incidence of Rhizopus stolonifer during the shelf life.

Clinical effect and necessity of interventional treatment in diabetic foot before and after amputation

International Nuclear Information System (INIS)

Fang Chun; Li Minghua; Cheng Yingsheng; Zhang Peilei; Wang Wu; Cheng Yongde

2006-01-01

Objective: To assess the clinical effect and necessity of interventional treatment in diabetic foot before and after amputation. Methods: Combined intravascular angioplasty with intraarterial medicine perfusing were carried out in fourteen patients with diabetic foot including 10 patients treated before amputation and 4 after amputation involving superficial femoral, deep femoral, tibial and fitular arteries. Among them seventeen vessels with irregular stenosis and obstruction were treated by intravascular angioplasty through balloon dilation. Results: The technical successful rate was 100%, no complication happened. The symptoms were relieved in all patients after treatment, including promotion of lower extremity arterial blood perfusion, reducing range of amputation and wound healing after amputation. Conclusions: Intravascular interventional treatment is safe, effective and valuable in diabetic foot before and after amputation. (authors)

Fully probabilistic control design in an adaptive critic framework

Czech Academy of Sciences Publication Activity Database

Herzallah, R.; Kárný, Miroslav

2011-01-01

Roč. 24, č. 10 (2011), s. 1128-1135 ISSN 0893-6080 R&D Projects: GA ČR GA102/08/0567 Institutional research plan: CEZ:AV0Z10750506 Keywords : Stochastic control design * Fully probabilistic design * Adaptive control * Adaptive critic Subject RIV: BC - Control Systems Theory Impact factor: 2.182, year: 2011 http://library.utia.cas.cz/separaty/2011/AS/karny-0364820.pdf

CREEK Project's Water Chemistry, Chlorophyll a, and Suspended Sediment Weekly Monitoring Database for Eight Creeks in the North Inlet Estuary, South Carolina: 1997-2000.

Data.gov (United States)

Baruch Institute for Marine and Coastal Sciences, Univ of South Carolina — A group of eight tidal creeks dominated by oysters, Crassostrea virginica, in North Inlet Estuary, South Carolina, USA were studied using a replicated BACI (Before -...

CREEK Project's Oyster Biomass Database for Eight Creeks in the North Inlet Estuary, South Carolina

Data.gov (United States)

Baruch Institute for Marine and Coastal Sciences, Univ of South Carolina — A group of eight tidal creeks dominated by oysters, Crassostrea virginica, in North Inlet Estuary, South Carolina, USA were studied using a replicated BACI (Before -...

Electronic and Optical Properties of Aluminum Oxide Before and After Surface Reduction by Ar+ Bombardment

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D. Tahir

2014-08-01

Full Text Available The electronic and optical properties of a-Al2O3 after induced by 3-keV Ar+ sputtering have been studied quantitatively by use of reflection electron energy loss spectroscopy (REELS spectra. The band gap values of a-Al2O3 was determined from the onset values of the energy loss spectrum to the background level of REELS spectra as a function of time Ar+ bombardment. The bandgap changes from 8.4 eV before sputtering to 6.2 eV after 4 minutes of sputtering.The optical properties of α-Al2O3 thin films have been determined by comparing the experimental cross section obtained from reflection electron energy loss spectroscopy with the theoretical inelastic scattering cross section, deduced from the simulated energy loss function (ELF by using QUEELS-ε(k-REELS software. The peak assignments are based on ELF and compared with reported data on the electronic structure of α-Al2O3 obtained using different techniques. The results demonstrate that the electronic and optical properties before and after surface reduction will provide further understanding in the fundamental properties of α-Al2O3 which will be useful in the design, modeling and analysis of devices applications performance.

Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study.

Science.gov (United States)

Arroz, Jorge A H; Candrinho, Baltazar; Mendis, Chandana; Varela, Pablo; Pinto, João; Martins, Maria do Rosário O

2018-02-05

In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.

Bulimia nervosa: mood changes do have an impact on body width estimation.

Science.gov (United States)

Kulbartz-Klatt, Y J; Florin, I; Pook, M

1999-09-01

This study was designed to investigate the impact of mood changes on body width estimation in women with bulimia nervosa. A pre-post controlled experimental design was chosen. Mood changes were induced in 40 women with bulimia nervosa, 20 women with panic disorder and 40 women with no diagnosis of a psychological disorder. A combination of autobiographical memory method and music induction method was used to induce positive and negative mood, respectively. Before and after mood induction a video distorting technique was used for body width estimation. Induction of negative mood increased and induction of positive mood decreased the body width estimations of women with bulimia. Patients with panic disorder and 'healthy' controls did not show these changes after mood induction. The findings suggest that change in mood state rather than the more habitual mood quality are relevant for bulimic women's body perception.

Grid integration impacts on wind turbine design and development

DEFF Research Database (Denmark)

Hansen, Anca Daniela; Cutululis, Nicolaos Antonio; Sørensen, Poul Ejnar

2009-01-01

This paper presents an overall perspective on contemporary issues like wind power plants and grid integration. The purpose is to present and discuss the impacts of emerging new grid connection requirements on modern wind turbines. The grid integration issue has caused several new challenges......, the grid integration aspect has also an effect on wind turbines' role in the power system, on wind turbine technologies' survival on the market, as well as on the wind turbines' loads. Over the last years, it became obviously, that there it is an increasing need for design and research of wind turbines...... to the wind turbine design and development. The survival of different wind turbine concepts and controls is strongly conditioned by their ability to comply with stringent grid connection requirements, imposed by utility companies. Beside its impact on the mechanical design and control of wind turbines...

EPR study on tomatoes before and after gamma-irradiation

International Nuclear Information System (INIS)

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

2009-01-01

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 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.

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.

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.

Portfolio Choice of Homeowners: Before and After the Crisis

DEFF Research Database (Denmark)

Lyng, Ran Sun

2017-01-01

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...

IMPACTS OF GROUP-BASED SIGNAL CONTROL POLICY ON DRIVER BEHAVIOR AND INTERSECTION SAFETY

Directory of Open Access Journals (Sweden)

Keshuang TANG

2008-01-01

Full Text Available Unlike the typical stage-based policy commonly applied in Japan, the group-based control (often called movement-based in the traffic control industry in Japan refers to such a control pattern that the controller is capable of separately allocating time to each signal group instead of stage based on traffic demand. In order to investigate its applicability at signalized intersections in Japan, an intersection located in Yokkaichi City of Mie Prefecture was selected as an experimental application site by the Japan Universal Traffic Management Society (UTMS. Based on the data collected at the intersection before and after implementing the group-based control policy respectively, this study evaluated the impacts of such a policy on driver behavior and intersection safety. To specify those impacts, a few models utilizing cycle-based data were first developed to interpret the occurrence probability and rate of red-light-running (RLR. Furthermore, analyses were performed on the yellow-entry time (Ye of the last cleared vehicle and post encroachment time (PET during the phase switching. Conclusions supported that the group-based control policy, along with certain other factors, directly or indirectly influenced the RLR behavior of through and right-turn traffics. Meanwhile, it has potential safety benefits as well, indicated by the declined Ye and increased PET values.

Changes in quality of life and perceptions of general health before and after operation of wind turbines.

Science.gov (United States)

Jalali, Leila; Bigelow, Philip; McColl, Stephen; Majowicz, Shannon; Gohari, Mahmood; Waterhouse, Ryan

2016-09-01

Ontario is Canada's provincial leader in wind energy, with over 4000 MW of installed capacity supplying approximately five percent of the province's electricity demand. Wind energy is now one of the fastest-growing sources of renewable power in Canada and many other countries. However, its possible negative impact on population health, as a new source of environmental noise, has raised concerns for people living in proximity to wind turbines (WTs). The aims of this study were to assess the effect of individual differences and annoyance on the self-reported general health and health-related quality of life (QOL) of nearby residents, using a pre- and post-exposure design. Prospective cohort data were collected before and after WT operations, from the individuals (n = 43) in Ontario, Canada. General health and QOL metrics were measured using standard scales, such as SF12, life satisfaction scales developed by Diener (SWLS) and the Canadian Community Health Survey (CCHS-SWL). The mean values for the Mental Component Score of SF12 (p = 0.002), SWLS (p < 0.001), and CCHS-SWL (p = 0.044) significantly worsened after WT operation for those participants who had a negative attitude to WTs, who voiced concerns about property devaluation, and/or who reported being visually or noise annoyed. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of prevention and control of infectious disease law on diarrhoea control: a 5-year evaluation in multiple provinces in Vietnam.

Science.gov (United States)

Phung, Dung; Tran, Phu Dac; Nguyen, Lien Huong; Do, Cuong Manh; Rutherford, Shannon; Chu, Cordia

2017-12-01

To address to burden of infectious diseases such as diarrhoea, the Vietnamese government has enacted the Law on Prevention and Control of Infectious Diseases (LPCIDs) since July 2008. However, no evaluation of the impact of the LPCID has been conducted. This study aims to evaluate the impact of the LPCID on diarrhoeal control for the 5 years following the implementation of LPCID in Vietnam. We used an interrupted time series design using a segmented regression analysis to estimate the 'province-level' impact of LPCID and then used random-effect meta-analysis to estimate the pooled effect sizes of the 'country-level' impact of LPCID on diarrhoeal control throughout Vietnam. The results show that the impacts varied by provinces. They were classified in four groups: 'positive impact, positive impact without sustainability, possibly positive impact, no or negative impact' of the LPCID. The meta-analysis indicated that the country-level impact of the LPCID became significant at 11 months after the LPCID took effect, with a decrease in level of diarrhoea of 9.7% (coefficient, -0.097; 95% CI: -19.1 to - 0.002) and a permanent downward trend of diarrhoea at a rate of 1.1% per month (coefficient, -0.011; 95% CI: -0.02 to - 0.003); whereas the trend in diarrhoea before the LPCID took effect was unchanging (coefficient, 0.002; 95% CI, 0-0.004). At 12, 24, 36, 48 and 60 months following the LPCID implementation date the levels of diarrhoea decreased by 10.9% (coefficient, -0.109; 95% CI: -0.203 to - 0.015), P < 0.01), 21.8% (coefficient, -0.218; 95% CI: -0.338 to - 0.098), P < 0.01), 31% (coefficient, -0.31; 95% CI: -0.474 to - 0.145), P < 0.01), 46.8% (coefficient, -0.468; 95% CI: -0.667 to - 0.27), P < 0.01), 48.2% (coefficient, -0.482; 95% CI: -0.708 to - 0.256), P < 0.01) respectively. The findings of this study reveal the effectiveness of the LPCID in reducing diarrhoea incidence in Vietnam. However, further studies should be conducted to

Fear appeals in advanced tobacco control environments: the impact of a National Mass Media Campaign in Norway

OpenAIRE

Halkjelsvik, Torleif; Lund, Karl Erik; Kraft, Pål; Rise, Jostein

2013-01-01

- Norway has one of the most comprehensive infrastructures for tobacco control in the world and has launched several media campaigns recent years. Can yet another anti-smoking campaign, using fear appeal messages, have an immediate impact on smoking behavior, motivation to quit and health beliefs? A sample of smokers (N = 2543) completed a survey before and after a 7-week national media campaign. Individual exposure to campaign (unaided recall) was used as predictor of change. We observed ...

Fear appeals in advanced tobacco control environments: the impact of a National Mass Media Campaign in Norway

OpenAIRE

Halkjelsvik, Torleif; Lund, Karl Erik; Kraft, Pål; Rise, Jostein

2013-01-01

Norway has one of the most comprehensive infrastructures for tobacco control in the world and has launched several media campaigns recent years. Can yet another anti-smoking campaign, using fear appeal messages, have an immediate impact on smoking behavior, motivation to quit and health beliefs? A sample of smokers (N = 2543) completed a survey before and after a 7-week national media campaign. Individual exposure to campaign (unaided recall) was used as predictor of change. We observed no st...

Instructional design considerations promoting engineering design self-efficacy

Science.gov (United States)

Jackson, Andrew M.

Engineering design activities are frequently included in technology and engineering classrooms. These activities provide an open-ended context for practicing critical thinking, problem solving, creativity, and innovation---collectively part of the 21st Century Skills which are increasingly needed for success in the workplace. Self-efficacy is a perceptual belief that impacts learning and behavior. It has been shown to directly impact each of these 21st Century Skills but its relation to engineering design is only recently being studied. The purpose of this study was to examine how instructional considerations made when implementing engineering design activities might affect student self-efficacy outcomes in a middle school engineering classroom. Student responses to two self-efficacy inventories related to design, the Engineering Design Self-Efficacy Instrument and Creative Thinking Self-Efficacy Inventory, were collected before and after participation in an engineering design curriculum. Students were also answered questions on specific factors of their experience during the curriculum which teachers may exhibit control over: teamwork and feedback. Results were analyzed using Pearson's correlation coefficients, paired and independent t-tests, and structural equation modeling to better understand patterns for self-efficacy beliefs in students. Results suggested that design self-efficacy and creative thinking self-efficacy are significantly correlated, r(1541) = .783, p classroom strategies for increasing self-efficacy and given specific recommendations related to teamwork and feedback to support students. Finally, although there were weaknesses in the study related to the survey administration, future research opportunities are presented which may build from this work.

Alterations of the blood pool in the femoral head before and after renal transplantation

International Nuclear Information System (INIS)

Hamaguchi, Hiroyuki; Fujioka, Mikihiro; Inoue, Shigehiro; Shibatani, Masahiko; Kubo, Toshikazu; Kubota, Takao; Ushijima, Yo; Nishimura, Tsunehiko

2003-01-01

The pathogenesis of idiopathic osteonecrosis of the femoral head (ION) is thought to be an ischemic event. The purpose of this study is to investigate alterations of the blood pool in the femoral head before and after renal transplantation. After renal transplantation, all patients received the same immunosuppressive therapy: corticosteroids, cyclosporin-A, and azathioprine. We performed 3-phase bone scintigraphy on 16 renal allograft recipients within 1 week before renal transplantation, and between week 4 and 9 after renal transplantation. Regions of interest (ROI) were assigned bilaterally in the femoral head, diaphysis, and soft tissue. The head-to-diaphysis ratios (HD ratios) were then calculated. Idiopathic osteonecrosis of the femoral head occurred in 2 femoral heads of 1 patient. The HD ratio before renal transplantation (mean HD±SD, 1.52±0.30) and the HD ratio after renal transplantation (1.28±0.30) were significantly different (P=0.000024). The HD ratios before and after renal transplantation were significantly different, indicating that the administration of steroids diminished the blood pool in the femoral head. A low HD ratio before renal transplantation revealed a poor blood pool in the femoral head, which may be a risk factor for ION. (author)

Change of sonographic findings on cervical lymph nodes before and after preoperative radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Chikui, Toru; Yuasa, Kenji; Tokumori, Kenji; Kanda, Shigenobu [Department of Oral and Maxillofacial Radiology, Graduate School of Dental Science, 3-1-1 Maidashi Higashi-ku, 812-8582, Fukuoka (Japan); Kunitake, Naonobu; Nakamura, Katsumasa [Department of Clinical Radiology, Graduate School of Medical Science, Kyushu University, Fukuoka (Japan); Nagata, Tetsuji [First Department of Oral and Maxillofacial Surgery, Graduate School of Dental Science, Kyushu University, Fukuoka (Japan); Hiraki, Akimitsu [Second Department of Oral and Maxillofacial Surgery, Graduate School of Dental Science, Kyushu University, Fukuoka (Japan)

2004-07-01

The aim of this study was to assess the changes in the power Doppler sonographic findings in patients with oral cancer undergoing chemotherapy and radiotherapy. We performed US examinations on 187 cervical lymph nodes (71 metastatic and 116 reactive nodes) excised from 52 patients before and after preoperative therapy. On Power Doppler images, we calculated the vascular index (VI) and evaluated the vascular pattern. We also assessed the diagnostic power using receiver operating characteristic (ROC) curve analysis. Irradiation caused an increase of the VI and better visualization of the vessels within the lymph node in the reactive nodes; however, in the metastatic nodes, the VI was not significantly different between that before and after irradiation. When the reader observed the images before irradiation, the area under an ROC curve (Az values) observed by B-mode sonography were closely similar to those obtained by B-mode plus power Doppler sonography. With both images before and after irradiation, the Az value obtained by B-mode plus power Doppler sonography was higher than that by B-mode sonography alone. After irradiation, the enhanced Doppler signals contributed to a better visualization of the vessels and a better detection of any vascular abnormalities. (orig.)

Sleep restriction alters plasma endocannabinoids concentrations before but not after exercise in humans.

Science.gov (United States)

Cedernaes, Jonathan; Fanelli, Flaminia; Fazzini, Alessia; Pagotto, Uberto; Broman, Jan-Erik; Vogel, Heike; Dickson, Suzanne L; Schiöth, Helgi B; Benedict, Christian

2016-12-01

Following binding to cannabinoid receptors, endocannabinoids regulate a variety of central nervous system processes including appetite and mood. Recent evidence suggests that the systemic release of these lipid metabolites can be altered by acute exercise and that their levels also vary across the 24-h sleep-wake cycle. The present study utilized a within-subject design (involving 16 normal-weight men) to determine whether daytime circulating endocannabinoid concentrations differ following three nights of partial sleep deprivation (4.25-h sleep opportunity, 2:45-7a.m. each night) vs. normal sleep (8.5-h sleep opportunity, 10:30p.m.-7a.m. each night), before and after an acute bout of ergometer cycling in the morning. In addition, subjective hunger and stress were measured. Pre-exercise plasma concentrations of 2-arachidonoylglycerol (2AG) were 80% higher 1.5h after awakening (vs. normal sleep, pexercise (+44%, pexercise-induced rise. Finally, subjective stress was generally lower on the day after three nights of short sleep vs. normal sleep, especially after exercise (pexercise-induced elevations of endocannabinoids appear to be less affected by short sleep duration. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Effects of experimental removal of Barred Owls on population demography of Northern Spotted Owls in Washington and Oregon—2017 progress report

Science.gov (United States)

Wiens, J. David; Dugger, Katie M.; Lesmeister, Damon B.; Dilione, Krista E.; Simon, David C.

2018-05-21

Populations of Northern Spotted Owls (Strix occidentalis caurina; hereinafter referred to as Spotted Owl) are declining throughout this subspecies’ geographic range. Evidence indicates that competition with invading populations of Barred Owls (S. varia) has contributed significantly to those declines. A pilot study in California showed that localized removal of Barred Owls coupled with conservation of suitable forest conditions can slow or even reverse population declines of Spotted Owls. It remains unknown, however, whether similar results can be obtained in areas with different forest conditions, greater densities of Barred Owls, and fewer remaining Spotted Owls. During 2015–17, we initiated a before-after-control-impact (BACI) experiment at three study areas in Oregon and Washington to determine if removal of Barred Owls can improve population trends of Spotted Owls. Each study area had at least 20 years of pre-treatment demographic data on Spotted Owls, and represented different forest conditions occupied by the two owl species in the Pacific Northwest. This report describes research accomplishments and preliminary results from the first 2.5 years (March 2015–August 2017) of the planned 5-year experiment.

Configuration management after design basis reconstitution

International Nuclear Information System (INIS)

Purcell, J.J.; Livingston, B.R.

1991-01-01

Over the last few years, Fort Calhoun station (FCS) has implemented a number of programs to enhance plant operability and readiness. The design basis document (DBD) reconstitution project was the cornerstone of this effort. Vendor manual upgrade, operating procedures upgrade, plant equipment data-base verification, equipment labeling, and warehousing improvements were also implemented as part of this improvement program. With the completion of these programs, plant documentation was current to the baselines established by each program, and a configuration management program (CMP) was established to maintain this level of accuracy throughout the remaining life of FCS. Change control throughout the organization has been reviewed and upgraded to ensure that all changes are evaluated for impact to the design bases

The changing relationship between the December North Atlantic Oscillation and the following February East Asian trough before and after the late 1980s

Science.gov (United States)

Feng, Guolin; Zou, Meng; Qiao, Shaobo; Zhi, Rong; Gong, Zhiqiang

2018-03-01

This study investigates the changing relationship between the December North Atlantic Oscillation (NAO) and the following February East Asian trough (EAT) throughout the past 60 years. We found that the relationship between the December NAO and the following February EAT is significantly enhanced after the late 1980s compared with the period before the late 1980s. The changing relationship mainly results from the enhanced relationship between the December NAO and the following February North Atlantic mid-latitudes' sea surface temperature (SST) anomalies (NAMA) during the same period. During the period after the late 1980s, the persistent positive (negative) NAO pattern from December to the following January contributes to a positive (negative) NAMA, which reaches its maximum magnitude in the following February and excites an anomalous wave train along the North Atlantic and northern Eurasia, and significantly impacts the EAT. During the period before the late 1980s, the positive (negative) NAO pattern during December cannot persist into the following January, and the related positive (negative) NAMA is insignificant during the following February, causing the response of the simultaneous EAT to be insignificant as well. Moreover, there exists a significant impact of the December NAO on the December-January NAMA after the late 1980s, while the December-January NAMA is relatively less affected by the December NAO before the late 1980s. As a result, the simultaneous response of the atmospheric circulation anomalies to the December-January NAMA are evident before the late 1980s, and the positive (negative) NAMA can excite an anomalous wave train along the North Atlantic and northern Eurasia and significantly deepen (shallow) the downstream EAT. By contrast, after involving a feature of atmosphere forcing of SST, the simultaneous feedback of the December-January NAMA on EAT is significantly decreased after the 1980s.

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."

Hepatic extraction of the aminoterminal propeptide of type III procollagen before and after bile duct ligation in pigs

DEFF Research Database (Denmark)

Bentsen, K D; Henriksen, Jens Henrik Sahl; Boesby, S

1991-01-01

before and during a 4-h period after ligation of the common bile duct was assessed from serum PIIINP concentrations in a systemic artery, the portal vein and a hepatic vein of seven healthy anaesthetized pigs. Seven sham-operated anaesthetized pigs served as controls. Ligation of the bile duct did...

Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial

DEFF Research Database (Denmark)

Lossl, K; Andersen, C Yding; Loft, A

2008-01-01

Temporary exposure of follicles to increased levels of androgens may augment follicular responsiveness. The present study tested whether short-term androgen priming by aromatase inhibitor and human chorionic gonadotrophin (hCG) before controlled ovarian stimulation (COS) increases the number of top......-quality embryos after IVF/ICSI....

Immunological state of patients with carcinoma of the bronchus before and after radiotherapy

International Nuclear Information System (INIS)

Savage, A.M.; Pritchard, J.A.V.; Deeley, T.J.; Davies, B.H.; Sully Hospital

1980-01-01

The immunological state of 30 patients with carcinoma of the bronchus was assessed before and after radiotherapy by lymphocyte response to PHA and E and EAC rosette formation. The results were compared with those from age-matched patients with benign chest disease and a group of healthy control subjects. Differences were found between the three groups and decreased immunological responses were found to correlate with shorter survival times for patients with cancer of the bronchus. These differences were associated with the extent of the disease, or with the smoking habits of the patients. Significant differences in percentage EAC cell rosetting were demonstrated between lymphocytes from patients with malignant disease (31.3 +- 2.0) and those for control groups (21.5 +- 1.9 and 24.0 +- 2.2). Cancer patients and benign chest disease patients both had significantly decreased mean E rosetting values (59.3% and 55.6%) compared with healthy control subjects (69.7%). The group of cancer patients with a normal percentage of T lymphocytes and total number of lymphocytes and radiotherapy, or those with low percentage EAC cell rosettes, had a greater than 80% survival after seven months compared with less than 50% for the rest of the patients with carcinoma of the bronchus. (author)

Empowerment of personal injury victims through the internet: design of a randomized controlled trial

Directory of Open Access Journals (Sweden)

Elbers Nieke A

2011-02-01

Full Text Available Abstract Background Research has shown that current claims settlement process can have a negative impact on psychological and physical recovery of personal injury (PI victims. One of the explanations for the negative impact on health is that the claims settlement process is a stressful experience and victims suffer from renewed victimization caused by the claims settlement process. PI victims can experience a lack of information, lack of involvement, lack of 'voice', and poor communication. We present the first study that aims to empower PI victims with respect to the negative impact of the claims settlement process by means of an internet intervention. Methods/design The study is a two armed, randomized controlled trial (RCT, in which 170 PI victims are randomized to either the intervention or control group. The intervention group will get access to a website providing 1 an information module, so participants learn what is happening and what to expect during the claims settlement process, and 2 an e-coach module, so participants learn to cope with problems they experience during the claims settlement process. The control group will get access to a website with hyperlinks to commonly available information only. Participants will be recruited via a PI claims settlement office. Participants are included if they have been involved in a traffic accident which happened less than two years ago, and are at least 18 years old. The main study parameter is the increase of empowerment within the intervention group compared to the control group. Empowerment will be measured by the mastery scale and a self-efficacy scale. The secondary outcomes are perceived justice, burden, well being, work ability, knowledge, amount of damages, and lawyer-client communication. Data are collected at baseline (T0 measurement before randomization, at three months, six months, and twelve months after baseline. Analyses will be conducted according to the intention