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Sample records for children study protocol

  1. A Field-Based Testing Protocol for Assessing Gross Motor Skills in Preschool Children: The Children's Activity and Movement in Preschool Study Motor Skills Protocol

    Science.gov (United States)

    Williams, Harriet G.; Pfeiffer, Karin A.; Dowda, Marsha; Jeter, Chevy; Jones, Shaverra; Pate, Russell R.

    2009-01-01

    The purpose of this study was to develop a valid and reliable tool for use in assessing motor skills in preschool children in field-based settings. The development of the Children's Activity and Movement in Preschool Study Motor Skills Protocol included evidence of its reliability and validity for use in field-based environments as part of large…

  2. Comparative study of preventive protocols in children at high cariogenic risk.

    Science.gov (United States)

    Martínez, María C; Tolcachir, Betina; Lescano de Ferrer, Alfonsina; Bojanich, María A; Barembaum, Silvina R; Calamari, Silvia E; Azcurra, Ana I

    2012-01-01

    The aim of this study was to compare the efficacy of two preventive protocols -fluoride gel (F) alone or combined with chlorhexidine varnishes (CHX) - on sialochemical, clinical and microbiological parameters in a group of children at high cariogenic risk Two therapeutic-preventive protocols were applied in 73 children at high cariogenic risk (average age 6.2 +/- 1.4 years old) and clinical parameters (simplified oral hygiene index: OHI-S; decayed, missing and filled teeth: dmf index; sugar intake and exposure to fluoride), as well as sialochemical parameters (salivary pH and flow, buffer capacity) and microbiological parameters (CFU/mg of dental biofilm of Streptococcus mutans group) were recorded and correlated before and after the protocols. Association was found between parameters that cause deficient control of dental biofilm: high values of OHIS index, CFU/mg dental biofilm, sugar intake and the d component of dmft index, and lower values of salivary flow rate and buffer capacity. After the protocols, a significant decrease was found in OHI-S and CFU/mg dental biofilm. No significant difference was found with children's gender and age. The association observed between OHI-S and cariogenic bacteria emphasizes the importance of prevention, especially regarding the oral health of the most vulnerable children. The early inclusion of F associated with CHX in the initial step of preventive and therapeutic protocols would provide benefits regarding oral microbe control while children acquire new habits of oral hygiene.

  3. Study protocol

    DEFF Research Database (Denmark)

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis;

    2013-01-01

    in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation...... to interaction with peers.Methods/design: The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark (n = 120). RESPECT....... Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational...

  4. Study protocol

    DEFF Research Database (Denmark)

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis;

    2013-01-01

    During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related...... includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy...

  5. Study protocol

    DEFF Research Database (Denmark)

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis;

    2013-01-01

    in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation......During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related...... includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy...

  6. Study protocol

    DEFF Research Database (Denmark)

    Madsen, Helle Østergaard; Dam, Ole Henrik; Hageman, Ida

    2012-01-01

    and demographically matched control respondents will be contacted in a similar manner the subsequent winter season. The Seasonal Pattern Assessment Questionnaire rates seasonal variation within the six items: sleep, appetite, social activity, mood, energy and body weight. The Seasonal Pattern Assessment Questionnaire......INTRODUCTION: People with seasonal affective disorder (SAD) experience recurrent seasonal fluctuations in energy, mood and appetite. Retinal light exposure is suggested to play an important role in the pathogenesis and treatment of SAD. The aim of the study is to determine the prevalence of SAD...

  7. The HALO submaximal treadmill protocol to measure cardiorespiratory fitness in obese children and youth: a proof of principle study.

    Science.gov (United States)

    Breithaupt, Peter; Adamo, Kristi B; Colley, Rachel C

    2012-04-01

    Many limitations exist with completing cardiorespiratory fitness testing in obese children. The aim of this study was to determine if the new Healthy Active Living and Obesity Research Group's (HALO's) submaximal cardiorespiratory fitness testing protocol for obese children and youth provides a comparable estimate of peak oxygen uptake to that measured using validated maximal and submaximal, equation-based protocols in the obese pediatric population. A group of obese children (n = 21; all ≥95th body mass index percentile; aged 10-17 years) completed 3 exercise testing protocols. Testing was completed as part of an ongoing cohort study and 2 submaximal cardiorespiratory fitness tests were completed, in randomized order, during a second visit. Significant correlations were found between observed peak oxygen uptake (mL·min(-1)) and predicted peak oxygen uptake for both the HALO (r = 0.75, p = 0.001) and Nemeth (r = 0.66, p = 0.001) submaximal protocols. A similar correlation was found, after accounting for body mass, between measured and predicted HALO peak oxygen uptake (mL·kg(-1)·min(-1)) values (r = 0.54, p = 0.01). HALO predicted peak oxygen uptake values showed a significant correlation when plotted against the measured values (r = 0.99). A Bland-Altman analysis found agreement between the maximal and HALO submaximal protocols (mean bias = -201.75 mL·min(-1)). The significant relationships found between estimates of peak oxygen uptake from the HALO submaximal protocol and measures of peak oxygen uptake during maximal cardiorespiratory testing support the use of the HALO submaximal protocol as a valid measure to estimate maximal cardiorespiratory fitness within the obese pediatric population. Given the proof of principle goal of this study, future research in the obese, pediatric population is encouraged to confirm the generalizability of the protocol.

  8. Yoga-teaching protocol adapted for children with visual impairment

    Directory of Open Access Journals (Sweden)

    Soubhagyalaxmi Mohanty

    2016-01-01

    Conclusions: Specially designed protocol may pave the way to impart yoga in an exciting and comfortable way to children with VI. More studies are needed to further investigate the effectiveness of this new yoga protocol in similar settings.

  9. Motor imagery training for children with developmental coordination disorder: Study protocol for a randomized controlled trial

    OpenAIRE

    2016-01-01

    Background Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. Motor imagery paradigms have been used to test this internal modeling deficit. The aim of the present study is to examine whether a training focused on the mental imagery of motor skills, can help to improve the motor abilities of children with DCD. Methods/Design A pre-post d...

  10. Better movers and thinkers (BMT: A quasi-experimental study into the impact of physical education on children's cognition—A study protocol

    Directory of Open Access Journals (Sweden)

    Andrew Dalziell

    2015-01-01

    This protocol provides the details of the rationale and design of the study and details of the intervention, outcome measures, and the recruitment process. The study will address gaps within current research by evaluating if a change of approach in the delivery of PE within schools has an effect on children's cognition, PA habits, and GMC within a Scottish setting.

  11. Motor imagery training for children with developmental coordination disorder: Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Adams, I.L.J.; Steenbergen, B.; Lust, J.M.; Smits-Engelsman, B.C.M.

    2016-01-01

    Background: Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. Motor imagery paradigms have been used to test this internal modeling deficit.

  12. Azithromycin for Indigenous children with bronchiectasis: study protocol for a multi-centre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Valery Patricia C

    2012-08-01

    Full Text Available Abstract Background The prevalence of chronic suppurative lung disease (CSLD and bronchiectasis unrelated to cystic fibrosis (CF among Indigenous children in Australia, New Zealand and Alaska is very high. Antibiotics are a major component of treatment and are used both on a short or long-term basis. One aim of long-term or maintenance antibiotics is to reduce the frequency of acute pulmonary exacerbations and symptoms. However, there are few studies investigating the efficacy of long-term antibiotic use for CSLD and non-CF bronchiectasis among children. This study tests the hypothesis that azithromycin administered once a week as maintenance antibiotic treatment will reduce the rate of pulmonary exacerbations in Indigenous children with bronchiectasis. Methods/design We are conducting a multicentre, randomised, double-blind, placebo controlled clinical trial in Australia and New Zealand. Inclusion criteria are: Aboriginal, Torres Strait Islander, Maori or Pacific Island children aged 1 to 8 years, diagnosed with bronchiectasis (or probable bronchiectasis with no underlying disease identified (such as CF or primary immunodeficiency, and having had at least one episode of pulmonary exacerbation in the last 12 months. After informed consent, children are randomised to receive either azithromycin (30 mg/kg once a week or placebo (once a week for 12–24 months from study entry. Primary outcomes are the rate of pulmonary exacerbations and time to pulmonary exacerbation determined by review of patient medical records. Secondary outcomes include length and severity of pulmonary exacerbation episodes, changes in growth, school loss, respiratory symptoms, forced expiratory volume in 1-second (FEV1; for children ≥6 years, and sputum characteristics. Safety endpoints include serious adverse events. Antibiotic resistance in respiratory bacterial pathogens colonising the nasopharynx is monitored. Data derived from medical records and clinical

  13. Parental intimate partner homicide and its consequences for children : protocol for a population-based study

    NARCIS (Netherlands)

    Alisic, Eva; Groot, Arend; Snetselaar, Hanneke; Stroeken, Tielke; van de Putte, Elise

    2015-01-01

    Background: The loss of a parent due to intimate partner homicide has a major impact on children. Professionals involved have to make far-reaching decisions regarding placement, guardianship, mental health care and contact with the perpetrating parent, without an evidence base to guide these decisio

  14. Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

    OpenAIRE

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis; Andersen, Lars Bo; Andersen, Karen Vitting; Christensen, Karl Bang; Halse, Henrik; Heilmann, Carsten; Hejgaard, Nete; Johansen, Christoffer; Madsen, Marianne; Madsen, Svend Aage; Simovska, Venka; Strange, Birgit; Thing, Lone Friis

    2013-01-01

    Background During cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers. Methods/design The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years n...

  15. Slow cortical potential Neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hanna eChristiansen

    2014-11-01

    Full Text Available Background: Treatment for children with attention deficit/hyperactivity disorder (ADHD today is predominantly pharmacological. While it is the most common treatment, it might not always be the most appropriate one. Moreover, long term effects remain unclear. Behavior therapy and non-pharmacological treatments such as neurofeedback (NF are promising alternatives, though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication.Methods/design: This paper presents the protocol of a randomized controlled trial to compare the effectiveness of a Slow Cortical Potential (SCP NF protocol with self-management (SM in a high frequent outpatient care setting. Both groups (NF/SM receive a total of 30 high frequent therapy sessions. Additionally, 6 sessions are reserved for comorbid problems. The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings.Preliminary Results: Untill now 58 children were included in the study (48 males, with a mean age of 8.42 (1.34 years, and a mean IQ of 110 (13.37. Conners-3 parent and teacher ratings were used to estimate core symptom change. Since the study is still ongoing, and children are in different study stages, pre-post and follow-up results are not yet available for all children included. Preliminary results suggest overall good pre-post effects, though. For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects (η2 .175 to .513. Differences between groups (NF vs. SM could not yet be established (p = .81.Discussion: This is the first randomized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication. First preliminary results show positive effects. The rationale for the trial, the design, and the strengths and limitations of the study are

  16. Study protocol: SPARCLE – a multi-centre European study of the relationship of environment to participation and quality of life in children with cerebral palsy

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    Colver Allan

    2006-04-01

    Full Text Available Abstract Background SPARCLE is a nine-centre European epidemiological research study examining the relationship of participation and quality of life to impairment and environment (physical, social and attitudinal in 8–12 year old children with cerebral palsy. Concepts are adopted from the International Classification of Functioning, Disability and Health which bridges the medical and social models of disability. Methods/Design A cross sectional study of children with cerebral palsy sampled from total population databases in 9 European regions. Children were visited by research associates in each country who had been trained together. The main instruments used were KIDSCREEN, Life-H, Strength and Difficulties Questionnaire, Parenting Stress Index. A measure of environment was developed within the study. All instruments were translated according to international guidelines. The potential for bias due to non response and missing data will be examined. After initial analysis using multivariate regression of how the data captured by each instrument relate to impairment and socio-economic characteristics, relationships between the latent traits captured by the instruments will then be analysed using structural equation modelling. Discussion This study is original in its methods by directly engaging children themselves, ensuring those with learning or communication difficulty are not excluded, and by studying in quantitative terms the crucial outcomes of participation and quality of life. Specification and publication of this protocol prior to analysis, which is not common in epidemiology but well established for randomised controlled trials and systematic reviews, should avoid the pitfalls of data dredging and post hoc analyses.

  17. Better movers and thinkers (BMT): A quasi-experimental study into the impact of physical education on children's cognition—A study protocol

    Science.gov (United States)

    Dalziell, Andrew; Boyle, James; Mutrie, Nanette

    2015-01-01

    This study will extend on a pilot study and will evaluate the impact of a novel approach to PE, Better Movers and Thinkers (BMT), on students' cognition, physical activity habits, and gross motor coordination (GMC). The study will involve six mainstream state schools with students aged 9–11 years. Three schools will be allocated as the intervention condition and three as the control condition. The design of the study is a 16-week intervention with pre-, post- and 6 month follow-up measurements taken using the ‘Cognitive Assessment System (CAS)’ GMC tests, and the ‘Physical Activity Habits Questionnaire for Children (PAQ-C).’ Qualitative data will be gathered using student focus groups and class teacher interviews in each of the six schools. ANCOVA will be used to evaluate any effect of intervention comparing pre-test scores with post-test scores and then pre-test scores with 6 month follow-up scores. Qualitative data will be analysed through an iterative process using grounded theory. This protocol provides the details of the rationale and design of the study and details of the intervention, outcome measures, and the recruitment process. The study will address gaps within current research by evaluating if a change of approach in the delivery of PE within schools has an effect on children's cognition, PA habits, and GMC within a Scottish setting. PMID:26844172

  18. Educator engagement and interaction and children's physical activity in early childhood education and care settings: an observational study protocol

    Science.gov (United States)

    Jones, Rachel A; Hagenbuchner, Markus; Nguyen, Tuc V; Okely, Anthony D

    2017-01-01

    Introduction The benefits of regular physical activity for children are significant. Previous research has addressed the quantity and quality of children's physical activity while in early childhood education and care (ECEC) settings, yet little research has investigated the social and physical environmental influences on physical activity in these settings. The outcomes of this study will be to measure these social and physical environmental influences on children's physical activity using a combination of a real-time location system (RTLS) (a closed system that tracks the location of movement of participants via readers and tags), accelerometry and direct observation. Methods and analysis This study is the first of its kind to combine RTLSs and accelerometer data in ECEC settings. It is a cross-sectional study involving ∼100 educators and 500 children from 11 ECEC settings in the Illawarra region of New South Wales, Australia. A RTLS and Actigraph GT3X+ accelerometers will be concurrently used to measure the level and location of the children's and educators' physical activity while in outside environments. Children and educators will wear accelerometers on their hip that record triaxial acceleration data at 100 Hz. Children and educators will also wear a tag watch on their wrist that transmits a signal to anchors of the RTLS and the triangulation of signals will identify their specific location. In addition to these, up to three random periods (10–25 min in length) will be used to collect observational data each day and assessed with the classroom assessment and scoring system to measure the quality of interactions. In conjunction with the real-time location system (RTLS) and accelerometers, these observations will measure the relationship between the quality of interactions and children's physical activity. Ethics and dissemination The results of this study will be disseminated through peer-reviewed publications and presentations. Ethical approval was

  19. [Influence of a program of physical activity in children and obese adolescents with sleep apnea; study protocol].

    Science.gov (United States)

    Aguilar Cordero, M J; Sánchez López, A M; Mur Villar, N; Sánchez Marenco, A; Guisado Barrilao, R

    2013-01-01

    Recent studies show an alarming increase in the rate of overweight / obesity among the infant - juvenile population. Obesity in childhood is associated with a significant number of complications, such as sleep apnea syndrome, insulin resistance and type 2 diabetes, hypertension, cardiovascular disease and some cancers. It is estimated that the prevalence of sleep apnea in children is 2-3% in the general population, while in obese adolescents, varies between 13% and 66%, according to various studies. It is associated with impairment of neurocognitive function, behavior, cardiovascular system, metabolic disorders and growth. Sleep apnea is a serious public health problem that increases when children and adolescents are overweight or obese. We hypothesize that aerobic endurance exercise can be an effective treatment for obesity and apnea at the same time. The aim of this study was to determine the influence of physical activity in children and adolescents with overweight / obesity in sleep apnea. An observational, descriptive, prospective, longitudinal study will be carried out in children with sleep apnea and obesity. The universe will be made up of 60 children and adolescents aged between 10 and 18 years, attending the endocrinology service for suffering of obesity in the Hospital Clinico San Cecilio of Granada during the period September 2012-September 2013. The smple will consist of children and adolescents that meet these characteristics and to whom their parents/tutors have authorized through the informed consent. Sleep apnea in children wil be measured by polysomnography and sleep quality questionnaire. There will also be a nutritional assessment by a food frequency questionnaire and an anthropometric assessment. Among the expected results are the lower overweight and obesity in children through the physical activity program. To reduce apnea and to improve sleep quality.

  20. Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: Study protocol for prospective, randomized, controlled trial

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    Kazon Soráia

    2012-05-01

    Full Text Available Abstract Background The use of botulinum toxin A (BT-A for the treatment of lower limb spasticity is common in children with cerebral palsy (CP. Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist. Neuromuscular electrical stimulation (NMES is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A. Methods/Design Protocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae. The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1 one week prior to the administration of BT-A; 2 one week after the administration of BT-A; and 3 four months after the administration of BT-A (end of intervention. Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale. Discussion The aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior

  1. Antibiotics for bronchiectasis exacerbations in children: rationale and study protocol for a randomised placebo-controlled trial

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    Chang Anne B

    2012-08-01

    Full Text Available Abstract Background Despite bronchiectasis being increasingly recognised as an important cause of chronic respiratory morbidity in both indigenous and non-indigenous settings globally, high quality evidence to inform management is scarce. It is assumed that antibiotics are efficacious for all bronchiectasis exacerbations, but not all practitioners agree. Inadequately treated exacerbations may risk lung function deterioration. Our study tests the hypothesis that both oral azithromycin and amoxicillin-clavulanic acid are superior to placebo at improving resolution rates of respiratory exacerbations by day 14 in children with bronchiectasis unrelated to cystic fibrosis. Methods We are conducting a bronchiectasis exacerbation study (BEST, which is a multicentre, randomised, double-blind, double-dummy, placebo-controlled, parallel group trial, in five centres (Brisbane, Perth, Darwin, Melbourne, Auckland. In the component of BEST presented here, 189 children fulfilling inclusion criteria are randomised (allocation-concealed to receive amoxicillin-clavulanic acid (22.5 mg/kg twice daily with placebo-azithromycin; azithromycin (5 mg/kg daily with placebo-amoxicillin-clavulanic acid; or placebo-azithromycin with placebo-amoxicillin-clavulanic acid for 14 days. Clinical data and a paediatric cough-specific quality of life score are obtained at baseline, at the start and resolution of exacerbations, and at day 14. In most children, blood and deep nasal swabs are also collected at the same time points. The primary outcome is the proportion of children whose exacerbations have resolved at day 14. The main secondary outcome is the paediatric cough-specific quality of life score. Other outcomes are time to next exacerbation; requirement for hospitalisation; duration of exacerbation; and spirometry data. Descriptive viral and bacteriological data from nasal samples and blood markers will also be reported. Discussion Effective, evidence-based management

  2. School-based intervention to reduce anxiety in children: study protocol for a randomized controlled trial (PACES

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    Stallard Paul

    2012-11-01

    Full Text Available Abstract Background Emotional problems such as anxiety and low mood in children are common, impair everyday functioning and increase the risk of severe mental health disorders in adulthood. Relatively few children with emotional health problems are identified and referred for treatment indicating the need to investigate preventive approaches. Methods/Design The study is designed to be a pragmatic cluster randomized controlled trial evaluating the effectiveness of an efficacious school-based cognitive behavior therapy (CBT prevention program (FRIENDS on symptoms of anxiety and low mood in children 9 to 10 years of age. The unit of allocation is schools which are assigned to one of three conditions: school-led FRIENDS, health-led FRIENDS or treatment as usual. Assessments will be undertaken at baseline, 6 months and 12 months. The primary outcome measure is change on the Revised Child Anxiety and Depression Scale. Secondary outcome measures assess changes in self-esteem, worries, bullying and life satisfaction. An economic evaluation will be undertaken. Discussion As of September 2011, 41 schools have been recruited and randomized. Final 12-month assessments are scheduled to be completed by May 2013. Trial Registration ISRCTN23563048

  3. Randomised controlled trial of improvisational music therapy's effectiveness for children with autism spectrum disorders (TIME-A: study protocol

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    Geretsegger Monika

    2012-01-01

    Full Text Available Abstract Background Previous research has suggested that music therapy may facilitate skills in areas typically affected by autism spectrum disorders such as social interaction and communication. However, generalisability of previous findings has been restricted, as studies were limited in either methodological accuracy or the clinical relevance of their approach. The aim of this study is to determine effects of improvisational music therapy on social communication skills of children with autism spectrum disorders. An additional aim of the study is to examine if variation in dose of treatment (i.e., number of music therapy sessions per week affects outcome of therapy, and to determine cost-effectiveness. Methods/Design Children aged between 4;0 and 6;11 years who are diagnosed with autism spectrum disorder will be randomly assigned to one of three conditions. Parents of all participants will receive three sessions of parent counselling (at 0, 2, and 5 months. In addition, children randomised to the two intervention groups will be offered individual, improvisational music therapy over a period of five months, either one session (low-intensity or three sessions (high-intensity per week. Generalised effects of music therapy will be measured using standardised scales completed by blinded assessors (Autism Diagnostic Observation Schedule, ADOS and parents (Social Responsiveness Scale, SRS before and 2, 5, and 12 months after randomisation. Cost effectiveness will be calculated as man years. A group sequential design with first interim look at N = 235 will ensure both power and efficiency. Discussion Responding to the need for more rigorously designed trials examining the effectiveness of music therapy in autism spectrum disorders, this pragmatic trial sets out to generate findings that will be well generalisable to clinical practice. Addressing the issue of dose variation, this study's results will also provide information on the relevance of session

  4. Hand sanitisers for reducing illness absences in primary school children in New Zealand: a cluster randomised controlled trial study protocol

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    Poore Marion R

    2010-01-01

    Full Text Available Abstract Background New Zealand has relatively high rates of morbidity and mortality from infectious disease compared with other OECD countries, with infectious disease being more prevalent in children compared with others in the population. Consequences of infectious disease in children may have significant economic and social impact beyond the direct effects of the disease on the health of the child; including absence from school, transmission of infectious disease to other pupils, staff, and family members, and time off work for parents/guardians. Reduction of the transmission of infectious disease between children at schools could be an effective way of reducing the community incidence of infectious disease. Alcohol based no-rinse hand sanitisers provide an alternative hand cleaning technology, for which there is some evidence that they may be effective in achieving this. However, very few studies have investigated the effectiveness of hand sanitisers, and importantly, the potential wider economic implications of this intervention have not been established. Aims The primary objective of this trial is to establish if the provision of hand sanitisers in primary schools in the South Island of New Zealand, in addition to an education session on hand hygiene, reduces the incidence rate of absence episodes due to illness in children. In addition, the trial will establish the cost-effectiveness and conduct a cost-benefit analysis of the intervention in this setting. Methods/Design A cluster randomised controlled trial will be undertaken to establish the effectiveness and cost-effectiveness of hand sanitisers. Sixty-eight primary schools will be recruited from three regions in the South Island of New Zealand. The schools will be randomised, within region, to receive hand sanitisers and an education session on hand hygiene, or an education session on hand hygiene alone. Fifty pupils from each school in years 1 to 6 (generally aged from 5 to 11 years

  5. Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol

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    Aanstoot Henk-Jan

    2011-04-01

    Full Text Available Abstract Background In young children with type 1 diabetes mellitus (T1DM parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin. Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life. Methods/Design First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15. Observed behaviors are described into rating scales, with each scale describing characteristics of parent-child interactional behaviors. Next, we apply the observational tool on a larger scale for further evaluation of the instrument (N = 120. The parents are asked

  6. The effect of the video game Mindlight on anxiety symptoms in children with an Autism Spectrum Disorder [study protocol

    NARCIS (Netherlands)

    Wijnhoven, L.A.M.W.; Creemers, D.H.M.; Engels, R.C.M.E.; Granic, I.

    2015-01-01

    Background In the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience anxiety symptoms. Because anxiety is an important cause of impairment for children with an ASD, it is necessary that effective anxiety interventions are implemented for these children

  7. The diagnosis of urinary tract infections in young children (DUTY: protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

    Directory of Open Access Journals (Sweden)

    Downing Harriet

    2012-07-01

    Full Text Available Abstract Background Urinary tract infection (UTI is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results most strongly associated with a positive urine culture result. We will

  8. Study protocol of a randomised controlled trial of intranasal ketamine compared with intranasal fentanyl for analgesia in children with suspected, isolated extremity fractures in the paediatric emergency department

    Science.gov (United States)

    Reynolds, Stacy L; Studnek, Jonathan R; Bryant, Kathleen; VanderHave, Kelly; Grossman, Eric; Moore, Charity G; Young, James; Hogg, Melanie; Runyon, Michael S

    2016-01-01

    Introduction Fentanyl is the most widely studied intranasal (IN) analgesic in children. IN subdissociative (INSD) ketamine may offer a safe and efficacious alternative to IN fentanyl and may decrease overall opioid use during the emergency department (ED) stay. This study examines the feasibility of a larger, multicentre clinical trial comparing the safety and efficacy of INSD ketamine to IN fentanyl and the potential role for INSD ketamine in reducing total opioid medication usage. Methods and analysis This double-blind, randomised controlled, pilot trial will compare INSD ketamine (1 mg/kg) to IN fentanyl (1.5 μg/kg) for analgesia in 80 children aged 4–17 years with acute pain from a suspected, single extremity fracture. The primary safety outcome for this pilot trial will be the frequency of cumulative side effects and adverse events at 60 min after drug administration. The primary efficacy outcome will be exploratory and will be the mean reduction of pain scale scores at 20 min. The study is not powered to examine efficacy. Secondary outcome measures will include the total dose of opioid pain medication in morphine equivalents/kg/hour (excluding study drug) required during the ED stay, number and reason for screen failures, time to consent, and the number and type of protocol deviations. Patients may receive up to 2 doses of study drug. Ethics and dissemination This study was approved by the US Food and Drug Administration, the local institutional review board and the study data safety monitoring board. This study data will be submitted for publication regardless of results and will be used to establish feasibility for a multicentre, non-inferiority trial. Trial registration number NCT02521415. PMID:27609854

  9. A Healthy Lifestyle Intervention Delivered by Aspiring Physical Education Teachers to Children from Social Disadvantage: Study Protocol and Preliminary Findings

    Science.gov (United States)

    Breslin, Gavin; Brennan, Deirdre

    2012-01-01

    We describe the design of a school-based healthy lifestyle intervention for eight-year-old to nine-year-old school children from lower socio-economic backgrounds, intended to increase physical activity, decrease sedentary behaviours, reduce screen-time behaviours, encourage healthy attitudes and behaviours to nutrition, and reduce body mass index.…

  10. Integration of nutrition support into oncologic treatment protocols for high and low nutritional risk children with Wilms' tumor. A prospective randomized study.

    Science.gov (United States)

    Rickard, K A; Godshall, B J; Loghmani, E S; Coates, T D; Grosfeld, J L; Weetman, R M; Lingard, C D; Foland, B B; Yu, P L; McGuire, W

    1989-07-15

    Benefits and risks of nutrition support were evaluated in 31 malnourished children with newly diagnosed Wilms' tumor managed according to the third National Wilms' Tumor Study protocol. Patients were classified at diagnosis as being at high nutritional risk (HNR, n = 19) or low nutritional risk (LNR, n = 12). Ten HNR patients were randomized to central parenteral nutrition (CPN) and nine HNR patients were randomized to peripheral parenteral nutrition (PPN) plus enteral nutrition (EN) for 4 weeks of initial intense treatment and EN (nutritional counseling, oral foods and supplements) thereafter. Thirteen HNR patients (seven CPN, six PPN) completed the protocol. Twelve LNR patients received EN; 11 Stage I malnourished patients were randomized to 10 or 26 weeks of chemotherapy. Dietary, anthropometric, and biochemical data were determined for HNR patients at weeks 0-4, 6, 13, 19, and 26 and for LNR patients at weeks 1, 2, 5, and 26. In HNR patients, adequate parenteral nutrition support reversed protein energy malnutrition (PEM), and prevented chemotherapy and radiotherapy delays due to granulocytopenia. CPN was superior to PPN in reversing PEM: energy intake, weight gain, and retinol binding protein were higher (P less than 0.05). LNR patients lost weight and fat reserves in the first 2 weeks of treatment; depletion persisted at week 5, and 25% had chemotherapy delays. Thereafter, EN reversed PEM in patients with both chemotherapy regimens. These data suggest that CPN is preferable during initial intense treatment for HNR patients, and that, although EN is ineffective in preventing depletion and treatment delays in the first 5 weeks of treatment for LNR patients, it is effective thereafter.

  11. Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

    Directory of Open Access Journals (Sweden)

    Jöbsis Quirijn

    2009-06-01

    Full Text Available Abstract Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study, is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure on basis of lung function assessments and current respiratory symptoms ('golden standard'. From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate, blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have

  12. Danish Focus group protocol for children & adults

    DEFF Research Database (Denmark)

    Werther, Michelle Nadia; Pedersen, Dorthe; Sansolios, Sanne

    2010-01-01

    the opportunity to explore the children’s knowledge and perception of a given subject. Thus recognizes the participants as experts of their world. FG’s have the additional advantages of minimize the possibility of the children responding to please the interviewer, and also remove the pressure from the individual...

  13. Dental care protocol based on visual supports for children with autism spectrum disorders

    OpenAIRE

    2015-01-01

    Background Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments. Material and Methods 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in...

  14. Longitudinal cohort protocol study of oropharyngeal dysphagia: relationships to gross motor attainment, growth and nutritional status in preschool children with cerebral palsy

    OpenAIRE

    Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L.; Ware, Robert S; Davies, Peter S. W.; Boyd, Roslyn N.

    2012-01-01

    Introduction The prevalence of oropharyngeal dysphagia (OPD) in children with cerebral palsy (CP) is estimated to be between 19% and 99%. OPD can impact on children's growth, nutrition and overall health. Despite the growing recognition of the extent and significance of health issues relating to OPD in children with CP, lack of knowledge of its profile in this subpopulation remains. This study aims to investigate the relationship between OPD, attainment of gross motor skills, growth and nutri...

  15. Pan-Britain, mixed-methods study of multidisciplinary teams teaching parents to manage children's long-term kidney conditions at home: Study protocol

    Directory of Open Access Journals (Sweden)

    Swallow Veronica M

    2012-02-01

    Full Text Available Abstract Background Care of children and young people (children with long-term kidney conditions is usually managed by multidisciplinary teams. Published guidance recommends that whenever possible children with long-term conditions remain at home, meaning parents may be responsible for performing the majority of clinical care-giving. Multidisciplinary team members, therefore, spend considerable time promoting parents' learning about care-delivery and monitoring care-giving. However, this parent-educative aspect of clinicians' role is rarely articulated in the literature so little evidence exists to inform professionals' parent-teaching interventions. Methods/Design This ongoing study addresses this issue using a combination of quantitative and qualitative methods involving the twelve children's kidney units in England, Scotland and Wales. Phase I involves a survey of multidisciplinary team members' parent-teaching interventions using: i A telephone-administered questionnaire to determine: the numbers of professionals from different disciplines in each team, the information/skills individual professionals relay to parents and the teaching strategies/interventions they use. Data will be managed using SPSS to produce descriptive statistics ii Digitally-recorded, qualitative group or individual interviews with multidisciplinary team members to explore their accounts of the parent-teaching component of their role. Interviews will be transcribed anonymously and analysed using Framework Technique. Sampling criteria will be derived from analysis to identify one/two unit(s for subsequent in-depth study Phase II involves six prospective, ethnographic case-studies of professional-parent interactions during parent-teaching encounters. Parents of six children with a long-term kidney condition will be purposively sampled according to their child's age, diagnosis, ethnicity and the clinical care-giving required; snowball sampling will identify the

  16. Security Protocol Design: A Case Study Using Key Distribution Protocols

    Directory of Open Access Journals (Sweden)

    Reiner Dojen

    2009-10-01

    Full Text Available Nowadays security protocols are a key component in providing security services for fixed and mobile networks. These services include data confidentiality, radio link encryption, message integrity, mobile subscriber authentication, electronic payment, certified e-mail, contract signing and nonrepudiation. This paper is concerned with design of effective security protocols. Security protocols are introduced and some common attacks against security protocols are discussed. The vulnerabilities that lead to theattacks are analyzed and guidelines for effective security protocol design are proposed. The presented guidelines are applied to the Andrew Secure RPC protocol and its adapted versions. It is demonstrated that compliance with the guidelines successfully avoidsfreshness and parallel session attacks.

  17. A high-precision protocol for identification of preschool children at risk for persisting obesity.

    Directory of Open Access Journals (Sweden)

    Toomas Timpka

    Full Text Available BACKGROUND: Recent studies suggest that adolescent adiposity is established already in preadolescence. Earlier studies have confirmed a strong tracking of obesity from adolescence to adulthood. Our aim was to examine the diagnostic accuracy of a population-derived protocol for identification of preschool children at risk for obesity in preadolescence. METHODOLOGY/PRINCIPAL FINDINGS: We analysed data obtained for child health surveillance up to age 5 from 5778 children born in a Swedish county in 1991. The basic data set included age, sex, and weight and height measurements from the regular checkups between ages 1.5 and 5. Data not routinely collected in the child health centre setting were disregarded. The children were at age 10 randomly assigned to protocol derivation and validation cohorts and assessed for obesity according to IOTF criteria. The accuracy of predicting obesity in the validation cohort was measured using decision precision, specificity, and sensitivity. The decision protocol selected 1.4% of preschool children as being at obesity risk. The precision of the protocol at age 10 was 82% for girls and 80% for boys, and the specificity was 100% for both boys and girls. The sensitivity was higher for girls (41% than for boys (21%. The relative risk for obesity at age 10 estimated by the odds ratio for individuals selected by the protocol compared to non-selected peers was 212.6 (95% confidence interval 56.6 to 798.4 for girls and 120.3 (95% CI 24.5 to 589.9 for boys. CONCLUSION/SIGNIFICANCE: A simple and inexpensive decision protocol based on BMI values proved to have high precision and specificity for identification of preschool children at risk for obesity persisting into adolescence, while the sensitivity was low especially for boys. Implementation and further evaluations of the protocol in child health centre settings are warranted.

  18. Rheumatic Fever Follow-Up Study (RhFFUS protocol: a cohort study investigating the significance of minor echocardiographic abnormalities in Aboriginal Australian and Torres Strait Islander children

    Directory of Open Access Journals (Sweden)

    Rémond Marc Gerard Wootton

    2012-11-01

    Full Text Available Abstract Background In Australia, rheumatic heart disease (RHD is almost exclusively restricted to Aboriginal Australian and Torres Strait Islander people with children being at highest risk. International criteria for echocardiographic diagnosis of RHD have been developed but the significance of minor heart valve abnormalities which do not reach these criteria remains unclear. The Rheumatic Fever Follow-Up Study (RhFFUS aims to clarify this question in children and adolescents at high risk of RHD. Methods/design RhFFUS is a cohort study of Aboriginal and/or Torres Strait Islander children and adolescents aged 8–17 years residing in 32 remote Australian communities. Cases are people with non-specific heart valve abnormalities detected on prior screening echocardiography. Controls (two per case are age, gender, community and ethnicity-matched to cases and had a prior normal screening echocardiogram. Participants will have echocardiography about 3 years after initial screening echocardiogram and enhanced surveillance for any history suggestive of acute rheumatic fever (ARF. It will then be determined if cases are at higher risk of (1 ARF or (2 developing progressive echocardiography-detected valve changes consistent with RHD. The occurrence and timing of episodes of ARF will be assessed retrospectively for 5 years from the time of the RhFFUS echocardiogram. Episodes of ARF will be identified through regional surveillance and notification databases, carer/subject interviews, primary healthcare history reviews, and hospital separation diagnoses. Progression of valvular abnormalities will be assessed prospectively using transthoracic echocardiography and standardized operating and reporting procedures. Progression of valve lesions will be determined by specialist cardiologist readers who will assess the initial screening and subsequent RhFFUS screening echocardiogram for each participant. The readers will be blinded to the initial assessment and

  19. PEG-asparaginase allergy in children with acute lymphoblastic leukemia in the NOPHO ALL2008 protocol

    DEFF Research Database (Denmark)

    Henriksen, Louise Tram; Harila-Saari, Arja; Ruud, Ellen;

    2015-01-01

    BACKGROUND: L-Asparaginase is an effective drug in the treatment of childhood acute lymphoblastic leukemia (ALL). The use of L-asparaginase may be limited by serious adverse events of which allergy is the most frequent. The objective of this study was to describe the clinical aspects of PEG......-asparaginase allergy in children treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol. PROCEDURE: Children (1-17 years) enrolled in the NOPHO ALL2008 protocol between July 2008 and August 2011, who developed PEG-asparaginase allergy were identified through the NOPHO...

  20. A protocol for management of temporomandibular joint ankylosis in children.

    Science.gov (United States)

    Kaban, Leonard B; Bouchard, Carl; Troulis, Maria J

    2009-09-01

    Temporomandibular joint (TMJ) ankylosis in children is a challenging problem. Surgical correction is technically difficult and the incidence of recurrence after treatment is high. The purpose of the present report is to describe the protocol currently used at the Massachusetts General Hospital for the management of TMJ ankylosis in children. It has been our observation that the most common cause of treatment failure is inadequate resection of the ankylotic mass and failure to achieve adequate passive maximal opening in the operating room. The 7-step protocol consists of 1) aggressive excision of the fibrous and/or bony ankylotic mass, 2) coronoidectomy on the affected side, 3) coronoidectomy on the contralateral side, if steps 1 and 2 do not result in a maximal incisal opening greater than 35 mm or to the point of dislocation of the unaffected TMJ, 4) lining of the TMJ with a temporalis myofascial flap or the native disc, if it can be salvaged, 5) reconstruction of the ramus condyle unit with either distraction osteogenesis or costochondral graft and rigid fixation, and 6) early mobilization of the jaw. If distraction osteogenesis is used to reconstruct the ramus condyle unit, mobilization begins the day of the operation. In patients who undergo costochondral graft reconstruction, mobilization begins after 10 days of maxillomandibular fixation. Finally (step 7), all patients receive aggressive physiotherapy. A case series of children with ankylosis treated using this protocol is presented.

  1. Acute uncomplicated appendicitis study: rationale and protocol for a multicentre, prospective randomised controlled non-inferiority study to evaluate the safety and effectiveness of non-operative management in children with acute uncomplicated appendicitis

    Science.gov (United States)

    Xu, Jane; Liu, Yingrui Cyril; Adams, Susan; Karpelowsky, Jonathan

    2016-01-01

    Introduction This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention. Design A multicentre, prospective randomised controlled clinical trial, conducted in 2 Australian tertiary paediatric hospitals. Participants Children who meet the inclusion criteria of an age between 5 and 15 years and a clinical diagnosis of AUA will be invited to participate, and after consent will be randomised via a computer-based program into treatment groups. The study started in June 2016, and the target recruitment is 220 patients. Interventions Children in the control group will be treated with prophylactic antibiotics and appendicectomy, and those in the intervention group will be treated with antibiotic therapy alone. Primary outcome measures include unplanned or unnecessary operation and complications at 30 days. Secondary outcomes include longer term complications within 1 year, length of stay, time off work and school analgesic requirements and cost. Analysis Data analyses will be on the intention-to-treat principle using non-inferiority analysis. Analysis will include the Pearson χ2 test for categorical variables and independent sample t-test or Mann-Whitney test for continuous variables. Non-inferiority for NOM will be tested using 1-sided Wald tests with an α level of 0.05. Ethics and dissemination The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospital Network. In addition, results will be reported through academic journals, seminars and conference presentations. Trial

  2. A cluster randomised trial to evaluate a physical activity intervention among 3-5 year old children attending long day care services: study protocol

    Directory of Open Access Journals (Sweden)

    Finch Meghan

    2010-09-01

    Full Text Available Abstract Background Young children are not participating in recommended levels of physical activity and exhibit high levels of sedentary behaviour. Childcare services provide access to large numbers of young children for prolonged periods, yet there is limited experimental evidence regarding the effectiveness of physical activity interventions implemented in this setting. The aim of this study is to assess the effectiveness and acceptability of a multi-component physical activity intervention, delivered by childcare service staff, in increasing the physical activity levels of children attending long day care services. Methods/Design The study will employ a cluster randomised controlled trial design. Three hundred children aged between 3-5 years from twenty randomly selected long day care services in the Hunter Region of New South Wales, Australia will be invited to participate in the trial. Ten of the 20 long day care services will be randomly allocated to deliver the intervention with the remaining ten services allocated to a wait list control group. The physical activity intervention will consist of a number of strategies including: delivering structured fundamental movement skill activities, increasing physical activity opportunities, increasing staff role modelling, providing children with a physical activity promoting indoor and outdoor environment and limiting children's small screen recreation and sedentary behaviours. Intervention effectiveness will be measured via child physical activity levels during attendance at long day care. The study also seeks to determine the acceptability and extent of implementation of the intervention by services and their staff participating in the study. Discussion The trial will address current gaps in the research evidence base and contribute to the design and delivery of future interventions promoting physical activity for young children in long day care settings. Trial registration Australian New

  3. Optimised low-dose multidetector CT protocol for children with cranial deformity

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, Jose Luis [Complejo Hospitalario Universitario de Vigo, Department of Radiology, Vigo, Pontevedra (Spain); Pombar, Miguel Angel [Complejo Hospitalario Universitario de Santiago, Department of Radiophysics, Santiago de Compostela, La Coruna (Spain); Pumar, Jose Manuel [Complejo Hospitalario Universitario de Santiago, Department of Radiology, Santiago de Compostela, La Coruna (Spain); Campo, Victor Miguel del [Complejo Hospitalario Universitario de Vigo, Department of Public Health, Vigo, Pontevedra (Spain)

    2013-08-15

    To present an optimised low-dose multidetector computed tomography (MDCT) protocol for the study of children with cranial deformity. Ninety-one consecutive MDCT studies were performed in 80 children. Studies were performed with either our standard head CT protocol (group 1, n = 20) or a low-dose cranial deformity protocol (groups 2 and 3). Group 2 (n = 38), initial, and group 3 (n = 33), final and more optimised. All studies were performed in the same 64-MDCT equipment. Cranial deformity protocol was gradationally optimised decreasing kVp, limiting mA range, using automatic exposure control (AEC) and increasing the noise index (NI). Image quality was assessed. Dose indicators such us CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (E) were used. The optimised low-dose protocol reached the following values: 80 kVp, mA range: 50-150 and NI = 23. We achieved a maximum dose reduction of 10-22 times in the 1- to 12-month-old cranium in regard to the 2004 European guidelines for MDCT. A low-dose MDCT protocol that may be used as the first diagnostic imaging option in clinically selected patients with skull abnormalities. (orig.)

  4. The Impact of a Management Protocol on the Outcomes of Child Abuse in Hospitalized Children in Hong Kong

    Science.gov (United States)

    Lee, Anselm C. W.; Li, C. H.; So, K. T.

    2006-01-01

    Objective: To study the outcomes of children hospitalized for suspected child abuse before and after the implementation of a management protocol in a hospital in Hong Kong. Study period: Two 2-year periods before (1994-1995) and after (2002-2003) the implementation of the protocol in 1998. Methods: This is a retrospective hospital chart review in…

  5. Systematic review of the effectiveness of the Wilbarger protocol with children

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    Weeks S

    2012-12-01

    Full Text Available Scott Weeks, Kobie Boshoff, Hugh StewartSchool of Health Sciences Occupational Therapy Program, University of South Australia, Adelaide, South Australia, AustraliaBackground: Sensory processing disorders have an estimated prevalence of 5%–10% in children without disability and 40%–88% in children with disability. A subtype of sensory processing disorder is sensory overresponsivity, which can result in fear, irritability, aggression, or avoidance behaviors in children. The Wilbarger protocol is the most prescriptive program used to treat sensory overresponsivity in children aged 2–12 years. Strong anecdotal evidence suggests that the Wilbarger protocol successfully reduces challenging behavior in children with sensory overresponsivity. The aim of this systematic review was to identify and appraise the existing evidence for the effectiveness of the Wilbarger protocol with children aged 0–18 years.Methods: A systematic review was conducted of the peer-reviewed literature written in English. The electronic databases searched up to April 2012 included CINAHL, Ovid Medline (R, Embase, Scopus, the Cochrane Library, AMED, and the Web of Science. OT Seeker and Google Scholar were searched for missed literature, along with hand-searching of retained articles. Adult studies were excluded. The Critical Review Form for Quantitative Studies by McMaster University and the levels of hierarchy from the Australian National Health and Medical Research Council were used to appraise the literature.Results: A total of 341 studies were found, and 302 were screened for eligibility after duplicates were removed. Four level IV intervention (case series with pretest/posttest studies were included for indepth review. All four studies had very small sample sizes, exhibited low methodological quality, differed in outcome measures used, and lacked homogeneity of samples and treatment fidelity.Conclusion: A lack of high quality evidence currently exists to support or

  6. Effects of exercise intensity and nutrition advice on myocardial function in obese children and adolescents: a multicentre randomised controlled trial study protocol

    Science.gov (United States)

    Dias, Katrin A; Coombes, Jeff S; Green, Daniel J; Gomersall, Sjaan R; Keating, Shelley E; Tjonna, Arnt Erik; Hollekim-Strand, Siri Marte; Hosseini, Mansoureh Sadat; Ro, Torstein Baade; Haram, Margrete; Huuse, Else Marie; Davies, Peter S W; Cain, Peter A; Leong, Gary M; Ingul, Charlotte B

    2016-01-01

    Introduction The prevalence of paediatric obesity is increasing, and with it, lifestyle-related diseases in children and adolescents. High-intensity interval training (HIIT) has recently been explored as an alternate to traditional moderate-intensity continuous training (MICT) in adults with chronic disease and has been shown to induce a rapid reversal of subclinical disease markers in obese children and adolescents. The primary aim of this study is to compare the effects of HIIT with MICT on myocardial function in obese children and adolescents. Methods and analysis Multicentre randomised controlled trial of 100 obese children and adolescents in the cities of Trondheim (Norway) and Brisbane (Australia). The trial will examine the efficacy of HIIT to improve cardiometabolic outcomes in obese children and adolescents. Participants will be randomised to (1) HIIT and nutrition advice, (2) MICT and nutrition advice or (3) nutrition advice. Participants will partake in supervised exercise training and/or nutrition sessions for 3 months. Measurements for study end points will occur at baseline, 3 months (postintervention) and 12 months (follow-up). The primary end point is myocardial function (peak systolic tissue velocity). Secondary end points include vascular function (flow-mediated dilation assessment), quantity of visceral and subcutaneous adipose tissue, myocardial structure and function, body composition, cardiorespiratory fitness, autonomic function, blood biochemistry, physical activity and nutrition. Lean, healthy children and adolescents will complete measurements for all study end points at one time point for comparative cross-sectional analyses. Ethics and dissemination This randomised controlled trial will generate substantial information regarding the effects of exercise intensity on paediatric obesity, specifically the cardiometabolic health of this at-risk population. It is expected that communication of results will allow for the development of

  7. Inhaled corticosteroids for abnormal pulmonary function in children with a history of Chronic Lung Disease of Infancy: study protocol [ISRCTN55153521

    Directory of Open Access Journals (Sweden)

    Sauve Reginald

    2005-04-01

    Full Text Available Abstract Background There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD. Methods Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD. Discussion We propose that Beclomethasone Dipropionate (QVAR will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.

  8. Psychosocial interventions for children exposed to traumatic events in low- and middle-income countries: study protocol of an individual patient data meta-analysis

    NARCIS (Netherlands)

    Purgato, M.; Gross, A.L.; Jordans, M.J.D.; de Jong, J.T.V.M.; Barbui, C.; Tol, W.

    2014-01-01

    Background: The burden of mental health and psychosocial problems in children exposed to traumatic events in humanitarian settings in low- and middle-income countries is substantial. An increasing number of randomized studies has shown promising effects of psychosocial interventions, but this eviden

  9. The effect of family-based multidisciplinary cognitive behavioral treatment in children with obesity: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kruyff Carolien C

    2011-05-01

    Full Text Available Abstract Background The prevalence of childhood obesity has increased rapidly during the last three decades in the Netherlands. It is assumed that mainly environmental factors have contributed to this trend. Parental overweight and low social economic status are risk factors for childhood obesity. Childhood obesity affects self-esteem and has negative consequences on cognitive and social development. Obese children tend to become obese adults, which increases the risk for developing cardiovascular complications, type 2 diabetes mellitus, and psychosocial problems. Additionally, the secretion of several gastrointestinal hormones, responsible for appetite and food intake, is impaired in obese subjects. Weight reduction through lifestyle changes in order to change health risks is, until now, suggested as the preferred treatment for childhood obesity. The objective of this study is the effect evaluation of a family-based cognitive behavioral multidisciplinary lifestyle treatment. The intervention aims to establish long-term weight reduction and stabilization, reduction of obesity-related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques. Study design/Methods In this randomized clinical trial newly presented children with obesity (8-17 years old are divided, by randomization, in an intervention and control group, both consisting of 40 obese children. The intervention is carried out in groups of 8-11 children, and consists of respectively 7 and 5 separate group meetings for the children and their parents and 1 joint group meeting of 2 ½ hours. Main topics are education on nutrition, self-control techniques, social skills, physical activity and improvement of self-esteem. The control group is given advice on physical activity and nutrition. For normal data comparison, data were collected of 40 normal-weight children, 8-17 years old. Discussion Because of the increasing prevalence of

  10. NEURAPRO-E study protocol

    DEFF Research Database (Denmark)

    Markulev, Connie; McGorry, Patrick D; Nelson, Barnaby;

    2016-01-01

    polyunsaturated fatty acids (PUFAs), coupled with the falling transition rate in ultra high-risk (UHR) samples, mean that further study of such benign, potentially neuroprotective interventions is clinically and ethically required. Employing a multicentre approach, enabling a large sample size, this study...

  11. Efficacy of a mandibular advancement appliance on sleep-disordered breathing in children: a study protocol of a crossover randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ghassan Idris

    2016-08-01

    Full Text Available Background: Sleep-Disordered Breathing (SDB varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children’s wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS may represent a viable treatment option. Whilst the efficacy of these appliances has been consistently demonstrated in adults, there is little information about their effectiveness in children.Aims: To determine the efficacy of mandibular advancement appliances for the management of SDB and related health problems in children. Methods/design: The study will be designed as a single-blind crossover randomized controlled trial with administration of both an ‘Active MAS’ (Twin-block and a ‘Sham MAS’. Eligible participants will be children aged 8 to 12 years whose parents report they snore ≥ 3 nights per week. Sixteen children will enter the full study after confirming other inclusion criteria, particularly Skeletal class I or class II confirmed by lateral cephalometric radiograph. Each child will be randomly assigned to either a treatment sequence starting with the Active or the Sham MAS. Participants will wear the appliances for three weeks separated by a two-week washout period. For each participant, home-based polysomnographic data will be collected four times; once before and once after each treatment period. The Apnea Hypopnea Index (AHI will represent the main outcome variable. Secondary outcomes will include, snoring frequency, masseter muscle activity, sleep symptoms, quality

  12. A GO intervention program for enhancing elementary school children's cognitive functions and control abilities of emotion and behavior: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tachibana Yoshiyuki

    2012-01-01

    Full Text Available Abstract Background Executive function is critical for children's healthy development. We propose an intervention program to enhance children's executive function using the game, GO. Many neuroimaging studies have revealed that playing GO is related to executive function. In addition, previous studies also revealed that executive function can be enhanced by training. We will perform a randomized controlled trial to investigate the effectiveness of a GO intervention group and a control group without intervention. Methods/Design 35 elementary school children aged 8 to 10 were recruited from Edogawa elementary school in Tokyo, Japan. They will be randomized into two groups; either the 5-week GO intervention group or no-intervention control group. We will ask the participants of the intervention group to join the GO course which will be held once every week for five weeks (total: six times. In the GO course, the children will be taught GO by the GO masters of the Nihon Ki-in and enjoy it for an hour. Besides the course, the participants will perform GO problems about twenty minutes a day, three times a week during the intervention period. We will use the Stroop task, the digit span, the Raven's colored progressive matrices, the Span-board task, and the Behavioral inhibition/behavioral activation scale for the outcome measures. Outcomes will be measured at a baseline (Assessment 1 and 5 weeks after the intervention program started (Assessment 2. The intervention group will be compared with the control group using one-way analyses of covariance with the difference between Assessment 1 and Assessment 2 measures as dependent variables and pretest scores as covariates. Discussion To our knowledge, this study will be the first RCT to investigate the efficacy of a GO intervention program for elementary school children. If this intervention is effective, we will be able to take the next steps in making an educational program to enhance children's executive

  13. Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study

    Science.gov (United States)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

    2016-01-01

    Introduction The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers’ physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers’ physical activity. Methods and analysis The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2–5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers’ physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethics and dissemination Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and

  14. Insights From Verbal Protocols: A Case Study

    Directory of Open Access Journals (Sweden)

    Margaret Kumar

    2012-09-01

    Full Text Available This study explores a postgraduate student writer’s responses and reactions through verbal protocols as she attends to teacher feedback. Teacher feedback has been heralded as an important element in process writing. Numerous studies have been carried out on various aspects of teacher feedback such as on the effectiveness of feedback, students’ preferences for teacher feedback and students’ perceptions of feedback. However, there is still a gap in the literature in determining how students respond as they engage with teacher feedback. This paper reports on one postgraduate student’s responses on and her reactions to teacher feedback. Concurrent verbal protocols used in complement with written drafts and teacher commentaries were the main sources of data for this study. The analyses reveal that attending to feedback is a recursive process that fosters self-reflection which, in turn promotes planning for revision. Keywords: Verbal protocols, Teacher written feedback; Recursion; Reflection; Planning

  15. Effectiveness of a cognitive-behavioral therapy (CBT manualized program for clinically anxious children: study protocol of a randomized controlled trial

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    Jansen Mélou

    2012-03-01

    Full Text Available Abstract Background In the Netherlands, the prevalence of anxiety disorders is 20%; and children with anxiety are at increased risk for psychopathology throughout adulthood. Recently, a revised version of a cognitive behavioral therapy manualized program called 'Thinking + Doing = Daring' (TDD was developed for children between 8 and 12 years old with an anxiety disorder. The main aim of this project is to conduct a Randomized Controlled Trial (RCT to evaluate the effectiveness of TDD. Methods/Design The CBT program will be tested with a RCT with 120 clinically anxious children (8-12 years old referred to one of three mental health care agencies. Children will be randomly assigned to the experimental (N = 60, TDD or to the control condition (N = 60, treatment as usual. The primary outcome measure will be the child's anxiety symptoms level. Secondary outcome measures will be externalizing (e.g. aggression and internalizing problems (e.g. depression. Two potential mediators of change will be examined in the current study: therapeutic alliance and parenting. Mother and child in both the experimental and control condition will be surveyed at baseline, post treatment and after 6 and 12 months (follow-up. It is hypothesized that children in the experimental condition will show a stronger decrease in anxiety symptoms compared to children that receive treatment as usual. Moreover, we expect that a strong therapeutic alliance and decreases in parental control and rejection will contribute to treatment success. Discussion Early treatment for anxiety problems has the potential to not only result in anxiety reductions, but also to prevent future problems such as substance abuse and psychopathology throughout adulthood. Our results will be immediately relevant to practice, since we are partnering with 'real world' community agencies. If the CBT program proves more effective than treatment as usual, it could be implemented in community mental health care

  16. The 'Healthy Dads, Healthy Kids' community effectiveness trial: study protocol of a community-based healthy lifestyle program for fathers and their children

    Directory of Open Access Journals (Sweden)

    Morgan Philip J

    2011-11-01

    Full Text Available Abstract Background The 'Healthy Dads, Healthy Kids' program was designed to help overweight fathers lose weight and positively influence the health behaviors of their children. The aim of the current study was to evaluate the previously established program in a community setting, in a large effectiveness trial. Methods/Design The Healthy Dads, Healthy Kids community trial consists of three stages: (i Stage 1 - program refinement and resource development (ii Stage 2 - community randomized controlled trial (iii Stage 3 - community effectiveness trial. The program will be evaluated in five Local Government Areas in the Hunter Valley Region of NSW, Australia. For the community randomized controlled trial, 50 overweight/obese men (aged 18-65 years from one Local Government Area with a child aged between 5-12 years of age will be recruited. Families will be randomized to either the program or a 6-month wait-list control group. Fathers and their children will be assessed at baseline, post-intervention (3-months and 6-months. Inclusion criteria are: body mass index 25-40 kg/m2; no participation in other weight loss programs during the study; pass a health-screening questionnaire; and access to a computer with Internet facilities. In the community trial, the program will be evaluated using a non-randomized, prospective design in five Local Government Areas. The exclusion criteria is body mass index 2 or lack of doctor's approval. Measures will be collected at baseline, 3-, 6- and 12-months. The program involves fathers attending seven face-to-face group sessions (three with children over 3-months. Measures: The primary outcome is fathers' weight. Secondary outcomes for both fathers and children include: waist circumference, blood pressure, resting heart rate, physical activity, sedentary behaviors and dietary intake. Father-only measures include portion size, alcohol consumption, parenting for physical activity and nutrition and parental engagement

  17. Acupuncture for Children with Cerebral Palsy: A Systematic Review Protocol

    Science.gov (United States)

    Zhang, Qian; Yang, Yejiao; He, Qi; Zhang, Xinghe

    2017-01-01

    Background Cerebral palsy (CP), a childhood disease of high morbidity and serious harmfulness, has no effective therapies to completely relieve the associated pain. Acupuncture has been used widely in China to alleviate several CP symptoms, such as pain and motion disorders, despite the deficiency of high-quality evidence related to this practice. Objective The aim of this systematic review protocol is to assess the efficacy and safety of acupuncture for the treatment of children with CP. Methods The following electronic databases will be searched: Cochrane Library, Web of Science, EBASE, Springer, World Health Organization International Clinical Trials Registry Platform, China National Knowledge Infrastructure, Wan-fang database, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and other sources. All published randomized controlled trials from inception to December 2016 will be included. RevMan V.5.3 software will be implemented for the assessment of bias risk, data synthesis, subgroup analysis, and meta-analyses if inclusion conditions are met. Individuals recruited into the trials will include children with all types of CP, and these individuals will be involved as coresearchers to develop and evaluate the efficacy and safety of acupuncture for the treatment of children with CP. Due to language barriers, only English and Chinese articles will be retrieved. Results The systematic review will synthesize the available knowledge surrounding acupuncture for children with CP. The findings will be synthesized to determine the efficacy and safety of acupuncture for children with CP. Conclusions The review has not been completed. This protocol presents a proper method to implement the systematic review, and ensures transparency for the completed review. Findings from the systematic review will be disseminated in a peer-reviewed journal and results will be presented at relevant conferences. The data of individual patients will not be included

  18. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Overbeek Mathilde M

    2012-02-01

    Full Text Available Abstract Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!' has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140 are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program

  19. Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

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    Kerkum Yvette L

    2013-02-01

    Full Text Available Abstract Background Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs, are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP, walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations. The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success. Method/Design A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics. Discussion The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique

  20. Insights From Verbal Protocols: A Case Study

    OpenAIRE

    Margaret Kumar

    2012-01-01

    This study explores a postgraduate student writer’s responses and reactions through verbal protocols as she attends to teacher feedback. Teacher feedback has been heralded as an important element in process writing. Numerous studies have been carried out on various aspects of teacher feedback such as on the effectiveness of feedback, students’ preferences for teacher feedback and students’ perceptions of feedback. However, there is still a gap in the literature in determining how students res...

  1. Development of Experimental Protocol for Visual Cognitive Function Evaluation in Children with Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Pereverzeva D.S.,

    2016-10-01

    Full Text Available The article aims to present experimental protocol for investigation of visual cognitive function in children and adolescents with autism spectrum disorders. Description of experimental design is introduced by theoretical review of visual attention, perception and visual-motor control development in children with idiopathic autism and those with Fragile X mental retardation syndrome. Research method presented in the article is based on recent studies of visual cognitive function development under normal and pathological condition. The protocol includes three experimental paradigms: “antisaccade test”, “big/ figures”, and “photos test” performed by making use of eye tracking recording. This work was supported by grant RFBR 14-06-31284

  2. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Overbeek, M.M.; Schipper, de J.C.; Lamers-Winkelman, F.; Schuengel, C.

    2012-01-01

    Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has b

  3. Statistical principles for prospective study protocols:

    DEFF Research Database (Denmark)

    Christensen, Robin; Langberg, Henning

    2012-01-01

    In the design of scientific studies it is essential to decide on which scientific questions one aims to answer, just as it is important to decide on the correct statistical methods to use to answer these questions. The correct use of statistical methods is crucial in all aspects of research...... to quantify relationships in data. Despite an increased focus on statistical content and complexity of biomedical research these topics remain difficult for most researchers. Statistical methods enable researchers to condense large spreadsheets with data into means, proportions, and difference between means...... are "statistically significant" or not. In the present paper we outline the considerations and suggestions on how to build a trial protocol, with an emphasis on having a rigorous protocol stage, always leading to a full article manuscript, independent of statistical findings. We conclude that authors, who find...

  4. Statistical principles for prospective study protocols:

    DEFF Research Database (Denmark)

    Christensen, Robin; Langberg, Henning

    2012-01-01

    In the design of scientific studies it is essential to decide on which scientific questions one aims to answer, just as it is important to decide on the correct statistical methods to use to answer these questions. The correct use of statistical methods is crucial in all aspects of research...... are "statistically significant" or not. In the present paper we outline the considerations and suggestions on how to build a trial protocol, with an emphasis on having a rigorous protocol stage, always leading to a full article manuscript, independent of statistical findings. We conclude that authors, who find...... to quantify relationships in data. Despite an increased focus on statistical content and complexity of biomedical research these topics remain difficult for most researchers. Statistical methods enable researchers to condense large spreadsheets with data into means, proportions, and difference between means...

  5. Common beans and cowpeas as complementary foods to reduce environmental enteric dysfunction and stunting in Malawian children: Study protocol for two randomized controlled trials

    Science.gov (United States)

    Interventions to decrease the burden of childhood malnutrition are urgently needed, as millions of children die annually owing to undernutrition and hundreds of millions more are left cognitively and physically stunted. Environmental enteric dysfunction (EED), a pervasive chronic subclinical inflamm...

  6. Motor trajectories from birth to 5 years of children born at less than 30 weeks’ gestation: early predictors and functional implications. Protocol for a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Alicia J Spittle

    2016-10-01

    Discussion/significance: Understanding the developmental precursors of motor impairment in children born before 30 weeks is essential for limiting disruption to skill development, and potential secondary impacts on physical activity, participation, academic achievement, self-esteem and associated outcomes (such as obesity, poor physical fitness and social isolation. An improved understanding of motor skill development will enable targeting of interventions and streamlining of services to children at highest risk of motor impairments.

  7. Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.

    Science.gov (United States)

    De Craemer, M; De Decker, E; De Bourdeaudhuij, I; Verloigne, M; Duvinage, K; Koletzko, B; Ibrügger, S; Kreichauf, S; Grammatikaki, E; Moreno, L; Iotova, V; Socha, P; Szott, K; Manios, Y; Cardon, G

    2014-08-01

    Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.

  8. Self Fault-Tolerance of Protocols: A Case Study

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The prerequisite for the existing protocols' correctness is that protocols can be normally operated under the normal conditions, rather than dealing with abnormal conditions.In other words, protocols with the fault-tolerance can not be provided when some fault occurs. This paper discusses the self fault-tolerance of protocols. It describes some concepts and methods for achieving self fault tolerance of protocols. Meanwhile, it provides a case study, investigates a typical protocol that does not satisfy the self fault-tolerance, and gives a new redesign version of this existing protocol using the proposed approach.

  9. A Randomized Controlled Trial Investigating the Effects of a Special Extract of Bacopa monnieri (CDRI 08 on Hyperactivity and Inattention in Male Children and Adolescents: BACHI Study Protocol (ANZCTRN12612000827831

    Directory of Open Access Journals (Sweden)

    James D. Kean

    2015-12-01

    Full Text Available Clinical diagnoses of Attention Deficit Hyperactivity Disorder (ADHD and the use of prescription medications for its treatment have increased in recent years. Current treatments may involve the administration of amphetamine-type substances, a treatment path many parents are apprehensive to take. Therefore, alternative pharmacological treatments are required. Few nutritional or pharmacological alternatives that reduce ADHD associated symptoms (hyperactivity and inattention have been subjected to rigorous clinical trials. Bacopa monnieri is a perennial creeping herb. CDRI 08 is a special extract of Bacopa monnieri which has been subjected to hundreds of scientific studies and has been shown in human randomized controlled trials (RCTs to improve memory, attention, and mood. It is hypothesised that chronic administration of CDRI 08 will improve attention, concentration and behaviour in children with high levels of hyperactivity and/or inattention. This paper reports the protocol for the first 16-week, randomized, placebo-controlled, double-blind, parallel groups trial examining the efficacy and safety of CDRI 08 in male children aged 6–14 years with high levels of inattention and hyperactivity. The primary outcome variable will be the level of hyperactivity and inattention measured by the Conners’ Parent Rating Scale (CPRS. Secondary outcome variables include cognition, mood, sleep, and EEG. Trial registration: Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12612000827831.

  10. Prevalence, Motivations, and Social, Mental Health and Health Consequences of Cyberbullying Among School-Aged Children and Youth: Protocol of a Longitudinal and Multi-Perspective Mixed Method Study

    Science.gov (United States)

    McInroy, Lauren B; Lacombe-Duncan, Ashley; Bhole, Payal; Van Wert, Melissa; Schwan, Kaitlin; Birze, Arija; Daciuk, Joanne; Beran, Tanya; Craig, Wendy; Pepler, Debra J; Wiener, Judith; Khoury-Kassabri, Mona; Johnston, David

    2016-01-01

    Background While the online environment may promote important developmental and social benefits, it also enables the serious and rapidly growing issue of cyberbullying. Cyberbullying constitutes an increasing public health problem – victimized children and youth experience a range of health and mental health concerns, including emotional and psychosomatic problems, maladaptive behaviors, and increased suicidality. Perpetrators demonstrate a lack of empathy, and may also struggle with health and mental health issues. Objective This paper describes the protocols applied in a longitudinal and multi-perspective mixed-methods study with five objectives: (1) to explore children/youth’s experiences, and children/youth’s, parents’, and teachers’ conceptions, definitions, and understanding of cyberbullying; (2) to explore how children/youth view the underlying motivations for cyberbullying; (3) to document the shifting prevalence rates of cyberbullying victimization, witnessing, and perpetration; (4) to identify risk and protective factors for cyberbullying involvement; and (5) to explore social, mental health, and health consequences of cyberbullying. Methods Quantitative survey data were collected over three years (2012-2014) from a stratified random baseline sample of fourth (n=160), seventh (n=243), and tenth (n=267) grade children/youth, their parents (n=246), and their teachers (n=103). Quantitative data were collected from students and teachers during in-person school visits, and from parents via mail-in surveys. Student, parent, and teacher surveys included questions regarding: student experiences with bullying/cyberbullying; student health, mental health, and social and behavioral issues; socio-demographics; and information and communication technology use. In-depth semi-structured qualitative interviews were conducted twice with a sub-sample of students (n=57), purposively selected based on socio-demographics and cyberbullying experience, twice with

  11. Internet-based information and self-help program for parents of children with burns: Study protocol for a randomized controlled trial

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    Josefin Sveen

    2015-11-01

    Conclusion: We believe that this program will offer parents of children with burns information and support, decrease symptoms of stress, and that parents will perceive the program as useful. If the program is found to be beneficial, it could be implemented in burn care as it is accessible and cost-effective.

  12. Maintenance interventions for overweight or obese children and adolescents who participated in a treatment program: study protocol for a systematic review

    NARCIS (Netherlands)

    Heijden, van der L.B.; Feskens, E.J.M.; Janse, A.J.

    2014-01-01

    Background Childhood overweight and obesity are associated with significant health consequences. Early and successful treatment of this public health issue is necessary. Although several intervention programs for children result in weight loss or stabilisation in the short term, preventing relapse a

  13. The effects of parental components in a trauma-focused cognitive behavioral based therapy for children exposed to interparental violence: study protocol for a randomized controlled trial

    OpenAIRE

    Visser, Margreet M.; Telman, Machteld D.; DE SCHIPPER, J. CLASIEN; Lamers-Winkelman, Francien; Schuengel, Carlo; Finkenauer, Catrin

    2015-01-01

    Background Interparental violence is both common and harmful and impacts children’s lives directly and indirectly. Direct effects refer to affective, behavioral, and cognitive responses to interparental violence and psychosocial adjustment. Indirect effects refer to deteriorated parental availability and parent-child interaction. Standard Trauma Focused Cognitive Behavioral Therapy may be insufficient for children traumatized by exposure to interparental violence, given the pervasive impact o...

  14. The impact of insecticide-treated school uniforms on dengue infections in school-aged children: study protocol for a randomised controlled trial in Thailand

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    Wilder-Smith Annelies

    2012-11-01

    Full Text Available Abstract Background There is an urgent need to protect children against dengue since this age group is particularly sensitive to the disease. Since dengue vectors are active mainly during the day, a potential target for control should be schools where children spend a considerable amount of their day. School uniforms are the cultural norm in most developing countries, worn throughout the day. We hypothesise that insecticide-treated school uniforms will reduce the incidence of dengue infection in school-aged children. Our objective is to determine the impact of impregnated school uniforms on dengue incidence. Methods A randomised controlled trial will be conducted in eastern Thailand in a group of schools with approximately 2,000 students aged 7–18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-quality insecticide impregnation with permethrin. A double-blind, randomised, crossover trial at the school level will cover two dengue transmission seasons. Discussion Practical issues and plans concerning intervention implementation, evaluation, analysing and interpreting the data, and possible policy implications arising from the trial are discussed. Trial registration clinicaltrial.gov. Registration number: NCT01563640

  15. A calibration protocol for population-specific accelerometer cut-points in children.

    Directory of Open Access Journals (Sweden)

    Kelly A Mackintosh

    Full Text Available PURPOSE: To test a field-based protocol using intermittent activities representative of children's physical activity behaviours, to generate behaviourally valid, population-specific accelerometer cut-points for sedentary behaviour, moderate, and vigorous physical activity. METHODS: Twenty-eight children (46% boys aged 10-11 years wore a hip-mounted uniaxial GT1M ActiGraph and engaged in 6 activities representative of children's play. A validated direct observation protocol was used as the criterion measure of physical activity. Receiver Operating Characteristics (ROC curve analyses were conducted with four semi-structured activities to determine the accelerometer cut-points. To examine classification differences, cut-points were cross-validated with free-play and DVD viewing activities. RESULTS: Cut-points of ≤ 372, >2160 and >4806 counts • min(-1 representing sedentary, moderate and vigorous intensity thresholds, respectively, provided the optimal balance between the related needs for sensitivity (accurately detecting activity and specificity (limiting misclassification of the activity. Cross-validation data demonstrated that these values yielded the best overall kappa scores (0.97; 0.71; 0.62, and a high classification agreement (98.6%; 89.0%; 87.2%, respectively. Specificity values of 96-97% showed that the developed cut-points accurately detected physical activity, and sensitivity values (89-99% indicated that minutes of activity were seldom incorrectly classified as inactivity. CONCLUSION: The development of an inexpensive and replicable field-based protocol to generate behaviourally valid and population-specific accelerometer cut-points may improve the classification of physical activity levels in children, which could enhance subsequent intervention and observational studies.

  16. Protocol for north of England and Scotland study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC. A pragmatic randomised controlled trial comparing surgical intervention with conventional medical treatment in children with recurrent sore throats

    Directory of Open Access Journals (Sweden)

    Lock Catherine

    2006-08-01

    Full Text Available Abstract Background Uncertainties surrounding the effectiveness and cost-effectiveness of childhood tonsillectomy for recurrent sore throat led the NHS Health Technology Assessment Programme to commission this research to evaluate the effectiveness and cost-effectiveness of tonsillectomy and adeno-tonsillectomy in comparison with standard non-surgical management in children aged under 16 with recurrent throat infections. The aim is to evaluate if tonsillectomy and adeno-tonsillectomy reduces the number of episodes of sore throats among children to a clinically significant extent. Methods/design A simple prospective pragmatic randomised controlled trial with economic analysis and prospective cohort study of non-trial participants comparing surgical intervention with conventional medical treatment. The treatment arm will receive tonsillectomy and adeno-tonsillectomy while in the control arm non-surgical conventional medical treatment only will be used. The primary outcome measure will be reported number of episodes of sore throat over two years with secondary outcomes measures of reported number of episodes of sore throat, otitis media and upper respiratory tract infection which invoke a GP consultation; reported number of symptom-free days; reported severity of sore throats and surgical and anaesthetic morbidity. The study will take place in five hospitals in the UK. The trial population will be 406 children aged 4–15 on their last birthday with recurrent sore throat referred by primary care to the 5 otolaryngology departments. The duration of the study is seven years (July 2001- July 2008. Discussion As with all pragmatic randomised controlled trials it is impossible to control the external environment in which the research is taking place. Since this trial began a number of factors have arisen which could affect the outcome including; a reduction in the incidence of respiratory tract infections, marked socio-economic differences in

  17. Diabetes research in children network:availability of protocol data sets.

    Science.gov (United States)

    Ruedy, Katrina J; Beck, Roy W; Xing, Dongyuan; Kollman, Craig

    2007-09-01

    The Diabetes Research in Children Network (DirecNet) was established in 2001 by the National Institute of Child Health and Human Development and the National Institute of Diabetes and Digestive and Kidney Diseases through special congressional funding for type 1 diabetes research. The network consists of five clinical centers, a coordinating center, and a central laboratory. Since its inception, DirecNet has conducted nine protocols, resulting in 28 published manuscripts with an additional 2 under review and 5 in development. The protocols have involved evaluation of technology available for the treatment of type 1 diabetes, including home glucose meters (OneTouch Ultra, FreeStyle, and BD Logic), continuous glucose monitoring systems (GW2B, CGMS, FreeStyle Navigator, and Guardian RT), and hemoglobin A1c (HbA1c) devices (DCA 2000 and A1cNow). In addition, the group has conducted several studies evaluating factors affecting hypoglycemia, including exercise and bedtime snack composition. The data sets that have resulted from these studies include data from the devices being evaluated, central laboratory glucose, HbA1c and hormone data, clinical center glucose and HbA1c data, accelerometer data, and pump data depending on the procedures involved with each protocol. These data sets are, or will be, available at no charge on the study group's public Web site. Several psychosocial questionnaires developed by DirecNet are also available.

  18. 'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children : Design of a cluster randomised controlled trial

    NARCIS (Netherlands)

    L. Veldhuis (Lydian); M.K. Struijk (Mirjam); W. Kroeze (Willemieke); A. Oenema (Anke); C.M. Renders (Carry); A.M.W. Bulk-Bunschoten (Anneke); R.A. Hirasing (Remy); H. Raat (Hein)

    2009-01-01

    textabstractBACKGROUND: The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence

  19. The cost-effectiveness of an intensive treatment protocol for severe dyslexia in children.

    Science.gov (United States)

    Hakkaart-van Roijen, Leona; Goettsch, Wim G; Ekkebus, Michel; Gerretsen, Patty; Stolk, Elly A

    2011-08-01

    Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued by proxies using a general quality-of-life instrument (EQ-5D). We considered medical cost and non-medical cost (e.g. remedial teaching). The model computed cost per successful treatment and cost per quality adjusted life year (QALY) in time. About 75% of the total costs was related to diagnostic tests to distinguish between children with severe dyslexia and children who have reading difficulties for other reasons. The costs per successful treatment of severe dyslexia were €36 366. Successful treatment showed a quality-of-life gain of about 11%. At primary school, the average cost per QALY for severe dyslexia amounted to €58 647. In the long term, the cost per QALY decreased to €26 386 at secondary school and €17 663 thereafter. The results of this study provide evidence that treatment of severe dyslexia is cost-effective when the investigated protocol is followed.

  20. International multiphase mixed methods study protocol to develop a cross-cultural patient-reported outcome instrument for children and young adults with cleft lip and/or palate (CLEFT-Q)

    Science.gov (United States)

    Wong Riff, Karen W Y; Tsangaris, Elena; Goodacre, Tim; Forrest, Christopher R; Pusic, Andrea L; Cano, Stefan J; Klassen, Anne F

    2017-01-01

    Introduction Patient-reported outcome (PRO) instruments should be developed according to rigorous guidelines in order to provide clinically meaningful, scientifically sound measurement. Understanding the methodology behind instrument development informs the selection of the most appropriate tool. This mixed methods protocol describes the development of an internationally applicable PRO instrument, the CLEFT-Q, for evaluating outcomes of treatment for cleft lip and/or palate (CL/P). Methods and analysis The study includes three main phases that occur iteratively and interactively. In phase I, we determine what concepts are important to patients regarding their outcome. A conceptual framework for the CLEFT-Q is formed through a systematic review and an extensive international qualitative study. The systematic review ascertains what concepts have previously been measured in patients with CL/P. The qualitative study employs interpretive description and involves in-depth interviews with patients in high-income and lower-middle income countries. Preliminary items are generated from the qualitative data. Preliminary scales are then created for each theme in the framework. Cognitive debriefing interviews and expert clinician input are used to refine the scales in an iterative process. In phase II, the preliminary scales are administered to a large international group of patients with CL/P. The modern psychometric method of Rasch Measurement Theory analysis is employed to define the measurement characteristics. The preliminary scales are shortened based on these results. In phase III, further tests assess reliability, validity and responsiveness of the instrument. Ethics and dissemination The study is approved by Research Ethics Boards for each participating site. Findings from this study will be published in open access peer-reviewed journals and presented at national and international conferences. Integrated knowledge translation is employed to engage stakeholders from

  1. [The research protocol IV: study variables].

    Science.gov (United States)

    Villasís-Keever, Miguel Ángel; Miranda-Novales, María Guadalupe

    2016-01-01

    The variables in a research study are all that is measured, the information collected, or the data that is collected in order to answer the research questions, which are specified in the objectives. Their selection is essential to the research protocol. This article aims to point out the elements to be considered in the section of the variables. To avoid ambiguity, it is necessary to select only those that will help achieve the study objectives. It should subsequently be defined how they will be measured to ensure that the findings can be replicated; it is therefore desirable to include conceptual and operational definitions. From the methodological point of view, the classification of variables helps us understand how the relationship between them is conceptualized. Depending on the study design, the independent, dependent, universal, and confounding variables should be noted. Another indispensable element for planning statistical analyses is the scale of variable measurement. Therefore, one must specify whether the variables correspond to one of the following four: qualitative nominal, qualitative ordinal, quantitative range, or quantitative ratio. Finally, we should detail the measurement units of each variable.

  2. Meropenem vs standard of care for treatment of late onset sepsis in children of less than 90 days of age: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    de Cabre Vincent

    2011-09-01

    Full Text Available Abstract Background Late onset neonatal sepsis (LOS with the mortality of 17 to 27% is still a serious disease. Meropenem is an antibiotic with wide antibacterial coverage. The advantage of it over standard of care could be its wider antibacterial coverage and thus the use of mono-instead of combination therapy. Methods NeoMero-1, an open label, randomised, comparator controlled, superiority trial aims to compare the efficacy of meropenem with a predefined standard of care (ampicillin + gentamicin or cefotaxime + gentamicin in the treatment of LOS in neonates and infants aged less than 90 days admitted to a neonatal intensive care unit. A total of 550 subjects will be recruited following a 1:1 randomisation scheme. The trial includes patients with culture confirmed (at least one positive culture from normally sterile site except coagulase negative staphylococci in addition to one clinical or laboratory criterion or clinical sepsis (at least two laboratory and two clinical criteria suggestive of LOS in subjects with postmenstrual age The study will start recruitment in September 2011; the total duration is of 24 months. Trial registration EudraCT 2011-001515-31

  3. Interactive verification of Markov chains: Two distributed protocol case studies

    Directory of Open Access Journals (Sweden)

    Johannes Hölzl

    2012-12-01

    Full Text Available Probabilistic model checkers like PRISM only check probabilistic systems of a fixed size. To guarantee the desired properties for an arbitrary size, mathematical analysis is necessary. We show for two case studies how this can be done in the interactive proof assistant Isabelle/HOL. The first case study is a detailed description of how we verified properties of the ZeroConf protocol, a decentral address allocation protocol. The second case study shows the more involved verification of anonymity properties of the Crowds protocol, an anonymizing protocol.

  4. Study Application of RADIUS Protocol on Ethernet

    Institute of Scientific and Technical Information of China (English)

    GUO Fang; YANG Huan-yu; LI Hong

    2004-01-01

    This paper presents how to apply the RADIUS (Remote Authentication Dial In User Service)protocol ,which is generally applied to dial-up network, to the authentication & charge of Broad Band accessing control system on Ethernet. It is provided that the Broad Band accessing control system included a self-designed communication protocol is used in communicating between an terminal user and Network Access Server .The interface module on the servers side and the Radius system is also given in this article.

  5. Treatment of Children with Multiple System Langerhans Cell Histiocytosis by Japan Langerhans Cell Histiocytosis Study Group Protocol%JLSG方案治疗儿童多系统朗格汉斯细胞组织细胞增生症

    Institute of Scientific and Technical Information of China (English)

    黄俊彬; 薛红漫; 陈岩岩; 黄科

    2013-01-01

    The purpose of this study was to evaluate the efficiency of Japan Langerhans Cell Histiocytosis Study Group (JLSG) Protocol in treatment of children suffering from multiple system langerhans cell histiocytosis (MS-LCH). The clinical features, therapeutic response and prognosis of 11 children who were diagnosed and treated by JLSG in our department during October 2004 through October 2011 were analyzed. Among all 11 cases, 8 males and 3 females, the age at diagnosis was from 3 month to 6.5 years old with a median age of 3 years old. There were 10 cases of LCH with multi-system involvement (MS-LCH) and 1 case of single-system involvement (SS-LCH). Among those MS-LCH patients, 5 patients had risk organ involvement, and the other 5 patients did not develop risk organ involvement. All patients had been treated with JLSG protocol. The results showed that 4 cases achieved good response after 6-week induction treatment and the time of drug discontinuation were 5-20 months without relapse; 3 cases achieved partial response after 6-week induction treatment, among them 1 case did not relapse after discontinuation of drugs for 19 months, 1 case was still receiving maintenance treatment, 1 case abandoned induction treatment; 4 patients got no response(NR) or progressive disease after 6-week of induction treatment and were switched to salvage therapy, among them, 2 patients had stopped treatment for 2-20 months without relapse, 1 patient was still receiving maintenance treatment, one had changed to another therapy. It is concluded that the most of childhood LCH can be effectively controlled by immunochemical therapy based on the JLSG protocol. For children with LCH who has a poor response after 6-week induction treatment, LCH can still be well controlled if switched to salvage treatment.%本研究观察以JLSG(Japan Langerhans Cell Histiocytosis Study Group,JLSG)方案为基础治疗儿童多系统朗格汉斯细胞组织细胞增生症(MS-LCH)的疗效.

  6. The Familial Intracranial Aneurysm (FIA study protocol

    Directory of Open Access Journals (Sweden)

    Meissner Irene

    2005-04-01

    Full Text Available Abstract Background Subarachnoid hemorrhage (SAH due to ruptured intracranial aneurysms (IAs occurs in about 20,000 people per year in the U.S. annually and nearly half of the affected persons are dead within the first 30 days. Survivors of ruptured IAs are often left with substantial disability. Thus, primary prevention of aneurysm formation and rupture is of paramount importance. Prior studies indicate that genetic factors are important in the formation and rupture of IAs. The long-term goal of the Familial Intracranial Aneurysm (FIA Study is to identify genes that underlie the development and rupture of intracranial aneurysms (IA. Methods/Design The FIA Study includes 26 clinical centers which have extensive experience in the clinical management and imaging of intracerebral aneurysms. 475 families with affected sib pairs or with multiple affected relatives will be enrolled through retrospective and prospective screening of potential subjects with an IA. After giving informed consent, the proband or their spokesperson invites other family members to participate. Each participant is interviewed using a standardized questionnaire which covers medical history, social history and demographic information. In addition blood is drawn from each participant for DNA isolation and immortalization of lymphocytes. High- risk family members without a previously diagnosed IA undergo magnetic resonance angiography (MRA to identify asymptomatic unruptured aneurysms. A 10 cM genome screen will be performed to identify FIA susceptibility loci. Due to the significant mortality of affected individuals, novel approaches are employed to reconstruct the genotype of critical deceased individuals. These include the intensive recruitment of the spouse and children of deceased, affected individuals. Discussion A successful, adequately-powered genetic linkage study of IA is challenging given the very high, early mortality of ruptured IA. Design features in the FIA Study

  7. Protocol for "Academic interventions for children and students with low socioeconomic status: A systematic review"

    DEFF Research Database (Denmark)

    Bøg, Martin; Dietrichson, Jens; Filges, Trine

    This protocol describes the outline for a systematic review of interventions intended to improve the educational achievement of children and students from families that have low socioeconomic status (SES) in terms of for example parental income, parental education, and/or paren-tal occupation...

  8. SIMULATION STUDY AND IMPLEMENTATION ON ROUTING PROTOCOLS IN MANET

    Directory of Open Access Journals (Sweden)

    Anju Yadav

    2012-09-01

    Full Text Available Ad-hoc networks are characterized by a lack of infrastructure, and by a random and quickly changing network topology; thus the need for a robust dynamic routing protocol that can accommodate such an environment. Consequently, many routing algorithms have come in toexistence to satisfy the needs of communications in such networks. This article presents a simulation study and comparison the performance between two categories of routing protocols, table-driven (Proactive and on-demand (Reactive routing protocols, this two categories were illustrated by using two different examples ofrouting protocols, first example is DSDV (Destination Sequenced Distance-Vector from the Proactive family and the second example isAODV (Ad Hoc On-Demand Distance Vector and DSR (Dynamic Source Routing Protocol from the Reactive family. Both protocols weresimulated by using NS-2 (network simulator-2 package. Both routing protocols were compared in terms of average throughput (packets delivery ratio while varying data rate, TCP types ,maximumpackets in queue and number of packet drop while varying data rate by using the Trace file. For the same queue length DSDV performsbetter than AODV. AODV is preferred due to its more efficient use of bandwidth.

  9. Partner randomized controlled trial: study protocol and coaching intervention

    Directory of Open Access Journals (Sweden)

    Garbutt Jane M

    2012-04-01

    Full Text Available Abstract Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1 effective use of controller medications, 2 effective use of rescue medications and 3 monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1 the child's asthma control score, 2 the parent's quality of life score, and 3 the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications

  10. Adapting a rapid river assessment protocols to be used by elementary school children

    Directory of Open Access Journals (Sweden)

    Guilherme Malafaia

    2012-12-01

    Full Text Available The present study aimed to adapt a rapid river assessment protocols (RAP to be used by elementary school children. The study was conducted in Ipameri, GO and the RAP was adapted for the evaluation of streams in the Cerrado biome. Based on two protocol models, the developed RAP included: physical parameters that affect the functioning of streams, language adapted to the educational level of elementary school and the presence of drawings that could facilitate the field application of RAP by the students. For consolidation of the adapted instrument, it was offered a monitoring workshop to 95 students from two public education institutions, and developed an analysis and interpretation of the pattern of responses obtained during the practical step of the workshop. The Bartlett and Levene tests revealed no statistical differences between the response patterns of the students, allowing to infer that the developed RAP was understandable by the evaluators. The application of the RAP was fast (20 to 40 minutes and the students reported that the developed instrument helped them to familiarize with environmental issues. In addition, the monitoring workshop helped them to understand the instrument and the available illustrations facilitated the field evaluation. In addition, the students concluded that they have become aware of the issues related to the water resource preservation and also that participation in the environmental monitoring workshop allowed the appropriation of knowledge about the river system functioning. It was concluded that adapted RAP has been proved to be a useful and interesting tool for using in environmental education projects and programs.

  11. European study protocol: `Effect of short-term changes in urban air pollution on the respiratory health of children with chronic respiratory symptoms. The PEACE project, Pollution Effects on Asthmatic Children in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W.; Hoek, G.; Brunekreef, B. [Wageningen Univ. (Netherlands). Dept. of Epidemiology and Public Health] [and others

    1995-12-31

    Over the last decades, concentrations of air pollution components such as SO{sub 2} and airborne, coarse particulates have decreased in many areas in Europe. This decrease can be ascribed to emission abatement measures and changes in energy production for industrial processes and space heating. Levels of other pollutants such as NO{sub 2} have increased during the same period, mostly due to higher intensity of motor vehicle traffic. Older epidemiologic studies on health effects of air pollution used indicator pollutants such as SO{sub 2}, Total Suspended Particulate matter (TSP) and Black Smoke at extremely high levels. More recent studies using the same and other indicators such as PM10 (particles with a median aerodynamic diameter of 10 {mu}m) have shown effects of air pollution on mortality and morbidity at lower levels, even sometimes lower than current WHO air quality guidelines for Europe. These findings suggest that due to the changing composition of air pollution, effects of air pollution can be seen below levels of exposure which were thought to be safe. Another reason is that the recent studies are conducted at levels which were hard to find in earlier days. Therefore new, quantitative data are needed to evaluate the current guidelines and standards. In order to achieve this, standardization of methodology as well as the execution of epidemiologic studies using such standardized methodology is needed. In the framework of the ENVIRONMENT Research Programme of the Commission of the European Communities, a collaborative study was funded that sought to develop a standardized methodology for epidemiologic studies of effects short-term changes in air pollution on the respiratory system

  12. Protocols for Late Maxillary Protraction in Cleft Lip and Palate Patients at Childrens Hospital Los Angeles

    Science.gov (United States)

    Yen, Stephen L-K

    2011-01-01

    This paper describes the protocols used at Childrens Hospital Los Angeles (CHLA) to protract the maxilla during early adolescence. It is a modification of techniques introduced by Eric Liou with his Alternate Rapid Maxillary Expansion and Constriction (ALT-RAMEC) technique. The main differences between the CHLA protocol and previous maxillary protraction protocols are the age the protraction is attempted, the sutural loosening by alternating weekly expansion with constriction and the use of Class III elastics to support and redirect the protraction by nightly facemask wear. The CHLA protocol entirely depends on patient compliance and must be carefully taught and monitored. In a cooperative patient, the technique can correct a Class III malocclusion that previously would have been treated with LeFort 1 maxillary advancement surgery. Thus, it is not appropriate for patients requiring 2 jaw surgeries to correct mandibular prognathism, occlusal cants or facial asymmetry. The maxillary protraction appears to work by a combination of skeletal advancement, dental compensation and rotation of the occlusal planes. Microscrew/microimplant/temporary anchorage devices have been used with these maxillary protraction protocols to assist in expanding the maxilla, increasing skeletal anchorage during protraction, limiting dental compensations and reducing skeletal relapse. PMID:21765629

  13. Air pollution and respiratory health of children: the PEACE panel study in Umea., Sweden.

    NARCIS (Netherlands)

    Forsberg, B.; Segerstedt, B.; Stjernberg, N.; Roemer, W.

    1998-01-01

    The Pollution Effects on Asthmatic Children in Europe (PEACE) study examined the acute effects of short-term changes in air pollution on symptomatic children. We were one of 14 research centres in Europe that used a common study protocol. Seventy five children in an urban panel and 72 children in a

  14. Standardisation of Study Protocols - Pros and Cons.

    Science.gov (United States)

    D'Haens, Geert

    2016-09-01

    Designing clinical trials in inflammatory bowel diseases is challenging. Composite scores that have been used for drug approval until recently such as the Crohn's disease activity index (CDAI) and the Mayo score for ulcerative colitis have been criticized by regulatory bodies for its lack of validation, poor correlation with objective mucosal disease and absence of 'patient reported outcomes'.Most drug development programs use the 'classic 'separation' between an induction and a maintenance phase. Challenging issues are the 'ideal timing' of the primary endpoint for induction and maintenance studies, strategies to reduce placebo response rates and rules for corticosteroids withdrawal. Discussion about which patients to re-randomize after induction into the maintenance phase of the study is critical.Presently, new instruments for disease assessment in IBD are being developed and validated. Central (independent) review of endoscopic recordings at screening and at the end of the intervention will probably become standard. Finally, the most optimal trial design for every individual intervention is likely to depend on the mechanism of action of the medication under study.

  15. Investigating the validity of a structured interview protocol for assessing the preferences of children with autism spectrum disorders

    NARCIS (Netherlands)

    Verschuur, R.; Didden, H.C.M.; Meer, L. van der; Achmadi, D.; Kagohara, D.; Green, V.A.; Lang, R.; Lancioni, G.E.

    2011-01-01

    PURPOSE: To investigate the congruent validity of a structured interview protocol for assessing the preferences of seven children with autism spectrum disorder (ASD). METHOD: Using the structured interview protocol described by Green et al., parents were asked to provide a rank ordering of their chi

  16. A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: study protocol

    Directory of Open Access Journals (Sweden)

    Fletcher Amanda

    2010-04-01

    Full Text Available Abstract Background Inadequate fruit and vegetable consumption in childhood increases the risk of developing chronic disease. Despite this, a substantial proportion of children in developed nations, including Australia, do not consume sufficient quantities of fruits and vegetables. Parents are influential in the development of dietary habits of young children but often lack the necessary knowledge and skills to promote healthy eating in their children. The aim of this study is to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption of their 3- to 5-year-old children. Methods/Design The study, conducted in the Hunter region of New South Wales, Australia, employs a cluster randomised controlled trial design. Two hundred parents from 15 randomly selected preschools will be randomised to receive the intervention, which consists of print resources and four weekly 30-minute telephone support calls delivered by trained telephone interviewers. The calls will assist parents to increase the availability and accessibility of fruit and vegetables in the home, create supportive family eating routines and role-model fruit and vegetable consumption. A further two hundred parents will be randomly allocated to the control group and will receive printed nutrition information only. The primary outcome of the trial will be the change in the child's consumption of fruit and vegetables as measured by the fruit and vegetable subscale of the Children's Dietary Questionnaire. Pre-intervention and post-intervention parent surveys will be administered over the telephone. Baseline surveys will occur one to two weeks prior to intervention delivery, with follow-up data collection calls occurring two, six, 12 and 18 months following baseline data collection. Discussion If effective, this telephone-based intervention may represent a promising public health strategy to increase fruit and vegetable consumption in

  17. 'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Veldhuis Lydian

    2009-06-01

    Full Text Available Abstract Background The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence of overweight and health behaviour among children. Methods and design A cluster randomised controlled trial is conducted among 5-year-old children included by 44 Youth Health Care teams randomised within 9 Municipal Health Services. The teams are randomly allocated to the intervention or control group. The teams measure the weight and height of all children. When a child in the intervention group is detected with overweight according to the international age and gender specific cut-off points of BMI, the prevention protocol is applied. According to this protocol parents of overweight children are invited for up to three counselling sessions during which they receive personal advice about a healthy lifestyle, and are motivated for and assisted in behavioural change. The primary outcome measures are Body Mass Index and waist circumference of the children. Parents will complete questionnaires to assess secondary outcome measures: levels of overweight inducing/reducing behaviours (i.e. being physically active, having breakfast, drinking sweet beverages and watching television/playing computer games, parenting styles, parenting practices, and attitudes of parents regarding these behaviours, health-related quality of life of the children, and possible negative side effects of the prevention protocol. Data will be collected at baseline (when the children are aged 5 years, and after 12 and 24 months of follow-up. Additionally, a process and a cost-effectiveness evaluation will be conducted. Discussion In this study called 'Be active, eat right' we evaluate an overweight prevention protocol for use in the setting of Youth Health Care. It is hypothesized that the

  18. The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

    Directory of Open Access Journals (Sweden)

    Freitag Christine M

    2013-01-01

    Full Text Available Abstract Background Group-based social skills training (SST has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD. To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS compared to treatment as usual (TAU. It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

  19. Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols

    NARCIS (Netherlands)

    Fudalej, P.S.; Katsaros, C.; Bongaarts, C.; Dudkiewicz, Z.; Kuijpers-Jagtman, A.M.

    2011-01-01

    The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft

  20. Studies on Algorithms for Self-Stabilizing Communication Protocols

    Institute of Scientific and Technical Information of China (English)

    LI Layuan; LI Chunlin

    1999-01-01

    In this paper the algorithms forself-stabilizing communication protocols are studied. First someconcepts and a formal method for describing the proposed algorithms aredescribed, then an improved algorithm for achieving global states ispresented. Thestudy shows that the improved algorithm can be applied to obtain the globalstates in the case of a loss of cooperation of the different processesin the protocol, which can be used as a recovery point that will be usedby the following recovery procedure. Thus, the improved algorithm can beused to self-stabilize a communication protocol. Meanwhile,a recovery algorithm for self-stabilizing communicationprotocols is presented. After a failure is detected, all processes caneventuallyknow the error. The recovery algorithm uses the contextual information exchanged during the progress of the protocol and recorded on the stablememory. The proof of correctness and analysis of complexity for these algorithms have been made. The availability and efficiency of the algorithms have been verified by illustrating the example protocols.Finally, some conclusions and remarks are given.

  1. Randomized control study on two different protocols of ketogenic diet for refractory epilepsy in children%两种生酮饮食方案治疗儿童难治性癫(癎)的随机对照研究

    Institute of Scientific and Technical Information of China (English)

    胡雁; 路新国; 文家伦; 王春; 陈黎; 陈彦; 廖建湘

    2012-01-01

    目的 评估按需和按时服用生酮饮食(ketogenic diet,KD)两种方案的疗效和安全性.方法 采用随机数字表法将60例难治性癫(癎)患儿随机分成按需服用KD组和按时服用KD组,每组30例.全量服用KD后连续72 h每6小时监测血酮、血糖和尿酮,比较两组患儿酮症状态的稳定性.记录发作频率并确定起效时间,分别在治疗后4周、12周、24周、48周评估两组患儿的疗效及安全性.结果 治疗4周后,按需服用KD组与按时服用KD组发作完全缓解率分别为33.3% (10/30)与30.0% (9/30),两组疗效相当(P>0.05).按需服用KD组治疗有效病例平均起效时间为(6.18±2.42)d,而按时服用KD组有效病例平均起效时间为(8.63±2.63)d,两组比较差异有统计学意义(P<0.05).治疗后12周、24周和48周,按需服用KD组发作完全缓解率分别为30.0%(9/30)、34.8%(8/23)和36.8% (7/19);按时服用KD组发作完全缓解率分别为33.3% (10/30)、30.4% (7/23)和44.4% (8/18),两组比较差异无统计学意义(P>0.05).1年后,按需服用KD组和按时服用KD组治疗保留率分别为63.3% (19/30)与60.0% (18/30),两组比较差异无统计学意义(P>0.05).治疗过程中,按需服用KD组与按时服用KD组的不良反应主要为可治疗的胃肠道反应和代谢紊乱.结论 按需服用KD和按时服用KD两种治疗方案均基本安全有效,按需服用方案更易达到酮症状态,起效更迅速,较易被患儿接受.因此在临床实施过程中可根据患儿的饮食习惯,灵活安排进食时间以提高治疗的依从性.%Objective To assess the efficacy and safety of two different protocols of ketogenic diet (KD)-eating on demand or eating at regular intervals for refractory epilepsy in children.Methods Sixty children with refractory epilepsy were randomly divided into eating on demand group (n =30) and eating at regular intervals group (n =30) by random number table method.After taking the whole amount of

  2. Gastric emptying scintigraphy results in children are affected by age, anthropometric factors, and study duration

    Science.gov (United States)

    A standardized 4-hour adult-based gastric emptying scintigraphy (GES) protocol is increasingly being used in children to evaluate for gastroparesis. We sought to determine the effect of age, anthropometrics, and study duration on GES results using this protocol in children. Retrospective review of c...

  3. MR spectroscopy in children: protocols and pitfalls in non-tumorous brain pathology

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Jacques F. [University Children' s Hospital Basel (UKBB), Basel (Switzerland)

    2016-06-15

    Proton nuclear magnetic resonance spectroscopy (MRS) delivers information about cell content and metabolism in a noninvasive manner. The diagnostic strength of MRS lies in its evaluation of pathologies in combination with conventional magnetic resonance imaging (MRI). MRS in children has been most widely used to evaluate brain conditions like tumors, infections, metabolic diseases or learning disabilities and especially in neonates with hypoxic-ischemic encephalopathy. This article reviews some basic theoretical considerations, routine procedures, protocols and pitfalls and will illustrate the range of spectrum alterations occurring in some non-tumorous pediatric brain pathologies. (orig.)

  4. Characterisation of exposure to non-ionising electromagnetic fields in the Spanish INMA birth cohort: Study protocol

    NARCIS (Netherlands)

    M. Gallastegi (Mara); M. Guxens (Mònica ); A. Jiménez-Zabala (Ana); I. Calvente (Irene); M. Fernández (Marta); L. Birks (Laura); B. Struchen (Benjamin); M. Vrijheid (Martine); M. Estarlich (Marisa); M.F. Fernandez (Mariana); M. Torrent (Maties); F. Ballester (Ferran); J.J. Aurrekoetxea (Juan José); J. Ibarluzea (Jesús); D. Guerra (David); J. González (Julián); M. Röösli (Martin); L. Santa-Marina (Loreto)

    2016-01-01

    textabstractBackground: Analysis of the association between exposure to electromagnetic fields of non-ionising radiation (EMF-NIR) and health in children and adolescents is hindered by the limited availability of data, mainly due to the difficulties on the exposure assessment. This study protocol de

  5. THE EFFECTS OF A STRETCH-SHORTENING CYCLE FATIGUE PROTOCOL ON KNEE KINEMATICS DURING RUNNING IN UNTRAINED CHILDREN

    Directory of Open Access Journals (Sweden)

    Tsatalas T

    2010-06-01

    Full Text Available The purpose of the current study was to examine the effects of an intensive stretch shortening-cycle (SSC protocol (100 plyometric jumps on knee kinematics during running on a treadmill in healthy children using 3D kinematics. Twelve healthy and untrained children volunteered. Their mean + age, height and weight was 10,1±0,5 years, 142± 6,1 cm and 37 ±4,6kg, respectively. Muscle damage of lower extremities was caused by 100 maximal intensity plyometric jumps performed as 10 sets of 10 continuous jumps with a 30 second restperiod between sets. Muscle damage indicators [delayed onset muscle soreness (DOMS, knee-joint flexion/extension angles during running on a treadmill (speed at 2.8 m/s] were assessed pre-, 0h, 24h, 48h and 72h post exercise. Kinematic data were captured at 100 Hz using a six-camera 3D motion analysis system (VICON 612. Repeated measures one-way ANOVA with five levels were utilised for the parameters. Allmuscle damage indicators revealed significant changes post- compared to pre-exercise data (p<0.05. Kinematic analysis revealed that the 100 plyometric jumps decreased knee-joint angles at different phases of stance (impact, support, push-off phase. These changes were more evident just after (0h the protocol and 48h after this, and remained till 72h post at a great extent (p<0.05. Lastly, children suffered from delayed muscle soreness on their thigh muscles which remained only 24 hours after this (p<0.05. Muscle damage causesalterations in treadmill running in knee kinematics of untrained children probable due to differentiation of their central nervous system running strategy

  6. Treatment and long-term results in children with acute myeloid leukaemia treated according to the AIEOP AML protocols.

    Science.gov (United States)

    Pession, A; Rondelli, R; Basso, G; Rizzari, C; Testi, A M; Fagioli, F; De Stefano, P; Locatelli, F

    2005-12-01

    Since 1982, four consecutive studies on childhood acute myeloid leukaemia (AML) (namely LAM-82, -87, -87M and -92) have been conducted in Italy by the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP) group. The induction therapy of the first three studies consisted of daunorubicin and cytarabine structured in a 3+7 backbone. In the most recent protocol (LAM92), patients received two induction courses including idarubicin, cytarabine and etoposide. Patients with acute promyelocytic leukaemia (20% of diagnoses) were included in LAM-87 and 87M studies. Postremissional therapy significantly changed over time, with an ever-increasing role given to stem cell transplantation (SCT). The long-term outcome of patients enrolled in the LAM-82, 87 and 87M studies was comparable, whereas that of children treated according to LAM-92 study was significantly better (P<0.005). Either allogeneic or autologous SCT was employed as consolidation therapy in more than 75% of cases enrolled in this latter study. Patients enrolled in the LAM-92 study were stratified in standard and high-risk groups with different outcome (67 vs 47%, respectively, P=0.04). Altogether, the results obtained in these four studies have permitted a progressive refinement of treatment, contributing to the structure of the ongoing LAM-2002 protocol that stratifies patients according to the presence of definite genetic anomalies and response to induction therapy.

  7. The Introduction of a Protocol for the Use of Biobrane for Facial Burns in Children

    Directory of Open Access Journals (Sweden)

    A. D. Rogers

    2011-01-01

    Full Text Available Biobrane has become an indispensible dressing with three established indications in acute burns care at our institution: (1 as the definitive dressing of superficial partial thickness facial burns, (2 after tangential excision of deep burns when autograft or cadaver skin is unavailable, and (3 for graft reduction. This paper details our initial experience of Biobrane for the management of superficial partial thickness facial burns in children and the protocol that was compiled for its optimal use. A retrospective analysis of theatre records, case notes and photographs was performed to evaluate our experience with Biobrane over a one-year period. Endpoints included length of stay, analgesic requirements, time to application of Biobrane, healing times, and aesthetic results. Historical controls were used to compare the results with our previous standard of care. 87 patients with superficial partial thickness burns of the face had Biobrane applied during this period. By adhering to the protocol we were able to demonstrate significant reductions in hospital stay, healing time, analgesic requirements, nursing care, with excellent cosmetic results. The protocol is widely accepted by all involved in the optimal management of these patients, including parents, anaesthetists, and nursing staff.

  8. Taking Action Together: A YMCA-based protocol to prevent Type-2 Diabetes in high-BMI inner-city African American children

    Directory of Open Access Journals (Sweden)

    Mitchell Rita A

    2010-05-01

    Full Text Available Abstract Background Associated with a tripling in obesity since 1970, type 2 diabetes mellitus (T2DM in children has risen 9-10 fold. There is a critical need of protocols for trials to prevent T2DM in children. Methods/Design This protocol includes the theory, development, evaluation components and lessons learned from a novel YMCA-based T2DM prevention intervention designed specifically for high-BMI African American children from disadvantaged, inner-city neighborhoods of Oakland, California. The intervention was developed on the basis of: review of epidemiological and intervention studies of pediatric T2DM; a conceptual theory (social cognitive; a comprehensive examination of health promotion curricula designed for children; consultation with research, clinical experts and practitioners and; input from community partners. The intervention, Taking Action Together, included culturally sensitive and age-appropriate programming on: healthy eating; increasing physical activity and, improving self esteem. Discussion Evaluations completed to date suggest that Taking Action Together may be an effective intervention, and results warrant an expanded evaluation effort. This protocol could be used in other community settings to reduce the risk of children developing T2DM and related health consequences. Trial registration ClinicalTrials.gov NCT01039116.

  9. Studies in children.

    Science.gov (United States)

    Perera, Frederica P; Edwards, Susan C

    2011-01-01

    This chapter first discusses the urgent need for prevention of childhood diseases that impose a huge and growing burden on families and society. It provides a review of recent research in this area to illustrate both the strengths and limitations of molecular epidemiology in drawing needed links between environmental exposures and illness in children. For illustration, three of the major diseases in children are discussed: asthma, cancer and developmental disorders. All three impose significant difficulties, have increased in recent decades, and are thought to be caused in substantial part by environmental factors, such as toxic exposures due to lifestyle choices (i.e. smoking and diet), pollutants in the workplace, ambient air, water and the food supply. These exogenous exposures can interact with "host" factors, such as genetic susceptibility and nutritional deficits, to cause disease. Molecular epidemiology has provided valuable new insights into the magnitude and diversity of exposures beginning in utero, the unique susceptibility of the young, and the adverse preclinical and clinical effects resulting from the interactions between these factors. However, molecular epidemiology also faces certain constraints and challenges that are specific to studies of the very young, including ethical issues, technical issues due to the limited amount of biological specimens that can be obtained, and communication of results to parents and communities. These challenges are particularly apparent when incorporating the newer epigenetic and "omic" techniques and biomarkers into studies of children's diseases.

  10. Lingual orthodontics for children and adolescents: improvement of the indirect bonding protocol

    Science.gov (United States)

    2013-01-01

    Introduction Demineralization of the dental enamel is a finding associated with fixed orthodontic treatment. When an indirect bonding procedure is used in children and adolescents the area beneath the bracket base may be affected. Aim To evaluate if the addition of an extra layer of a hydrophilic resin, to a conventional indirect bonding protocol, can reduce the incidence of demineralization beneath the bracket base. Methods 40 patients under 18 years of age were treated with completely customized lingual appliances. Two different bonding protocols were used either with or without the application of an additional layer of hydrophilic resin. Demineralization beneath the bracket base, after de-bonding, was evaluated by standardized intra-oral photographs. Results The addition of an extra layer of a hydrophilic resin helps to reduce the number of demineralized areas beneath the bracket bases significantly (three times less). The severity of the few remaining defects were minor and without any clinical consequence. Conclusion When bonding a completely customized lingual appliance in children and adolescents, an extra layer of a hydrophilic resin should be added to the teeth. PMID:24025345

  11. The Cost-Effectiveness of an Intensive Treatment Protocol for Severe Dyslexia in Children

    Science.gov (United States)

    Hakkaart-van Roijen, Leona; Goettsch, Wim G.; Ekkebus, Michel; Gerretsen, Patty; Stolk, Elly A.

    2011-01-01

    Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued…

  12. Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic

    DEFF Research Database (Denmark)

    Most, Sebastian W; Højgaard, Birgitte; Teilmann, Grete Katrine

    2015-01-01

    BACKGROUND: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol. METHODS: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th......, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time. CONCLUSIONS: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time...

  13. Boosting bioluminescence neuroimaging: an optimized protocol for brain studies.

    Science.gov (United States)

    Aswendt, Markus; Adamczak, Joanna; Couillard-Despres, Sebastien; Hoehn, Mathias

    2013-01-01

    Bioluminescence imaging is widely used for optical cell tracking approaches. However, reliable and quantitative bioluminescence of transplanted cells in the brain is highly challenging. In this study we established a new bioluminescence imaging protocol dedicated for neuroimaging, which increases sensitivity especially for noninvasive tracking of brain cell grafts. Different D-Luciferin concentrations (15, 150, 300 and 750 mg/kg), injection routes (i.v., i.p., s.c.), types of anesthesia (Isoflurane, Ketamine/Xylazine, Pentobarbital) and timing of injection were compared using DCX-Luc transgenic mice for brain specific bioluminescence. Luciferase kinetics was quantitatively evaluated for maximal photon emission, total photon emission and time-to-peak. Photon emission followed a D-Luciferin dose-dependent relation without saturation, but with delay in time-to-peak increasing for increasing concentrations. The comparison of intravenous, subcutaneous and intraperitoneal substrate injection reflects expected pharmacokinetics with fastest and highest photon emission for intravenous administration. Ketamine/Xylazine and Pentobarbital anesthesia showed no significant beneficial effect on maximal photon emission. However, a strong difference in outcome was observed by injecting the substrate pre Isoflurane anesthesia. This protocol optimization for brain specific bioluminescence imaging comprises injection of 300 mg/kg D-Luciferin pre Isoflurane anesthesia as an efficient and stable method with a signal gain of approx. 200% (compared to 150 mg/kg post Isoflurane). Gain in sensitivity by the novel imaging protocol was quantitatively assessed by signal-to-noise calculations of luciferase-expressing neural stem cells grafted into mouse brains (transplantation of 3,000-300,000 cells). The optimized imaging protocol lowered the detection limit from 6,000 to 3,000 cells by a gain in signal-to-noise ratio.

  14. 'You are Okay': A support and educational program for children with mild intellectual disability and their parents with a mental illness: study protocol of a quasi-experimental design

    NARCIS (Netherlands)

    Riemersma, I.; Santvoort, F. van; Janssens, J.M.A.M.; Hosman, C.M.H.; Doesum, K.T.M. van

    2015-01-01

    Background: Children of parents with a mental illness or substance use disorder (COPMI) have an increased risk of developing social-emotional problems themselves. Fear of stigmatisation or unawareness of problems prevents children and parents from understanding each other. Little is known about COPM

  15. "Young people, adult worries": RCT of an internet-based self-support method "Feel the ViBe" for children, adolescents and young adults exposed to family violence, a study protocol

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A.W.L.; Prins, J.B.; Vergeer, M.; Wong, S.H.; Lagro-Janssen, A.L.M.

    2013-01-01

    BACKGROUND: Violence in families affects children. Exposure to violence is seen as child abuse. Figures show that about one third of children exposed to violence become victim or perpetrator in their adult life: known as intergenerational transmission. Violence also affects sexual and reproductive h

  16. Rorschach Responses of Sexually Abused Children: An Exploratory Study.

    Science.gov (United States)

    Clinton, Gregory T.; Jenkins-Monroe, Valata

    1994-01-01

    Using archival data, this study compared Rorschach protocols of 94 sexually abused children to the Exner norms in order to determine the potential usefulness of the Rorschach test in the area of child abuse assessment and treatment. Of the 18 Rorschach variables studied, 17 significantly distinguished at least one subject group from the norms.…

  17. A comparative study of protocols for secure quantum communication under noisy environment: single-qubit-based protocols versus entangled-state-based protocols

    Science.gov (United States)

    Sharma, Vishal; Thapliyal, Kishore; Pathak, Anirban; Banerjee, Subhashish

    2016-11-01

    The effect of noise on various protocols of secure quantum communication has been studied. Specifically, we have investigated the effect of amplitude damping, phase damping, squeezed generalized amplitude damping, Pauli type as well as various collective noise models on the protocols of quantum key distribution, quantum key agreement, quantum secure direct quantum communication and quantum dialogue. From each type of protocol of secure quantum communication, we have chosen two protocols for our comparative study: one based on single-qubit states and the other one on entangled states. The comparative study reported here has revealed that single-qubit-based schemes are generally found to perform better in the presence of amplitude damping, phase damping, squeezed generalized amplitude damping noises, while entanglement-based protocols turn out to be preferable in the presence of collective noises. It is also observed that the effect of noise depends upon the number of rounds of quantum communication involved in a scheme of quantum communication. Further, it is observed that squeezing, a completely quantum mechanical resource present in the squeezed generalized amplitude channel, can be used in a beneficial way as it may yield higher fidelity compared to the corresponding zero squeezing case.

  18. Efficacy of smoking prevention program 'Smoke-free Kids': study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Schayck Onno CP

    2009-12-01

    Full Text Available Abstract Background A strong increase in smoking is noted especially among adolescents. In the Netherlands, about 5% of all 10-year olds, 25% of all 13-year olds and 62% of all 17-year olds report ever smoking. In the U.S., an intervention program called 'Smoke-free Kids' was developed to prevent children from smoking. The present study aims to assess the effects of this home-based smoking prevention program in the Netherlands. Methods/Design A randomized controlled trial is conducted among 9 to 11-year old children of primary schools. Participants are randomly assigned to the intervention and control conditions. The intervention program consists of five printed activity modules designed to improve parenting skills specific to smoking prevention and parent-child communication regarding smoking. These modules will include additional sheets with communication tips. The modules for the control condition will include solely information on smoking and tobacco use. Initiation of cigarette smoking (first instance of puffing on a lighted cigarette, susceptibility to cigarette smoking, smoking-related cognitions, and anti-smoking socialization will be the outcome measures. To collect the data, telephone interviews with mothers as well as with their child will be conducted at baseline. Only the children will be examined at post-intervention follow-ups (6, 12, 24, and 36 months after the baseline. Discussion This study protocol describes the design of a randomized controlled trial that will evaluate the effectiveness of a home-based smoking prevention program. We expect that a significantly lower number of children will start smoking in the intervention condition compared to control condition as a direct result of this intervention. If the program is effective, it is applicable in daily live, which will facilitate implementation of the prevention protocol. Trial registration Netherlands Trial Register NTR1465

  19. An improved pyrite pretreatment protocol for kinetic and isotopic studies

    Science.gov (United States)

    Mirzoyan, Natella; Kamyshny, Alexey; Halevy, Itay

    2014-05-01

    An improved pyrite pretreatment protocol for kinetic and isotopic studies Natella Mirzoyan1, Alexey Kamyshny Jr.2, Itay Halevy1 1Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel 2Geological and Environmental Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel Pyrite is one of the most abundant and widespread of the sulfide minerals with a central role in biogeochemical cycles of iron and sulfur. Due to its diverse roles in the natural and anthropogenic sulfur cycle, pyrite has been extensively studied in various experimental investigations of the kinetics of its dissolution and oxidation, the isotopic fractionations associated with these reactions, and the microbiological processes involved. Pretreatment of pyrite for removal of oxidation impurities to prevent experimental artifacts and inaccuracies is often practiced. While numerous pyrite-cleaning methods have been used in experiments, a common pyrite pretreatment method, often used to investigate pyrite chemistry by the isotopic fractionations associated with it, includes several rinses by HCl, acetone and deionized water. Elemental sulfur (S0) is a common product of incomplete pyrite oxidation. Removal of S0 is desirable to avoid experimental biases associated with its participation in pyrite transformations, but is more complicated than the removal of sulfate. Although rinsing with an organic solvent is in part aimed at removing S0, to the best of our knowledge, the extraction efficiency of S0 in existing protocols has not been assessed. We have developed and tested a new protocol for elemental sulfur removal from the surface of pyrite by ultrasonication with warm acetone. Our data demonstrate the presence of large fractions of S0 on untreated pyrite particle surfaces, of which only approximately 60% was removed by the commonly used pretreatment method. The new protocol described here was found to be more efficient at S0 removal than the commonly used method

  20. The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9-13 years of age: study protocol for a two-armed cluster randomized controlled trial

    NARCIS (Netherlands)

    Ruiter, E.L.M.; Fransen, G.A.J.; Molleman, G.R.M.; Velden, K. van der; R.C.E.M. Engels,

    2015-01-01

    BACKGROUND: Although parental support is an important component in overweight prevention programs for children, current programs pay remarkably little attention to the role of parenting. To close this gap, we developed a web-based parenting program for parents entitled "Making a healthy deal with yo

  1. Comparison Study of Transmission Control Protocol and User Datagram Protocol Behavior over Multi-Protocol Label Switching Networks in Case of Failures

    Directory of Open Access Journals (Sweden)

    Taha A.A Radaei

    2009-01-01

    Full Text Available Problem statement: In only a few years, Multi-Protocol Label Switching (MPLS has evolved from an exotic technology to a mainstream tool used by service providers to create revenue-generating services. MPLS provides a high reliable Label Switched Path (LSP. MPLS failures may degrade the reliability of the MPLS networks. Approach: For that reason, many studies have been conducted to keep the high reliability and survivability of the MPLS networks. Unlike User Datagram Protocol (UDP, Transmission Control Protocol does not perform well in case of like-failure of MPLS networks because of its inability to distinguish packet loss due to link-failure. After the recovery time, TCP takes longer time than UDP to continue as it was before the failure. Results: In terms of packet loss, TCP performs better than UDP. However, the receiving rate of the TCP traffic is much worse than UDP traffic. A need for a mechanism to improve the behavior of TCP after a link failure is needed. This study focused on comparing the behavior of different types TCP as well as UDP traffic over MPLS networks in case of link, node or congestion failures. Conclusion: Although extensions of RSVP-TE protocol support fast recovery mechanism of MPLS networks, the behavior of TCP will be affected during recovery time much more than with UDP.

  2. Study and Improvement of WTLS Protocol in WAP

    Institute of Scientific and Technical Information of China (English)

    CHEN Kai; LIU Ying; XIAO Guozhen

    2001-01-01

    Wireless application protocol (WAP)is a set of protocol designed for mobile terminal toconnect to Internet and is likely to become world stan-dard. Wireless transport layer security (WTLS) incor-porates the security features in WAP. In this paper,the analysis of the performance of WTLS is made.Two improvement schemes on WTLS are given: oneis that the client stores the certificate of servers; theother is that a new WTLS protocol is proposed basedon the designed authentication scheme.

  3. Recommended Protocol for Round Robin Studies in Additive Manufacturing

    Science.gov (United States)

    Moylan, Shawn; Brown, Christopher U.; Slotwinski, John

    2016-01-01

    One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST’s experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed. PMID:27274602

  4. Recommended Protocol for Round Robin Studies in Additive Manufacturing.

    Science.gov (United States)

    Moylan, Shawn; Brown, Christopher U; Slotwinski, John

    2016-03-01

    One way to improve confidence and encourage proliferation of additive manufacturing (AM) technologies and parts is by generating more high quality data describing the performance of AM processes and parts. Many in the AM community see round robin studies as a way to generate large data sets while distributing the cost among the participants, thereby reducing the cost to individual users. The National Institute of Standards and Technology (NIST) has conducted and participated in several of these AM round robin studies. While the results of these studies are interesting and informative, many of the lessons learned in conducting these studies concern the logistics and methods of the study and unique issues presented by AM. Existing standards for conducting interlaboratory studies of measurement methods, along with NIST's experience, form the basis for recommended protocols for conducting AM round robin studies. The role of round robin studies in AM qualification, some of the limitations of round robin studies, and the potential benefit of less formal collaborative experiments where multiple factors, AM machine being only one, are varied simultaneously are also discussed.

  5. Enhancing the early home learning environment through a brief group parenting intervention: study protocol for a cluster randomised controlled trial

    OpenAIRE

    2016-01-01

    Background The quality of the home learning environment has a significant influence on children’s language and communication skills during the early years with children from disadvantaged families disproportionately affected. This paper describes the protocol and participant baseline characteristics of a community-based effectiveness study. It evaluates the effects of ‘smalltalk’, a brief group parenting intervention (with or without home coaching) on the quality of the early childhood home l...

  6. Prognostic significance of flow-cytometry evaluation of minimal residual disease in children with acute myeloid leukaemia treated according to the AIEOP-AML 2002/01 study protocol.

    Science.gov (United States)

    Buldini, Barbara; Rizzati, Frida; Masetti, Riccardo; Fagioli, Franca; Menna, Giuseppe; Micalizzi, Concetta; Putti, Maria Caterina; Rizzari, Carmelo; Santoro, Nicola; Zecca, Marco; Disarò, Silvia; Rondelli, Roberto; Merli, Pietro; Pigazzi, Martina; Pession, Andrea; Locatelli, Franco; Basso, Giuseppe

    2017-04-01

    In children with acute myeloid leukaemia (AML), assessment of initial treatment response is an essential prognostic factor; methods more sensitive than morphology are still under evaluation. We report on the measurement of minimal residual disease (MRD), by multicolour flow-cytometry in one centralized laboratory, in 142 children with newly diagnosed AML enrolled in the Associazione Italiana di EmatoOncologia Pediatrica-AML 2002/01 trial. At the end of the first induction course, MRD was 1% in 51 patients. The 8-year disease-free survival (DFS) of 125 children in morphological complete remission and with MRD <0·1%, 0·1-1% and ≥1% was 73·1 ± 5·6%, 37·8 ± 12·1% and 34·1 ± 8·8%, respectively (P < 0·01). MRD was also available after the second induction course in 92/142 patients. MRD was ≥0·1% at the end of the first induction course in 36 patients; 13 reached an MRD <0·1% after the second one and their DFS was 45·4 ± 16·7% vs. 22·8 ± 8·9% in patients with persisting MRD ≥0·1% (P = 0·037). Multivariate analysis demonstrated that MRD ≥0·1% after first induction course was, together with a monosomal karyotype, an independent adverse prognostic factor for DFS. Our results show that MRD detected by flow-cytometry after induction therapy predicts outcome in patients with childhood AML and can help stratifying post-remission treatment.

  7. Type 2 diabetes in children in the Netherlands: The need for diagnostic protocols

    NARCIS (Netherlands)

    Rotteveel, J.; Belksma, E.J.; Renders, C.M.; Hirasing, R.A.; Delemarre-Van de Waal, H.A.

    2007-01-01

    Objective: The worldwide trend towards obesity in childhood is also observed in the Netherlands and one of the consequences may be type 2 diabetes. In this study, we assessed the number of children with type 2 diabetes, diagnosed by paediatricians, in the Netherlands. Methods: In 2003 and 2004 the D

  8. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept ... treatments based on what is known to work in adults. To improve clinical care of children, more ...

  9. Study protocol: The Intensive Care Outcome Network ('ICON' study

    Directory of Open Access Journals (Sweden)

    Barber Vicki S

    2008-06-01

    Full Text Available Abstract Background Extended follow-up of survivors of ICU treatment has shown many patients suffer long-term physical and psychological consequences that affect their health-related quality of life. The current lack of rigorous longitudinal studies means that the true prevalence of these physical and psychological problems remains undetermined. Methods/Design The ICON (Intensive Care Outcome Network study is a multi-centre, longitudinal study of survivors of critical illness. Patients will be recruited prior to hospital discharge from 20–30 ICUs in the UK and will be assessed at 3, 6, and 12 months following ICU discharge for health-related quality of life as measured by the Short Form-36 (SF-36 and the EuroQoL (EQ-5D; anxiety and depression as measured by the Hospital Anxiety and Depression Scale (HADS; and post traumatic stress disorder (PTSD symptoms as measured by the PTSD Civilian Checklist (PCL-C. Postal questionnaires will be used. Discussion The ICON study will create a valuable UK database detailing the prevalence of physical and psychological morbidity experienced by patients as they recover from critical illness. Knowledge of the prevalence of physical and psychological morbidity in ICU survivors is important because research to generate models of causality, prognosis and treatment effects is dependent on accurate determination of prevalence. The results will also inform economic modelling of the long-term burden of critical illness. Trial Registration ISRCTN69112866

  10. The Tehran Eye Study: research design and eye examination protocol

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    Fotouhi Akbar

    2003-07-01

    Full Text Available Abstract Background Visual impairment has a profound impact on society. The majority of visually impaired people live in developing countries, and since most disorders leading to visual impairment are preventable or curable, their control is a priority in these countries. Considering the complicated epidemiology of visual impairment and the wide variety of factors involved, region specific intervention strategies are required for every community. Therefore, providing appropriate data is one of the first steps in these communities, as it is in Iran. The objectives of this study are to describe the prevalence and causes of visual impairment in the population of Tehran city; the prevalence of refractive errors, lens opacity, ocular hypertension, and color blindness in this population, and also the familial aggregation of refractive errors, lens opacity, ocular hypertension, and color blindness within the study sample. Methods Design Through a population-based, cross-sectional study, a total of 5300 Tehran citizens will be selected from 160 clusters using a stratified cluster random sampling strategy. The eligible people will be enumerated through a door-to-door household survey in the selected clusters and will be invited. All participants will be transferred to a clinic for measurements of uncorrected, best corrected and presenting visual acuity; manifest, subjective and cycloplegic refraction; color vision test; Goldmann applanation tonometry; examination of the external eye, anterior segment, media, and fundus; and an interview about demographic characteristics and history of eye diseases, eye trauma, diabetes mellitus, high blood pressure, and ophthalmologic cares. The study design and eye examination protocol are described. Conclusion We expect that findings from the TES will show the status of visual problems and their causes in the community. This study can highlight the people who should be targeted by visual impairment prevention programs.

  11. Assessing sex-differences and the effect of timing of vaccination on immunogenicity, reactogenicity and efficacy of vaccines in young children: study protocol for an individual participant data meta-analysis of randomised controlled trials

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    Voysey, Merryn; Pollard, Andrew J; Perera, Rafael; Fanshawe, Thomas R

    2016-01-01

    Introduction Disease incidence differs between males and females for some infectious or inflammatory diseases. Sex-differences in immune responses to some vaccines have also been observed, mostly to viral vaccines in adults. Little evidence is available on whether sex-differences occur in response to immunisation in infancy even though this is the age group in which most vaccines are administered. Factors other than sex, such as timing or coadministration of other vaccines, can also influence the immune response to vaccination. Methods and analysis Individual participant data meta-analysis of randomised controlled trials of vaccines in healthy infants and young children will be conducted. Fully anonymised data from ∼170 randomised controlled trials of vaccines for diphtheria, tetanus, Bordetella pertussis, polio, Haemophilus influenzae type B, hepatitis B, Streptococcus pneumoniae, Neisseria meningitidis, measles, mumps, rubella, varicella and rotavirus will be combined for analysis. Outcomes include measures of immunogenicity (immunoglobulins), reactogenicity, safety and disease-specific clinical efficacy. Data from trials of vaccines containing similar components will be combined in hierarchical models and the effect of sex and timing of vaccinations estimated for each outcome separately. Ethics and dissemination Systematic reviews of published estimates of sex-differences cannot adequately answer questions in this field since such comparisons are never the main purpose of a clinical trial, thus a large degree of reporting bias exists in the published literature. Recent improvements in the widespread availability of individual participant data from randomised controlled trials makes it feasible to conduct extensive individual participant data meta-analyses which were previously impossible, thereby reducing the effect of publication or reporting bias on the understanding of the infant immune response. Preliminary results will be available in 2016 with final

  12. A protocol for conducting rainfall simulation to study soil runoff.

    Science.gov (United States)

    Kibet, Leonard C; Saporito, Louis S; Allen, Arthur L; May, Eric B; Kleinman, Peter J A; Hashem, Fawzy M; Bryant, Ray B

    2014-04-03

    Rainfall is a driving force for the transport of environmental contaminants from agricultural soils to surficial water bodies via surface runoff. The objective of this study was to characterize the effects of antecedent soil moisture content on the fate and transport of surface applied commercial urea, a common form of nitrogen (N) fertilizer, following a rainfall event that occurs within 24 hr after fertilizer application. Although urea is assumed to be readily hydrolyzed to ammonium and therefore not often available for transport, recent studies suggest that urea can be transported from agricultural soils to coastal waters where it is implicated in harmful algal blooms. A rainfall simulator was used to apply a consistent rate of uniform rainfall across packed soil boxes that had been prewetted to different soil moisture contents. By controlling rainfall and soil physical characteristics, the effects of antecedent soil moisture on urea loss were isolated. Wetter soils exhibited shorter time from rainfall initiation to runoff initiation, greater total volume of runoff, higher urea concentrations in runoff, and greater mass loadings of urea in runoff. These results also demonstrate the importance of controlling for antecedent soil moisture content in studies designed to isolate other variables, such as soil physical or chemical characteristics, slope, soil cover, management, or rainfall characteristics. Because rainfall simulators are designed to deliver raindrops of similar size and velocity as natural rainfall, studies conducted under a standardized protocol can yield valuable data that, in turn, can be used to develop models for predicting the fate and transport of pollutants in runoff.

  13. Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

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    Wartha, Olivia; Dreyhaupt, Jens; Lämmle, Christine; Friedemann, Eva-Maria; Kelso, Anne; Kutzner, Claire; Hermeling, Lina

    2017-01-01

    Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. PMID:28303253

  14. Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

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    Susanne Kobel

    2017-01-01

    Full Text Available Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew’s Intervention Mapping approach considering Bandura’s social-cognitive theory and Bronfenbrenner’s ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS, Freiburg University, Germany, ID: DRKS00010089.

  15. Lactobacillus reuteri DSM 17938 in the prevention of antibiotic-associated diarrhoea in children: protocol of a randomised controlled trial

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    Kołodziej, Maciej; Szajewska, Hania

    2017-01-01

    Introduction Administration of some probiotics appears to reduce the risk of antibiotic-associated diarrhoea (AAD). The effects of probiotics are strain-specific, thus, the efficacy and safety of each probiotic strain should be established separately. We aim to assess the effects of Lactobacillus reuteri DSM 17938 administration for the prevention of diarrhoea and AAD in children. Methods and analysis A total of 250 children younger than 18 years treated with antibiotics will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will additionally receive L. reuteri DSM 17938 at a dose 108 colony-forming units or an identically appearing placebo, orally, twice daily, for the entire duration of antibiotic treatment. The primary outcome measures will be the frequencies of diarrhoea and AAD. Diarrhoea will be defined according to 1 of 3 definitions: (1) ≥3 loose or watery stools per day for a minimum of 48 hours during antibiotic treatment; (2) ≥3 loose or watery stools per day for a minimum of 24 hours during antibiotic treatment; or (3) ≥2 loose or watery stools per day for a minimum of 24 hours during antibiotic treatment. AAD will be diagnosed in cases of diarrhoea, defined clinically as above, caused by Clostridium difficile or for otherwise unexplained diarrhoea (ie, negative laboratory stool tests for infectious agents). Ethics and dissemination The Bioethics Committee approved the study protocol. The findings of this trial will be submitted to a peer-reviewed paediatric journal. Abstracts will be submitted to relevant national and international conferences. Trial registration number NCT02871908. PMID:28057659

  16. Improving outpatient safety through effective electronic communication: a study protocol

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    Espadas Donna

    2009-09-01

    Full Text Available Abstract Background Health information technology and electronic medical records (EMRs are potentially powerful systems-based interventions to facilitate diagnosis and treatment because they ensure the delivery of key new findings and other health related information to the practitioner. However, effective communication involves more than just information transfer; despite a state of the art EMR system, communication breakdowns can still occur. 123 In this project, we will adapt a model developed by the Systems Engineering Initiative for Patient Safety (SEIPS to understand and improve the relationship between work systems and processes of care involved with electronic communication in EMRs. We plan to study three communication activities in the Veterans Health Administration's (VA EMR: electronic communication of abnormal imaging and laboratory test results via automated notifications (i.e., alerts; electronic referral requests; and provider-to-pharmacy communication via computerized provider order entry (CPOE. Aim Our specific aim is to propose a protocol to evaluate the systems and processes affecting outcomes of electronic communication in the computerized patient record system (related to diagnostic test results, electronic referral requests, and CPOE prescriptions using a human factors engineering approach, and hence guide the development of interventions for work system redesign. Design This research will consist of multiple qualitative methods of task analysis to identify potential sources of error related to diagnostic test result alerts, electronic referral requests, and CPOE; this will be followed by a series of focus groups to identify barriers, facilitators, and suggestions for improving the electronic communication system. Transcripts from all task analyses and focus groups will be analyzed using methods adapted from grounded theory and content analysis.

  17. A Comparision Study of Common Routing Protocols Used In Wireless Ad-Hoc Networks

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    Basim Alhadidi

    2013-04-01

    Full Text Available The aim of this study is to analyze and compare performance of both reactive and proactive Mobile Ad hoc Networks (MANETs routing protocols using different environments. Wireless networks are divided into two types: infrastructure and ad hoc network. In wireless ad hoc networks each node can be a sender, router and receiver, so these types of network are less structure compared to infrastructure network. Therefore wireless ad hoc networks need special routing protocols to overcome the limitations of wireless ad hoc networks. Wireless ad hoc networks routing protocols can be categorized into two types: reactive (on demand routing protocols and proactive routing protocols. In proactive routing protocols the nodes periodically send control messages across the network to build routing table. Different routing protocols have been simulated using GloMoSim (Global Mobile Information system simulation library and PARSEC compiler. Five multi-hop wireless ad hoc network routing protocols have been simulated to cover a range of design choices: Wireless Routing Protocol (WRP, Fisheye State Routing (FSR, Dynamic Source Routing (DSR, Ad hoc On-demand Distance Vector (AODV and Location Aided Routing (LAR. The protocols are evaluated in different environments to investigate performance metrics. Performance metric includes the following aspects: packets deliver ratio, end-to-end delay and end-to-end throughput.

  18. Study of Prevalence and Risk Factors of Asthma and Allergic Diseases Among School Children (6-7 and 13-14 years Based on ISAAC Protocol in Jam City, Bushehr Province in 2014

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    Tahere Assadi

    2017-01-01

    Full Text Available Background: Asthma and allergic diseases are raised as a major health problem in the world. The prevalence of these diseases is on the rise specifically in the world and Iran. Accordingly, the aim of this study was to assess the prevalence of these diseases in Jam City, from environs of Bushehr Province. Material and Methods: this study was performed on 516 schoolchildren aged 6-7 years and 569 schoolchildren aged 13-14 years in schools of this city based on a standard questionnaire of allergic conditions and asthma (ISAAC phase 1 and 3, which mention to the prevalence and risk factors for these diseases in 2014.     Results: in prevalence of atopic eczema, allergic rhinitis and asthma among 6-7year old schoolchildren were 13.8 %, 20% and 3.9%, respectively, While, the prevalence of these diseases among 13-14 year old schoolchildren were 19.5%, 19.2% and 6.7%, respectively. There were a significant association in each group, between affliction rate to asthmaand its association with rhinitis and eczema (P<0.05. Also, there were a significant association between the prevalence of these diseases and the presence of risk factors such as exposure to cigarette smoke, pet care and use of gas as a fuel at home. (P<0.05. Conclusion: the prevalence of asthma and allergic diseases was high in Jam city and this increase is associated to risk factors such as exposure to cigarette smoke, pet care and use of gas as a fuel at home.

  19. Hypertension Improvement Project (HIP: study protocol and implementation challenges

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    Pollak Kathryn I

    2009-02-01

    Full Text Available Abstract Background Hypertension affects 29% of the adult U.S. population and is a leading cause of heart disease, stroke, and kidney failure. Despite numerous effective treatments, only 53% of people with hypertension are at goal blood pressure. The chronic care model suggests that blood pressure control can be achieved by improving how patients and physicians address patient self-care. Methods and design This paper describes the protocol of a nested 2 × 2 randomized controlled trial to test the separate and combined effects on systolic blood pressure of a behavioral intervention for patients and a quality improvement-type intervention for physicians. Primary care practices were randomly assigned to the physician intervention or to the physician control condition. Physician randomization occurred at the clinic level. The physician intervention included training and performance monitoring. The training comprised 2 internet-based modules detailing both the JNC-7 hypertension guidelines and lifestyle modifications for hypertension. Performance data were collected for 18 months, and feedback was provided to physicians every 3 months. Patient participants in both intervention and control clinics were individually randomized to the patient intervention or to usual care. The patient intervention consisted of a 6-month behavioral intervention conducted by trained interventionists in 20 group sessions, followed by 12 monthly phone contacts by community health advisors. Follow-up measurements were performed at 6 and 18 months. The primary outcome was the mean change in systolic blood pressure at 6 months. Secondary outcomes were diastolic blood pressure and the proportion of patients with adequate blood pressure control at 6 and 18 months. Discussion Overall, 8 practices (4 per treatment group, 32 physicians (4 per practice; 16 per treatment group, and 574 patients (289 control and 285 intervention were enrolled. Baseline characteristics of patients and

  20. Association of physical activity with cognition, metacognition and academic performance in children and adolescents: a protocol for systematic review and meta-analysis

    Science.gov (United States)

    Álvarez-Bueno, Celia; Pesce, Caterina; Cavero-Redondo, Iván; Sánchez-López, Mairena; Pardo-Guijarro, María Jesús; Martínez-Vizcaíno, Vicente

    2016-01-01

    Introduction Schools provide a relevant context for improving children's and adolescents’ physical and mental health by increasing physical activity during school hours and/or beyond. The interest in the relationship between physical activity programmes and cognition during development has recently increased, with evidence suggesting a positive association. We present a protocol of systematic reviews and meta-analysis of intervention studies that, by determining the effects of chronic physical exercise on children's and adolescents’ cognitive and metacognitive functions, cognitive life skills, academic behaviours and achievement, aims to ensure procedural objectivity and transparency, and maximise the extraction of relevant information to inform policy development. Methods This protocol is guided by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. Databases to be utilised for a thorough selection of the pertinent literature are MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO and ERIC. Selection is proposed to encompass an international and a national publication level, with inclusion of experimental studies written in English or in Spanish, respectively. Also, relevant references included in the selected studies will be considered suitable for review as supplemental sources. We present an integrated approach to the methodological quality assessment of the selected studies, including the Jadad Scale for the assessment of the quality of randomised controlled trials and the Quality Assessment Tool for Quantitative Studies for pre–post studies and non-randomised controlled trials. The pre–post interventions mean differences will be the primary indicator of the intervention outcome. Statistical analysis A subgroup analysis is proposed based on cognitive functions and their neural correlates

  1. A Comparative Study of Key Management Protocols for WSN

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    Seema Verma

    2014-03-01

    Full Text Available Increased employment of WSN (Wireless Sensor Network in real life applications and their hostile and remote locations accelerate demand of security in WSN. Publicly accessible wireless communication channel also makes WSN vulnerable to numerous security attacks. Scarcity of resources acquaints new sort of challenges and difficulties during implementation of effective security mechanisms. In this paper, we evaluate and compare performance of three different security mechanisms (ECRKS, CKP and AP scheme. ECRKS (Energy-efficient, Connected, Resilient Key pre-distribution Scheme is based upon multi hop communication architecture specifically designed for homogeneous WSN. Clustering based protocols, AP (Asymmetric pre-distribution scheme and CKP (Clustering based Key management Protocol are proposed for heterogeneous WSN. All the above mentioned schemes are simulated in MATLAB to evaluate their effectiveness and suitability for WSN. Simulation result shows that CKP outperforms other two schemes in terms of transmission distance, memory burden, energy dissipation and resilience.

  2. Predicting infectious complications in neutropenic children and young people with cancer (IPD protocol

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    Phillips Robert S

    2012-02-01

    Full Text Available Abstract Background A common and potentially life-threatening complication of the treatment of childhood cancer is infection, which frequently presents as fever with neutropenia. The standard management of such episodes is the extensive use of intravenous antibiotics, and though it produces excellent survival rates of over 95%, it greatly inconveniences the three-fourths of patients who do not require such aggressive treatment. There have been a number of studies which have aimed to develop risk prediction models to stratify treatment. Individual participant data (IPD meta-analysis in therapeutic studies has been developed to improve the precision and reliability of answers to questions of treatment effect and recently have been suggested to be used to answer questions regarding prognosis and diagnosis to gain greater power from the frequently small individual studies. Design In the IPD protocol, we will collect and synthesise IPD from multiple studies and examine the outcomes of episodes of febrile neutropenia as a consequence of their treatment for malignant disease. We will develop and evaluate a risk stratification model using hierarchical regression models to stratify patients by their risk of experiencing adverse outcomes during an episode. We will also explore specific practical and methodological issues regarding adaptation of established techniques of IPD meta-analysis of interventions for use in synthesising evidence derived from IPD from multiple studies for use in predictive modelling contexts. Discussion Our aim in using this model is to define a group of individuals at low risk for febrile neutropenia who might be treated with reduced intensity or duration of antibiotic therapy and so reduce the inconvenience and cost of these episodes, as well as to define a group of patients at very high risk of complications who could be subject to more intensive therapies. The project will also help develop methods of IPD predictive modelling

  3. Peer mentorship to promote effective pain management in adolescents: study protocol for a randomised controlled trial

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    Hayes Loran P

    2011-05-01

    Full Text Available Abstract Background This protocol is for a study of a new program to improve outcomes in children suffering from chronic pain disorders, such as fibromyalgia, recurrent headache, or recurrent abdominal pain. Although teaching active pain self-management skills through cognitive-behavioral therapy (CBT or a complementary program such as hypnotherapy or yoga has been shown to improve pain and functioning, children with low expectations of skill-building programs may lack motivation to comply with therapists' recommendations. This study will develop and test a new manualized peer-mentorship program which will provide modeling and reinforcement by peers to other adolescents with chronic pain (the mentored participants. The mentorship program will encourage mentored participants to engage in therapies that promote the learning of pain self-management skills and to support the mentored participants' practice of these skills. The study will examine the feasibility of this intervention for both mentors and mentored participants, and will assess the preliminary effectiveness of this program on mentored participants' pain and functional disability. Methods This protocol will recruit adolescents ages 12-17 with chronic pain and randomly assign them to either peer mentorship or a treatment-as-usual control group. Mentored participants will be matched with peer mentors of similar age (ages 14-18 who have actively participated in various treatment modalities through the UCLA Pediatric Pain Program and have learned to function successfully with a chronic pain disorder. The mentors will present information to mentored participants in a supervised and monitored telephone interaction for 2 months to encourage participation in skill-building programs. The control group will receive usual care but without the mentorship intervention. Mentored and control subjects' pain and functioning will be assessed at 2 months (end of intervention for mentored participants and

  4. Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.

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    Proczko, Monika; Kaska, Lukasz; Twardowski, Pawel; Stepaniak, Pieter

    2016-02-01

    While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and ERABS periods in an academic hospital. The primary endpoint was the length of stay in hospital. The secondary endpoints were turnover times-the time required for preparing the operating room for the next case, induction time (from induction of anesthesia until a patient is ready for surgery), surgical time (duration of surgery), procedure time (duration of stay in the operating room), and the incidence of re-admissions, re-operations and complications during admission and within 30 days after surgery. Of a total of 374 patients, 228 and 146 received surgery following the pre-ERABS and ERABS protocols, respectively. The length of hospital stay was significantly shortened from 3.7 (95 % confidence interval [CI] 3.1-4.7) days to 2.1 (95 % CI 1.6-2.6) days (P surgery, respectively (P < 0.001 for both), by introducing the ERABS protocol. Induction times were reduced from 15.2 (95 % CI 14.3-16.1) min to 12.5 (95 % CI 11.7-13.3) min (P < 0.001).Turnover times were shortened significantly from 38 (95 % CI 44-32) min to 11 (95 % CI 8-14) min. The incidence of re-operations, re-admissions and complications did not change.

  5. Pediatric endurance and limb strengthening for children with cerebral palsy (PEDALS – a randomized controlled trial protocol for a stationary cycling intervention

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    Simms Victoria

    2007-03-01

    Full Text Available Abstract Background In the past, effortful exercises were considered inappropriate for children with spastic cerebral palsy (CP due to concern that they would escalate abnormalities including spasticity and abnormal movement patterns. Current scientific evidence indicates that these concerns were unfounded and that therapeutic interventions focused on muscle strengthening can lead to improved functional ability. However, few studies have examined the potential benefits of cardiorespiratory fitness exercises in this patient population. Methods/design The rationale and design of a randomized controlled trial examining the effects of a stationary cycling intervention for children with CP are outlined here. Sixty children with spastic diplegic CP between the ages of 7 and 18 years and Gross Motor Function Classification System (GMFCS levels of I, II, or III will be recruited for this study. Participants will be randomly assigned to either an intervention (cycling or a control (no cycling group. The cycling intervention will be divided into strengthening and cardiorespiratory endurance exercise phases. During the strengthening phase, the resistance to lower extremity cycling will be progressively increased using a uniquely designed limb-loaded mechanism. The cardiorespiratory endurance phase will focus on increasing the intensity and duration of cycling. Children will be encouraged to exercise within a target heart rate (HR range (70 – 80% maximum HR. Thirty sessions will take place over a 10–12 week period. All children will be evaluated before (baseline and after (follow-up the intervention period. Primary outcome measures are: knee joint extensor and flexor moments, or torque; the Gross Motor Function Measure (GMFM; the 600 Yard Walk-Run test and the Thirty-Second Walk test (30 sec WT. Discussion This paper presents the rationale, design and protocol for Pediatric Endurance and Limb Strengthening (PEDALS; a Phase I randomized controlled trial

  6. A comparative study of wireless sensor networks and their routing protocols.

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    Bhattacharyya, Debnath; Kim, Tai-hoon; Pal, Subhajit

    2010-01-01

    Recent developments in the area of micro-sensor devices have accelerated advances in the sensor networks field leading to many new protocols specifically designed for wireless sensor networks (WSNs). Wireless sensor networks with hundreds to thousands of sensor nodes can gather information from an unattended location and transmit the gathered data to a particular user, depending on the application. These sensor nodes have some constraints due to their limited energy, storage capacity and computing power. Data are routed from one node to other using different routing protocols. There are a number of routing protocols for wireless sensor networks. In this review article, we discuss the architecture of wireless sensor networks. Further, we categorize the routing protocols according to some key factors and summarize their mode of operation. Finally, we provide a comparative study on these various protocols.

  7. The Study of Environment on Aboriginal Resilience and Child Health (SEARCH: study protocol

    Directory of Open Access Journals (Sweden)

    2010-05-01

    Full Text Available Abstract Background Aboriginal Australians have a life expectancy more than ten years less than that of non-Aboriginal Australians, reflecting their disproportionate burden of both communicable and non-communicable disease throughout the lifespan. Little is known about the health and health trajectories of Aboriginal children and, although the majority of Aboriginal people live in urban areas, data are particularly sparse in relation to children living in urban areas. Methods/Design The Study of Environment on Aboriginal Resilience and Child Health (SEARCH is a cohort study of Aboriginal children aged 0-17 years, from urban and large regional centers in New South Wales, Australia. SEARCH focuses on Aboriginal community identified health priorities of: injury; otitis media; vaccine-preventable conditions; mental health problems; developmental delay; obesity; and risk factors for chronic disease. Parents/caregivers and their children are invited to participate in SEARCH at the time of presentation to one of the four participating Aboriginal Community Controlled Health Organisations at Mount Druitt, Campbelltown, Wagga Wagga and Newcastle. Questionnaire data are obtained from parents/caregivers and children, along with signed permission for follow-up through repeat data collection and data linkage. All children have their height, weight, waist circumference and blood pressure measured and complete audiometry, otoscopy/pneumatic otoscopy and tympanometry. Children aged 1-7 years have speech and language assessed and their parents/caregivers complete the Parental Evaluation of Developmental Status. The Study aims to recruit 1700 children by the end of 2010 and to secure resources for long term follow up. From November 2008 to March 2010, 1010 children had joined the study. From those 446 children with complete data entry, participating children ranged in age from 2 weeks to 17 years old, with 144 aged 0-3, 147 aged 4-7, 75 aged 8-10 and 79 aged 11

  8. Lower limb strength training in children with cerebral palsy – a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles

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    Verschuren Olaf

    2008-10-01

    Full Text Available Abstract Background Until recently, strength training in children with cerebral palsy (CP was considered to be inappropriate, because it could lead to increased spasticity or abnormal movement patterns. However, the results of recent studies suggest that progressive strength training can lead to increased strength and improved function, but low methodological quality and incomplete reporting on the training protocols hampers adequate interpretation of the results. This paper describes the design and training protocol of a randomized controlled trial to assess the effects of a school-based progressive functional strength training program for children with CP. Methods/Results Fifty-one children with Gross Motor Function Classification Systems levels I to III, aged of 6 to 13 years, were recruited. Using stratified randomization, each child was assigned to an intervention group (strength training or a control group (usual care. The strength training was given in groups of 4–5 children, 3 times a week, for a period of 12 weeks. Each training session focussed on four exercises out of a 5-exercise circuit. The training load was gradually increased based on the child's maximum level of strength, as determined by the 8 Repetition Maximum (8 RM. To evaluate the effectiveness of the training, all children were evaluated before, during, directly after, and 6 weeks after the intervention period. Primary outcomes in this study were gross motor function (measured with the Gross Motor Function Measure and functional muscle strength tests and walking ability (measured with the 10-meter, the 1-minute and the timed stair test. Secondary outcomes were lower limb muscle strength (measured with a 6 RM test, isometric strength tests, and a sprint capacity test, mobility (measured with a mobility questionnaire, and sport activities (measured with the Children's Assessment of Participation and Enjoyment. Spasticity and range of motion were assessed to evaluate any

  9. Preparing for severe contrast media reactions in children - results of a national survey, a literature review and a suggested protocol

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    Lindsay, R., E-mail: rwklindsay@hotmail.co [Imaging Centre, Royal Victoria Hospital, Belfast, Northern Ireland (United Kingdom); Paterson, A. [Radiology Department, The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland (United Kingdom); Edgar, D. [Immunology Department, Royal Victoria Hospital, Belfast, Northern Ireland (United Kingdom)

    2011-04-15

    Aim: To identify current practices within paediatric radiology in the UK with regard to the use of prophylactic medication, prior to administering intravenous (IV) radiocontrast medium (RCM). In addition, the pre-injection risk management strategies of the departments questioned was to be evaluated, and using consensus opinion, a protocol for managing patients identified as being at high risk for an adverse reaction to RCM was to be outlined. Materials and methods: An online survey of paediatric radiology consultants representing all geographic regions of the UK was carried out. The questions asked included an assessment of the risk factors for adverse reactions to RCM, and how such reactions are anticipated and managed. The questionnaire asked about the perceived indications for, and the use of prophylactic medication prior to RCM administration. Results: A response rate of 51% was achieved. The majority of respondents felt that a history of previous RCM reaction was an indication to administer prophylactic drugs prior to a further dose of RCM. No other risk factor was believed to require prophylactic medication. Conclusion: Using information obtained from the survey, a literature search was performed to assess the evidence available in support of each practice. A protocol was devised to identify children at risk of an adverse reaction to RCM, and guide the use of prophylactic medication in this group of patients. The survey highlighted considerable variability in the risk-assessment and management practices within paediatric radiology in the UK. The derived protocol may guide radiologists' management of children at risk for an RCM reaction.

  10. Predicting implementation from organizational readiness for change: a study protocol

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    Kelly P Adam

    2011-07-01

    Full Text Available Abstract Background There is widespread interest in measuring organizational readiness to implement evidence-based practices in clinical care. However, there are a number of challenges to validating organizational measures, including inferential bias arising from the halo effect and method bias - two threats to validity that, while well-documented by organizational scholars, are often ignored in health services research. We describe a protocol to comprehensively assess the psychometric properties of a previously developed survey, the Organizational Readiness to Change Assessment. Objectives Our objective is to conduct a comprehensive assessment of the psychometric properties of the Organizational Readiness to Change Assessment incorporating methods specifically to address threats from halo effect and method bias. Methods and Design We will conduct three sets of analyses using longitudinal, secondary data from four partner projects, each testing interventions to improve the implementation of an evidence-based clinical practice. Partner projects field the Organizational Readiness to Change Assessment at baseline (n = 208 respondents; 53 facilities, and prospectively assesses the degree to which the evidence-based practice is implemented. We will conduct predictive and concurrent validities using hierarchical linear modeling and multivariate regression, respectively. For predictive validity, the outcome is the change from baseline to follow-up in the use of the evidence-based practice. We will use intra-class correlations derived from hierarchical linear models to assess inter-rater reliability. Two partner projects will also field measures of job satisfaction for convergent and discriminant validity analyses, and will field Organizational Readiness to Change Assessment measures at follow-up for concurrent validity (n = 158 respondents; 33 facilities. Convergent and discriminant validities will test associations between organizational readiness and

  11. Protocols on prenatal care for pregnant women with Zika infection and children with microcephaly: nutritional approach

    Directory of Open Access Journals (Sweden)

    Rachel de Sá Barreto Luna Callou Cruz

    Full Text Available Abstract This summary aimed to synthesize the protocol guidelines of Pernambuco, the Ministry of Health and the Centers for Disease Control and Prevention which deal with health care related to Zika virus infection during pregnancy and the preliminary procedures for surveillance on microcephaly cases including nutritional care. With the increase of number of cases on this event since August, 2015, it was necessary to reorganize the prenatal care which is offered to pregnant women, including the protocols in order to reduce the chances of a possible contamination of the virus, to detect previously suspected cases as well as perform follow up on confirmed cases. The gaps in the knowledge of this morbidity, it should be noted that the information and recommendations are subject to revision due to possible incorporation of new knowledge and other evidence, as well as the need for adequacy of surveillance actions in new epidemiological scenarios. It is known that cases of nutritional deficiencies are capable of producing malformation of the Central Nervous System, including microcephaly. In the analysis of the protocols, there were no changes as to the nutritional recommendations already established for the low-risk pregnant women. The authors presented a hypothesis and conceptually, as a prevention measurement, the inclusion of prenatal care to prevent and control isolated or multiple deficiencies associated to microcephaly, such as protein, vitamin A, iodine, folate, B12, vitamin D, biotin, zinc and selenium.

  12. A study protocol to evaluate the relationship between outdoor air pollution and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Selemane Ismael

    2010-10-01

    Full Text Available Abstract Background The present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design. Methods/Design Semi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models. Discussion Exposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location

  13. The Oxford Participation and Activities Questionnaire: study protocol

    Directory of Open Access Journals (Sweden)

    Morley D

    2013-12-01

    Full Text Available David Morley, Sarah Dummett, Laura Kelly, Jill Dawson, Ray Fitzpatrick, Crispin JenkinsonNuffield Department of Population Health, University of Oxford, Oxford, UKBackground: With an ageing population and increasing demands on health and social care services, there is growing importance attached to the management of long-term conditions, including maximizing the cost-effectiveness of treatments. In line with this, there is increasing emphasis on the need to keep people both active and participating in daily life. Consequently, it is essential that well developed and validated instruments that can meaningfully assess levels of participation and activity are widely available. Current measures, however, are largely focused on disability and rehabilitation, and there is no measure of activity or participation for generic use that fully meets the standards set by regulatory bodies such as the US Food and Drug Administration. Here we detail a protocol for the development and validation of a new patient-reported outcome measure (PROM for assessment of participation and activity in people experiencing a variety of health conditions, ie, the Oxford Participation and Activities Questionnaire (Ox-PAQ. The stages incorporated in its development are entirely in line with current regulations and represent best practice in the development of PROMs.Methods: Development of the Ox-PAQ is theoretically grounded in the World Health Organization International Classification of Functioning, Disability, and Health. The project incorporates a new strategy of engaging with stakeholders from the outset in an attempt to identify those characteristics of PROMs considered most important to a range of potential users. Items will be generated through interviews with patients from a range of conditions. Pretesting of the instrument will be via cognitive interviews and focus groups. A postal survey will be conducted, with data subject to factor and Rasch analysis in order to

  14. Adult-Based Massive Transfusion Protocol Activation Criteria Do Not Work in Children.

    Science.gov (United States)

    Acker, Shannon N; Hall, Brianne; Hill, Lauren; Partrick, David A; Bensard, Denis D

    2017-02-01

    Introduction In the adult population, assessment of blood consumption (ABC) score [penetrating mechanism, positive focused assessment sonography for trauma (FAST), systolic blood pressure  120] ≥2 identifies trauma patients who require massive transfusion (MT) with sensitivity and specificity of 75 and 86%. We hypothesized that the adult criteria cannot be applied to children, as the vital sign cut-offs are not age-adjusted. We aimed to determine if the use of a shock index, pediatric age-adjusted (SIPA) would improve the discriminate ability of the ABC score in children. Materials and Methods A retrospective review of children age 4 to 15 who received a packed red blood cell (PRBC) transfusion during admission for trauma between 2008 and 2014 was performed. We compared the sensitivity and specificity of ABC score ≥ 2, elevated SIPA, and age-adjusted ABC score (ABC-S) utilizing SIPA in place of HR and BP, to determine the need for MT. Results A total of 50 children were included, 31 received PRBC transfusion within 6 hours of injury, 7 children had a positive FAST, and 3 suffered penetrating trauma, all in the early transfusion group. ABC score ≥ 2 is 29% sensitive and 100% specific at predicting need for MT while ABC-S score ≥ 1 is 65% sensitive and 84% specific. Conclusions Adult-based criteria for activation of MT perform poorly in the pediatric population. The use of SIPA modestly improves the sensitivity of the ABC score in children; however, the sensitivity and specificity of this score are still worse than when used in an adult population. This suggests the need to develop a new score that takes into account the low rate of penetrating trauma and positive FAST in the pediatric population.

  15. Risk, resilience, and the rorschach: a longitudinal study of children who experienced sexual abuse.

    Science.gov (United States)

    Barnett, Douglas; Heinze, Hillary J; Arble, Eamonn

    2013-01-01

    Experiencing sexual abuse increases the risk that children will report or otherwise demonstrate problems with emotion, behavior, and health. This longitudinal study of 44 children who experienced sexual abuse examined whether information processing as assessed via the Rorschach Inkblot Test was associated with child-reported depression symptoms assessed via the Children's Depression Inventory (Kovacs, 1992) concurrently and an average of 15 months later. Children whose Rorschach protocols were relatively free of scores suggesting intense distress, complex processing, and sexual content were more likely to experience remission of depression symptoms at follow-up. Findings provide incremental validity for certain Rorschach indexes to inform prognosis regarding depression symptoms and perhaps their treatment.

  16. Children with intellectual disabilities and pain perception: a review and suggestions for future assessment protocols

    NARCIS (Netherlands)

    van Dijk, M.; Valkenburg, A.; Boerlage, A.A.; Tibboel, D.; Veerkamp, J.S.

    2009-01-01

    AIM: This was to review what is known about pain assessment in children with intellectual disabilities and to translate findings into clinical dental practice. Methods: Literature review. Review: The association between anxiety and pain as reported in the literature was explored. The specific pain e

  17. A STUDY ON LICHEN PLANUS IN CHILDREN

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    Neerja Puri

    2013-07-01

    Full Text Available Introduction: Lichen planus is considered to be rare in children. However, it does not appear to be uncommon in Indian subcontinent. Aims: The study was undertaken to analyse the clinical profile of childhood lichen planus. Material and Methods: We selected 30 children with LP for the study. The children selected were below the age of 14 years of age. Results and Discussion: In our study, it was seen that that the maximum onset of disease was between 5-9 years of age and mean age of children with LP was 6.8 years. The commonest type of LP in children was classical LP seen in 60% children, followed by actinic LP in 20% children. LP hypertrophicus and linear LP were seen in 10% patients each. Nail changes were seen in 10% patients.

  18. A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment

    NARCIS (Netherlands)

    Diderich, H.M.; Fekkes, M.; Verkerk, P.H.; Pannebakker, F.D.; Velderman, M.K.; Sorensen, P.J.G.; Baeten, P.; Oudesluys-Murphy, A.M.

    2013-01-01

    Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) based on characteristics of parents who attend the Emergency Department (ED) because they have the following problems: (1) intimate partner

  19. Assessment of Adverse Events in Protocols, Clinical Study Reports, and Published Papers of Trials of Orlistat

    DEFF Research Database (Denmark)

    Schroll, Jeppe Bennekou; Penninga, Elisabeth I; Gøtzsche, Peter C

    2016-01-01

    group were more severe. None of this was stated in the CSR or in the published paper. Our analysis was restricted to one drug tested in the mid-1990s; our results might therefore not be applicable for newer drugs. CONCLUSIONS: In the orlistat trials, we identified important disparities in the reporting...... the results of studies conducted as part of the application for marketing authorisation for the slimming pill orlistat. The purpose of this study was to study how adverse events were summarised and reported in study protocols, CSRs, and published papers of orlistat trials. METHODS AND FINDINGS: We received...... the CSRs from seven randomised placebo controlled orlistat trials (4,225 participants) submitted by Roche. The CSRs consisted of 8,716 pages and included protocols. Two researchers independently extracted data on adverse events from protocols and CSRs. Corresponding published papers were identified on Pub...

  20. Conduct of a personal radiofrequency electromagnetic field measurement study: proposed study protocol

    Directory of Open Access Journals (Sweden)

    Radon Katja

    2010-05-01

    Full Text Available Abstract Background The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF is ongoing, but little is known about the RF-EMF exposure distribution in the general population. Previous attempts to measure personal exposure to RF-EMF have used different measurement protocols and analysis methods making comparisons between exposure situations across different study populations very difficult. As a result, observed differences in exposure levels between study populations may not reflect real exposure differences but may be in part, or wholly due to methodological differences. Methods The aim of this paper is to develop a study protocol for future personal RF-EMF exposure studies based on experience drawn from previous research. Using the current knowledge base, we propose procedures for the measurement of personal exposure to RF-EMF, data collection, data management and analysis, and methods for the selection and instruction of study participants. Results We have identified two basic types of personal RF-EMF measurement studies: population surveys and microenvironmental measurements. In the case of a population survey, the unit of observation is the individual and a randomly selected representative sample of the population is needed to obtain reliable results. For microenvironmental measurements, study participants are selected in order to represent typical behaviours in different microenvironments. These two study types require different methods and procedures. Conclusion Applying our proposed common core procedures in future personal measurement studies will allow direct comparisons of personal RF-EMF exposures in different populations and study areas.

  1. Older Persons’ Transitions in Care (OPTIC: a study protocol

    Directory of Open Access Journals (Sweden)

    Cummings Greta G

    2012-12-01

    Full Text Available Abstract Background Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH residents and necessitate transitions between NHs and Emergency Departments (EDs. During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS, and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH – ED transitions. Methods/Design This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT approach. It uses data from multiple levels (facility, care unit, individual and sources (healthcare providers, residents, health records, and administrative databases. Discussion Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and

  2. Sarcopenia and its determinants among Iranian elderly (SARIR: study protocol

    Directory of Open Access Journals (Sweden)

    Hashemi Rezvan

    2012-11-01

    Full Text Available Abstract Background The elderly populations increase in world because of improved health status in communities, so health and independency of seniors has become and will be one of the main priorities of public health systems. Ageing have been associated with changes in body composition, including loss of muscle mass, loss of bone mass and increase fat mass. Involuntary age related loss of muscle mass, sarcopenia,has been linked to functional impairment and physical disability. Several definitions for sarcopenia have been presented based on the method of measuring body composition, but an internationally accepted definition doesn’t presently exist yet. In 2010, the European working group on sarcopenia developed a new definition for sarcopenia according to measure muscle mass and muscle function. Several studies have been done about sarcopenia in world, but to our knowledge this study is the first in Iran which is one of the largest countries of the Middle East that faces a fast growing elderly population. The aim of this study is to evaluate sarcopenia and related risk factors in Iran according new definition of sarcopenia. Methods This study will be conducted in two phase among elderly men and women over 55 years in the 6th district of TehranThe first phase will be a population-based cross-sectional study to determine the frequency of sarcopenia in the study population, and to conduct case finding for the second phase. The second phase will be a case–control study to comparison the metabolic and inflammatory factors in sarcopenic and non sarcopenic groups. The association between sarcopenia and major dietary pattern will be evaluated using factor analysis. Conclusion This study is the first study that evaluates sarcopenia and its risk factor in Iranian elderlies. We discuss details of how we collect the data and appropriate instruments to measure muscle mass, muscle power and muscle strength, and suitable cut- off to define sarcopenia in

  3. Michigan dioxin exposure study: planning phase and protocol development

    Energy Technology Data Exchange (ETDEWEB)

    Adriaens, P. [Univ. of Michigan, Coll. of Engineering, Ann Arbor (United States); Garabrant, D.; Franzblau, A. [Univ. of Michigan, School for Public Health, Ann Arbor (United States); Gillespie, B. [Univ. of Michigan, Center for Statistics, Ann Arbor (United States); Lepowski, J. [Univ. of Michigan, Inst. for Social Research, Ann Arbor (United States)

    2004-09-15

    The University of Michigan has been commissioned to conduct one of the largest environmental epidemiology studies (700 residents) of dioxin exposure among the population of Michigan to describe the pattern of serum dioxin levels among adults and to understand the factors that explain variation in serum dioxin levels. The study is being undertaken (2004-2006) in response to concerns among the population of Midland and Saginaw Counties that dioxins from the Dow Chemical Company facilities in Midland have resulted in contamination of areas of the City of Midland and have contaminated the sediments in the Tittabawassee River flood plain. There is concern that body burdens of dioxins are elevated because of environmental contamination. The appropriate way to respond to these concerns is to measure the serum dioxin levels in a probability sample of the population in the region and to estimate each individual's past exposure to various factors that are believed to contribute to the body burden of dioxins. By measuring factors that reflect potential exposure to dioxins through air, water, soil, food intake, occupations, and various recreational activities, we can identify the factors that correlate with (and explain variation in) serum dioxin levels. The central goal of the study is to determine which factors explain variation in serum dioxin levels, and to quantify how much variation each factor explains. This paper provides information on the planning phase, study scope and objectives.

  4. Study of Optimal Perimetric Testing in Children (OPTIC: Feasibility, Reliability and Repeatability of Perimetry in Children.

    Directory of Open Access Journals (Sweden)

    Dipesh E Patel

    Full Text Available To investigate feasibility, reliability and repeatability of perimetry in children.A prospective, observational study recruiting 154 children aged 5-15 years, without an ophthalmic condition that affects the visual field (controls, identified consecutively between May 2012 and November 2013 from hospital eye clinics. Perimetry was undertaken in a single sitting, with standardised protocols, in a randomised order using the Humphrey static (SITA 24-2 FAST, Goldmann and Octopus kinetic perimeters. Data collected included test duration, subjective experience and test quality (incorporating examiner ratings on comprehension of instructions, fatigue, response to visual and auditory stimuli, concentration and co-operation to assess feasibility and reliability. Testing was repeated within 6 months to assess repeatability.Overall feasibility was very high (Goldmann=96.1%, Octopus=89% and Humphrey=100% completed the tests. Examiner rated reliability was 'good' in 125 (81.2% children for Goldmann, 100 (64.9% for Octopus and 98 (63.6% for Humphrey perimetry. Goldmann perimetry was the most reliable method in children under 9 years of age. Reliability improved with increasing age (multinomial logistic regression (Goldmann, Octopus and Humphrey, p<0.001. No significant differences were found for any of the three test strategies when examining initial and follow-up data outputs (Bland-Altman plots, n=43, suggesting good test repeatability, although the sample size may preclude detection of a small learning effect.Feasibility and reliability of formal perimetry in children improves with age. By the age of 9 years, all the strategies used here were highly feasible and reliable. Clinical assessment of the visual field is achievable in children as young as 5 years, and should be considered where visual field loss is suspected. Since Goldmann perimetry is the most effective strategy in children aged 5-8 years and this perimeter is no longer available, further

  5. Neurofeedback for insomnia: a pilot study of Z-score SMR and individualized protocols.

    Science.gov (United States)

    Hammer, Barbara U; Colbert, Agatha P; Brown, Kimberly A; Ilioi, Elena C

    2011-12-01

    Insomnia is an epidemic in the US. Neurofeedback (NFB) is a little used, psychophysiological treatment with demonstrated usefulness for treating insomnia. Our objective was to assess whether two distinct Z-Score NFB protocols, a modified sensorimotor (SMR) protocol and a sequential, quantitative EEG (sQEEG)-guided, individually designed (IND) protocol, would alleviate sleep and associated daytime dysfunctions of participants with insomnia. Both protocols used instantaneous Z scores to determine reward condition administered when awake. Twelve adults with insomnia, free of other mental and uncontrolled physical illnesses, were randomly assigned to the SMR or IND group. Eight completed this randomized, parallel group, single-blind study. Both groups received fifteen 20-min sessions of Z-Score NFB. Pre-post assessments included sQEEG, mental health, quality of life, and insomnia status. ANOVA yielded significant post-treatment improvement for the combined group on all primary insomnia scores: Insomnia Severity Index (ISI pz-tests pZ-Score NFB groups improved in sleep and daytime functioning. Post-treatment, all participants were normal sleepers. Because there were no significant differences in the findings between the two groups, our future large scale studies will utilize the less burdensome to administer Z-Score SMR protocol.

  6. EVA Human Health and Performance Benchmarking Study Overview and Development of a Microgravity Protocol

    Science.gov (United States)

    Norcross, Jason; Jarvis, Sarah; Bekdash, Omar; Cupples, Scott; Abercromby, Andrew

    2017-01-01

    The primary objective of this study is to develop a protocol to reliably characterize human health and performance metrics for individuals working inside various EVA suits under realistic spaceflight conditions. Expected results and methodologies developed during this study will provide the baseline benchmarking data and protocols with which future EVA suits and suit configurations (e.g., varied pressure, mass, center of gravity [CG]) and different test subject populations (e.g., deconditioned crewmembers) may be reliably assessed and compared. Results may also be used, in conjunction with subsequent testing, to inform fitness-for-duty standards, as well as design requirements and operations concepts for future EVA suits and other exploration systems.

  7. Protocols to study the physiology of oral biofilms.

    Science.gov (United States)

    Lemos, José A; Abranches, Jacqueline; Koo, Hyun; Marquis, Robert E; Burne, Robert A

    2010-01-01

    The oral cavity harbors several hundred different bacterial species that colonize both hard (teeth) and soft tissues, forming complex populations known as microbial biofilms. It is widely accepted that the phenotypic characteristics of bacteria grown in biofilms are substantially different from those grown in suspensions. Because biofilms are the natural habitat for the great majority of oral bacteria, including those contributing to oral diseases, a better understanding of the physiology of adherent populations is clearly needed to control oral microbes in health and disease. In this chapter, we use oral streptococci as examples for studying the physiology of oral biofilms.

  8. Securing Internet Protocol (IP) Storage: A Case Study

    CERN Document Server

    Somayaji, Siva Rama Krishnan; 10.5121/ijngn.2010.2102

    2010-01-01

    Storage networking technology has enjoyed strong growth in recent years, but security concerns and threats facing networked data have grown equally fast. Today, there are many potential threats that are targeted at storage networks, including data modification, destruction and theft, DoS attacks, malware, hardware theft and unauthorized access, among others. In order for a Storage Area Network (SAN) to be secure, each of these threats must be individually addressed. In this paper, we present a comparative study by implementing different security methods in IP Storage network.

  9. An Empirical Study on variants of TCP over AODV routing protocol in MANET

    CERN Document Server

    Morshed, Md Monzur; Islam, Md Rafiqul

    2011-01-01

    The cardinal concept of TCP development was to carry data within the network where network congestion plays a vital role to cause packet loss. On the other hand, there are several other reasons to lose packets in Mobile Ad Hoc Networks due to fading, interfaces, multi-path routing, malicious node, and black hole. Along with throughput, fairness of TCP protocols is important to establish a good communication. In this paper, an empirical study has been done by simulation and analysis of TCP variations under AODV routing protocol. In our simulation, we studied multiple variations of TCP, such as Reno, New-Reno, Vegas, and Tahoe. The simulation work has been done in NS2 environment. Based on the analysis simulation result of we carried out our observations with respect to the behavior of AODV routing protocol for different TCP packets under several QoS metrics such as drop, throughput, delay, and jitter.

  10. Therapist-Designed Adaptive Riding in Children With Cerebral Palsy : Results of a Feasibility Study

    NARCIS (Netherlands)

    Angsupaisal, Mattana; Visser, Baudina; Alkema, Anne; Meinsma-van der Tuin, Marja; Maathuis, Carel G. B.; Reinders-Messelink, Heleen; Hadders-Algra, Mijna

    2015-01-01

    Background. It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development. Objective. The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed ada

  11. Words and Feelings: A Developmental Study of the Language of Emotion in Children.

    Science.gov (United States)

    Farmer, Capen

    This study examines ways in which children verbalize emotional experiences at successive age levels. Four groups of 16 boys and girls each drawn from the second, fourth, sixth, and eighth grades of a middle class private school in New York City were asked to describe happiness, sadness, love, anger, and fear. Raw protocols were scored according to…

  12. Study protocol of the CHOiCE trial

    DEFF Research Database (Denmark)

    Nielsen, Mette Tranberg; Bech, Bodil Hammer; Blaakær, Jan;

    2016-01-01

    BACKGROUND: The effectiveness of cervical cancer screening programs is challenged by suboptimal participation and coverage. Offering cervico-vaginal self-sampling for human papillomavirus testing (HPV self-sampling) to non-participants can increase screening participation. However, the effect......-up testing at 30, 60, or 90 days after mail out of the results. DISCUSSION: The CHOiCE trial will provide strong and important evidence allowing us to determine if and how HPV self-sampling can be used to increase participation in cervical cancer screening. This trial therefore has the potential to improve...... varies substantially among studies, especially depending on the approach used to offer HPV self-sampling. The present trial evaluates the effect on participation in an organized screening program of a HPV self-sampling kit mailed directly to the home of the woman or mailed to the woman's home on demand...

  13. FIRE (facilitating implementation of research evidence: a study protocol

    Directory of Open Access Journals (Sweden)

    Seers Kate

    2012-03-01

    Full Text Available Abstract Background Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. Objectives This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. Setting and sample Four European countries, each with six long-term nursing care sites (total 24 sites for people aged 60 years and over with documented urinary incontinence Methods and design Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation, with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline

  14. Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

    Science.gov (United States)

    Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

    2016-01-01

    ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use

  15. STUDY ON NEIGHBORHOOD DISCOVERY PROTOCOL IN COMMUNICATION NETWORKSGRANULAR SLUDGE BY BATCH TESTS

    Institute of Scientific and Technical Information of China (English)

    时成阁; 胡家骏

    2001-01-01

    One algorithm and one method for PNNI(Private Network to Network Interface) routing were presented. The algorithm is OIL (Older Is Leader) algorithms for Peer Group selection, and the method is the DOO (Distributed object-oriented) method for HDOS (Hierarchy Distributed-Object System), PNNI systems and IP(Internet Protocol) networks. Based on the specifications from ATM forum, and the creative ideas from Distributed System realization, this paper studies and analyzes the private ATM network environment. The OIL algorithm and the DOO method are both for PNNI routing protocol. Through the PNNI simulation, the availability and robustness are proved for the above two improvements.

  16. STUDY & ANALYSIS OF SECURED E-COMMERCE TRANSACTIONS INFORMATION PROTOCOLS-PURCHASING ORDER

    Directory of Open Access Journals (Sweden)

    Deepu Soni

    2012-09-01

    Full Text Available Electronic Commerce is the very rapid growing field in today’s scenario. It is used for Purchasing Order i.e. for buying and selling electronic goods and all other type of things. And there is need for development of a number of e-commerce protocols, which ensure integrity, confidentiality, atomicity and fair exchange.The protocol uses a smart card for ensuring mutual authentication, dispute resolution and fair exchange and reduces reliance on a trusted third party. Also study and analysis of the security in e-transactions may avoid some of the frauds on internet transactionsfor purchasing and buying orders.

  17. The Dutch 'Focus on Strength' intervention study protocol : programme design and production, implementation and evaluation plan

    NARCIS (Netherlands)

    Ten Hoor, G A; Kok, G; Rutten, G M; Ruiter, R A C; Kremers, S P J; Schols, Annemie; Plasqui, G

    2016-01-01

    BACKGROUND: Overweight youngsters are better in absolute strength exercises than their normal-weight counterparts; a physiological phenomenon with promising psychological impact. In this paper we describe the study protocol of the Dutch, school-based program 'Focus on Strength' that aims to improve

  18. Effectiveness of proactive telephone counselling for smoking cessation in parents: Study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bricker Jonathan B

    2011-09-01

    Full Text Available Abstract Background Smoking is the world's fourth most common risk factor for disease, the leading preventable cause of death, and it is associated with tremendous social costs. In the Netherlands, the smoking prevalence rate is high. A total of 27.7% of the population over age 15 years smokes. In addition to the direct advantages of smoking cessation for the smoker, parents who quit smoking may also decrease their children's risk of smoking initiation. Methods/Design A randomized controlled trial will be conducted to evaluate the effectiveness of proactive telephone counselling to increase smoking cessation rates among smoking parents. A total of 512 smoking parents will be proactively recruited through their children's primary schools and randomly assigned to either proactive telephone counselling or a control condition. Proactive telephone counselling will consist of up to seven counsellor-initiated telephone calls (based on cognitive-behavioural skill building and Motivational Interviewing, distributed over a period of three months. Three supplementary brochures will also be provided. In the control condition, parents will receive a standard brochure to aid smoking cessation. Assessments will take place at baseline, three months after start of the intervention (post-measurement, and twelve months after start of the intervention (follow-up measurement. Primary outcome measures will include sustained abstinence between post-measurement and follow-up measurement and 7-day point prevalence abstinence and 24-hours point prevalence abstinence at both post- and follow-up measurement. Several secondary outcome measures will also be included (e.g., smoking intensity, smoking policies at home. In addition, we will evaluate smoking-related cognitions (e.g., attitudes towards smoking, social norms, self-efficacy, intention to smoke in 9-12 year old children of smoking parents. Discussion This study protocol describes the design of a randomized

  19. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

    Directory of Open Access Journals (Sweden)

    Masters IB

    2010-11-01

    Full Text Available Abstract Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250 fulfilling inclusion criteria (new patients with chronic cough are randomised (allocation concealed to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks or usual care (existing care until review by specialist at 6 weeks. Cough diary, cough-specific quality of life (QOL and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses. A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years. This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471

  20. COMPARATIVE STUDY ON ENERGY CONSUMPTION IN DYNAMIC WINDOW SECURED IMPLICIT GEOGRAPHIC FORWARDING ROUTING PROTOCOL

    Directory of Open Access Journals (Sweden)

    Abubakar Idris Umar

    2014-01-01

    Full Text Available An Ideal WSNs should operate with the least possible energy required in order to increase the lifetime of the sensor nodes and at the same time, ensure network connectivity. But the Inherent power limitation makes power-awareness a critical requirement for WSN, this calls for the need to manage energy in sensor nodes. Also In order to ensure successful transmission of data from sensor node source to destination, it becomes necessary to maintain network availability. The network must be resilient to individual node failure which can happen due to zero power posses by the node and due to security attacks posed on the node and the network. Dynamic Window Secured Implicit Geographic Forwarding (DWSIGF routing protocol has proven to be robust, efficient and resistant to some security attack which causes failure in network availability. However the extent to which energy is consumed in sensor nodes which deploys DWSIGF as its routing protocol has never been mentioned. In this research, we performed a comparative study on energy consumption in DWSIGF routing protocol. Using the first order radio model, we determined the energy consumed in a network. The protocol (DWSIGF is matched up against its counterpart SIGF as the traffic is increased. Observation shows that DWSIGF due to the variable timing assigned to the CTS collection window, CTS signal fails to reach destination as collection window time expires, thus the need for retransmission. This in turn consumes more energy than the counterpart SIGF which has a fixed CTS collection time. The simulation work was done using Matlab 7.0. Energy consumed in the random variant of both protocols (DWSIGF and SIGF was also observed to be higher than the priority variant of the protocols.

  1. Dysphonia risk screening protocol

    Directory of Open Access Journals (Sweden)

    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  2. Promoting Sleep Health Among Families of Young Children in Head Start: Protocol for a Social-Ecological Approach.

    Science.gov (United States)

    Bonuck, Karen A; Blank, Arthur; True-Felt, Barbara; Chervin, Ronald

    2016-09-01

    Inadequate or poor quality sleep in early childhood impairs social-emotional and cognitive function via effects on the developing brain and increases obesity risk via hormonal and endocrine effects. The prevalence of short sleep duration, behavioral sleep problems, and sleep-disordered breathing among children aged 3 to 5 years is 20% to 50%. Healthy sleep habits increase sleep duration and prevent behavioral sleep problems. Awareness of sleep-disordered breathing symptoms leads to its timely treatment. We designed a study that aims to empower families whose children are in early childhood programs with the knowledge and skills needed to obtain healthy sleep and to recognize a sleep problem. We used the social-ecological framework to guide individual, interpersonal, organizational, community, and policy interventions. This study builds on the Sweet Dreamzzz, Inc, Early Childhood Sleep Education Program (ECSEP) in Head Start. A stepped-wedge-cluster randomized trial will test effects on child, parent, and classroom outcomes; a policy evaluation will assess the impact of knowledge-translation strategies. The study has 3 aims. The first is to adapt educational materials into multimedia formats and build the capacity of Head Start agencies to implement the study. The second aim is to enroll 540 parent-child dyads in a primary prevention trial of sleep health promotion in Head Start and to analyze effects on children's sleep duration (primary outcome); parents' knowledge, attitudes, self-efficacy, and behavior; and children's sleep difficulties. The third aim is to conduct a secondary prevention feasibility study of screening and guidance for sleep problems. Secondary outcomes are changes in classroom behaviors and policies. Integrating sleep health literacy into early childhood programs could affect the life-course development of millions of children.

  3. Efficacy of family mediation and the role of family violence: study protocol

    OpenAIRE

    Cleak, Helen; Schofield, Margot; Bickerdike, Andrew

    2014-01-01

    Background Family law reforms in Australia require separated parents in dispute to attempt mandatory family dispute resolution (FDR) in community-based family services before court attendance. However, there are concerns about such services when clients present with a history of high conflict and family violence. This study protocol describes a longitudinal study of couples presenting for family mediation services. The study aims to describe the profile of family mediation clients, including ...

  4. A family of quantum protocols

    CERN Document Server

    Devetak, I; Winter, A

    2003-01-01

    We introduce two dual, purely quantum protocols: for entanglement distillation assisted by quantum communication (``mother'' protocol) and for entanglement assisted quantum communication (``father'' protocol). We show how a large class of ``children'' protocols (including many previously known ones) can be derived from the two by direct application of teleportation or super-dense coding. Furthermore, the parent may be recovered from most of the children protocols by making them ``coherent''. We also summarize the various resource trade-offs these protocols give rise to.

  5. Children's Friendship Development: A Comparative Study

    Science.gov (United States)

    Yu, SeonYeong; Ostrosky, Michaelene M.; Fowler, Susan A.

    2011-01-01

    Establishing friendships is an important developmental goal of early childhood, but little research has addressed ways in which parents support the friendship development of their young children with disabilities. The purpose of this survey study was to explore the support strategies that parents use to facilitate their children's friendships.…

  6. Bridging the gap between comprehensive extraction protocols in plant metabolomics studies and method validation.

    Science.gov (United States)

    Bijttebier, Sebastiaan; Van der Auwera, Anastasia; Foubert, Kenn; Voorspoels, Stefan; Pieters, Luc; Apers, Sandra

    2016-09-07

    It is vital to pay much attention to the design of extraction methods developed for plant metabolomics, as any non-extracted or converted metabolites will greatly affect the overall quality of the metabolomics study. Method validation is however often omitted in plant metabolome studies, as the well-established methodologies for classical targeted analyses such as recovery optimization cannot be strictly applied. The aim of the present study is to thoroughly evaluate state-of-the-art comprehensive extraction protocols for plant metabolomics with liquid chromatography-photodiode array-accurate mass mass spectrometry (LC-PDA-amMS) by bridging the gap with method validation. Validation of an extraction protocol in untargeted plant metabolomics should ideally be accomplished by validating the protocol for all possible outcomes, i.e. for all secondary metabolites potentially present in the plant. In an effort to approach this ideal validation scenario, two plant matrices were selected based on their wide versatility of phytochemicals: meadowsweet (Filipendula ulmaria) for its polyphenols content, and spicy paprika powder (from the genus Capsicum) for its apolar phytochemicals content (carotenoids, phytosterols, capsaicinoids). These matrices were extracted with comprehensive extraction protocols adapted from literature and analysed with a generic LC-PDA-amMS characterization platform that was previously validated for broad range phytochemical analysis. The performance of the comprehensive sample preparation protocols was assessed based on extraction efficiency, repeatability and intermediate precision and on ionization suppression/enhancement evaluation. The manuscript elaborates on the finding that none of the extraction methods allowed to exhaustively extract the metabolites. Furthermore, it is shown that depending on the extraction conditions enzymatic degradation mechanisms can occur. Investigation of the fractions obtained with the different extraction methods

  7. Systematic evaluation of patient-reported outcome (PRO) protocol content and reporting in UK cancer clinical trials: the EPiC study protocol

    Science.gov (United States)

    Ahmed, Khaled; Kyte, Derek; Keeley, Thomas; Efficace, Fabio; Armes, Jo; Brown, Julia M; Calman, Lynn; Copland, Chris; Gavin, Anna; Glaser, Adam; Greenfield, Diana M; Lanceley, Anne; Taylor, Rachel; Velikova, Galina; Brundage, Michael; Mercieca-Bebber, Rebecca; King, Madeleine T

    2016-01-01

    Introduction Emerging evidence suggests that patient-reported outcome (PRO)-specific information may be omitted in trial protocols and that PRO results are poorly reported, limiting the use of PRO data to inform cancer care. This study aims to evaluate the standards of PRO-specific content in UK cancer trial protocols and their arising publications and to highlight examples of best-practice PRO protocol content and reporting where they occur. The objective of this study is to determine if these early findings are generalisable to UK cancer trials, and if so, how best we can bring about future improvements in clinical trials methodology to enhance the way PROs are assessed, managed and reported. Hypothesis: Trials in which the primary end point is based on a PRO will have more complete PRO protocol and publication components than trials in which PROs are secondary end points. Methods and analysis Completed National Institute for Health Research (NIHR) Portfolio Cancer clinical trials (all cancer specialities/age-groups) will be included if they contain a primary/secondary PRO end point. The NIHR portfolio includes cancer trials, supported by a range of funders, adjudged as high-quality clinical research studies. The sample will be drawn from studies completed between 31 December 2000 and 1 March 2014 (n=1141) to allow sufficient time for completion of the final trial report and publication. Two reviewers will then review the protocols and arising publications of included trials to: (1) determine the completeness of their PRO-specific protocol content; (2) determine the proportion and completeness of PRO reporting in UK Cancer trials and (3) model factors associated with PRO protocol and reporting completeness and with PRO reporting proportion. Ethics and dissemination The study was approved by the ethics committee at University of Birmingham (ERN_15-0311). Trial findings will be disseminated via presentations at local, national and international conferences, peer

  8. Sodium intake and blood pressure in children and adolescents: protocol for a systematic review and meta-analysis.

    OpenAIRE

    Leyvraz, M.; Taffé, P.; Chatelan, A.; Paradis, G; Tabin, R.; Bovet, P.; Bochud, M; Chiolero, A.

    2016-01-01

    Introduction Hypertension is a major risk factor for cardiovascular diseases. In adults, high sodium intake is associated with elevated blood pressure. In children, experimental studies have shown that reducing sodium intake can reduce blood pressure. However, their external validity is limited, notably because the sodium reduction was substantial and not applicable in a real-life setting. Observational studies, on the other hand, allow assess the association between blood pressure and sodium...

  9. Stream Control Transmission Protocol as a Transport for SIP: a case study

    Directory of Open Access Journals (Sweden)

    Giuseppe De Marco

    2004-06-01

    Full Text Available The dominant signalling protocol both in future wireless and wired networks will be the Session Initiation Protocol (SIP, as pointed out in the 3G IP-based mobile networks specifications, entailing a fully Internet integrated network. The use of SIP in the IP Multimedia Subsytem (IMS of Release 5 involves the development of servers capable to handle a large number of call requests. The signaling traffic associated to such requests could explode, if an intelligent congestion control were not introduced. Stream Control Transmission Protocol (SCTP was born to support transport of SS7 signaling messages. However, many of the SCTP features are also useful for transport of SIP messages, as: congestion control mechanism, good separation among independent messages, multihoming. Indeed, adoption of SCTP as transport of SIP signaling might prove useful in some situations where usual transport protocols, like TCP and UDP, suffer performance degradation. In this paper, we analyse the general framework wherein SIP operates and we discuss the benefits of using SCTP as a transport for SIP, toward fair sharing of network resources. This study is carried on in the context of the implementation of an high-performance SIP Proxy Server. We also present some preliminar results of an implementation of SIP over SCTP/UDP in a real LAN environment.

  10. An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol

    Directory of Open Access Journals (Sweden)

    Flynn Kathryn

    2003-03-01

    Full Text Available Abstract Background The global rise of Type 2 diabetes and its complications has drawn attention to the burden of non-communicable diseases on populations undergoing epidemiological transition. The life course approach of a birth cohort has the potential to increase our understanding of the development of these chronic diseases. In 1987 we sought to establish an Australian Indigenous birth cohort to be used as a resource for descriptive and analytical studies with particular attention on non-communicable diseases. The focus of this report is the methodology of recruiting and following-up an Aboriginal birth cohort of mobile subjects belonging to diverse cultural and language groups living in a large sparsely populated area in the Top End of the Northern Territory of Australia. Methods A prospective longitudinal study of Aboriginal singletons born at the Royal Darwin Hospital 1987–1990, with second wave cross-sectional follow-up examination of subjects 1998–2001 in over 70 different locations. A multiphase protocol was used to locate and collect data on 686 subjects with different approaches for urban and rural children. Manual chart audits, faxes to remote communities, death registries and a full time subject locator with past experience of Aboriginal communities were all used. Discussion The successful recruitment of 686 Indigenous subjects followed up 14 years later with vital status determined for 95% of subjects and examination of 86% shows an Indigenous birth cohort can be established in an environment with geographic, cultural and climatic challenges. The high rates of recruitment and follow up indicate there were effective strategies of follow-up in a supportive population.

  11. An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol

    Science.gov (United States)

    Sayers, Susan M; Mackerras, Dorothy; Singh, Gurmeet; Bucens, Ingrid; Flynn, Kathryn; Reid, Alison

    2003-01-01

    Background The global rise of Type 2 diabetes and its complications has drawn attention to the burden of non-communicable diseases on populations undergoing epidemiological transition. The life course approach of a birth cohort has the potential to increase our understanding of the development of these chronic diseases. In 1987 we sought to establish an Australian Indigenous birth cohort to be used as a resource for descriptive and analytical studies with particular attention on non-communicable diseases. The focus of this report is the methodology of recruiting and following-up an Aboriginal birth cohort of mobile subjects belonging to diverse cultural and language groups living in a large sparsely populated area in the Top End of the Northern Territory of Australia. Methods A prospective longitudinal study of Aboriginal singletons born at the Royal Darwin Hospital 1987–1990, with second wave cross-sectional follow-up examination of subjects 1998–2001 in over 70 different locations. A multiphase protocol was used to locate and collect data on 686 subjects with different approaches for urban and rural children. Manual chart audits, faxes to remote communities, death registries and a full time subject locator with past experience of Aboriginal communities were all used. Discussion The successful recruitment of 686 Indigenous subjects followed up 14 years later with vital status determined for 95% of subjects and examination of 86% shows an Indigenous birth cohort can be established in an environment with geographic, cultural and climatic challenges. The high rates of recruitment and follow up indicate there were effective strategies of follow-up in a supportive population. PMID:12659639

  12. Survival of Mexican Children with Acute Lymphoblastic Leukaemia under Treatment with the Protocol from the Dana-Farber Cancer Institute 00-01

    Science.gov (United States)

    Jiménez-Hernández, Elva; Jaimes-Reyes, Ethel Zulie; Arellano-Galindo, José; García-Jiménez, Xochiketzalli; Tiznado-García, Héctor Manuel; Sánchez-Jara, Berenice; Bekker-Méndez, Vilma Carolina; Ortíz-Torres, María Guadalupe; Ortíz-Fernández, Antonio; Marín-Palomares, Teresa; Mejía-Aranguré, Juan Manuel

    2015-01-01

    Our aim in this paper is to describe the results of treatment of acute lymphoblastic leukaemia (ALL) in Mexican children treated from 2006 to 2010 under the protocol from the Dana-Farber Cancer Institute (DFCI) 00-01. The children were younger than 16 years of age and had a diagnosis of ALL de novo. The patients were classified as standard risk if they were 1–9.9 years old and had a leucocyte count 100 × 109/L. The poor outcomes were associated with toxic death during induction, complete remission, and relapse. These factors remain the main obstacles to the success of this treatment in our population. PMID:25922837

  13. Sodium intake and blood pressure in children and adolescents: protocol for a systematic review and meta-analysis

    Science.gov (United States)

    Leyvraz, Magali; Taffé, Patrick; Chatelan, Angeline; Paradis, Gilles; Tabin, René; Bovet, Pascal; Bochud, Murielle; Chiolero, Arnaud

    2016-01-01

    Introduction Hypertension is a major risk factor for cardiovascular diseases. In adults, high sodium intake is associated with elevated blood pressure. In children, experimental studies have shown that reducing sodium intake can reduce blood pressure. However, their external validity is limited, notably because the sodium reduction was substantial and not applicable in a real-life setting. Observational studies, on the other hand, allow assess the association between blood pressure and sodium intake across usual levels of consumption. There is also evidence that the association differs between subgroups of children according to age and body weight. Our objective is to conduct a systematic review and meta-analysis of experimental and observational studies on the association between sodium intake and blood pressure in children and adolescents and to assess whether the association differs according to age and body weight. Methods and analysis A systematic search of the MEDLINE, EMBASE, CINAHL and CENTRAL databases will be conducted and supplemented by a manual search of bibliographies and unpublished studies. Experimental and observational studies involving children or adolescents between 0 and 18 years of age will be included. The exposure will be dietary sodium intake, estimated using different methods including urinary sodium excretion. The outcomes will be systolic and diastolic blood pressure, elevated blood pressure and hypertension. If appropriate, meta-analyses will be performed by pooling data across all studies together and separately for experimental and observational studies. Subgroup meta-analyses by age and body weight will be also conducted. Moreover, separate meta-analyses for different sodium intake levels will be conducted to investigate the dose–response relationship. Ethics and dissemination This systematic review and meta-analysis will be published in a peer-reviewed journal. A report will be prepared for national authorities and other

  14. A Pilot Study on the effects of Music Therapy on Frontotemporal Dementia - developing a research protocol

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Wigram, Tony; Ottesen, Anne Marie

    2009-01-01

    Background: Some forms of dementia particularly affect the frontal parts of the brain which, in some cases, causes the onset of severe behavioural and psychological symptoms. No specific treatment for the primary diseases that cause these frontotemporal dementia conditions has yet been developed....... As an example of a non-pharmacologic treatment procedure music therapy was investigated. With the focus to develop a research protocol for a future larger population study a pilot study was carried out. In two case studies a combination of data collection methods were examined with the overall goal to document...... of Life (ADRQL), the Cohen-Mansfield Agitation Inventory (CMAI), and the Neuro-Psychiatric Inventory (NPI), and related to case descriptions and video analyses. Results: Recommendations for a mixed method research protocol focused on measuring the effect of music therapy with persons with frontotemporal...

  15. A prospective study of GnRH long agonist versus flexible GnRH antagonist protocol in PCOS: Indian experience

    Directory of Open Access Journals (Sweden)

    Harpreet Kaur

    2012-01-01

    Full Text Available Background: Polycystic ovarian syndrome is a common endocrine disorder of reproductive age women. Many controlled ovarian stimulation (COS strategies have been offered for the treatment of patients with PCOS undergoing in vitro fertilization, but the optimal protocol is still a controversy. There is no compelling evidence for the advantage of one stimulation protocol over the other. Materials and Methods: This is a single-center prospective controlled study comparing long agonist and antagonist protocol in PCOS women. Results: There was no significant difference in live birth rate and clinical pregnancy rate. Rate of ovarian hyperstimulation syndrome was significantly higher in the agonist group. Number of oocytes retrieved, number of follicles and peak estradiol levels were significantly more in the agonist group. Conclusion: The GnRH antagonist protocol is an equally effective but safer protocol in PCOS patients compared with the long agonist protocol.

  16. Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group.

    Science.gov (United States)

    Hayakawa, F; Sakura, T; Yujiri, T; Kondo, E; Fujimaki, K; Sasaki, O; Miyatake, J; Handa, H; Ueda, Y; Aoyama, Y; Takada, S; Tanaka, Y; Usui, N; Miyawaki, S; Suenobu, S; Horibe, K; Kiyoi, H; Ohnishi, K; Miyazaki, Y; Ohtake, S; Kobayashi, Y; Matsuo, K; Naoe, T

    2014-10-17

    The superiority of the pediatric protocol for adolescents with acute lymphoblastic leukemia (ALL) has already been demonstrated, however, its efficacy in young adults remains unclear. The ALL202-U protocol was conducted to examine the efficacy and feasibility of a pediatric protocol in adolescents and young adults (AYAs) with BCR-ABL-negative ALL. Patients aged 15-24 years (n=139) were treated with the same protocol used for pediatric B-ALL. The primary objective of this study was to assess the disease-free survival (DFS) rate and its secondary aims were to assess toxicity, the complete remission (CR) rate and the overall survival (OS) rate. The CR rate was 94%. The 5-year DFS and OS rates were 67% (95% confidence interval (CI) 58-75%) and 73% (95% CI 64-80%), respectively. Severe adverse events were observed at a frequency that was similar to or lower than that in children treated with the same protocol. Only insufficient maintenance therapy significantly worsened the DFS (hazard ratio 5.60, P<0.001). These results indicate that this protocol may be a feasible and highly effective treatment for AYA with BCR-ABL-negative ALL.

  17. Whole spine CT for evaluation of scoliosis in children - Feasibility of sub-milli Sievert scanning protocol

    Energy Technology Data Exchange (ETDEWEB)

    Kalra, Mannudeep K. [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden); Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston (United States); Quick, Petter; Persson, Anders [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden)], e-mail: anders.persson@cmiv.liu.se; Singh, Sarabjeet [Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston (United States); Sandborg, Michael [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden); Department of Radiophysics, Linkoeping Univ. Hospital, Linkoeping (Sweden)

    2013-03-15

    Background: Optimization of CT radiation dose is important for children due to their higher risk of radiation-induced adverse effects. Anatomical structures with high inherent contrast, such as bones can be imaged at very low radiation doses by optimizing scan parameters. Purpose: To assess feasibility of sub-milli Sievert whole spine CT scanning protocol for evaluation of scoliosis in children. Material and Methods: With approval of the ethical board, we performed whole spine CT for evaluation of scoliosis in 22 children (age range, 3-18 years; mean age, 13 years; 13 girls, 9 boys) on a 128-slice dual source multidetector-row CT scanner. Lowest possible quality reference mAs value (image quality factor for xy-z automatic exposure control or xyz-AEC, CARE Dose 4D) was selected on a per patient basis. Remaining parameters were held constant at 3.0:1 pitch, 128 X 0.6 mm detector collimation, 115.2 mm table feed per gantry rotation, 100 kVp, and 1 and 3 mm reconstructed sections. Average mAs, projected estimated dose savings with AEC, computed tomography dose index volume (CTDI vol), and dose length product (DLP) were recorded. Artifacts were graded on a four-point scale (1, no artifacts; 4, severe artifacts). Ability to identify vertebral and pedicular contours, and measure pedicular width and degree of vertebral rotation was graded on a three-point scale (1, unacceptable; 3, excellent). Results: All CT examinations were deemed as reliable for identifying vertebral and pedicular contours as well as for measuring pedicular width (5.9 {+-} 1.6 mm) and degree of vertebral rotation (28.7{+-} 23.4 deg). Mean objective image noise and signal to noise ratio (SNR) were 57.5 {+-} 21.5 {+-} 4.7 2.3, respectively. With a mean quality reference mAs of 13, the scanner employed an average actual effective mAs of 10 {+-} 3.8 (range, 6-18 mAs) with an estimated radiation dose saving of 43.5 {+-} 16.3% with xyz-AEC compared with fixed mAs. The mean CTDI, DLP, and estimated effective

  18. National Children's Study Dietary Assessment Workshop

    Science.gov (United States)

    The National Children's Study dietary assessment workshop was an opportunity for experts in dietary assessment methodology to gather and discuss the current state of knowledge about methodologies used to assess dietary intake during pregnancy, lactation, infancy, childhood, and adolescence.

  19. A follow-up study of heroin addicts (VEdeTTE2: study design and protocol

    Directory of Open Access Journals (Sweden)

    Lampis Fabio

    2007-03-01

    Full Text Available Abstract Background In Italy, a large cohort study (VEdeTTE1 was conducted between 1998–2001 to evaluate the effectiveness of treatments in reducing mortality and increasing treatment retention among heroin addicts. The follow-up of this cohort (VEdeTTE2 was designed to evaluate the effectiveness of treatments on long-term outcomes, such as rehabilitation and social re-integration. The purpose of this paper is to describe the protocol of the VEdeTTE2 study, and to present the results of the pilot study carried out to assess the feasibility of the study and to improve study procedures. Methods The source population for the VEdeTTE2 study was the VEdeTTE1 cohort, from which a sample of 2,200 patients, traced two or more years after enrolment in the cohort, were asked to participate. An interview investigates drug use; overdose; family and social re-integration. Illegal activity are investigated separately in a questionnaire completed by the patient. Patients are also asked to provide a hair sample to test for heroin and cocaine use. Information on treatments and HIV, HBV and HCV morbidity are obtained from clinical records. A pilot phase was planned and carried out on 60 patients. Results The results of the pilot phase pointed out the validity of the procedures designed to limit attrition: the number of traced subjects was satisfactory (88%. Moreover, the pilot phase was very useful in identifying possible causes of delays and attrition, and flaws in the instruments. Improvements to the procedures and the instruments were subsequently implemented. Sensitivity of the biological test was quite good for heroin (78% but lower for cocaine (42.3%, highlighting the need to obtain a hair sample from all patients. Conclusion In drug addiction research, studies investigating health status and social re-integration of subjects at long-term follow-up are lacking. The VEdeTTE2 study aims to investigate these outcomes at long-term follow-up. Results of the

  20. Declarative Specification of Fault Tolerant Auction Protocols: The English Auction Case Study

    DEFF Research Database (Denmark)

    Dragoni, Nicola; Gaspari, Mauro

    2012-01-01

    ‐allocation and negotiation mechanisms have also led to a great deal of interest in auctions within the agent community. A challenging issue for agents operating in open Multiagent Systems (such as the emerging semantic Web infrastructure) concerns the specification of declarative communication rules which could be published......Auction mechanisms are nowadays widely used in electronic commerce Web sites for buying and selling items among different users. The increasing importance of auction protocols in the negotiation phase is not limited to online marketplaces. In fact, the wide applicability of auctions as resource...... an auction process even if some bidding agents dynamically crash. In this paper, we propose an approach to specify fault tolerant auction protocols in open and dynamic environments by means of communication rules dealing with crash failures of agents. We illustrate these concepts considering a case study...

  1. Replication protocol analysis: a method for the study of real-world design thinking

    DEFF Research Database (Denmark)

    Galle, Per; Kovacs, L. B.

    1996-01-01

    ’ is refined into a method called ‘replication protocol analysis’ (RPA), and discussed from a methodological perspective of design research. It is argued that for the study of real-world design thinking this method offers distinct advantages over traditional ‘design protocol analysis’, which seeks to capture......Given the brief of an architectural competition on site planning, and the design awarded the first prize, the first author (trained as an architect but not a participant in the competition) produced a line of reasoning that might have led from brief to design. In the paper, such ‘design replication...... the designer’s authentic line of reasoning. To illustrate how RPA can be used, the site planning case is briefly presented, and part of the replicated line of reasoning analysed. One result of the analysis is a glimpse of a ‘logic of design’; another is an insight which sheds new light on Darke’s classical...

  2. The effects of exercise during pregnancy on the newborn’s brain: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    LeMoyne Elise L

    2012-05-01

    Full Text Available Abstract Background It is generally accepted that an active lifestyle is beneficial for cognition in children, adults and the elderly. Recently, studies using the rat animal model found that the pups of mothers who exercised during pregnancy had increased hippocampal neurogenesis and better memory and learning abilities. The aim of this report is to present the experimental protocol of a study that is designed to verify if an active lifestyle during pregnancy in humans has an impact on the newborn's brain. Methods 60 pregnant women will be included in a randomized controlled study. The experimental group will be asked to exercise a minimum of 20 minutes three times per week, at a minimal intensity of 55% of their maximal aerobic capacity. The control group will not be exercising. The effect of exercise during pregnancy on the newborn's brain will be investigated 8 to 12 days postpartum by means of the mismatch negativity, a neurophysiological brain potential that is associated to auditory sensory memory. We hypothesize that children born to mothers who exercised during their pregnancy will present shorter latencies and larger mismatch negativity amplitudes, indicating more efficient auditory memory processes. Discussion As of September 2011, 17 women have joined the study. Preliminary results show that the experimental group are active 3.1 ± 0.9 days per week while the control group only exercise 0.8 ± 0.6 days per week. The results of this study will present insight on fetal neuroplasticity and will be a valuable tool for health professionals who wish to encourage pregnant women to exercise. Trial registration ClinicalTrials.gov registration: NTC01220778

  3. Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases

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    Gülsün Yildirim

    2010-07-01

    Full Text Available Background: The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour.Methods: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years.Results: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations.Conclusions: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

  4. Proposed computerized protocol for epidemiological study of patients undergoing microsurgery of the larynx

    Science.gov (United States)

    Catani, Guilherme Simas do Amaral; Carvalho, Bettina; Filho, Jorge Massaaki Ido; Filho, Evaldo Dacheux de Macedo; Pinto, José Simão de Paula; Malafaia, Osvaldo; Stahlke, Henrique Jorge

    2012-01-01

    Summary Introduction: The merging of medicine with information technology facilitates the retrieval of stored data, aiding the conduct of research with greater scientific rigor. Studies in the field of otorhinolaryngology, specifically in the area of laryngology and voice, are of fundamental importance, since 70% of the economically active need their voice to work. Objective: To create a computerized protocol of the diseases of the larynx, apply and validate it, and use it to evaluate patients undergoing laryngoscopic microsurgery of the larynx. Method: We created a database of ENT diseases through a literature review of textbooks and scientific articles. Next, we computerized the data and incorporated it into the SINPE©, creating a master protocol (ENT diseases) and a specific protocol (laryngeal diseases). Data were collected prospectively from patients undergoing laryngeal microsurgery in the ENT Hospital of Paraná. The collected data were analyzed with graphs through the SINPE© Analyzer module. Results: We evaluated 245 patients aged 9–79 years, and determined that 36.61% (93 patients) underwent surgery for the presence of polyps on the vocal folds, 12.6% (32) underwent surgery for papillomatosis, and 11.83% (29) underwent surgery for intracordal cysts. Conclusions: The creation of an electronic database of clinical ENT diseases was feasible. We were also able to implement and validate the protocol. The database may be released to physicians involved in clinical data collection and retrieval of information to conduct scientific research in an organized manner. The most common laryngeal disorders identified were polyps, papilloma, and intracordal cysts. PMID:25991956

  5. Automated extraction protocol for quantification of SARS-Coronavirus RNA in serum: an evaluation study

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    Lui Wing-bong

    2006-02-01

    Full Text Available Abstract Background We have previously developed a test for the diagnosis and prognostic assessment of the severe acute respiratory syndrome (SARS based on the detection of the SARS-coronavirus RNA in serum by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR. In this study, we evaluated the feasibility of automating the serum RNA extraction procedure in order to increase the throughput of the assay. Methods An automated nucleic acid extraction platform using the MagNA Pure LC instrument (Roche Diagnostics was evaluated. We developed a modified protocol in compliance with the recommended biosafety guidelines from the World Health Organization based on the use of the MagNA Pure total nucleic acid large volume isolation kit for the extraction of SARS-coronavirus RNA. The modified protocol was compared with a column-based extraction kit (QIAamp viral RNA mini kit, Qiagen for quantitative performance, analytical sensitivity and precision. Results The newly developed automated protocol was shown to be free from carry-over contamination and have comparable performance with other standard protocols and kits designed for the MagNA Pure LC instrument. However, the automated method was found to be less sensitive, less precise and led to consistently lower serum SARS-coronavirus concentrations when compared with the column-based extraction method. Conclusion As the diagnostic efficiency and prognostic value of the serum SARS-CoV RNA RT-PCR test is critically associated with the analytical sensitivity and quantitative performance contributed both by the RNA extraction and RT-PCR components of the test, we recommend the use of the column-based manual RNA extraction method.

  6. Efficiency of different protocols for enamel clean-up after bracket debonding: an in vitro study

    Science.gov (United States)

    Sigilião, Lara Carvalho Freitas; Marquezan, Mariana; Elias, Carlos Nelson; Ruellas, Antônio Carlos; Sant'Anna, Eduardo Franzotti

    2015-01-01

    Objective: This study aimed to assess the efficiency of six protocols for cleaning-up tooth enamel after bracket debonding. Methods: A total of 60 premolars were divided into six groups, according to the tools used for clean-up: 12-blade bur at low speed (G12L), 12-blade bur at high speed (G12H), 30-blade bur at low speed (G30L), DU10CO ORTHO polisher (GDU), Renew System (GR) and Diagloss polisher (GD). Mean roughness (Ra) and mean roughness depth (Rz) of enamel surface were analyzed with a profilometer. Paired t-test was used to assess Ra and Rz before and after enamel clean-up. ANOVA/Tukey tests were used for intergroup comparison. The duration of removal procedures was recorded. The association between time and variation in enamel roughness (∆Ra, ∆Rz) were evaluated by Pearson's correlation test. Enamel topography was assessed by scanning electron microscopy (SEM). Results: In Groups G12L and G12H, original enamel roughness did not change significantly. In Groups G30L, GDU, GR and GD, a smoother surface (p < 0.05) was found after clean-up. In Groups G30L and GD, the protocols used were more time-consuming than those used in the other groups. Negative and moderate correlation was observed between time and (∆Ra, ∆Rz); Ra and (∆Ra, ∆Rz); Rz (r = - 0.445, r = - 0.475, p < 0.01). Conclusion: All enamel clean-up protocols were efficient because they did not result in increased surface roughness. The longer the time spent performing the protocol, the lower the surface roughness. PMID:26560825

  7. Proposed computerized protocol for epidemiological study of patients undergoing microsurgery of the larynx

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    Catani, Guilherme Simas do Amaral

    2012-01-01

    Full Text Available Introduction: The merging of medicine with information technology facilitates the retrieval of stored data, aiding the conduct of research with greater scientific rigor. Studies in the field of otorhinolaryngology, specifically in the area of laryngology and voice, are of fundamental importance, since 70% of the economically active need their voice to work. Objective: To create a computerized protocol of the diseases of the larynx, apply and validate it, and use it to evaluate patients undergoing laryngoscopic microsurgery of the larynx. Method: We created a database of ENT diseases through a literature review of textbooks and scientific articles. Next, we computerized the data and incorporated it into the SINPE©, creating a master protocol (ENT diseases and a specific protocol (laryngeal diseases. Data were collected prospectively from patients undergoing laryngeal microsurgery in the ENT Hospital of Paraná. The collected data were analyzed with graphs through the SINPE© Analyzer module. Results: We evaluated 245 patients aged 9-79 years, and determined that 36.61% (93 patients underwent surgery for the presence of polyps on the vocal folds, 12.6% (32 underwent surgery for papillomatosis, and 11.83% (29 underwent surgery for intracordal cysts. Conclusions: The creation of an electronic database of clinical ENT diseases was feasible. We were also able to implement and validate the protocol. The database may be released to physicians involved in clinical data collection and retrieval of information to conduct scientific research in an organized manner. The most common laryngeal disorders identified were polyps, papilloma, and intracordal cysts.

  8. Efficiency of different protocols for enamel clean-up after bracket debonding: an in vitro study

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    Lara Carvalho Freitas Sigilião

    2015-10-01

    Full Text Available Objective: This study aimed to assess the efficiency of six protocols for cleaning-up tooth enamel after bracket debonding.Methods:A total of 60 premolars were divided into six groups, according to the tools used for clean-up: 12-blade bur at low speed (G12L, 12-blade bur at high speed (G12H, 30-blade bur at low speed (G30L, DU10CO ORTHO polisher (GDU, Renew System (GR and Diagloss polisher (GD. Mean roughness (Ra and mean roughness depth (Rz of enamel surface were analyzed with a profilometer. Paired t-test was used to assess Ra and Rz before and after enamel clean-up. ANOVA/Tukey tests were used for intergroup comparison. The duration of removal procedures was recorded. The association between time and variation in enamel roughness (∆Ra, ∆Rz were evaluated by Pearson's correlation test. Enamel topography was assessed by scanning electron microscopy (SEM.Results:In Groups G12L and G12H, original enamel roughness did not change significantly. In Groups G30L, GDU, GR and GD, a smoother surface (p < 0.05 was found after clean-up. In Groups G30L and GD, the protocols used were more time-consuming than those used in the other groups. Negative and moderate correlation was observed between time and (∆Ra, ∆Rz; Ra and (∆Ra, ∆Rz; Rz (r = - 0.445, r = - 0.475, p < 0.01.Conclusion:All enamel clean-up protocols were efficient because they did not result in increased surface roughness. The longer the time spent performing the protocol, the lower the surface roughness.

  9. Use of clomiphene-based stimulation protocol in oocyte donors: A comparative study

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    Aparna Singh

    2016-01-01

    Full Text Available INTRODUCTION: This study was undertaken to compare between clomiphene citrate (CC and gonadotropin-releasing hormone antagonist-based protocols in donor-recipient cycles in terms of parameters of ovarian stimulation and obstetric outcome. MATERIALS AND METHODS: Two hundred and three fertile oocyte donors were stimulated using two different protocols: Clomiphene based (n = 103 and antagonist based (n = 100. Donors in the one group were stimulated from day 1 or 2 of spontaneous or withdrawal bleeds with CC (50 mg/day and recombinant follicle-stimulating hormone (FSH till the day of trigger while donors in the other group were stimulated using recombinant FSH from day 1 or 2, and the antagonist was added as per flexible antagonist protocol. When >3 follicles were >17 mm in diameter, trigger was given with 2 mg leuprolide intramuscular. Transvaginal oocyte retrieval was done after 34 h of trigger. RESULTS: There was no significant difference in between the two groups in terms of age, antral follicle count, starting dose of gonadotropins, total dose required, duration of stimulation, number of follicles retrieved, mature follicles, and fertilization rate. The serum estradiol levels were significantly raised in the clomiphene group (P < 0.001. Pregnancy rate was similar in both the groups. The clinical pregnancy rate was 65.94% in the clomiphene group and 57.46% in the antagonist group. The live birth rate per cycle started was 47.8% in the clomiphene group and 39.55% in the antagonist group. There was one case of ectopic pregnancy in the antagonist group. CONCLUSION: Controlled ovarian stimulation using clomiphene and gonadotropin is a viable option for donor oocyte cycles. The cost and number of injections used per cycle can be reduced by using the clomiphene-based protocols.

  10. Clinical Study on Ocular Trauma in Children

    Institute of Scientific and Technical Information of China (English)

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou

    2002-01-01

    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.

  11. Why standard brain-computer interface (BCI) training protocols should be changed: an experimental study

    Science.gov (United States)

    Jeunet, Camille; Jahanpour, Emilie; Lotte, Fabien

    2016-06-01

    Objective. While promising, electroencephaloraphy based brain-computer interfaces (BCIs) are barely used due to their lack of reliability: 15% to 30% of users are unable to control a BCI. Standard training protocols may be partly responsible as they do not satisfy recommendations from psychology. Our main objective was to determine in practice to what extent standard training protocols impact users’ motor imagery based BCI (MI-BCI) control performance. Approach. We performed two experiments. The first consisted in evaluating the efficiency of a standard BCI training protocol for the acquisition of non-BCI related skills in a BCI-free context, which enabled us to rule out the possible impact of BCIs on the training outcome. Thus, participants (N = 54) were asked to perform simple motor tasks. The second experiment was aimed at measuring the correlations between motor tasks and MI-BCI performance. The ten best and ten worst performers of the first study were recruited for an MI-BCI experiment during which they had to learn to perform two MI tasks. We also assessed users’ spatial ability and pre-training μ rhythm amplitude, as both have been related to MI-BCI performance in the literature. Main results. Around 17% of the participants were unable to learn to perform the motor tasks, which is close to the BCI illiteracy rate. This suggests that standard training protocols are suboptimal for skill teaching. No correlation was found between motor tasks and MI-BCI performance. However, spatial ability played an important role in MI-BCI performance. In addition, once the spatial ability covariable had been controlled for, using an ANCOVA, it appeared that participants who faced difficulty during the first experiment improved during the second while the others did not. Significance. These studies suggest that (1) standard MI-BCI training protocols are suboptimal for skill teaching, (2) spatial ability is confirmed as impacting on MI-BCI performance, and (3) when faced

  12. Enhancing research quality and reporting: why the Journal of Comorbidity is now publishing study protocols

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    Susan Smith

    2014-08-01

    Full Text Available The Journal of Comorbidity was launched in 2011 and has since become established as a high-quality journal that publishes open-access, peer-reviewed articles, with a focus on advancing the clinical management of patients with comorbidity/multimorbidity. To further enhance research quality and reporting of studies in this field, the journal is now offering authors the opportunity to publish a summary of their study protocols – a move designed to generate interest and raise awareness in ongoing clinical research and to enable researchers to detail their methodologies in order that replication by scientific peers is possible.

  13. Research on Protocol Migration

    Institute of Scientific and Technical Information of China (English)

    汪芸; 顾冠群; 等

    1996-01-01

    This paper elaborates the concept and model of protocol migration in network interconnection.Migration strategies and principles are discussed and several cases are studied in detail which show the basic procedure and techniques used in protocol migration.

  14. Reproducibility of anthropometric measurements in children: a longitudinal study.

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    Leppik, Aire; Jürimäe, Toivo; Jürimäe, Jaak

    2004-03-01

    The purpose of this study was to establish the reproducibility of a series of anthropometric measures performed twice during one week during a three year period in boys and girls. The subjects of this investigation were 39 children (21 boys and 18 girls), 9-10 year of age at the beginning of the study. Children were measured three times with one year interval. Children were classified by Tanner stage 1-2 during the first measurements, stage 1-3 during the second measurements and stage 1-4 during the third measurements. Body height and weight were measured and BMI calculated. All anthropometric parameters were measured according to the protocol recommended by the International Society for the Advancement of Kinanthropometry (Norton & Olds 1996). Nine skinfolds, 13 girths, eight lengths and eight breadths/lengths were measured. The reproducibility of body height (r = 0.995-0.999), body weight (r = 0.990-0.999) and BMI (r = 0.969-0.999) was very high in boys and girls. The intraclass correlations (ICC), technical errors (TE) and coefficients of variation (CV) were quite different depending on the measurement site of the skinfold thickness. It was surprising that the ICCs were highest and TEs and CVs were lowest during the second year of the measurement. The computed ICC was high, and TE and CV values were quite similar and relatively low in girth, length and breadth/length measurements. It was concluded that the reproducibility of girths, lengths and breadths/lengths in children is very high and the reproducibility of skinfolds is high. Specifically, the reproducibility is very high immediately before puberty in boys and girls.

  15. EPIDEMIOLOGICAL STUDY OF DRUG INTOXICATION IN CHILDREN

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    F. Cheraghali M. Taymori

    2006-05-01

    Full Text Available Unintentional drug intoxication is still a major cause of morbidity and mortality in young children. In order to study the epidemiological pattern of childhood drug poisoning in Golestan province, all cases diagnosed with poisoning from 1997 to 2002 in the only pediatric hospital in province were recruited. During this period 563 cases of poisoned children were hospitalized in Taleqani hospital, of these 305 cases were due to drug poisoning. Opium was responsible for more than half of the poisoning cases, and 91% of deaths, among drug intoxicated children. Metoclopramide, benzodiazepines, tricyclic antidepressants and anticonvulsants were among the other frequent causes of poisoning. Neurological symptoms were the most prominent symptoms of poisoning and more than 80% of cases showed some neurological symptoms. Mortality rate among the cases was 3.6% and of total of 11 deaths, 10 were poisoned with opium. About 61% of cases were hospitalized between 24-48 hrs. Most of the poisoning cases in young children were unintentional and in many cases, their parents played a critical role in their intoxication. This role specially is crucial in infants and children under one year of age. Parents in Golestan province use opium widely for symptomatic treatment of routine illnesses in their young children and overdose of opium may cause severe intoxication and even death of the child.

  16. Physiological and emotional responses of disabled children to therapeutic clowns: a pilot study.

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    Kingsnorth, Shauna; Blain, Stefanie; McKeever, Patricia

    2011-01-01

    This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions-television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n = 7) and nurses of participating children (n = 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings.

  17. Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

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    Shauna Kingsnorth

    2011-01-01

    Full Text Available This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood and behavior (facial expressions and vocalizations. Semistructured interviews were completed with verbally expressive children (n = 7 and nurses of participating children (n = 13. Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self and nurses' (observed reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings.

  18. Development of new method and protocol for cryopreservation related to embryo and oocytes freezing in terms of fertilization rate: A comparative study including review of literature

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    Barik, Mayadhar; Bajpai, Minu; Patnaik, Santosh; Mishra, Pravash; Behera, Priyamadhaba; Dwivedi, Sada Nanda

    2016-01-01

    Background: Cryopreservation is basically related to meritorious thin samples or small clumps of cells that are cooled quickly without loss. Our main objective is to establish and formulate an innovative method and protocol development for cryopreservation as a gold standard for clinical uses in laboratory practice and treatment. The knowledge regarding usefulness of cryopreservation in clinical practice is essential to carry forward the clinical practice and research. Materials and Methods: We are trying to compare different methods of cryopreservation (in two dozen of cells) at the same time we compare the embryo and oocyte freezing interms of fertilization rate according to the International standard protocol. Results: The combination of cryoprotectants and regimes of rapid cooling and rinsing during warming often allows successful cryopreservation of biological materials, particularly cell suspensions or thin tissue samples. Examples include semen, blood, tissue samples like tumors, histological cross-sections, human eggs and human embryos. Although presently many studies have reported that the children born from frozen embryos or “frosties,” show consistently positive results with no increase in birth defects or development abnormalities is quite good enough and similar to our study (50–85%). Conclusions: We ensure that cryopreservation technology provided useful cell survivability, tissue and organ preservation in a proper way. Although it varies according to different laboratory conditions, it is certainly beneficial for patient's treatment and research. Further studies are needed for standardization and development of new protocol. PMID:27512686

  19. Ozone therapy as an adjuvant for endondontic protocols: microbiological – ex vivo study and citotoxicity analyses

    Science.gov (United States)

    NOGALES, Carlos Goes; FERREIRA, Marina Beloti; MONTEMOR, Antonio Fernando; RODRIGUES, Maria Filomena de Andrade; Lage-MARQUES, José Luiz; ANTONIAZZI, João Humberto

    2016-01-01

    ABSTRACT Objectives This study evaluated the antimicrobial efficacy of ozone therapy in teeth contaminated with Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus using a mono-species biofilm model. Parallel to this, the study aimed to evaluate the cytotoxicity of ozone for human gingival fibroblasts. Material and Methods: One hundred and eighty single-root teeth were contaminated with a mono-species biofilm of Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus. Groups were formed: Group I – control; Group II – standard protocol; Group III – standard protocol + ozone gas at 40 µg/mL; and Group IV – standard protocol + aqueous ozone at 8 µg/mL. In parallel, human gingival fibroblasts were submitted to the MTT test. Cells were plated, then ozone was applied as follows: Group I (control) – broth medium; Group II – aqueous ozone at 2 µg/mL; Group III – aqueous ozone at 5 µg/mL; and Group IV – aqueous ozone at 8 µg/mL. Data were submitted to the Kruskal Wallis test and Bonferroni post hoc analyses to assess microbiology and cytotoxicity, respectively (p<0.05%). Results The results revealed antimicrobial efficacy by Group IV with no CFU count. The cytotoxicity assay showed Groups III and IV to be the most aggressive, providing a decrease in cell viability at hour 0 from 100% to 77.3% and 68.6%, respectively. Such a decrease in cell viability was reverted, and after 72 hours Groups III and IV provided the greatest increase in cell viability, being statistically different from Groups I and II. Conclusion According to the applied methodology and the limitations of this study, it was possible to conclude that ozone therapy improved the decontamination of the root canal ex vivo. Ozone was toxic to the cells on first contact, but cell viability was recovered. Thus, these findings suggest that ozone might be useful to improve root canal results. PMID:28076466

  20. Children with severe malnutrition: can those at highest risk of death be identified with the WHO protocol?

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    Kathryn Maitland

    2006-12-01

    Full Text Available BACKGROUND: With strict adherence to international recommended treatment guidelines, the case fatality for severe malnutrition ought to be less than 5%. In African hospitals, fatality rates of 20% are common and are often attributed to poor training and faulty case management. Improving outcome will depend upon the identification of those at greatest risk and targeting limited health resources. We retrospectively examined the major risk factors associated with early (<48 h and late in-hospital death in children with severe malnutrition with the aim of identifying admission features that could distinguish a high-risk group in relation to the World Health Organization (WHO guidelines. METHODS AND FINDINGS: Of 920 children in the study, 176 (19% died, with 59 (33% deaths occurring within 48 h of admission. Bacteraemia complicated 27% of all deaths: 52% died before 48 h despite 85% in vitro antibiotic susceptibility of cultured organisms. The sensitivity, specificity, and likelihood ratio of the WHO-recommended "danger signs" (lethargy, hypothermia, or hypoglycaemia to predict early mortality was 52%, 84%, and 3.4% (95% confidence interval [CI] = 2.2 to 5.1, respectively. In addition, four bedside features were associated with early case fatality: bradycardia, capillary refill time greater than 2 s, weak pulse volume, and impaired consciousness level; the presence of two or more features was associated with an odds ratio of 9.6 (95% CI = 4.8 to 19 for early fatality (p < 0.0001. Conversely, the group of children without any of these seven features, or signs of dehydration, severe acidosis, or electrolyte derangements, had a low fatality (7%. CONCLUSIONS: Formal assessment of these features as emergency signs to improve triage and to rationalize manpower resources toward the high-risk groups is required. In addition, basic clinical research is necessary to identify and test appropriate supportive treatments.

  1. Cariogenic microbiota of children under chemotherapy: A pilot study

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    Luiz Evaristo Ricci Volpato

    2016-01-01

    Full Text Available Aim: To analyze the cariogenic microbiota of children who are under antineoplastic therapy. Methods: Twenty-seven patients undergoing cancer treatment in the Pediatric Unit of Mato Grosso Cancer Hospital were selected. The inclusion criteria of volunteers were being under chemotherapy in the saliva collection period, age between 2 and 18 years, collaborate with the protocol for clinical examination and saliva collection, and responsible have given their written consent. For the realization of lactobacilli and Streptococcus mutans count in the patients′ saliva, respectively, Dentalcult I and II (LaborClin; kits were used. Statistical Analysis: Kruskal-Wallis and Fisher′s exact tests were used to assess the association of the variables age group, prevalence of lactobacilli and S. mutans, diagnosis of patients, presence and level of decay of patients defined by decayed, filled, and missing teeth (DMFT/dmft indexes with a significance level of 5%. Results: The group of patients consisted of 27 children, 15 males, and 12 females; 44% were aged between 6 and 10 years; 61% had present or past history of caries (dmft/DMFT >0; 48% had low value for Dentalcult I; 59% presented value grade 0 to Dentalcult II; and 63% were diagnosed with acute lymphoid leukemia. Conclusion: There was a high prevalence of dental caries in the study population but low rates of S. mutans and lactobacilli in the saliva of the children. Lactobacilli rate was significantly associated with caries index scores, and the prevalence of caries was directly associated with the age group of the children.

  2. Overweight and thinness in 7-9 year old children from Florianópolis, Southern Brazil: a comparison with a French study using a similar protocol Sobrepeso e baixo peso em crianças de 7 a 9 anos de idade de Florianópolis, Sul do Brasil: uma comparação com estudo francês usando protocolo similar

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    Maria Alice Altenburg de Assis

    2006-06-01

    Full Text Available OBJECTIVE: To assess nutritional status based on weight and height variables in children aged 7-9-y-old in a city from the South of Brazil (Florianópolis and to compare the prevalence of thinness and overweight and environmental factors between Brazil and France. METHODS: Randomly stratified samples of 7-9 y-old children (Florianópolis, n= 2.232; France, n= 1.582. Both studies followed the protocol recommended by the European Childhood Obesity Group. Weight and height were recorded according to World Health Organization recommendation. Thinness and overweight were defined using the French references. Physical activity and sedentary behaviors were compared. RESULTS: Florianópolis children were taller and heavier than the French. The frequency of thinness was lower in Florianópolis as compared to France (1.1 vs 3.9%. Overweight frequency was 19.9% in Florianópolis as compared to 16.3% in France. French children had a higher level of physical activity. In particular, 66.5% of French children had a regular sport activity compared to 35.7% in Florianópolis. In France, daily television and screen viewing time was 2 hours per day as compared to 3.3 hours in Brazil. CONCLUSION: Behavioral parameters, particularly sedentary lifestyle, could account for the higher prevalence of overweight in Brazilian children. Strategies to decrease the prevalence of overweight in children should take into account the particularities of each country.OBJETIVO: Avaliar o estado nutricional de crianças de sete a nove anos de idade de Florianópolis (Brasil e comparar a prevalência de sobrepeso e baixo peso com um estudo realizado na França. MÉTODOS: Os dois estudos comparados consistiram em investigações transversais de amostras aleatórias estratificadas de crianças de sete a nove anos da idade (Florianópolis, n= 2.232 ; França, n= 1.582 , delineados com base no protocolo recomendado pelo European Childhood Obesity Group. As medidas antropométricas (peso e

  3. Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

    Energy Technology Data Exchange (ETDEWEB)

    Verger, Antoine; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Fourquet, Nicolas [Clinique Pasteur, Toulouse (France); Rouzet, Francois; Le Guludec, Dominique [AP-HP, Hopital Bichat, Department of Nuclear Medicine, Paris (France); INSERM U 773 Inserm and Denis Diderot University, Paris (France); Koehl, Gregoire; Roch, Veronique [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Imbert, Laetitia [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Centre Alexis Vautrin, Department of Radiotherapy, Vandoeuvre (France); Poussier, Sylvain [INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Fay, Renaud [INSERM, Centre d' Investigation Clinique CIC-P 9501, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U961, Nancy (France); Hopital de Brabois, CHU-Nancy, Medecine Nucleaire, Vandoeuvre-les-Nancy (France)

    2013-03-15

    The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving {sup 201}Tl (n = 120) or {sup 99m}Tc-sestamibi injected at low dose at stress ({sup 99m}Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ({sup 99m}Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, {sup 201}Tl 92 %, {sup 99m}Tc-Low 86 %, {sup 99m}Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p < 0.001). This larger extent was mainly observed in 50 obese patients who were in the {sup 201}Tl or {sup 99m}Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 {+-} 101 kcounts) and dramatically enhanced with CZT SPECT (+279 {+-} 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

  4. Indicators of Sexual Abuse in Children's Rorschach Responses: An Exploratory Study.

    Science.gov (United States)

    Billingsley, Ralph C.

    1995-01-01

    Rorschach protocols of 18 sexually-abused children were compared to protocols of 18 clinical controls. Dependent variables included responses with overt sexual contents, sexual symbols, and near-sexual content. Results suggested that the dependent variables, in combination, could differentiate sexually abused children from other groups. Other…

  5. Acute lymphoblastic leukemia in children with Down syndrome: A retrospective analysis from the Ponte di Legno study group

    NARCIS (Netherlands)

    T.D. Buitenkamp (Trudy); S. Izraeli (Shai); M. Zimmermann (Martin); E. Forestier (Erik); N.A. Heerema (Nyla); M.M. van den Heuvel-Eibrink (Marry); R. Pieters (Rob); C.M. Korbijn (Carin); L.B. Silverman (Lewis); K. Schmiegelow (Kjeld); D.-C. Liang (Der-Cheng); K. Horibe (Keizo); M. Aricò (Maurizio); A. Biondi (Andrea); G. Basso (Giuseppe); K.R. Rabin (Karin); M. Schrappe (Martin); G. Cario (Gunnar); G. Mann (Georg); M. Morak (Maria); R. Panzer-Grümayer (Renate); V. Mondelaers (Veerle); T. Lammens (Tim); H. Cavé (Hèléne); B. Stark (Batia); I. Ganmore (Ithamar); A.V. Moorman (Anthony); A. Vora (Ajay); S.P. Hunger (Stephen); C.H. Pui (Ching-Hon); C.G. Mullighan (Charles); A. Manabe (Atsushi); G. Escherich (Gabriele); J.R. Kowalczyk (Jerzy R.); J.A. Whitlock (James); C.M. Zwaan (Michel)

    2014-01-01

    textabstractChildren with Down syndrome (DS) have an increased risk of B-cell precursor (BCP) acute lymphoblastic leukemia (ALL). The prognostic factors and outcome of DS-ALL patients treated in contemporary protocols are uncertain. We studied 653 DS-ALL patients enrolled in 16 international trials

  6. Children as donors : a national study to assess procurement of organs and tissues in pediatric intensive care units

    NARCIS (Netherlands)

    Siebelink, Marion J.; Albers, Marcel J. I. J.; Roodbol, Petrie F.; Van de Wiel, Harry B. M.

    2012-01-01

    A shortage of size-matched organs and tissues is the key factor limiting transplantation in children. Empirical data on procurement from pediatric donors is sparse. This study investigated donor identification, parental consent, and effectuation rates, as well as adherence to the national protocol.

  7. Early Intervention with a Parent-Delivered Massage Protocol Directed at Tactile Abnormalities Decreases Severity of Autism and Improves Child-to-Parent Interactions: A Replication Study

    Directory of Open Access Journals (Sweden)

    Louisa M. T. Silva

    2015-01-01

    Full Text Available Tactile abnormalities are severe and universal in preschool children with autism. They respond well to treatment with a daily massage protocol directed at tactile abnormalities (QST massage for autism. Treatment is based on a model for autism proposing that tactile impairment poses a barrier to development. Two previous randomized controlled trials evaluating five months of massage treatment reported improvement of behavior, social/communication skills, and tactile and other sensory symptoms. This is the first report from a two-year replication study evaluating the protocol in 103 preschool children with autism. Parents gave daily treatment; trained staff gave weekly treatment and parent support. Five-month outcomes replicated earlier studies and showed normalization of receptive language (18%, P=.03, autistic behavior (32%, P=.006, total sensory abnormalities (38%, P=.0000005, tactile abnormalities (49%, P=.0002, and decreased autism severity (medium to large effect size, P=.008. In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, P=.00008. Early childhood special education programs are tasked with addressing sensory abnormalities and engaging parents in effective home programs. Until now, they have lacked research-based methods to do so. This program fulfills the need. It is recommended to parents and ECSE programs (ages 3–5 at autism diagnosis.

  8. Russia's Unwanted Children: A Cultural Anthropological Study of Marginalized Children in Moscow and St. Petersburg.

    Science.gov (United States)

    Creuziger, Clementine G. K.

    1997-01-01

    Studied the plight of marginalized children in urban Russia, including orphans, children with some family ties living in group homes, and street children. Found that changing public views toward these groups since WWII have led to a deterioration in lifestyle for these children, further contributing to criminal activity and poverty in urban areas.…

  9. Pathways to Language: A Naturalistic Study of Children with Williams Syndrome and Children with Down Syndrome

    Science.gov (United States)

    Levy, Yonata; Eilam, Ariela

    2013-01-01

    This is a naturalistic study of the development of language in Hebrew-speaking children with Williams syndrome (WS) and children with Down syndrome (DS), whose MLU extended from 1[multiplied by]0 to 4[multiplied by]4. Developmental curves over the entire span of data collection revealed minor differences between children with WS, children with DS,…

  10. A comparative study of protocols for mouse embryonic stem cell culturing.

    Directory of Open Access Journals (Sweden)

    Christoffer Tamm

    Full Text Available Most stem cell laboratories still rely on old culture methods to support the expansion and maintenance of mouse embryonic stem (ES cells. These involve growing cells on mouse embryonic fibroblast feeder cells or on gelatin in media supplemented with fetal bovine serum and leukemia inhibitory factor (LIF. However, these techniques have several drawbacks including the need for feeder-cells and/or use of undefined media containing animal derived components. Culture of stem cells under undefined conditions can induce spontaneous differentiation and reduce reproducibility of experiments. In recent years several new ES cell culture protocols, using more well-defined conditions, have been published and we have compared the standard culture protocols with two of the newly described ones: 1 growing cells in semi-adherence in a medium containing two small molecule inhibitors (CHIR99021, PD0325901 and; 2 growing cells in a spheroid suspension culture in a defined medium containing LIF and bFGF. Two feeder-dependent mouse ES (mES cell lines and two cell lines adapted to feeder-independent growth were used in the study. The overall aim has not only been to compare self-renewal and differentiation capacity, but also ease-of-use and cost efficiency. We show that mES cells when grown adherently proliferate much faster than when grown in suspension as free-floating spheres, independent of media used. Although all the tested culture protocols could maintain sustained pluripotency after prolonged culturing, our data confirm previous reports showing that the media containing two chemical inhibitors generate more pure stem cell cultures with negligible signs of spontaneous differentiation as compared to standard mES media. Furthermore, we show that this medium effectively rescues and cleans up cultures that have started to deteriorate, as well as allow for effective adaption of feeder-dependent mES cell lines to be maintained in feeder-free conditions.

  11. Survival of Mexican Children with Acute Lymphoblastic Leukaemia under Treatment with the Protocol from the Dana-Farber Cancer Institute 00-01

    Directory of Open Access Journals (Sweden)

    Elva Jiménez-Hernández

    2015-01-01

    Full Text Available Our aim in this paper is to describe the results of treatment of acute lymphoblastic leukaemia (ALL in Mexican children treated from 2006 to 2010 under the protocol from the Dana-Farber Cancer Institute (DFCI 00-01. The children were younger than 16 years of age and had a diagnosis of ALL de novo. The patients were classified as standard risk if they were 1–9.9 years old and had a leucocyte count 100 × 109/L. The poor outcomes were associated with toxic death during induction, complete remission, and relapse. These factors remain the main obstacles to the success of this treatment in our population.

  12. Rush allergen specific immunotherapy protocol in feline atopic dermatitis: a pilot study of four cats.

    Science.gov (United States)

    Trimmer, Ann M; Griffin, Craig E; Boord, Mona J; Rosenkrantz, Wayne S

    2005-10-01

    Rush immunotherapy has been shown to be as safe as conventional immunotherapy in canine atopic patients. Rush immunotherapy has not been reported in the feline atopic patient. The purpose of this pilot study was to determine a safe protocol for rush immunotherapy in feline atopic patients. Four atopic cats diagnosed by history, physical examination and exclusion of appropriate differential diagnoses were included in the study. Allergens were identified via liquid phase immunoenzymatic testing (VARL: Veterinary Allergy Reference Labs, Pasadena, CA). Cats were premedicated with 1.5 mg triamcinolone orally 24 and 2 h prior to first injection and 10 mg hydroxyzine PO 24, 12 and 2 h prior to first injection. An intravenous catheter was placed prior to first injection. Allergen extracts (Greer Laboratories, Lenoir, North Carolina) were all administered subcutaneously at increasing protein nitrogen units (pnu) every 30 minutes for 5 h to maintenance dose of 15,000 pnus ml-1. Vital signs were assessed every 15 minutes. Two cats developed mild pruritus and the subsequent injection was delayed 30 minutes. No changes in either cat's vital signs were noted, nor was there any further pruritus. All four cats successfully completed rush immunotherapy. Two cats developed a dermal swelling on the dorsal neck one week later. In these four cats, this protocol appeared to be a safe regimen to reach maintenance therapy. A larger sample of feline patients is needed to determine the incidence of adverse reactions and to follow the success of ASIT based upon this method of induction.

  13. Optimization of the protocols for the use of contrast agents in PET/CT studies.

    Science.gov (United States)

    Pelegrí Martínez, L; Kohan, A A; Vercher Conejero, J L

    The introduction of PET/CT scanners in clinical practice in 1998 has improved care for oncologic patients throughout the clinical pathway, from the initial diagnosis of disease through the evaluation of the response to treatment to screening for possible recurrence. The CT component of a PET/CT study is used to correct the attenuation of PET studies; CT also provides anatomic information about the distribution of the radiotracer. CT is especially useful in situations where PET alone can lead to false positives and false negatives, and CT thereby improves the diagnostic performance of PET. The use of intravenous or oral contrast agents and optimal CT protocols have improved the detection and characterization of lesions. However, there are circumstances in which the systematic use of contrast agents is not justified. The standard acquisition in PET/CT scanners is the whole body protocol, but this can lead to artifacts due to the position of patients and respiratory movements between the CT and PET acquisitions. This article discusses these aspects from a constructive perspective with the aim of maximizing the diagnostic potential of PET/CT and providing better care for patients.

  14. Simulation Studies On An Energy Efficient Multipath Routing Protocol Using Directional Antennas For Manets

    Directory of Open Access Journals (Sweden)

    Sandhya Chilukuri

    2012-09-01

    Full Text Available The paper proposes the development of an energy efficient multipath routing protocol with directional antenna for MANET as an optimization task as well as a multidisciplinary entity. A comprehensive analysis to link all the multi-disciplinary viewpoints involved in the development of desired multipath routing protocol with requisite technical details is presented in this paper. A simple and elegant mathematical formulation for the analysis of relative improvement of the performance metrics of ad-hocnetworks with omnidirectional and directional antenna is presented. Through extensive numerical simulations, the multi-dimensional desirable performance attributes of wireless link such as improvedrange, improved RSS, reduced RF transmit power and consequent reduced consumption of battery power have been analyzed keeping the directional gain of the antenna as a variable parameter. Development or modification of a protocol with concurrent focus on multipath routing with optimization of the batteryenergy is a significant step to increase the life time of MANET without recharging. Selection of the energy efficient path amongst several alternative ones is of paramount significance in the evaluation of overall performance of MANET system. A formulation to compute the required Battery Energy taking into account the data pertaining to the power efficiency of the associated transceiver design as well as the specified link performance parameters is also discussed. Through a case study involving the specifications of a typical transceiver operating in the 2.4 GHz band, the desirable impact of higher gain of a directional antenna in the reduction of RF transmitter power is illustrated. The consequential reduced battery power consumption while still retaining the specified performance parameters of the adhoc network like range and Received Signal Strength (RSS is also demonstrated. This paper also addresses the importance of alignment of beam peaks of directional

  15. Study of television viewing habits in children.

    Science.gov (United States)

    Mukherjee, Sharmila Banerjee; Gupta, Yogita; Aneja, Satinder

    2014-11-01

    Previous studies from developing countries have reported that Television (TV) viewing, if excessive and of poor quality has a proven negative influence on child health. Indian studies on this subject are few. The present study aimed at determining TV viewing habits of children and their families as well as parental perspectives on the impact of TV on child health using a provider completed indigenously developed questionnaire in Hindi. The study group comprised of 109 children attending a government hospital who belonged predominantly to lower socio-economic strata with poor maternal literacy. It was observed that 100 % children watched excessive TV (> 2 h daily), with majority viewing unsupervised and low quality content. There were minimal parental restrictions and no active discussion regarding contents. Negative impact was found on play, hobbies, sleep hygiene and eating habits in most children. Most parents were unaware of unhealthy viewing and the associated deleterious effects. As pediatricians we need to enquire about TV viewing habits routinely and educate parents about appropriate TV viewing.

  16. Children with Lesbian Parents: A Community Study.

    Science.gov (United States)

    Golombok, Susan; Perry, Beth; Burston, Amanda; Murray, Clare; Mooney-Somers, Julid; Stevens, Madeleine; Golding, Jean

    2003-01-01

    Examined the quality of parent-child relationships and the socioemotional and gender development of a community sample of 7-year-olds with lesbian parents, with two-parent heterosexual parents, or with single heterosexual mothers from the Avon Longitudinal Study of Parents and Children. Found no significant differences between lesbian mothers and…

  17. Risk group assignment differs for children and adults 1-45 yr with acute lymphoblastic leukemia treated by the NOPHO ALL-2008 protocol

    DEFF Research Database (Denmark)

    Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas;

    2013-01-01

    The prognosis of acute lymphoblastic leukemia is poorer in adults than in children. Studies have indicated that young adults benefit from pediatric treatment, although no upper age limit has been defined.......The prognosis of acute lymphoblastic leukemia is poorer in adults than in children. Studies have indicated that young adults benefit from pediatric treatment, although no upper age limit has been defined....

  18. Real-Time QoS Routing Protocols in Wireless Multimedia Sensor Networks: Study and Analysis.

    Science.gov (United States)

    Alanazi, Adwan; Elleithy, Khaled

    2015-09-02

    Many routing protocols have been proposed for wireless sensor networks. These routing protocols are almost always based on energy efficiency. However, recent advances in complementary metal-oxide semiconductor (CMOS) cameras and small microphones have led to the development of Wireless Multimedia Sensor Networks (WMSN) as a class of wireless sensor networks which pose additional challenges. The transmission of imaging and video data needs routing protocols with both energy efficiency and Quality of Service (QoS) characteristics in order to guarantee the efficient use of the sensor nodes and effective access to the collected data. Also, with integration of real time applications in Wireless Senor Networks (WSNs), the use of QoS routing protocols is not only becoming a significant topic, but is also gaining the attention of researchers. In designing an efficient QoS routing protocol, the reliability and guarantee of end-to-end delay are critical events while conserving energy. Thus, considerable research has been focused on designing energy efficient and robust QoS routing protocols. In this paper, we present a state of the art research work based on real-time QoS routing protocols for WMSNs that have already been proposed. This paper categorizes the real-time QoS routing protocols into probabilistic and deterministic protocols. In addition, both categories are classified into soft and hard real time protocols by highlighting the QoS issues including the limitations and features of each protocol. Furthermore, we have compared the performance of mobility-aware query based real-time QoS routing protocols from each category using Network Simulator-2 (NS2). This paper also focuses on the design challenges and future research directions as well as highlights the characteristics of each QoS routing protocol.

  19. A PROSPECTIVE STUDY OF 97 CASES TO ARRIVE AT TREATMENT PROTOCOLS FOR FLOATING KNEE

    Directory of Open Access Journals (Sweden)

    Prasad

    2015-03-01

    Full Text Available BACKGROUND : Floating knee is an injury in which fractures are present both above and below isolating it. It’s a high velocity injury 1 f requently associated with multiple fractures and injuries to other organs . ² The management i.e. , timing of surgery , no of incisions and the type of implants is still a gray area as several protocols have been advocated. MATERIALS AND METHODS : This study comprises of 97 cases and was conducted in the two tertiary care hospitals of Hyderabad , during a period of 6 yrs i.e. , between 2007 - 2013. The average of the patients is 28.2 years and the Male to Female ratio is 6:1 , there were 68 open fractur es. Each case is individually assessed and managed. Different implants are used to fix these fractures depending upon the situation and fracture type. RESULTS : All the cases are evaluated after fracture union based on criteria Karlstrom and Olerud. Sixty f ive patients had union of femoral and tibial fractures with 90 degrees of knee flexion falling into the category of excellent and good results. Complications encountered were Infection , Knee - stiffness , nonunion , malunion , injury to nerves. CONCLUSIONS : The re is no fixed protocol in the number of incisions , choice of fixation device , and timing of surgery in the management of floating knee injuries. Each case should be dealt with basing on its merits. The management should be tailor - made for that particular case.

  20. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

    Directory of Open Access Journals (Sweden)

    Fayers Peter

    2010-09-01

    Full Text Available Abstract Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1 To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2 To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1 To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1 in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2 To conduct patient focus group discussions at each of these (Phase 1 to determine care received. 3 To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2. 4 To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2. 5 To undertake document

  1. Parenting for Autism, Language, And Communication Evaluation Study (PALACES): protocol for a pilot randomised controlled trial

    Science.gov (United States)

    Williams, Margiad Elen; Hastings, Richard; Charles, Joanna Mary; Evans, Sue; Hutchings, Judy

    2017-01-01

    Introduction Children with autistic spectrum disorder (ASD) often have associated behavioural difficulties that can present a challenge for parents and parenting. There are several effective social learning theory-based parenting programmes for dealing with behavioural difficulties, including the Incredible Years (IY) parent programmes. However, these programmes typically do not specifically target parents of children with ASD. Recently, a new addition to the IY suite of programmes known as the IY Autistic Spectrum and Language Delays (IY-ASLD) parent programme was developed. The main aims of the present study are to examine the feasibility of delivering this programme within child health services and to provide initial evidence for effectiveness and economic costs. Methods and analysis The Parenting for Autism, Language, And Communication Evaluation Study (PALACES) trial is a pragmatic, multicentre, pilot randomised controlled trial comparing the IY-ASLD programme with a wait-list control condition. 72 parents of children with ASD (aged 3–8 years) will be randomly allocated to either the intervention or control condition. Data will be collected prior to randomisation and 6 months postrandomisation for all families. Families in the intervention condition only will also be followed up at 12 and 18 months postrandomisation. This study will provide initial evidence of effectiveness for the newly developed IY-ASLD parenting programme. It will also add to the limited economic evidence for an intervention targeting parents of children with ASD and provide longer term data, an important component for evaluations of parenting programmes. Ethics and dissemination Approval for the study was granted by the Research Ethics Committee at the School of Psychology, Bangor University (reference number: 2016–15768) and the North Wales Research Ethics Committee, UK (reference number: 16/WA/0224). The findings will be disseminated through research conferences and peer

  2. Online support program for parents of children with a chronic kidney disease using intervention mapping: a development and evaluation protocol

    NARCIS (Netherlands)

    Geense, W.W.; van Gaal, B.G.I.; Knoll, J.L.; Cornelissen, E.A.M.; Schoonhoven, L.; Kok, G.

    2016-01-01

    Background: The care for children with a chronic kidney disease (CKD) is complex. Parents of these children may experience high levels of stress in managing their child's disease, potentially leading to negative effects on their child's health outcomes. Although the experienced problems are well kno

  3. A Study Issues Related To Improve Route Stability In AODY Routing Protocol In VANET

    Directory of Open Access Journals (Sweden)

    Annu Mor

    2013-01-01

    Full Text Available Vehicular Ad Hoc Network (VANET is a sub class of mobile ad hoc networks. VANET provides wireless communication among vehicles and vehicle to road side equipments, according to IEEE 802.11 p standard for end to end communication between vehicles . For end to end communication between vehicles a routing protocols is used to find a route based on link properties. One of the most important routing protocols used in ad hoc networks is AODV. This protocol is connectivity based reactive protocol that searches routes only when they are needed. It always exchanges control packets between neighbor nodes for routing. In this article author present cross layer technique that find channel security at link layer to AODV routing protocol to improve the communication in vehicles for safety purpose. To eliminate route discovery routers, propose PAODV as routing protocol. It improves AODV control overhead and makes routes more stable.

  4. Developing a Taxonomy of Dark Triad Triggers at Work – A Grounded Theory Study Protocol

    Science.gov (United States)

    Nübold, Annika; Bader, Josef; Bozin, Nera; Depala, Romil; Eidast, Helena; Johannessen, Elisabeth A.; Prinz, Gerhard

    2017-01-01

    In past years, research and corporate scandals have evidenced the destructive effects of the dark triad at work, consisting of narcissism (extreme self-centeredness), psychopathy (lack of empathy and remorse) and Machiavellianism (a sense of duplicity and manipulativeness). The dark triad dimensions have typically been conceptualized as stable personality traits, ignoring the accumulating evidence that momentary personality expressions – personality states – may change due to the characteristics of the situation. The present research protocol describes a qualitative study that aims to identify triggers of dark triad states at work by following a grounded theory approach using semi-structured interviews. By building a comprehensive categorization of dark triad triggers at work scholars may study these triggers in a parsimonious and structured way and organizations may derive more effective interventions to buffer or prevent the detrimental effects of dark personality at work. PMID:28326048

  5. Attachment styles in maltreated children: a comparative study.

    Science.gov (United States)

    Finzi, R; Cohen, O; Sapir, Y; Weizman, A

    2000-01-01

    The study compares the emotional impact of maltreatment on the attachment styles in three groups of children aged 6-12 years: children of drug-user fathers (n = 76), physically abused children (n = 41), neglected children (n = 38); non-abused/non-neglected children (n = 35)--control group. The secure style characterized 52% of the children of drug-user fathers and the insecure style characterized the other 48% (anxious/ambivalent or avoidant); physically abused children were characterized mainly by the avoidant attachment style, and neglected children by the anxious/ambivalent style. The conclusion is that physically abused children are at risk of antisocial behavior and sustained suspicion towards others; neglected children are at risk of social withdrawal, social rejection and feelings of incompetence, and children of drug-user fathers may be at risk of behavioral problems and drug use in adolescence.

  6. A Study on the Distributed Antenna Based Heterogeneous Cognitive Wireless Network Synchronous MAC Protocol

    Directory of Open Access Journals (Sweden)

    Lian-Fen Huang

    2015-01-01

    Full Text Available This paper introduces distributed antennas into a cognitive radio network and presents a heterogeneous network. The best contribution of this paper is that it designs a synchronous cognitive MAC protocol (DAHCWNS-MAC protocol: distributed antenna based heterogeneous cognitive wireless network synchronous MAC protocol. The novel protocol aims at combining the advantages of cognitive radio and distributed antennas to fully utilize the licensed spectrum, broaden the communication range, and improve throughput. This paper carries out the mathematical modeling and performance simulation to demonstrate its superiority in improving the network throughput at the cost of increasing antenna hardware costs.

  7. Children and media: a cultural studies approach

    OpenAIRE

    D av i d B u c k i n g h a m

    2012-01-01

    Defying the traditional psychology understanding on what are the effects of the media and also the researches made on the subject, the present article offers an approach to the study of the relationship between children and the media, focusing mainly on television. We retrace the Cultural Studies perspective, although the researches from the Birmingham Centre have not worked over such age group.The work includes the model of the cultural circuit, it refuses to understand meaning as something ...

  8. National validation study of a swab protocol for the recovery of Bacillus anthracis spores from surfaces.

    Science.gov (United States)

    Hodges, Lisa R; Rose, Laura J; O'Connell, Heather; Arduino, Matthew J

    2010-05-01

    Twelve Laboratory Response Network (LRN) affiliated laboratories participated in a validation study of a macrofoam swab protocol for the recovery, detection, and quantification of viable B. anthracis (BA) Sterne spores from steel surfaces. CDC personnel inoculated steel coupons (26cm(2)) with 1-4 log(10) BA spores and recovered them by sampling with pre-moistened macrofoam swabs. Phase 1 (P1) of the study evaluated swabs containing BA only, while dust and background organisms were added to swabs in Phase 2 (P2) to mimic environmental conditions. Laboratories processed swabs and enumerated spores by culturing eluted swab suspensions and counting colonies with morphology consistent with BA. Processed swabs were placed in enrichment broth, incubated 24h, and cultured by streaking for isolation. Real-time PCR was performed on selected colonies from P2 samples to confirm the identity of BA. Mean percent recovery (%R) of spores from the surface ranged from 15.8 to 31.0% (P1) and from 27.9 to 55.0% (P2). The highest mean percent recovery was 31.0% (sd 10.9%) for P1 (4 log(10) inoculum) and 55.0% (sd 27.6%) for P2 (1 log(10) inoculum). The overall %R was higher for P2 (44.6%) than P1 (24.1%), but the overall reproducibility (between-lab variability) was lower in P2 than in P1 (25.0 vs 16.5%CV, respectively). The overall precision (within-lab variability) was close to identical for P1 and P2 (44.0 and 44.1, respectively), but varied greatly between inoculum levels. The protocol demonstrated linearity in %R over the three inoculum levels and is able to detect between 26 and 5x10(6)spores/26cm(2). Sensitivity as determined by culture was >98.3% for both phases and all inocula, suggesting that the culture method maintains sensitivity in the presence of contaminants. The enrichment broth method alone was less sensitive for sampled swabs (66.4%) during P2, suggesting that the presence of background organisms inhibited growth or isolation of BA from the broth. The addition of

  9. Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol

    Science.gov (United States)

    Furberg, Robert D; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

    2016-01-01

    Background Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Objective Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. Methods The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care–related infections were reviewed to develop the infection control protocol to support tablet maintenance. Results This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. Conclusions These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings. PMID:27350013

  10. Renal disorders in children: a Nigerian study.

    Science.gov (United States)

    Eke, F U; Eke, N N

    1994-06-01

    A 5-year prospective study of 699 children with various renal disorders from around the Rivers State, which is in the eastern part of Nigeria, was carried out to investigate the prevalence and significance of renal disorders in a third world country with no facilities for paediatric dialysis and transplantation. Renal disorders accounted for 1.1% of the total outpatients and hospital admissions. The commonest renal disorders were urinary tract infection (UTI, 68.9%); nephrotic syndrome (NS 14.6%) and acute post streptococcal glomerulonephritis (11.4%). Patients with UTI had no vesico-ureteric reflux (VUR); 22.5% of NS patients were steroid sensitive. Wilms' tumour (1.6%) was the second commonest childhood malignant tumour; 8 of 17 cases of obstructive uropathy were secondary to meatal stenosis following circumcision. Fifteen children developed end-stage renal failure (ESRF), mainly due to chronic glomerulonephritis, giving a prevalence rate of 7.5 children per year per million childhood population. Hence, renal disorders are common in Nigeria and although VUR is rare, ESRF may approximate figures seen in the western world. This highlights the need to improve the country's socioeconomic conditions, make medical facilities more available to children and prevent renal diseases that may lead to ESRF.

  11. An Empirical Study and some Improvements of the MiniMac Protocol for Secure Computation

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Lauritsen, Rasmus; Toft, Tomas

    2014-01-01

    suggest a modification of MiniMac that achieves increased parallelism at no extra communication cost. This gives an asymptotic improvement of the original protocol as well as an 8-fold speed-up of our implementation. We compare the resulting protocol to TinyOT for the case of secure computation in parallel...

  12. Outcome and Toxicity of an Ifosfamide-Based Soft Tissue Sarcoma Treatment Protocol in Children. The Importance of Local Therapy

    Directory of Open Access Journals (Sweden)

    S. Murray Yule

    1998-01-01

    Full Text Available Background. Although the survival of children with soft tissue sarcoma (STS has improved considerably, the outcome of patients with metastatic disease, and those with primary tumours of the extremities or parameningeal sites remains disappointing. We describe the clinical outcome of an ifosfamide-based regimen with local therapy directed only to children who failed to achieve a complete response to initial chemotherapy.

  13. The Study and Simulation of Multi-interface Extension for OLSR Protocol

    Directory of Open Access Journals (Sweden)

    Zhong Hui

    2016-01-01

    Full Text Available The way to improve the performance of the throughput in the wireless Mesh network is nodes with multiple interfaces. In view of the problem of multi-interface multi-channel extension for OLSR protocol, multi–interface multi-channel OLSR protocol is proposed. Nodes can have multiple network interfaces, but each node has only one IP, using the index of interface to distinguish the multiple interfaces of the node. Selected the receiving interface according to the channel, modified the message delivery method and introduces the protocol implementation and technology. Finally, the simulation is carried out by using the extended NS2. Simulation results show that extended OLSR protocol has high network performance, and improve the network throughput. What is new and original in this paper is adding multiple physical interface support for proactive protocol OLSR.

  14. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş

    2016-04-01

    Full Text Available Introduction: Aims of the study to investigate the frequency and the nature ofnail disorders in children significant clinical data is available. Nail disorders although common in children in some parts of our country. This study was carried out to document the clinical and demographic pattern of nail disorders in a dermatology outpatient clinic of a pediatric hospital in Ankara, Turkey. Material and Methods: All consecutive patients a total of 3000 children from age 0-16 were admitted to dermatology outpatient clinic of Ankara Pediatric Hematology and Oncology Education and Research Hospital during January 2011 to December 2011 were studied and retrospectively evaluated for age, gender, drug use, diseases, systemic or genetic disorders and demographic features. Diagnostic evaluation results were noted and patients were categorized for demographic features and diagnosis. Results: These 133 patients (M: F 58:75, %44 vs 56, respectively were under 16 years of age and have 17 different dermatological disorders related with nail symptoms. Fifty three of (39,8% these patient were under 2 years of age, 31 (23.3% were between 3-5 years, 30 (22.5% were between 6-11 years old, 19 of 133 (14%, 2 were between 11-16 years of age. Through all of ages and independent of gender the most etiologies of nail disorders were, onychomadesis, paronychia, onycholysis, onychomycosis and systemic nail presentation of systemic dermatosis. Conclusion: Nail disorders are different in children than in adults. In our study, the first 5 years of age was found in 53% of nail disorders. Nail disorders are uncommon but may be seen as a part of a systemic disease and may be associated with cosmetic and psychologic problem.

  15. Study of effective dose of various protocols in equipment cone beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Soares, M. R.; Maia, A. F. [Universidade Federale de Sergipe, Departamento de Fisica, Cidade Universitaria Prof. Jose Aloisio de Campos, Marechal Rondon s/n, Jardim Rosa Elze, 49-100000 Sao Cristovao, Sergipe (Brazil); Batista, W. O. [Instituto Federal da Bahia, Rua Emidio dos Santos s/n, Barbalho, Salvador, 40301015 Bahia (Brazil); Caldas, L. V. E.; Lara, P. A., E-mail: mrs2206@gmail.com [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil)

    2014-08-15

    Currently the cone beam computed tomography is widely used in various procedures of dental radiology. Although the doses values associated with the procedures of cone beam CT are low compared to typical values associated with dental radiology procedure in multi slices CT. However can be high compared to typical values of other techniques commonly used in dental radiology. The present scenario is a very wide range of designs of equipment and, consequently, lack of uniformity in all parameters associated with x-ray generation and geometry. In this context, this study aimed to evaluate and calculate the absorbed dose in organs and tissues relevant and estimate effective dose for different protocols with different geometries of exposure in five cone beam CT equipment. For this, a female Alderson anthropomorphic phantom, manufactured by Radiology Support Devices was used. The phantom was irradiated with 26 dosimeters LiF: Mg, Ti (TLD-100), inserted in organs and tissues along the layers forming the head and neck of the phantom. The equipment used, in this present assessment, was: i-CAT Classical, Kodak 9000 3D, Gendex GXCB 500, Sirona Orthophos X G 3D and Planmeca Pro Max 3D. The effective doses were be determined by the ICRP 103 weighting factors. The values were between 7.0 and 111.5 micro Sv, confirming the broad dose range expected due to the diversity of equipment and protocols used in each equipment. The values of effective dose per Fov size were: between 7 and 51.2 micro Sv for located Fov; between 17.6 and 52.0 micro Sv for medium Fov; and between 11.5 and 43.1 micro Sv to large Fov (maxillofacial). In obtaining the effective dose the measurements highlighted a relevance contribution of dose absorbed by the remaining organs (36%), Salivary glands (30%), thyroid (12%) and bone marrow (12%). (Author)

  16. A Reflective Study into Children's Cognition When Making Computer Games

    Science.gov (United States)

    Allsop, Yasemin

    2016-01-01

    In this paper, children's mental activities when making digital games are explored. Where previous studies have mainly focused on children's learning, this study aimed to unfold the children's thinking process for learning when making computer games. As part of an ongoing larger scale study, which adopts an ethnographic approach, this research…

  17. Evaluation of an intensive insulin transition protocol in the intensive care unit setting: a before and after study

    Directory of Open Access Journals (Sweden)

    Jacobson LA

    2012-03-01

    Full Text Available The benefits of controlling blood glucose levels in intensive care units (ICUs are well documented.Objective: This study determined the effectiveness and safety of a standardized transition order set for converting a continuous insulin infusion to a subcutaneous insulin regimen in non-cardiovascular surgery ICUs patient population.Methods: A retrospective study was conducted. Patients presenting with diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome were excluded. One hundred patients were included prior to and 100 patients were included after initiating the transition order set. Blood glucose control was reviewed for up to 72 hours following the transition.Results: A total of 115 patients were included in data analysis: 85 prior to and 30 after transition protocol. All patients transitioned using the protocol were transitioned to basal insulin, compared to only 40% of the prior to protocol group. Patients transitioned correctly per the transition order set, “per protocol,” had 54% of blood sugars within the desired range, no increase in hypoglycemic events, and on average 5.56 hyperglycemic events (blood glucose >180 mg/dL per person during the 72 hours compared to 6.68 and 9.00 for the prior to protocol group and the “off protocol” group (transitioned different than the protocol recommended, respectively (p= 0.05. There were significant differences in blood sugar control at 48 and 72 hours between the “per protocol” and “off protocol” groups (p= 0.01 and a 40% reduction in sliding scale or correctional insulin coverage.Conclusion: The addition of basal insulin to transition regimens resulted in fewer hyperglycemic events with no increase in hypoglycemic events. Patients transitioned “per protocol” had better glucose control demonstrated by: less hyperglycemic events, lower mean blood glucose levels at 48 and 72 hours, and lower need for correctional insulin. These findings showed benefits of glycemic control in

  18. Tackling inequalities in obesity: a protocol for a systematic review of the effectiveness of public health interventions at reducing socioeconomic inequalities in obesity amongst children

    Directory of Open Access Journals (Sweden)

    Bambra Clare L

    2012-02-01

    Full Text Available Abstract Background There is growing evidence of the impact of overweight and obesity on short- and long-term functioning, health and well-being. Internationally, childhood obesity rates continue to rise in some countries (for example, Mexico, India, China and Canada, although there is emerging evidence of a slowing of this increase or a plateauing in some age groups. In most European countries, the United States and Australia, however, socioeconomic inequalities in relation to obesity and risk factors for obesity are widening. Addressing inequalities in obesity, therefore, has a very high profile on the public health and health services agendas. However, there is a lack of accessible policy-ready evidence on what works in terms of interventions to reduce inequalities in obesity. Methods and design This article describes the protocol for a National Health Service Trust (NHS National Institute for Health Research-funded systematic review of public health interventions at the individual, community and societal levels which might reduce socioeconomic inequalities in relation to obesity amongst children ages 0 to 18 years. The studies will be selected only if (1 they included a primary outcome that is a proxy for body fatness and (2 examined differential effects with regard to socioeconomic status (education, income, occupation, social class, deprivation and poverty or the intervention was targeted specifically at disadvantaged groups (for example, children of the unemployed, lone parents, low income and so on or at people who live in deprived areas. A rigorous and inclusive international literature search will be conducted for randomised and nonrandomised controlled trials, prospective and retrospective cohort studies (with and/or without control groups and prospective repeat cross-sectional studies (with and/or without control groups. The following electronic databases will be searched: MEDLINE, Embase, CINAHL, PsycINFO, Social Science Citation

  19. Indoor air pollution on nurseries and primary schools: impact on childhood asthma – study protocol

    Directory of Open Access Journals (Sweden)

    Sousa Sofia I V

    2012-06-01

    Full Text Available Abstract Background Several studies have demonstrated an association between the exposure to indoor air pollution (IAP and childhood asthma. Evidence is suggesting that several air pollutants may contribute to both exacerbation and development of asthma, but some uncertainty remains concerning the specific causative role of IAP. This paper reports an epidemiologic study aiming to reduce the existing lacks on the association between long-term exposure to pollution mixtures and the development and exacerbation of childhood asthma. Methods/design Based on the implementation of the study in 8 nurseries and 8 primary schools, from which, 2 nurseries and 2 primary schools in sites influenced by traffic and other 2 nurseries and 2 primary schools in background sites at urban and rural areas, the study will analyse the exposure to both urban and rural pollution as well as to traffic emissions (some homes of the children will be included in the study. Furthermore, based on the answers to validated questionnaires (as those used in the International Study of Asthma and Allergies in Childhood - ISAAC filled in by the parents and on medical exams, the study will assess the prevalence, incidence and exacerbation of asthma, thus considering both short and long-term effects. The approximate number of children in the study will never be less than 600, guaranteeing 80% of study power (significant at a 5% level. Discussion This study intends to contribute for the understanding of the role of environmental factors, namely indoor air pollution, on asthma considering a risk group of different ages, and for the development of preventive measures, which are considered priority issues by the European Commission, according to the European Environmental Agency and the World Health Organization.

  20. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

    Directory of Open Access Journals (Sweden)

    van der Vlugt Maureen J

    2011-02-01

    Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

  1. TABADO: "Evaluation of a smoking cessation program among Adolescents in Vocational Training Centers": Study protocol

    Directory of Open Access Journals (Sweden)

    Martinet Yves

    2009-11-01

    Full Text Available Abstract Background Most of the efforts to reduce teenagers' tobacco addiction have focused on smoking prevention and little on smoking cessation. A smoking cessation program (TABADO study, associating pharmacologic and cognitive-behavioural strategy, on a particularly vulnerable population (vocational trainees, was developed. This study aims to evaluate the efficacy of the program which was offered to all smokers in a population aged 15 to 20 years in Vocational Training Centers (VTC. This paper presents the TABADO study protocol. Methods The study is quasi-experimental, prospective, evaluative and comparative and takes place during the 2 years of vocational training. The final population will be composed of 2000 trainees entering a VTC in Lorraine, France, during the 2008-2009 period. The intervention group (1000 trainees benefited from the TABADO program while no specific intervention took place in the "control" group (1000 trainees other than the treatment and education services usually available. Our primary outcome will be the tobacco abstinence rate at 12 months. Discussion If the program proves effective, it will be a new tool in the action against smoking in populations that have been seldom targeted until now. In addition, the approach could be expanded to other young subjects from socially disadvantaged backgrounds in the context of a public health policy against smoking among adolescents. Trial registration Clinical trial identification number is NTC00973570.

  2. Histomorphometric assessment of bone necrosis produced by two cryosurgery protocols using liquid nitrogen: an experimental study on rat femurs

    Directory of Open Access Journals (Sweden)

    Fábio Wildson Gurgel Costa

    2011-12-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the effects of liquid nitrogen cryosurgery on the femoral diaphysis of rats. MATERIAL AND METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphometrically. RESULTS: The depth and extent of peak bone necrosis were 124.509 µm and 2087.094 µm for the 1-min protocol, respectively, and 436.424 µm and 12046.426 µm for the 2-min protocol. Peak necrosis was observed in the second experimental week with both cryotherapy protocols. CONCLUSIONS: The present results indicate that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. Although our results cannot be entirely extrapolated to clinical practice, they contribute to the understanding of the behavior of bone tissue submitted to different cycles of liquid nitrogen freezing and may serve as a basis for new studies.

  3. A Feasibility Randomised Controlled Trial of the New Orleans Intervention for Infant Mental Health: A Study Protocol

    Directory of Open Access Journals (Sweden)

    Rachel Pritchett

    2013-01-01

    Full Text Available Child maltreatment is associated with life-long social, physical, and mental health problems. Intervening early to provide maltreated children with safe, nurturing care can improve outcomes. The need for prompt decisions about permanent placement (i.e., regarding adoption or return home is internationally recognised. However, a recent Glasgow audit showed that many maltreated children “revolve” between birth families and foster carers. This paper describes the protocol of the first exploratory randomised controlled trial of a mental health intervention aimed at improving placement permanency decisions for maltreated children. This trial compares an infant's mental health intervention with the new enhanced service as usual for maltreated children entering care in Glasgow. As both are new services, the trial is being conducted from a position of equipoise. The outcome assessment covers various fields of a child’s neurodevelopment to identify problems in any ESSENCE domain. The feasibility, reliability, and developmental appropriateness of all outcome measures are examined. Additionally, the potential for linkage with routinely collected data on health and social care and, in the future, education is explored. The results will inform a definitive randomised controlled trial that could potentially lead to long lasting benefits for the Scottish population and which may be applicable to other areas of the world. This trial is registered with ClinicalTrials.gov (NC01485510.

  4. Analysis of efficiency of the double- centrifugation protocol to prepare platelet rich plasma (PRP – an experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Michel Reis MESSORA

    2009-09-01

    Full Text Available Introduction and objective:The purpose of this study was to evaluatethe concentrations of platelets obtained from platelet rich plasma (PRP prepared according to the double-centrifugation protocol. Material and methods: Eight adult male rabbits (White New Zealand weighing 2.8 to 4 kg were used.After general anesthesia, 10 ml of blood were drawn from each animal via cardiac puncture. Each blood sample was centrifuged according to the protocol of Sonnleitner et al.(2000.The peripheral blood (total from each animal and the PRP samples platelets were counted manually. Data were submitted to statistical analysis.The normality of the data was confirmed and the Student’s t test was applied (p < 0.05.Results: PRP samples presented an average platele count significantly higher than that of peripheral blood.Conclusion Within the limits of this study, it was concluded that the double centrifugation protocol was adequate to prepare PRP .

  5. Recent Studies on Feeding Problems in Children with Autism

    Science.gov (United States)

    Volkert, Valerie M.; Vaz, Petula C. M.

    2010-01-01

    This paper reviews recent studies on behavioral interventions for children with autism and feeding problems. The applicability of interventions that have been tested with other populations of children with feeding problems is discussed, as well as directions for future research.

  6. Protocol adaptations to conduct Systematic Literature Reviews in Software Engineering: a chronological study

    Directory of Open Access Journals (Sweden)

    Samuel Sepúlveda

    2015-12-01

    Full Text Available Systematic literature reviews (SLR have reached a considerable level of adoption in Software Engineering (SE, how-ever protocol adaptations for its implementation remain tangentially addressed. This work provides a chronological framework for the use and adaptation of the SLR protocol, including its current status. A systematic literature search was performed, reviewing a set of twelve articles being selected in accordance with the inclusion and exclusion criteria between 2004 and 2013, using digital data sources recognized by the SE community. A chronological framework is provided that includes the current state of the protocol adaptations to conduct SLR in SE. The results indicate areas where the quantity and quality of investigations needs to be increased and the identi- fication of the main proposals providing adaptations for the protocol conducting SLR in SE.

  7. The Study of MSADQ/CDMA Protocol in Voice/Data Integration Packet Networks

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    A new packet medium access protocol, namely, minislot signalingaccess based on distributed queues(MSADQ/CDMA), is proposed in voice and data intergration CDMA networks. The MSADQ protocol is based on distributed queues and collision resolution algorithm. Through proper management of the PN codes, the number of random competition collision reduces greatly, the multiple access interference (MAI) decreases. It has several special access signaling channels to carry the voice and data access request. Each slot is devided into several control minislots (CMSs), in which the Data Terminals (DT) or Voice Terminals (VT) transmit their request. According to the voice and data traffic character, the signaling access structure is proposed. The code assign rules and queue managing rules are also proposed to ensure the QoS requirement of each traffic. Comparisions with other three protocol are developed by simulation, which shows that MSADQ/CDMA protocol occupies less PN codes, but still has very good performance.

  8. Cottonwood data collection protocol : Great Sand Dunes National Park : Elk/Bison grazing ecology study

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This protocol/SOP is from USGS to estimate percent consumption of cottonwood saplings, seedlings, and resprouts and recruitment rates of cottonwood subjected to...

  9. Melanocytic nevi in children: A clinical study

    Directory of Open Access Journals (Sweden)

    Senthilkumar M

    2006-01-01

    Full Text Available BACKGROUND: Melanocytic nevi show different presentations in children which have not much studied in India. PURPOSES: To document the incidence and pattern of melanocytic nevi in children. METHODS: A total of 4,256 paediatric cases attending the dermatology OPD, JIPMER during the study period from August 2002 to August 2004 were screened for melanocytic nevi. FINDINGS: Out of these, 41 (0.96% cases were found to have melanocytic nevi. The mean age of these cases was 1.4 years (range of 3 days to 14 years. Fourteen (34.1% of them were males and 27 (65.9% were females with male to female ratio of 1:1.9. Majority of these cases (32 cases, 78% were in the age group of 0-1 year. Thirty-seven (90.2% cases had single lesion and 4 (9.8% cases had multiple lesions. The size of the nevi varied from 1.5 cm to 20 cm in 40 (97.6% cases and more than 20 cm in 1 (2.4% case. The most common site of involvement was the back (32 cases, 78% followed by head and neck (6 cases, 14.6%. Out of the total of 41 cases, 30 (73.2% were Mongolian spots, 8 (19.5% were congenital melanocytic nevi, one case (2.4% each had giant congenital melanocytic nevus, nevus spilus and nevus of Ota. Four cases had other associated cutaneous disorders. These included ashleaf macules in 2 cases, epidermolysis bullosa simplex in 1 case and a solitary case had both cafι-au-lait macule and mixed hemangioma. The systemic associations included seizures (suspected neurocutaneous melanosis in a solitary case of congenital melanocytic nevi. CONCLUSIONS: The spectrum of melanocytic nevi seen in children in this study partially differs from this of abroad studies. LIMITATION: Unicentre hospital-based study which cannot be generalized.

  10. Experimental study for Yuen-Kim protocol of quantum key distribution with unconditional secure

    OpenAIRE

    Hirota, O.; Kato, K; Sohma, M.

    2002-01-01

    In this report, we simulate practical feature of Yuen-Kim protocol for quantum key distribution with unconditional secure. In order to demonstrate them experimentally by intensity modulation/direct detection(IMDD) optical fiber communication system, we use simplified encoding scheme to guarantee security for key information(1 or 0). That is, pairwise M-ary intensity modulation scheme is employed. Furthermore, we give an experimental implementation of YK protocol based on IMDD.

  11. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    LENUS (Irish Health Repository)

    Moorhead, Anne

    2011-03-31

    Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  12. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    Directory of Open Access Journals (Sweden)

    Murphy Kathy

    2011-03-01

    Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  13. Study of accent-based music speech protocol development for improving voice problems in stroke patients with mixed dysarthria.

    Science.gov (United States)

    Kim, Soo Ji; Jo, Uiri

    2013-01-01

    Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. Each session was conducted for 30 minutes and 12 sessions including pre- and post-test were administered for each patient. For examining the protocol efficacy, the measures of maximum phonation time (MPT), fundamental frequency (F0), average intensity (dB), jitter, shimmer, noise to harmonics ratio (NHR), and diadochokinesis (DDK) were compared between pre and post-test and analyzed with a paired sample t-test. The results showed that the measures of MPT, F0, dB, and sequential motion rates (SMR) were significantly increased after administering the protocol. Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /K$\\inve$/ between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria.

  14. Acupuncture Antiarrhythmic Effects on Drug Refractory Persistent Atrial Fibrillation: Study Protocol for a Randomized, Controlled Trial

    Directory of Open Access Journals (Sweden)

    Jimin Park

    2015-01-01

    Full Text Available Background. Atrial fibrillation (AF is the most common form of arrhythmia. Several trials have suggested that acupuncture may prevent AF. However, the efficacy of acupuncture for AF prevention has not been well investigated. Therefore, we designed a prospective, two-parallel-armed, participant and assessor blinded, randomized, sham-controlled clinical trial to investigate acupuncture in persistent AF (ACU-AF. Methods. A total of 80 participants will be randomly assigned to active acupuncture or sham acupuncture groups in a 1 : 1 ratio. Both groups will take the same antiarrhythmic medication during the study period. Patients will receive 10 sessions of acupuncture treatment once a week for 10 weeks. The primary endpoint is AF recurrence rate. Secondary endpoints are left atrium (LA and left atrial appendage (LAA changes in function and volume, and inflammatory biomarker changes. Ethics. This study protocol was approved by the institutional review boards (IRBs of Kyung Hee University Hospital (number 1335-04. This trial is registered with clinicaltrials.gov NCT02110537.

  15. Bio-repository of DNA in stroke: a study protocol of three ancestral populations

    Directory of Open Access Journals (Sweden)

    Ioana Cotlarciuc

    2012-07-01

    Full Text Available Stroke is a leading cause of death and disability in the world. Identifying the genes underlying stroke risk may help us to improve our understanding of the mechanisms that cause stroke and also identify novel therapeutic targets. To have sufficient power to disentangle the genetic component of stroke, large-scale highly phenotyped DNA repositories are necessary. The BRAINS (Bio-repository of DNA in stroke study aims to recruit subjects with all subtypes of stroke as well as controls from UK, India, Sri Lanka and Qatar. BRAINS-UK will include 1500 stroke patients of European ancestry as well as British South Asians. BRAINS-South Asia aims to recruit 3000 stroke subjects and 3000 controls from across India and Sri Lanka. BRAINS-Middle East aims to enrol 1500 stroke patients from Qatar. The controls for BRAINS-Middle East will be recruited from a population-based Qatari Biobank. With the addition of new recruitment centres in India and Qatar, we present an updated version of the BRAINS study protocol. This is the first international DNA biobank for stroke patients and controls from the Middle East. By investigating the influence of genetic factors on stroke risk in European, South Asian and Middle Eastern populations, BRAINS has the potential to improve our understanding of genetic differences between these groups and may lead to new population-specific therapeutic targets.

  16. Memory outcomes following cognitive interventions in children with neurological deficits: A review with a focus on under-studied populations.

    Science.gov (United States)

    Schaffer, Yael; Geva, Ronny

    2016-01-01

    Given the primary role of memory in children's learning and well-being, the aim of this review was to examine the outcomes of memory remediation interventions in children with neurological deficits as a function of the affected memory system and intervention method. Fifty-seven studies that evaluated the outcome of memory interventions in children were identified. Thirty-four studies met the inclusion criteria, and were included in a systematic review. Diverse rehabilitation methods for improving explicit and implicit memory in children were reviewed. The analysis indicates that teaching restoration strategies may improve, and result in the generalisation of, semantic memory and working memory performance in children older than 7 years with mild to moderate memory deficits. Factors such as longer protocols, emotional support, and personal feedback contribute to intervention efficacy. In addition, the use of compensation aids seems to be highly effective in prospective memory tasks. Finally, the review unveiled a lack of studies with young children and the absence of group interventions. These findings point to the importance of future evidence-based intervention protocols in these areas.

  17. New predictive model for microsurgical outcome of intracranial arteriovenous malformations: study protocol

    Science.gov (United States)

    Tong, Xianzeng; Wu, Jun; Cao, Yong; Zhao, Yuanli; Wang, Shuo

    2017-01-01

    Introduction Although microsurgical resection is currently the first-line treatment modality for arteriovenous malformations (AVMs), microsurgery of these lesions is complicated due to the fact that they are very heterogeneous vascular anomalies. The Spetzler-Martin grading system and the supplementary grading system have demonstrated excellent performances in predicting the risk of AVM surgery. However, there are currently no predictive models based on multimodal MRI techniques. The purpose of this study is to propose a predictive model based on multimodal MRI techniques to assess the microsurgical risk of intracranial AVMs. Methods and analysis The study consists of 2 parts: the first part is to conduct a single-centre retrospective analysis of 201 eligible patients to create a predictive model of AVM surgery based on multimodal functional MRIs (fMRIs); the second part is to validate the efficacy of the predictive model in a prospective multicentre cohort study of 400 eligible patients. Patient characteristics, AVM features and multimodal fMRI data will be collected. The functional status at pretreatment and 6 months after surgery will be analysed using the modified Rankin Scale (mRS) score. The patients in each part of this study will be dichotomised into 2 groups: those with improved or unchanged functional status (a decreased or unchanged mRS 6 months after surgery) and those with worsened functional status (an increased mRS). The first part will determine the risk factors of worsened functional status after surgery and create a predictive model. The second part will validate the predictive model and then a new AVM grading system will be proposed. Ethics and dissemination The study protocol and informed consent form have been reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (KY2016-031-01). The results of this study will be disseminated through printed media. Trial registration

  18. Early signaling, referral, and treatment of adolescent chronic pain: a study protocol

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    Voerman Jessica S

    2012-06-01

    Full Text Available Abstract Background Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study. Methods and design The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition. Discussion If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based. Trial registration Dutch Trial Register NTR1926

  19. Experimental performance study of wireless ad hoc system utilizing 802.11a standard base on different routing protocols

    Science.gov (United States)

    Zhong, Xiao F.; Wang, You-Zheng; Mei, Shunliang; Wang, Jing

    2002-08-01

    The wireless ad hoc network technology provides a flexible infrastructure for next generation mobile telecommunication. In this paper, the performances of the networks based on IEEE802.11a standard, including packets successful delivery rate, average end-to-end delay and system throughput, have been studied with different routing protocols (AODV, WRP, and FISHEYE) using GloMoSim to evaluate the effects of various factors, such as node mobility, node density, and node radio transmission range. The simulation results show that adaptive routing protocol will be more suitable for the variation ad hoc network and the results are helpful for the optimum design and deployment of an actual network.

  20. Acute symptoms related to air pollution in urban areas: a study protocol

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    Forouzanfar Mohammad

    2006-08-01

    Full Text Available Abstract Background The harmful effects of urban air pollution on general population in terms of annoying symptoms are not adequately evaluated. This is in contrast to the hospital admissions and short term mortality. The present study protocol is designed to assess the association between the level of exposure to certain ambient air pollutants and a wide range of relevant symptoms. Awareness of the impact of pollution on the population at large will make our estimates of the pertinent covert burden imposed on the society more accurate. Methods/design A cross sectional study with spatial analysis for the addresses of the participants was conducted. Data were collected via telephone interviews administered to a representative sample of civilians over age four in the city. Households were selected using random digit dialling procedures and randomization within each household was also performed to select the person to be interviewed. Levels of exposure are quantified by extrapolating the addresses of the study population over the air pollution matrix of the city at the time of the interview and also for different lag times. This information system uses the data from multiple air pollution monitoring stations in conjunction with meteorological data. General linear models are applied for statistical analysis. Discussion The important limitations of cross-sectional studies on acute effects of air pollution are personal confounders and measurement error for exposure. A wide range of confounders in this study are controlled for in the statistical analysis. Exposure error may be minimised by employing a validated geographical information system that provides accurate estimates and getting detailed information on locations of individual participants during the day. The widespread operation of open air conditioning systems in the target urban area which brings about excellent mixing of the outdoor and indoor air increases the validity of outdoor pollutants

  1. Protocol for a scoping review study to identify and classify patient-centred quality indicators

    Science.gov (United States)

    Jolley, Rachel J; Lorenzetti, Diane L; Manalili, Kimberly; Lu, Mingshan; Santana, Maria J

    2017-01-01

    Introduction The concept of patient-centred care (PCC) is changing the way healthcare is understood, accepted and delivered. The Institute of Medicine has defined PCC as 1 of its 6 aims to improve healthcare quality. However, in Canada, there are currently no nationwide standards in place for measuring and evaluating healthcare from a patient-centred approach. In this paper, we outline our scoping review protocol to systematically review published and unpublished literature specific to patient-centred quality indicators that have been implemented and evaluated across various care settings. Methods and analysis Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. We will search electronic databases (MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Social Work Abstracts, Social Services Abstracts), grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. 2 reviewers will independently screen all abstracts and full-text studies for inclusion. We will include any study which focuses on quality indicators in the context of PCC. All bibliographic data, study characteristics and indicators will be collected and analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. Ethics and dissemination The scoping review will synthesise patient-centred quality indicators and their characteristics as described in the literature. This review will be the first step to formally identify what quality indicators have been used to evaluate PCC across the healthcare continuum, and will be used to inform a stakeholder consensus process exploring the development of a generic set of patient-centred quality indicators applicable to multiple care settings. The

  2. Effects of chronic inflammatory bowel diseases on left ventricular structure and function: a study protocol

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    Botti Fiorenzo

    2002-09-01

    Full Text Available Abstract Background Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD. In particular, large amounts of collagen type I, III and V have been described and correlated to the development of intestinal fibrotic lesions. No information has been available until now about the possible increased collagen deposition far from the main target organ. In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splancnic and systemic collagen metabolism (procollagen III assay, deposition (ultrasonic tissue characterization, and cardiac function (echocardiography in patients with different long standing history of IBD, before and after surgery. Methods Thirty patients affected by active IBD, 15 with Crohn and 15 with Ulcerative Colitis, submitted to surgery will be enrolled in the study in a double blind fashion. They will be studied before the surgical operation and 6, 12 months after surgery. A control group of 15 healthy age and gender-matched subjects will also be studied. At each interval blood samples will be collected in order to assess the collagen metabolism; a transthoracic echocardiogram will be recorded for the subsequent determination of cardiac function and collagen deposition. Discussion From this study protocol we expect additional information about the association between IBD and cardiovascular disorders; in particular to address the question if chronic inflammation, through the altered collagen metabolism, could affect left ventricular structure and function in a manner directly related to the estimated duration of the disease.

  3. Do autistic children have higher levels of caries? A cross-sectional study in Turkish children

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    Namal Necmi

    2007-06-01

    Full Text Available The aim of this study is to assess whether the dental caries experience is higher in children with an autistic disorder (AD than in normal children. Three schools for autistic children and three standard elementary schools in Istanbul, Turkey, were included in a cross-sectional study. Subjects were orally examined. Socio-demographic information and data about their oral care habits were obtained from their parents from records. Sixty-two children with AD and 301 children without AD were examined. Their ages varied between 6 and 12 years. Children with AD compared to those without AD had lower experience of caries. Logistic regression analysis of DMFT showed that the dental status was positively affected in younger children (OR = 15.57; 95% CI 7.62, 31.80, children from families with high income (OR = 5.42; 95% CI 2.31, 12.75, children brushing teeth regularly (OR = 2.01, 95% CI 1.10, 3.68, children consuming less sugar (OR = 5.01; 95% CI 2.57, 9.76 and in those with AD (OR=3.99; 95% CI 1.56, 10.19. Children with AD had better caries status than children without AD at younger ages.

  4. Acupuncture, Counseling, and Usual care for Depression (ACUDep: study protocol for a randomized controlled trial

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    MacPherson Hugh

    2012-11-01

    Full Text Available Abstract Background The evidence on the effect of acupuncture or counseling for depression is not conclusive yet is sufficient to warrant further research. Our aim is to conduct a full-scale RCT to determine the clinical and cost effectiveness of acupuncture and counseling compared to usual care alone. We will explore the experiences and perspectives of patients and practitioners. Methods/Design Randomized controlled trial with three parallel arms: acupuncture plus usual care, counseling plus usual care, and usual care alone, in conjunction with a nested qualitative study using in-depth interviews with purposive samples of trial participants. Participants: Patients aged over 18 years diagnosed with depression or mood disorder by their GP and with a score of 20 or above on the Beck Depression Inventory (BDI-II. Randomization: Computer randomization by York Trials Unit to acupuncture, counseling, and usual care alone in proportions of 2:2:1, respectively, with secure allocation concealment. Interventions: Patients allocated to acupuncture and counseling groups receive the offer of up to 12 weekly sessions. Both interventions allow flexibility to address patient variation, yet are constrained within defined protocols. Acupuncture is based on traditional Chinese medicine and counseling is non-directive within the humanistic tradition. Outcome: The PHQ-9 is the primary outcome measure, collected at baseline, 3, 6, 9, and 12 months. Also measured is BDI-II, SF-36 Bodily pain subscale, and EQ-5D. Texted mood scores are collected weekly over the first 15 weeks. Health-related resource use is collected over 12 months. Analysis: The sample size target was for 640 participants, calculated for an effect size of 0.32 on the PHQ-9 when comparing acupuncture with counseling given 90% power, 5% significance, and 20% loss to follow-up. Analysis of covariance will be used on an intention-to-treat basis. Thematic analysis will be used for qualitative data. We will

  5. Which dressing do donor site wounds need?: study protocol for a randomized controlled trial

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    Ubbink Dirk T

    2011-10-01

    Full Text Available Abstract Background Donor site wounds after split-skin grafting are rather 'standard' wounds. At present, lots of dressings and topical agents for donor site wounds are commercially available. This causes large variation in the local care of these wounds, while the optimum 'standard' dressing for local wound care is unclear. This protocol describes a trial in which we investigate the effectiveness of various treatment options for these donor site wounds. Methods A 14-center, six-armed randomized clinical trial is being carried out in the Netherlands. An a-priori power analysis and an anticipated dropout rate of 15% indicates that 50 patients per group are necessary, totaling 300 patients, to be able to detect a 25% quicker mean time to complete wound healing. Randomization has been computerized to ensure allocation concealment. Adult patients who need a split-skin grafting operation for any reason, leaving a donor site wound of at least 10 cm2 are included and receive one of the following dressings: hydrocolloid, alginate, film, hydrofiber, silicone dressing, or paraffin gauze. No combinations of products from other intervention groups in this trial are allowed. Optimum application and changes of these dressings are pursued according to the protocol as supplied by the dressing manufacturers. Primary outcomes are days to complete wound healing and pain (using a Visual Analogue Scale. Secondary outcomes are adverse effects, scarring, patient satisfaction, and costs. Outcome assessors unaware of the treatment allocation will assess whether or not an outcome has occurred. Results will be analyzed according to the intention to treat principle. The first patient was randomized October 1, 2009. Discussion This study will provide comprehensive data on the effectiveness of different treatment options for donor site wounds. The dressing(s that will prevail in effectiveness, satisfaction and costs will be promoted among clinicians dealing with such

  6. Optimal Scanning Protocols for Dual-Energy CT Angiography in Peripheral Arterial Stents: An in Vitro Phantom Study

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    Abdulrahman Almutairi

    2015-05-01

    Full Text Available Objective: To identify the optimal dual-energy computed tomography (DECT scanning protocol for peripheral arterial stents while achieving a low radiation dose, while still maintaining diagnostic image quality, as determined by an in vitro phantom study. Methods: Dual-energy scans in monochromatic spectral imaging mode were performed on a peripheral arterial phantom with use of three gemstone spectral imaging (GSI protocols, three pitch values, and four kiloelectron volts (keV ranges. A total of 15 stents of different sizes, materials, and designs were deployed in the phantom. Image noise, the signal-to-noise ratio (SNR, different levels of adaptive statistical iterative reconstruction (ASIR, and the four levels of monochromatic energy for DECT imaging of peripheral arterial stents were measured and compared to determine the optimal protocols. Results: A total of 36 scans with 180 datasets were reconstructed from a combination of different protocols. There was a significant reduction of image noise with a higher SNR from monochromatic energy images between 65 and 70 keV in all investigated preset GSI protocols (p < 0.05. In addition, significant effects were found from the main effect analysis for these factors: GSI, pitch, and keV (p = 0.001. In contrast, there was significant interaction on the unstented area between GSI and ASIR (p = 0.015 and a very high significant difference between keV and ASIR (p < 0.001. A radiation dose reduction of 50% was achieved. Conclusions: The optimal scanning protocol and energy level in the phantom study were GSI-48, pitch value 0.984, and 65 keV, which resulted in lower image noise and a lower radiation dose, but with acceptable diagnostic images.

  7. Optimal Scanning Protocols for Dual-Energy CT Angiography in Peripheral Arterial Stents: An in Vitro Phantom Study

    Science.gov (United States)

    Almutairi, Abdulrahman; Sun, Zhonghua; Al Safran, Zakariya; Poovathumkadavi, Abduljaleel; Albader, Suha; Ifdailat, Husam

    2015-01-01

    Objective: To identify the optimal dual-energy computed tomography (DECT) scanning protocol for peripheral arterial stents while achieving a low radiation dose, while still maintaining diagnostic image quality, as determined by an in vitro phantom study. Methods: Dual-energy scans in monochromatic spectral imaging mode were performed on a peripheral arterial phantom with use of three gemstone spectral imaging (GSI) protocols, three pitch values, and four kiloelectron volts (keV) ranges. A total of 15 stents of different sizes, materials, and designs were deployed in the phantom. Image noise, the signal-to-noise ratio (SNR), different levels of adaptive statistical iterative reconstruction (ASIR), and the four levels of monochromatic energy for DECT imaging of peripheral arterial stents were measured and compared to determine the optimal protocols. Results: A total of 36 scans with 180 datasets were reconstructed from a combination of different protocols. There was a significant reduction of image noise with a higher SNR from monochromatic energy images between 65 and 70 keV in all investigated preset GSI protocols (p < 0.05). In addition, significant effects were found from the main effect analysis for these factors: GSI, pitch, and keV (p = 0.001). In contrast, there was significant interaction on the unstented area between GSI and ASIR (p = 0.015) and a very high significant difference between keV and ASIR (p < 0.001). A radiation dose reduction of 50% was achieved. Conclusions: The optimal scanning protocol and energy level in the phantom study were GSI-48, pitch value 0.984, and 65 keV, which resulted in lower image noise and a lower radiation dose, but with acceptable diagnostic images. PMID:26006234

  8. Rationale and protocol for using a smartphone application to study autism spectrum disorders: SMARTAUTISM

    Science.gov (United States)

    Bonnot, Olivier; Bonneau, Dominique; Doudard, Aude; Duverger, Philippe

    2016-01-01

    Introduction Longitudinal studies on the evolution of autism spectrum disorder (ASD) symptoms are limited and have primarily used repeated measurements performed several months apart. However, measurements of changes in everyday life should more closely reflect the ‘real life’ of the patient and his or her family. We propose to study the child's ASD symptoms and their effect on the quality of life, psychological status and anxiety of the child's parents over a 6-month period using SMARTAUTISM, a smartphone application. Method and analysis This is a prospective, longitudinal, exploratory, open study with a 6-month follow-up period. Data will be recorded longitudinally over multiple weeks under natural conditions. The factors affecting the quality of life and anxiety of parents of children with ASD and the children's functional symptoms will be examined, and the feasibility of using a smartphone application designed for parents of ASD patients will be assessed. Primary objective: Explore the evolution of a child's behaviour over 6 months and the (psychological and social) effects of these changes on the family. Secondary objective: Assess the feasibility of our application by examining the filling rate and application usage by parents for 6 months. 100 families containing 1 child diagnosed with ASD will be included. At baseline, sociodemographic, psychiatric and medical data will be recorded. The correlations of the general epidemiological variables (primary outcome measure) will be evaluated via multivariate analysis. The application filling rate (relative to the ideal filling rate) will be used to assess the feasibility of the application (secondary outcome measure). Ethics and dissemination The SMARTAUTISM study has the approval of the local ethics committee, and data security will be ensured via the use of encryption and a secure medical server. The use of this application will be proposed at autism resource centres across France. PMID:27881525

  9. Evaluating community health centers’ adoption of a new global capitation payment (eCHANGE) study protocol

    Science.gov (United States)

    Angier, H; O’Malley, JP; Marino, M; McConnell, KJ; Cottrell, E; Jacob, RL; Likumahuwa-Ackman, S; Heintzman, J; Huguet, N; Bailey, SR; DeVoe, JE

    2017-01-01

    Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon’s Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment. We will implement a difference-in-difference analytic approach to evaluate pre-post APM changes between intervention and control groups, including: 1) clinic-level outcomes, 2) patient-level clinical outcomes, and 3) patient-level econometric outcomes. Findings from the project will be of national significance, as there is a need for evidence regarding how novel payment methods might enhance PCMH capabilities and support their capacity to produce better quality and outcomes. If this capitated payment method is proven effective, study findings will inform dissemination of similar APMs nationwide. PMID:27836506

  10. A simple, economical and reproducible protein extraction protocol for proteomics studies of soybean roots

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    Elisete Pains Rodrigues

    2012-01-01

    Full Text Available Sample preparation is a critical step in two-dimensional gel electrophoresis (2-DE of plant tissues. Here we describe a phenol/SDS procedure that, although greatly simplified, produced well-resolved and reproducible 2-DE profiles of protein extracts from soybean [Glycine max (L. Merril] roots. Extractions were made in three replicates using both the original and simplified procedure. To evaluate the quality of the extracted proteins, ten spots were randomly selected and identified by mass spectrometry (MS. The 2-DE gels were equally well resolved, with no streaks or smears, and no significant differences were observed in protein yield, reproducibility, resolution or number of spots. Mass spectra of the ten selected spots were compared with database entries and allowed high-quality identification of proteins. The simplified protocol described here presents considerable savings of time and reagents without compromising the quality of 2-DE protein profiles and compatibility with MS analysis, and may facilitate the progress of proteomics studies of legume-rhizobia interactions.

  11. Effective protein extraction protocol for proteomics studies of Jerusalem artichoke leaves.

    Science.gov (United States)

    Zhang, Meide; Shen, Shihua

    2013-07-01

    Protein extraction is a crucial step for proteomics studies. To establish an effective protein extraction protocol suitable for two-dimensional electrophoresis (2DE) analysis in Jerusalem artichoke (Helianthus tuberosus L.), three different protein extraction methods-trichloroacetic acid/acetone, Mg/NP-40, and phenol/ammonium acetate-were evaluated using Jerusalem artichoke leaves as source materials. Of the three methods, trichloroacetic acid/acetone yielded the best protein separation pattern and highest number of protein spots in 2DE analysis. Proteins highly abundant in leaves, such as Rubisco, are typically problematic during leaf 2DE analysis, however, and this disadvantage was evident using trichloroacetic acid/acetone. To reduce the influence of abundant proteins on the detection of low-abundance proteins, we optimized the trichloroacetic acid/acetone method by incorporating a PEG fractionation approach. After optimization, 363 additional (36.2%) protein spots were detected on the 2DE gel. Our results suggest that trichloroacetic acid/acetone method is a better protein extraction technique than Mg/NP-40 and phenol/ammonium acetate in Jerusalem artichoke leaf 2DE analysis, and that trichloroacetic acid/acetone method combined with PEG fractionation procedure is the most effective approach for leaf 2DE analysis of Jerusalem artichoke.

  12. Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

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    Eva Comin

    2013-03-01

    Full Text Available Background The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs. This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension.Methods Eligible study participants are those aged 35–74 years assigned to family practitioners (FPs of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1 a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2 a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1 suspected and confirmed diagnoses, (2 control of clinical variables, (3 requests for tests and (4 proportions of patients with adequate drug prescriptions.Results This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013.Conclusion This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.

  13. Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol

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    Ricciardelli Lina A

    2012-01-01

    Full Text Available Abstract Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in

  14. ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol

    Science.gov (United States)

    Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S

    2017-01-01

    Introduction Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues—including conceptualisation, measurement and data analysis—that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. Methods and analysis This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. Ethics and dissemination An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at

  15. Celeration of Executive Functioning while Solving the Tower of Hanoi: Two Single Case Studies Using Protocol Analysis

    NARCIS (Netherlands)

    Janssen, G.T.L.; Mey, H.R.A. de; Egger, J.I.M.; Witteman, C.L.M.

    2010-01-01

    The present study was designed to systematically explore individual learning abilities by an in depth analysis of the performances of two single participants on the five disk Tower of Hanoi. Verbal protocols were obtained to provide us with a detailed picture of strategy development and learning. Co

  16. Teacher's Perceptions of Sheltered Instruction Observation Protocol for Teaching Young English Language Learners: A Qualitative Case Study

    Science.gov (United States)

    Rodriguez Moux, Shirley

    2010-01-01

    This qualitative case study explored the use of sheltered instruction observation protocol (SIOP) instructional practices to promote the language development and learning of elementary English language learners (ELLs) in an immersion setting in 1st and 2nd grades. The SIOP model was developed for middle school ELLs, and there is scant information…

  17. An evidenced based protocol on promoting positive parenting program (triple P) for pre-school children in Hong Kong

    OpenAIRE

    Chan, Yin-fung; 陳燕鳳

    2013-01-01

    Ineffective and tough parenting has been associated with physical child abuse. Parenting support would be the key component to act as a preventive measure of the problem. The evidenced based parenting intervention has proved to reduce prevalence of child abuse and children behavioural and emotional problems as well. As a result, there is a marked increased international recognition of the value of Positive Parenting Program (Triple P). Triple P is developed at University of Queensland in A...

  18. A Longitudinal Study of Children's Social Adjustment during Elementary School.

    Science.gov (United States)

    Battistich, Victor; Solomon, Daniel

    A 7-year, longitudinal study of children's social development from kindergarten through sixth grade was designed to identify unusually prosocial children and characteristics that differentiated them from average and antisocial peers. Another objective was to identify functional socioemotional predictors of changes in children's social adjustment.…

  19. Egyptian Children's Use of Technology: A Phenomenological Study

    Science.gov (United States)

    Morgan, Hani; Lee, Guang-Lea

    2017-01-01

    Although the use of technology can be very important for children younger than age 12 years, not all countries possess the financial resources to make digital resources widely available to students. Children can also use technology inappropriately. This study explores the consequences of exposure to different forms of technology on children. It…

  20. Syntax and Prosody in Narratives: A Study of Preschool Children

    Science.gov (United States)

    Zanchi, Paola; Zampini, Laura; Fasolo, Mirco; D'Odorico, Laura

    2016-01-01

    The present study examines narrative competence and its relationships with syntactic and prosodic skills in preschool children. The narrative skills of 30 typically developing Italian children were assessed during their first year of kindergarten attendance (T1) and again one year later (T2). A picture book was used to elicit children's…

  1. Observational cohort study of HIV-infected African children.

    NARCIS (Netherlands)

    Laufer, M.K.; Oosterhout, J.J. van; Perez, M.A.; Kanyanganlika, J.; Taylor, T.E.; Plowe, C.V.; Graham, S.M.

    2006-01-01

    BACKGROUND: Most information about children living with HIV is based on follow up from children identified through mother-to-child transmission studies. Children identified through voluntary counseling and testing (VCT) represent a unique cohort that has not been previously described in the literatu

  2. Psychological and Educational Studies with Spina Bifida Children. Final Report.

    Science.gov (United States)

    Diller, Leonard; And Others

    To measure school achievements in spina bifida children, to relate these measures to certain variables, to obtain information on educational problems, and to study facets of cognition and its changes with age, 77 spina bifida children and 53 amputees (all aged 5 to 15) were tested. Sixty non-disabled children were at times used for controls. The…

  3. NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol

    Directory of Open Access Journals (Sweden)

    Schmidt Barbara

    2011-01-01

    Full Text Available Abstract Background The appropriate level of oxygenation for extremely preterm neonates (90% have been reported to have greater rates of morbidity including retinopathy of prematurity and chronic lung disease. In order to answer this clinical dilemma reliably, large scale trial evidence is needed. Methods/Design To detect a small but important 4% increase in death or severe disability in survivors, over 5000 neonates would need to be recruited. As extreme prematurity affects 1% of births, such a project undertaken by one trial group would be prohibitively lengthy and expensive. Hence, the Neonatal Oxygenation Prospective Meta-analysis (NeOProM Collaboration has been formed. A prospective meta-analysis (PMA is one where studies are identified, evaluated, and determined to be eligible before the results of any included studies are known or published, thereby avoiding some of the potential biases inherent in standard, retrospective meta-analyses. This methodology provides the same strengths as a single large-scale multicentre randomised study whilst allowing greater pragmatic flexibility. The NeOProM Collaboration protocol (NCT01124331 has been agreed prior to the results of individual trials being available. This includes pre-specifying the hypotheses, inclusion criteria and outcome measures to be used. Each trial will first publish their respective results as they become available and the combined meta-analytic results, using individual patient data, will be published when all trials are complete. The primary outcome to be assessed is a composite outcome of death or major disability at 18 months - 2 years corrected age. Secondary outcomes include several measures of neonatal morbidity. The size of the combined dataset will allow the effect of the interventions to be explored more reliably with respect to pre-specified patient- and intervention-level characteristics. Discussion Results should be available by 2014.

  4. Using Ontario's "Telehealth" health telephone helpline as an early-warning system: a study protocol

    Directory of Open Access Journals (Sweden)

    Moore Kieran M

    2006-02-01

    Full Text Available Abstract Background The science of syndromic surveillance is still very much in its infancy. While a number of syndromic surveillance systems are being evaluated in the US, very few have had success thus far in predicting an infectious disease event. Furthermore, to date, the majority of syndromic surveillance systems have been based primarily in emergency department settings, with varying levels of enhancement from other data sources. While research has been done on the value of telephone helplines on health care use and patient satisfaction, very few projects have looked at using a telephone helpline as a source of data for syndromic surveillance, and none have been attempted in Canada. The notable exception to this statement has been in the UK where research using the national NHS Direct system as a syndromic surveillance tool has been conducted. Methods/design The purpose of our proposed study is to evaluate the effectiveness of Ontario's telephone nursing helpline system as a real-time syndromic surveillance system, and how its implementation, if successful, would have an impact on outbreak event detection in Ontario. Using data collected retrospectively, all "reasons for call" and assigned algorithms will be linked to a syndrome category. Using different analytic methods, normal thresholds for the different syndromes will be ascertained. This will allow for the evaluation of the system's sensitivity, specificity and positive predictive value. The next step will include the prospective monitoring of syndromic activity, both temporally and spatially. Discussion As this is a study protocol, there are currently no results to report. However, this study has been granted ethical approval, and is now being implemented. It is our hope that this syndromic surveillance system will display high sensitivity and specificity in detecting true outbreaks within Ontario, before they are detected by conventional surveillance systems. Future results will be

  5. Limiting CT radiation dose in children with craniosynostosis: phantom study using model-based iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kaasalainen, Touko; Lampinen, Anniina [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); University of Helsinki, Department of Physics, Helsinki (Finland); Palmu, Kirsi [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); School of Science, Aalto University, Department of Biomedical Engineering and Computational Science, Helsinki (Finland); Reijonen, Vappu; Kortesniemi, Mika [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, POB 340, Helsinki (Finland); Leikola, Junnu [University of Helsinki and Helsinki University Hospital, Department of Plastic Surgery, Helsinki (Finland); Kivisaari, Riku [University of Helsinki and Helsinki University Hospital, Department of Neurosurgery, Helsinki (Finland)

    2015-09-15

    Medical professionals need to exercise particular caution when developing CT scanning protocols for children who require multiple CT studies, such as those with craniosynostosis. To evaluate the utility of ultra-low-dose CT protocols with model-based iterative reconstruction techniques for craniosynostosis imaging. We scanned two pediatric anthropomorphic phantoms with a 64-slice CT scanner using different low-dose protocols for craniosynostosis. We measured organ doses in the head region with metal-oxide-semiconductor field-effect transistor (MOSFET) dosimeters. Numerical simulations served to estimate organ and effective doses. We objectively and subjectively evaluated the quality of images produced by adaptive statistical iterative reconstruction (ASiR) 30%, ASiR 50% and Veo (all by GE Healthcare, Waukesha, WI). Image noise and contrast were determined for different tissues. Mean organ dose with the newborn phantom was decreased up to 83% compared to the routine protocol when using ultra-low-dose scanning settings. Similarly, for the 5-year phantom the greatest radiation dose reduction was 88%. The numerical simulations supported the findings with MOSFET measurements. The image quality remained adequate with Veo reconstruction, even at the lowest dose level. Craniosynostosis CT with model-based iterative reconstruction could be performed with a 20-μSv effective dose, corresponding to the radiation exposure of plain skull radiography, without compromising required image quality. (orig.)

  6. The effect of using an interactive booklet on childhood respiratory tract infections in consultations: Study protocol for a cluster randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2008-04-01

    Full Text Available Abstract Background Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary. About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations. Methods/Design This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes. Discussion Previous studies in adults and children have shown that educational interventions can result in reductions

  7. DVB—RCS协议研究%Study on DVB RCS Protocols

    Institute of Scientific and Technical Information of China (English)

    陈相登; 雷菁; 刘伟

    2012-01-01

    The DVB RCS communication systems, which are based on interaction applications, have attracted much attention recently. This paper first introduces the reference model and the protocol stack of DVB RCS systems. Then, the forward link protocol and the return link protocol are analyzed, respectively. Finally, sev- eral technical difficulties of the DVB RCS systems are described.%DVB—RCS通信系统是基于交互式应用的卫星通信系统,目前已受到业界的广泛关注。首先介绍了DVB—RCS系统的模型和协议结构,然后分别对前向信道和反向信道协议进行了分析,最后对所存在的问题进行了说明。

  8. Comparative Study of AODV and DSR Routing Protocols for MANET: Performance Analysis

    Directory of Open Access Journals (Sweden)

    Nidhi Goyal

    2013-11-01

    Full Text Available An ad hoc network is an assortment of wireless mobile nodes dynamically forming a transitory network lacking the use of any presented network communications or centralized management. A number of routing protocols like Dynamic Source Routing (DSR, Ad Hoc on-Demand Distance Vector Routing (AODV and Temporally Ordered Routing Algorithm (TORA have been projected. In this work an attempt has been ended to evaluate the performance of two outstanding on demand reactive routing protocols for mobile ad hoc networks: DSR and AODV. Although DSR and AODV share comparable on-demand behavior, the differences in the protocol mechanics can lead to significant performance differentials. The performance differentials are analyzed using varying time, packet delivery ratio, throughput and end-to-end delay. These simulations are carried out using the ns-2 network simulator, which is used to run ad hoc simulations.

  9. Born in Bradford, a cohort study of babies born in Bradford, and their parents: Protocol for the recruitment phase

    Directory of Open Access Journals (Sweden)

    Raynor Pauline

    2008-09-01

    Full Text Available Abstract Background Bradford, one of the most deprived cities in the United Kingdom, has a wide range of public health problems associated with socioeconomic deprivation, including an infant mortality rate almost double that for England and Wales. Infant mortality is highest for babies of Pakistani origin, who comprise almost half the babies born in Bradford. The Born in Bradford cohort study aims to examine environmental, psychological and genetic factors that impact on health and development perinatally, during childhood and subsequent adult life, and those that influence their parents' health and wellbeing. This protocol outlines methods for the recruitment phase of the study. Methods Most Bradford women attend for antenatal care and give birth at the Bradford Royal Infirmary, which has approximately 5,800 births per year. Women are eligible for recruitment if they plan to give birth here. Babies born from March 2007 are eligible to participate, recruitment is planned to continue until 2010. Fathers of babies recruited are invited to participate. Women are usually recruited when they attend for a routine oral glucose tolerance test at 26–28 weeks gestation. Recruitment of babies is at birth. Fathers are recruited whenever possible during the antenatal period, or soon after the birth. The aim is to recruit 10,000 women, their babies, and the babies' fathers. At recruitment women have blood samples taken, are interviewed to complete a semi-structured questionnaire, weighed, and have height, arm circumference and triceps skinfold measured. Umbilical cord blood is collected at birth. Within two weeks of birth babies have their head, arm and abdominal circumference measured, along with subscapular and triceps skinfold thickness. Fathers self-complete a questionnaire at recruitment, have height and weight measured, and provide a saliva sample. Participants are allocated a unique study number. NHS numbers will be used to facilitate record linkage

  10. A randomised controlled trial linking mental health inpatients to community smoking cessation supports: A study protocol

    Directory of Open Access Journals (Sweden)

    Clancy Richard

    2011-07-01

    Full Text Available Abstract Background Mental health inpatients smoke at higher rates than the general population and are disproportionately affected by tobacco dependence. Despite the advent of smoke free policies within mental health hospitals, limited systems are in place to support a cessation attempt post hospitalisation, and international evidence suggests that most smokers return to pre-admission smoking levels following discharge. This protocol describes a randomised controlled trial that will test the feasibility, acceptability and efficacy of linking inpatient smoking care with ongoing community cessation support for smokers with a mental illness. Methods/Design This study will be conducted as a randomised controlled trial. 200 smokers with an acute mental illness will be recruited from a large inpatient mental health facility. Participants will complete a baseline survey and will be randomised to either a multimodal smoking cessation intervention or provided with hospital smoking care only. Randomisation will be stratified by diagnosis (psychotic, non-psychotic. Intervention participants will be provided with a brief motivational interview in the inpatient setting and options of ongoing smoking cessation support post discharge: nicotine replacement therapy (NRT; referral to Quitline; smoking cessation groups; and fortnightly telephone support. Outcome data, including cigarettes smoked per day, quit attempts, and self-reported 7-day point prevalence abstinence (validated by exhaled carbon monoxide, will be collected via blind interview at one week, two months, four months and six months post discharge. Process information will also be collected, including the use of cessation supports and cost of the intervention. Discussion This study will provide comprehensive data on the potential of an integrated, multimodal smoking cessation intervention for persons with an acute mental illness, linking inpatient with community cessation support. Trial Registration

  11. Can Alice and Bob be random: a study on human playing zero knowledge protocols

    CERN Document Server

    Kulesza, Kamil

    2007-01-01

    The research described in this abstract was initiated by discussions between the author and Giovanni Di Crescenzo in Barcelona in early 2004. It was during Advanced Course on Contemporary Cryptology that Di Crescenzo gave a course on zero knowledge protocols (ZKP), see [1]. After that course we started to play with unorthodox ideas for breaking ZKP, especially one based on graph 3-coloring. It was chosen for investigation because it is being considered as a "benchmark" ZKP, see [2], [3]. At this point we briefly recall such a protocol's description.

  12. Comparative Study of Hidden Node Problem and Solution Using Different Techniques and Protocols

    CERN Document Server

    Kapadia, Viral V; Jhaveri, Rutvij H

    2010-01-01

    Hidden nodes in a wireless network refer to nodes that are out of range of other nodes or a collection of nodes. We will discuss a few problems introduced by the RTS/CTS mechanism of collision avoidance and focus on the virtual jamming problem, which allows a malicious node to effectively jam a large fragment of a wireless network at minimum expense of power. We have also discussed WiCCP (Wireless Central Coordinated Protocol) which is a protocol booster that also provides good solution to hidden nodes.

  13. Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study: A study of protocols in Greater London

    Directory of Open Access Journals (Sweden)

    Ford Tamsin

    2008-06-01

    Full Text Available Abstract Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS to Adult Mental Health Services (AMHS in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005 of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65% responded to the survey. Teams varied in type (generic/targeted/in-patient, catchment area (locality-based, wider or national and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37 was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33. In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in

  14. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments

    Directory of Open Access Journals (Sweden)

    Patrick DL

    2006-01-01

    Full Text Available Abstract Background Choosing an adequate measurement instrument depends on the proposed use of the instrument, the concept to be measured, the measurement properties (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability, the requirements, the burden for subjects, and costs of the available instruments. As far as measurement properties are concerned, there are no sufficiently specific standards for the evaluation of measurement properties of instruments to measure health status, and also no explicit criteria for what constitutes good measurement properties. In this paper we describe the protocol for the COSMIN study, the objective of which is to develop a checklist that contains COnsensus-based Standards for the selection of health Measurement INstruments, including explicit criteria for satisfying these standards. We will focus on evaluative health related patient-reported outcomes (HR-PROs, i.e. patient-reported health measurement instruments used in a longitudinal design as an outcome measure, excluding health care related PROs, such as satisfaction with care or adherence. The COSMIN standards will be made available in the form of an easily applicable checklist. Method An international Delphi study will be performed to reach consensus on which and how measurement properties should be assessed, and on criteria for good measurement properties. Two sources of input will be used for the Delphi study: (1 a systematic review of properties, standards and criteria of measurement properties found in systematic reviews of measurement instruments, and (2 an additional literature search of methodological articles presenting a comprehensive checklist of standards and criteria. The Delphi study will consist of four (written Delphi rounds, with approximately 30 expert panel members with different backgrounds in clinical medicine, biostatistics, psychology, and epidemiology. The final checklist will

  15. Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Walker Bruce F

    2011-10-01

    Full Text Available Abstract Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable Outcome Questionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial

  16. In Defense of Children's Lies: On Ethics and Methods of Studying Children's Communication of Deception.

    Science.gov (United States)

    Feldman, Robert S.

    Studies of children's deceptive behavior have scientific merit and can be carried out in an ethically defensible manner. Many arguments against studies requiring children to deceive others in an experimental context are relatively easy to refute. It is true, though, that the debriefing phase of deception studies presents ethical problems,…

  17. Aesthetics of movement with sight disabled children - pilot study

    Directory of Open Access Journals (Sweden)

    Mirosław Górny

    2010-01-01

    Full Text Available The aim of the study was to establish the aesthetics of movement in people with vision defects. This knowledge will provide tools to improve the methodology of study in the area of assessment of movement aesthetics in people with disabilities. In order to establish its level a test was used which measured its selected elements such as precision, rhythm, harmony, fluidity and speed. The aesthetics of movement was assessed using exercise tests which were to represent the components of aesthetics of movement. Individual tests were carried out on blind and partially sighted children aged 6 to 15 years and on a group of healthy children of the same age. Using the test tasks a general indicator of movement aesthetics in blind children was obtained. The participants of the study were 145 children from four School and Education Centres for Blind Children in Poland and the control group consisted of 310 children from a primary school in Poznań. The studies confirmed a lower level of movement aesthetics in children with vision defects, but the differences in groups between the partially sighted children and children with correct vision were definitely smaller. A higher level of aesthetics of movement characterised children from older groups irrespective of their sex. The best developed property in blind and partially sighted children was precision.

  18. Optimal scanning protocols of 64-slice CT angiography in coronary artery stents: An in vitro phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Almutairi, Abdulrahman Marzouq [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Sun Zhonghua [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia)], E-mail: z.sun@curtin.edu.au; Ng, Curtise [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Al-Safran, Zakariya A.; Al-Mulla, Abeer A.; Al-Jamaan, Abdulaziz I. [Department of Medical Imaging, King Fahad Specialist Hospital, Dammam (Saudi Arabia)

    2010-04-15

    Purpose: The purpose of the study was to investigate the optimal scanning protocol of 64-slice CT angiography for assessment of coronary artery stents based on a phantom study. Materials and methods: Coronary stents with a diameter of 2.5 mm was implanted in thin plastic tubes with an inner diameter of 3.0 mm to simulate a coronary artery. The tubes were filled with iodinated contrast medium diluted to 178 HU, closed at both ends and positioned in a plastic container filled with vegetable oil (-70 to -100 HU). A series of scans were performed with a 64-slice CT scanner with the following protocols: section thickness: 0.67 mm, 1.0 mm, 1.5 mm, 2.0 mm, pitch value: 0.2, 0.3, 0.5 and reconstruction interval of 50% overlap of the section thickness. 2D axial and multiplanar reformatted images were generated to assess the visibility of stent lumen, while virtual intravascular endoscopy (VIE) was reconstructed to evaluate the artery wall and stent surface. Results: Our results showed that a scanning protocol of 1.0 mm slice thickness with a pitch of 0.3 produced acceptable images with best demonstration of the intrastent lumen and stent surface with minimal image noise or artifacts. In contrast, submillimeter scans with 0.67 mm resulted in moderate artifacts which affected visualization of the coronary lumen, in addition to the increased noise. When the section thickness increased to 1.5 mm and 2.0 mm, visualization of the artery wall and stent surface was compromised, although the intrastent lumen was still visible. Conclusion: Our in vitro study suggested that a scanning protocol of 1.0 mm section thickness with pitch of 0.3 is the optimal protocol for evaluation of coronary artery stents as it allows generation of acceptable images with better visualization of stent lumen, stent surface and coronary artery wall.

  19. Train High Eat Low for Osteoarthritis study (THE LO study: protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Yareni Guerrero

    2015-10-01

    Discussion: THE LO study will provide the first direct comparison of the long-term benefits of gait retraining, progressive resistance training and a high-protein/low-glycaemic-index energy-restricted diet, separately and in combination, on joint load, radiographic progression, symptoms, and associated co-morbidities in overweight/obese adults with OA of the knee.

  20. The Healthy Primary School of the Future : study protocol of a quasi-experimental study

    NARCIS (Netherlands)

    Willeboordse, M; Jansen, M W; van den Heijkant, S N; Simons, A; Winkens, B; de Groot, R H M; Bartelink, N; Kremers, S P; van Assema, P; Savelberg, H H; de Neubourg, E; Borghans, L; Schils, T; Coppens, K M; Dietvorst, R; Ten Hoopen, R; Coomans, F; Klosse, S; Conjaerts, M H J; Oosterhoff, M; Joore, M A; Ferreira, I; Muris, P; Bosma, H; Toppenberg, H L; van Schayck, C P

    2016-01-01

    BACKGROUND: Unhealthy lifestyles in early childhood are a major global health challenge. These lifestyles often persist from generation to generation and contribute to a vicious cycle of health-related and social problems. This design article presents a study evaluating the effects of two novel heal

  1. Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol

    Directory of Open Access Journals (Sweden)

    Rose Ekama Ilesanmi

    2015-07-01

    Full Text Available Background: The 2014 International Pressure Ulcer Prevention (PUP Clinical Practice Guidelines (CPG provides the most current evidence based strategies to prevent Pressure Ulcer (PU. The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. Aim: To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Methods: Guided by the Knowledge to Action (KTA framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. Results: A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Conclusion: Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

  2. Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN Study): study protocol.

    Science.gov (United States)

    Takagi, Yasushi; Miyamoto, Susumu

    2015-01-01

    Moyamoya disease is a cerebrovascular occlusive disease characterized by progressive stenosis or by occlusion at the terminal portion of the bilateral internal carotid arteries. The unusual vascular network (moyamoya vessels) at the base of the brain with this disease as collateral channels is developed in this disease. Social independence because of cognitive impairment has recently been recognized as an important unsolved social issue with adult moyamoya disease. The patients with cognitive impairment have difficulty in proving their status because the standard neuroradiological and neuropsychological methods to define cognitive impairment with moyamoya disease are not determined. These patients with cognitive impairment should be supported by social welfare as psychologically handicapped persons. Thus Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN study) is planned. In this study, we want to establish a standard finding of the cognitive impairment in patients with moyamoya disease.

  3. A simulation study of TaMAC protocol using network simulator 2.

    Science.gov (United States)

    Ullah, Sana; Kwak, Kyung Sup

    2012-10-01

    A Wireless Body Area Network (WBAN) is expected to play a significant role in future healthcare system. It interconnects low-cost and intelligent sensor nodes in, on, or around a human body to serve a variety of medical applications. It can be used to diagnose and treat patients with chronic diseases such as hypertensions, diabetes, and cardiovascular diseases. The lightweight sensor nodes integrated in WBAN require low-power operation, which can be achieved using different optimization techniques. We introduce a Traffic-adaptive MAC protocol (TaMAC) for WBAN that supports dual wakeup mechanisms for normal, emergency, and on-demand traffic. In this letter, the TaMAC protocol is simulated using a well-known Network Simulator 2 (NS-2). The problem of multiple emergency nodes is solved using both wakeup radio and CSMA/CA protocol. The power consumption, delay, and throughput performance are closely compared with beacon-enabled IEEE 802.15.4 MAC protocol using extensive simulations.

  4. Protocol for Bone Augmentation with Simultaneous Early Implant Placement: A Retrospective Multicenter Clinical Study

    Directory of Open Access Journals (Sweden)

    Peter Fairbairn

    2015-01-01

    Full Text Available Purpose. To present a novel protocol for alveolar bone regeneration in parallel to early implant placement. Methods. 497 patients in need of extraction and early implant placement with simultaneous bone augmentation were treated in a period of 10 years. In all patients the same specific method was followed and grafting was performed utilizing in situ hardening fully resorbable alloplastic grafting materials consisting of β-tricalcium phosphate and calcium sulfate. The protocol involved atraumatic extraction, implant placement after 4 weeks with simultaneous bone augmentation, and loading of the implant 12 weeks after placement and grafting. Follow-up periods ranged from 6 months to 10 years (mean of 4 years. Results. A total of 601 postextraction sites were rehabilitated in 497 patients utilizing the novel protocol. Three implants failed before loading and three implants failed one year after loading, leaving an overall survival rate of 99.0%. Conclusions. This standardized protocol allows successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation. The concept of placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable, alloplastic materials, and loading the implant at 12 weeks seems to offer advantages when compared with traditional treatment modalities.

  5. European active surveillance study of women taking HRT (EURAS-HRT: study protocol [NCT00214903

    Directory of Open Access Journals (Sweden)

    Heinemann Lothar AJ

    2006-01-01

    Full Text Available Abstract Background The post marketing safety surveillance program for a drug containing a new chemical entity should assess both, the safety outcomes that relate specifically to the targeted population, as well as those that could potentially be related to special pharmacological characteristics of the drug. Active safety surveillance using valid epidemiological study designs has been proven to be a pertinent and reliable method to approach this endeavor. Methods/design The primary objective of the study is to compare incidence rates of serious adverse events in users of all types of newly prescribed oral HRT products. This active surveillance study will assess pertinent cardiovascular outcomes - in particular venous and arterial thromboembolism - and other serious adverse events (SAEs in new HRT users over a period of several years. One product under surveillance is Angeliq®, which contains the novel progestagen drospirenone (DRSP combined with estradiol. In addition, all other oral combined HRT products with a novel progestagen or estrogen that will be newly marketed during the study period will be studied. These new HRT products will be compared with established HRT products. The combined cohort will include at least 30,000 women recruited in several European countries. At least 90,000 years of observation are expected from the field work which started in early 2002 and will end around 2008. The participating women will complete a baseline survey using a self-administered questionnaire to describe the baseline risk. After 6 months, 12 months, and then on an annual basis, they will fill out a questionnaire in which they record complaints and events during the use of the prescribed HRTs. All adverse outcomes occurring during the observational period will be evaluated. Discussion A complete lifetime medical history, individually validated SAEs over time, and a low loss to follow-up rate are essential for a robust safety assessment. Therefore

  6. SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol

    Directory of Open Access Journals (Sweden)

    Lundgren-Nilsson Åsa

    2011-05-01

    Full Text Available Abstract Background Recovery patterns of upper extremity motor function have been described in several longitudinal studies, but most of these studies have had selected samples, short follow up times or insufficient outcomes on motor function. The general understanding is that improvements in upper extremity occur mainly during the first month after the stroke incident and little if any, significant recovery can be gained after 3-6 months. The purpose of this study is to describe the recovery of upper extremity function longitudinally in a non-selected sample initially admitted to a stroke unit with first ever stroke, living in Gothenburg urban area. Methods/Design A sample of 120 participants with a first-ever stroke and impaired upper extremity function will be consecutively included from an acute stroke unit and followed longitudinally for one year. Assessments are performed at eight occasions: at day 3 and 10, week 3, 4 and 6, month 3, 6 and 12 after onset of stroke. The primary clinical outcome measures are Action Research Arm Test and Fugl-Meyer Assessment for Upper Extremity. As additional measures, two new computer based objective methods with kinematic analysis of arm movements are used. The ABILHAND questionnaire of manual ability, Stroke Impact Scale, grip strength, spasticity, pain, passive range of motion and cognitive function will be assessed as well. At one year follow up, two patient reported outcomes, Impact on Participation and Autonomy and EuroQol Quality of Life Scale, will be added to cover the status of participation and aspects of health related quality of life. Discussion This study comprises a non-selected population with first ever stroke and impaired arm function. Measurements are performed both using traditional clinical assessments as well as computer based measurement systems providing objective kinematic data. The ICF classification of functioning, disability and health is used as framework for the selection of

  7. Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings

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    Fröberg Anders

    2011-01-01

    Full Text Available Abstract Background Reviews of randomized controlled trials (RCTs of cognitive behavioural therapy (CBT for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders. Methods and design Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol. Discussion The resulting protocol (NCT01205191 at clinicaltrials.gov for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.

  8. Application of the Putting Women First protocol in a study on violence against immigrant women in Spain.

    Science.gov (United States)

    Torrubiano-Domínguez, Jordi; Vives-Cases, Carmen

    2013-01-01

    In this paper, we describe our experience of using the Putting Women First protocol in the design and implementation of a cross-sectional study on violence against women (VAW) among 1607 immigrant women from Morocco, Ecuador and Romania living in Spain in 2011. The Putting Women First protocol is an ethical guideline for VAW research, which includes recommendations to ensure the safety of the women involved in studies on this subject. The response rate in this study was 59.3%. The prevalence of VAW cases last year was 11.7%, of which 15.6% corresponded to Ecuadorian women, 10.9% to Moroccan women and 8.6% to Romanian women. We consider that the most important goal for future research is the use of VAW scales validated in different languages, which would help to overcome the language barriers encountered in this study.

  9. Longitudinal study of spatial working memory development in young children.

    Science.gov (United States)

    Tsujii, Takeo; Yamamoto, Eriko; Masuda, Sayako; Watanabe, Shigeru

    2009-05-27

    This study longitudinally compared activity in the frontal cortex during a spatial working memory task between 5-year-old and 7-year-old children using near-infrared spectroscopy. Eight children participated in this study twice, once at 5 years and once at 7 years of age. Behavioral analysis showed that older children performed the working memory task more precisely and more rapidly than younger children. Near-infrared spectroscopy analysis showed that right hemisphere dominance was observed in older children, whereas no hemispheric difference was apparent in younger children. Children with strengthened lateralization showed improved performance from 5 to 7 years. We therefore offer the first demonstration of the developmental changes in frontal cortical activation during spatial working memory tasks during the preschool period.

  10. The study to understand mortality and morbidity in COPD (SUMMIT) study protocol

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Anderson, Julie; Brook, Robert D;

    2013-01-01

    medications on CVD in patients with both diseases.The "Study to Understand Mortality and MorbidITy in COPD" (SUMMIT) aims at determining the impact of Fluticasone Furoate/Vilanterol combination (FF/VI), and the individual components on the survival of patients with moderate COPD and either a history of CVD...... or at increased risk for CVD.SUMMIT is a multi-center, randomised, double-blind, parallel-group, placebo-controlled trial of 16,000 patients with moderate COPD randomly assigned to once daily treatment with FF/VI (100/25 ;mcg), Fluticasone Furoate (100 ;mcg), Vilanterol (25 ;mcg) or matched placebo; mortality...

  11. Assessing function in patients undergoing joint replacement: a study protocol for a cohort study

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    Wylde Vikki

    2012-11-01

    Full Text Available Abstract Background Joint replacement is an effective intervention for people with advanced arthritis, although there is an important minority of patients who do not improve post-operatively. There is a need for robust evidence on outcomes after surgery, but there are a number of measures that assess function after joint replacement, many of which lack any clear theoretical basis. The World Health Organisation has introduced the International Classification of Functioning, Disability and Health (ICF, which divides function into three separate domains: Impairment, activity limitations and participation restrictions. The aim of this study is to compare the properties and responsiveness of a selection of commonly used outcome tools that assess function, examine how well they relate to the ICF concepts, and to explore the changes in the measures over time. Methods/design Two hundred and sixty three patients listed for lower limb joint replacement at an elective orthopaedic centre have been recruited into this study. Participants attend the hospital for a research appointment prior to surgery and then at 3-months and 1-year after surgery. At each assessment time, function is assessed using a range of measures. Self-report function is assessed using the WOMAC, Aberdeen Impairment, Activity Limitation and Participation Restriction Measure, SF-12 and Measure Yourself Medical Outcome Profile 2. Clinician-administered measures of function include the American Knee Society Score for knee patients and the Harris Hip Score for hip patients. Performance tests include the timed 20-metre walk, timed get up and go, sit-to-stand-to-sit, step tests and single stance balance test. During the performance tests, participants wear an inertial sensor and data from motion analysis are collected. Statistical analysis will include exploring the relationship between measures describing the same ICF concepts, assessing responsiveness, and studying changes in measures over

  12. Brief intervention to reduce risky drinking in pregnancy: study protocol for a randomized controlled trial

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    Wilson Graeme B

    2012-09-01

    delivery, and retention in the study population, to inform power calculations for a definitive trial. The health-economics component will establish how cost-effectiveness will be assessed, and examine which data on health service resource use should be collected in a main trial. Participants’ views on instruments and procedures will be sought to confirm their acceptability. Discussion The study will produce a full trial protocol with robust sample-size calculations to extend evidence on effectiveness of screening and brief intervention. Trial Registration Current Controlled Trials ISRCTN43218782

  13. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol

    Directory of Open Access Journals (Sweden)

    Gagliardi Stefano

    2005-05-01

    Scale (GCS, Cognitive state (SPMSQ, Functional state (ADL and IADL, Psychological Distress (HADS, Cumulative Illness Rating Scale (CIRS, Hypotension (classified in: light; moderate and severe and duration, Blood loss (classified in: 2 lt, Blood transfusions ( 2 lt, Quantity of red cells and plasma transfusions, Visual VAS / SVS (timing: I-II-III post-operative day, Red cells and Plasma transfusions, Blood count evaluation and Saturation (O2%, Postoperative analgesia (Emilia-Romagna protocol, Presence of malignant tumoral disease, APACHE Score II. Moreover the presence of some relevant genetic polymorphisms will be studied in different genes such as IL-6, IL-10, TNF-alpha, and IL-1 cluster.

  14. Concurrent Validity of a Pragmatic Protocol.

    Science.gov (United States)

    Duncan, Julie Condon; Perozzi, Joseph A.

    1987-01-01

    The scores of 11 non-handicapped kindergarten children on the Pragmatic Protocol (used in assessing language-handicapped children) were correlated with their ratings by five experienced judges on a 7-point equal-appearing interval scale of communicative competence. The concurrent validity of the Protocol and interobserver reliability were…

  15. Charting the progression of disability in parkinson disease: study protocol for a prospective longitudinal cohort study

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    Ford Matthew P

    2010-11-01

    Full Text Available Abstract Background People with Parkinson disease (PD, even in the presence of symptomatic relief from medical, surgical, and rehabilitative interventions, face a persistent worsening of disability. This disability is characterized by diminished quality of life, reduced functional mobility, declining performance in activities of daily living and worsening neurological impairments. While evidence has emerged supporting the clinically meaningful benefits of short-term exercise programs on these underlying factors, assertions regarding the effects of sustained programs of exercise and physical activity on the trajectory of disablement in PD are made in the absence of direct evidence. Indeed, the natural decline in quality of life and functional mobility in people diagnosed with PD is poorly understood. Moreover, outcome measures commonly used in clinical exercise trials typically do not capture the full spectrum of disability as defined by the World Health Organization (WHO. Methods/Design The objective of this multicenter prospective study will be to examine the 2-year trajectory of disablement in a cohort of persons with PD. Two hundred sixty participants will be recruited to produce an expected final sample size of 150 individuals. Participants will be included if they are greater than 40 years of age, have a neurologist confirmed diagnosis of idiopathic PD, and are at Hoehn and Yahr stages 1 through 4. Data will be collected every 6 months during the study period. Primary outcome measures reflecting a broad spectrum of disablement will include, but will not be limited to, MDS-UPDRS, Timed Up and Go, Berg Balance Test, Nine Hole Peg Test, PDQ-39, and directly monitored ambulatory activity. Self-reported exercise and physical activity data also will be recorded. Statistical analyses will be used to characterize the trajectory of disablement and examine the influence of its underlying contributing factors. Discussion Tertiary prevention is an

  16. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Children have often had to accept medicines and treatments based on what is known to work in ... on children's health with the goal to develop treatments, drugs, and devices specific to children. Resources for ...

  17. Prednisolone and acupuncture in Bell's palsy: study protocol for a randomized, controlled trial

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    Wang Kangjun

    2011-06-01

    Full Text Available Abstract Background There are a variety of treatment options for Bell's palsy. Evidence from randomized controlled trials indicates corticosteroids can be used as a proven therapy for Bell's palsy. Acupuncture is one of the most commonly used methods to treat Bell's palsy in China. Recent studies suggest that staging treatment is more suitable for Bell's palsy, according to different path-stages of this disease. The aim of this study is to compare the effects of prednisolone and staging acupuncture in the recovery of the affected facial nerve, and to verify whether prednisolone in combination with staging acupuncture is more effective than prednisolone alone for Bell's palsy in a large number of patients. Methods/Design In this article, we report the design and protocol of a large sample multi-center randomized controlled trial to treat Bell's palsy with prednisolone and/or acupuncture. In total, 1200 patients aged 18 to 75 years within 72 h of onset of acute, unilateral, peripheral facial palsy will be assessed. There are six treatment groups, with four treated according to different path-stages and two not. These patients are randomly assigned to be in one of the following six treatment groups, i.e. 1 placebo prednisolone group, 2 prednisolone group, 3 placebo prednisolone plus acute stage acupuncture group, 4 prednisolone plus acute stage acupuncture group, 5 placebo prednisolone plus resting stage acupuncture group, 6 prednisolone plus resting stage acupuncture group. The primary outcome is the time to complete recovery of facial function, assessed by Sunnybrook system and House-Brackmann scale. The secondary outcomes include the incidence of ipsilateral pain in the early stage of palsy (and the duration of this pain, the proportion of patients with severe pain, the occurrence of synkinesis, facial spasm or contracture, and the severity of residual facial symptoms during the study period. Discussion The result of this trial will assess the

  18. Individual and occupational risk factors for knee osteoarthritis – Study protocol of a case control study

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    Bouillon Bertil

    2008-02-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is one of the frequent and functionally impairing disorders of the musculoskeletal system. In the literature, a number of occupational risk factors are discussed as being related to the development and progress of knee joint diseases, e.g. working in kneeling or squatting posture, lifting and carrying of heavy weights. The importance of the single risk factors and the possibility of prevention are currently under discussion. Besides the occupational factors, a number of individual risk factors are important, too. The distinction between work-related factors and individual factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In existing studies, the occupational stress is determined mainly by surveys in employees and/or by making assumptions about individual occupations. Direct evaluation of occupational exposure has been performed only exceptionally. The aim of the research project ArGon is the assessment of different occupational factors in relation to individual factors (e.g. constitutional factors, leisure time activities, sports, which might influence the development and/or progression of knee (OA. The project is designed as a case control study. Methods/Design To raise valid data about the physical stress associated with occupational and leisure time activities, patients with and without knee OA are questioned by means of a standardised questionnaire and an interview. The required sample size was estimated to 800 cases and an equal number of controls. The degree and localisation of the knee cartilage or joint damages in the cases are documented on the basis of radiological, arthroscopic and/or operative findings in a patient record. Furthermore, occupational exposure is analysed at selected workplaces. To evaluate the answers provided in the questionnaire, work analysis is performed. Discussion In this research project, specific information on the

  19. A pilot study of a smoking cessation intervention for women living with HIV: study protocol

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    Kim SS

    2017-02-01

    Full Text Available Sun S Kim, Sabreen Darwish, Sang A Lee, Rosanna F DeMarco Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA Background: Prevalence of cigarette smoking is substantially higher among people living with human immunodeficiency virus (HIV than the general population in the USA. Women living with HIV (WLHIV who smoke are at higher risk of developing acquired immunodeficiency syndrome and have a higher mortality rate than nonsmoking WLHIV. Compared to men, women generally require more intensive counseling for smoking cessation. The primary aim of this study is to examine the acceptability and feasibility of a videoconferencing smoking cessation intervention that is tailored to the specific needs of WLHIV. Methods: A total of 50 WLHIV will be randomized at a ratio of 1:1 to either a videoconferencing or a telephone counseling arm. Both arms have the same cessation intervention, that is, eight weekly individualized counseling sessions of 30-minute cognitive behavioral therapy plus active nicotine patches for 8 weeks. The only difference between the two arms is the delivery mode of the counseling, that is, telephone video call vs. telephone voice call. Data collection is scheduled at baseline and three follow-up points: 1, 3, and 6 months from the target quit day. Data will be analyzed using STATA 14. The primary outcome is a 6-month prolonged abstinence. Home-based salivary cotinine test will be conducted to verify self-reported smoking abstinence using a NicAlert® test strip, while a research coordinator monitors the whole process by a telephone video call. Conclusion: The study is a two-arm parallel-group pilot clinical trial of a smoking cessation intervention. It attempts to examine whether videoconferencing smoking cessation intervention will be acceptable and feasible for WLHIV and will yield a better cessation outcome than telephone counseling intervention. Findings may have the

  20. A comparative study of Sterofundin and Ringer lactate based infusion protocol in scoliosis correction surgery

    Science.gov (United States)

    Sharma, Ashima; Yadav, Monu; Kumar, B. Rajesh; Lakshman, P. Sai; Iyenger, Raju; Ramchandran, Gopinath

    2016-01-01

    Background: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid–base changes, hemodynamics, and readiness for extubation during scoliosis surgery. Subjects and Methods: Thirty consecutive children posted for scoliosis surgery were randomized to receive either RL (n = 15) or SF (n = 15) as intraoperative fluid at 10 mg/kg/h. Fluid boluses were added according to the study fluid algorithm. Arterial blood was sampled and analyzed at hourly intervals during surgery. Red blood cell transfusion was guided by hematocrit below 27. Patients were followed for 24 h postoperatively in the Intensive Care Unit. Results: There was no statistically significant difference in the volume of infused fluid (2400 ± 512 ml in Group RL and 2200 ± 640 ml in Group SF. There were no significant changes in pH of patients infused with SF. Statistically, significant higher lactate levels were seen in RL-infused group. The strong ion difference was decreased in both groups, but it normalized earlier with SF. Conclusions: SF-infused patients had nonremarkable changes in acid–base physiology in scoliosis surgery. PMID:27746547

  1. Protocol design for large-scale cross-sectional studies of sexual abuse and associated factors in individual sports: feasibility study in Swedish athletics.

    Science.gov (United States)

    Timpka, Toomas; Janson, Staffan; Jacobsson, Jenny; Ekberg, Joakim; Dahlström, Örjan; Kowalski, Jan; Bargoria, Victor; Mountjoy, Margo; Svedin, Carl G

    2015-03-01

    To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasibility survey. 89% (n = 177) reported that they agreed with that the questions in the survey were important, and 95% (n = 189) reported that they answered truthfully to all questions. Similarly, 91% (n = 180) reported that they did not agree with that the questions were unpleasant for them. However, 16% (n = 32) reported that they did not find the survey to be of personal value, and 12% (n = 23) reported that the survey had caused them to think about issues that they did not want to think about. Responding that participation was not personally gratifying was associated with training more hours (p = 0.01). There is a scarcity of research on the prevention of sexual abuse in individual sports. The present protocol should be regarded as a means to overcome this shortcoming in athletics. When implementing the protocol, it is necessary to encourage athlete compliance and to adapt the web-based survey to the particular infrastructural conditions in the sports setting at hand. Key points

  2. TRACHEOSTOMY IN CHILDREN: A CLINICAL STUDY

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    Shankar

    2015-11-01

    Full Text Available : A trachestomy is a small, surgical opening from the skin to the anterior wall of the trachea, pediatric patients for whom tracheostomy is more hazardous than adults, consideration have different anatomy, medical conditions, and prognoses than adults, even the tracheostomy tubes are different in size, the indications for tracheostomy in children include, bypassing airway obstruction (Laryngo- tracheobronchitis, epiglottitis, providing access for prolong ventilation, and facilitating tracheo-bronchial toilet, to day prime indication for pediatrics tracheostomy is subglottic stenosis. We have reviewed experience with 84 tracheostomies under 13 years of age in our hospital. We are here discussing the common indications and complications, difficulty in decannulation in pediatric patients, in our study the common indication is the foreign body bronchus followed by other conditions.

  3. Environmental Health Ethics in Study of Children

    DEFF Research Database (Denmark)

    Knudsen, L. E.; Hansen, P. W.; Pedersen, M.;

    2017-01-01

    and lactating child may be exposed to environmental pollutants that depend on the maternal exposures. Also children are exposed to different levels of environmental agents because of the size and developmental stage. Children may experience different sources of exposure because of behavior, for example, eating......Children are not small adults in relation to exposure and vulnerability. Rapid growth, development, and anatomical and physiological changes in various organs and organ systems differentiate children from adults in relation to exposure and vulnerability to environmental exposures. The unborn child...

  4. The randomized shortened dental arch study (RaSDA: design and protocol

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    Kern Matthias

    2010-02-01

    Full Text Available Abstract Background Various treatment options for the prosthetic treatment of jaws where all molars are lost are under discussion. Besides the placement of implants, two main treatment types can be distinguished: replacement of the missing molars with removable dental prostheses and non-replacement of the molars, i.e. preservation of the shortened dental arch. Evidence is lacking regarding the long-term outcome and the clinical performance of these approaches. High treatment costs and the long time required for the treatment impede respective clinical trials. Methods/design This 14-center randomized controlled investigator-initiated trial is ongoing. Last patient out will be in 2010. Patients over 35 years of age with all molars missing in one jaw and with at least both canines and one premolar left on each side were eligible. One group received a treatment with removable dental prostheses for molar replacement (treatment A. The other group received a treatment limited to the replacement of all missing anterior and premolar teeth using fixed bridges (treatment B. A pilot trial with 32 patients was carried out. Two hundred and fifteen patients were enrolled in the main trial where 109 patients were randomized for treatment A and 106 for treatment B. The primary outcome measure is further tooth loss during the 5-year follow-up. The secondary outcome measures encompassed clinical, technical and subjective variables. The study is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation, DFG WA 831/2-1, 2-2, 2-3, 2-4, 2-5. Discussion The particular value of this trial is the adaptation of common design components to the very specific features of complex dental prosthetic treatments. The pilot trial proved to be indispensable because it led to a number of adjustments in the study protocol that considerably improved the practicability. The expected results are of high clinical relevance and will show the efficacy of two common

  5. MAVIDOS Maternal Vitamin D Osteoporosis Study: study protocol for a randomized controlled trial. The MAVIDOS Study Group

    Directory of Open Access Journals (Sweden)

    Harvey Nicholas C

    2012-02-01

    Full Text Available Abstract MAVIDOS is a randomised, double-blind, placebo-controlled trial (ISRCTN82927713, registered 2008 Apr 11, funded by Arthritis Research UK, MRC, Bupa Foundation and NIHR. Background Osteoporosis is a major public health problem as a result of associated fragility fractures. Skeletal strength increases from birth to a peak in early adulthood. This peak predicts osteoporosis risk in later life. Vitamin D insufficiency in pregnancy is common (31% in a recent Southampton cohort and predicts reduced bone mass in the offspring. In this study we aim to test whether offspring of mothers supplemented with vitamin D in pregnancy have higher bone mass at birth than those whose mothers were not supplemented. Methods/Design Women have their vitamin D status assessed after ultrasound scanning in the twelfth week of pregnancy at 3 trial centres (Southampton, Sheffield, Oxford. Women with circulating 25(OH-vitamin D levels 25-100 nmol/l are randomised in a double-blind design to either oral vitamin D supplement (1000 IU cholecalciferol/day, n = 477 or placebo at 14 weeks (n = 477. Questionnaire data include parity, sunlight exposure, dietary information, and cigarette and alcohol consumption. At 19 and 34 weeks maternal anthropometry is assessed and blood samples taken to measure 25(OH-vitamin D, PTH and biochemistry. At delivery venous umbilical cord blood is collected, together with umbilical cord and placental tissue. The babies undergo DXA assessment of bone mass within the first 14 days after birth, with the primary outcome being whole body bone mineral content adjusted for gestational age and age. Children are then followed up with yearly assessment of health, diet, physical activity and anthropometric measures, with repeat assessment of bone mass by DXA at age 4 years. Discussion As far as we are aware, this randomised trial is one of the first ever tests of the early life origins hypothesis in human participants and has the potential to inform

  6. Cactus and Visapult: A case study of ultra-high performance distributed visualization using connectionless protocols

    Energy Technology Data Exchange (ETDEWEB)

    Shalf, John; Bethel, E. Wes

    2002-05-07

    This past decade has seen rapid growth in the size, resolution, and complexity of Grand Challenge simulation codes. Many such problems still require interactive visualization tools to make sense of multi-terabyte data stores. Visapult is a parallel volume rendering tool that employs distributed components, latency tolerant algorithms, and high performance network I/O for effective remote visualization of massive datasets. In this paper we discuss using connectionless protocols to accelerate Visapult network I/O and interfacing Visapult to the Cactus General Relativity code to enable scalable remote monitoring and steering capabilities. With these modifications, network utilization has moved from 25 percent of line-rate using tuned multi-streamed TCP to sustaining 88 percent of line rate using the new UDP-based transport protocol.

  7. A Tribolium castaneum whole-embryo culture protocol for studying the molecular mechanisms and morphogenetic movements involved in insect development.

    Science.gov (United States)

    Macaya, Constanza C; Saavedra, Patricio E; Cepeda, Rodrigo E; Nuñez, Viviana A; Sarrazin, Andres F

    2016-01-01

    The development of the red flour beetle Tribolium castaneum is more representative of arthropods than the evolutionarily derived fly, Drosophila melanogaster. Thus, Tribolium is becoming an emerging organism model for studying the evolution of the mechanisms that control embryonic development in arthropods. In this regard, diverse genetic and molecular tools are currently available for Tribolium, as well as imaging and embryonic techniques. Recently, we developed a method for culturing embryos in order to study specific stages during Tribolium development. In this report, we present a detailed and "easy-to-follow" protocol for embryo handling and dissection, extending the use of whole-embryo culture to functional analysis by performing in vivo pharmacological manipulations. This experimental accessibility allowed us to study the relevance of microtubules in axis elongation, using nocodazole and taxol drugs to interfere with microtubule networks, followed by length measurement analysis. Additionally, we demonstrated that embryo handling had no effect on the development of Tribolium embryos, and we checked viability after dissection and bisection and during incubation using propidium iodide. The embryo culture protocol we describe here can be applied to study diverse developmental processes in Tribolium. We expect that this protocol can be adapted and applied to other arthropods.

  8. A Comparative Study On The Action Potential Simulation (APS Therapy And The Routine Physiotherapy Protocol In Knee Osteoarthritisin Elderly People

    Directory of Open Access Journals (Sweden)

    Abbas Rahimi

    2012-04-01

    Full Text Available Background and Aim: Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS Therapy and the routine physiotherapy (PT protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis. Materials and Methods: 69 patients (62 females & 7 males with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old and the routine PT protocol (n=32, mean age: 61±14 years old groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up. The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded.Results: In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P<0.05. Visual Analogue Pain Scale (VAPS indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P<0.05. It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P<0.05. A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4.Conclusion: The

  9. MObile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background Providing women with contraceptive methods following abortion is important to reduce repeat abortion rates, yet evidence for effective post-abortion family planning interventions are limited. This protocol outlines the evaluation of a mobile phone-based intervention using voice messages to support post-abortion family planning in Cambodia. Methods/Design A single blind randomised controlled trial of 500 participants. Clients aged 18 or over, attending for abortion at four Marie Stopes International clinics in Cambodia, owning a mobile phone and not wishing to have a child at the current time are randomised to the mobile phone-based intervention or control (standard care) with a 1:1 allocation ratio. The intervention comprises a series of six automated voice messages to remind clients about available family planning methods and provide a conduit for additional support. Clients can respond to message prompts to request a phone call from a counsellor, or alternatively to state they have no problems. Clients requesting to talk to a counsellor, or who do not respond to the message prompts, receive a call from a Marie Stopes International Cambodia counsellor who provides individualised advice and support regarding family planning. The duration of the intervention is 3 months. The control group receive existing standard of care without the additional mobile phone-based support. We hypothesise that the intervention will remind clients about contraceptive methods available, identify problems with side effects early and provide support, and therefore increase use of post-abortion family planning, while reducing discontinuation and unsafe method switching. Participants are assessed at baseline and at 4 months. The primary outcome measure is use of an effective modern contraceptive method at 4 months post abortion. Secondary outcome measures include contraception use, pregnancy and repeat abortion over the 4-month post-abortion period. Risk ratios will be used as

  10. Photoanthropometric Study of Dysmorphic Features of the Face in Children with Autism and Asperger Syndrome

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    Katarzyna Ziora

    2012-04-01

    Full Text Available Objective: Childhood autism is a neurodevelopmental disorder characterized by impairments in social interactions, verbal and non-verbal communication and by a pattern of stereotypical behaviors and interests. The aim of this study was to estimate the dysmorphic facial features of children with autism and children with Asperger syndrome . Methods: The examination was conducted on 60 children (30 with childhood autism and 30 with Asperger syndrome. The photo anthropometric method used in this study followed the protocol established by Stengel-Rutkowski et al . Results: The performed statistical analysis showed that in patients with childhood autism, the anteriorly rotated ears and the long back of the nose appeared more often. In the group of children with autism, there was a connection between the amount of dysmorphies and the presence of some somatic diseases in the first-degree relatives. There was also a connection between the motor coordination and the age the child began to walk. Discussion: In patients with childhood autism, there were certain dysmorphies (like the anterior rotated ears and the long back of the nose which appeared more often. Although the connection was not statistically significant, it seemed to concur with data from the literature . Conclusion: Formulation of the other conclusions would require broader studies e.g. dealing with a familial analysis of dysmorphic features.

  11. Haemorrhoids in Children: A Retrospective Study

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    Afra Karavelioglu

    2015-06-01

    Conclusions: We followed up one of the largest group for haemorrhoids in children. We performed laboratory examinations only for suspected hepatobiliary disorder. Patients did not have progressive illness during follow-up period. We believe that haemorrhoids disease in children can be followed up by routine control examinations, without detailed laboratory examinations. [J Contemp Med 2015; 5(2.000: 106-110

  12. Birth Defects Among Children Born to Human Immunodeficiency Virus-Infected Women Pediatric AIDS Clinical Trials Protocols 219 and 219C

    NARCIS (Netherlands)

    Brogly, Susan B.; Abzug, Mark J.; Watts, D. Heather; Cunningham, Coleen K.; Williams, Paige L.; Oleske, James; Conway, Daniel; Sperling, Rhoda S.; Spiegel, Hans; Van Dyke, Russell B.

    2010-01-01

    Background: Some studies have detected associations between in utero antiretroviral therapy (ARV) exposure and birth defects but evidence is inconclusive. Methods: A total of 2202 human immunodeficiency virus (HIV)-exposed children enrolled in the Pediatric AIDS Clinical Trials Group 219 and 219 C p

  13. Occupational Therapy and Sensory Integration for Children with Autism: A Feasibility, Safety, Acceptability and Fidelity Study

    Science.gov (United States)

    Schaaf, Roseann C.; Benevides, Teal W.; Kelly, Donna; Mailloux-Maggio, Zoe

    2012-01-01

    Objective: To examine the feasibility, safety, and acceptability of a manualized protocol of occupational therapy using sensory integration principles for children with autism. Methods: Ten children diagnosed with autism spectrum disorder ages 4-8 years received intensive occupational therapy intervention using sensory integration principles…

  14. Clinical improvements in adopted children with fetal alcohol spectrum disorders through neurodevelopmentally informed clinical intervention: A pilot study.

    Science.gov (United States)

    Zarnegar, Zohreh; Hambrick, Erin P; Perry, Bruce D; Azen, Stanley P; Peterson, Cassandra

    2016-10-01

    Research on early intervention for young children (infants and toddlers) with fetal alcohol spectrum disorders (FASD), particularly children with comorbid maltreatment experiences, is limited. Existing research has primarily focused on structuring environments to be responsive to the needs experienced by children with FASD rather than improving their functioning. The purpose of this study is to present outcomes from an early psychosocial intervention with 10 adopted, maltreated young children diagnosed with FASD, aged 10-53 months (M = 35 months), and their adoptive parents. The potential for early, targeted interventions to improve developmental outcomes for children with prenatal alcohol exposure was examined, as well as improving the skills of and reducing stress experienced by their adoptive parents. Based on the outcomes of a neurodevelopmentally informed assessment protocol, the 10 children whose data are presented were recommended to receive a range of regulatory, somatosensory, relational, and cognitive enrichments. As part of their treatment, children and caregivers received Child-Parent Psychotherapy (CPP), and caregivers (here, adoptive parents) also received Mindful Parenting Education (MPE). Related-samples Wilcoxon signed-rank tests indicated that scores of several measures of child developmental functioning improved from pre- to post-intervention and that parents' caregiving skills improved while their caregiving stress decreased. Reliable change analyses indicated that change observed from pre- to post-intervention was reliable. The promise of using neurodevelopmentally informed assessment strategies to sequence interventions for young children with diverse neurodevelopmental insults is discussed.

  15. The world health organization multicountry survey on maternal and newborn health: study protocol

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    Souza João

    2011-10-01

    Full Text Available Abstract Background Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health. Methods/Design This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that ranges from two to three months according to the annual number of deliveries. Discussion Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal near-miss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more

  16. Sleep in children with asthma: results of the PIAMA study.

    Science.gov (United States)

    van Maanen, Annette; Wijga, Alet H; Gehring, Ulrike; Postma, Dirkje S; Smit, Henriëtte A; Oort, Frans J; Rodenburg, Roos; Meijer, Anne Marie

    2013-04-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Parents reported about asthma symptoms (wheezing, dyspnoea, prescription of inhaled corticosteroids and asthma diagnosis) and children reported about different aspects of sleep (bedtime, rise time, sleep quality and daytime sleepiness/tiredness). Results were analysed with (logistic) regression analysis. Children with frequent asthma symptoms significantly more often reported that they felt sleepy or tired during the day (34.4% experienced daytime sleepiness/tiredness at least once a week) than children without asthma symptoms (22.2%) and children with infrequent asthma symptoms (21.9%). This association was not confounded by sex, age of the child, parental educational level or smoking inside the house; the effect was also not modified by sex. There were no associations between asthma and bedtime, time spent in bed or sleep quality. Children with frequent asthma symptoms experienced daytime sleepiness/tiredness more often than children with infrequent or no asthma symptoms. Otherwise, children with asthma did not differ much from children without asthma with regard to sleep.

  17. SCISSOR—Spinal Cord Injury Study on Small molecule-derived Rho inhibition: a clinical study protocol

    Science.gov (United States)

    Kopp, Marcel A; Liebscher, Thomas; Watzlawick, Ralf; Martus, Peter; Laufer, Stefan; Blex, Christian; Schindler, Ralf; Jungehulsing, Gerhard J; Knüppel, Sven; Kreutzträger, Martin; Ekkernkamp, Axel; Dirnagl, Ulrich; Strittmatter, Stephen M; Niedeggen, Andreas; Schwab, Jan M

    2016-01-01

    Introduction The approved analgesic and anti-inflammatory drugs ibuprofen and indometacin block the small GTPase RhoA, a key enzyme that impedes axonal sprouting after axonal damage. Inhibition of the Rho pathway in a central nervous system-effective manner requires higher dosages compared with orthodox cyclooxygenase-blocking effects. Preclinical studies on spinal cord injury (SCI) imply improved motor recovery after ibuprofen/indometacin-mediated Rho inhibition. This has been reassessed by a meta-analysis of the underlying experimental evidence, which indicates an overall effect size of 20.2% regarding motor outcome achieved after ibuprofen/indometacin treatment compared with vehicle controls. In addition, ibuprofen/indometacin may also limit sickness behaviour, non-neurogenic systemic inflammatory response syndrome (SIRS), neuropathic pain and heterotopic ossifications after SCI. Consequently, ‘small molecule’-mediated Rho inhibition after acute SCI warrants clinical investigation. Methods and analysis Protocol of an investigator-initiated clinical open-label pilot trial on high-dose ibuprofen treatment after acute traumatic, motor-complete SCI. A sample of n=12 patients will be enrolled in two cohorts treated with 2400 mg/day ibuprofen for 4 or 12 weeks, respectively. The primary safety end point is an occurrence of serious adverse events, primarily gastroduodenal bleedings. Secondary end points are pharmacokinetics, feasibility and preliminary effects on neurological recovery, neuropathic pain and heterotopic ossifications. The primary safety analysis is based on the incidence of severe gastrointestinal bleedings. Additional analyses will be mainly descriptive and casuistic. Ethics and dissemination The clinical trial protocol was approved by the responsible German state Ethics Board, and the Federal Institute for Drugs and Medical Devices. The study complies with the Declaration of Helsinki, the principles of Good Clinical Practice and all further

  18. A social work study on family patterns and street children

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    Mohammad Reza Iravani

    2014-06-01

    Full Text Available This paper presents a social work study on relationship between various family characteristics and street children in rural area as well as city of Esfahan, Iran. The proposed study selects a sample of 150 street children, 75 from city and 75 from rural area, and using some statistical tests verifies the effects of three factors including family income, place of residency and family size on street children. The results indicate that the city residence had more street children than rural residence did. In addition, there was a meaningful difference between the number of street children in low-income families and high-income families. Finally, the survey results indicate that big size families more likely suffered from street children than low size families did.

  19. Children's advertising exposure and materialistic orientations: A longitudinal study

    NARCIS (Netherlands)

    Opree, S.J.; Valkenburg, P.M.; Reijmersdal, E.A. van; Buijzen, M.A.

    2012-01-01

    As many as nine out of 10 parents worry that children's frequent exposure to advertising makes them materialistic. In this study we not only aim to investigate if children's advertising exposure indeed affects their materialism, but also how it affects their materialism (i.e., by studying the mediat

  20. The Active for Life Year 5 (AFLY5 school based cluster randomised controlled trial: study protocol for a randomized controlled trial

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    Campbell Rona

    2011-07-01

    Full Text Available Abstract Background Low levels of physical activity, high levels of sedentary behaviour and low levels of fruit and vegetable consumption are common in children and are associated with adverse health outcomes. The aim of this paper is to describe the protocol for a cluster randomised controlled trial (RCT designed to evaluate a school-based intervention that aims to increase levels of physical activity, decrease sedentary behaviour and increase consumption of fruit and vegetables in school children. Methods/design The Active for Life Year 5 (AFLY5 study is a school-based, cluster RCT that targets school children in Year 5 (age 9-10 years. All state junior/primary schools in the area covered by Bristol City and North Somerset Council are invited to participate; special schools are excluded. Eligible schools are randomised to one of two arms: intervention arm (receive the intervention 2011-2012 and control arm (receive the intervention after the final follow-up assessment, 2013-2014. The primary outcomes of the trial are levels of accelerometer assessed physical activity and sedentary behaviour and questionnaire assessed fruit and vegetable consumption. A number of secondary outcomes will also be measured, including body mass index, waist circumference and overweight/obesity. Outcomes will be assessed at baseline (prior to intervention when the children are in Year 4, at the end of intervention 'immediate follow-up' and '12 months long-term' follow-up. We will use random effects linear and logistic regression models to compare outcomes by randomised arm. The economic evaluation from a societal perspective will take the form of a cost consequence analysis. Data from focus groups and interviews with pupils, parents and teachers will be used to increase understanding of how the intervention has any effect and is integrated into normal school activity. Discussion The results of the trial will provide information about the public health effectiveness

  1. A simple protocol for the extraction and sequence analysis of DNA from study skin of museum collections

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    Nadia de Moraes-Barros

    2007-01-01

    Full Text Available Museum collections have been widely used as sources of biological samples for molecular biology studies and there are several methodologies and techniques to obtain and analyze DNA from tissues archived in museums, but most of these protocols have been developed for a specific tissue or are commercial kits. We present a simple protocol for extracting and amplifying DNA segments from sloth museum specimens. With this simple protocol we analyzed DNA fragments from 64% of 64 skin samples from three-toed sloths (Bradypus variegatus and Bradypus tridactylus archived in three different museums: 43 samples from the University of São Paulo Museum of Zoology (Museu de Zoologia da Universidade de São Paulo, MUZUSP São Paulo, São Paulo, Brazil; 18 samples from the Emílio Goeldi Museum (Museu Paraense Emílio Goeldi, MPEG, Belém, Pará, Brazil; and 3 samples from the Museum of Vertebrate Zoology (MVZ University of California, Berkeley, USA. The specimens sampled ranged in age from 18 to 108 years old. Our methodology allowed the recovery of up to 700 bp of mitochondrial DNA and 400 bp of nuclear genes. Thereafter, it is useful for genetic diversity studies of three-toed sloths and could be applied to other animals.

  2. A study of food buying behavior among Chinese children

    OpenAIRE

    Fan, Y.; Li, Y.

    2009-01-01

    The paper reports a study on food buying behaviour among Chinese children aged between 10-13 years old. There are two important findings. Firstly, the growing influence of commercial environment. During the learning of consumer behaviour by Chinese children, the parental role of guidance remains prominent, and their recommendations have a decisive impact on children’s food choices. Secondly, the perceived importance of product attributes. Chinese children tend to pay more attention to nutr...

  3. The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS to reduce respiratory illness in Indigenous infants

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    Segan Catherine

    2010-03-01

    Full Text Available Abstract Background Acute respiratory illness (ARI is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ. Environmental tobacco smoke (ETS from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Māori. Methods/Design This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program. Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Discussion Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of

  4. A cohort study of the recovery of health and wellbeing following colorectal cancer (CREW study: protocol paper

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    Fenlon Deborah

    2012-04-01

    Full Text Available Abstract Background The number of people surviving colorectal cancer has doubled in recent years. While much of the literature suggests that most people return to near pre-diagnosis status following surgery for colorectal cancer, this literature has largely focused on physical side effects. Longitudinal studies in colorectal cancer have either been small scale or taken a narrow focus on recovery after surgery. There is a need for a comprehensive, long-term study exploring all aspects of health and wellbeing in colorectal cancer patients. The aim of this study is to establish the natural history of health and wellbeing in people who have been treated for colorectal cancer. People have different dispositions, supports and resources, likely resulting in individual differences in restoration of health and wellbeing. The protocol described in this paper is of a study which will identify who is most at risk of problems, assess how quickly people return to a state of subjective health and wellbeing, and will measure factors which influence the course of recovery. Methods/design This is a prospective, longitudinal cohort study following 1000 people with colorectal cancer over a period of two years, recruiting from 30 NHS cancer treatment centres across the UK. Questionnaires will be administered prior to surgery, and 3, 9, 15 and 24 months after surgery, with the potential to return to this cohort to explore on-going issues related to recovery after cancer. Discussion Outcomes will help inform health care providers about what helps or hinders rapid and effective recovery from cancer, and identify areas for intervention development to aid this process. Once established the cohort can be followed up for longer periods and be approached to participate in related projects as appropriate and subject to funding.

  5. Research Protocol: Development, implementation and evaluation of a cognitive behavioural therapy-based intervention programme for the management of anxiety symptoms in South African children with visual impairments

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    Lisa Visagie

    2015-02-01

    Full Text Available Background: Childhood anxiety presents a serious mental health problem, and it is one of the most common forms of psychological distress reported by youth worldwide. The prevalence of anxiety symptoms amongst South African youth is reported to be significantly higher than in other parts of the world. These high prevalence rates become even more significant when viewed in terms of children with visual impairments, as it is suggested that children with physical disabilities may be more prone, than their non-disabled peers, for the development of psychological difficulties. Objectives: The main aim of this study is to develop, implement and evaluate a specifically tailored anxiety intervention programme for use with South African children with visual impairments. Method: A specifically tailored cognitive-behavioural therapy-based anxiety intervention, for 9–13 year old South African children with visual impairments, will be evaluated in two special schools. The study will employ a randomised wait-list control group design with pre- postand follow-up intervention measures, with two groups each receiving a 10 session anxiety intervention programme. The main outcome measure relates to the participants’ symptoms of anxiety as indicated on the Revised Child Anxiety and Depression Scale. Conclusion: If the anxiety intervention programme is found to be effective in reducing symptoms of anxiety, this universal intervention will lay down the foundation upon which future contextually sensitive (South African anxiety intervention programmes can be built.

  6. The effect of standardised implantoplasty protocol on titanium surface roughness: an in-vitro study

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    Andrew TAWSE-SMITH

    Full Text Available Abstract: To analyse the changes of surface characteristics of machined and moderately roughened titanium disks following a standardised implantoplasty protocol. Forty titanium discs (machined: n = 20; moderately roughened: n = 20 were instrumented with one half of each disc maintained as the control (non-instrumented. The standardised implantoplasty protocol was carried out using a custom jig with the sequential change of burs: 1 Regular grit diamond [10s], 2 Super-fine grit diamond [10s], 3 Brownie(tm silicone polisher [15s], 4 Greenie(tm silicone polisher [15s]. Surface topography was analysed using confocal laser scanning microscopy (CLSM and scanning electron microscopy (SEM. Energy dispersive x-ray spectroscopy (EDS was used to measure the elemental profiles of each disc. Quantitative analysis showed similar changes in level of roughness between the machined and moderately roughened titanium discs. CLSM demonstrated an increased roughness (Ra and Sa values after polishing with a regular grit diamond bur when compared to the uninstrumented surfaces. Although the roughness decreased after the further polishing with the super-fine grit diamond bur, subsequent instrumentation using silicon burs tended to increase the roughness, albeit being statistically insignificant. There was a residue of silicon particles despite the irrigation after each polishing stage. The proposed implantoplasty protocol did not achieve a sufficient level of smoothness on the machined or moderately roughened titanium surfaces when compared to the Ra threshold. Further research is recommended to test the efficacy of each bur on titanium surfaces with longer duration using actual oral implants to allow better comparison.

  7. The effect of standardised implantoplasty protocol on titanium surface roughness: an in-vitro study.

    Science.gov (United States)

    Tawse-Smith, Andrew; Kota, Akash; Jayaweera, Yathen; Vuuren, Wendy Jansen van; Ma, Sunyoung

    2016-12-22

    To analyse the changes of surface characteristics of machined and moderately roughened titanium disks following a standardised implantoplasty protocol. Forty titanium discs (machined: n = 20; moderately roughened: n = 20) were instrumented with one half of each disc maintained as the control (non-instrumented). The standardised implantoplasty protocol was carried out using a custom jig with the sequential change of burs: 1) Regular grit diamond [10s], 2) Super-fine grit diamond [10s], 3) Brownie(tm) silicone polisher [15s], 4) Greenie(tm) silicone polisher [15s]. Surface topography was analysed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Energy dispersive x-ray spectroscopy (EDS) was used to measure the elemental profiles of each disc. Quantitative analysis showed similar changes in level of roughness between the machined and moderately roughened titanium discs. CLSM demonstrated an increased roughness (Ra and Sa values) after polishing with a regular grit diamond bur when compared to the uninstrumented surfaces. Although the roughness decreased after the further polishing with the super-fine grit diamond bur, subsequent instrumentation using silicon burs tended to increase the roughness, albeit being statistically insignificant. There was a residue of silicon particles despite the irrigation after each polishing stage. The proposed implantoplasty protocol did not achieve a sufficient level of smoothness on the machined or moderately roughened titanium surfaces when compared to the Ra threshold. Further research is recommended to test the efficacy of each bur on titanium surfaces with longer duration using actual oral implants to allow better comparison.

  8. Pilot study testing a European human biomonitoring framework for biomarkers of chemical exposure in children and their mothers

    DEFF Research Database (Denmark)

    Exley, Karen; Aerts, Dominique; Biot, Pierre;

    2015-01-01

    Exposure to a number of environmental chemicals in UK mothers and children has been assessed as part of the European biomonitoring pilot study, Demonstration of a Study to Coordinate and Perform Human Biomonitoring on a European Scale (DEMOCOPHES). For the European-funded project, 17 countries...... tested the biomonitoring guidelines and protocols developed by COPHES. The results from the pilot study in the UK are presented; 21 school children aged 6-11 years old and their mothers provided hair samples to measure mercury and urine samples, to measure cadmium, cotinine and several phthalate...... on environment, health and lifestyle. Mercury in hair was higher in children who reported frequent consumption of fish (geometric mean 0.35 μg/g) compared to those that ate fish less frequently (0.13 μg/g, p = 0.002). Cadmium accumulates with age as demonstrated by higher levels of urinary cadmium in the mothers...

  9. Ethical issues related to biomonitoring studies on children

    DEFF Research Database (Denmark)

    Pedersen, Marie; Merlo, Domenico Franco; Knudsen, Lisbeth E.

    2007-01-01

    -off and the recruitments. In the initial phase of planning a biomonitoring study consideration of communication of results including risk and means of risk prevention should be made. Ethical considerations regarding the study protocol should take into account (a) justification of biological sampling related...

  10. Study on experimental motion sickness in children.

    Science.gov (United States)

    Takahashi, M; Toriyabe, I; Takei, Y; Kanzaki, J

    1994-05-01

    To clarify the characteristics of motion sickness in children we investigated autonomic nervous symptoms and instability evoked by walking while wearing horizontally reversing goggles in 90 children aged 4 to 15 years. Kindergarten children had hardly any autonomic nervous symptoms except headache; however, they often fell, could not stand up or move, and exhibited a to-and-fro deviation gait. Although the frequency and severity of sickness gradually increased during growth, the severity of gait disorder became milder as age increased. On the basis of these findings it seems likely that functions which perceive disorder of spatial orientation and action are immature in young children, and once spatial orientation is impaired, instability becomes very severe, since inadequate control is not stopped by an alarm function against disorientation.

  11. Impact of maternal antibodies and infant gut microbiota on the immunogenicity of rotavirus vaccines in African, Indian and European infants: protocol for a prospective cohort study

    Science.gov (United States)

    Sindhu, Kuladaipalayam Natarajan C; Cunliffe, Nigel; Peak, Matthew; Turner, Mark; Darby, Alistair; Grassly, Nicholas; Gordon, Melita; Dube, Queen; Babji, Sudhir; Praharaj, Ira; Verghese, Valsan; Iturriza-Gómara, Miren; Kang, Gagandeep

    2017-01-01

    Introduction Gastroenteritis is the leading cause of morbidity and mortality among young children living in resource-poor settings, majority of which is attributed to rotavirus. Rotavirus vaccination can therefore have a significant impact on infant mortality. However, rotavirus vaccine efficacy in Sub-Saharan Africa and Southeast Asia is significantly lower than in high-income countries. Maternally derived antibodies, infant gut microbiota and concomitant oral polio vaccination have been proposed as potential reasons for poor vaccine performance in low-income settings. The overall aim of this study is to compare the role of maternally derived antibodies and infant gut microbiota in determining immune response to rotavirus vaccine in high-income and low-income settings, using the same vaccine and a similar study protocol. Methods and analysis The study is an observational cohort in three countries—Malawi, India and UK. Mothers will be enrolled in third trimester of pregnancy and followed up, along with infants after delivery, until the infant completes two doses of oral rotavirus vaccine (along with routine immunisation). The levels of prevaccination maternally derived rotavirus-specific antibodies (IgG) will be correlated with infant seroconversion and antibody titres, 4 weeks after the second dose of rotavirus vaccine. Both within-country and between-country comparisons of gut microbiome will be carried out between children who seroconvert and those who do not. The impact of oral polio vaccine coadministration on rotavirus vaccine response will be studied in Indian infants. Ethics and dissemination Ethical approvals have been obtained from Integrated Research Application System (IRAS, NHS ethics) in UK, College of Medicine Research and Ethics Committee (COMREC) in Malawi and Institutional Review Board (IRB), Christian Medical College, Vellore in India. Participant recruitment and follow-up is ongoing at all three sites. Analysis of data, followed by

  12. Assessment of Adverse Events in Protocols, Clinical Study Reports, and Published Papers of Trials of Orlistat: A Document Analysis

    Science.gov (United States)

    Schroll, Jeppe Bennekou; Penninga, Elisabeth I.; Gøtzsche, Peter C.

    2016-01-01

    Background Little is known about how adverse events are summarised and reported in trials, as detailed information is usually considered confidential. We have acquired clinical study reports (CSRs) from the European Medicines Agency through the Freedom of Information Act. The CSRs describe the results of studies conducted as part of the application for marketing authorisation for the slimming pill orlistat. The purpose of this study was to study how adverse events were summarised and reported in study protocols, CSRs, and published papers of orlistat trials. Methods and Findings We received the CSRs from seven randomised placebo controlled orlistat trials (4,225 participants) submitted by Roche. The CSRs consisted of 8,716 pages and included protocols. Two researchers independently extracted data on adverse events from protocols and CSRs. Corresponding published papers were identified on PubMed and adverse event data were extracted from this source as well. All three sources were compared. Individual adverse events from one trial were summed and compared to the totals in the summary report. None of the protocols or CSRs contained instructions for investigators on how to question participants about adverse events. In CSRs, gastrointestinal adverse events were only coded if the participant reported that they were “bothersome,” a condition that was not specified in the protocol for two of the trials. Serious adverse events were assessed for relationship to the drug by the sponsor, and all adverse events were coded by the sponsor using a glossary that could be updated by the sponsor. The criteria for withdrawal due to adverse events were in one case related to efficacy (high fasting glucose led to withdrawal), which meant that one trial had more withdrawals due to adverse events in the placebo group. Finally, only between 3% and 33% of the total number of investigator-reported adverse events from the trials were reported in the publications because of post hoc

  13. Implementing mentor mothers in family practice to support abused mothers: Study protocol

    NARCIS (Netherlands)

    Loeffen, M.J.W.; Lo Fo Wong, S.H.; Wester, F.P.J.; Laurant, M.G.H.; Lagro-Janssen, A.L.M.

    2011-01-01

    ABSTRACT: BACKGROUND: Intimate partner violence is highly prevalent and mostly affects women with negative consequences for their physical and mental health. Children often witness the violence which has negative consequences for their well-being too. Care offered by family physicians is often rejec

  14. Implementing mentor mothers in family practice to support abused mothers: Study protocol

    NARCIS (Netherlands)

    Loeffen, M.J.W.; Lo Fo Wong, S.H.; Wester, F.P.J.; Laurant, M.G.H.; Lagro-Janssen, A.L.M.

    2011-01-01

    Background Intimate partner violence is highly prevalent and mostly affects women with negative consequences for their physical and mental health. Children often witness the violence which has negative consequences for their well-being too. Care offered by family physicians is often rejected because

  15. Efficacy of smoking prevention program 'Smoke-free Kids': Study protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Hiemstra, M.; Ringlever, L.; Otten, R.; Jackson, C.; Schayck, O.C.P. van; Engels, R.C.M.E.

    2009-01-01

    Background - A strong increase in smoking is noted especially among adolescents. In the Netherlands, about 5% of all 10-year olds, 25% of all 13-year olds and 62% of all 17-year olds report ever smoking. In the U.S., an intervention program called 'Smoke-free Kids' was developed to prevent children

  16. The study comparing parenting style of children with ADHD and normal children

    Directory of Open Access Journals (Sweden)

    Moghaddam, Mahboobeh Firouzkouhi

    2013-12-01

    Full Text Available Aim. Attention deficit-hyperactivity disorder is one of the most often diagnosed psychiatric disorders in children and adolescents based on hyperactivity, attention deficit and impulsivity criteria. This disorder causes a lot of problems at home, school and social situations. Considering the family and parenting factors in growth and development of ADHD children, the parenting interventions are consider as a primary intervention programs for this children. Parenting management training, based on social learning models, is an effective and practical way for treatment of children with incongruent behavior. In this study, we evaluate parenting styles of ADHD children and normal children. Methods. This study was conducted in Zahedan in 2012. Subjects aged 7 to 12. They were divided into patient and normal groups. Parenting styles were evaluated with Baumrind’s questionnaire. The data were analyzed with SPSS ver.18. Results. The findings showed that the parents of ADHD children have lower permissive score than the normal group, but authoritarian score was lower in the normal group. The authoritative score has no significant difference between the two groups. In addition, age, gender, and parent’s education affected the parenting styles. Discussion. The present study indicates that parents with ADHD children have different parenting styles; and factors like gender and parents education are influential in parenting methods. This finding were also present in some past surveys. Many studies have shown that teaching-parenting styles to parents with ADHD children improves the inner family relationship. Conclusion . The results indicated that parents of children with ADHD are less permissive but more authoritarian in their parenting.

  17. Clean Development Mechanism” projects in the developing countries within the Kyoto protocol: problem analysis of a case study in Morocco

    Directory of Open Access Journals (Sweden)

    Gaglioppa P

    2009-11-01

    Full Text Available An internship period spent in the north of Morocco kingdom (Tetouan gave a contribute to the organization activity in promoting sustainable development in the rural areas under the Kyoto Protocol. The multitasking project will increase biodiversity planting trees for wood, forage and fruits productions. The paper show a first step study to evaluate the possibility to reach an agreement with the propriety and the manager of these areas in a multifunctional reforestation project. The eligible site suitable for reforestation in accordance with the CDM international scheme is a large plateau (more than 5000 hectares 600 meters high on the sea level far from the Cannabis crops area. The evaluation of the project costs and of the social benefits for the population consider (using different species the indigenous communities necessity. The evaluation of carbon sequestration show the small scale of the reforestation project on behalf of the Kyoto Protocol, but give also an idea about the people rights and necessities. The normal afforestation and reforestation projects, under the Kyoto Protocol, try to maximize the CO2 sequestration in a short time, than business laws usually require. A small scale project could be self-managing, less expensive (international certification costs and more interesting for local communities.

  18. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deblaere, K.; Vandemaele, P.; Achten, E. [MRI Department -1 K12, Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Backes, W.H.; Hofman, P.; Wilmink, J. [Department of Neuroradiology, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht (Netherlands); Boon, P.A.; Vonck, K. [Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Boon, P. [Department of Medical Psychology, University Hospital Maastricht (Netherlands); Troost, J. [Department of Neurology, University Hospital Maastricht (Netherlands); Vermeulen, J. [S.E.I.N Heemstede, Psychological Laboratory, Achterweg 5, 2103 SW Heemstede (Netherlands); Aldenkamp, A. [Epilepsy Center ' Kempenhaeghe' , Postbus 61, 5900 AB Heeze (Netherlands)

    2002-08-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  19. An Internet study of men sexually attracted to children: Correlates of sexual offending against children.

    Science.gov (United States)

    Bailey, J Michael; Bernhard, Paula A; Hsu, Kevin J

    2016-10-01

    We conducted an Internet survey of 1,102 men sexually attracted to children concerning their history of adjudicated offenses related to child pornography and sexual contact with children. Most of the men reported no offenses, but their rate of offenses was much higher than that expected for adult-attracted men. Correlates of offending are consistent with a strong role of the cumulative effects of temptation, especially age. Older men, men who had repeatedly worked in jobs with children, men who had repeatedly fallen in love with children, and men who had often struggled not to offend were especially likely to have offended. Attraction to male children, relative attraction to children versus adults, and childhood sexual abuse experiences were also strong predictors of offending. In contrast, permissive attitudes regarding child-adult sex and frequent indulgence in sexual fantasies about children were not significantly related to offending. Our findings represent the first large study of offending among men sexually attracted to children who were not recruited via contact with the legal system. Because of methodological limitations, our findings cannot be definitive. Reassuringly, however, results are generally consistent with those from the most pertinent existing studies, of recidivism among convicted sex offenders. (PsycINFO Database Record

  20. Lifestyle modification and metformin as long-term treatment options for obese adolescents: study protocol

    Directory of Open Access Journals (Sweden)

    Watson Margaret

    2009-11-01

    Full Text Available Abstract Background Childhood obesity is a serious health concern affecting over 155 million children in developed countries worldwide. Childhood obesity is associated with significantly increased risk for development of type 2 diabetes, cardiovascular disease and psychosocial functioning problems (i.e., depression and decreased quality of life. The two major strategies for management of obesity and associated metabolic abnormalities are lifestyle modification and pharmacologic therapy. This paper will provide the background rationale and methods of the REACH childhood obesity treatment program. Methods/design The REACH study is a 2-year multidisciplinary, family-based, childhood obesity treatment program. Seventy-two obese adolescents (aged 10-16 years and their parents are being recruited to participate in this randomized placebo controlled trial. Participants are randomized to receive either metformin or placebo, and are then randomized to a moderate or a vigorous intensity supervised exercise program for the first 12-weeks. After the 12-week exercise program, participants engage in weekly exercise sessions with an exercise facilitator at a local community center. Participants engage in treatment sessions with a dietitian and social worker monthly for the first year, and then every three months for the second year. The primary outcome measure is change in body mass index and the secondary outcome measures are changes in body composition, risk factors for type 2 diabetes and cardiovascular disease, changes in diet, physical activity, and psychosocial well-being (e.g., quality of life. It is hypothesized that participants who take metformin and engage in vigorous intensity exercise will show the greatest improvements in body mass index. In addition, it is hypothesized that participants who adhere to the REACH program will show improvements in body composition, physical activity, diet, psychosocial functioning and risk factor profiles for type 2

  1. Pemanfaatan Jaringan Komputer Untuk Aplikasi IPTV (Internet Protocol Television Studi Kasus Akatel Sandhy Putra Purwokerto

    Directory of Open Access Journals (Sweden)

    Galih Sasmi Ramdhani

    2010-11-01

    Full Text Available Internet Protocol Television (IPTV adalah suatu pengembangan baru dalam software komunikasi client-server yang mem-broadcast video yang berkualitas tinggi melalui jaringan internet protocol. IPTV melayani baik siaran langsung (live maupun program atau video yang tersimpan di server. Streaming adalah sebuah teknologi untuk memainkan file video atau audio secara langsung ataupun dengan prerecorded dari sebuah mesin server. File video atau audio  yang terletak pada server dapat secara langsung dijalankan pada komputer client sesaat setelah ada permintaan dari users sehingga proses download yang menghabiskan waktu cukup lama dapat dihindari. Digital Video Broadcasting (DVB adalah salah satu sistem yang digunakan untuk mentransmisikan siaran TV / Video digital hingga sampai ke pengguna akhir (end-user. Proses Transmisi siaran TV umumnya masih menggunakan metode analog, maka dengan adanya streaming TV channel berbasis DVB merupakan suatu perkembangan distribusi siaran televisi yang tadinya secara analog menjadi digital. Oleh karena itu pada penelitian ini akan dibahas mengenai aplikasi IPTV yang berbasis DVB dengan metode streaming pada Ubuntu 9.04 yang merupakan distro Linux dengan media transmisi Wireless LAN Akatel Sandhy Putra Purwokerto. Metode streaming yang digunakan adalah broadcast yaitu pengiriman data, dimana data dikirimkan ke banyak titik sekaligus, tanpa melakukan pengecekan apakah titik tersebut siap atau tidak, atau tanpa memperhatikan apakah data itu sampai atau tidak. Contoh penggunaan sistem ini adalah siaran televisi dan radio.

  2. Study protocol: a cluster randomised controlled trial of a school based fruit and vegetable intervention – Project Tomato

    Directory of Open Access Journals (Sweden)

    Conner Mark T

    2009-06-01

    Full Text Available Abstract Background The School Fruit and Vegetable Scheme (SFVS is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3 their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group, consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET, and height and weight measurements collected, at baseline (Year 2 and 18 month follow-up (Year 4. The primary outcome will be the ability of the intervention (Project Tomato to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297

  3. Functional Magnetic Resonance Imaging of Goal-Directed Reaching in Children with Autism Spectrum Disorders: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Nicole M. G. Salowitz

    2014-04-01

    Full Text Available An unanswered question concerning the neural basis of autism spectrum disorders (ASD is how sensorimotor deficits in individuals with ASD are related to abnormalities of brain function. We previously described a robotic joystick and video game system that allows us to record functional magnetic resonance images (FMRI while adult humans make goal-directed wrist motions. We anticipated several challenges in extending this approach to studying goal-directed behaviors in children with ASD and in typically developing (TYP children. In particular we were concerned that children with autism may express increased levels of anxiety as compared to typically developing children due to the loud sounds and small enclosed space of the MRI scanner. We also were concerned that both groups of children might become restless during testing, leading to an unacceptable amount of head movement. Here we performed a pilot study evaluating the extent to which autistic and typically developing children exhibit anxiety during our experimental protocol as well as their ability to comply with task instructions. Our experimental controls were successful in minimizing group differences in drop-out due to anxiety. Kinematic performance and head motion also were similar across groups. Both groups of children engaged cortical regions (frontal, parietal, temporal, occipital while making goal-directed movements. In addition, the ASD group exhibited task-related correlations in subcortical regions (cerebellum, thalamus, whereas correlations in the TYP group did not reach statistical significance in subcortical regions. Four distinct regions in frontal cortex showed a significant group difference such that TYP children exhibited positive correlations between the hemodynamic response and movement, whereas children with ASD exhibited negative correlations. These findings demonstrate feasibility of simultaneous application of robotic manipulation and functional imaging to study goal

  4. A Comparative Study of the Spontaneous Social Interactions of Children with High-Functioning Autism and Children with Asperger's Disorder

    Science.gov (United States)

    Macintosh, Kathleen; Dissanayake, Cheryl

    2006-01-01

    A comparative observational study was undertaken of the spontaneous social interactions of children with high-functioning autism and Asperger's disorder. The sample comprised 20 children with high-functioning autism, 19 children with Asperger's disorder and 17 typically developing children matched on chronological age and overall mental age. A…

  5. Executive Function Training in Children with SLI: A Pilot Study

    Science.gov (United States)

    Vugs, Brigitte; Knoors, Harry; Cuperus, Juliane; Hendriks, Marc; Verhoeven, Ludo

    2017-01-01

    The aim of this study was to evaluate the effectiveness of a computer-based executive function (EF) training in children with specific language impairment (SLI). Ten children with SLI, ages 8 to 12 years, completed a 25-session training of visuospatial working memory, inhibition and cognitive flexibility over a 6-week period. Treatment outcome was…

  6. Children in care (CIC): A Danish longitudinal study

    DEFF Research Database (Denmark)

    Egelund, Tine; Hestbæk, Anne-Dorthe

    This paper presents results describing what characterizes young, Danish children in care and their parents, and, furthermore, discusses social policy implications of the complex psychosocial disadvantages influencing the families. The paper is based on a longitudinal study of all Danish children,...... collection newcomers into care from the 1995 cohort will be included in the sample....

  7. Realistic Fiction and the Social Studies. Children's Literature.

    Science.gov (United States)

    Mitchell-Powell, Brenda, Ed.

    1995-01-01

    Asserts that children's literature is an effective tool to access and present sophisticated social studies concepts in the elementary classroom. Maintains that realistic fiction can integrate the social sciences with philosophy and religion. Presents a bibliographic essay including children's books and teacher resources. (CFR)

  8. Peer Group Status of Gender Dysphoric Children : A Sociometric Study

    NARCIS (Netherlands)

    Wallien, Madeleine S. C.; Veenstra, Rene; Kreukels, Baudewijntje P. C.; Cohen-Kettenis, Peggy T.

    2010-01-01

    In this sociometric study, we aimed to investigate the social position of gender-referred children in a naturalistic environment. We used a peer nomination technique to examine their social position in the class and we specifically examined bullying and victimization of gender dysphoric children. A

  9. Mothers' Teaching Strategies and Children's Effortful Control: A Longitudinal Study

    Science.gov (United States)

    Eisenberg, Nancy; Vidmar, Masa; Spinrad, Tracy L.; Eggum, Natalie D.; Edwards, Alison; Gaertner, Bridget; Kupfer, Anne

    2010-01-01

    Findings on the relation of maternal verbal teaching strategies to children's effortful control (EC; i.e., self-regulation) are limited in quantity and somewhat inconsistent. In this study, children's EC was assessed at 18, 30, and 42 months (ns = 255, 229, and 209, respectively) with adults' reports and a behavioral measure. Mothers' verbal…

  10. A Genetic Study of Problem Behaviors in Children

    NARCIS (Netherlands)

    E.J.C.G. van den Oord (Edwin)

    1993-01-01

    textabstractBehavioral/emotional problems are common among children of preschool and school age. Verhulst, and Koot (1992, p. 130) reviewed prevalence studies published since 1965. They reported a median prevalence rate for general psychiatric dysfunction in children and adolescents of l3%. This num

  11. Mathematics Anxiety in Young Children: An Exploratory Study

    Science.gov (United States)

    Harari, Rachel R.; Vukovic, Rose K.; Bailey, Sean P.

    2013-01-01

    This study explored the nature of mathematics anxiety in a sample of 106 ethnically and linguistically diverse first-grade students. Although much is known about mathematics anxiety in older children and adults, little is known about when mathematics anxiety first emerges or its characteristics in young children. Results from exploratory factor…

  12. Sleep in children with asthma : results of the PIAMA study

    NARCIS (Netherlands)

    van Maanen, Annette; Wijga, Alet H.; Gehring, Ulrike; Postma, Dirkje S.; Smit, Henriette A.; Oort, Frans J.; Rodenburg, Roos; Meijer, Anne Marie

    2013-01-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (

  13. Sleep in children with asthma: results of the PIAMA study

    NARCIS (Netherlands)

    van Maanen, A.; Wijga, A.H.; Gehring, U.; Postma, D.S.; Smit, H.A.; Oort, F.J.; Rodenburg, R.; Meijer, A.M.

    2013-01-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (

  14. Early nutrition, growth and cognitive development of infants from birth to 2 years in Malaysia: a study protocol

    OpenAIRE

    Nurliyana, Abdul Razak; Mohd Shariff, Zalilah; Mohd Taib, Mohd Nasir; Gan, Wan Ying; Tan, Kit-Aun

    2016-01-01

    Background The first 2 years of life is a critical period of rapid growth and brain development. During this period, nutrition and environmental factors play important roles in growth and cognitive development of a child. This report describes the study protocol of early nutrition, growth and cognitive development of infants from birth to 2 years of age. Methods/Design This is a prospective cohort study of mothers and infants recruited from government health clinics in Seremban district in Ne...

  15. The Strathclyde Evaluation of Children's Active Travel (SE-CAT: study rationale and methods

    Directory of Open Access Journals (Sweden)

    McMinn David

    2011-12-01

    Full Text Available Abstract Background The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Methods/Design Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male aged 8-9 years from 5 primary schools. Two schools (n = 79 children received TG in September/October 2009. Three schools (n = 87 children acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. Discussion The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including

  16. The Clinical Usefulness of Sleep Studies in Children.

    Science.gov (United States)

    Oliveira, Virginia X Noronha; Teng, Arthur Y

    2016-01-01

    Sleep disordered breathing is common in children and has the potential to have a significant impact on cognition, activity and social interaction. The overnight in-laboratory polysomnography (PSG) continues to be the gold standard instrument for the investigation of sleep-disordered breathing in children. It has the ability to rule in or rule out the need for intervention for common conditions such as obstructive sleep apnoea, assess the role of sleep quality in children and adolescents with hypersomnolence, provide physiologic data in children with hypoventilation as may be seen in neuromuscular disease and assist in the assessment of children with structural airway and lung abnormalities. Polysomnography is valuable and the only reliable method to differentiate habitual snoring from many levels of sleep apnoea syndrome [1]. The American Academy of Paediatrics recommends that, in order to diagnose and manage OSA syndrome, all children should be screened for snoring and complex cases should be referred to a specialist. PSG is the diagnostic gold standard and adenotonsillectomy is the first line of treatment [2]. There is no evidence to support nap studies or ambulatory sleep studies in children [3]. With adequate staffing, expertise, and a child and family-friendly environment, children of any age can undergo a sleep study.

  17. A comparative study on the results of agonist and antagonist protocols based on serum AMH levels in patients undergoing intracytoplasmic sperm injection

    Science.gov (United States)

    Nikmard, Fatemeh; Aflatoonian, Behrouz; Hosseini, Elham; Aflatoonian, Abbas; Bakhtiyari, Mehrdad; Aflatoonian, Reza

    2016-01-01

    Background: Serum concentrations of antimullerian hormone (AMH) correlate with ovarian response during assisted reproduction treatment (ART) cycles. Objective: This retrospective study attempted to evaluate the selection of ovarian stimulation protocols based on serum AMH levels in patients and its impact on the results of ART. Materials and Methods: Based on AMH levels, the patients with tubal factor infertility were divided in three groups of normal, low and high AMH levels. Oocyte, good embryo number and pregnancy rate in each group were analyzed. Results: Using agonist and antagonist protocols, an increase in serum AMH led to higher number of oocytes and better quality embryos. At all low, normal and high AMH levels, the agonist protocol led to a more significant increase in the number of oocytes than the antagonist protocol (p<0.05). The number of high quality embryos significantly increased by the agonist protocol than antagonist protocol in women with normal AMH levels of 1.3-2.6 ng/ml (p=0.00). Moreover, the results for the number of high quality embryos at AMH ˃2.6 ng/ml was in favor of the antagonist protocol (p=0.00). The results showed the lowest pregnancy rate at AMH ˂1.3 ng/ml. At AMH ˃2.6 ng/ml, there was a significant increase in pregnancy rate through the antagonist protocol (p=0.04). Conclusion: Findings of this study suggested that the ART results are predictable, taking into account the AMH levels. The protocol specific to each patient can be used given the AMH level in each individual. This is because the results of each protocol depend on individual conditions. PMID:28066836

  18. [Detection of nosocomial infections: a proposal of a protocol for a prospective study].

    Science.gov (United States)

    Gallet, E; Le Coutour, X; Turrou, J; Noyer, V; Lechevalier, B; Charbonneau, P; Bazin, C

    1989-05-01

    If meant to be effective, the detection of nosocomial infections demands considering the means that should be used for a daily gathering of necessary complete information. An experiment led in a medical intensive care unit have suggested the elements of such a gathering work. This must be prospective and aimed to relate the frequency, more that the importance of nosocomial infections. It will be carried by a willing and specialized nurse, and will be limited to the necessary warning signs only. As a rule, the information linked to the infection causes will not be looked for. Finally, a special care will be given to ensure a good feedback to the clinician, which is the main purpose of that work. Yet, such an information gathering protocol has to be flexible, and it is even one of its survival conditions regarding the variety of means and requirements inherent of each department.

  19. SSH协议的研究与应用%Study and Application on Secure Shell Protocol

    Institute of Scientific and Technical Information of China (English)

    杨婧

    2011-01-01

    SSH support the ability of secure remote login through network environment, which is\\the powerful tool for remote server configure and management. The theory and application of secure shell protocol are discussed and an environment on virtual machine is supplied for implement of OpenSSH.%SSH协议能够实现安全的网络远程登录功能,是远程服务配置管理的有力工具,文章论述SSH的基本原理和实现方法,并结合开源软件OpenSSH,采用虚拟机方式验证SSH技术的应用环境.

  20. Protocol to Study β-Arrestin Recruitment by CB1 and CB2 Cannabinoid Receptors.

    Science.gov (United States)

    Soethoudt, Marjolein; van Gils, Noortje; van der Stelt, Mario; Heitman, Laura H

    2016-01-01

    Cannabinoid CB1 and CB2 receptors are G-protein-coupled receptors (GPCRs) that recruit β-arrestins upon activation by (partial) agonists. β-Arrestin recruitment is induced by phosphorylation of their C-terminal tails, and is associated with the termination of GPCR signaling; yet, it may also activate cellular signaling pathways independent of G-proteins. Here, we describe a detailed protocol to characterize the potency and efficacy of ligands to induce or inhibit β-arrestin recruitment to the human CB1 and CB2 receptors, by using the PathHunter(®) assay. The latter is a cellular assay that can be performed in plates with 384-wells. The PathHunter(®) assay makes use of β-galactosidase complementation, and has a chemiluminescent readout. We used this assay to characterize a set of reference ligands (both agonists and antagonists) on human CB1 and CB2 receptors.

  1. A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

    Directory of Open Access Journals (Sweden)

    Weggelaar Anne-Marie

    2011-10-01

    Full Text Available Abstract Background although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. Methods/design in-depth multi-level (macro, meso and micro-system analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims. Discussion the protocol is based on the premise that

  2. Centralization of politrauma. Study of Ferrara’s reality and simulation of an agreed-upon protocol

    Directory of Open Access Journals (Sweden)

    Luigi Melcarne

    2011-09-01

    Full Text Available In a time in which everybody’s asked a big effort to use hospitals, resources and emergency departments in a rational way, the Centralization – that is sending the right patient to the right hospital at the right time – allows an optimization of the resources and a better management of medical patients. In this study we examined the actual state of Centralization in the city of Ferrara where an experimental protocol of “centralization” has been introduced. This study has the purpose of simulating reality if the protocol had been introduced in the years 2008/2009. The results confirm not only that an important number of patients that were meant to be sent to the CTZ of Ferrara where instead sent to the PST but also that, on the contrary, patients from the suburbs that didn’t require advanced treatments were sent to the Sant’Anna hospital of Ferrara. So if medical literature already points out the advantages of a correct Centralization for patients with polytraumas; the study, based on the reality in Ferrara , shows how the creation of an agreed protocol with the goal to guide health workers at sending polytrauma patients to the right destination , instead of creating an excessive flow th the main hub, can improve the overall organization of health services, with an equal distribution between hub and spoke. When considering First Aid not always speed and rapidity guarantee survival; this is so much more real in the case of patients with polytrauma, where quality of cures assumes more importance than time.

  3. Children's environmental knowing: A case study of children's experiences during an environmental education programme

    Science.gov (United States)

    Scott, Sandra Anne

    This study explores children's experiences during WaterWorlds (pseudonym) a field-based environmental education programme at a marine science centre. The study objectives were to investigate how children understand and interpret their experiences, and how these experiences foster their environmental knowing. To address these objectives, I carried out a case study at a marine science centre in British Columbia. I examined children's WaterWorlds experiences and explored their environmental understandings and commitment to environmental action. I analysed the experiences of children in four separate classes and carried out an in-depth examination of four individual children. Data were collected using informal semi-structured interviews, observations, conversations, researcher journal logs, and student documents including their writing and illustrations. My findings indicate that the WaterWorlds programme experience fosters children's environmental knowing. Participation in WaterWorlds activities led to connection, caring, and concern for other species and in some cases, for the marine environment as a whole. During the programme, children chose the ways they interpreted and expressed their environmental knowledge, ethic of care, advocacy, and commitment to action. This development of each child's self-expression resulted in motivational and powerful learning experiences that inspired and nurtured their connections to the earth. This research provides evidence and examples of how educators can foster children's environmental knowing through multi-disciplinary environmental education experiences. It illustrates that activities such as observing and documenting the lives of other animal species, collecting data and conducting research on those species, and working and learning alongside experts in the field of environmental education are powerful experiences that motivate concern and care for the earth among children.

  4. A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Weir Kelly A

    2010-04-01

    Full Text Available Abstract Background Cerebral palsy is the most common cause of physical disability in childhood, occurring in one in 500 children. It is caused by a static brain lesion in the neonatal period leading to a range of activity limitations. Oral motor and swallowing dysfunction, poor nutritional status and poor growth are reported frequently in young children with cerebral palsy and may impact detrimentally on physical and cognitive development, health care utilisation, participation and quality of life in later childhood. The impact of modifiable factors (dietary intake and physical activity on growth, nutritional status, and body composition (taking into account motor severity in this population is poorly understood. This study aims to investigate the relationship between a range of factors - linear growth, body composition, oral motor and feeding dysfunction, dietary intake, and time spent sedentary (adjusting for motor severity - and health outcomes, health care utilisation, participation and quality of life in young children with cerebral palsy (from corrected age of 18 months to 5 years. Design/Methods This prospective, longitudinal, population-based study aims to recruit a total of 240 young children with cerebral palsy born in Queensland, Australia between 1st September 2006 and 31st December 2009 (80 from each birth year. Data collection will occur at three time points for each child: 17 - 25 months corrected age, 36 ± 1 months and 60 ± 1 months. Outcomes to be assessed include linear growth, body weight, body composition, dietary intake, oral motor function and feeding ability, time spent sedentary, participation, medical resource use and quality of life. Discussion This protocol describes a study that will provide the first longitudinal description of the relationship between functional attainment and modifiable lifestyle factors (dietary intake and habitual time spent sedentary and their impact on the growth, body composition and

  5. The study on Young Children's breakfast and the life rhythm

    OpenAIRE

    戸井田, 英子; 加藤, 麻樹; 村澤, 初子

    2009-01-01

    Young chi ldren need wel balanced breakfast, with staple food, main dish, side dish for the physical and mental development. Previous study has shown that young children have habit to take breakfast, however the combination of menu have to be improved. In this study, we investigates young children's breakfast tendency mainly from view point of the life rhythm, lifestyle patterns and appetite. The purpose of this study is to clear the cause of the difference of combination of the menu. A ques...

  6. Teaching Entrepreneurship to Children: A Case Study

    Science.gov (United States)

    do Paco, Arminda; Palinhas, Maria Joao

    2011-01-01

    Nowadays few young people are prepared to consider setting up and managing their own business as a realistic and attractive career option. It is therefore necessary to expose children to the concept of entrepreneurship from a very early age, which means that the school has a fundamental role to play in this task. This research seeks to understand…

  7. MRI study of lumbosacral lipoma in children

    Energy Technology Data Exchange (ETDEWEB)

    Taviere, V.; Brunelle, F.; Baraton, J.; Teman, M.; Pierre-Kahn, A.; Lallemand, D.

    1989-06-01

    We report our experience with 16 cases of lumbosacral lipoma and MRI in children. From these observations, MRI appears to be a suitable examination. The exact situation of the cord and the lipoma is clearly seen. Associated anomalies such as syringomyelia is also clearly demonstrated.

  8. High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner–the Diabetes Research in Children Network (DirecNet) experience

    Science.gov (United States)

    Barnea-Goraly, Naama; Weinzimer, Stuart A.; Mauras, Nelly; Beck, Roy W.; Marzelli, Matt J.; Mazaika, Paul K.; Aye, Tandy; White, Neil H.; Tsalikian, Eva; Fox, Larry; Kollman, Craig; Cheng, Peiyao; Reiss, Allan L.

    2013-01-01

    Background The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk. Objective We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children. Materials and methods 222 children (4–9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner. Results 205 children (92.3%), mean age 7±1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner. Conclusion Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation. PMID:24096802

  9. High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner-the Diabetes Research in Children Network (DirecNet) experience

    Energy Technology Data Exchange (ETDEWEB)

    Barnea-Goraly, Naama; Marzelli, Matt J.; Mazaika, Paul K. [Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Weinzimer, Stuart A. [Yale University, Pediatric Endocrinology, New Haven, CT (United States); Ruedy, Katrina J.; Beck, Roy W.; Kollman, Craig; Cheng, Peiyao [Jaeb Center for Health Research, Tampa, FL (United States); Mauras, Nelly; Fox, Larry [Nemours Children' s Clinic, Pediatric Endocrinology, Jacksonville, FL (United States); Aye, Tandy [Stanford University, Department of Pediatrics, Stanford, CA (United States); White, Neil H. [Washington University in St. Louis, Department of Pediatrics, St. Louis, MO (United States); Tsalikian, Eva [University of Iowa, Pediatric Endocrinology, Iowa City, IA (United States); Reiss, Allan L. [Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Stanford University, Department of Pediatrics, Stanford, CA (United States); Stanford University, Department of Radiology, Diabetes Research in Children Network (DirecNet), Stanford, CA (United States); Collaboration: on behalf of the Diabetes Research in Children Network (DirecNet)

    2014-02-15

    The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk. We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children. 222 children (4-9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner. 205 children (92.3%), mean age 7 ± 1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner. Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation. (orig.)

  10. A comparative study of leptospirosis and dengue in Thai children.

    Directory of Open Access Journals (Sweden)

    Daniel H Libraty

    Full Text Available Leptospirosis is an emerging zoonosis that is often under-recognized in children and commonly confused with dengue in tropical settings. An enhanced ability to distinguish leptospirosis from dengue in children would guide clinicians and public health personnel in the appropriate use of limited healthcare resources.We conducted a prospective, hospital-based, study of children with acute febrile illnesses and dengue in Thailand. Among the children without dengue, we identified those with leptospirosis using anti-leptospira IgM and microscopic agglutination titers in paired acute and convalescent blood samples. We then performed a case-control comparison of symptoms, signs, and clinical laboratory values between children with leptospirosis and dengue. In a semi-rural region of Thailand, leptospirosis accounted for 19% of the non-dengue acute febrile illnesses among children presenting during the rainy season. None of the children with leptospirosis were correctly diagnosed at the time of hospital discharge, and one third (33% were erroneously diagnosed as dengue or scrub typhus. A predictive model to distinguish pediatric leptospirosis from dengue was generated using three variables: the absolute neutrophil count, plasma albumin, and aspartate aminotransferase levels in the first 72 hours of illness.Unrecognized leptospirosis can be a significant cause of "dengue-like" febrile illness in children. Increased awareness of pediatric leptospirosis, and an enhanced ability to discriminate between leptospirosis and dengue early in illness, will help guide the appropriate use of healthcare resources in often resource-limited settings.

  11. A protocol for the development of Mediterranean climate services based on the experiences of the CLIM-RUN case studies

    Science.gov (United States)

    Goodess, Clare; Ruti, Paolo; Rousset, Nathalie

    2014-05-01

    During the closing stages of the CLIM-RUN EU FP7 project on Climate Local Information in the Mediterranean region Responding to User Needs, the real-world experiences encountered by the case-study teams are being assessed and synthesised to identify examples of good practice and, in particular, to produce the CLIM-RUN protocol for the development of Mediterranean climate services. The specific case studies have focused on renewable energy (Morocco, Spain, Croatia, Cyprus), tourism (Savoie, Tunisia, Croatia, Cyprus) and wild fires (Greece) as well as one cross-cutting case study (Veneto region). They have been implemented following a common programme of local workshops, questionnaires and interviews, with Climate Expert Team and Stakeholder Expert Team members collaborating to identify and translate user needs and subsequently develop climate products and information. Feedback from stakeholders has been essential in assessing and refining these products. The protocol covers the following issues: the overall process and methodological key stages; identification and selection of stakeholders; communication with stakeholders; identification of user needs; translation of needs; producing products; assessing and refining products; methodologies for evaluating the economic value of climate services; and beyond CLIM-RUN - the lessons learnt. Particular emphasis is given to stakeholder analysis in the context of the participatory, bottom-up approach promoted by CLIM-RUN and to the iterative approach taken in the development of climate products. Recommendations are also made for an envisioned three-tier business model for the development of climate services involving climate, intermediary and stakeholder tiers.

  12. The “Healthy Habits, Healthy Girls” randomized controlled trial for girls: study design, protocol, and baseline results

    Directory of Open Access Journals (Sweden)

    Ana Carolina Barco Leme

    2015-07-01

    Full Text Available The purpose of this article is to describe the study design, protocol, and baseline results of the “Healthy Habits, Healthy Girls” program. The intervention is being evaluated through a randomized controlled trial in 10 public schools in the city of São Paulo, Brazil. Data on the following variables were collected and assessed at baseline and will be reevaluated at 7 and 12 months: body mass index, waist circumference, dietary intake, nutrition, physical activity, social cognitive mediators, physical activity level, sedentary behaviors, self-rated physical status, and overall self-esteem. According to the baseline results, 32.4% and 23.4% of girls were overweight in the intervention and control groups, respectively, and in both groups a higher percentage failed to meet daily recommendations for moderate and vigorous physical activity and maximum screen time (TV, computer, mobile devices. There were no significant differences between the groups for most of the variables, except age (p = 0.000 and waist circumference (p = 0.014. The study showed a gap in the Brazilian literature on protocols for randomized controlled trials to prevent obesity among youth. The current study may thus be an important initial contribution to the field.

  13. [Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain].

    Science.gov (United States)

    Pérez, Glòria; Gotsens, Mercè; Palència, Laia; Marí-Dell'Olmo, Marc; Domínguez-Berjón, M Felicitas; Rodríguez-Sanz, Maica; Puig, Vanessa; Bartoll, Xavier; Gandarillas, Ana; Martín, Unai; Bacigalupe, Amaia; Díez, Elia; Ruiz, Miguel; Esnaola, Santiago; Calvo, Montserrat; Sánchez, Pablo; Luque Fernández, Miguel Ángel; Borrell, Carme

    The aim is to present the protocol of the two sub-studies on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain. Substudy 1: describe the evolution of mortality and reproductive health between 1990 and 2013 through a longitudinal ecological study in the Autonomous Communities. This study will identify changes caused by the economic crisis in trends or reproductive health and mortality indicators using panel data (17 Autonomous Communities per study year) and adjusting Poisson models with random effects variance. Substudy 2: analyse inequalities by socioeconomic deprivation in mortality and reproductive health in several areas of Spain. An ecological study analysing trends in the pre-crisis (1999-2003 and 2004-2008) and crisis (2009-2013) periods will be performed. Random effects models Besag York and Mollié will be adjusted to estimate mortality indicators softened in reproductive health and census tracts.

  14. Autism Center First to Study Minimally Verbal Children

    Science.gov (United States)

    ... on. Feature: Taste, Smell, Hearing, Language, Voice, Balance Autism Center First to Study Minimally Verbal Children Past ... research exploring the causes, diagnosis, and treatment of autism spectrum disorder (ASD), a complex developmental disorder that ...

  15. Evaluation of a Modified Pamidronate Protocol for the Treatment of Osteogenesis Imperfecta.

    Science.gov (United States)

    Palomo, Telma; Andrade, Maria C; Peters, Barbara S E; Reis, Fernanda A; Carvalhaes, João Tomás A; Glorieux, Francis H; Rauch, Frank; Lazaretti-Castro, Marise

    2016-01-01

    Intravenous pamidronate is widely used to treat children with osteogenesis imperfecta (OI). In a well-studied protocol ('standard protocol'), pamidronate is given at a daily dose of 1 mg per kg body weight over 4 h on 3 successive days; infusion cycles are repeated every 4 months. Here, we evaluated renal safety of a simpler protocol for intravenous pamidronate infusions (2 mg per kg body weight given in a single infusion over 2 h, repeated every 4 months; 'modified protocol'). Results of 18 patients with OI types I, III, or IV treated with the modified protocol for 12 months were compared to 18 historic controls, treated with standard protocol. In the modified protocol, mild transient post-infusion increases in serum creatinine were found during each infusion but after 12 months serum creatinine remained similar from baseline [0.40 mg/dl (SD: 0.13)] to the end of the study [0.41 mg/dl (SD: 0.11)] (P = 0.79). The two protocols led to similar changes in serum creatinine during the first pamidronate infusion [modified protocol: +2% (SD: 21%); standard protocol: -3% (SD: 8%); P = 0.32]. Areal lumbar spine bone mineral density Z-scores increased from -2.7 (SD: 1.5) to -1.8 (SD: 1.4) with the modified protocol, and from -4.1 (SD: 1.4) to -3.1 (SD: 1.1) with standard protocol (P = 0.68 for group differences in bone density Z-score changes). The modified pamidronate protocol is safe and may have similar effects on bone density as the standard pamidronate protocol. More studies are needed with longer follow-up to prove anti-fracture efficacy.

  16. Validation study of the Dinamap ProCare 200 upper arm blood pressure monitor in children and adolescents

    Directory of Open Access Journals (Sweden)

    Chong Guk Lee

    2011-11-01

    Full Text Available Purpose : To validate the Dinamap ProCare 200 blood pressure (BP monitor against a mercury sphygmomanometer in children 7 to 18 years old in accordance with the 2010 International Protocol of European Society of Hypertension (ESH-IP2 and the British Hypertension Society (BHS protocol. Methods : Forty-five children were recruited for the study. A validation procedure was performed following the protocol based on the ESHIP2 and BHS protocols for children and adolescents. Each subject underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device by trained nurses. The results were analyzed according to the validation criteria of ESH-IP2. Results : The mean (¡?#?D ;difference in the absolute BP values between test device and mercury sphygmomanometer readings was 1.85¡?#?.65; mmHg for systolic BP (SBP and 4.41¡?#?.53; mmHg for diastolic BP (DBP. These results fulfilled the Association for the Advancement of Medical Instrumentation criterion of a mean¡?#?D b;elow 5¡?#? mm;Hg for both SBP and DBP. The percentages of test device-observer mercury sphygmomanometer BP differences within 5, 10, and 15 mmHg were 96%, 100%, and 100% for SBP, and 69%, 92%, and 100% for DBP, respectively, in the part 1 analysis; both SBP and DBP passed the part 1 criteria. In the part 2 analysis, SBP passed the criteria but DBP failed. Conclusion : Although the Dinamap ProCare 200 BP monitor failed an adapted ESH-IP2, SBP passed. When comparing BP readings measured by oscillometers and mercury sphygmomanometers, one has to consider the differences between them, particularly in DBP, because DBP can be underestimated.

  17. A six-step protocol to systematic process evaluation of multicomponent cluster-randomised health promoting interventions illustrated by the Boost study

    DEFF Research Database (Denmark)

    Aarestrup, Anne Kristine; Jørgensen, Thea Suldrup; Due, Pernille;

    2014-01-01

    and concepts, we developed a six-step protocol: 1. Brainstorm of processes necessary for full implementation and potential barriers and facilitators to implementation; 2. Application of process evaluation concepts to ensure inclusion of important implementation processes; 3. Measurement of proximal outcomes; 4....... Identification of relevant data sources; 5. Selection of methods and timing of data collection of process measures; 6. Development of instruments. The protocol was applied to the Boost study, a multicomponent school-based dietary intervention. RESULTS AND CONCLUSIONS: The protocol was readily applicable...

  18. Using Think-Aloud Protocols to Uncover Misconceptions and Improve Developmental Math Instruction: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Charles Secolsky

    2016-01-01

    Full Text Available Deficiencies in education continue to escalate around the world. The focus on outcomes assessment has narrowed instructional research and curriculum evaluation to standardized testing in certain subject areas. A prototype for a quantitative literacy assessment instrument was developed with the goal of diagnosing student misconceptions of basic mathematics content and changing instructional practices to undo the misconceptions by applying cognitive psychological theory. Two hundred thirty-eight basic math high school students and 209 remedial community college students in New Jersey and New York were administered the instrument, which had been based on coded data from think-aloud protocols. The instrument asked students to answer 20 basic mathematics items and, in addition, to evaluate four possible solution strategies. For each item, frequencies of selected solution strategies and the association between strategy selection and performance on the 20-question math test are presented as a means for improving instruction. Follow-up research is proposed for determining whether undoing the student misconceptions first before teaching material on a new unit of instruction may yield more positive student outcomes.

  19. Building America Case Study: Philadelphia Housing Authority Energy-Efficiency Turnover Protocols, Philadelphia, Pennsylvania

    Energy Technology Data Exchange (ETDEWEB)

    2016-02-01

    Over one million HUD-supported public housing units provide rental housing for eligible low-income families across the country. A survey of over 100 public housing authorities (PHAs) across the country indicated that there is a high level of interest in developing low-cost solutions that improve energy efficiency and can be seamlessly included in the refurbishment process. Further, PHAs, have incentives (both internal and external) to reduce utility bills. ARIES worked with four PHAs to develop packages of energy efficiency retrofit measures the PHAs can cost-effectively implement with their own staffs in the normal course of housing operations at the time when units are refurbished between occupancies. The energy efficiency turnover protocols emphasized air infiltration reduction, duct sealing, and measures that improve equipment efficiency. ARIES documented implementation in 18 housing units. Reductions in average air leakage were 16 percent and duct leakage reductions averaged 23 percent. Total source energy consumption savings due to implemented measures was estimated at 3-10 percent based on BEopt modeling with a simple payback of 1.6 to 2.5 years. Implementation challenges were encountered mainly related to required operational changes and budgetary constraints. Nevertheless, simple measures can feasibly be accomplished by PHA staff at low or no cost. At typical housing unit turnover rates, these measures could impact hundreds of thousands of units per year nationally.

  20. FRENCH PROTOCOL CARDS

    CERN Multimedia

    Division des Ressources Humaines; Human Resources Division; Tel. 74683-79494

    2000-01-01

    Senior officials, holders of FRENCH PROTOCOL cards (blue cards) due to expire on 31.12.2000, are requested to return these cards and those of family members, for extension to: Bureau des cartes, Bât 33.1-009/1-015 Should the three spaces for authentication on the back of the card be full, please enclose two passport photographs for a new card. In the case of children aged 14 and over, an attestation of dependency and a school certificate should be returned with the card.

  1. FRENCH PROTOCOL CARDS

    CERN Multimedia

    Division du Personnel

    1999-01-01

    Senior officials, holders of FRENCH PROTOCOL cards (blue cards) due to expire on 31.12.1999, are requested to return these cards and those of family members, for extension to:Bureau des cartes, bâtiment 33.1-025Should the 3 spaces for authentication on the back of the card be full, please enclose 2 passport photographs for a new card.In the case of children aged 14 and over, an attestation of dependency and a school certificate should be returned with the card.Personnel DivisionTel. 79494/74683

  2. Histology protocols

    Directory of Open Access Journals (Sweden)

    CarloAlberto Redi

    2010-06-01

    Full Text Available Tim D. Hewitson & Ian A. Darby (Eds Humana press, Totowa, New Jersey (USA Series: Springer Protocols Methods in Molecular Biology, Volume 611, 2010 Pages: 230; € 83.15 ISBN: 978-1-60327-344-2 Impressive as it can sounds in the era that Biology see a clear dominance of reductionism with the idea that complexity can be disentagled more and more thanks to the use of molecular tools, the reader will remain fascinated by this slim and agile volume devoted to bring together what apparently are two separeted words: molecular biology and histology. Simply remembering to the youngest scientists.....

  3. Prevention of abdominal wound infection (PROUD trial, DRKS00000390: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Heger Ulrike

    2011-11-01

    Full Text Available Abstract Background Wound infection affects a considerable portion of patients after abdominal operations, increasing health care costs and postoperative morbidity and affecting quality of life. Antibacterial coating has been suggested as an effective measure to decrease postoperative wound infections after laparotomies. The INLINE metaanalysis has recently shown the superiority of a slowly absorbable continuous suture for abdominal closure; with PDS plus® such a suture has now been made available with triclosan antibacterial coating. Methods/Design The PROUD trial is designed as a randomised, controlled, observer, surgeon and patient blinded multicenter superiority trial with two parallel groups and a primary endpoint of wound infection during 30 days after surgery. The intervention group will receive triclosan coated polydioxanone sutures, whereas the control group will receive the standard polydioxanone sutures; abdominal closure will otherwise be standardized in both groups. Statistical analysis is based on intention-to-treat population via binary logistic regression analysis, the total sample size of n = 750 is sufficient to ensure alpha = 5% and power = 80%, an interim analysis will be carried out after data of 375 patients are available. Discussion The PROUD trial will yield robust data to determine the effectiveness of antibacterial coating in one of the standard sutures for abdominal closure and potentially lead to amendment of current guidelines. The exploration of clinically objective parameters as well as quality of life holds immediate relevance for clinical management and the pragmatic trial design ensures high external validity. Trial Registration The trial protocol has been registered with the German Clinical Trials Register (DRKS00000390.

  4. Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Mollerup Annette

    2012-06-01

    Full Text Available Abstract Background Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. Methods/design This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out. The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. Discussion The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as

  5. Splenectomy in children with idiopathic thrombocytopenic purpura : A prospective study of 134 children from the Intercontinental Childhood ITP Study Group

    NARCIS (Netherlands)

    Kuehne, Thomas; Blanchette, Victor; Buchanan, George R.; Ramenghi, Ugo; Donato, Hugo; Tamminga, Rienk Y. J.; Rischewski, Johannes; Berchtold, Willi; Imbach, Paul

    2007-01-01

    Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-eight Intercontinental Childhood ITP Study Group (ICIS) investigators from 57 institutions in

  6. Comparative Evaluation of Stroke Triage Algorithms for Emergency Medical Dispatchers (MeDS: Prospective Cohort Study Protocol

    Directory of Open Access Journals (Sweden)

    Bloom Evan

    2011-01-01

    Full Text Available Abstract Background Stroke is a major cause of death and leading cause of disability in the United States. To maximize a stroke patient's chances of receiving thrombolytic treatment for acute ischemic stroke, it is important to improve prehospital recognition of stroke. However, it is known from published reports that emergency medical dispatchers (EMDs using Card 28 of the Medical Priority Dispatch System protocols recognize stroke poorly. Therefore, to improve EMD's recognition of stroke, the National Association of Emergency Medical Dispatchers recently designed a new diagnostic stroke tool (Cincinnati Stroke Scale -CSS to be used with Card 28. The objective of this study is to determine whether the addition of CSS improves diagnostic accuracy of stroke triage. Methods/Design This prospective experimental study will be conducted during a one-year period in the 911 call center of Santa Clara County, CA. We will include callers aged ≥ 18 years with a chief complaint suggestive of stroke and second party callers (by-stander or family who are in close proximity to the patient and can administer the tool ≥ 18 years of age. Life threatening calls will be excluded from the study. Card 28 questions will be administered to subjects who meet study criteria. After completion of Card 28, CSS tool will be administered to all calls. EMDs will record their initial assessment of a cerebro-vascular accident (stroke after completion of Card 28 and their final assessment after completion of CSS. These assessments will be compared with the hospital discharge diagnosis (ICD-9 codes recorded in the Office of Statewide Health Planning and Development (OSHPD database after linking the EMD database and OSHPD database using probabilistic linkage. The primary analysis will compare the sensitivity of the two stroke protocols using logistic regression and generalizing estimating equations to account for clustering by EMDs. To detect a 15% difference in sensitivity

  7. Treatment influencing down-staging in EORTC Melanoma Group sentinel node histological protocol compared with complete step-sectioning: A national multicentre study

    DEFF Research Database (Denmark)

    Riber-Hansen, Rikke; Hastrup, Nina; Clemmensen, Ole;

    2012-01-01

    Metastasis size in melanoma sentinel lymph nodes (SLNs) is an emerging prognostic factor. Two European melanoma treatment trials include SLN metastasis diameters as inclusion criteria. Whilst diameter estimates are sensitive to the number of sections examined, the level of this bias is largely...... unknown. We performed a prospective multicentre study to compare the European Organisation for Research and Treatment of Cancer (EORTC) recommended protocol with a protocol of complete step-sectioning....

  8. A study on the development of the protocol of leisure activity program for the elderly's deviant prevention.

    Science.gov (United States)

    Ahn, Chan-Woo; Yi, Eun-Surk; Park, Dong-Kyun; Lee, Hi-Wan; Lee, Kwang-Uk; Min, Byeong-Seok; Cho, Gun-Sang; Chang, Ik-Young

    2014-04-01

    The purpose of this study is to provide planning methods for leisure activity program to prevent the elderly's deviance, using the program components and protocol factors. This section discusses the results obtained through document analysis and Delphi technique. First, the components of leisure activity program were classified into five stages such as definition, condition analysis, program composition, application and evaluation. Second, the protocol factors in each stage of leisure activity program for the elderly's deviant prevention were 19 main themes and 75 sub-themes respectively. In the stage of condition analysis, five main themes such as deviant prediction, individual, socio-demographic, social and cultural factors and 25 sub-themes were found. Program composition included three main themes, facilities, instructor and program and 16 sub-themes and in the application stage, there were three key themes, facilities, instructor and program and 14 sub-themes. Lastly, the evaluation found four main themes such as deviant prevention, participation in leisure activities, management and wellbeing and 16 sub-themes.

  9. Microbiological evaluation of different irrigation protocols on root canal disinfection in teeth with apical periodontitis: an in vivo study.

    Science.gov (United States)

    Cohenca, Nestor; Silva, Lea Assed Bezerra; Silva, Raquel Assed Bezerra; Nelson-Filho, Paulo; Heilborn, Carlos; Watanabe, Evandro; Saraiva, Maria Conceição Pereira

    2013-01-01

    The present in vivo study was designed to evaluate the efficacy of apical negative pressure irrigation (ANP), passive ultrasonic irrigation (PUI) and positive pressure irrigation (PP) in the reduction of intracanal bacteria of dogs' teeth with pulp necrosis and apical periodontitis. Eighty root canals were randomly distributed into 3 experimental and 2 control groups according to the irrigation delivery system: group ANP (n=20), group PUI (n=20), group PP (n=20), group PC (positive control - sterile saline irrigation; n=10) and group NC (negative control - vital pulps not subjected to bacterial inoculation; n=10). The first sample (S1) was collected at baseline, and the second sample (S2) was collected after the disinfection protocols. All samples were seeded in culture media for anaerobic bacteria. CFU counts were analyzed statistically by the Kruskal-Wallis, Dwass-Steel-Critchlow-Fligner post-hoc and Chi-square followed by Tukey like multiple comparisons for proportions (α=0.05). All experimental groups were effective in reducing Gram-positive bacteria compared with PC (p0.05). In dog's teeth with apical periodontitis, the use of ANP and PUI can be considered promising disinfection protocols as both delivery systems promoted a significant bacterial reduction.

  10. Optimization of the imaging quality of 64-slice CT acquisition protocol using Taguchi analysis: A phantom study.

    Science.gov (United States)

    Pan, Lung Fa; Erdene, Erdenetsetseg; Chen, Chun Chi; Pan, Lung Kwang

    2015-01-01

    In this study, the phantom imaging quality of 64-slice CT acquisition protocol was quantitatively evaluated using Taguchi. The phantom acrylic line group was designed and assembled with multiple layers of solid water plate in order to imitate the adult abdomen, and scanned with Philips brilliance CT in order to simulate a clinical examination. According to the Taguchi L8(2(7)) orthogonal array, four major factors of the acquisition protocol were optimized, including (A) CT slice thickness, (B) the image reconstruction filter type, (C) the spiral CT pitch, and (D) the matrix size. The reconstructed line group phantom image was counted by four radiologists for three discrete rounds in order to obtain the averages and standard deviations of the line counts and the corresponding signal to noise ratios (S/N). The quantified S/N values were analyzed and the optimal combination of the four factor settings was determined to be comprised of (A) a 1-mm thickness, (B) a sharp filter type, (C) a 1.172 spiral CT pitch, and (D) a 1024×1024 matrix size. The dominant factors included the (A) filter type and the cross interaction between the filter type and CT slice thickness (A×B). The minor factors were determined to be (C) the spiral CT pitch and (D) the matrix size since neither was capable of yielding a 95% confidence level in the ANOVA test.

  11. Study of Mothers' Anxieties Related to Their Children's Future

    Science.gov (United States)

    Ilgar, Sengul

    2015-01-01

    The purpose of this study is to study anxieties of mothers related to their children's future. Qualitative method was used in order to study anxieties of mothers from different socio-economic levels. Sample of the study participants are 129 mothers living in Istanbul. 32 of those mothers are from upper socio-economic level, 57, from middle…

  12. A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-07-01

    Full Text Available Abstract Background There are several clinical and radiological methods available to classify foot posture in research, however there is no clear strategy for selecting the most appropriate measurements. Therefore, the aim of this study was to develop a foot screening protocol to distinguish between participants with normal- and flat-arched feet who would then subsequently be recruited into a series of laboratory-based gait studies. Methods The foot posture of ninety-one asymptomatic young adults was assessed using two clinical measurements (normalised navicular height and arch index and four radiological measurements taken from antero-posterior and lateral x-rays (talus-second metatarsal angle, talo-navicular coverage angle, calcaneal inclination angle and calcaneal-first metatarsal angle. Normative foot posture values were taken from the literature and used to recruit participants with normal-arched feet. Data from these participants were subsequently used to define the boundary between normal- and flat-arched feet. This information was then used to recruit participants with flat-arched feet. The relationship between the clinical and radiographic measures of foot posture was also explored. Results Thirty-two participants were recruited to the normal-arched study, 31 qualified for the flat-arched study and 28 participants were classified as having neither normal- or flat-arched feet and were not suitable for either study. The values obtained from the two clinical and four radiological measurements established two clearly defined foot posture groups. Correlations among clinical and radiological measures were significant (p r = 0.24 to 0.70. Interestingly, the clinical measures were more strongly associated with the radiographic angles obtained from the lateral view. Conclusion This foot screening protocol provides a coherent strategy for researchers planning to recruit participants with normal- and flat-arched feet. However, further research is

  13. An evaluation of the parents under pressure programme : a study protocol for an RCT into its clinical and cost effectiveness

    OpenAIRE

    Barlow, Jane; Sembi, Sukhdev; Gardner, Frances E. M.; Macdonald, Geraldine M; Petrou, Stavros; Parsons, Helen; Harnett, Paul; Dawe, Sharon

    2013-01-01

    Background: Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant’s physical and emotional needs. The poor outcom...

  14. An evaluation of the parents under pressure programme: a study protocol for an RCT into its clinical and cost effectiveness

    OpenAIRE

    Barlow, Jane; Sembi, Sukhdev; Gardner, Frances; Macdonald, Geraldine; Petrou, Stavros; Parsons, Helen; Harnett, Paul; Dawe, Sharon

    2013-01-01

    Background Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant’s physical and emotional needs. The poor outcome...

  15. The Agricultural Model Intercomparison and Improvement Project (AgMIP): Protocols and Pilot Studies

    Science.gov (United States)

    Rosenzweig, C.; Jones, J. W.; Hatfield, J. L.; Ruane, A. C.; Boote, K. J.; Thorburn, P.; Antle, J. M.; Nelson, G. C.; Porter, C.; Janssen, S.; Asseng, S.; Basso, B.; Ewert, F.; Wallach, D.; Baigorria, G.; Winter, J. M.

    2012-01-01

    The Agricultural Model Intercomparison and Improvement Project (AgMIP) is a major international effort linking the climate, crop, and economic modeling communities with cutting-edge information technology to produce improved crop and economic models and the next generation of climate impact projections for the agricultural sector. The goals of AgMIP are to improve substantially the characterization of world food security due to climate change and to enhance adaptation capacity in both developing and developed countries. Analyses of the agricultural impacts of climate variability and change require a transdisciplinary effort to consistently link state-of-the-art climate scenarios to crop and economic models. Crop model outputs are aggregated as inputs to regional and global economic models to determine regional vulnerabilities, changes in comparative advantage, price effects, and potential adaptation strategies in the agricultural sector. Climate, Crop Modeling, Economics, and Information Technology Team Protocols are presented to guide coordinated climate, crop modeling, economics, and information technology research activities around the world, along with AgMIP Cross-Cutting Themes that address uncertainty, aggregation and scaling, and the development of Representative Agricultural Pathways (RAPs) to enable testing of climate change adaptations in the context of other regional and global trends. The organization of research activities by geographic region and specific crops is described, along with project milestones. Pilot results demonstrate AgMIP's role in assessing climate impacts with explicit representation of uncertainties in climate scenarios and simulations using crop and economic models. An intercomparison of wheat model simulations near Obregón, Mexico reveals inter-model differences in yield sensitivity to [CO2] with model uncertainty holding approximately steady as concentrations rise, while uncertainty related to choice of crop model increases with

  16. HEART: heart exercise and remote technologies: A randomized controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Kira Geoffrey

    2011-05-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the leading cause of death worldwide. Cardiac rehabilitation (CR is aimed at improving health behaviors to slow or reverse the progression of CVD disease. Exercise is a central element of CR. Technologies such as mobile phones and the Internet (mHealth offer potential to overcome many of the psychological, physical, and geographical barriers that have been associated with lack of participation in exercise-based CR. We aim to trial the effectiveness of a mobile phone delivered exercise-based CR program to increase exercise capacity and functional outcomes compared with usual CR care in adults with CVD. This paper outlines the rationale and methods of the trial. Methods A single-blinded parallel two-arm randomized controlled trial is being conducted. A total of 170 people will be randomized at 1:1 ratio either to receive a mHealth CR program or usual care. Participants are identified by CR nurses from two metropolitan hospitals in Auckland, New Zealand through outpatient clinics and existing databases. Consenting participants are contacted to attend a baseline assessment. The intervention consists of a theory-based, personalized, automated package of text and video message components via participants' mobile phones and the Internet to increase exercise behavior, delivered over six months. The control group will continue with usual CR. Data collection occurs at baseline and 24 weeks (post-intervention. The primary outcome is change in maximal oxygen uptake from baseline to 24 weeks. Secondary outcomes include post-intervention measures on self-reported physical activity (IPAQ, cardiovascular risk factors (systolic blood pressure, weight, and waist to hip ratio, health related quality of life (SF-36, and cost-effectiveness. Discussion This manuscript presents the protocol for a randomized controlled trial of a mHealth exercise-based CR program. Results of this trial will provide much needed

  17. Evaluation of methodological protocols using point counts and mist nets: a case study in southeastern Brazil

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    Vagner Cavarzere

    2013-01-01

    Full Text Available Despite their wide use in ornithological surveys, point counts and mist nets follow protocols developed in temperate regions, with little attention to possible modifications for tropical systems. Using these methods on a 3-month basis from December 2009-January 2011 in two forest fragments in southeastern Brazil, we wished to evaluate how long these locations needed to be surveyed with point counts for a relatively complete avifaunal inventory (at least 90% of all species and contacts, and if mist net hourly captures can equally detect numbers of species and individuals. Daily counting with four 20-min points during five consecutive days in a rain forest (MC detected 90% of the estimated species richness after 20 h (60 20-min point counts, while 17 h (51 20-min point counts did not detect 90% of the estimated species richness in a semideciduous forest (IT. The first 5 min of point counting in MC (63% of all species and in IT (65% detected significantly more species than the remaining minutes, but it took 15 min to accumulate 86% of all contacts in both forests. Consecutive 5-day mist netting (~ 9 h/day resulted in 70.5 net-h/m² (MC and 74.8 net-h/m² (IT of sample effort, but 80-85% of the estimated number of species was obtained. Although accumulation curves showed no tendency towards stabilization of the number of observed species, the estimated number of species began to stabilize after the first 20 h in both forests. There was no significant difference in capture rates for both species richness and abundance among hourly net checks, but a trend in which these parameters were highest between the second and fourth checks of the day was observed. A 3-day (43.8 and 63.3 net-h/m² mist netting section was enough to record 90% of the species captured during five days in MC and IT, respectively, while precise enough not to jeopardize species richness estimation. The number of individuals, however, decreased order 34% in MC and 38% in IT under the

  18. A new perspective on adolescent athletes’ transition into upper secondary school: A longitudinal mixed methods study protocol

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    Tatiana V. Ryba

    2016-12-01

    Full Text Available The challenge of combining elite sport and education into a dual career pathway remains to be a source of concern for many high-performance athletes. Previous research findings suggest that committed participation in both domains is highly demanding and success in one pursuit often comes at the expense of the other. There are emergent studies, however, that argue for the beneficial and complementary nature of dual career pathways. Consequently, we emphasize the importance of understanding the processes underlying differences in the development of athletes’ life trajectories. This article presents a study protocol to explore new methodological and analytical approaches that may extend current understandings of the ways psychological and sociocultural processes are interconnected in the construction of adolescent athletes’ identities, motivation, well-being, and career aspirations in the transitory social world.

  19. Designing isothermal titration calorimetry experiments for the study of 1:1 binding: problems with the "standard protocol".

    Science.gov (United States)

    Tellinghuisen, Joel

    2012-05-15

    Literature recommendations for designing isothermal titration calorimetry (ITC) experiments to study 1:1 binding, M+X -->/applicability of the ITC technique. These deficiencies are discussed here along with other misconceptions. Whether a specific binding process can be studied by ITC is determined less by c (the product of binding constant K and titrand concentration [M](0)) than by the total detectable heat q(tot) and the extent to which M can be converted to MX. As guidelines, with 90% conversion to MX, K can be estimated within 5% over the range 10 to 10(8)M(-1) when q(tot)/σ(q)≈700, where σ(q) is the standard deviation for estimation of q. This ratio drops to ~150 when the stoichiometry parameter n is treated as known. A computer application for modeling 1:1 binding yields realistic estimates of parameter standard errors for use in protocol design and feasibility assessment.

  20. Agreements between Industry and Academia on Publication Rights: A Retrospective Study of Protocols and Publications of Randomized Clinical Trials.

    Directory of Open Access Journals (Sweden)

    Benjamin Kasenda

    2016-06-01

    Full Text Available Little is known about publication agreements between industry and academic investigators in trial protocols and the consistency of these agreements with corresponding statements in publications. We aimed to investigate (i the existence and types of publication agreements in trial protocols, (ii the completeness and consistency of the reporting of these agreements in subsequent publications, and (iii the frequency of co-authorship by industry employees.We used a retrospective cohort of randomized clinical trials (RCTs based on archived protocols approved by six research ethics committees between 13 January 2000 and 25 November 2003. Only RCTs with industry involvement were eligible. We investigated the documentation of publication agreements in RCT protocols and statements in corresponding journal publications. Of 647 eligible RCT protocols, 456 (70.5% mentioned an agreement regarding publication of results. Of these 456, 393 (86.2% documented an industry partner's right to disapprove or at least review proposed manuscripts; 39 (8.6% agreements were without constraints of publication. The remaining 24 (5.3% protocols referred to separate agreement documents not accessible to us. Of those 432 protocols with an accessible publication agreement, 268 (62.0% trials were published. Most agreements documented in the protocol were not reported in the subsequent publication (197/268 [73.5%]. Of 71 agreements reported in publications, 52 (73.2% were concordant with those documented in the protocol. In 14 of 37 (37.8% publications in which statements suggested unrestricted publication rights, at least one co-author was an industry employee. In 25 protocol-publication pairs, author statements in publications suggested no constraints, but 18 corresponding protocols documented restricting agreements.Publication agreements constraining academic authors' independence are common. Journal articles seldom report on publication agreements, and, if they do

  1. Agreements between Industry and Academia on Publication Rights: A Retrospective Study of Protocols and Publications of Randomized Clinical Trials

    Science.gov (United States)

    Kasenda, Benjamin; von Elm, Erik; You, John J.; Tomonaga, Yuki; Saccilotto, Ramon; Amstutz, Alain; Bengough, Theresa; Meerpohl, Joerg J.; Stegert, Mihaela; Olu, Kelechi K.; Tikkinen, Kari A. O.; Neumann, Ignacio; Carrasco-Labra, Alonso; Faulhaber, Markus; Mulla, Sohail M.; Mertz, Dominik; Akl, Elie A.; Bassler, Dirk; Busse, Jason W.; Nordmann, Alain; Gloy, Viktoria; Ebrahim, Shanil; Schandelmaier, Stefan; Sun, Xin; Vandvik, Per O.; Johnston, Bradley C.; Walter, Martin A.; Burnand, Bernard; Hemkens, Lars G.; Bucher, Heiner C.; Guyatt, Gordon H.; Briel, Matthias

    2016-01-01

    Background Little is known about publication agreements between industry and academic investigators in trial protocols and the consistency of these agreements with corresponding statements in publications. We aimed to investigate (i) the existence and types of publication agreements in trial protocols, (ii) the completeness and consistency of the reporting of these agreements in subsequent publications, and (iii) the frequency of co-authorship by industry employees. Methods and Findings We used a retrospective cohort of randomized clinical trials (RCTs) based on archived protocols approved by six research ethics committees between 13 January 2000 and 25 November 2003. Only RCTs with industry involvement were eligible. We investigated the documentation of publication agreements in RCT protocols and statements in corresponding journal publications. Of 647 eligible RCT protocols, 456 (70.5%) mentioned an agreement regarding publication of results. Of these 456, 393 (86.2%) documented an industry partner’s right to disapprove or at least review proposed manuscripts; 39 (8.6%) agreements were without constraints of publication. The remaining 24 (5.3%) protocols referred to separate agreement documents not accessible to us. Of those 432 protocols with an accessible publication agreement, 268 (62.0%) trials were published. Most agreements documented in the protocol were not reported in the subsequent publication (197/268 [73.5%]). Of 71 agreements reported in publications, 52 (73.2%) were concordant with those documented in the protocol. In 14 of 37 (37.8%) publications in which statements suggested unrestricted publication rights, at least one co-author was an industry employee. In 25 protocol-publication pairs, author statements in publications suggested no constraints, but 18 corresponding protocols documented restricting agreements. Conclusions Publication agreements constraining academic authors’ independence are common. Journal articles seldom report on

  2. The Acute Asthma Severity Assessment Protocol (AASAP) Study: Objectives and Methods of a Study to Develop an Acute Asthma Clinical Prediction Rule

    OpenAIRE

    2011-01-01

    Acute asthma exacerbations are one of the most common reasons for pediatric emergency department (PED) visits and hospitalizations, and relapse frequently necessitates repeat urgent care. While care plans exist, there are no acute asthma prediction rules (APR)to assess severity and predict outcome. The primary objective of the Acute Asthma Severity Assessment Protocol (AASAP) study is to develop a multivariable APR for acute asthma exacerbations in the pediatric patient.

  3. [Street food among children: a study in north Tunisia].

    Science.gov (United States)

    Neffati, Larbi; Ridha, Hamza; Kolsteren, Patrick; Hilderbrand, Katherine

    2004-01-01

    As urbanization increases in Tunisia, eating meals outside the home is becoming more frequent. Children are prime consumers for the fast food sold in the streets. Neither their nor their parents' attitude towards street food is well documented as yet. This study was conducted in the city of Bizerte in February 1998. Its aim was to gather information about street food and parents' and children's attitudes towards it to help organize educational sessions with the children, parents, teachers, and vendors. The study interviewed 421 primary school children, ranging in age from 6 to 15 years (mean age: 10 years), from 24 schools. Half received pocket money, a percentage that did not differ by sex. Three quarters of the children used more than 75% of their pocket money to buy street food. The items bought most frequently were candy (27.2%), sandwiches (23.9%), pastries (23.9%), sunflower seeds and peanuts (21%), and either pizza, chocolate, or cheese (20.3%); the largest proportion of money was spent on sandwiches. In more than half the cases (55.7% of the children), the main motivation for buying street food was either to replace or fill out a meal at home, with sandwiches or pastries. The parents' monthly income did not influence the children's purchasing behavior, but the rhythm of receiving pocket money did. Most children were satisfied with the nutritional and hygienic quality of the food available, but their opinion of this quality as well as the reasons for buying the food and the prices spent on it differed considerably from that of their parents. This study highlights the important role of street foods in the daily diet of schoolchildren and the need for appropriate nutrition education in primary schools.

  4. A STUDY ON TUBERCULO US EMPYEMA THORACIS IN CHILDREN

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    Bhaskar Reddy

    2015-02-01

    Full Text Available INTRODUCTION: Pleural decortication is surgical removal of the fibrous peel that covers the l ungs in third stage empyema thoracis. Pleural biopsy, increased pleural fluid adenosine deaminase level are diagnostic of tuberculous pleuritis. Pleural decortication can be done in either intra pleural or extrapleural approach. We performed a study with the objective of comparing the clinical profiles and outcome of patients with tuberculous and non - tuberculous empyema thoracis who underwent open pleural decortication. MATERIALS AND METHODS: A study was conducted in th e General Hospital during a period of 2 years. All the cases of empyema thoracis that underwent decortication were examined and pleural fluid analysis, pleural biopsy, physical examination, chest X - ray, CT - scan, Montoux test were done. Etiology of empyema was decided based on history, clinical ex amination and laboratory tests. RESULTS: In our study, non - tuberculous empyema was more frequent in infants and children below 6 years and t uberculous empyema was more frequent in 6 - 10 years. Among children with non - tuberculous empyema 28 children (42.42% underwent intra pleural decortication and 38 children (57.57% underwent extra pleural decortication. Among children with tuberculous empyema 2 children (25% underwent extra pleural decortication and 6 children (7 5% underwe nt intra pleural decortication. DISCUSSION: Non tuberculous empyemas required surgery (decortication more often than tuberculous empyema and e xtrapleural approach of decortication was possible in slightly higher percentage of children with non tuberculous empyema compared to tuberculous empyema thoracis. Pulmonary tuberculosis probably had good response to antituberculous treatment for which they did not progress to organizing phase requiring surgery .

  5. Interrupting transmission of soil-transmitted helminths: a study protocol for cluster randomised trials evaluating alternative treatment strategies and delivery systems in Kenya

    Science.gov (United States)

    Brooker, Simon J; Mwandawiro, Charles S; Halliday, Katherine E; Njenga, Sammy M; Mcharo, Carlos; Gichuki, Paul M; Wasunna, Beatrice; Kihara, Jimmy H; Njomo, Doris; Alusala, Dorcas; Chiguzo, Athuman; Turner, Hugo C; Teti, Caroline; Gwayi-Chore, Claire; Nikolay, Birgit; Truscott, James E; Hollingsworth, T Déirdre; Balabanova, Dina; Griffiths, Ulla K; Freeman, Matthew C; Allen, Elizabeth; Pullan, Rachel L; Anderson, Roy M

    2015-01-01

    Introduction In recent years, an unprecedented emphasis has been given to the control of neglected tropical diseases, including soil-transmitted helminths (STHs). The mainstay of STH control is school-based deworming (SBD), but mathematical modelling has shown that in all but very low transmission settings, SBD is unlikely to interrupt transmission, and that new treatment strategies are required. This study seeks to answer the question: is it possible to interrupt the transmission of STH, and, if so, what is the most cost-effective treatment strategy and delivery system to achieve this goal? Methods and analysis Two cluster randomised trials are being implemented in contrasting settings in Kenya. The interventions are annual mass anthelmintic treatment delivered to preschool- and school-aged children, as part of a national SBD programme, or to entire communities, delivered by community health workers. Allocation to study group is by cluster, using predefined units used in public health provision—termed community units (CUs). CUs are randomised to one of three groups: receiving either (1) annual SBD; (2) annual community-based deworming (CBD); or (3) biannual CBD. The primary outcome measure is the prevalence of hookworm infection, assessed by four cross-sectional surveys. Secondary outcomes are prevalence of Ascaris lumbricoides and Trichuris trichiura, intensity of species infections and treatment coverage. Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, worm burden and proportion of unfertilised eggs will be assessed longitudinally. A nested process evaluation, using semistructured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system. Ethics and dissemination Study protocols have been reviewed and approved by the ethics committees of the Kenya Medical Research Institute and National Ethics Review Committee, and

  6. Sedative Effect Of Oral Diazepam And Chloral Hydrate In The Dental Treatment Of Children

    OpenAIRE

    2007-01-01

    Purpose : The purpose was to evaluate two sedation protocols during dental sessions in anxious children. Materials and Methods : It was a randomized and double-blind study, with each individual being his/her own control within each protocol. Furthermore, the two protocols were compared. Twenty children (36 to 84 months old) who exhibited "definitely negative" behavior according to the Frankl scale were assigned to receive oral chloral hydrate (40 mg/kg) (Group I) or Diazepamβ (5 mg) (Gr...

  7. Impact of nutrition messages on children's food choice: pilot study.

    Science.gov (United States)

    Bannon, Katie; Schwartz, Marlene B

    2006-03-01

    This pilot study tested the influence of nutrition message framing on snack choice among kindergarteners. Three classrooms were randomly assigned to watch one of the following 60s videos: (a) a gain-framed nutrition message (i.e. the positive benefits of eating apples) (n=14); (b) a loss-framed message (i.e. the negative consequences of not eating apples) (n=18); or (c) a control scene (children playing a game) (n=18). Following this, the children were offered a choice between animal crackers and an apple for their snack. Among the children who saw one of the nutrition message videos, 56% chose apples rather than animal crackers; in the control condition only 33% chose apples. This difference was statistically significant (chi2=7.56, p<0.01). These results suggest that videos containing nutritional messages may have a positive influence on children's short-term food choices.

  8. Functional near-infrared spectroscopy studies in children

    Directory of Open Access Journals (Sweden)

    Nagamitsu Shinichiro

    2012-03-01

    Full Text Available Abstract Psychosomatic and developmental behavioral medicine in pediatrics has been the subject of significant recent attention, with infants, school-age children, and adolescents frequently presenting with psychosomatic, behavioral, and psychiatric symptoms. These may be a consequence of insecurity of attachment, reduced self-confidence, and peer -relationship conflicts during their developmental stages. Developmental cognitive neuroscience has revealed significant associations between specific brain lesions and particular cognitive dysfunctions. Thus, identifying the biological deficits underlying such cognitive dysfunction may provide new insights into therapeutic prospects for the management of those symptoms in children. Recent advances in noninvasive neuroimaging techniques, and especially functional near-infrared spectroscopy (NIRS, have contributed significant findings to the field of developmental cognitive neuroscience in pediatrics. We present here a comprehensive review of functional NIRS studies of children who have developed normally and of children with psychosomatic and behavioral disorders.

  9. Keeping Weight Off: study protocol of an RCT to investigate brain changes associated with mindfulness-based stress reduction

    Science.gov (United States)

    Siegel, Julia A; Allison, Jeroan; Rosal, Milagros C; Brewer, Judson; King, Jean A

    2016-01-01

    Introduction Obesity is a growing epidemic fuelled by unhealthy behaviours and associated with significant comorbidities and financial costs. While behavioural interventions produce clinically meaningful weight loss, weight loss maintenance is challenging. This may partially be due to failure to target stress and emotional reactivity. Mindfulness-based stress reduction (MBSR) reduces stress and emotional reactivity and may be a useful tool for behaviour change maintenance. This study seeks to provide a mechanistic understanding for clinical trials of the benefits of MBSR for weight loss maintenance by examining changes in functional connectivity (FC) and the association of these changes with clinical outcomes. Methods and analysis Community-dwelling individuals (n=80) who intentionally lost ≥5% of their body weight in the past year will be recruited and randomised to an MBSR programme or educational control. FC using resting-state functional MRI will be measured at baseline and 8 weeks. Psychological factors, health behaviours, body mass index and waist circumference will be measured at baseline, 8 weeks and 6 months post intervention. A 12-month telephone follow-up will assess self-reported weight. Analyses will characterise FC changes in response to MBSR in comparison with a control condition, assess the relationship between baseline FC status and pre–post MBSR changes in FC and investigate the association of FC change with changes in psychological factors and weight loss maintenance. Ethics and dissemination The University of Massachusetts Medical School Institutional Review Board has approved this study, Declaration of Helsinki protocols are being followed, and patients will give written informed consent. The Independent Monitoring Committee will monitor protocol adherence. Results from the study will be disseminated to the medical community at conferences and submitted for publication in peer-reviewed journals when the last patient included has been

  10. Randomised controlled trial of thermostatic mixer valves in reducing bath hot tap water temperature in families with young children in social housing: A protocol

    Directory of Open Access Journals (Sweden)

    Phillips Ceri

    2008-03-01

    Full Text Available Abstract Background Each year in the UK 2000 children attend emergency departments and 500 are admitted to hospital following a bath water scald. The long term effects can include disability, disfigurement or psychological harm and repeated skin grafts may be required as the child grows. The costs of treating a severe scald are estimated at 250,000 GBP. Children living in the most deprived wards are at greatest risk of thermal injuries; hospital admission rates are three times that for children living in the least deprived wards. Domestic hot water, which is usually stored at around 60 degrees Celsius, can result in a second-degree burn after 3 seconds and a third-degree burn after 5 seconds. Educational strategies to encourage testing of tap water temperature and reduction of hot water thermostat settings have largely proved unsuccessful. Legislation in the USA mandating pre-setting hot water heater thermostats at 49 degrees Celsius was effective in reducing scald injuries, suggesting passive measures may have a greater impact. Thermostatic mixer valves (TMVs, recently developed for the domestic market, fitted across the hot and cold water supply pipes of the bath, allow delivery of water set at a fixed temperature from the hot bath tap. These valves therefore offer the potential to reduce scald injuries. Design/Methods A pragmatic, randomised controlled trial to assess the effectiveness of TMVs in reducing bath hot tap water temperatures in the homes of families with young children in rented social housing. Two parallel arms include an intervention group and a control group where the intervention will be deferred. The intervention will consist of fitting a TMV (set at 44 degrees Celsius by a qualified plumber and provision of educational materials. The control arm will not receive a TMV or the educational materials for the study duration but will be offered the intervention after collection of follow-up data 12 months post randomisation. The

  11. Pollution effects on asthmatic children in Europe: the PEACE study.

    NARCIS (Netherlands)

    Roemer, W.

    1998-01-01

    This thesis is based upon the 'Pollution Effects on Asthmatic Children in Europe (PEACE)' study. The PEACE study is a multi-centre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 µm (PM 10 ), Black Smoke (BS), SO 2 and NO 2 on re

  12. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

    Directory of Open Access Journals (Sweden)

    Enserink Remko

    2012-10-01

    Full Text Available Abstract Background Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network. The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. Methods/design The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff, medical consumption, absenteeism and circulating enteric pathogens (children are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. Discussion The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (biodatabases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.

  13. Brazilian indigenous children: Review of studies about nutritional status

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    Dixis Figueroa Pedraza

    2014-08-01

    Full Text Available Objective: To systematize studies on the anthropometric nutritional status of Brazilian indigenous children in order to examine the ability to address the totality of biological, anthropological, and ecological aspects, as well as to characterize the main analytical results of the determinants of nutritional status of Brazilian indigenous children. Methods: MedLine and Lilacs were searched using the intersection of "South American Indians" and "nutritional status" descriptors (the search in MedLine also included the descriptor "Brazil". Results: Overall, 65 studies were identified, and 23 were considered relevant to this study. The systematization of these studies highlights the concentration of studies in the midwestern and northern regions of Brazil, as well as the lack of cultural, biochemical, and food consumption approaches. Regarding nutritional status, we found: 1 greater vulnerability of younger children, especially in relation to stunting; 2 absence of differences in nutritional status according to sex; 3 socioeconomic determination of nutritional status; 4 differences in nutritional status between children from different villages. Conclusion: The nutritional status of Brazilian indigenous children is associated with age, socioeconomic status, and ethnic characteristics. Efforts are needed to understand the ethnic and cultural influence on nutritional status and on its causal network, as well as of various factors minimally discussed.

  14. Social facilitation maintenance treatment for adults with obesity: study protocol for a randomised-controlled feasibility study (SFM study)

    Science.gov (United States)

    Hilbert, Anja

    2016-01-01

    Introduction The long-term success of non-surgical weight loss treatment in adults with obesity is limited by substantial relapse, and only a few evidence-based weight loss maintenance treatments exist. This clinical trial investigates the feasibility and efficacy of a social facilitation maintenance programme for weight loss maintenance, tailored to meet the needs of obese adults who have undergone a lifestyle weight loss intervention. Methods and analysis In a single-centre, open feasibility trial, 72 adults currently or previously obese or overweight who have undergone a lifestyle weight loss intervention are centrally randomised to 4 months of social facilitation maintenance treatment or treatment as a usual control condition. In 16 outpatient group sessions, the social facilitation maintenance treatment, based on a socioecological model and on evidence supporting social facilitation as a key process in maintaining weight loss, focuses on promoting interpersonal relationships to build up a healthy lifestyle for long-term weight loss maintenance. Primary outcome is the amount of weight regain at 6-month follow-up, compared with pre-treatment weight, derived from measured body weight. Secondary outcomes address feasibility, including recruitment, attrition, assessment non-completion, compliance and patients' programme evaluation; and in comparison with pre-weight loss maintenance, social and interpersonal functioning, eating behaviour and physical activity, psychological and physical symptoms, body composition and risk of comorbidity, and quality of life at post-treatment and follow-up assessments. Ethics and dissemination The study was approved by the Ethical Committee at the University of Leipzig (165-13-15072013). The study results will be disseminated through peer-reviewed publications. Trial registration number DRKS00005182. PMID:27580827

  15. Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hart Michael B

    2010-10-01

    Full Text Available Abstract Background This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health. Methods and Design Fifty-seven schools (86% of 66 eligible secondary schools in Perth, Australia were recruited to the clustered (by school randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms. Discussion This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide

  16. The EpiDerm test protocol for the upcoming ECVAM validation study on in vitro skin irritation tests--an assessment of the performance of the optimised test.

    Science.gov (United States)

    Kandárová, Helena; Liebsch, Manfred; Gerner, Ingrid; Schmidt, Elisabeth; Genschow, Elke; Traue, Dieter; Spielmann, Horst

    2005-08-01

    During the past decade, several validation studies have been conducted on in vitro methods for discriminating between skin irritating and non-irritating chemicals. The reconstructed human skin models, EpiDerm and EPISKIN, provided the most promising results. Based on experience of the similar performance of the two skin models, it was suggested that a common test protocol and prediction model should be developed for the prediction of skin irritation potential with the two models. When the EPISKIN protocol was applied with the EpiDerm model, an acceptable specificity (80%) was achieved, whereas the sensitivity (60%) was low. In 2003, the EPISKIN protocol was further refined by extending the post-incubation period following exposure to test chemicals. This extension and additional technical improvements to the EpiDerm protocol were evaluated with 19 chemicals from the prevalidation study. With the new test design, high sensitivity (80%) and specificity (78%) were obtained. The statistical probability for correct classifications was high, so the test was considered to be ready for formal validation. However, since test optimisation had been conducted with the same test chemicals as were used in the ECVAM prevalidation study, it was decided that the optimisation of the protocol had to be verified with a new set of chemicals. Thus, in the current study, 26 additional chemicals (10 rabbit irritants and 16 non-irritants), which had previously been selected and tested by LOREAL with EPISKIN, were evaluated in three independent experiments with EpiDerm. With this unbalanced testing set, a specificity of 94%, and a sensitivity of 60% were obtained, while the positive and negative predictivity and accuracy remained almost unchanged (around 80%) in comparison to the in vivo rabbit data. Overall, 45 chemicals (20 irritants and 25 non-irritants) were tested according to the final protocol. The resulting high positive (82%) and negative predictive values (79%) confirmed the

  17. An Examination of the Design, Development, and Implementation of an Internet Protocol Version 6 Network: The ADTRAN Inc. Case Study

    Science.gov (United States)

    Perigo, Levi

    2013-01-01

    In this dissertation, the author examined the capabilities of Internet Protocol version 6 (IPv6) in regard to replacing Internet Protocol version 4 (IPv4) as the internetworking technology for Medium-sized Businesses (MBs) in the Information Systems (IS) field. Transition to IPv6 is inevitable, and, thus, organizations are adopting this protocol…

  18. Evaluation of the implementation of an 'oral hygiene protocol' in nursing homes: a 5-year longitudinal study

    NARCIS (Netherlands)

    Visschere, L. de; Baat, C. de; Schols, J.M.; Deschepper, E.; Vanobbergen, J.

    2011-01-01

    OBJECTIVES: To explore the long-term effects of the implementation of an oral hygiene protocol in nursing homes. METHODS: Out of 14 nursing homes (Flanders) seven nursing homes were randomly allocated to the intervention group and confirmed to implement an 'oral hygiene protocol'. The remaining nurs

  19. Novo protocolo para as ações de saúde bucal coletiva: padronização no armazenamento, distribuição e uso do material de higiene bucal A new protocol for use and storage of tooth-brushing material for school children

    Directory of Open Access Journals (Sweden)

    Fabiano Vieira Vilhena

    2008-12-01

    Full Text Available Este trabalho avaliou o material de higiene bucal usado em escolas para estabelecer um protocolo às ações de higiene bucal coletiva. O estudo foi dividido em duas etapas: 1ª- 20 responsáveis pelos procedimentos coletivos com escolares de Bauru e São José dos Campos - SP responderam a dois questionários sobre o uso de cinco kits de higiene bucal coletiva. A análise estatística foi realizada através do teste Wilcoxon (p The aim of this study was to evaluate the storage and distribution of toothbrushing material for school children. Twenty individuals responsible for the collective oral hygiene of school children from Bauru - SP and São José dos Campos - SP participated in the first stage of the study, answering 2 questionnaires about five different kits for use by school children. The statistical analysis was performed using Wilcoxon (p<0,05. In the second stage, the amount of toothpaste or liquid cleanser applied to the toothbrush by 178 school children aged 4 to 8 years from 2 cities from the state of São Paulo (Bauru e Bariri was weighed using a portable balance. The statistical analysis was obtained by using Pearson's correlation coefficient and analysis of covariance (p <0,05. Kit 5 obtained levels of satisfaction and high satisfaction when compared with the others kits (1 - 4. The school children from Bauru (0,41g used smaller amounts of toothpaste than the school children from Bariri (0,48g. The average of the amount of liquid cleanser applied by the sample was 0,15g. The "drop technique" (liquid cleanser was considered practical for dispensing a small, standardized quantity of the product. Kit 5 was considered a good alternative for establishing a collective oral health protocol in the Brazilian health system.

  20. Extremity fractures in children: a hospital based study in Tehran

    Institute of Scientific and Technical Information of China (English)

    Ali Khaji; Mousa Zargar; Mojgan Karbakhsh

    2010-01-01

    Objective: Although long bone fracture in children is not life-threatening, it may cause major disability, loss of working days and severe psychological distress. We conducted this study to determine the pattern of extremity fracture due to trauma in children.Methods: During one year in six general hospitals in Tehran, trauma patients who were hospitalized for more than 24 hours and sustained injuries within seven days before admission were included in the study. The records of children (≤16 years old) hospitalized in six general hospitals in Tehran due to trauma were reviewed prospectively.Results: During the study period, 1274 children had sustained extremity fractures. Male to female ratio was 3.6/1, with the mean age of (10.3±4.2) years. Falls and traffic crashes were the main causes of injuries, with the percentages of 57.3% and 37.1%, respectively. Simple fall (falling on the ground) consisted 60% of patients that sustained fall-related injuries. Pedestrians and bicycle riders comprised most of the cases that were injured due to traffic crashes. Of our cases, 56.8% sustained fractures in the upper extremities and 43.2% in the lower extremities. Forearm was the most common fracture site (34.1%). Comparing our results in preschool and school-age children, falls were the main cause of injuries in both groups, but fractures of lower extremities were significantly more common in preschool children.Conclusions:Improvement of physical condition of sidewalks and crossings in roads will be necessary for prevention of injuries. More attention to safety of home environment should be paid for control of preschools' injury at home. Education of children and adults is necessary to reduce injuries resulting from road traffic crashes.

  1. Screening Preschool Children for Visual Disorders: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Suman Adhikari, BOptom

    2013-12-01

    Full Text Available Purpose: Ocular and/or vision defects are one of the most common reasons for the referral of young children to the hospital. Vision disorders are the fourth most common disability of children and the leading cause of handicapping conditions in childhood. In preschool-age children, amblyopia and amblyogenic risk factors, such as strabismus and significant refractive errors, are the most prevalent and important visual disorders. The purpose of this pilot study was to determine the prevalence of visual disorders in preschool children in Kathmandu Valley, Nepal.Methods: Four hundred and eighty-four children attending eight preschools in Kathmandu Valley underwent detailed optometric examination. Visual acuity was assessed with either Sheridan Gardiner or Kay Picture chart monocularly. Binocularity was assessed with cover test and prism bar neutralisation. Refraction was carried out in all children. In most instances this was done without the use of a cycloplegic agent. Stereopsis was assessed with the Lang stereo test. Anterior and posterior segment abnormalities were assessed by using a pen light, hand-held slit lamp, and direct ophthalmoscope.Results: Refractive error was the most common visual disorder. Considering our criteria of refractive error for myopia ≥ 0.50 D, hyperopia ≥ 1.50 D, astigmatism ≥ 1.00 D, and anisometropia ≥ 1.00 D, the overall prevalence of refractive error in our study was 31.82%. The overall prevalence of myopia, hyperopia, and astigmatism was 24.17%, 2.48%, and 5.17%, respectively. Anisometropia was present in 1.65% of the participants, and 2%, 1.4%, and 0.2% had strabismus, amblyopia, and nystagmus, respectively.Conclusion: The relatively high prevalence of refractive error in our studied population needs more attention. The results suggest that there is a need for a large-scale community-based preschool screening program in Nepal so that affected children can be identified early and appropriate treatment can be

  2. Efficacy of a children’s procedural preparation and distraction device on healing in acute burn wound care procedures: study protocol for a randomized controlled trial

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    Brown Nadia J

    2012-12-01

    Full Text Available Abstract Background The intense pain and anxiety triggered by burns and their associated wound care procedures are well established in the literature. Non-pharmacological intervention is a critical component of total pain management protocols and is used as an adjunct to pharmacological analgesia. An example is virtual reality, which has been used effectively to dampen pain intensity and unpleasantness. Possible links or causal relationships between pain/anxiety/stress and burn wound healing have previously not been investigated. The purpose of this study is to investigate these relationships, specifically by determining if a newly developed multi-modal procedural preparation and distraction device (Ditto™ used during acute burn wound care procedures will reduce the pain and anxiety of a child and increase the rate of re-epithelialization. Methods/design Children (4 to 12 years with acute burn injuries presenting for their first dressing change will be randomly assigned to either the (1 Control group (standard distraction or (2 Ditto™ intervention group (receiving Ditto™, procedural preparation and Ditto™ distraction. It is intended that a minimum of 29 participants will be recruited for each treatment group. Repeated measures of pain intensity, anxiety, stress and healing will be taken at every dressing change until complete wound re-epithelialization. Further data collection will aid in determining patient satisfaction and cost effectiveness of the Ditto™ intervention, as well as its effect on speed of wound re-epithelialization. Discussion Results of this study will provide data on whether the disease process can be altered by reducing stress, pain and anxiety in the context of acute burn wounds. Trial registration ACTRN12611000913976

  3. Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol

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    Madhu Gupta

    2015-02-01

    Full Text Available Background: A multiple-strategy community intervention, known as National Rural Health Mission (NRHM, launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal and child health inequalities across geographical areas, socioeconomic status groups, and sex of the child. Extensive, in-depth research is necessary to assess the effectiveness of NRHM, on multiple outcome dimensions. This paper presents the design of a new study, able to overcome the shortcomings of previous research. Objective: To propose a comprehensive, methodologically sound protocol to assess the extent of implementation and the effectiveness of NRHM measures to improve maternal and child health outcomes and reduce maternal and child health inequalities. Design: A mixed-methods approach (qu