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Sample records for controlled prospective questionnaire

  1. Asthma control measurement using five different questionnaires: a prospective study.

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    Vermeulen, Francois; de Meulder, Isabelle; Paesmans, Marianne; Muylle, Inge; Bruyneel, Marie; Ninane, Vincent

    2013-09-01

    Questionnaires play a key place in the assessment of asthma control. Different questionnaires have been developed. However, it remains largely unknown whether they can be used interchangeably. We wondered whether the panel of frequently used scores would give similar measurement of asthma control. The present study aimed to assess the agreement between five specific questionnaires. In this prospective study, ninety-nine patients completed five commonly used asthma control scores: the GINA, the Asthma Control Test™, the Royal College of Physician score, the Asthma Therapy Assessment Questionnaire (ATAQ), and the Asthma Control Questionnaire(©) (ACQ). The kappa coefficient was used to assess the agreement between questionnaires. The agreement between the GINA and other scores was only moderate (kappa coefficients amounted from 0.41 to 0.60). With respect to the "controlled" level, all the other scores gave higher results than GINA. All other scores also tended to underestimate GINA "uncontrolled level". For the "partly controlled level" defined by 3 of the 5 questionnaires, ACQ identified the same percentage of patients than GINA while ATAQ overestimated this percentage. This study shows only moderate agreement between five commonly used asthma control scores. The GINA score showed the lowest percentage of controlled and the highest percentage of uncontrolled asthma. As a consequence, all these scores do not seem to evaluate the same symptoms. NCT01350661. © 2013 Elsevier Ltd. All rights reserved.

  2. Coral farming – a questionnaire based prospect for coastal ...

    African Journals Online (AJOL)

    Coral farming – a questionnaire based prospect for coastal inhabitants' ... tourism industry; altogether deteriorating the reefs to the verge of destruction. ... already existing aquaculture, available local community and excellent water conditions.

  3. Development of a Questionnaire To Evaluate Fox Valley Technical College's Marketing Communications with Prospective Student Inquiries.

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    May, Susan A.

    A questionnaire was developed to evaluate the effectiveness of Fox Valley Technical College's (FVTC's) marketing communications with prospective students. The literature on customer service, marketing communications, and institutional image was reviewed, and 17 construct criteria and 7 content criteria were developed as the framework for the…

  4. The Prospective Retrospective Memory Questionnaire: psychometric properties and normative data of a Dutch translation

    NARCIS (Netherlands)

    van der Werf, S.P.; Vos, S.

    2011-01-01

    Ten years ago the Prospective Retrospective Memory Questionnaire (PRMQ) was specifically developed to assess perceived problems concerning both episodic memory and memory for future intentions. Since then, various PRMQ translations have been carried out. These previous studies of this self­report me

  5. The role of questionnaires in the assessment of asthma control.

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    Przybyszowski, Marek; Bochenek, Grażyna

    2015-01-01

    The achievement and the maintenance of asthma control is currently considered the main goal of asthma treatment. Recent guidelines recommend regular assessment of asthma control and indicate questionnaires as important tools that can facilitate its evaluation. Questionnaires relate to GINA or NAEPP guidelines. Questionnaires constitute complex numerical or categorical scales and consist of several to over a dozen questions relating to the patient's symptoms of asthma, limitations in daily activities and usage of rescue medications within a period of time. Each questionnaire is characterized by the features that affect its reliability and usefulness. In the following paper we discuss most of the questionnaires which assess asthma control. We focus on the items they include and present the results of studies that prove the effectiveness of individual questionnaires in assessment of asthma control. Attention was drawn to the patient groups to which the questionnaires are addressed. We list the features of the questionnaire which should be considered before choosing a test, so that it satisfies both the doctor's and the patient's needs. The role of questionnaires as the easy-to-use tools is growing steadily. Unfortunately, not all are available in Polish language. Conducting appropriate validation studies may allow to use many of them in Polish conditions.

  6. Spanish version of the Prospective and Retrospective Memory Questionnaire (PRMQ-S).

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    González-Ramírez, Mónica Teresa; Mendoza-González, María Eugenia

    2011-05-01

    The concept of prospective memory is relatively recent. Thus, it is necessary to have instruments to assess it, in interaction with retrospective memory. The Prospective and Retrospective Memory Questionnaire (PRMQ; Smith et al., 2000) is an instrument that has been effectively used for assessment in several languages. Nevertheless, there is still no Spanish adaptation. The aim of this study was to translate the PRMQ and obtain information about its psychometric properties. A back translation process was applied to the PRMQ. The resulting PRMQ-S was self-administered to 520 subjects after applying the pilot test. Confirmatory factor analysis (CFA) was used to test competing models of its latent structure. Internal consistency was evaluated using Cronbach's alpha. The results showed an adequate internal consistency of the total scale and the Prospective and Retrospective scales were: .89, .84 and .76, respectively. The factor structure was compared with the original study. Our results suggested a disagreement with the tripartite model defended by the authors of the PRMQ. Since there is a high correlation between two factors in the bi-factor model, and the tripartite model showed non-significant loadings to the two specific factors, we recommend that the PRMQ-S be used as one general memory score. We demonstrated adequate psychometric properties of the PRMQ-S if it is used as unique measurement of memory failures. These results are relevant due to the need for a short and accurate instrument in our language that explores memory failures, which has a major impact on the activities of daily living.

  7. Genital heat stress in men of barren couples: a prospective evaluation by means of a questionnaire.

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    Jung, A; Schill, W-B; Schuppe, H-C

    2002-12-01

    Exposure to genital heat stress among men of barren couples was evaluated in a prospective study. Five hundred and forty-two consecutive patients referred for andrological examination were asked to complete a specific questionnaire at their first visit. For 449 patients who answered all questions, the individual score values could be calculated by scoring each answer with points. Patients with 'idiopathic' oligoasthenoteratozoospermia had significantly higher score values when compared with men showing normozoospermia (P cryptozoospermia (P < 0.01) or other pathological semen profiles (P < 0.05). These data support the hypothesis that patients with 'idiopathic' oligoasthenoteratozoospermia are more exposed to genital heat stress than normozoospermic men. Moreover, in patients with a varicocele impairment semen quality was associated with significantly higher score values compared with the subgroup of men with normal semen profiles (P < 0.05). In contrast, the score values did not significantly differ between equivalent subgroups of men with a history of a retractile testis. Our observations indicate that the questionnaire used in the present study allows an integrative assessment of genital heat stress, which is superior to single factor analysis. Notably, the group of men with 'idiopathic' oligoasthenoteratozoospermia showed the highest mean score values for 10 of the 18 questions compared with the other groups. Prolonged sitting in a vehicle represented the only single factor with significantly different score values in patients with 'idiopathic' oligoasthenoteratozoospermia and those with normozoospermia (P < 0.05).

  8. The Asthma Control Questionnaire as a clinical trial endpoint

    DEFF Research Database (Denmark)

    Barnes, P J; Casale, T B; Dahl, Ronald;

    2014-01-01

    The goal of asthma treatment is to control the disease according to guidelines issued by bodies such as the Global Initiative for Asthma. Effective control is dependent upon evaluation of symptoms, initiation of appropriate treatment and minimization of the progressive adverse effects...... of the disease and its therapies. Although individual outcome measures have been shown to correlate with asthma control, composite endpoints are preferred to enable more accurate and robust monitoring of the health of the individual patient. A number of validated instruments are utilized to capture...... these component endpoints; however, there is no consensus on the optimal instrument for use in clinical trials. The Asthma Control Questionnaire (ACQ) has been shown to be a valid, reliable instrument that allows accurate and reproducible assessment of asthma control that compares favourably with other commonly...

  9. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study.

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    Laufenberg-Feldmann, Rita; Kappis, Bernd

    2013-12-01

    Preoperative anxiety and need for information can be detected during preoperative consultation via structured and standardised screening by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. To identify the prevalence of preoperative anxiety and need for information, with regard to influencing factors such as age, sex, previous operation and grade of surgery, and to examine the level of agreement between patients' self-rating and physicians' ratings. Prospective observational study. Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany. Two hundred seventeen patients scheduled for elective surgery. The patients completed questionnaires prior to the interaction with the anaesthesiologist. Physicians were blinded to the patients' ratings and provided their subjective ratings about patients' anxiety and need for information immediately after seeing the patient. Degree of anxiety and need for information, agreement of patients' self-reports and physician's rating. 18.9% of patients were classified as 'anxiety cases' (31.8% in women and 10.6% in men). The grade of the intended surgery but no other investigated factor was related to patients' anxiety. Age (older patients) was correlated with information requirement (r = 0.21, P = 0.002). Analysis of agreement showed only weak correlations between patients' self-reports and physicians' ratings, demonstrated in low weighted Kappa-coefficients (0.12 to 0.32). The APAIS is a useful instrument to assess the level of patients' preoperative anxiety and the need for information. Given the relationship between preoperative anxiety and postoperative outcome, it seems justified to incorporate this approach into the preoperative consultation. German Clinical Trials Register DRKS00003084.

  10. Validity of the international physical activity questionnaire and the Singapore prospective study program physical activity questionnaire in a multiethnic urban Asian population

    Directory of Open Access Journals (Sweden)

    Tai E Shyong

    2011-10-01

    Full Text Available Abstract Background Physical activity patterns of a population remain mostly assessed by the questionnaires. However, few physical activity questionnaires have been validated in Asian populations. We previously utilized a combination of different questionnaires to assess leisure time, transportation, occupational and household physical activity in the Singapore Prospective Study Program (SP2. The International Physical Activity Questionnaire (IPAQ has been developed for a similar purpose. In this study, we compared estimates from these two questionnaires with an objective measure of physical activity in a multi-ethnic Asian population. Methods Physical activity was measured in 152 Chinese, Malay and Asian Indian adults using an accelerometer over five consecutive days, including a weekend. Participants completed both the physical activity questionnaire in SP2 (SP2PAQ and IPAQ long form. 43subjects underwent a second set of measurements on average 6 months later to assess reproducibility of the questionnaires and the accelerometer measurements. Spearman correlations were used to evaluate validity and reproducibility and correlations for validity were corrected for within-person variation of accelerometer measurements. Agreement between the questionnaires and the accelerometer measurements was also evaluated using Bland Altman plots. Results The corrected correlation with accelerometer estimates of energy expenditure from physical activity was better for the SP2PAQ (vigorous activity: r = 0.73; moderate activity: r = 0.27 than for the IPAQ (vigorous activity: r = 0.31; moderate activity: r = 0.15. For moderate activity, the corrected correlation between SP2PAQ and the accelerometer was higher for Chinese (r = 0.38 and Malays (r = 0.57 than for Indians (r = -0.09. Both questionnaires overestimated energy expenditure from physical activity to a greater extent at higher levels of physical activity than at lower levels of physical activity. The

  11. Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire.

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    Currie, Z; Bhan, A; Pepper, I

    2000-10-21

    To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving. Prospective study of patients and postal questionnaire to healthcare professionals. 50 patients with 6/9 vision and 50 with 6/12 vision and 100 general practitioners, 100 optometrists or opticians, and 100 ophthalmologists. Ophthalmology outpatient clinics in Sheffield. Ability to read a number plate at 20.5 m and health professionals' advice about driving on the basis of visual acuity. 26% of patients with 6/9 vision failed the number plate test, and 34% with 6/12 vision passed it. Of the general practitioners advising patients with 6/9 vision, 76% said the patients could drive, 13% said they should not drive, and 11% were unsure. Of the general practitioners advising patients with 6/12 vision, 21% said the patients could drive, 54% said they should not drive, and 25% were unsure. The level of acuity at which optometrists, opticians, and ophthalmologists would advise drivers against driving ranged from 6/9(-2) (ability to read all except two letters on the 6/9 line of the Snellen chart) to less than 6/18. Snellen acuity is a poor predictor of an individual's ability to meet the required visual standard for driving. Patients with 6/9 vision or less should be warned that they may fail to meet this standard, but those with 6/12 vision should not be assumed to be below the standard.

  12. Headache prevalence and characteristics among adolescents in the general population: a comparison between retrospect questionnaire and prospective paper diary data.

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    Larsson, Bo; Fichtel, Asa

    2014-11-27

    In the present school-based study, a convenience sample of 237 adolescents in grade 6-9 and second year in high school (age 12-18 years) was recruited from a city and a smaller town. The aim of the study was to compare information on the prevalence and various characteristics of headaches not related to disease in a retrospect questionnaire and prospective daily recordings of headaches in a standard paper diary during a 3-week period. Besides headache severity, number of headache days, intensity levels and duration of headache episodes were estimated with both assessment methods. Most of the school children suffered from tension-type headaches and a smaller portion of migraine attacks. The overall results showed that school children significantly (p headache intensity in questionnaires as compared to diary recordings, whereas they underestimated frequency (p headaches. While the correlations on headache severity, frequency and duration between retrospect information in questionnaires and prospective diary recordings were low, the agreement varied with levels of headache characteristics. Our findings concur well with results from a few similar community studies on headache complaints in school-aged children. We recommend that prospective recordings in diaries should be systematically used in clinical practice but also in epidemiological surveys to increase the validity and reliability in estimates of point prevalence of headache complaints in children and adolescents.

  13. Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study

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    Runeson Bo

    2007-04-01

    Full Text Available Abstract Background Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Methods Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i and Performance-based self-esteem (PBSE-scale were assessed at first year, Study conditions (HESI, Burnout (OLBI, Depression (MDI at 1st and 3rd years. Diagnostic interviews (MINI were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. Results 98 (77% responded on both occasions, 80 (63% of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27% had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Conclusion Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students

  14. Screening for developmental delay in the setting of a community pediatric clinic: a prospective assessment of parent-report questionnaires.

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    Rydz, David; Srour, Myriam; Oskoui, Maryam; Marget, Nancy; Shiller, Mitchell; Birnbaum, Rena; Majnemer, Annette; Shevell, Michael I

    2006-10-01

    Our goal for this study was to prospectively test whether parent-completed questionnaires can be effectively used in the setting of a busy ambulatory pediatric clinic to accurately screen for developmental impairments. Specific objectives included (1) assessing the feasibility of using parent-report instruments in the setting of a community pediatric clinic, (2) evaluating the accuracy of 2 available screening tests (the Ages and Stages Questionnaire and Child Development Inventory), and (3) ascertaining if the pediatrician's clinical judgment could be used as a potential modifier. Subjects were recruited from the patient population of a community clinic providing primary ambulatory pediatric care. Subjects without previous developmental delay or concerns noted were contacted at the time of their routine 18-month-old visit. Those subjects who agreed to participate were randomly assigned to 1 of 2 groups and completed either the Ages and Stages Questionnaire or Child Development Inventory. The child's pediatrician also completed a brief questionnaire regarding his or her opinion of the child's development. Those children for whom concerns were identified by either questionnaire underwent additional detailed testing by the Battelle Development Inventory, the "gold standard" for the purposes of this study. An equal number of children scoring within the norms of the screening measures also underwent testing with the Battelle Development Inventory. Of the 356 parents contacted, 317 parents (90%) agreed to participate. Most parents correctly completed the Ages and Stages Questionnaire (81%) and the Child Development Inventory (75%). Predictive values were calculated for the Ages and Stages Questionnaire and the Child Development Inventory (sensitivity: 0.67 and 0.50; specificity: 0.39 and 0.86; positive predictive value: 34% and 50%; negative predictive value: 71% and 86%, respectively). Incorporating the physician's opinion regarding the developmental status of the

  15. Multiple sclerosis in the Faroe Islands. 7. Results of a case control questionnaire with multiple controls

    DEFF Research Database (Denmark)

    Kurtzke, J F; Hyllested, K; Arbuckle, J D

    1997-01-01

    Detailed questionnaires were completed in 1978-79 by 23 of the 28 then known resident Faroese multiple sclerosis (MS) patients and 127 controls. These controls were divided into 69 Group A (patient sibs and other relatives), 37 Group B (matched neighbor controls, their spouses and sibs, plus...... patient's spouse), and 21 Group C (distant matched controls, spouses, relatives living where MS patients never resided and British troops were not encamped during the war). No differences between cases and controls were found for education, occupation, types of residence, bathing, sanitary or drinking...

  16. Asthma control questionnaires in the management of asthma in children: A review.

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    Voorend-van Bergen, S; Vaessen-Verberne, A A; de Jongste, J C; Pijnenburg, M W

    2015-02-01

    Several self-administered questionnaires have been developed to assess childhood asthma control in a simple and standardized way. This review discusses the most commonly used questionnaires and explores their usefulness in asthma management in children. We conclude that the use of asthma control questionnaires in daily practice and in research contributes to the standardized evaluation of children with asthma and helps to track asthma symptoms, but validation studies in a wider range of settings are needed. © 2014 Wiley Periodicals, Inc.

  17. Biolarvicides in vector control : challenges and prospects

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    P.K. Mittal

    2003-03-01

    Full Text Available Biolarvicides, based on mosquitocidal toxins of certain strains of Bacillus sphaericus and Bacillusthuringiensis var israelensis H-14 (Bti are highly effective against mosquito larvae at very lowdoses and safe to other non-target organisms. During past two decades various biolarvicide formulationsproduced in India and abroad have been tested at Malaria Research Centre and some formulationshave undergone large-scale operational trials. Biolarvicide formulations of B. sphaericusare useful in the control of Culex and certain Anopheles spp, such as An. stephensi and An. subpictus,but not much effective against An. culicifacies and almost ineffective against Aedes aegypti.Repeated application of B. sphaericus in the same habitat, however, results in the developmentof resistance in larvae of target mosquitoes. In view of its low specificity for An. culicifacies andthe potential for resistance in An. stephensi, B. sphaericus has limited prospects for control of malariavectors. However, with some resistance management, B. sphaericus can still be used againstCulex mosquitoes. On the other hand Bti formulations, which have broader spectrum of activityagainst Aedes, Culex and Anopheles spp, have not shown significant development of resistance inmosquitoes but their activity in field, particularly against surface feeding anopheline larvae is affectedby various bioenvironmental factors, thus requiring weekly application in most habitats. Toovercome this problem development of slow release formulations and genetically engineered biolarvicidesby transplanting mosquitocidal toxin genes of Bti and B. sphaericus in some other environmentallycompatible organisms have been investigated by different scientists.

  18. Prospective evaluation of PBC-specific health-related quality of life questionnaires in patients with primary sclerosing cholangitis.

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    Raszeja-Wyszomirska, Joanna; Wunsch, Ewa; Krawczyk, Marek; Rigopoulou, Eirini I; Bogdanos, Dimitrios; Milkiewicz, Piotr

    2015-06-01

    Primary biliary cirrhosis and Primary sclerosing cholangitis are autoimmune cholestatic liver diseases sharing a lot in common, including a significant impairment of patients' health-related quality of life HRQoL HRQoL in PBC is assessed with disease-specific PBC-40 and PBC-27 questionnaires. A PSC-specific questionnaire has not been developed. Neither PBC-40 nor PBC-27s applicability for PSC has been evaluated. We applied these three questionnaires for HRQoL assessment in a large homogenous cohort of PSC patients. This cross-sectional study enrolled 102 Caucasian PSCs and 53 matched healthy controls and measured HRQoL using generic SF-36, and disease-specific (PBC-40/PBC-27) questionnaires. (i) SF-36. Most SF-36 domains were significantly lower in PSCs than controls. Physical Functioning and Mental Component Summary scores were significantly lower in female patients and correlated negatively with age but not with concurrent inflammatory bowel disease. Cirrhosis was associated with lower Physical Functioning, Role Physical, General Health, Vitality and Physical Component Summary. (ii) PBC-40 and PBC-27. Both tools showed similar HRQoL impairment scoring. Fatigue and Cognitive were impaired in female patients. Several correlations existed between HRQoL and laboratory parameters, including cholestatic tests and Itch. Cirrhosis correlated with Other symptoms and Fatigue PBC-40. (iii) PBC-40 vs PBC-27. Strong correlations among most domains of both questionnaires were seen, as well as between (iv) SF-36 vs PBC-40 or SF-36 vs PBC-27. This is the first study directly comparing PBC-40, PBC-27 and SF-36 in PSC. PSC patients, especially females, show HRQoL impairment. PBC-40 and PBC-27 questionnaires could be of potential use for HRQoL assessment in PSC. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. [Development of knowledge, attitude and practice questionnaire on prevention and control of occupational diseases].

    Science.gov (United States)

    Gao, Yuan; Feng, Yuchao; Wang, Min; Su, Yiwei; Li, Yanhua; Wang, Zhi; Tang, Shihao

    2015-04-01

    To develop the knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups, and to provide a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect. The initial questionnaire which was evaluated by the experts was used to carry out a pre-survey in Guangzhou, China. The survey results were statistically analyzed by t test, identification index method, correlation analysis, and Cronbach's a coefficient method. And then the questionnaire was further modified, and the content of the questionnaire was determined finally. After modification, there were 18 items on knowledge, 16 items on attitude, and 12 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for enterprise managers"; there were 19 items on knowledge, 10 items on attitude, and 11 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for workers". The knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups is developed successfully, and it is a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

  20. Exploratory Factor Analysis of the Anxiety Control Questionnaire among Older Adults

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    Gerolimatos, Lindsay A.; Gould, Christine E.; Edelstein, Barry A.

    2012-01-01

    Among young adults and clinical populations, perceived inability to control internal and external events is associated with anxiety. At present, it is unclear what role perceived anxiety control plays in anxiety among older adults. The Anxiety Control Questionnaire (ACQ) was developed to assess one's perceived ability to cope with anxiety-related…

  1. Vaccinations and malaria prophylaxis for long-term travellers travelling from Greece: a prospective, questionnaire-based analysis.

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    Pavli, Androula; Smeti, Paraskevi; Spilioti, Athina; Silvestros, Chrysovalantis; Katerelos, Panagiotis; Maltezou, Helena C

    2014-01-01

    The purpose of this prospective, questionnaire-based study is to assess pre-travel vaccinations and malaria prophylaxis for long-term travellers who receive pre-travel advice in Greece. A total of 4721 travellers were studied from January 1, 2009 through December 31, 2012. Travellers sought pre-travel advice at a mean of 19.7 days (range: 0-349 days) before departure. Long-term travellers (≥ 1 month) accounted for 2205 (46.7%) of all travellers. Long-term travellers had a mean age of 34.5 years. The majority of them were men (79.8%). In terms of destinations, 84% were visiting malaria-endemic countries and sub-Saharan Africa was the most common destination (17.7%). Most long-term travellers pursued trips for work purposes (70%), visited urban areas (79.6%) and stayed in hotels (29.2%). Yellow fever, typhoid fever, hepatitis A and tetanus/diphtheria vaccines were administered to 1647 (74.7%), 741 (33.6%), 652 (29.5%), and 589 (26.7%) travellers, respectively. Yellow fever vaccine was administered to 339 (87%) and 132 (71%) of long-term travellers to sub-Saharan Africa and South America respectively, whereas typhoid vaccine to 119 (90.8%) and 330 (84.6%) of those travelling to the Indian subcontinent and sub-Saharan Africa respectively. Rabies vaccine was administered to 14 (0.6%) of them. Malaria prophylaxis was recommended to 446 (20%) of long-term travellers. Mefloquine was the most commonly (49%) prescribed agent, and was prescribed to 26.7% of long-term travellers to sub-Sahara Africa. In conclusion, this study revealed that recommendations for vaccine and malaria prophylaxis for long-term travellers to developing countries should be more selective, based on the assessment of all travellers' and travel characteristics, in order to provide adequate pre-travel preparation for this high risk group of travellers. More focused studies are suggested in order to understand the particular needs of long-term travellers. Increasing awareness of travellers and travel

  2. Evaluation of a Modified Italian European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire for Individuals with Celiac Disease.

    Science.gov (United States)

    Mazzeo, Teresa; Roncoroni, Leda; Lombardo, Vincenza; Tomba, Carolina; Elli, Luca; Sieri, Sabina; Grioni, Sara; Bardella, Maria T; Agostoni, Carlo; Doneda, Luisa; Brighenti, Furio; Pellegrini, Nicoletta

    2016-11-01

    To date, it is unclear whether individuals with celiac disease following a gluten-free (GF) diet for several years have adequate intake of all recommended nutrients. Lack of a food frequency questionnaire (FFQ) for individuals with celiac disease could be partly responsible for this still-debated issue. The aim of the study is to evaluate the performance of a modified European Prospective Investigation into Cancer and Nutrition (EPIC) FFQ in estimating nutrient and food intake in a celiac population. In a cross-sectional study, the dietary habits of individuals with celiac disease were reported using a modified Italian EPIC FFQ and were compared to a 7-day weighed food record as a reference method. A total of 200 individuals with histologically confirmed celiac disease were enrolled in the study between October 2012 and August 2014 at the Center for Prevention and Diagnosis of Celiac Disease (Milan, Italy). Nutrient and food category intake were calculated by 7-day weighed food record using an Italian food database integrated with the nutrient composition of 60 GF foods and the modified EPIC FFQ, in which 24 foods were substituted with GF foods comparable for energy and carbohydrate content. An evaluation of the modified FFQ compared to 7-day weighed food record in assessing the reported intake of nutrient and food groups was conducted using Spearman's correlation coefficients and weighted κ. One hundred individuals completed the study. The Spearman's correlation coefficients of FFQ and 7-day weighed food record ranged from .13 to .73 for nutrients and from .23 to .75 for food groups. A moderate agreement, which was defined as a weighted κ value of .40 to .60, was obtained for 30% of the analyzed nutrients, and 40% of the nutrients showed values between .30 and .40. The weighted κ exceeded .40 for 60% of the 15 analyzed food groups. The modified EPIC FFQ demonstrated moderate congruence with a weighed food record in ranking individuals by dietary intakes

  3. Automation of Food Questionnaires in Medical Studies: a state-of-the-art review and future prospects.

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    Falomir, Zoe; Arregui, María; Madueño, Francisco; Corella, Dolores; Coltell, Óscar

    2012-10-01

    Applications for automating the most commonly used dietary surveys in nutritional research, Food Frequency Questionnaires (FFQs) and 24 h Dietary Recalls (24HDRs), are reviewed in this paper. A comprehensive search of electronic databases was carried out and findings were classified by a group of experts in nutrition and computer science into: (i) Computerized Questionnaires and Web-based Questionnaires; (ii) FFQs and 24HDRs and combinations of both; and (iii) interviewer-administered or self-administered questionnaires. A discussion on the classification made and the works reported is included. Finally, works that apply innovative technologies are outlined and the future trends for automating questionnaires in nutrition are identified. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Etiological factors in nasopharyngeal carcinoma: a hospital-based, retrospective, case-control, questionnaire study.

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    Shanmugaratnam, K; Tye, C Y; Goh, E H; Chia, K B

    1978-01-01

    A total of 379 Singapore Chinese patients with NPC were interviewed by use of a questionnaire covering the following items: occupation, level of education, language medium of education, personal and family history of nasal illnesses, types of medicines used, use of Chinese medicines for the nose and throat, use of soya sauce, Chinese tea, cooling drinks and alcohol, cigarette smoking (number and duration), cooking fuels and use of incense (frequency and duration) and of anti-mosquito coils. The same questionnaire was given to two groups of controls: 595 patients with diseases of the ear, nose and throat other than NPC and 1 044 patients with diseases other than cancer or otorhinolaryngeal disease. NPC patients differed significantly from both groups of controls in that they showed stronger associations with personal history of nasal illnesses, family history of nasal illnesses, use of Chinese medicines for the nose and throat and exposure to smoke from anti-mosquito coils.

  5. Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

    Directory of Open Access Journals (Sweden)

    Lawlor Debbie A

    2005-11-01

    Full Text Available Abstract Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP. Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32% responded. Of the 386 in the comparison group 223 (58% responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work

  6. Impact of Length or Relevance of Questionnaires on Attrition in Online Trials: Randomized Controlled Trial

    Science.gov (United States)

    Kalaitzaki, Eleftheria; White, Ian R; Khadjesari, Zarnie; Murray, Elizabeth; Linke, Stuart; Thompson, Simon G; Godfrey, Christine; Wallace, Paul

    2011-01-01

    Background There has been limited study of factors influencing response rates and attrition in online research. Online experiments were nested within the pilot (study 1, n = 3780) and main trial (study 2, n = 2667) phases of an evaluation of a Web-based intervention for hazardous drinkers: the Down Your Drink randomized controlled trial (DYD-RCT). Objectives The objective was to determine whether differences in the length and relevance of questionnaires can impact upon loss to follow-up in online trials. Methods A randomized controlled trial design was used. All participants who consented to enter DYD-RCT and completed the primary outcome questionnaires were randomized to complete one of four secondary outcome questionnaires at baseline and at follow-up. These questionnaires varied in length (additional 23 or 34 versus 10 items) and relevance (alcohol problems versus mental health). The outcome measure was the proportion of participants who completed follow-up at each of two follow-up intervals: study 1 after 1 and 3 months and study 2 after 3 and 12 months. Results At all four follow-up intervals there were no significant effects of additional questionnaire length on follow-up. Randomization to the less relevant questionnaire resulted in significantly lower rates of follow-up in two of the four assessments made (absolute difference of 4%, 95% confidence interval [CI] 0%-8%, in both study 1 after 1 month and in study 2 after 12 months). A post hoc pooled analysis across all four follow-up intervals found this effect of marginal statistical significance (unadjusted difference, 3%, range 1%-5%, P = .01; difference adjusted for prespecified covariates, 3%, range 0%-5%, P = .05). Conclusions Apparently minor differences in study design decisions may have a measurable impact on attrition in trials. Further investigation is warranted of the impact of the relevance of outcome measures on follow-up rates and, more broadly, of the consequences of what we ask participants to

  7. Validity test of the IPD-Work consortium approach for creating comparable job strain groups between Job Content Questionnaire and Demand-Control Questionnaire

    Directory of Open Access Journals (Sweden)

    Bongkyoo Choi

    2015-04-01

    Full Text Available Objectives: This study aims to test the validity of the IPD-Work Consortium approach for creating comparable job strain groups between the Job Content Questionnaire (JCQ and the Demand-Control Questionnaire (DCQ. Material and Methods: A random population sample (N = 682 of all middle-aged Malmö males and females was given a questionnaire with the 14-item JCQ and 11-item DCQ for the job control and job demands. The JCQ job control and job demands scores were calculated in 3 different ways: using the 14-item JCQ standard scale formulas (method 1; dropping 3 job control items and using the 11-item JCQ standard scale formulas with additional scale weights (method 2; and the approach of the IPD Group (method 3, dropping 3 job control items, but using the simple 11-item summation-based scale formulas. The high job strain was defined as a combination of high demands and low control. Results: Between the 2 questionnaires, false negatives for the high job strain were much greater than false positives (37–49% vs. 7–13%. When the method 3 was applied, the sensitivity of the JCQ for the high job strain against the DCQ was lowest (0.51 vs. 0.60–0.63 when the methods 1 and 2 were applied, although the specificity was highest (0.93 vs. 0.87–0.89 when the methods 1 and 2 were applied. The prevalence of the high job strain with the JCQ (the method 3 was applied was considerably lower (4–7% than with the JCQ (the methods 1 and 2 were applied and the DCQ. The number of congruent cases for the high job strain between the 2 questionnaires was smallest when the method 3 was applied. Conclusions: The IPD-Work Consortium approach showed 2 major weaknesses to be used for epidemiological studies on the high job strain and health outcomes as compared to the standard JCQ methods: the greater misclassification of the high job strain and lower prevalence of the high job strain.

  8. Evaluation of asthma control: a questionnaire-based survey in China

    Institute of Scientific and Technical Information of China (English)

    Su Nan; Lin Jiangtao; Chen Ping; Li Jing; Wu Changgui; Yin Kaisheng; Liu Chuntao

    2014-01-01

    Background Little is known about asthma control and perception of asthma among asthmatic patients in China.This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients' perception of asthma and providing a point of reference for future studies.Methods This face-to-face,questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.Results Consistent with the Global Initiative for Asthma (GINA) guidelines,28.7% and 45.0% of our patients achieved control and partial control,respectively.Of the patients in the study,only 21.8% had used a peak flow meter (PFM),and 6.6% of these patients used it daily.Inhaled corticosteroids (ICS) plus a long-acting β2 agonist (LABA) and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients,respectively.Asthma had a significant effect on the patients' life and work.A considerable number of hospitalizations,emergency department visits,and sick days were observed.Conclusion Despite improvements in asthma control and ICS and PFM compliance compared with past literature,the current level of asthma control countrywide continues to fall short of the goals set in the GINA.

  9. Dimensional structure of the demand control support questionnaire: a Brazilian context.

    Science.gov (United States)

    Hökerberg, Yara Hahr Marques; Aguiar, Odaleia Barbosa; Reichenheim, Michael; Faerstein, Eduardo; Valente, Joaquim Gonçalves; Fonseca, Maria de Jesus; Passos, Sonia Regina Lambert

    2010-04-01

    According to Karasek, job strain results from an interaction between high demands and low decision latitude. To reassess the dimensional structure and evaluate the internal consistency of demand control support questionnaire (DCSQ), a shortened version of job content questionnaire that was not sufficiently evaluated in validation studies. The study investigated 825 workers who completed the DCSQ in Rio de Janeiro, Brazil; to 399 workers, the questionnaire was self-administered at a hospital (2004-2005), and 426 workers were interviewed at nine restaurants (2006-2007). Confirmatory factor analysis using structural equation models was used to test theoretical structure of dimensionality. Internal consistency was evaluated by composite reliability and convergent validity by average variance extracted. Confirmatory factor analysis supported the instrument in three dimensions: demands, skill discretion and decision authority. The best fit model was achieved by removing social support at work and the item repetitive work (skill discretion). A cross-loading from learning new things on demands and an error measurement correlation between work fast and work intense were confirmed. Composite reliability was acceptable for all dimensions, except for demands (0.58), which also showed inadequate average variance extracted (0.32). This final model was confirmed in separate analyses according to work setting, but the loadings of demands were lower for restaurant workers. Our results indicated that skill discretion and decision authority formed two distinct dimensions. Additionally, the item repetitive work should be removed, as well as one of the items work fast or work intense (demands). Future research is still required to confirm these findings.

  10. Active prospective control is required for effective sensorimotor learning.

    Directory of Open Access Journals (Sweden)

    Winona Snapp-Childs

    Full Text Available Passive modeling of movements is often used in movement therapy to overcome disabilities caused by stroke or other disorders (e.g. Developmental Coordination Disorder or Cerebral Palsy. Either a therapist or, recently, a specially designed robot moves or guides the limb passively through the movement to be trained. In contrast, action theory has long suggested that effective skill acquisition requires movements to be actively generated. Is this true? In view of the former, we explicitly tested the latter. Previously, a method was developed that allows children with Developmental Coordination Disorder to produce effective movements actively, so as to improve manual performance to match that of typically developing children. In the current study, we tested practice using such active movements as compared to practice using passive movement. The passive movement employed, namely haptic tracking, provided a strong test of the comparison, one that showed that the mere inaction of the muscles is not the problem. Instead, lack of prospective control was. The result was no effective learning with passive movement while active practice with prospective control yielded significant improvements in performance.

  11. Active prospective control is required for effective sensorimotor learning.

    Science.gov (United States)

    Snapp-Childs, Winona; Casserly, Elizabeth; Mon-Williams, Mark; Bingham, Geoffrey P

    2013-01-01

    Passive modeling of movements is often used in movement therapy to overcome disabilities caused by stroke or other disorders (e.g. Developmental Coordination Disorder or Cerebral Palsy). Either a therapist or, recently, a specially designed robot moves or guides the limb passively through the movement to be trained. In contrast, action theory has long suggested that effective skill acquisition requires movements to be actively generated. Is this true? In view of the former, we explicitly tested the latter. Previously, a method was developed that allows children with Developmental Coordination Disorder to produce effective movements actively, so as to improve manual performance to match that of typically developing children. In the current study, we tested practice using such active movements as compared to practice using passive movement. The passive movement employed, namely haptic tracking, provided a strong test of the comparison, one that showed that the mere inaction of the muscles is not the problem. Instead, lack of prospective control was. The result was no effective learning with passive movement while active practice with prospective control yielded significant improvements in performance.

  12. Measuring Effortful Control Using the Children's Behavior Questionnaire-Very Short Form: Modeling Matters.

    Science.gov (United States)

    Backer-Grøndahl, Agathe; Nærde, Ane; Ulleberg, Pål; Janson, Harald

    2016-01-01

    Effortful control (EC) is an important concept in the research on self-regulation in children. We tested 2 alternative factor models of EC as measured by the Children's Behavior Questionnaire-Very Short Form (CBQ-VSF; Putnam & Rothbart, 2006 ) in a large sample of preschoolers (N = 1,007): 1 lower order and 1 hierarchical second-order structure. Additionally, convergent and predictive validity of EC as measured by the CBQ-VSF were investigated. The results supported a hierarchical model. Moderate convergent validity of the second-order latent EC factor was found in that it correlated with compliance and observed EC tasks. Both CBQ-VSF EC measures were also negatively correlated with child physical aggression. The results have implications for the measurement, modeling, and interpretation of EC applying the CBQ.

  13. A prospective questionnaire study in 100 healthy sleepers: non-bothersome forms of recognizable sleep disorders are still present.

    Science.gov (United States)

    Frauscher, Birgit; Mitterling, Thomas; Bode, Aleke; Ehrmann, Laura; Gabelia, David; Biermayr, Marlene; Walters, Arthur Scott; Poewe, Werner; Högl, Birgit

    2014-06-15

    Despite several polysomnographic normative studies and multiple surveys of sleep disorders in the general population, few data have been collected on healthy sleepers. We aimed to survey the characteristics of healthy sleep. We prospectively investigated the sleep history of 100 subjects of a representative population sample who reported undisturbed sleep and in whom relevant sleep disorders were ruled out by a two-step screening procedure. Approximately four subjects had to be contacted for identifying 1 eligible subject who participated. The median reported time in bed was from 23:00 (21:30-02:00) to 07:00 (05:30-11:00). The total sleep duration was 7.3 h (5-10 h), varying from 7.5 h in the age group ≤ 30 years to 7 h in subjects aged 40-60 years and to 8 h in subjects > 60 years (p = 0.002). The median sleep efficiency was high (93.3%, range: 55.6% to 100%). Fifty-one subjects reported occasional snoring. Forty-five subjects reported sporadic non-bothersome sleep-related movement disorders (25 sleep-related leg cramps, 22 lifetime bruxism, 5 restless legs syndrome), and 36 had a history of sporadic non-bothersome parasomnias (27 nightmares, 12 sleepwalking, 1 sleep paralysis). In this population of healthy sleepers, snoring is the most common finding. Moreover, non-bothersome forms of recognizable sleep-related movement disorders and parasomnias are surprisingly common. These findings may suggest that diagnostic criteria of sleep disorders should not only be based on the presence of symptoms but also account for a minimum frequency or discomfort.

  14. The Diabetes Intention, Attitude, and Behavior Questionnaire: evaluation of a brief questionnaire to measure physical activity, dietary control, maintenance of a healthy weight, and psychological antecedents.

    Science.gov (United States)

    Traina, Shana B; Mathias, Susan D; Colwell, Hilary H; Crosby, Ross D; Abraham, Charles

    2016-01-01

    This study assessed measurement properties of the 17-item Diabetes Intention, Attitude, and Behavior Questionnaire (DIAB-Q), which measures intention to engage in self-care behaviors, including following a diabetes diet and engaging in appropriate physical activity. The DIAB-Q includes questions based on the Theory of Planned Behavior. Items were developed using published literature, input from health care professionals, and qualitative research findings in patients with and without type 2 diabetes mellitus (T2DM). In Stage I of the study, 23 adults with T2DM were interviewed to evaluate the content and clarity of the DIAB-Q. In Stage II 1,015 individuals with T2DM completed the DIAB-Q and supplemental questionnaires, including the Short Form-36 acute (SF-36), section III of the Multidimensional Diabetes Questionnaire, the Summary of Diabetes Self-Care Activities questionnaire, and self-administered items relevant to the treatment and management of T2DM (eg, blood pressure and glycated hemoglobin [HbA1c]) at baseline and 3-7 days later. Once the DIAB-Q scale structure was determined, its test-retest reliability, construct validity, and known-groups validity were evaluated, and minimal clinically important change was estimated. In Stage I, the 23 respondents surveyed generally reported that the DIAB-Q was clear and comprehensive and endorsed questions as relevant to their intentions to engage in diabetes-related self-care activities. Most subjects in Stage II were male, Caucasian, and married. Mean age was 63 years. Factor analysis revealed six psychological constructs (Behavior, Planning, Intention, Perceived Behavioral Control, Attitude, and Subjective Norm). Test-retest reliability was acceptable (≥0.70) for all scales, except Perceived Behavioral Control. Construct validity was demonstrated based on correlations with diabetes-specific items/scales and the SF-36. Known-groups validity was confirmed for Behavior, Planning, and Intention when respondents were

  15. The role of perceived control over anxiety in prospective symptom reports across the menstrual cycle.

    Science.gov (United States)

    Mahon, Jennifer N; Rohan, Kelly J; Nillni, Yael I; Zvolensky, Michael J

    2015-04-01

    The present investigation tested the role of psychological vulnerabilities to anxiety in reported menstrual symptom severity. Specifically, the current study tested the incremental validity of perceived control over anxiety-related events in predicting menstrual symptom severity, controlling for the effect of anxiety sensitivity, a documented contributor to menstrual distress. It was expected that women with lower perceived control over anxiety-related events would report greater menstrual symptom severity, particularly in the premenstrual phase. A sample of 49 normally menstruating women, aged 18-47 years, each prospectively tracked their menstrual symptoms for one cycle and completed the Anxiety Control Questionnaire (Rapee, Craske, Brown, & Barlow Behav Ther 27:279-293. doi: 10.1016/S0005-7894(96)80018-9 , 1996) in their follicular and premenstrual phases. A mixed model analysis revealed perceived control over anxiety-related events was a more prominent predictor of menstrual symptom severity than anxiety sensitivity, regardless of the current cycle phase. This finding provides preliminary evidence that perceived control over anxiety-related events is associated with the perceived intensity of menstrual symptoms. This finding highlights the role of psychological vulnerabilities in menstrual distress. Future research should examine whether psychological interventions that target cognitive vulnerabilities to anxiety may help reduce severe menstrual distress.

  16. The Diabetes Intention, Attitude, and Behavior Questionnaire: evaluation of a brief questionnaire to measure physical activity, dietary control, maintenance of a healthy weight, and psychological antecedents

    Directory of Open Access Journals (Sweden)

    Traina SB

    2016-02-01

    -related self-care activities. Most subjects in Stage II were male, Caucasian, and married. Mean age was 63 years. Factor analysis revealed six psychological constructs (Behavior, Planning, Intention, Perceived Behavioral Control, Attitude, and Subjective Norm. Test–retest reliability was acceptable (≥0.70 for all scales, except Perceived Behavioral Control. Construct validity was demonstrated based on correlations with diabetes-specific items/scales and the SF-36. Known-groups validity was confirmed for Behavior, Planning, and Intention when respondents were categorized into groups that differed based on body mass index, disease severity, and HbA1c. Item scores were transformed to a 100-point scale, and minimal clinically important change estimates ranged from 6–11 points, representing the change that would be considered important to a respondent. Conclusion: The DIAB-Q is a brief, psychometrically sound, patient-reported outcome that can be used among individuals with T2DM to evaluate intention to engage in self-care behaviors. Keywords: diabetes, Theory of Planned Behavior, DIAB-Q, attitude, intention, behavior, patient-reported outcome, questionnaire

  17. Patient-Reported Outcomes Following Breast Reconstruction Surgery and Therapeutic Mammoplasty: Prospective Evaluation 1 Year Post-Surgery with BREAST-Q Questionnaire.

    Science.gov (United States)

    Shekhawat, Laxmi; Busheri, Laleh; Dixit, Santosh; Patel, Chaula; Dhar, Upendra; Koppiker, Chaitanyanand

    2015-12-01

    Breast Cancer (BC) treatment leads to mutilation and destruction of breast shape with negative effects on body image and self-esteem.One of the main goals of reconstructive and oncoplastic breast surgery is to satisfy patients and improve their quality of life (QoL).Therefore, it is important to assess the patient experience post-surgery by means of patient-reported outcome measures (PROMs) that focus on the patient's perception of the surgery and surgical care, as well as psychosocial well-being and physical functioning. The objective of the current study was to identify predictors of patient satisfaction such as breast appearance including implant type in a selective sample of women who underwent breast reconstruction surgery using implants. Participants in this prospective study were women, (age 26-75 years) that were newly diagnosed with breast carcinoma. All consecutive patients who underwent breast reconstruction between January 2013 and October 2014 were asked to complete the BREAST-Q questionnaire 1 year after surgery. 120 patients underwent unilateral breast reconstruction using implant. While 38 patients underwent reconstruction with opposite breast reduction symmertization, 27 patients underwent therapeutic mammoplasty. The response rate for BREAST-Q questionnaire completion was 98 % with 147 out of 150 study participants completed the questionnaire. From the data collected from 147 patients, the responses could be distributed into 4 distinct groups based on the reconstruction outcomes namely "very much satisfied" (93 %) or "definitely and mostly satisfied" (94 %) or "satisfied" with the outcome (88 %) or "definitely agree on having reconstruction rather than the alternative of having no breast "(91 %).The results showed significant improvement in all four areas that were evaluated after surgery namely satisfaction with the appearance of the breasts, psychosocial, sexual and physical well-being. While the reconstruction surgery had an overall

  18. Prospective dynamic balance control in healthy children and adults.

    Science.gov (United States)

    Austad, Hanne; van der Meer, Audrey L H

    2007-08-01

    Balance control during gait initiation was studied using center of pressure (CoP) data from force plate measurements. Twenty-four participants were divided into four age groups: (1) 2-3 years, (2) 4-5 years, (3) 7-8 years, and (4) adults. Movement in the antero-posterior (CoPy) direction during the initial step was tau-G analyzed, investigating the hypothesis that tau of the CoPy motion-gap (tau(CoPy)), i.e., the time it will take to close the gap at its current closure rate, is tau-coupled onto an intrinsic tau-G guide (tau(G)), by maintaining the relation tau(CoPy )= Ktau(G), for a constant K. Mean percentage of tau-guidance for all groups was >/=99%, resulting in all r(2) exceeding 0.95, justifying an investigation of the regression slope as an estimate of the coupling constant K in the tau-coupling equation. Mean K values decreased significantly with age and were for 2- to 3-year-olds 0.56, for 4- to 5-year-olds 0.50, for 7- to 8-year-olds 0.47, and for adults 0.41. Therefore, the control of dynamic balance develops from the youngest children colliding with the boundaries of the base of support (K > 0.5) to the older children and adults making touch contact (K prospective balance control, a helpful tool in assessing whether a child is following a normal developmental pattern.

  19. Zika virus: History, emergence, biology, and prospects for control.

    Science.gov (United States)

    Weaver, Scott C; Costa, Federico; Garcia-Blanco, Mariano A; Ko, Albert I; Ribeiro, Guilherme S; Saade, George; Shi, Pei-Yong; Vasilakis, Nikos

    2016-06-01

    Zika virus (ZIKV), a previously obscure flavivirus closely related to dengue, West Nile, Japanese encephalitis and yellow fever viruses, has emerged explosively since 2007 to cause a series of epidemics in Micronesia, the South Pacific, and most recently the Americas. After its putative evolution in sub-Saharan Africa, ZIKV spread in the distant past to Asia and has probably emerged on multiple occasions into urban transmission cycles involving Aedes (Stegomyia) spp. mosquitoes and human amplification hosts, accompanied by a relatively mild dengue-like illness. The unprecedented numbers of people infected during recent outbreaks in the South Pacific and the Americas may have resulted in enough ZIKV infections to notice relatively rare congenital microcephaly and Guillain-Barré syndromes. Another hypothesis is that phenotypic changes in Asian lineage ZIKV strains led to these disease outcomes. Here, we review potential strategies to control the ongoing outbreak through vector-centric approaches as well as the prospects for the development of vaccines and therapeutics.

  20. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study.

    Science.gov (United States)

    Aerts, L; Christiaens, M R; Enzlin, P; Neven, P; Amant, F

    2014-10-01

    Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions. Copyright © 2014. Published by Elsevier Ltd.

  1. COMPARISON OF CBCT PARAMETERS AND SLEEP QUESTIONNAIRES IN SLEEP APNEA PATIENTS AND CONTROLS

    Science.gov (United States)

    Enciso, Reyes; Nguyen, Manuel; Shigeta, Yuko; Ogawa, Takumi; Clark, Glenn T.

    2009-01-01

    Objective To compare the Cone-Beam Computerized Tomography (CBCT) scan measurements between patients with Obstructive Sleep Apnea (OSA) and snorers to develop a prediction model for OSA based on CBCT imaging and the Berlin Questionnaire. Materials and methods 80 subjects (46 OSA patients with Apnea-Hypoapnea Index [AHI]≥ 10 and 34 snorers AHI57 years, male gender, a “high risk” Berlin Questionnaire and narrow upper airway lateral dimension (<17mm) were identified as significant risk factors for OSA. The results of this study indicate that 3-dimensional CBCT airway analysis could be used as a tool to assess the presence and severity of OSA. The presence and severity (as measured by the RDI) of OSA is associated with a narrow lateral dimension of the airway, increasing age, male gender, and the Berlin questionnaire. PMID:20123412

  2. Study designs may influence results: the problems with questionnaire-based case-control studies on the epidemiology of glioma.

    Science.gov (United States)

    Johansen, Christoffer; Schüz, Joachim; Andreasen, Anne-Marie Serena; Dalton, Susanne Oksbjerg

    2017-03-28

    Glioma is a rare brain tumour with a very poor prognosis and the search for modifiable factors is intense. We reviewed the literature concerning risk factors for glioma obtained in case-control designed epidemiological studies in order to discuss the influence of this methodology on the observed results. When reviewing the association between three exposures, medical radiation, exogenous hormone use and allergy, we critically appraised the evidence from both case-control and cohort studies. For medical radiation and hormone replacement therapy (HRT), questionnaire-based case-control studies appeared to show an inverse association, whereas nested case-control and cohort studies showed no association. For allergies, the inverse association was observed irrespective of study design. We recommend that the questionnaire-based case-control design be placed lower in the hierarchy of studies for establishing cause-and-effect for diseases such as glioma. We suggest that a state-of-the-art case-control study should, as a minimum, be accompanied by extensive validation of the exposure assessment methods and the representativeness of the study sample with regard to the exposures of interest. Otherwise, such studies cannot be regarded as 'hypothesis testing' but only 'hypothesis generating'. We consider that this holds true for all questionnaire-based case-control studies on cancer and other chronic diseases, although perhaps not to the same extent for each exposure-outcome combination.

  3. Food acceptance and neophobia in children with phenylketonuria: a prospective controlled study.

    Science.gov (United States)

    Evans, S; Daly, A; Chahal, S; MacDonald, J; MacDonald, A

    2016-08-01

    In phenylketonuria (PKU), little is known about the effect of bitter-tasting phenylalanine-free l-amino acid exposure on taste preference development. The present prospective study aimed to determine the flavour preferences of children with PKU versus healthy control children. Thirty-five children with PKU and 35 age/gender-matched controls, aged 4-13 years, tasted 10 blinded puree foods in random order. They were rated using a seven-point pictorial hedonic scale (super yummy to super yucky) and ranked in preferential order. Caregivers completed a neophobia and food frequency questionnaire on behalf of their children. Both PKU and control groups rated sweet foods higher than savoury, bitter and sour foods. However, control children ranked fruits as a group higher than PKU children (mean 3.7 versus 4.6; P = 0.03), whereas PKU children ranked vegetables as a group higher than controls (mean 5.6 versus 6.3; P = 0.05). Children with PKU had more neophobia and were untrusting/fearful of new foods. Although there was some evidence to suggest that children with PKU aged ≥4 years prefer savoury foods (vegetables) more than control children, they did not prefer bitter-tasting foods, and so early and persistent administration of bitter-tasting l-amino acids was not associated with apparent taste imprinting. Neophobia appears to play significant part in food refusal in PKU, perhaps more so than taste preferences. © 2015 The British Dietetic Association Ltd.

  4. Healthcare professionals' attitudes, knowledge and self-efficacy levels regarding the use of self-hypnosis in childbirth: A prospective questionnaire survey.

    Science.gov (United States)

    McAllister, Sophie; Coxon, Kirstie; Murrells, T; Sandall, J

    2017-04-01

    to examine healthcare professionals' attitudes, knowledge and levels of self-efficacy regarding the use of self-hypnosis in childbirth. a prospective survey. two large maternity units in London, England. healthcare professionals (n=129) involved in the care of childbearing women (anaesthetists, midwives and obstetricians). online questionnaire assessing healthcare professionals' experience, knowledge, attitudes and self-efficacy relating to self-hypnosis in childbirth. attitude, self-efficacy and knowledge. over half of the participants surveyed (56%) reported they had minimal or no knowledge of hypnosis. Higher levels of knowledge were associated with higher levels of self-efficacy (p<0.001) and also with more positive attitudes (p<.001). Midwives reported significantly higher levels of knowledge, more positive attitudes (7.25, 95% CI: 4.60-9.89) and higher levels of self-efficacy (3.48, 95% CI: 1.46-5.51) than doctors. Midwives also reported more exposure to/experience of hypnosis than doctors, and more exposure was significantly associated with higher levels of self-efficacy (midwives p<.001; doctors p=.001). Professionals who would plan to use self-hypnosis in their own or partners' births had significantly higher self-efficacy scores (p<.001). if healthcare professionals are to effectively support women using self-hypnosis in childbirth, they need to be confident in their ability to facilitate this method. Previous research has established that self-efficacy is a strong indicator of performance. Professionals with more knowledge of self-hypnosis are also more confident in supporting women using this technique in childbirth. Multi-disciplinary staff training which aims to increase knowledge, and which includes exposure to hypnosis in labour, may be beneficial in assisting staff to support women choosing to use self-hypnosis in labour. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Performance of the quantitative food frequency questionnaire used in the Brazilian center of the prospective study Natural History of Human Papillomavirus Infection in Men: The HIM Study.

    Science.gov (United States)

    Teixeira, Juliana Araujo; Baggio, Maria Luiza; Giuliano, Anna R; Fisberg, Regina Mara; Marchioni, Dirce Maria Lobo

    2011-07-01

    The Natural History of Human Papillomavirus (HPV) Infection in Men: The HIM Study is a prospective multicenter cohort study that, among other factors, analyzes participants' diet. A parallel cross-sectional study was designed to evaluate the validity and reproducibility of the quantitative food frequency questionnaire (QFFQ) used in the Brazilian center from the HIM Study. For this, a convenience subsample of 98 men aged 18 to 70 years from the HIM Study in Brazil answered three 54-item QFFQ and three 24-hour recall interviews, with 6-month intervals between them (data collection January to September 2007). A Bland-Altman analysis indicated that the difference between instruments was dependent on the magnitude of the intake for energy and most nutrients included in the validity analysis, with the exception of carbohydrates, fiber, polyunsaturated fat, vitamin C, and vitamin E. The correlation between the QFFQ and the 24-hour recall for the deattenuated and energy-adjusted data ranged from 0.05 (total fat) to 0.57 (calcium). For the energy and nutrients consumption included in the validity analysis, 33.5% of participants on average were correctly classified into quartiles, and the average value of 0.26 for weighted kappa shows a reasonable agreement. The intraclass correlation coefficients for all nutrients were greater than 0.40 in the reproducibility analysis. The QFFQ demonstrated good reproducibility and acceptable validity. The results support the use of this instrument in the HIM Study. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  6. Internalizing versus Externalizing Control: Different Ways to Perform a Time-Based Prospective Memory Task

    Science.gov (United States)

    Huang, Tracy; Loft, Shayne; Humphreys, Michael S.

    2014-01-01

    "Time-based prospective memory" (PM) refers to performing intended actions at a future time. Participants with time-based PM tasks can be slower to perform ongoing tasks (costs) than participants without PM tasks because internal control is required to maintain the PM intention or to make prospective-timing estimates. However, external…

  7. Internalizing versus Externalizing Control: Different Ways to Perform a Time-Based Prospective Memory Task

    Science.gov (United States)

    Huang, Tracy; Loft, Shayne; Humphreys, Michael S.

    2014-01-01

    "Time-based prospective memory" (PM) refers to performing intended actions at a future time. Participants with time-based PM tasks can be slower to perform ongoing tasks (costs) than participants without PM tasks because internal control is required to maintain the PM intention or to make prospective-timing estimates. However, external…

  8. Hepatic Dysfunction in Asphyxiated Neonates: Prospective Case-Controlled Study

    Directory of Open Access Journals (Sweden)

    Mukesh Choudhary

    2015-01-01

    Full Text Available Objective This study was performed to determine the occurrence of hypoxic hepatitis in full-term neonates after perinatal asphyxia and to correlate between the rise in enzymes and severity of asphyxia with Apgar score and hypoxic ischemic encephalopathy (HIE grading of the neonates. Method and Material This prospective case-controlled study was conducted in a tertiary-level hospital in India for a period of 12 months. The study group A comprised 70 newborns suffering from birth asphyxia, while 30 healthy neonates were included in group B (control. All biochemical parameters of liver function, ie, serum alanine transferase (ALT, aspartate transferase (AST, alkaline phosphatase (ALP, lactate dehydrogenase (LDH, total protein, serum albumin, bilirubin (total and direct, and international normalized ratio (INR, were measured on postnatal days 1, 3, and 10 in both study and control groups. Results In group A, 22.8% newborns had severe (Apgar score 0–3, 47.1% had moderate (Apgar score 4–5, and 30% had mild (Apgar score 6–7 birth asphyxia at five minutes. In all, 14.28% babies were in HIE stage I, 25.73% babies were in HIE stage II, and 11.42% babies were in HIE stage III. The rest of the newborns, 48.57%, were normal. The prevalence of liver function impairment was seen in 42.85% of asphyxiated neonates. On day 1, ALT, AST, ALP, LDH, PT, and INR were significantly higher, and total protein and serum albumin were significantly lower in group A than in group B. However, ALT and AST correlated well with increasing severity of HIE score. On day 3, there was a rising trend observed in the concentration of mean LDH as HIE staging of neonates progressed from stage 0 to stage III, and among various HIE stages, the difference in LDH was statistically significant. Conclusion We concluded that AST, ALT at 24 hours, and LDH at 72 hours of animation can be a utilitarian diagnostic tool to differentiate asphyxiated neonates from non-asphyxiated neonates and

  9. Social Exclusion Index-for Health Surveys (SEI-HS): a prospective nationwide study to extend and validate a multidimensional social exclusion questionnaire.

    Science.gov (United States)

    van Bergen, Addi P L; Hoff, Stella J M; Schreurs, Hanneke; van Loon, Annelies; van Hemert, Albert M

    2017-03-14

    Social exclusion (SE) refers to the inability of certain groups or individuals to fully participate in society. SE is associated with socioeconomic inequalities in health, and its measurement in routine public health monitoring is considered key to designing effective health policies. In an earlier retrospective analysis we demonstrated that in all four major Dutch cities, SE could largely be measured with existing local public health monitoring data. The current prospective study is aimed at constructing and validating an extended national measure for SE that optimally employs available items. In 2012, a stratified general population sample of 258,928 Dutch adults completed a version of the Netherlands Public Health Monitor (PHM) questionnaire in which 9 items were added covering aspects of SE that were found to be missing in our previous research. Items were derived from the SCP social exclusion index, a well-constructed 15-item instrument developed by the Netherlands Institute for Social Research (SCP). The dataset was randomly divided into a development sample (N =129,464) and a validation sample (N = 129,464). Canonical correlation analysis was conducted in the development sample. The psychometric properties were studied and compared with those of the original SCP index. All analyses were then replicated in the validation sample. The analysis yielded a four dimensional index, the Social Exclusion Index for Health Surveys (SEI-HS), containing 8 SCP items and 9 PHM items. The four dimensions: "lack of social participation", "material deprivation", "lack of normative integration" and "inadequate access to basic social rights", were each measured with 3 to 6 items. The SEI-HS showed adequate internal consistency for both the general index and for two of four dimension scales. The internal structure and construct validity of the SEI-HS were satisfactory and similar to the original SCP index. Replication of the SEI-HS in the validation sample confirmed its

  10. Quality of life of children with cystic periventricular leukomalacia – a prospective analysis with the Child Health Questionnaire-Parent Form 50

    Directory of Open Access Journals (Sweden)

    Bernhard eResch

    2016-05-01

    Full Text Available Objective: Cystic periventricular leukomalacia (PVL is associated with moderate to severe physical and mental handicaps in preterm infants. We hypothesized whether or not those handicaps were associated with a poorer quality of life (QOL of affected children and their families compared to matched controls.Patients and Methods: All children with the diagnosis PVL collected from a local database of the Division of Neonatology of the Medical University of Graz, Austria, and born between 1997 and 2008 were included in the study group. Preterm infants matched for gestational age, birth weight, year of birth, and gender without PVL served as controls. Selected perinatal data and neurological outcome were documented. The interview of the parents was conducted using the Child-Health-Questionnaire – Parent Form 50 (CHQ-PF50, German version. The CHQ-PF50 consists of 50 items divided over 11 multi-item scales and 2 single-item questions.Results: The CHQ-PF50 was answered by 21 parents of the study (26% and 44 of the control (39% group. Cases were diagnosed as having developmental delay, dystonia, strabismus, central visual impairment, seizures, and cerebral palsy (81 vs. 7%, p<0.001 more common than controls. Analysis of the CHQ-PF 50 revealed significantly poorer results for cases regarding physical health (physical functioning: p<0.001, physical social limitations: p<0.001, physical summary score: p<0.001. Several psychosocial categories (behavior, mental health, self-esteem and the psychosocial summary score did not differ between groups. Only two categories (parental impact concerning time p=0,004, and family activities: p=0.026 revealed significantly poorer results in the cases as it was for the global category for health (p=0.009.Conclusion: Children with PVL had an overall poorer QOL regarding physical aspects. However, PVL was not generally associated with a poorer QOL regarding psychosocial aspects.

  11. Reproducibility and Validity of Dietary Patterns Assessed by a Food Frequency Questionnaire Used in the 5-Year Follow-Up Survey of the Japan Public Health Center-Based Prospective Study

    OpenAIRE

    Nanri, Akiko; Shimazu, Taichi; Ishihara, Junko; Takachi, Ribeka; Mizoue, Tetsuya; Inoue, Manami; Tsugane, Shoichiro

    2012-01-01

    Background Analysis of dietary pattern is increasingly popular in nutritional epidemiology. However, few studies have examined the validity and reproducibility of dietary patterns. We assessed the reproducibility and validity of dietary patterns identified by a food frequency questionnaire (FFQ) used in the 5-year follow-up survey of the Japan Public Health Center-Based Prospective Study (JPHC Study). Methods The participants were a subsample (244 men and 254 women) from the JPHC Study. Princ...

  12. Preanesthesia Questionnaire

    Science.gov (United States)

    ... Brochures and Resources Videos AANA / Patients Pre-Anesthesia Questionnaire Page Content The information you supply below assists ... complementary or alternative medicines)______________________________________________________ _______________________________________________________________ Prior Operations ... Pre-Anesthesia Questionnaire Please answer the following questions. These responses will ...

  13. Disease control and treatment modalities have impact on quality of life in acromegaly evaluated by Acromegaly Quality of Life (AcroQoL) Questionnaire.

    Science.gov (United States)

    Vandeva, Silvia; Yaneva, Maria; Natchev, Emil; Elenkova, Atanaska; Kalinov, Krasimir; Zacharieva, Sabina

    2015-08-01

    Various factors influence quality of life (QoL) in acromegaly. Whether disease control and treatment approach are related to QoL is still a matter of debate. The aim of the present study was to evaluate QoL in patients with acromegaly using the disease-specific Acromegaly Quality of Life Questionnaire in respect to disease activity, treatment modalities, and other factors. We studied 212 patients with acromegaly in a cross-sectional manner over a 6-year period in a single tertiary center. As a second step, seventy of the patients who were with active disease at baseline were followed up prospectively and 45 of them were in remission at re-evaluation. In regard to the cross-sectional group, active acromegaly independently predicted worse appearance scores. Prior radiotherapy and older age were independent negative predictors of all scales. Female gender negatively predicted all scales except the appearance domain. Longer duration of remission predicted worse personal relations scores in biochemically controlled patients. The use of somatostatin analog (SSA) was associated with worse personal relations scores, while higher IGF-1 index predicted worse appearance scores in patients with active acromegaly. In the prospective group, achievement of remission independently predicted improvement of the total scale. Lower corresponding baseline scores predicted improvement of the total, physical, and appearance scales, while the absence of hypopituitarism independently predicted improvement of the appearance scale. The use of SSA was associated with improvement of the total and appearance scores. In conclusion, QoL is a multifactorial issue that needs an individualized approach for detection and management.

  14. Dietary Screener Questionnaire in the National Health Interview Survey Cancer Control Supplement 2010: Overview

    Science.gov (United States)

    The National Health Interview Survey (NHIS) Cancer Control Supplement (CCS) is administered every five years and focuses on knowledge, attitudes, and practices in cancer-related health behaviors, screening, and risk assessment.

  15. Manual versus target-controlled infusion of balanced propofol during diagnostic colonoscopy: A prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Vučićević Vera

    2016-01-01

    Full Text Available Introduction. There is an increasing interest in balanced propofol sedation (BPS for colonoscopy in outpatient settings. Propofol is a potent anesthetic agent for this purpose and has a narrow therapeutic range, which increases a risk of cardiovascular and respiratory complications in case of improper administration. Objective. The aim of this study was to compare patients’ safety and comfort of endoscopists in two methods of BPS targeting deep sedation - propofol target-controlled infusion (TCI and manual intravenous titration technique (MT - during colonoscopy. Methods. This prospective randomized controlled trial included 90 patients (class I or II of the American Society of Anesthesiologists deeply sedated with propofol, coadministered with small doses of midazolam and fentanyl. Propofol was given by MT technique (45 patients or by TCI (45 patients. The following adverse effects were recorded: hypotension, hypertension, bradycardia, tachycardia, hypoxemia, bradypnea, apnea, hiccupping, and coughing, as well as endoscopist’s comfort during colonoscopy by means of a questionnaire. Results. The MT group compared to the TCI group had a lower mean arterial pressure in the 10th minute after the beginning (p = 0.017, and at the end of colonoscopy (p = 0.006, higher oxygen saturation in the fifth minute (p = 0.033, and in the 15th minute (p = 0.008 after the beginning of colonoscopy, and lower heart rate at the beginning of the procedure (p = 0.001. There were no statistically significant differences in adverse events. Endoscopist’s comfort during colonoscopy was high 95.6% in the TCI group vs. 88.9% in the MT group (p = 0.069. Conclusion. MT is clinically as stable as TCI of propofol for deep sedation during colonoscopy, and endoscopists experienced the same comfort during colonoscopy in both groups. Thus, both combinations are suitable for deep sedation during diagnostic colonoscopy.

  16. Essence and Prospect of International Export Control Regimes

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ International export control regimes are referring to the regimes and systems concerning limitation of export and transference of military-use and dual-use items and related parts as well as technologies. In the past couple of years, the control regimes have shown a strengthening posture. In addition, a new global export control regime is brewing. Hence export control has caught the attention of the international community, and particularly of the circles of armament control and commerce. The author would like to make some analyses of the posture and then try to predict the trend of international export control regimes.

  17. Hypnosis and dental anesthesia in children: a prospective controlled study.

    Science.gov (United States)

    Huet, Adeline; Lucas-Polomeni, Marie-Madeleine; Robert, Jean-Claude; Sixou, Jean-Louis; Wodey, Eric

    2011-01-01

    The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

  18. Automaticity and control in prospective memory: a computational model.

    Directory of Open Access Journals (Sweden)

    Sam J Gilbert

    Full Text Available Prospective memory (PM refers to our ability to realize delayed intentions. In event-based PM paradigms, participants must act on an intention when they detect the occurrence of a pre-established cue. Some theorists propose that in such paradigms PM responding can only occur when participants deliberately initiate processes for monitoring their environment for appropriate cues. Others propose that perceptual processing of PM cues can directly trigger PM responding in the absence of strategic monitoring, at least under some circumstances. In order to address this debate, we present a computational model implementing the latter account, using a parallel distributed processing (interactive activation framework. In this model PM responses can be triggered directly as a result of spreading activation from units representing perceptual inputs. PM responding can also be promoted by top-down monitoring for PM targets. The model fits a wide variety of empirical findings from PM paradigms, including the effect of maintaining PM intentions on ongoing response time and the intention superiority effect. The model also makes novel predictions concerning the effect of stimulus degradation on PM performance, the shape of response time distributions on ongoing and prospective memory trials, and the effects of instructing participants to make PM responses instead of ongoing responses or alongside them. These predictions were confirmed in two empirical experiments. We therefore suggest that PM should be considered to result from the interplay between bottom-up triggering of PM responses by perceptual input, and top-down monitoring for appropriate cues. We also show how the model can be extended to simulate encoding new intentions and subsequently deactivating them, and consider links between the model's performance and results from neuroimaging.

  19. Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study.

    Science.gov (United States)

    Calvo, Naiara; Ramos, Pablo; Montserrat, Silvia; Guasch, Eduard; Coll-Vinent, Blanca; Domenech, Mònica; Bisbal, Felipe; Hevia, Sara; Vidorreta, Silvia; Borras, Roger; Falces, Carles; Embid, Cristina; Montserrat, Josep Maria; Berruezo, Antonio; Coca, Antonio; Sitges, Marta; Brugada, Josep; Mont, Lluís

    2016-01-01

    The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF. Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11

  20. Hypersomnia in children affected by migraine without aura: a questionnaire-based case-control study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-02-01

    Full Text Available Maria Esposito,1 Michele Roccella,2 Lucia Parisi,2 Beatrice Gallai,3 Marco Carotenuto11Center for Childhood Headache, Unit of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical, and Preventive Medicine, Second University of Naples, Naples, Italy; 2Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 3Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, ItalyBackground: The relationship between sleep and headache is meaningful and complex. Children affected by migraines tend to show many sleep disorders, such as insufficient sleep duration and excessive daytime somnolence. Therefore, the aim of this study is to assess the rate of reported sleep habits and self-reported sleepiness in a large pediatric sample of individuals affected by migraine without aura (MoA.Methods: The study population consisted of 271 children aged between 6 and 13 years affected by MoA. The control group was composed of 305 typically developing children. To assess the sleep habits of all individuals (MoA and control, parents filled out the Sleep Disturbance Scale for Children, and to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale.Results: The two study groups were matched for age (P = 0.124, sex distribution (P = 0.775, and body mass index z-score (P = 0.107. Parents of children affected by MoA reported a higher total score of sleep disorder symptoms (P < 0.001, disorders of initiating and maintaining (P < 0.001, and disorders of arousal (P < 0.001 than did parents of controls. No significant differences were found in disorders of excessive somnolence. Conversely, in the Pediatric Daytime Sleepiness Scale, migraine children had higher scores (24.67 ± 3.19 vs 11.94 ± 4.81; P < 0.001 and a reduction in referred total sleep time mean duration (469.83 ± 98.112 vs 527.94 ± 83.02; P < 0.001 than typically

  1. LEGAL SUPPORT FOR PUBLIC CONTROL: PROBLEMS AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    Savchenko M. S.

    2015-06-01

    Full Text Available In the article we reveal the basic problems of forming the legal basis of public control over the activities of public authorities. The relevance of this topic has been steadily increasing due to the increasing influence of civil society on the decisions made by public authorities. The authors analyze the provisions of the Federal Law "On the basis of public control in the Russian Federation", the regional laws, to fix the foundations of social control in some subjects of the federation, as well as other legal acts in this area. Special attention is paid to the formulation of the concept of social control and the conclusion of the need legislative consolidation of the concept of "individual public authority 'and a common list of agencies and organizations that operate them. Analyzing the law enshrined in the range of subjects of public control, the authors substantiate the feasibility of incorporating the Advisory Board at the government and public experts. On the basis of the provisions of the law, in this work we have determined the legal status of the subjects of social control, their powers and procedures of the in collaboration with the authorities, as well as the legal framework for the implementation of certain forms of social control. It is proposed to expand the interaction of subjects of public control with prosecutors by holding regular meetings to expand the powers of public monitoring commissions for visiting places of detention

  2. Development of visual motion perception for prospective control: Brain and behavioural studies in infants

    Directory of Open Access Journals (Sweden)

    Seth B. Agyei

    2016-02-01

    Full Text Available During infancy, smart perceptual mechanisms develop allowing infants to judge time-space motion dynamics more efficiently with age and locomotor experience. This emerging capacity may be vital to enable preparedness for upcoming events and to be able to navigate in a changing environment. Little is known about brain changes that support the development of prospective control and about processes, such as preterm birth, that may compromise it. As a function of perception of visual motion, this paper will describe behavioural and brain studies with young infants investigating the development of visual perception for prospective control. By means of the three visual motion paradigms of occlusion, looming, and optic flow, our research shows the importance of including behavioural data when studying the neural correlates of prospective control.

  3. Using the Training Reactions Questionnaire to Analyze the Reactions of University Students Undergoing Career-Related Training in Jordan: A Prospective Human Resource Development Approach

    Science.gov (United States)

    Khasawneh, Samer; Al-Zawahreh, Abdelghafour

    2015-01-01

    The primary purpose of the present study was to validate Morgan and Casper's training reactions questionnaire (TRQ) for use in Jordan. The study also investigated the reactions of university students to career-related training programs. Another purpose of the study was to determine the impact of certain aspects of training programs on the…

  4. Using the Training Reactions Questionnaire to Analyze the Reactions of University Students Undergoing Career-Related Training in Jordan: A Prospective Human Resource Development Approach

    Science.gov (United States)

    Khasawneh, Samer; Al-Zawahreh, Abdelghafour

    2015-01-01

    The primary purpose of the present study was to validate Morgan and Casper's training reactions questionnaire (TRQ) for use in Jordan. The study also investigated the reactions of university students to career-related training programs. Another purpose of the study was to determine the impact of certain aspects of training programs on the overall…

  5. Resilient controls for ordering uncertain prospects change and response

    CERN Document Server

    Pham, Khanh D

    2014-01-01

    Providing readers with a detailed examination of resilient controls in risk-averse decision, this monograph is aimed toward researchers and graduate students in applied mathematics and electrical engineering with a systems-theoretic concentration. This work contains a timely and responsive evaluation of reforms on the use of asymmetry or skewness pertaining to the restrictive family of quadratic costs that have been appeared in various scholarly forums.  Additionally, the book includes a discussion of the current and ongoing efforts in the usage of risk, dynamic game decision optimization and disturbance mitigation techniques with output feedback measurements tailored toward the worst-case scenarios. This work encompasses some of the current changes across uncertainty quantification, stochastic control communities, and the creative efforts that are being made to increase the understanding of resilient controls. Specific considerations are made in this book for the application of decision theory to resilient ...

  6. Symbolics in control design: prospects and research issues

    DEFF Research Database (Denmark)

    Christensen, Anders

    1994-01-01

    The symbolic processor is targeted as a novel basic service in computer aided control system design. Basic symbolic tools are exemplified. A design process model is formulated for control design, with subsets manipulator, tools, target and goals. It is argued, that symbolic processing will give...... substantial contributions to future design environments, as it provides flexibility of representation not possible with traditional numerics. Based on the design process, views on research issues in the incorporation of symbolic processing into traditional numerical design environments are given...

  7. Prospects for advancing tuberculosis control efforts through novel therapies

    NARCIS (Netherlands)

    J.A. Salomon; J.O. Lloyd-Smith; W.M. Getz; S. Resch; M.S. Sanchez; T.C. Porco; M.W. Borgdorff

    2006-01-01

    Background Development of new, effective, and affordable tuberculosis ( TB) therapies has been identified as a critical priority for global TB control. As new candidates emerge from the global TB drug pipeline, the potential impacts of novel, shorter regimens on TB incidence and mortality have not y

  8. Myocardial function at the early phase of traumatic brain injury: a prospective controlled study

    OpenAIRE

    Cuisinier, Adrien; Maufrais, Claire; Payen, Jean-François; Nottin, Stephane; Walther, Guillaume; Bouzat, Pierre

    2016-01-01

    Background The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies. Methods We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoin...

  9. Contemporary models and prospects of control of parasitic diseases

    Directory of Open Access Journals (Sweden)

    Petričević Saša M.

    2007-01-01

    Full Text Available Economic, social and expert-scientific factors determine activities in connection with the development of the control of parasitic infections in the upcoming period of the 21st century. The primary research activities are directed at studies of the physiological functions of parasites and the ecological relations between the parasite and the host, and all that is undertaken with the objective of securing adequate pharmacotherapy/pharmacoprophylaxis and immunoprophilaxis. As there is a huge expansion in the synthesis of chemical compounds, there is a great number of potential substances for use in the form of a medicine. Along these lines, activities concerning the development of new antiparasitics and/or modification of existing ones are primarily based on securing a quality target spot for its action. Another possibility in the area of research is connected to the problem of resistance of parasites and intensive studies of the biochemical-physiological characteristics of parasites, as well as the development of an active epidemiological-episootiological network for monitoring resistance. In parallel with the development of medicines, the results of investigations of physiological functions of parasites and their mutual relations with their host, are intensely used for the development of immunological control, and the development of vaccines (for example, the development of vaccines for the control of coccidiosis, babesiosis, echinococcosis. The second important approach is related to studies of parasitic zoonoses, the effect of global warming on the epidemiological-episootiological characteristics of parasitic diseases and the selection of resistant animal breeds/hybrids. Animal welfare is also of importance, the perfecting of reliable, rapid and less-costly methods for diagnosing parasitic diseases and the development of in vitro methods for the examination of resistance to antiparasitics.

  10. Air Pollution Control Policies in China: A Retrospective and Prospects

    Science.gov (United States)

    Jin, Yana; Andersson, Henrik; Zhang, Shiqiu

    2016-01-01

    With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) During 2006–2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO2) emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5) and ground level ozone (O3) emerged and worsened; (3) After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions. PMID:27941665

  11. Air Pollution Control Policies in China: A Retrospective and Prospects

    Directory of Open Access Journals (Sweden)

    Yana Jin

    2016-12-01

    Full Text Available With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1 The early policies, until 2005, were ineffective at reducing emissions; (2 During 2006–2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO2 emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5 and ground level ozone (O3 emerged and worsened; (3 After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions.

  12. Prospects for chaos control of machine tool chatter

    Energy Technology Data Exchange (ETDEWEB)

    Hively, L.M.; Protopopescu, V.A.; Clapp, N.E.; Daw, C.S.

    1998-06-01

    The authors analyze the nonlinear tool-part dynamics during turning of stainless steel in the nonchatter and chatter regimes, toward the ultimate objective of chatter control. Their previous work analyzed tool acceleration in three dimensions at four spindle speeds. In the present work, the authors analyze the machining power and obtain nonlinear measures of this power. They also calculate the cycle-to-cycle energy for the turning process. Return maps for power cycle times do not reveal fixed points or (un)stable manifolds. Energy return maps do display stable and unstable directions (manifolds) to and from an unstable period-1 orbit, which is the dominant periodicity. Both nonchatter and chatter dynamics have the unusual feature of arriving at the unstable period-1 fixed point and departing from that fixed point of the energy return map in a single step. This unusual feature makes chaos maintenance, based on the well-known Ott-Grebogi-Yorke scheme, a very difficult option for chatter suppression. Alternative control schemes, such as synchronization of the tool-part motion to prerecorded nonchatter dynamics or dynamically damping the period-1 motion, are briefly discussed.

  13. Air Pollution Control Policies in China: A Retrospective and Prospects.

    Science.gov (United States)

    Jin, Yana; Andersson, Henrik; Zhang, Shiqiu

    2016-12-09

    With China's significant role on pollution emissions and related health damage, deep and up-to-date understanding of China's air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) During 2006-2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO₂) emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5) and ground level ozone (O₃) emerged and worsened; (3) After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions.

  14. Prospects and Challenges towards Sustainable Liver Fluke Control.

    Science.gov (United States)

    Sripa, Banchob; Echaubard, Pierre

    2017-10-01

    The liver fluke Opisthorchis viverrini (Ov) is endemic in Southeast Asia where more than 10 million people are estimated to be infected. The infection is associated with several hepatobiliary diseases, including cholangiocarcinoma (CCA). Northeast Thailand is a hotspot for Ov transmission, and, despite extensive public health prevention campaigns led by the government, the prevalence of Ov infection is still high. High infection rates result from cultural and ecological complexities where wet-rice agrarian habitats, centuries-old raw-food culture, and the parasite's complex biology combine to create an ideal transmission arena. Here we review the state of our knowledge regarding the social-ecological determinants underlying Ov transmission. We also describe an integrative research rationale for liver fluke control better aligned with sustainable health development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Increasing response rates to follow-up questionnaires in health intervention research: Randomized controlled trial of a gift card prize incentive.

    Science.gov (United States)

    Morgan, Amy J; Rapee, Ronald M; Bayer, Jordana K

    2017-08-01

    Background/aims Achieving a high response rate to follow-up questionnaires in randomized controlled trials of interventions is important for study validity. Few studies have tested the value of incentives in increasing response rates to online questionnaires in clinical trials of health interventions. This study evaluated the effect of a gift card prize-draw incentive on response rates to follow-up questionnaires within a trial of an online health intervention. Method The study was embedded in a host randomized controlled trial of an online parenting program for child anxiety. A total of 433 participants were randomly allocated to one of two groups: (1) being informed that they would enter a gift card prize-draw if they completed the final study questionnaire (24-week follow-up) and (2) not informed about the prize-draw. All participants had a 1 in 20 chance of winning an AUD50 gift card after they completed the online questionnaire. Results The odds of the informed group completing the follow-up questionnaire were significantly higher than the uninformed group, (79.6% vs 68.5%, odds ratio = 1.79, 95% confidence interval = 1.15-2.79). This response rate increase of 11.1% (95% confidence interval = 2.8-19.1) occurred in both intervention and control groups in the host randomized controlled trial. The incentive was also effective in increasing questionnaire commencement (84.6% vs 75.9%, odds ratio = 1.74, 95% confidence interval = 1.07-2.84) and reducing the delay in completing the questionnaire (19.9 vs 22.6 days, hazard ratio = 1.34, 95% confidence interval = 1.07-1.67). Conclusion This study adds to evidence for the effectiveness of incentives to increase response rates to follow-up questionnaires in health intervention trials.

  16. Prospective associations between bilingualism and executive function in Latino children: sustained effects while controlling for biculturalism.

    Science.gov (United States)

    Riggs, Nathaniel R; Shin, Hee-Sung; Unger, Jennifer B; Spruijt-Metz, Donna; Pentz, Mary Ann

    2014-10-01

    The study purpose was to test 1-year prospective associations between English-Spanish bilingualism and executive function in 5th to 6th grade students while controlling for biculturalism. Participants included 182 US Latino students (50 % female). Self-report surveys assessed biculturalism, bilingualism, and executive function (i.e., working memory, organizational skills, inhibitory control, and emotional control, as well as a summary executive function score). General linear model regressions demonstrated that bilingualism significantly predicted the summary executive function score as well as working memory such that bilingual proficiency was positively related to executive function. Results are the first to demonstrate (a) prospective associations between bilingualism to executive function while controlling for the potential third variable of biculturalism, and (b) a principal role for working memory in this relationship. Since executive function is associated with a host of health outcomes, one implication of study findings is that bilingualism may have an indirect protective influence on youth development.

  17. Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Evandro Pereira Palacio

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the effects of platelet-rich plasma (PRP infiltration in patients with lateral epicondylitis of the elbow, through analysis of the Disabilities of the Arm, Shoulder and Hand (DASH and Patient-Rated Tennis Elbow Evaluation (PRTEE questionnaires. METHODS: Sixty patients with lateral epicondylitis of the elbow were prospectively randomized and evaluated after receiving infiltration of three milliliters of PRP, or 0.5% neocaine, or dexamethasone. For the scoring process, the patients were asked to fill out the DASH and PRTEE questionnaires on three occasions: on the day of infiltration and 90 and 180 days afterwards. RESULTS: Around 81.7% of the patients who underwent the treatment presented some improvement of the symptoms. The statistical tests showed that there was evidence that the cure rate was unrelated to the substance applied (p = 0.62. There was also intersection between the confidence intervals of each group, thus demonstrating that the proportions of patients whose symptoms improved were similar in all the groups. CONCLUSION: At a significance level of 5%, there was no evidence that one treatment was more effective than another, when assessed using the DASH and PRTEE questionnaires.

  18. Prospects for advancing tuberculosis control efforts through novel therapies.

    Directory of Open Access Journals (Sweden)

    Joshua A Salomon

    2006-08-01

    Full Text Available BACKGROUND: Development of new, effective, and affordable tuberculosis (TB therapies has been identified as a critical priority for global TB control. As new candidates emerge from the global TB drug pipeline, the potential impacts of novel, shorter regimens on TB incidence and mortality have not yet been examined. METHODS AND FINDINGS: We used a mathematical model of TB to evaluate the expected benefits of shortening the duration of effective chemotherapy for active pulmonary TB. First, we considered general relationships between treatment duration and TB dynamics. Next, as a specific example, we calibrated the model to reflect the current situation in the South-East Asia region. We found that even with continued and rapid progress in scaling up the World Health Organization's DOTS strategy of directly observed, short-course chemotherapy, the benefits of reducing treatment duration would be substantial. Compared to a baseline of continuing DOTS coverage at current levels, and with currently available tools, a 2-mo regimen introduced by 2012 could prevent around 20% (range 13%-28% of new cases and 25% (range 19%-29% of TB deaths in South-East Asia between 2012 and 2030. If effective treatment with existing drugs expands rapidly, overall incremental benefits of shorter regimens would be lower, but would remain considerable (13% [range 8%-19%] and 19% [range 15%-23%] reductions in incidence and mortality, respectively, between 2012 and 2030. A ten-year delay in the introduction of new drugs would erase nearly three-fourths of the total expected benefits in this region through 2030. CONCLUSIONS: The introduction of new, shorter treatment regimens could dramatically accelerate the reductions in TB incidence and mortality that are expected under current regimens-with up to 2- or 3-fold increases in rates of decline if shorter regimens are accompanied by enhanced case detection. Continued progress in reducing the global TB burden will require a

  19. Prospective cross-sectional study using questionnaire to assess the effect of a different nomenclature for psychiatric illnesses on the perception of these diseases by university students.

    Science.gov (United States)

    Lau, Jerome; Kam, L S; Tsang, Y M; Chow, Boris C K; Fang, Y Y; Lam, K W; Lam, Y T; Li, Y Y; Wong, Cally H S

    2012-10-01

    OBJECTIVE. To assess the effect of a difference in nomenclature for psychiatric illness on perceptions of university students. DESIGN. Cross-sectional study. SETTING. Three local universities in Hong Kong. PARTICIPANTS. A total of 201 university students (undergraduates or postgraduates) were interviewed with a questionnaire. MAIN OUTCOME MEASURES. Score difference between the new and old nomenclature of each disease for each question of the questionnaire, using a 5-point Likert scale and an integrated score difference for each disease. RESULTS. Of the seven diseases investigated, six yielded a significant yet mild increase in positive perceptions with the new nomenclature. These diseases included schizophrenia (integrated score difference: +0.158, Pperception with its new nomenclature (integrated score difference: -0.119, Pperceptions among the university students than the old nomenclature. Epilepsy was the exception for which the old nomenclature conferred a more positive perception. Further studies on this topic involving a more general population should be advocated to confirm the improvements in perception with the new naming system for psychiatric diseases.

  20. Validation of the post sleep questionnaire for assessing subjects with restless legs syndrome: results from two double-blind, multicenter, placebo-controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Bharmal Murtuza

    2011-04-01

    Full Text Available Abstract Background Because of the subjective nature of Restless Legs Syndrome (RLS symptoms and the impact of these symptoms on sleep, patient-reported outcomes (PROs play a prominent role as study endpoints in clinical trials investigating RLS treatments. The objective of this study was to validate a new measure, the Post Sleep Questionnaire (PSQ, to assess sleep dysfunction in subjects with moderate-to-severe RLS symptoms. Methods Pooled data were analyzed from two 12-week, randomized, placebo-controlled trials of gabapentin enacarbil (N = 540. At baseline and Week 12, subjects completed the PSQ and other validated health surveys: IRLS Rating Scale, Clinical Global Impression of Improvement (CGI-I, Profile of Mood States (POMS, Medical Outcomes Study Scale-Sleep (MOS-Sleep, and RLS-Quality of Life (RLSQoL. Pooled data were used post hoc to examine the convergent, divergent, known-group validity and the responsiveness of the PSQ. Results Convergent validity was demonstrated by significant correlations between baseline PSQ items and total scores of IRLS, POMS, RLSQoL, and the MOS-Sleep Scale (p ≤ 0.007 each. Divergent validity was demonstrated through the lack of significant correlations between PSQ items and demographic characteristics. Correlations (p Conclusions Although these analyses were potentially limited by the use of clinical trial data and not prospective data from a study conducted solely for validation purposes, the PSQ demonstrated robust psychometric properties and is a valid instrument for assessing sleep and sleep improvements in subjects with moderate-to-severe RLS symptoms. Trial Registration This study analyzed data from two registered trials, NCT00298623 and NCT00365352.

  1. Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Albert Lecube

    Full Text Available Type 2 diabetes (T2D is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters.A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS. In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI to calculate sleep quality.Daytime sleepiness was higher in T2D than in control subjects (p = 0.003, with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10. Patients with fasting plasma glucose (FPG ≥13.1 mmol/l were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8-7.9, p = 0.0003. A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90% independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0-18.0 vs. 4 (0.0-12.0, p<0.001].The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted.

  2. [Condition of patients after surgical wisdom tooth extraction under general anesthesia with different premedication variants--a prospective study based on a post-anesthesia questionnaire].

    Science.gov (United States)

    Markus, H; Schwarz, A

    2001-01-01

    Evaluation of the modified "postanaesthesiological questionnaire" pointed to a subtle influencing of the condition of patients who had undergone 3rd molar surgery in general anaesthesia by using different premedication variants: "Atropine, Pethidine and Midazolam" (group A) and "Atropine, Midazolam and S-Ketamin" (group B). The combination in group B seems to be more suitable. On the one hand, a lower incidence of unwanted side-effects was found and, on the other hand, remarkable positive effects were observed. Of particular significance with this combination was also the more effective suppression of postoperative pain. The Propofol-supplemented general anaesthesia prepared in this way and administered using a nasal intubation technique found the full approval of the patients. Postoperative pain therapy was effective and also inexpensive, costing just 8.20 DM per patient, according to current prices calculated by Magdeburg University Hospital.

  3. Daily physical activities and sports in adult survivors of childhood cancer and healthy controls: a population-based questionnaire survey.

    Directory of Open Access Journals (Sweden)

    Corina S Rueegg

    Full Text Available BACKGROUND: Healthy lifestyle including sufficient physical activity may mitigate or prevent adverse long-term effects of childhood cancer. We described daily physical activities and sports in childhood cancer survivors and controls, and assessed determinants of both activity patterns. METHODOLOGY/PRINCIPAL FINDINGS: The Swiss Childhood Cancer Survivor Study is a questionnaire survey including all children diagnosed with cancer 1976-2003 at age 0-15 years, registered in the Swiss Childhood Cancer Registry, who survived ≥5 years and reached adulthood (≥20 years. Controls came from the population-based Swiss Health Survey. We compared the two populations and determined risk factors for both outcomes in separate multivariable logistic regression models. The sample included 1058 survivors and 5593 controls (response rates 78% and 66%. Sufficient daily physical activities were reported by 52% (n = 521 of survivors and 37% (n = 2069 of controls (p<0.001. In contrast, 62% (n = 640 of survivors and 65% (n = 3635 of controls reported engaging in sports (p = 0.067. Risk factors for insufficient daily activities in both populations were: older age (OR for ≥35 years: 1.5, 95CI 1.2-2.0, female gender (OR 1.6, 95CI 1.3-1.9, French/Italian Speaking (OR 1.4, 95CI 1.1-1.7, and higher education (OR for university education: 2.0, 95CI 1.5-2.6. Risk factors for no sports were: being a survivor (OR 1.3, 95CI 1.1-1.6, older age (OR for ≥35 years: 1.4, 95CI 1.1-1.8, migration background (OR 1.5, 95CI 1.3-1.8, French/Italian speaking (OR 1.4, 95CI 1.2-1.7, lower education (OR for compulsory schooling only: 1.6, 95CI 1.2-2.2, being married (OR 1.7, 95CI 1.5-2.0, having children (OR 1.3, 95CI 1.4-1.9, obesity (OR 2.4, 95CI 1.7-3.3, and smoking (OR 1.7, 95CI 1.5-2.1. Type of diagnosis was only associated with sports. CONCLUSIONS/SIGNIFICANCE: Physical activity levels in survivors were lower than recommended, but comparable to controls and

  4. Measuring the quality of governmental websites in a controlled versus a laboratory setting with the Website Evaluation Questionnaire

    NARCIS (Netherlands)

    Elling, Sanne; Lentz, Leo; Jong, de Menno; Bergh, van den Huub

    2012-01-01

    The quality of governmental websites is often measured with questionnaires that ask users for their opinions on various aspects of the website. This article presents the Website Evaluation Questionnaire (WEQ), which was specifically designed for the evaluation of governmental websites. The multidime

  5. Mood impairs time-based prospective memory in young but not older adults: the mediating role of attentional control.

    Science.gov (United States)

    Schnitzspahn, Katharina M; Thorley, Craig; Phillips, Louise; Voigt, Babett; Threadgold, Emma; Hammond, Emily R; Mustafa, Besim; Kliegel, Matthias

    2014-06-01

    The present study examined age-by-mood interactions in prospective memory and the potential role of attentional control. Positive, negative, or neutral mood was induced in young and older adults. Subsequent time-based prospective memory performance was tested, incorporating a measure of online attentional control shifts between the ongoing and the prospective memory task via time monitoring behavior. Mood impaired prospective memory in the young, but not older, adults. Moderated mediation analyses showed that mood effects in the young were mediated by changes in time monitoring. Results are discussed in relation to findings from the broader cognitive emotional aging literature.

  6. Daily physical activities and sports in adult survivors of childhood cancer and healthy controls: a population-based questionnaire survey.

    Science.gov (United States)

    Rueegg, Corina S; von der Weid, Nicolas X; Rebholz, Cornelia E; Michel, Gisela; Zwahlen, Marcel; Grotzer, Michael; Kuehni, Claudia E

    2012-01-01

    Healthy lifestyle including sufficient physical activity may mitigate or prevent adverse long-term effects of childhood cancer. We described daily physical activities and sports in childhood cancer survivors and controls, and assessed determinants of both activity patterns. The Swiss Childhood Cancer Survivor Study is a questionnaire survey including all children diagnosed with cancer 1976-2003 at age 0-15 years, registered in the Swiss Childhood Cancer Registry, who survived ≥5 years and reached adulthood (≥20 years). Controls came from the population-based Swiss Health Survey. We compared the two populations and determined risk factors for both outcomes in separate multivariable logistic regression models. The sample included 1058 survivors and 5593 controls (response rates 78% and 66%). Sufficient daily physical activities were reported by 52% (n = 521) of survivors and 37% (n = 2069) of controls (psports (p = 0.067). Risk factors for insufficient daily activities in both populations were: older age (OR for ≥35 years: 1.5, 95CI 1.2-2.0), female gender (OR 1.6, 95CI 1.3-1.9), French/Italian Speaking (OR 1.4, 95CI 1.1-1.7), and higher education (OR for university education: 2.0, 95CI 1.5-2.6). Risk factors for no sports were: being a survivor (OR 1.3, 95CI 1.1-1.6), older age (OR for ≥35 years: 1.4, 95CI 1.1-1.8), migration background (OR 1.5, 95CI 1.3-1.8), French/Italian speaking (OR 1.4, 95CI 1.2-1.7), lower education (OR for compulsory schooling only: 1.6, 95CI 1.2-2.2), being married (OR 1.7, 95CI 1.5-2.0), having children (OR 1.3, 95CI 1.4-1.9), obesity (OR 2.4, 95CI 1.7-3.3), and smoking (OR 1.7, 95CI 1.5-2.1). Type of diagnosis was only associated with sports. Physical activity levels in survivors were lower than recommended, but comparable to controls and mainly determined by socio-demographic and cultural factors. Strategies to improve physical activity levels could be similar as for the general population.

  7. Risk Factors for Sporadic Domestically Acquired Campylobacter Infections in Norway 2010-2011: A National Prospective Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Emily MacDonald

    Full Text Available Campylobacteriosis is the most frequently reported food- and waterborne infection in Norway. We investigated the risk factors for sporadic Campylobacter infections in Norway in order to identify areas where control and prevention measures could be improved.A national prospective case-control study of factors associated with Campylobacter infection was conducted from July 2010 to September 2011. Cases were recruited from the Norwegian Surveillance System of Communicable Diseases (MSIS. Controls were randomly selected from the Norwegian Population Registry. Cases and controls were mailed a paper questionnaire with a prepaid return envelope. Univariable analyses using logistic regression were conducted for all exposures. A final parsimonious multivariable model was developed using regularized/penalized logistic regression, and adjusted odds ratios were calculated.A total of 995 cases and 1501 controls were included in the study (response proportion 55% and 30%, respectively. Exposures that had significant increases in odds of Campylobacter infection in multivariable analysis were drinking water directly from river, stream, or lake (OR: 2.96, drinking purchased bottled water (OR: 1.78, eating chicken (1.69, eating meat that was undercooked (OR: 1.77, eating food made on a barbecue (OR: 1.55, living on a farm with livestock (OR: 1.74, having a dog in the household (OR: 1.39, and having household water supply serving fewer than 20 houses (OR: 1.92.Consumption of poultry and untreated water remain important sources of Campylobacter infection in Norway, despite ongoing control efforts. The results justify the need for strengthening education for consumers and food handlers about the risks of cross-contamination when preparing poultry and with consuming raw or undercooked chicken. The public should also be reminded to take precautions when drinking untreated water in nature and ensure continued vigilance in order to protect and maintain the quality of

  8. Adhesive strip wound closure after thyroidectomy/parathyroidectomy: a prospective, randomized controlled trial.

    LENUS (Irish Health Repository)

    O'Leary, D Peter

    2013-03-01

    Conventional collar incision closure in thyroid and parathyroid surgery involves the insertion of an epidermal layer of subcutaneous absorbable sutures that are reinforced by a deep layer of sutures. Adhesive strips offer an alternative method to close the epidermal layer. The aim of this study was to compare adhesive strip closure with absorbable sutures for collar incisions in a prospective, single-blinded, randomized controlled trial.

  9. Complexity Theory of Beam Halo-Chaos and Its Control Methods With Prospective Applications

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This article offers an overview and comprehensive survey of the complexity theory of beamhalo-chaos and its control methods with prospective applications. In recent years, there has been growinginterest in proton beams of high power linear accelerator due to its attractive features in possiblebreakthrough applications, such as production of nuclear materials (e.g., tritium, transforming 232Th to233U), transmutation of radioactive wastes, productions of radioactive isotopes for medical use, heavy ion

  10. Analysis and Prediction of Claustrophobia during MR Imaging with the Claustrophobia Questionnaire: An Observational Prospective 18-month Single-Center Study of 6500 Patients.

    Science.gov (United States)

    Napp, Adriane E; Enders, Judith; Roehle, Robert; Diederichs, Gerd; Rief, Matthias; Zimmermann, Elke; Martus, Peter; Dewey, Marc

    2017-04-01

    Purpose To analyze claustrophobia during magnetic resonance (MR) imaging and to explore the potential of the 26-item claustrophobia questionnaire (CLQ) (range, 0-4) as a screening tool in patients scheduled for MR imaging. Materials and Methods The study received institutional review board approval, and patients in the CLQ cohort provided informed consent. A total of 6520 consecutive patients were included. Overall, 4288 patients completed the CLQ before MR imaging (CLQ cohort), and 2232 patients underwent MR imaging without having completed the CLQ (non-CLQ cohort). Claustrophobic events were recorded by the staff. Results The CLQ mean score in patients with claustrophobic events (1.48 ± 0.93) was significantly higher (P claustrophobic events (0.60 ± 0.5). The CLQ cutoff value was 0.16 for men and 0.56 for women. Because of the low prevalence, negative predictive values of CLQ cutoff values (men, 0.99 [573 of 582]; women, 0.97 [745 of 766]) were higher than positive predictive values (men, 0.01 [88 of 582]; women, 0.16 [192 of 1186]). The overall claustrophobic event rate was 9.8% (640 of 6520; 95% confidence interval [CI]: 9.1, 10.6). The CLQ did not induce claustrophobic events because the event rate in the CLQ cohort was significantly lower than that in the non-CLQ cohort, as shown by the adjusted odds ratio of 0.81 (95% CI: 0.68, 0.96). Conclusion The CLQ is a suitable screening tool for the absence of a subsequent claustrophobic event. Furthermore, while it is possible to identify patients with a considerable risk of claustrophobia, prediction in individual patients is not possible. (©) RSNA, 2016 Online supplemental material is available for this article.

  11. The use of heat pipes in thermal control system for electronics: current situation and prospects

    Directory of Open Access Journals (Sweden)

    Khairnasov S. M.

    2015-06-01

    Full Text Available Today, the widespread application of cooling systems based on heat pipes makes significant contribution to the solution of the thermal control of electronic equipment. The use of heat pipes as heat transfer devices and heat exchanging equipment allows creating an efficient new-generation heat sinks. Nowadays, heat pipes are widely used in the following areas: electronic equipment, special application computer equipment (from small computers to large data centres, high power electronics. The article provides an analysis of the current state and prospects of heat pipes application in thermal control systems for ground-based electronic equipment.

  12. Locus of Control & Motivation Strategies for Learning Questionnaire: Predictors of Student Success on the ATI Comprehensive Predictor Exam & NCLEX-RN Examination

    Science.gov (United States)

    Carpenter, Jane H.

    2011-01-01

    The two purposes of this study were to determine whether locus of control (LOC) was predictive of how a student would perform on the ATI Comprehensive Predictor Exam and the NCLEX-RN, and if the Motivated Strategies for Learning Questionnaire (MSLQ) provided information that would help determine predictors of success on these two exams. The study…

  13. Motivational and control mechanisms underlying adolescent cannabis use disorders: A prospective study

    Directory of Open Access Journals (Sweden)

    Janna Cousijn

    2015-12-01

    Full Text Available Cannabis use disorders (CUDs are the most prevalent substance use disorders among adolescents in treatment. Yet, little is known about the neuropsychological mechanisms underlying adolescent CUDs. Studies in adult cannabis users suggest a significant role for cognitive control and cannabis-oriented motivational processes, such as attentional bias, approach bias, and craving in CUDs. The current 6-month prospective study investigated the relationships between attentional bias, approach bias, craving, cognitive control, and cannabis use in adolescent patients in treatment for a primary or secondary CUD. Moreover, we investigated if these motivational processes and cognitive control could predict treatment progression after 6 months. Adolescents with a CUD had an attentional but no approach bias towards cannabis. In contrast to adult findings on the role of attentional bias, approach bias and cognitive control, only cannabis craving significantly correlated with current cannabis use and predicted cannabis use-related problems and abstinence from cannabis 6 months later. These findings identify craving as a predictor of treatment outcome, thereby supporting an important role for craving in the course of adolescent cannabis use and dependence. This prospective study is among the first to investigate neuropsychological mechanisms underlying adolescent CUDs, warranting future longitudinal studies.

  14. Indirect immunofluorescence test performance and questionnaire results from the Centers for Disease Control Model Performance Evaluation Program for human immunodeficiency virus type 1 testing.

    OpenAIRE

    Taylor, R N; Hearn, T L; Schalla, W O; Valdiserri, R O

    1990-01-01

    Results from laboratories performing indirect immunofluorescence (IIF) testing for human immunodeficiency virus type 1 antibody and participating in the Centers for Disease Control Model Performance Evaluation Program in 1988 are presented. Approximately 90% of all laboratories receiving specimen panels or questionnaires furnished results to the Centers for Disease Control. In September 1988, 111 reports were received from IIF laboratories from 34 states and nine countries; most of these labo...

  15. Reconstruction of large iliac crest defects after graft harvest using autogenous rib graft: a prospective controlled study.

    Science.gov (United States)

    Bapat, Mihir R; Chaudhary, Kshitij; Garg, Hitesh; Laheri, Vinod

    2008-11-01

    Prospective controlled study analyzing the donor site morbidity after reconstruction of full thickness iliac crest defects, using autologous rib grafts. To compare the pain and cosmetic outcomes of patients with iliac crest reconstruction with those who have had no reconstruction of the iliac crest. Chronic donor site pain and poor cosmesis have been the major deterrents in using iliac crest for long-segment spinal reconstructions. Iliac crest reconstruction with rib has been reported but most studies are uncontrolled and retrospective. Patients with iliac defects rib graft harvested during the anterolateral approach to spine. Rib graft of the appropriate contour was impacted into the notches created in the iliac crest defect. The control group comprised 16 patients without reconstruction of the iliac crest. The pain, cosmesis, and functional disability were assessed on the basis of visual analog scores and a predesigned questionnaire. Judet iliac views were used to assess the incorporation of the rib graft. Evaluation was performed at 1.5, 3, 6, and 12 months, respectively. Intensity and incidence of pain was significantly lower in the reconstructed group. Cosmetic outcome was also significantly better in this group. Patients in control group had significant complications related to the tenting of skin over the defect such as bursitis and skin necrosis. Radiologic incorporation was documented in 95% of patients with 1 patient having resorption of the rib graft. Rib graft reconstruction provides a cheap and effective alternative for iliac crest reconstruction. Patients undergoing thoracotomy or thoraco-phrenico-lumbotomy for spinal reconstruction, the unutilized rib graft should be used to reconstruct the iliac defect. Reduced donor site morbidity and better cosmesis are the major benefits of reconstruction.

  16. Primate cognition: attention, episodic memory, prospective memory, self-control, and metacognition as examples of cognitive control in nonhuman primates.

    Science.gov (United States)

    Beran, Michael J; Menzel, Charles R; Parrish, Audrey E; Perdue, Bonnie M; Sayers, Ken; Smith, J David; Washburn, David A

    2016-09-01

    Primate Cognition is the study of cognitive processes, which represent internal mental processes involved in discriminations, decisions, and behaviors of humans and other primate species. Cognitive control involves executive and regulatory processes that allocate attention, manipulate and evaluate available information (and, when necessary, seek additional information), remember past experiences to plan future behaviors, and deal with distraction and impulsivity when they are threats to goal achievement. Areas of research that relate to cognitive control as it is assessed across species include executive attention, episodic memory, prospective memory, metacognition, and self-control. Executive attention refers to the ability to control what sensory stimuli one attends to and how one regulates responses to those stimuli, especially in cases of conflict. Episodic memory refers to memory for personally experienced, autobiographical events. Prospective memory refers to the formation and implementation of future-intended actions, such as remembering what needs to be done later. Metacognition consists of control and monitoring processes that allow individuals to assess what information they have and what information they still need, and then if necessary to seek information. Self-control is a regulatory process whereby individuals forego more immediate or easier to obtain rewards for more delayed or harder to obtain rewards that are objectively more valuable. The behavioral complexity shown by nonhuman primates when given tests to assess these capacities indicates psychological continuities with human cognitive control capacities. However, more research is needed to clarify the proper interpretation of these behaviors with regard to possible cognitive constructs that may underlie such behaviors. WIREs Cogn Sci 2016, 7:294-316. doi: 10.1002/wcs.1397 For further resources related to this article, please visit the WIREs website.

  17. Serum Taurine and Stroke Risk in Women: A Prospective, Nested Case-Control Study.

    Science.gov (United States)

    Wu, Fen; Koenig, Karen L; Zeleniuch-Jacquotte, Anne; Jonas, Saran; Afanasyeva, Yelena; Wójcik, Oktawia P; Costa, Max; Chen, Yu

    2016-01-01

    Taurine (2-aminoethanesulfonic acid), a conditionally essential sulfur-containing amino acid, is mainly obtained from diet in humans. Experimental studies have shown that taurine's main biological actions include bile salt conjugation, blood pressure regulation, anti-oxidation, and anti-inflammation. We conducted a prospective case-control study nested in the New York University Women's Health Study, a cohort study involving 14,274 women enrolled since 1985. Taurine was measured in pre-diagnostic serum samples of 241 stroke cases and 479 matched controls. There was no statistically significant association between serum taurine and stroke risk in the overall study population. The adjusted ORs for stroke were 1.0 (reference), 0.87 (95% CI, 0.59-1.28), and 1.03 (95% CI, 0.69-1.54) in increasing tertiles of taurine (64.3-126.6, 126.7-152.9, and 153.0-308.5 nmol/mL, respectively). A significant inverse association between serum taurine and stroke risk was observed among never smokers, with an adjusted OR of 0.66 (95% CI, 0.37-1.18) and 0.50 (95% CI, 0.26-0.94) for the second and third tertile, respectively (p for trend = 0.01), but not among past or current smokers (p for interaction taurine and stroke risk, although a protective effect was observed in never smokers, which requires further investigation. Taurine, Stroke, Epidemiology, Prospective, Case-control study, NYUWHS.

  18. A Multifaceted Prospective Memory Intervention to Improve Medication Adherence: Design of a Randomized Control Trial

    Science.gov (United States)

    Insel, Kathie C.; Einstein, Gilles O.; Morrow, Daniel G.; Hepworth, Joseph T.

    2012-01-01

    Adherence to prescribed antihypertensive agents is critical because control of elevated blood pressure is the single most important way to prevent stroke and other end organ damage. Unfortunately, nonadherence remains a significant problem. Previous interventions designed to improve adherence have demonstrated only small benefits of strategies that target single facets such as understanding medication directions. The intervention described here is informed by prospective memory theory and performance of older adults in laboratory-based paradigms and uses a comprehensive, multifaceted approach to improve adherence. It incorporates multiple strategies designed to support key components of prospective remembering involved in taking medication. The intervention is delivered by nurses in the home with an education control group for comparison. Differences between groups in overall adherence following the intervention and 6 months later will be tested. Systolic and diastolic blood pressure levels also will be examined between groups and as it relates to adherence. Intra-individual regression is planned to examine change in adherence over time and its predictors. Finally, we will examine the association between executive function/working memory and adherence, predicting that adherence will be related to executive/working memory in the control group but not in the intervention group. PMID:23010608

  19. A Prospective Controlled Study of Living Kidney Donors: Three-Year Follow-up

    Science.gov (United States)

    Kasiske, Bertram L.; Anderson-Haag, Teresa; Israni, Ajay K.; Kalil, Roberto S.; Kimmel, Paul L.; Kraus, Edward S.; Kumar, Rajiv; Posselt, Andrew A.; Pesavento, Todd E.; Rabb, Hamid; Steffes, Michael W.; Snyder, Jon J.; Weir, Matthew R.

    2015-01-01

    Background There have been few prospective controlled studies of kidney donors. Understanding the pathophysiological effects of kidney donation is important for judging donor safety and for improving our understanding of the consequences of reduced kidney function in chronic kidney disease. Study Design Prospective, controlled, observational cohort study. Setting & Participants Three-year follow-up of kidney donors and paired controls suitable for donation at their donor’s center. Predictor Kidney donation. Outcomes Medical history, vital signs, glomerular filtration rate and other measurements at 6, 12, 24 and 36 months after donation. Results At 36 months, 182 of 203 (89.7%) original donors and 173 of 201 (86.1%) original controls continue to participate in follow-up visits. The linear slope of the glomerular filtration rate measured by plasma iohexol clearance declined 0.36±7.55 mL/min per year in 194 controls, but increased 1.47±5.02 mL/min per year in 198 donors (P = 0.005) between 6 and 36 months. Blood pressure was not different between donors and controls at any visit, and at 36 months all 24-hour ambulatory blood pressure parameters were similar in 126 controls and 135 donors (mean systolic: 120.0±11.2 [SD] v. 120.7±9.7 mmHg [P=0.6]; mean diastolic: 73.4±7.0 v. 74.5±6.5 mmHg [P=0.2]). Mean arterial pressure nocturnal dipping was manifest in 11.2%±6.6% of controls and 11.3%±6.1% donors (P=0.9). Urinary protein-creatinine and albumin-creatinine ratios were not increased in donors compared to controls. From 6 to 36 months post-donation, serum parathyroid hormone, uric acid, homocysteine and potassium levels were higher, whereas hemoglobin was lower in donors compared to controls. Limitations Possible bias resulting from an inability to select controls screened to be as healthy as donors, short follow-up duration, and drop-outs. Conclusions Kidney donors manifest several of the findings of mild chronic kidney disease. However, at 36 months after

  20. Telomere length in prospective and retrospective cancer case-control studies

    Science.gov (United States)

    Pooley, Karen A.; Sandhu, Manjinder S.; Tyrer, Jonathan; Shah, Mitul; Driver, Kristy E.; Luben, Robert N.; Bingham, Sheila A.; Ponder, Bruce A.J.; Pharoah, Paul D.P.; Khaw, Kay-Tee; Easton, Douglas F.; Dunning, Alison M.

    2010-01-01

    Previous studies have reported that shorter mean telomere length in lymphocytes is associated with increased susceptibility to common diseases of aging, and may be predictive of cancer risk. However, most analyses have examined retrospectively-collected case-control studies. Mean telomere length was measured using high-throughput quantitative Real Time PCR. Blood for DNA extraction was collected after cancer diagnosis in the East Anglian SEARCH Breast (2243 cases, 2181 controls) and SEARCH Colorectal (2249 cases, 2161 controls) studies. Prospective case-control studies were conducted for breast cancer (199 cases) and colorectal cancer (185 cases), nested within the EPIC-Norfolk cohort. Blood has been collected at least 6 months prior to diagnosis, and was matched to DNA from two cancer-free controls per case. In the retrospective, SEARCH studies, the age-adjusted Odds Ratios for shortest (Q4) vs. longest (Q1) quartile of mean telomere length was 15.5 (95%CI 11.6–20.8), p-het=5.7×10−75; with a ‘per quartile’ p-trend=2.1×10−80 for breast cancer, and 2.14 (95%CI 1.77–2.59), p-het=7.3×10−15; with a ‘per quartile’ p-trend=1.8×10−13 for colorectal cancer. In the prospective, EPIC study, the comparable Odds Ratios [Q4 vs. Q1] were 1.58 (95%CI 0.75–3.31), p-het=0.23 for breast cancer, and 1.13 (95%CI 0.54–2.36), p-het=0.75 for colorectal cancer risk. Mean telomere length was shorter in retrospectively-collected cases than in controls but the equivalent association was markedly weaker in the prospective studies. This suggests that telomere shortening largely occurs after diagnosis, and may not, therefore, be of value in cancer prediction. PMID:20395204

  1. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial

    Directory of Open Access Journals (Sweden)

    Poeze Martijn

    2011-05-01

    Full Text Available Abstract Background The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%, non-union (5-21% and early osteo-arthritis (up to 32% which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences. Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. Methods/Design This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning. Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory. Study parameters are clinical consolidation

  2. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial.

    Science.gov (United States)

    Hannemann, Pascal; Göttgens, Kevin W A; van Wely, Bob J; Kolkman, Karel A; Werre, Andries J; Poeze, Martijn; Brink, Peter R G

    2011-05-06

    The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning).Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory.Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional

  3. MECHANISMS FOR CONTROLLING ENTERPRISE COST WHILE DETERMINING ITS INVESTMENT PROSPECTS IN ORDER TO INCREASE BUSINESS RELIABILITY

    Directory of Open Access Journals (Sweden)

    R. A. Kopytov

    2011-01-01

    Full Text Available The paper considers a non-conventional approach of strategic control which is executed on the basis of integration of incompatible business platforms within the framework of the unified management system.  The system is constructed while superimposing investment prospect tool on the diagram of the running enterprise cost control on the basis of the given standards. Their determination reveals advantages of the proposed approach within the context of its influence on the enterprise management with due account of an impact of negative factors on cost losses. Their investigation within diagnostics of management system makes it possible to increase a business reliability. The results of the investigations are tested in the process of cost evaluation of a multi-profile transport enterprise. 

  4. Thoracic radiotherapy and breath control: current prospects; Radiotherapie thoracique et controle de la respiration: perspectives actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Reboul, F.; Mineur, L.; Paoli, J.B.; Bodez, V.; Oozeer, R.; Garcia, R. [Institut Sainte-Catherine, 84 - Avignon (France)

    2002-11-01

    Three-dimensional conformal radiotherapy (3D CRT) is adversely affected by setup error and organ motion. In thoracic 3D CRT, breathing accounts for most of intra-fraction movements, thus impairing treatment quality. Breath control clearly exhibits dosimetric improvement compared to free breathing, leading to various techniques for gated treatments. We review benefits of different breath control methods -i.e. breath-holding or beam gating, with spirometric, isometric or X-ray respiration sensor- and argument the choice of expiration versus inspiration, with consideration to dosimetric concerns. All steps of 3D-CRT can be improved with breath control. Contouring of organs at risk (OAR) and target are easier and more accurate on breath controlled CT-scans. Inter- and intra-fraction target immobilisation allows smaller margins with better coverage. Lung outcome predictors (NTCP, Mean Dose, LV20, LV30) are improved with breath-control. In addition, inspiration breath control facilitates beam arrangement since it widens the distance between OAR and target, and leaves less lung normal tissue within the high dose region. Last, lung density, as of CT scan, is more accurate, improving dosimetry. Our institutions choice is to use spirometry driven, patient controlled high-inspiration breath-hold; this technique gives excellent immobilization results, with high reproducibility, yet it is easy to implement and costs little extra treatment time. Breath control, whatever technique is employed, proves superior to free breathing treatment when using 3D-CRT. Breath control should then be used whenever possible, and is probably mandatory for IMRT. (authors)

  5. Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case-Control, Multicenter Trial

    Science.gov (United States)

    2015-01-01

    AD______________ AWARD NUMBER: W81XWH-13-2-0031 TITLE: Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case...DATES COVERED 15Mar2013-31Oct2014 4. TITLE AND SUBTITLE Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case-Control...assess the success of skin cell spray combined with a biocomposite subcutaneous (INTEGRA) layer for repair of large open wounds. The objective is the

  6. Social Media and Peer-Reviewed Medical Journal Readership: A Randomized Prospective Controlled Trial.

    Science.gov (United States)

    Hawkins, C Matthew; Hunter, Makeba; Kolenic, Giselle E; Carlos, Ruth C

    2017-05-01

    To prospectively evaluate the impact of increasing levels of social media engagement on page visits and web-link clicks for content published in the Journal of the American College of Radiology. A three-arm prospective trial was designed using a control group, a basic Twitter intervention group (using only the Journal's @JACRJournal Twitter account), and an enhanced Twitter intervention group (using the personal Twitter accounts of editorial board members and trainees). Overall, 428 articles published between June 2013 and July 2015 were randomly assigned to the three groups. Article-specific tweets for both intervention arms were sent between September 14, 2015, and October 28, 2015. Primary end points included article-specific weekly and monthly page visits on the journal's Elsevier website (Amsterdam, Netherlands). For the two intervention groups, additional end points included 7-day and 30-day Twitter link clicks. Weekly page visits for the enhanced Twitter arm (mean 18.2; 95% confidence interval [CI] 15.6-20.7) were significantly higher when compared with the weekly page visits for the control arm (mean 7.6; 95% CI 1.7-13.6). However, there was no demonstrable increase in weekly page visits (mean 9.4; 95% CI 7.4-11.5) for the basic Twitter arm compared with the control arm. No intervention effects over control, regardless of Twitter arm assignment, were demonstrated for monthly page visits. The enhanced Twitter intervention resulted in a statistically significant increase in both 7-day and 30-day Twitter link clicks compared with the basic Twitter intervention group. An organized social media strategy, with focused social media activity from editorial board members, increased engagement with content published in a peer-reviewed radiology journal. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Task-Based and Questionnaire Measures of Inhibitory Control Are Differentially Affected by Acute Food Restriction and by Motivationally Salient Food Stimuli in Healthy Adults.

    Science.gov (United States)

    Bartholdy, Savani; Cheng, Jiumu; Schmidt, Ulrike; Campbell, Iain C; O'Daly, Owen G

    2016-01-01

    Adaptive eating behaviors are dependent on an interaction between motivational states (e.g., hunger) and the ability to control one's own behavior (inhibitory control). Indeed, behavioral paradigms are emerging that seek to train inhibitory control to improve eating behavior. However, inhibitory control is a multifaceted concept, and it is not yet clear how different types (e.g., reactive motor inhibition, proactive motor inhibition, reward-related inhibition) are affected by hunger. Such knowledge will provide insight into the contexts in which behavioral training paradigms would be most effective. The present study explored the impact of promoting a "need" state (hunger) together with motivationally salient distracting stimuli (food/non-food images) on inhibitory control in 46 healthy adults. Participants attended two study sessions, once after eating breakfast as usual and once after acute food restriction on the morning of the session. In each session, participants completed questionnaires on hunger, mood and inhibitory control, and undertook task-based measures of inhibitory control, and had physiological measurements (height, weight, and blood glucose) obtained by a researcher. Acute food restriction influenced task-based assessments but not questionnaire measures of inhibitory control, suggesting that hunger affects observable behavioral control but not self-reported inhibitory control. After acute food restriction, participants showed greater temporal discounting (devaluation of future rewards), and subjective hunger and these were inversely correlated with stop accuracy on the stop signal task. Finally, participants generally responded faster when food-related distractor images were presented, compared to non-food images, independent of state. This suggests that although food stimuli motivate approach behavior, stimulus relevance does not impact inhibitory control in healthy individuals, nor interact with motivational state. These findings may provide some

  8. Task-based and questionnaire measures of inhibitory control are differentially affected by acute food restriction and by motivationally salient food stimuli in healthy adults

    Directory of Open Access Journals (Sweden)

    Savani Bartholdy

    2016-08-01

    Full Text Available Adaptive eating behaviors are dependent on an interaction between motivational states (e.g., hunger and the ability to control one’s own behavior (inhibitory control. Indeed, behavioral paradigms are emerging that seek to train inhibitory control to improve eating behavior. However, inhibitory control is a multifaceted concept, and it is not yet clear how different types (e.g., reactive motor inhibition, proactive motor inhibition, reward-related inhibition are affected by hunger. Such knowledge will provide insight into the contexts in which behavioral training paradigms would be most effective. The present study explored the impact of promoting a need state (hunger together with motivationally salient distracting stimuli (food/non-food images on inhibitory control in 46 healthy adults. Participants attended two study sessions, once after eating breakfast as usual and once after acute food restriction on the morning of the session. In each session, participants completed questionnaires on hunger, mood and inhibitory control, and undertook task-based measures of inhibitory control, and had physiological measurements (height, weight and blood glucose obtained by a researcher. Acute food restriction influenced task-based assessments but not questionnaire measures of inhibitory control, suggesting that hunger affects observable behavioral control but not self-reported inhibitory control. After acute food restriction, participants showed greater temporal discounting (devaluation of future rewards, and subjective hunger and these were inversely correlated with stop accuracy on the stop signal task. Finally, participants generally responded faster when food-related distractor images were presented, compared to non-food images, independent of state. This suggests that although food stimuli motivate approach behavior, stimulus relevance does not impact inhibitory control in healthy individuals, nor interact with motivational state. These findings may

  9. Correlation of Serum Zinc Level with Simple Febrile Seizures: A Hospital based Prospective Case Control Study

    Directory of Open Access Journals (Sweden)

    Imran Gattoo

    2015-04-01

    Full Text Available Background: Febrile seizures are one of the most common neurological conditions of childhood. It seems that zinc deficiency is associated with increased risk of febrile seizures.Aim: To estimate the serum Zinc level in children with simple Febrile seizures and to find the correlation between serum zinc level and simple Febrile seizures.Materials and Methods: The proposed study was a hospital based prospective case control study which included infants and children aged between 6 months to 5 years, at Post Graduate Department of Pediatrics, (SMGS Hospital, GMC Jammu, northern India. A total of 200 infants and children fulfilling the inclusion criteria were included. Patients were divided into 100(cases in Group A with simple febrile seizure and 100(controls in Group B of children with acute febrile illness without seizure. All patients were subjected to detailed history and thorough clinical examination followed by relevant investigations.Results: Our study had slight male prepondance of 62% in cases and 58% in controls . Mean serum zinc level in cases was 61.53±15.87 ugm/dl and in controls it was 71.90+18.50 ugm/dl .Serum zinc level was found significantly low in cases of simple febrile seizures as compaired to controls ,with p value of

  10. [Prospects for controlling hospital infection and the new social forces for upholding healthcare].

    Science.gov (United States)

    Puccini, Paulo de Tarso

    2011-07-01

    This paper discusses hospital infections based on the methodological concept of concrete totality and the resulting explanatory model of social determination, as critical paths for putting such occurrences and the social intervention possibilities to control them into context. It assesses the prospects for control by considering the advances in knowledge and control programs and the post-constitutional Brazilian institutional setting. It concludes that the increasing intervention by the judiciary and the Public Prosecutor's office, regarding issues involving hospital infection and the existing difficulties for control, reflect the level of healthcare service qualification in Brazil. It suggests that such judicial intervention contributes to the democratization process of healthcare policies and adds to the efforts of society in general to uphold the right to healthcare. It considers that following up the conditions under which control takes place in each institution may reveal important information that can be taken as markers for the general quality of the services and care provided, thereby becoming an instrument for a broad joint effort by the Public Prosecutor's office and healthcare institutions along with citizen participation.

  11. Portable Video Media Versus Standard Verbal Communication in Surgical Information Delivery to Nurses: A Prospective Multicenter, Randomized Controlled Crossover Trial.

    Science.gov (United States)

    Kam, Jonathan; Ainsworth, Hannah; Handmer, Marcus; Louie-Johnsun, Mark; Winter, Matthew

    2016-10-01

    Continuing education of health professionals is important for delivery of quality health care. Surgical nurses are often required to understand surgical procedures. Nurses need to be aware of the expected outcomes and recognize potential complications of such procedures during their daily work. Traditional educational methods, such as conferences and tutorials or informal education at the bedside, have many drawbacks for delivery of this information in a universal, standardized, and timely manner. The rapid uptake of portable media devices makes portable video media (PVM) a potential alternative to current educational methods. To compare PVM to standard verbal communication (SVC) for surgical information delivery and educational training for nurses and evaluate its impact on knowledge acquisition and participant satisfaction. Prospective, multicenter, randomized controlled crossover trial. Two hospitals: Gosford District Hospital and Wyong Hospital. Seventy-two nursing staff (36 at each site). Information delivery via PVM--7-minute video compared to information delivered via SVC. Knowledge acquisition was measured by a 32-point questionnaire, and satisfaction with the method of education delivery was measured using the validated Client Satisfaction Questionnaire (CSQ-8). Knowledge acquisition was higher via PVM compared to SVC 25.9 (95% confidence interval [CI] 25.2-26.6) versus 24.3 (95% CI 23.5-25.1), p = .004. Participant satisfaction was higher with PVM 29.5 (95% CI 28.3-30.7) versus 26.5 (95% CI 25.1-27.9), p = .003. Following information delivery via SVC, participants had a 6% increase in knowledge scores, 24.3 (95% CI 23.5-25.1) versus 25.7 (95% CI 24.9-26.5) p = .001, and a 13% increase in satisfaction scores, 26.5 (95% CI 25.1-27.9) versus 29.9 (95% CI 28.8-31.0) p information delivery via PVM. PVM provides a novel method for providing education to nurses that improves knowledge retention and satisfaction with the educational process. © 2016 Sigma Theta

  12. Multilocus genetic risk score associates with ischemic stroke in case-control and prospective cohort studies

    Science.gov (United States)

    Malik, R; Bevan, S; Nalls, MA; Holliday, EG; Devan, WJ; Cheng, YC; Ibrahim-Verbaas, CA; Verhaaren, BF; Bis, JC; Joon, AY; de Stefano, AL; Fornage, M; Psaty, BM; Ikram, MA; Launer, LJ; van Duijn, CM; Sharma, P; Mitchell, BD; Rosand, J; Meschia, JF; Levi, C; Rothwell, PM; Sudlow, C; Markus, HS; Seshadri, S; Dichgans, M

    2014-01-01

    BACKGROUND AND PURPOSE Genome-wide association studies have revealed multiple common variants associated with known risk factors for ischemic stroke (IS). However, their aggregate effect on risk is uncertain. We aimed to generate a multilocus genetic risk score (GRS) for IS based on genome-wide association studies data from clinical-based samples and to establish its external validity in prospective population-based cohorts. METHODS Three thousand five hundred forty-eight clinic-based IS cases and 6399 controls from the Wellcome Trust Case Control Consortium 2 were used for derivation of the GRS. Subjects from the METASTROKE consortium served as a replication sample. The validation sample consisted of 22 751 participants from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium. We selected variants that had reached genome-wide significance in previous association studies on established risk factors for IS. RESULTS A combined GRS for atrial fibrillation, coronary artery disease, hypertension, and systolic blood pressure significantly associated with IS both in the case-control samples and in the prospective population-based studies. Subjects in the top quintile of the combined GRS had >2-fold increased risk of IS compared with subjects in the lowest quintile. Addition of the combined GRS to a simple model based on sex significantly improved the prediction of IS in the combined clinic-based samples but not in the population-based studies, and there was no significant improvement in net reclassification. CONCLUSIONS A multilocus GRS based on common variants for established cardiovascular risk factors was significantly associated with IS both in clinic-based samples and in the general population. However, the improvement in clinical risk prediction was found to be small. PMID:24436234

  13. Safety and efficacy of vertebroplasty in the treatment of osteoporotic vertebral compression fractures: a prospective multicenter international randomized controlled study

    Science.gov (United States)

    Leali, Paolo Tranquilli; Solla, Federico; Maestretti, Gianluca; Balsano, Massimo; Doria, Carlo

    2016-01-01

    Summary Background Vertebral compression fractures (VCFs) treated non-operatively can diminish function and quality of life, and lead to chronic health effects. The short-term safety and effectiveness of vertebroplasty for symptomatic VCFs are well-documented, but long-term follow-up is needed. Purpose The aim of this paper was to analyse a multicenter international experience of 200 compression fractures treated with percutaneous vertebroplasty (VP) and compare the results of this procedure with the result of 200 patients treated conservatively. To estimate cost-effectiveness of VP compared to conservative care in terms of: pain reduction, quality of life, complications, secondary fractures and mortality. Materials and methods 400 patients have been enrolled in a prospective randomized controlled study with painful VCFs with bone edema on MR imaging, local back pain for 6 weeks or less, osteoporosis and aged 55 years or older; after obtaining informed consent patients are included and randomized for VP or conservative care. Before treatment and at follow-up with regular intervals during 1-year period were administered to patients standard questionnaires addressing: clinical symptoms, pain medication, Visual Analogue Scale (VAS) score for pain, Oswestry Disability Index (ODI) score to evaluate functional activity. Results 200 patients treated with PV compared with 200 patients treated conservatively had significantly better VAS and used less analgesics 1 day after treatment. Twenty-four hours after VP, there was a reduction in pain scores and an improvement in physical functions, whereas remain unchanged in the patients treated conservatively. Conclusions Pain relief and improvement of mobility and function after PV is immediate and significantly better in the short term compared with non-surgical care treatment. PMID:28228788

  14. Testing the role of expansion in the prospective control of locomotion.

    Science.gov (United States)

    Bastin, Julien; Jacobs, David M; Morice, Antoine H P; Craig, Cathy; Montagne, Gilles

    2008-11-01

    The constant bearing angle (CBA) strategy is a prospective strategy that permits the interception of moving objects. The purpose of the present study is to test this strategy. Participants were asked to walk through a virtual environment and to change, if necessary, their walking speed so as to intercept approaching targets. The targets followed either a rectilinear or a curvilinear trajectory and target size was manipulated both within trials (target size was gradually changed during the trial in order to bias expansion) and between trials (targets of different sizes were used). The curvature manipulation had a large effect on the kinematics of walking, which is in agreement with the CBA strategy. The target size manipulations also affected the kinematics of walking. Although these effects of target size are not predicted by the CBA strategy, quantitative comparisons of observed kinematics and the kinematics predicted by the CBA strategy showed good fits. Furthermore, predictions based on the CBA strategy were deemed superior to predictions based on a required velocity (V (REQ)) model. The role of target size and expansion in the prospective control of walking is discussed.

  15. Oncology E-Learning for Undergraduate. A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    da Costa Vieira, René Aloisio; Lopes, Ana Helena; Sarri, Almir José; Benedetti, Zuleica Caulada; de Oliveira, Cleyton Zanardo

    2016-01-14

    The e-learning education is a promising method, but there are few prospective randomized publications in oncology. The purpose of this study was to assess the level of retention of information in oncology from undergraduate students of physiotherapy. A prospective, controlled, randomized, crossover study, 72 undergraduate students of physiotherapy, from the second to fourth years, were randomized to perform a course of physiotherapy in oncology (PHO) using traditional classroom or e-learning. Students were offered the same content of the subject. The teacher in the traditional classroom model and the e-learning students used the Articulate® software. The course tackled the main issues related to PHO, and it was divided into six modules, 18 lessons, evaluated by 126 questions. A diagnosis evaluation was performed previous to the course and after every module. The sample consisted of 67 students, allocated in groups A (n = 35) and B (n = 32), and the distribution was homogeneous between the groups. Evaluating the correct answers, we observed a limited score in the pre-test (average grade 44.6 %), which has significant (p e-learning, a fact that encourages the use of e-learning in oncology.

  16. Cantharidin for the Treatment of Molluscum Contagiosum: A Prospective, Double-Blinded, Placebo-Controlled Trial

    Science.gov (United States)

    Dosal, Jacquelyn Coloe; Stewart, Paul W.; Lin, Ja-An; Williams, Christianna S.; Morrell, Dean S

    2012-01-01

    Background/Objective To study the effects and safety of cantharidin in the treatment of molluscum contagiosum. Methods We conducted a prospective, double-blinded, placebo-controlled, randomized clinical trial to evaluate the safety and efficacy of topical cantharidin for treatment of pediatric molluscum contagiosum in an academic ambulatory care center. Twenty-nine children aged 5–10 with the diagnosis of molluscum contagiosum were enrolled to receive treatment with cantharidin or placebo. The main outcome measure was complete clearance of molluscum lesions. Results In contrast to previous retrospective observational studies, the performance of cantharidin treatment over 2 months was not substantially better than the performance of placebo. Limitations The scope of follow-up was limited to 5 visits over 2 months of treatment. In hindsight, we can hypothesize that a longer follow up period may have captured a greater effect of cantharidin. Conclusion We conclude that during a 2 month period, the magnitude of the cantharidin treatment effects in the target population are, at best, not large. This study provided objective unbiased estimates of the magnitude of cantharidin treatment effects and provided important prospective safety data. Our subjects experienced minimal side effects when treated with cantharidin. PMID:22897595

  17. [Effect of specific physiotherapy on chronic pain, functional level and quality of life in osteoporosis. A prospective randomized single-blind placebo-controlled study].

    Science.gov (United States)

    Malmros, B; Jensen, M B; Charles, P; Mortensen, L S

    1999-08-16

    Patients suffering from osteoporotic vertebral fractures are handicapped by pain and reduced quality of life. Our aim was to investigate the effect of a short training program for osteoporotic patients with regard to pain level, use of analgetics and quality of life. We performed a prospective randomized single-blinded placebo-controlled study. The training program included general training of balance and muscle strength and stabilization of the back. The participants were randomised to 10 weeks of ambulatory training. Controls and training participants were tested weekly by registration of pain level and analgetic intake. Questionnaires on daily level of function and quality of life were given at the start and after five and 10 weeks. After three months both groups filled out the questionnaires at home. The training group had a significant reduction in pain score and use of analgetics. The distribution of functional score improved during training. Quality of life score improved significantly throughout the study and after three months. In conclusion, this ambulatory training program is effective for training osteoporotic patients with moderately severe pain and the training should be continued.

  18. Placebo controlled, prospectively randomized, double-blinded study for the investigation of the effectiveness and safety of the acoustic wave therapy (AWT(®)) for cellulite treatment.

    Science.gov (United States)

    Russe-Wilflingseder, Katharina; Russe-Wilfingsleder, Katharina; Russe, Elisabeth; Vester, Johannes C; Haller, Gerd; Novak, Pavel; Krotz, Alexander

    2013-06-01

    Placebo controlled double-blinded, prospectively randomized clinical trial with 17 patients (11 verum, 5 placebo) for evaluation of cellulite treatment with Acoustic Wave Therapy, (AWT(®)) was performed. The patients were treated once a week for 7 weeks, a total of 8 treatments with the D-ACTOR(®) 200 by Storz Medical AG. Data were collected at baseline, before 8th treatment, at 1 month (follow-up 1) and at 3 months (follow-up 2) after the last treatment with a patients' questionnaire, weight control, measurement of circumference and standardized photography. Treatment progress was further documented using a specially designed 3D imaging system (SkinSCAN(3D), 3D-Shape GmbH) providing an objective measure of cellulite (primary efficacy criteria). Patient's questionnaire in the verum group revealed an improvement in number and depth of dimples, skin firmness and texture, in shape and in reduction of circumference. The overall result (of skin waviness, Sq and Sz, surface and volume of depressions and elevations, Vvv and Vmp) at two follow-up visits indicates a more than medium sized superiority (MW = 0.6706) and is statistically significant (pWei-Lachin = 0.0106). The placebo group revealed no statistical significance. No side effects were seen. This indicates the efficacy and safety of AWT(®) for patients with cellulite.

  19. A Prospective Controlled Study of Kidney Donors: Baseline and 6-Month Follow-up

    Science.gov (United States)

    Kasiske, Bertram L.; Anderson-Haag, Teresa; Ibrahim, Hassan N.; Pesavento, Todd E.; Weir, Matthew R.; Nogueira, Joseph M.; Cosio, Fernando G.; Kraus, Edward S.; Rabb, Hamid H.; Kalil, Roberto S.; Posselt, Andrew A.; Kimmel, Paul L.; Steffes, Michael W.

    2013-01-01

    Background Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise normal individuals. Study Design Prospective, controlled, observational cohort study. Setting & Participants Consecutive patients approved for donation at 8 transplant centers in the US were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney was also enrolled. Predictor Kidney donation. Measurements At baseline pre-donation and at 6 months after donation, a medical history, vital signs, measured (iohexol) glomerular filtration rate and other measurements were collected. There were 201 donors and 198 controls that completed both baseline and 6 month visits and form the basis of this report. Results Compared to controls, donors had 28% lower glomerular filtration rate at 6 months (94.6±15.1 [SD] v. 67.6±10.1 mL/min/1.73m2; P<0.001), associated with a 23% greater parathyroid hormone (42.8±15.6 v. 52.7±20.9 pg/mL; P<0.001), 5.4% lower serum phosphate (3.5±0.5 v. 3.3±0.5 mg/dL; P<0.001), 3.7% lower hemoglobin (13.6±1.4 v. 13.1±1.2 g/dL; P<0.001), 8.2% greater uric acid (4.9±1.2 v. 5.3±1.1 mg/dL; P<0.001), 24% greater homocysteine (1.20±0.34 v. 1.49±0.43 mg/L; P<0.001), and 1.5% lower high density lipoprotein cholesterol (54.9±16.4 v. 54.1±13.9 mg/dL; P=0.03) level. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] v. 5.0 [IQR, 3.3-5.4] mg/g; P=0.5), office blood pressure, or glucose homeostasis. Limitations Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney

  20. 78 FR 3906 - Prospective Grant of a Co-Exclusive License: Adenovirus-Based Controls and Calibrators for...

    Science.gov (United States)

    2013-01-17

    ...-Based Controls and Calibrators for Molecular Diagnostics of Infectious Disease Agents AGENCY: National... recombinant constructs as controls and calibrators for molecular diagnostics for infectious disease agents... diagnostics (e.g. real time PCR tests). The prospective co-exclusive license will comply with the terms...

  1. Prospective randomized controlled trial of an injectable esophageal prosthesis versus a sham procedure for endoscopic treatment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    P. Fockens; L. Cohen; S.A. Edmundowicz; K. Binmoeller; R.I. Rothstein; D. Smith; E. Lin; N. Nickl; B. Overholt; P.J. Kahrilas; N. Vakil; A.M. Abdel Aziz Hassan; G.A. Lehman

    2010-01-01

    This study aimed to assess whether endoscopic implantation of an injectable esophageal prosthesis, the Gatekeeper Reflux Repair System (GK), is a safe and effective therapy for controlling gastroesophageal reflux disease (GERD). A prospective, randomized, sham-controlled, single-blinded, internation

  2. Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials

    Directory of Open Access Journals (Sweden)

    Young-Dae Kim

    2013-01-01

    Full Text Available To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were “acupuncture” and “PTSD.” No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs and 2 uncontrolled clinical trials (UCTs out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs. One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.

  3. Acupuncture for posttraumatic stress disorder: a systematic review of randomized controlled trials and prospective clinical trials.

    Science.gov (United States)

    Kim, Young-Dae; Heo, In; Shin, Byung-Cheul; Crawford, Cindy; Kang, Hyung-Won; Lim, Jung-Hwa

    2013-01-01

    To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were "acupuncture" and "PTSD." No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs) and 2 uncontrolled clinical trials (UCTs) out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT) were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs). One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.

  4. Pheromone use for insect control: present status and prospect in Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Azharul Islam

    2012-06-01

    Full Text Available The insect’s world is filled with many odors. Insects use these odors to cue them in a variety of complex social behaviors, including courtship, mating, and egg laying. Scientists and pest control specialists have known about these complex communication systems for decades. The main aim of this study was to visualize the availability, trends and differences in the sources of pheromone control in agricultural growth of Bangladesh. It also concerned on constrains and present use of pheromone and their possible recommendation on behalf of Bangladesh agriculture. It concentrated on the data during last three decades (1980-2010, comprising status of pheromone use in Bangladesh agriculture and its future. Review revealed that Bangladesh has been enormously successful in increasing pheromone use in agricultural production (especially for vegetables. Understanding of the nature of pheromones and their potential for pest control along with the future prospective of pheromone technique in agriculture were stated. Since the pheromone, technologies for control of major crop pests in Bangladesh are still limited. So that this review emphasized on more attention to the authority to increase the research works and project facilities related to develop and promote pheromone techniques. It is highly recommended to increase availability of pheromone in market, more investment in research and development, introduction of newly identified pheromone for specific pest, to assist government and non-government organizations to work with farmers to reduce harmful insecticide use and promote pheromone tactics as one part of integrated crop management (ICM.

  5. [Periprostatic anaesthesic infiltration for prostatic biopsy: a prospective, randomized, double blind and placebo-controlled study].

    Science.gov (United States)

    Valero, Gonzalo; González, E U Roxana

    2005-06-01

    A prospective, randomized, double blind and placebo-controlled study to evaluate the effectiveness of periprostatic infiltration with lidocaine to reduce pain of prostatic biopsy. In a thirteen months period of time, 115 patients were randomized to receive 10 ml of lidocaine 1% (n=60) or saline (n=55). Evaluating the pain with visual analogue scale (0-10), the first group referred average pain of 3.83 and the second group of 6.87, being this difference clearly significant (panesthesic puncture. The periprostatic infiltration is easy to perform without complications and it is effective in reducing the pain of this procedure. It should be used as a routine procedure in prostatic biopsy.

  6. A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System

    Science.gov (United States)

    Ellison, Richard T.; Barysauskas, Constance M.; Rundensteiner, Elke A.; Wang, Di; Barton, Bruce

    2015-01-01

    Background. The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods. A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results. In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions. In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity. PMID:26430698

  7. Obesity, inflammatory markers, and endometrial cancer risk: a prospective case–control study

    Science.gov (United States)

    Dossus, Laure; Rinaldi, Sabina; Becker, Susen; Lukanova, Annekatrin; Tjonneland, Anne; Olsen, Anja; Stegger, Jakob; Overvad, Kim; Chabbert-Buffet, Nathalie; Jimenez-Corona, Aida; Clavel-Chapelon, Francoise; Rohrmann, Sabine; Teucher, Birgit; Boeing, Heiner; Schütze, Madlen; Trichopoulou, Antonia; Benetou, Vassiliki; Lagiou, Pagona; Palli, Domenico; Berrino, Franco; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Redondo, Maria-Luisa; Travier, Noémie; Sanchez, Maria-Jose; Altzibar, Jone M; Chirlaque, Maria-Dolores; Ardanaz, Eva; Bueno-de-Mesquita, H Bas; van Duijnhoven, Fränzel J B; Onland-Moret, N Charlotte; Peeters, Petra H M; Hallmans, Goran; Lundin, Eva; Khaw, Kay-Tee; Wareham, Nicholas; Allen, Naomi; Key, Tim J; Slimani, Nadia; Hainaut, Pierre; Romaguera, Dora; Norat, Teresa; Riboli, Elio; Kaaks, Rudolf

    2010-01-01

    Obesity, a major risk factor for endometrial cancer, is a low-grade inflammatory state characterized by elevated concentrations of cytokines and acute phase reactants. The current study had two aims: first to investigate the associations of C-reactive protein (CRP), interleukin 6 (IL6), and IL1 receptor antagonist (IL1Ra) with endometrial cancer risk and second to examine to which extent these markers can influence the association between obesity and endometrial cancer. We conducted a case–control study, nested within the European Prospective Investigation into Cancer and Nutrition, which comprised 305 incident cases of endometrial cancer and 574 matched controls. CRP, IL6, and IL1Ra were measured in prospectively collected blood specimens by immunoassays. Data were analyzed using conditional logistic regression. All statistical tests were two-sided, and P values <0.05 were considered statistically significant. We observed a significant increase in risk of endometrial cancer with elevated levels of CRP (odds ratio (OR) for top versus bottom quartile: 1.58, 95% confidence interval (CI): 1.03–2.41, Ptrend=0.02), IL6 (OR for top versus bottom quartile: 1.66, 95% CI: 1.08–2.54, Ptrend=0.008), and IL1Ra (OR for top versus bottom quartile: 1.82, 95% CI: 1.22–2.73, Ptrend=0.004). After adjustment for body mass index (BMI), the estimates were strongly reduced and became non-significant. The association between BMI and endometrial cancer was also substantially attenuated (∼10–20%) after adjustment for inflammatory markers, even when the effects of C-peptide or estrone had already been taken into account. We provided epidemiological evidence that chronic inflammation might mediate the association between obesity and endometrial cancer and that endometrial carcinogenesis could be promoted by an inflammatory milieu. PMID:20843938

  8. Specific Approach for Size-Control III-V Quantum/Nano LED Fabrication for Prospective White Light Source

    Science.gov (United States)

    2007-08-10

    The Final Report Title: Specific approach for size-control III-V based quantum/nano LED fabrication for prospective white ...COVERED 14-06-2005 to 14-12-2005 4. TITLE AND SUBTITLE Size controlled GaN based quantum dot LED for the prospective white light source 5a. CONTRACT...structure LED The physical model of the PC LED for optical simulation is shown in Figure 10. The LED are composed with p-type GaN/ MQW of InGaN /GaN/ n

  9. Advancement of physical process by mental activation: A prospective controlled study

    Directory of Open Access Journals (Sweden)

    S. Lehrl, PhD

    2012-12-01

    Full Text Available According to the literature, patients who are significantly impaired by physical mobility limitations can be rehabilitated if the patient’s working memory is used to capacity. The conclusion that periodic mental activity improves physical rehabilitation should be evaluated. This is a prospective, controlled, and randomized open study of patients who underwent a total hip arthroplasty (THA. Sixteen patients who played the video game Dr. Kawashima’s Brain Training: How Old Is Your Brain? were compared in terms of rehabilitation progress to 16 individuals who did not play. Harris Hip and Merle d’Aubigné scores were evaluated 1 d preoperation and again 12 +/– 1 d postoperation. Preoperation, no significant differences in hip scores between the gaming and control groups were found (median Harris Hip score: 39 vs 33, respectively, p = 0.304; median Merle D’Aubigné score: 12 vs 9, respectively, p = 0.254. Postoperation, there were significant differences between the gaming and control groups (median Harris Hip score: 76.0 vs 56.5, respectively, p = 0.001; median Merle D’Aubigné score: 16.0 vs 13.5, respectively, p = 0.014. Within both groups, the posttest scores significantly improved; however, the increase for the gaming group was greater for both measures. Because the influence of age, sex, and level of education can be excluded, it can be assumed that mental activities can improve physical rehabilitation after THA.

  10. Cognitive control processes underlying time-based prospective memory impairment in individuals with high depressive symptomatology.

    Science.gov (United States)

    Li, Yanqi Ryan; Weinborn, Michael; Loft, Shayne; Maybery, Murray

    2014-06-01

    The current study compared time-based prospective memory (PM) for individuals with high depressive symptomatology (HDS) and low depressive symptomatology (LDS). We examined PM accuracy rate, clock-checking frequency, and decrements in ongoing task performance (i.e., costs to ongoing tasks) associated with an embedded time-based PM task. HDS participants demonstrated numerically lower but statistically comparable clock-checking frequency to LDS participants. However, their PM performance was significantly poorer than that of LDS participants. The pattern of observed costs to ongoing tasks and correlational analyses between ongoing task performance and PM accuracy showed that, relative to LDS participants, HDS participants were restricted in their allocation of attentional resources to support PM. We concluded that although HDS and LDS participants externally controlled their time-based PM task performance (i.e., clock-checking) similarly, the HDS participants lacked the cognitive initiative to allocate attentional resources to internally control PM task performance. Such internal control might reflect time-estimation processes, the resources required to maintain the PM task response intention, and/or the ability to coordinate the PM task response with ongoing task demands. To our knowledge, this is the first paper to have examined time-based PM strategies used by HDS individuals beyond clock-checking. The data suggest that interventions that encourage intermittent strategic reviews of PM goals may be beneficial for individuals with high depressive symptomatology.

  11. A new key neurohormone controlling reproduction, gonadotrophin-inhibitory hormone in birds: discovery, progress and prospects.

    Science.gov (United States)

    Tsutsui, K; Saigoh, E; Yin, H; Ubuka, T; Chowdhury, V S; Osugi, T; Ukena, K; Sharp, P J; Wingfield, J C; Bentley, G E

    2009-03-01

    In vertebrates, the neuropeptide control of gonadotrophin secretion is primarily through the stimulatory action of the hypothalamic decapeptide, gonadotrophin-releasing hormone (GnRH). Gonadal sex steroids and inhibin inhibit gonadotrophin secretion via feedback from the gonads, but a hypothalamic neuropeptide inhibiting gonadotrophin secretion was, until recently, unknown in vertebrates. In 2000, we discovered a novel hypothalamic dodecapeptide that directly inhibits gonadotrophin release in quail and termed it gonadotrophin-inhibitory hormone (GnIH). GnIH acts on the pituitary and GnRH neurones in the hypothalamus via a novel G-protein-coupled receptor for GnIH to inhibit gonadal development and maintenance by decreasing gonadotrophin release and synthesis. The pineal hormone melatonin is a key factor controlling GnIH neural function. GnIH occurs in the hypothalamus of several avian species and is considered to be a new key neurohormone inhibiting avian reproduction. Thus, the discovery of GnIH provides novel directions to investigate neuropeptide regulation of reproduction. This review summarises the discovery, progress and prospects of GnIH, a new key neurohormone controlling reproduction.

  12. Paracervical block with 1% lidocaine for pain control during intrauterine device insertion: a prospective, single-blinded, controlled study

    Directory of Open Access Journals (Sweden)

    Derya Akdag Cirik

    2013-06-01

    Full Text Available In this prospective controlled study we aimed to investigate efficacy of paracervical block with 1% Lidocaine for pain control and demographic variables which may affect pain perception during intrauterine device insertion in Turkish women. Data from 95 women assigned to paracervical block (n=34, placebo (n=30 and no treatment (n=31 arms and asked to grade the pain level they felt during tenaculum placement, intrauterine device insertion and 5 minutes after the procedure using a visual pain scale. Demographic variables were also recorded. Pain scores were found to be lower in paracervical block group when compared to other 2 groups during tenaculum placement (p=0.00, intrauterine device insertion (p=0.00 and 5 minutes after the procedure (p=0.00. Level of pain was unrelated to mode of previous deliveries and current breastfeeding. Paracervical block is an easy, safe and effective way of pain control during intrauterine device insertion. Lack of vaginal birth history is not a reason to draw back from intrauterine device use. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000: 263-267

  13. Testosterone treatment and MMPI-2 improvement in transgender men: a prospective controlled study.

    Science.gov (United States)

    Keo-Meier, Colton L; Herman, Levi I; Reisner, Sari L; Pardo, Seth T; Sharp, Carla; Babcock, Julia C

    2015-02-01

    Most transgender men desire to receive testosterone treatment in order to masculinize their bodies. In this study, we aimed to investigate the short-term effects of testosterone treatment on psychological functioning in transgender men. This is the 1st controlled prospective follow-up study to examine such effects. We examined a sample of transgender men (n = 48) and nontransgender male (n = 53) and female (n = 62) matched controls (mean age = 26.6 years; 74% White). We asked participants to complete the Minnesota Multiphasic Personality Inventory (2nd ed., or MMPI-2; Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) to assess psychological functioning at baseline and at the acute posttreatment follow-up (3 months after testosterone initiation). Regression models tested (a) Gender × Time interaction effects comparing divergent mean response profiles across measurements by gender identity; (b) changes in psychological functioning scores for acute postintervention measurements, adjusting for baseline measures, comparing transgender men with their matched nontransgender male and female controls and adjusting for baseline scores; and (c) changes in meeting clinical psychopathological thresholds. Statistically significant changes in MMPI-2 scale scores were found at 3-month follow-up after initiating testosterone treatment relative to baseline for transgender men compared with female controls (female template): reductions in Hypochondria (p < .05), Depression (p < .05), Hysteria (p < .05), and Paranoia (p < .01); and increases in Masculinity-Femininity scores (p < .01). Gender × Time interaction effects were found for Hysteria (p < .05) and Paranoia (p < .01) relative to female controls (female template) and for Hypochondria (p < .05), Depression (p < .01), Hysteria (p < .01), Psychopathic Deviate (p < .05), Paranoia (p < .01), Psychasthenia (p < .01), and Schizophrenia (p < .01) compared with male controls (male template). In addition, the proportion of

  14. Sleep disorders in spinal and bulbar muscular atrophy (Kennedy's disease): a controlled polysomnographic and self-reported questionnaires study.

    Science.gov (United States)

    Romigi, Andrea; Liguori, Claudio; Placidi, Fabio; Albanese, Maria; Izzi, Francesca; Uasone, Elisabetta; Terracciano, Chiara; Marciani, Maria Grazia; Mercuri, Nicola Biagio; Ludovisi, Raffaella; Massa, Roberto

    2014-05-01

    No data are available regarding the occurrence of sleep disorders in spinal and bulbar muscular atrophy (SBMA). We investigated the sleep-wake cycle in SBMA patients compared with healthy subjects. Nine SBMA outpatients and nine age-matched and sex-matched healthy controls were evaluated. Subjective quality of sleep was assessed by means of the Pittsburgh Sleep Quality Index (PSQI). The Epworth Sleepiness Scale was used in order to evaluate excessive daytime sleepiness. All participants underwent a 48-h polysomnography followed by the multiple sleep latency test. Time in bed, total sleep time and sleep efficiency were significantly lower in SBMA than controls. Furthermore, the apnea-hypopnea index (AHI) was significantly higher in SBMA than controls. Obstructive sleep apnea (OSA: AHI >5/h) was evident in 6/9 patients (66.6 %). REM sleep without atonia was evident in three patients also affected by OSA and higher AHI in REM; 2/9 (22.2 %) SBMA patients showed periodic limb movements in sleep. The global PSQI score was higher in SBMA versus controls. Sleep quality in SBMA is poorer than in controls. OSA is the most common sleep disorder in SBMA. The sleep impairment could be induced both by OSA or/and the neurodegenerative processes involving crucial areas regulating the sleep-wake cycle.

  15. Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation

    Science.gov (United States)

    Alicia Ommerborn, Michelle; Giraki, Maria; Schneider, Christine; Michael Fuck, Lars; Handschel, Jörg; Franz, Matthias; Hans-Michael Raab, Wolfgang; Schäfer, Ralf

    2012-01-01

    This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann–Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive capacity of the stomatognathic system into future investigations. PMID:22935746

  16. Cocktail sedation containing propofol versus conventional sedation for ERCP: a prospective, randomized controlled study

    Directory of Open Access Journals (Sweden)

    Angsuwatcharakon Phonthep

    2012-08-01

    Full Text Available Abstract Background ERCP practically requires moderate to deep sedation controlled by a combination of benzodiazepine and opiod. Propofol as a sole agent may cause oversedation. A combination (cocktail of infused propofol, meperidine, and midazolam can reduce the dosage of propofol and we hypothesized that it might decrease the risk of oversedation. We prospectively compare the efficacy, recovery time, patient satisfactory, and side effects between cocktail and conventional sedations in patients undergoing ERCP. Methods ERCP patients were randomized into 2 groups; the cocktail group (n = 103 and the controls (n = 102. For induction, a combination of 25 mg of meperidine and 2.5 mg of midazolam were administered in both groups. In the cocktail group, a bolus dose of propofol 1 mg/kg was administered and continuously infused. In the controls, 25 mg of meperidine or 2.5 mg/kg of midazolam were titrated to maintain the level of sedation. Results In the cocktail group, the average administration rate of propofol was 6.2 mg/kg/hr. In the control group; average weight base dosage of meperidine and midazolam were 1.03 mg/kg and 0.12 mg/kg, respectively. Recovery times and patients’ satisfaction scores in the cocktail and control groups were 9.67 minutes and 12.89 minutes (P = 0.045, 93.1and 87.6 (P P Conclusions Cocktail sedation containing propofol provides faster recovery time and better patients’ satisfaction for patients undergoing ERCP. However, mild degree of desaturation may still develop. Trial registration ClinicalTrials.gov, NCT01540084

  17. Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Luke E. Grzeskowiak

    2016-02-01

    Full Text Available There exists a paucity of data for socially disadvantaged populations describing patterns and predictors of asthma control status and exacerbations during pregnancy, and their relationship to adverse perinatal outcomes. Asthmatic women (n=189 were followed prospectively during pregnancy, with visits at 12, 20, 28 and 36 weeks gestation. Data on loss of control, recurrent uncontrolled asthma and moderate/severe exacerbations were collected at each visit and their relationship to perinatal outcomes examined following stratification for fetal sex. 50% of asthmatic women experienced a loss of control or moderate/severe exacerbation during pregnancy, with 22% of women experiencing a moderate/severe exacerbation. Factors associated with an increased risk of women experiencing recurrent uncontrolled asthma during pregnancy included smoking (relative risk 2.92, 95% CI 1.53–5.58, inhaled corticosteroid use at the beginning of pregnancy (relative risk 2.40, 95% CI 1.25–4.60 and increasing maternal age (relative risk 1.06, 95% CI 1.01–1.11. No factors were associated with moderate/severe exacerbations. Asthma control rather than exacerbations during pregnancy appeared to be most strongly correlated with perinatal outcomes. Following stratification by fetal sex, the presence of recurrent uncontrolled asthma was associated with an increased risk of being small for gestational age in women pregnant with females (33.3% versus 9.5%; p=0.018. In contrast, there was a nonsignificant increased risk of preterm birth in women with recurrent uncontrolled asthma that were pregnant with males (25.0% versus 11.8%; p=0.201 These results suggest that the key to improving perinatal outcomes lies in improving asthma control as early as possible in pregnancy and monitoring throughout pregnancy, rather than focusing on preventing exacerbations alone.

  18. Scope and Limits of an anamnestic questionnaire in a control-induced low-endemicity helminthiasis setting in south-central Cote d'Ivoire.

    Directory of Open Access Journals (Sweden)

    Thomas Fürst

    Full Text Available BACKGROUND: Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available. METHODOLOGY: Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d'Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals' helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings. PRINCIPAL FINDINGS: Our study sample consisted of 195 adults (101 males, 94 females. We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05 associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties. CONCLUSIONS

  19. [Questionnaires in sexual medicine].

    Science.gov (United States)

    Giuliano, F

    2013-07-01

    Screening, diagnosis and assessment of the management of male and female sexual dysfunctions have been greatly improved by the scientific development of self-administered questionnaires. Their use became the rule in clinical trials and epidemiological surveys. Nevertheless, their routine use has not yet become part of daily urological practice. Even if these tools replace neither the patient interview and medical history and the psychological and social context of the sexual behavior, nor clinical examination, they are of great assistance for determining management and are also highly reliable. Medical literature was reviewed and combined with expert opinion of the author. We present here several questionnaires which have been validated in their French version with the methodology for the calculation of the scores. The International Index of Erectile Function (15 items) and two abbreviated versions, the Erectile Function domain (six items) and the Sexual Health Inventory for Men (five questions) are mainly of use for patients with erectile dysfunction. They provide a robust classification of the severity of the condition. The Premature Ejaculation Profile (four questions) is used for patients with premature ejaculation. It describes premature ejaculation with the following criteria: time to ejaculation, control over ejaculation, the level of distress. The Male Health Sexual Questionnaire (25 questions) provides with a wider and more comprehensive approach to male sexuality of male sexuality including: erection, ejaculation, desire and satisfaction. This questionnaire is particularly useful to investigate ejaculatory disorders. Lastly, the Female Sexual Function Index (19 questions) is the tool of choice for female sexuality with questions regarding desire, arousal, lubrication, orgasm, satisfaction and pain. Validated, user-friendly questionnaires are available in French language for the diagnosis and the follow-up of sexual dysfunctions in both men and women

  20. Examination of the diagnostic validity of 'headache attributed to whiplash injury': a controlled, prospective study.

    Science.gov (United States)

    Schrader, H; Stovner, L J; Obelieniene, D; Surkiene, D; Mickeviciene, D; Bovim, G; Sand, T

    2006-11-01

    Acute and chronic headache attributed to whiplash injury are new diagnostic entities in the International Classification of Headache Disorders, second edition. A main objective of the present study was to assess the validity of these nosologic entities by studying the headache pattern in an inception cohort of 210 rear-end car collision victims and in 210 matched controls. Consecutive drivers involved in rear-end collisions were identified from the daily records of the Traffic Police Department of Kaunas, Lithuania. A standard self-report questionnaire was sent to the drivers between 2 and 7 days after the collision, and their passengers were recruited as well. Headache and neck pain were evaluated within 7 days of the collision, at 2 months and 1 year after the collision. A control group of non-traumatized subjects received questionnaires at the time of the selection and 1 year later. Of the 75 collision victims who developed headache within the first 7 days of the collision, 37 had a clinical picture in accordance with the criteria for acute whiplash headache (i.e., concomitant neck pain) and 38 did not. For acute headache after collision, concomitant neck pain was of no relevance to the headache type or its course. In both these subgroups, migraine and tension-type headache could be diagnosed in similar proportions and the prognosis after 2 months and 1 year was also similar. Preexisting headache was a strong prognostic factor in both groups for both acute and chronic pain. Compared with the non-traumatized control group, the 1-year incidence of new or worsened headache, or of headache improvement, was the same. A likely interpretation of the data is that acute headaches after rear-end car collisions mainly represent episodes of a primary headache precipitated by the stress of the situation. We conclude that the nosologic validity of both acute and chronic whiplash headache is poor as the headaches, in accordance with the criteria lack distinguishing clinical

  1. The effects of parental presence in the postanesthetic care unit on children's postoperative behavior: a prospective, randomized, controlled study.

    Science.gov (United States)

    Lardner, David R; Dick, Bruce D; Crawford, Susan

    2010-04-01

    The effects on children of parental presence in the postanesthesia care unit (PACU) have not been extensively studied. The few published studies are retrospective, nonrandomized, or lack adequate controls. They suggest that parental presence in the PACU decreases crying and negative behavior change postoperatively. We performed this prospective, randomized, controlled study to determine whether the presence of a parent affected crying behaviors in the PACU and behavior change 2 weeks postoperatively. Randomly selected patients, aged 2.0 to 8 years 11 months, ASA physical status I or II, and scheduled for elective outpatient surgery with an anticipated PACU stay of >10 minutes were randomly assigned to the parent present group (n = 150) or parent absent group (n = 150) in the PACU. All parents underwent the same preparation program. Reunification occurred once children's eyes had opened for the parent present group. In the PACU, crying was scored each minute after eye opening using a 5-point scale. Negative behavior change 2 weeks after discharge was determined using the Post Hospitalization Behavior Questionnaire. Because the anesthesia technique to be used was not determined a priori, data on the technique used were collected to ensure that groups were similar. Multiple and logistic regression techniques were used to determine predictors of crying in the PACU and behavior change 2 weeks postoperatively. Parental presence in the PACU made no difference in crying in the PACU. Negative behavior change 2 weeks postoperatively occurred more frequently in the parent absent group than the parent present group (45.8% vs 29.3%; P = 0.007). Multiple regression identified the following significant factors as predictive of larger proportion of time spent crying in the PACU (R(2) = 0.256, F[5, 273] = 15.66, P < 0.001): age <5 years (P < 0.001) and higher Children's Hospital of Eastern Ontario Pain Scale score at 15 minutes after arrival in day surgery (P < 0.001). Parental

  2. Influence of defective complete dentures renewal on TMD; an MRI and clinical controlled prospective study.

    Science.gov (United States)

    Abdelnabi, Mohamed H; Swelem, Amal A

    2015-09-01

    The influence of complete denture occlusion on temporomandibular disorder (TMD) is controversial. Some studies found that defective occlusion contributes to the development of TMD, while others found no correlation. This prospective controlled study evaluated the relationship between renewal of old defective complete dentures and TMD as evidenced both by clinical examination and magnetic resonance imaging (MRI) findings. The study included 25 complete denture patients with signs and symptoms of TMD and 21 asymptomatic controls. Clicking was a common finding in all symptomatic joints. All selected participants needed complete denture renewal. MRI and clinical assessment following research diagnostic criteria for TMD guidelines (RDC/TMD) were carried out at baseline and 2 years after new complete denture insertion. Temporomandibular joint (TMJ) pain, muscle pain, clicking and movement limitation were the assessed signs and symptoms. MRIs were conducted to evaluate the TMJs for disc displacement, disc morphology and joint effusion. Complete denture renewal significantly improved the signs and symptoms of TMD in symptomatic group (p dentures did not affect disc morphology in both groups (p = 0.5 for both groups) but significantly reduced joint effusion in the symptomatic group (symptomatic p complete dentures had a positive impact on TMD signs and symptoms, disc position and joint effusion but not on disc morphology. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  3. Lipid profile in nonobese pregnant women with polycystic ovary syndrome: a prospective controlled clinical study.

    Science.gov (United States)

    Palomba, Stefano; Falbo, Angela; Chiossi, Giuseppe; Muscogiuri, Giovanna; Fornaciari, Eleonora; Orio, Francesco; Tolino, Achille; Colao, Annamaria; La Sala, Giovanni Battista; Zullo, Fulvio

    2014-10-01

    Alterations in lipid pattern and increased risk for obstetric/neonatal complications have been observed in patients with polycystic ovary syndrome (PCOS). Pregnancy leads to physiologic changes in lipoprotein metabolism, and alterations in lipid profile have been related with adverse pregnancy outcomes. Based on these considerations, the aim of the present prospective controlled clinical study was to test the hypothesis that the changes in the lipid profile in patients with PCOS during pregnancy are characteristic and potentially related to the increased risk of obstetric/neonatal complications. One hundred and fifty nonobese PCOS women and 150 age- and body mass index (BMI)-matched healthy controls were enrolled. Serum lipids, glucose, insulin, and androgens levels were serially assayed in all subjects before and throughout pregnancy. Serum low-density lipoprotein (LDL) and triglyceride (TG) concentrations were significantly (Plipid levels, body weight gain, and insulin-resistance markers, serum TG concentrations during pregnancy were directly and independently associated with obstetric complications in both groups, whereas serum LDL levels only in PCOS patients. We can conclude that nonobese PCOS patients had specific changes in lipid profile during pregnancy, and that the lipid pattern typical of PCOS may account for the more frequent adverse pregnancy outcomes. PCOS-related hormonal and metabolic features, such as insulin resistance and high androgen levels, may mediate this phenomenon. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Prospective Randomized Controlled Trial of Liberal Vs Restricted Perioperative Fluid Management in Patients Undergoing Pancreatectomy.

    Science.gov (United States)

    Grant, Florence; Brennan, Murray F; Allen, Peter J; DeMatteo, Ronald P; Kingham, T Peter; D'Angelica, Michael; Fischer, Mary E; Gonen, Mithat; Zhang, Hao; Jarnagin, William R

    2016-10-01

    The aim of this study is to examine, by a prospective randomized controlled trial, the influence of liberal (LIB) vs restricted (RES) perioperative fluid administration on morbidity following pancreatectomy. Randomized controlled trials in patients undergoing major intra-abdominal surgery have challenged the historical use of LIB fluid administration, suggesting that a more restricted regimen may be associated with fewer postoperative complications. Patients scheduled to undergo pancreatic resection were consented for randomization to a LIB (n = 164) or RES (n = 166) perioperative fluid regimen. Sample size was designed with 80% power to decrease Grade 3 complications from 35% to 21%. Between July 2009 and July 2015, we randomized 330 patients undergoing pancreaticoduodenectomy (PD, n = 218), central (n = 16), or distal pancreatectomy (DP, n = 96). Patients were equally distributed for all demographic and intraoperative characteristics. Intraoperatively, LIB patients received crystalloid 12 mL/kg/h and RES patients 6 mL/kg/h. Cumulative crystalloid given (median, range, mL) days 0 to 3 was LIB: 12,252 (6600 to 21,365), RES 7808 (2700 to 16,274) P LIB and 27% of RES patients (P = 0.6). Median length of stay was 7 and 5 days for PD and DP, respectively, in both arms. In a high volume institution, major perioperative complications from pancreatic resection were not significantly influenced by fluid regimens that differed approximately 1.6-fold.

  5. Anxiety and Depressed Mood in Obese Pregnant Women: A Prospective Controlled Cohort Study

    Directory of Open Access Journals (Sweden)

    Annick.F.L. Bogaerts

    2013-04-01

    Full Text Available Background: The psychological health in obese women during pregnancy has been poorly studied. Objective: To compare levels of anxiety and depressed mood during pregnancy in obese versus normal-weight women. Methods: 63 obese pregnant women and 156 normal-weight controls were included prospectively before 15 weeks of gestation. Levels of state and trait anxiety and depressed mood were measured during the first, second and third trimester of pregnancy. A linear mixed-effect model with repeated measures was used to evaluate group differences. Results: The levels of state anxiety significantly increased from trimester 1 to trimester 3 in obese pregnant women (beta = 3.70; p = 0.007, while this parameter remained constant throughout pregnancy in normal-weight women. Levels of trait anxiety and depressed mood significantly decreased from trimester 1 to trimester 2 in controls, but not in obese pregnant women. Variables such as maternal education, ethnicity, marital state, psychological history and miscarriages, parity and smoking behaviour had significant effects on anxiety and/or depressed moods during pregnancy. Obese pregnant women show higher levels of anxiety and depressive symptomatology compared to normal-weight pregnant women. Conclusion: Interventional programmes aiming at preventing the deleterious influence of maternal obesity on perinatal outcomes should include a psycho-educational program specifically tailored to this high-risk group.

  6. Impact of an exercise program on acylcarnitines in obesity: a prospective controlled study

    Science.gov (United States)

    2012-01-01

    Background Acylcarnitine (AC) transport dysfunction into the mitochondrial matrix is one of the pathophysiological mechanisms of type 2 diabetes mellitus (DM). The effect of an aerobic exercise (AE) program on this condition in obese subjects without DM is unclear. Methods A prospective, randomized, longitudinal, interventional study in a University Research Center involved a 10-week AE program in 32 women without DM and a body mass index (BMI) greater than 27 kg/m2. (Cases n = 17; Controls n = 15). The primary objective was to evaluate the influence of a controlled AE program on beta-oxidation according to modifications in short, medium, and long-chain ACs. Secondary objectives were to define the behavior of amino acids, and the correlation between these modifications with metabolic and anthropometric markers. Results The proportion of dropouts was 17% and 6% in controls and cases, respectively. In cases there was a significant reduction in total carnitine (30.40 [95% CI 28.2 to 35.6]) vs. (29.4 [CI 95% 25.1 to 31.7]) p = 0.0008 and long-chain AC C14 (0.06 [95% CI 0.05 to 0.08]) vs. (0.05 [95% CI 0.05 to 0.09]) p = 0.005 and in C18 (0.31 [95% CI 0.27 to 0.45]) vs. (0.28 [95% CI 0.22 to 0.32]) p = 0.03. Free fatty acid levels remained without change during the study in both groups. Conclusion In conclusion, a controlled 10-week AE program improved beta-oxidation by reducing long-chain ACs. This finding highlights the importance that AE might have in avoiding or reverting lipotoxicity, and in consequence, improving insulin sensitivity and pancreatic beta cell functional reserve. PMID:22574901

  7. Calcium and Bone Turnover Markers in Acromegaly: A Prospective, Controlled Study.

    Science.gov (United States)

    Constantin, Tina; Tangpricha, Vin; Shah, Reshma; Oyesiku, Nelson M; Ioachimescu, Octavian C; Ritchie, James; Ioachimescu, Adriana G

    2017-07-01

    Acromegaly has been associated with calcium-phosphate and bone turnover alterations. Controlled studies of these interactions are sparse. To evaluate calcium and bone metabolism in active and treated acromegaly. We conducted a controlled, prospective study at a tertiary referral center. We studied 22 patients with acromegaly referred for surgical or medical therapy (ACM) and 22 with nonfunctioning pituitary adenomas referred for surgery (control). Calcium (serum and urine), phosphorus, parathyroid hormone (PTH), 25-hydroxy- and 1,25-dihydroxy-vitamin D, bone turnover markers [serum C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP)], and cytokines [receptor activator of nuclear factor κB ligand (RANK-L) and osteoprotegerin (OPG)] at baseline and 3 to 6 months after treatment. At baseline, the ACM group had lower PTH levels than controls (36.3 ± 13.9 pg/mL vs 56.0 ± 19.9 pg/mL) and higher phosphorus (4.34 ± 0.71 mg/dL vs 3.55 ± 0.50 mg/dL) (P acromegaly, serum calcium (9.52 ± 0.43 mg/dL to 9.26 ± 0.28 mg/dL), phosphorus (4.34 ± 0.71 mg/dL to 3.90 ± 0.80 mg/dL), and CTX (0.91 ± 0.75 ng/mL to 0.63 ± 0.68 ng/mL) decreased, while PTH increased (36.3 ± 13.9 pg/mL to 48.9 ± 16.7 pg/mL) (P Acromegaly patients exhibited PTH-independent calcium-phosphate alterations and enhanced coupled bone formation and resorption. Within 6 months of treatment, bone resorption decreased, whereas RANK-L/OPG changes were inconsistent.

  8. Impact of an exercise program on acylcarnitines in obesity: a prospective controlled study

    Directory of Open Access Journals (Sweden)

    Rodríguez-Gutiérrez René

    2012-05-01

    Full Text Available Abstract Background Acylcarnitine (AC transport dysfunction into the mitochondrial matrix is one of the pathophysiological mechanisms of type 2 diabetes mellitus (DM. The effect of an aerobic exercise (AE program on this condition in obese subjects without DM is unclear. Methods A prospective, randomized, longitudinal, interventional study in a University Research Center involved a 10-week AE program in 32 women without DM and a body mass index (BMI greater than 27 kg/m2. (Cases n = 17; Controls n = 15. The primary objective was to evaluate the influence of a controlled AE program on beta-oxidation according to modifications in short, medium, and long-chain ACs. Secondary objectives were to define the behavior of amino acids, and the correlation between these modifications with metabolic and anthropometric markers. Results The proportion of dropouts was 17% and 6% in controls and cases, respectively. In cases there was a significant reduction in total carnitine (30.40 [95% CI 28.2 to 35.6] vs. (29.4 [CI 95% 25.1 to 31.7] p = 0.0008 and long-chain AC C14 (0.06 [95% CI 0.05 to 0.08] vs. (0.05 [95% CI 0.05 to 0.09] p = 0.005 and in C18 (0.31 [95% CI 0.27 to 0.45] vs. (0.28 [95% CI 0.22 to 0.32] p = 0.03. Free fatty acid levels remained without change during the study in both groups. Conclusion In conclusion, a controlled 10-week AE program improved beta-oxidation by reducing long-chain ACs. This finding highlights the importance that AE might have in avoiding or reverting lipotoxicity, and in consequence, improving insulin sensitivity and pancreatic beta cell functional reserve.

  9. 大学生生涯自我控制问卷的编制%Development of the Career Self-control Questionnaire for Chinese College Students

    Institute of Scientific and Technical Information of China (English)

    刘华强; 王希华

    2013-01-01

    Objective:To develop the Career Self-control Questionnaire for College Students,and examine its reliability and validity.Methods:On the basis of interview, open-ended questionnaire and literature review, develops the Career Self-control Questionnaire for College Students,revised and finally administered to 992 college students from Fujian Province.Results: The results of exploratory factor analysis studies shows that the structure of the Career Self-control for College Students includes five dimensions , they are: Control efficiency,emotional state of control,action tendencies, plan tendency, control strategy, including 20 items,and explains 54.25%of the total variance.The five-factor model of Career Self-control for College Students had been affirmed by confirmatory factor analysis(χ2/df=1.85、AGFI=0.89、NFI=0.83、CFI=0.87、RM-SEA=0.049).The correlation between total score of Career Self-control Questionnaire for College Students and that of CollegeStudents’ Career Adaptability Questionnaire was 0.49(P<0.01).The internal consistency reliability of the full questionnaire score was 0.82,and those of five factors were 0.68-0.76.. The re-test reliability of full questionnaire was 0.81,and those of five factors were 0.71~0.85.Conclusion:The construct of Career Self-control Questionnaire for College Students is reasonable.The results show that the questionaire offers factorial validity and its scales present internal consistency to evaluate the Career Self-control for College Students.%目的:编制大学生生涯自我控制问卷,检验其信效度.方法:在文献探讨及访谈、开放问卷调查的基础上,编制和修改大学生生涯自我控制问卷,对992名福建省大学生进行测查.结果:探索性因素分析的结果表明,大学生涯自我控制包括控制效能、控制情绪、行动倾向、计划倾向、控制策略等5个因子,共20个项目,累积方差贡献率为55.32%.问卷的验证性因素分

  10. The risk behaviors and mental health of detained adolescents: a controlled, prospective longitudinal study.

    Directory of Open Access Journals (Sweden)

    Zhenhua Zhou

    Full Text Available BACKGROUND: To assess the behavioral risk factors and mental health needs of adolescents in juvenile detention centers (JDC. METHOD: A total of 238 boys aged 12-17 years was surveyed who had been admitted to a detention center and compared them with boys from the community (n = 238 matched for sex and age. We assessed behavioral risk factors and mental health problems by using the Youth Risk Behavior Survey questionnaire (YRBS and the Youth Self-Report questionnaire (YSR. RESULTS: Young offenders had significantly higher YRBS scores than controls for drug use (odds ratio (OR 5.16, 95% CI 2.27-7.84, sexual intercourse (OR, 2.51; 95% CI 1.55-2.90, irregular diet (4.78, 2.11-7.51, suicide attempts (1.96, 1.32-5.85, and physical fighting behavior (3.49, 1.60-7.07, but not for tobacco use, alcohol use, and high-risk cycling. Young offenders at the time of admission (6.61, 2.58-15.2, at 6 months (3.12, 1.81-10.1, and at 12 months (5.29, 1.98-13.3 reported statistically higher levels of total mental health problems than adolescents in a community sample. CONCLUSIONS: Young offenders have a high rate of mental and behavioral disorders. In the detention period, aggressive behavior, self-destructive/identity, and externalizing of problems improved while withdrawn, anxious or depressed, and internalizing of problems worsened.

  11. Day case shoulder surgery: satisfactory pain control without regional anaesthesia. A prospective analysis of a perioperative protocol.

    LENUS (Irish Health Repository)

    Daruwalla, Z J

    2009-03-01

    Pain control is an issue which may limit patients\\' acceptance of day case shoulder surgery. This study prospectively examined the outcome of a protocol for day case shoulder surgery to determine if satisfactory pain relief could be achieved without regional anaesthesia.

  12. Questionnaire-based survey on structural quality of hospitals and nursing homes for the elderly, their staffing with infection control personal, and implementation of infection control measures in Germany

    Directory of Open Access Journals (Sweden)

    Kramer, A.

    2013-04-01

    Full Text Available [english] From January to May 2012, 1,860 hospitals throughout Germany received a questionnaire encompassing 77 items. Additionally, 300 outpatient care services and 310 nursing homes for elderly in Berlin also received a 10-item questionnaire asking on their implemented infection control practices. All questionnaires were anonymous. A total of 229 completed questionnaires from hospitals, 14 questionnaires from outpatient care services, and 16 questionnaires from nursing homes were eligible for further analysis.The lack of Infection Control physicians was identified as the largest issue. In hospitals sized 400–999 beds a gap of 71%, and in hospitals sized ≥1,000 beds a gap of 17% was reported. Depending on the number of hospital beds, 13–29% of hospitals sized ≥100 beds reported not havening one infection control nurse. Since based on the number of beds in larger institutions or in facilities caring for high-risk patients several infection control nurses may be required, the deficiency in infection control nurses may even be higher, particularly in secondary and tertiary care facilities. Furthermore, the analysis revealed that the legal requirements for surveillance and reporting of notifiable infectious diseases have not yet been implemented in 11% of the facilities. The implementation of antibiotic strategies did show significant gaps. However, deficiencies in the implemented measures for the prevention of surgical site infections were less frequent. Yet 12% of the participants did not have a dedicated infection control concept for their surgical services. Eight percent of hospitals were not prepared for an outbreak management and 10% did not have established regulations for wearing surgical scrubs. Deficiencies in waste disposal and the control of air-conditioning systems were also noted. Based on the results of this survey, conclusions on the optimal resource allocation for further improvement of patient safety may be drawn.While all

  13. Questionnaire-based survey on structural quality of hospitals and nursing homes for the elderly, their staffing with infection control personal, and implementation of infection control measures in Germany.

    Science.gov (United States)

    Kramer, A; Assadian, O; Helfrich, J; Krüger, C; Pfenning, I; Ryll, S; Perner, A; Loczenski, B

    2013-01-01

    From January to May 2012, 1,860 hospitals throughout Germany received a questionnaire encompassing 77 items. Additionally, 300 outpatient care services and 310 nursing homes for elderly in Berlin also received a 10-item questionnaire asking on their implemented infection control practices. All questionnaires were anonymous. A total of 229 completed questionnaires from hospitals, 14 questionnaires from outpatient care services, and 16 questionnaires from nursing homes were eligible for further analysis. The lack of Infection Control physicians was identified as the largest issue. In hospitals sized 400-999 beds a gap of 71%, and in hospitals sized ≥1,000 beds a gap of 17% was reported. Depending on the number of hospital beds, 13-29% of hospitals sized ≥100 beds reported not havening one infection control nurse. Since based on the number of beds in larger institutions or in facilities caring for high-risk patients several infection control nurses may be required, the deficiency in infection control nurses may even be higher, particularly in secondary and tertiary care facilities. Furthermore, the analysis revealed that the legal requirements for surveillance and reporting of notifiable infectious diseases have not yet been implemented in 11% of the facilities. The implementation of antibiotic strategies did show significant gaps. However, deficiencies in the implemented measures for the prevention of surgical site infections were less frequent. Yet 12% of the participants did not have a dedicated infection control concept for their surgical services. Eight percent of hospitals were not prepared for an outbreak management and 10% did not have established regulations for wearing surgical scrubs. Deficiencies in waste disposal and the control of air-conditioning systems were also noted. Based on the results of this survey, conclusions on the optimal resource allocation for further improvement of patient safety may be drawn. While all participating nursing homes had

  14. Control of Intraoperative Shivering Under Spinal Anaesthesia- A Prospective Randomized Comparative Study of Butorphanol with Tramadol

    Directory of Open Access Journals (Sweden)

    Astha Palan

    2017-01-01

    Full Text Available Background: Shivering is very uncomfortable and distressing for the patient, anaesthesiologist and the surgeon, especially when the patient is under regional anaesthesia. Aim and Objectives: The present study was designed to evaluate the efficacy of butorphanol and tramadol in the control of shivering under spinal anaesthesia and to compare their side effects. To compare the efficacy, potency, response time, hemodynamic alterations, and adverse effects of intravenously administered tramadol and butorphanol for relief of shivering occurring during spinal anaesthesia. Material and Methods: This randomized prospective study was conducted in 100 patients who developed shivering under spinal anaesthesia during various abdominal, orthopaedic, urological and gynaecological procedures. Patients with fever, acute infections, drug allergy and compromised cardiorespiratory functions were not included in the study. On shivering, patients were randomly allocated in two groups of 50 patients each who received intravenously 1mg of butorphanol or 50 mg of tramadol in a double blinded manner. Control of shivering, time taken for cessation, recurrence, hemodynamic changes, axillary temperatures and side effects were noted and compared for both the groups. Collected data were analysed using Chi square test and Student's unpaired t test. Results: All patients were relieved of shivering after butorphanol, 58% within 1 min, 82% within 3min and 100% within 5 min. Tramadol relieved shivering in 98% of patients, 32% within 1 min, 60% within 3 min, 98% within 5 mins (p<0.05. There was higher incidence of side effects like nausea and vomiting with tramadol (16% and 12% respectively as compared to butorphanol. Conclusion: Both the drugs, tramadol and butorphanol are effective to control shivering after spinal anaesthesia. Butorphanol is better as compared to tramadol in treating shivering under spinal anaesthesia because of its quicker onset of action, higher success rate

  15. Current asthma control predicts future risk of asthma exacerbation: a 12-month prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    WEI Hua-hua; ZHOU Ting; WANG Lan; ZHANG Hong-ping; FU Juan-juan; WANG Lei; JI Yu-lin; WANG Gang

    2012-01-01

    Background The performance of asthma control test (ACT) at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated.This study was designed to explore the ability of the baseline ACT score to predict future risk of asthma exacerbation during a 12-month follow-up.Methods This post hoc analysis included data from a 12-month prospective cohort study in patients with asthma (n=290).The time to the first asthma exacerbation was analyzed and the association between baseline ACT scores and future risk of asthma exacerbation was calculated as adjusted odds ratio (OR) using Logistic regression models.Further,sensitivity and specificity were estimated at each cut-point of ACT scores for predicting asthma exacerbations.Results The subjects were divided into three groups,which were uncontrolled (U,n=128),partly-controlled (PC,n=111),and well controlled (C,n=51) asthma.After adjustment,the decreased ACT scores at baseline in the U and PC groups were associated with an increased probability of asthma exacerbations (OR 3.65 and OR 5.75,respectively),unplanned visits (OR 8.03 and OR 8.21,respectively) and emergency visits (OR 20.00 and OR 22.60,respectively) over a 12-month follow-up period.The time to the first asthma exacerbation was shorter in the groups with U and PC asthma (all P<0.05).The baseline ACT of 20 identified as the cut-point for screening the patients at high risk of asthma exacerbations had an increased sensitivity of over 90.0% but a lower specificity of about 30.0%.Conclusion Our findings indicate that the baseline ACT score with a high sensitivity could rule out patients at low risk of asthma exacerbations and oredict future risk of asthma exacerbations in clinical practice.

  16. Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.

    Science.gov (United States)

    Nendaz, Mathieu R; Gut, Anne M; Louis-Simonet, Martine; Perrier, Arnaud; Vu, Nu V

    2011-04-01

    Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

  17. I-ONE therapy in patients undergoing total knee arthroplasty: a prospective, randomized and controlled study

    Directory of Open Access Journals (Sweden)

    Moretti Biagio

    2012-06-01

    Full Text Available Abstract Background Total knee arthroplasty (TKA is often associated with a severe local inflammatory reaction which, unless controlled, leads to persistent pain up to one year after surgery. Standard and accelerated rehabilitation protocols are currently being implemented after TKA, but no consensus exists regarding the long-term effects. Biophysical stimulation with pulsed electromagnetic fields (PEMFs has been demonstrated to exert an anti-inflammatory effect, to promote early functional recovery and to maintain a positive long-term effect in patients undergoing joint arthroscopy. The aim of this study was to evaluate whether PEMFs can be used to limit the pain and enhance patient recovery after TKA. Methods A prospective, randomized, controlled study in 30 patients undergoing TKA was conducted. Patients were randomized into experimental PEMFs or a control group. Patients in the experimental group were instructed to use I-ONE stimulator 4hours/day for 60days. Postoperatively, all patients received the same rehabilitation program. Treatment outcome was assessed using the Knee Society Score, SF-36 Health-Survey and VAS. Patients were evaluated pre-operatively and one, two, six and 12 months after TKA. Joint swelling and Non Steroidal Anti Inflammatory Drug (NSAID consumption were recorded. Comparisons between the two groups were carried out using a two-tail heteroschedastic Student’s t-test. Analysis of variance for each individual subject during the study was performed using ANOVA for multiple comparisons, applied on each group, and a Dunnet post hoc test. A p value  Results Pre-operatively, no differences were observed between groups in terms of age, sex, weight, height, Knee-Score, VAS, SF-36 and joint swelling, with the exception of the Functional Score. The Knee-Score, SF-36 and VAS demonstrated significantly positive outcomes in the I-ONE stimulated group compared with the controls at follow-ups. In the I-ONE group, NSAID use was

  18. Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

    OpenAIRE

    2014-01-01

    Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T...

  19. Koi herpesvirus: distribution and prospects for control in England and Wales.

    Science.gov (United States)

    Taylor, N G H; Dixon, P F; Jeffery, K R; Peeler, E J; Denham, K L; Way, K

    2010-03-01

    Koi herpesvirus (KHV) causes a highly virulent disease affecting carp, Cyprinus carpio L., and poses a serious socio-economic threat to the UK carp industry. This study aimed to determine the geographic distribution and prevalence of KHV exposed fish in England and Wales through ELISA antibody testing. Only three of the 82 farms sampled produced positive results, suggesting fish farms provide a relatively safe source of fish. Of the 71 'high-risk' fisheries tested, 26 were positive. All eight geographic areas within England and Wales studied had at least one KHV positive site. Twelve consignments of imported koi carp from seven S.E. Asian countries were tested for KHV antibody. Six consignments from six different countries were positive. Although a high proportion of consignments were positive, the results indicate that lower risk stocks of fish exist that could be sourced by the ornamental carp sector. The study provides evidence that KHV is widespread and prevalent in 'high-risk' fisheries. There are, however, prospects for controlling KHV as English and Welsh farms appear to be relatively free of the virus, and in most cases fish are not moved from fisheries to other waters.

  20. Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Rosenson, Jonathan; Clements, Carter; Simon, Barry; Vieaux, Jules; Graffman, Sarah; Vahidnia, Farnaz; Cisse, Bitou; Lam, Joseph; Alter, Harrison

    2013-03-01

    Acute alcohol withdrawal syndrome (AAWS) is encountered in patients presenting acutely to the Emergency Department (ED) and often requires pharmacologic management. We investigated whether a single dose of intravenous (i.v.) phenobarbital combined with a standardized lorazepam-based alcohol withdrawal protocol decreases intensive care unit (ICU) admission in ED patients with acute alcohol withdrawal. This was a prospective, randomized, double-blind, placebo-controlled study. Patients were randomized to receive either a single dose of i.v. phenobarbital (10 mg/kg in 100 mL normal saline) or placebo (100 mL normal saline). All patients were placed on the institutional symptom-guided lorazepam-based alcohol withdrawal protocol. The primary outcome was initial level of hospital admission (ICU vs. telemetry vs. floor ward). There were 198 patients enrolled in the study, and 102 met inclusion criteria for analysis. Fifty-one patients received phenobarbital and 51 received placebo. Baseline characteristics and severity were similar in both groups. Patients that received phenobarbital had fewer ICU admissions (8% vs. 25%, 95% confidence interval 4-32). There were no differences in adverse events. A single dose of i.v. phenobarbital combined with a symptom-guided lorazepam-based alcohol withdrawal protocol resulted in decreased ICU admission and did not cause increased adverse outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Refractive predictability in eyes with intraocular gas tamponade - results of a prospective controlled clinical trial.

    Science.gov (United States)

    Wagenfeld, Lars; Hermsdorf, Kristin; Stemplewitz, Birthe; Druchkiv, Vasyl; Frings, Andreas

    2017-01-01

    To determine the postoperative refractive error in eyes with intraocular gas tamponade in combined phacovitrectomy using a Z-haptic intraocular lens (IOL). This prospective non-randomized case-control study compared patients with combined phacovitrectomy with or without intraocular gas tamponade to cataract surgery-only. The main outcome measure was the IOL power prediction error (PE). Secondary outcome measures were spherical equivalent, anterior chamber depth (ACD), and axial length. Thirty-four patients with epiretinal membranes and 18 patients with cataract only were enrolled. There were no statistically significant (P>0.05) differences of IOL power PE or postoperative ACDs (P=0.952-1.00). Nevertheless, IOL power PE indicated a myopic shift in cases with phacovitrectomy independent of gas tamponade (P=1.00). No statistically significant between-group differences between secondary outcome measures were observed. A myopic shift after phacovitrectomy seems to be independent of the use of intraocular gas tamponade. When using a Z-haptic IOL, aiming for slight residual hyperopia (+0.50 D) is suggested in patients having phacovitrectomy.

  2. Is air transport of stroke patients faster than ground transport? A prospective controlled observational study.

    Science.gov (United States)

    Hesselfeldt, Rasmus; Gyllenborg, Jesper; Steinmetz, Jacob; Do, Hien Quoc; Hejselbæk, Julie; Rasmussen, Lars S

    2014-04-01

    Helicopters are widely used for interhospital transfers of stroke patients, but the benefit is sparsely documented. We hypothesised that helicopter transport would reduce system delay to thrombolytic treatment at the regional stroke centre. In this prospective controlled observational study, we included patients referred to a stroke centre if their ground transport time exceeded 30 min, or they were transported by a secondarily dispatched, physician-staffed helicopter. The primary endpoint was time from telephone contact to triaging neurologist to arrival in the stroke centre. Secondary endpoints included modified Rankin Scale at 3 months, 30-day and 1-year mortality. A total of 330 patients were included; 265 with ground transport and 65 with helicopter, of which 87 (33%) and 22 (34%), received thrombolysis, respectively (p=0.88). Time from contact to triaging neurologist to arrival in the regional stroke centre was significantly shorter in the ground group (55 (34-85) vs 68 (40-85) min, pground group (67 (42-136) km) than in the helicopter group (83 (46-143) km) (pground and helicopter transport. We found significantly shorter time from contact to triaging neurologist to arrival in the regional stroke centre if stroke patients were transported by primarily dispatched ground ambulance compared with a secondarily dispatched helicopter.

  3. Infants Prospectively Control Reaching Based on the Difficulty of Future Actions: To What Extent Can Infants' Multiple-Step Actions Be Explained by Fitts' Law?

    Science.gov (United States)

    Gottwald, Janna M.; De Bortoli Vizioli, Aurora; Lindskog, Marcus; Nyström, Pär; L. Ekberg, Therese; von Hofsten, Claes; Gredebäck, Gustaf

    2017-01-01

    Prospective motor control, a key element of action planning, is the ability to adjust one's actions with respect to task demands and action goals in an anticipatory manner. The current study investigates whether 14-month-olds can prospectively control their reaching actions based on the difficulty of the subsequent action. We used a reach-to-place…

  4. Infants Prospectively Control Reaching Based on the Difficulty of Future Actions: To What Extent Can Infants' Multiple-Step Actions Be Explained by Fitts' Law?

    Science.gov (United States)

    Gottwald, Janna M.; De Bortoli Vizioli, Aurora; Lindskog, Marcus; Nyström, Pär; L. Ekberg, Therese; von Hofsten, Claes; Gredebäck, Gustaf

    2017-01-01

    Prospective motor control, a key element of action planning, is the ability to adjust one's actions with respect to task demands and action goals in an anticipatory manner. The current study investigates whether 14-month-olds can prospectively control their reaching actions based on the difficulty of the subsequent action. We used a reach-to-place…

  5. Serum taurine and risk of coronary heart disease: a prospective, nested case-control study

    Science.gov (United States)

    Wójcik, Oktawia P.; Koenig, Karen L.; Zeleniuch-Jacquotte, Anne; Pearte, Camille; Costa, Max; Chen, Yu

    2013-01-01

    Purpose Taurine (2-aminoethanesulfonic acid), a molecule obtained from diet, is involved in bile acid conjugation, blood pressure regulation, anti-oxidation and anti-inflammation. We performed the first prospective study of taurine and CHD risk. Methods We conducted a case-control study nested in the New York University Women’s Health Study to evaluate the association between circulating taurine levels and risk of coronary heart disease (CHD). Taurine was measured in two yearly pre-diagnostic serum samples of 223 CHD cases and 223 matched controls and averaged for a more reliable measurement of long-term taurine levels. Results Mean serum taurine was positively related to age and dietary intake of poultry, niacin, vitamin B1, fiber, and iron, and negatively related to dietary intake of saturated fat (all p values ≤ 0.05). There was no statistically significant association between the risk of CHD and serum taurine levels. The adjusted ORs for CHD in increasing taurine tertiles were 1.0 (reference), 0.85 (95% CI, 0.51–1.40), and 0.66 (0.39–1.13; p for trend = 0.14). There was a significant inverse association between serum taurine and CHD risk among women with high total serum cholesterol (>250 mg/dl) (adjusted OR = 0.39 (0.19–0.83) for the third vs. first tertile; p for trend = 0.02) but not among those with low total serum cholesterol (p for interaction = 0.01). The data suggest a possible inverse association of serum taurine with diabetes and hypertension risk. Conclusions The findings suggest that high levels of taurine may be protective against CHD among individuals with high serum cholesterol levels. PMID:22322924

  6. Endoscopic versus microscopic type 1 tympanoplasty in the same patients: a prospective randomized controlled trial.

    Science.gov (United States)

    Kaya, Isa; Sezgin, Baha; Sergin, Demet; Ozturk, Arin; Eraslan, Sevinc; Gode, Sercan; Bilgen, Cem; Kirazli, Tayfun

    2017-07-01

    The aim of this study was to compare the audiologic outcomes of the patients who underwent endoscopy on one ear and microscopic tympanoplasty on the other, and to investigate the operative time, graft success, postoperative pain and health status. This prospective randomized controlled study was carried out in Ege University ENT Department between February 2015 and September 2016. The patients who had bilateral chronic otitis media, normal middle ear mucosa and a hearing loss difference of 10 dB or less between the two ears randomly underwent microscopic tympanoplasty in one ear and endoscopic tympanoplasty in the contralateral ear, with 6-month intervals. 13 patients were included in the study with a mean age of 36.17 ± 3.61 years (range 17-53 years, 7 female, 6 male). The improvement in air-bone gap for groups 1 (endoscopic) and 2 (microscopic) was 9.48 ± 5.23 and 9.89 ± 2.79 dB, respectively. The duration of the surgery in group 1 was significantly lower than that in group 2 (p microscopic surgery. In addition, endoscopic surgery offers comparable improvement in air-bone gap and similar graft success. The endoscopic approach has comparable audiological and morphological graft outcomes with the microscopic one. The endoscopic approach yielded better health and pain status for the same patients. Level of evidence This is an individual randomized controlled trial. The level of evidence is 1b.

  7. Laparoscopic versus open gastrectomy for gastric cancer, a multicenter prospectively randomized controlled trial (LOGICA-trial).

    Science.gov (United States)

    Haverkamp, Leonie; Brenkman, Hylke J F; Seesing, Maarten F J; Gisbertz, Suzanne S; van Berge Henegouwen, Mark I; Luyer, Misha D P; Nieuwenhuijzen, Grard A P; Wijnhoven, Bas P L; van Lanschot, Jan J B; de Steur, Wobbe O; Hartgrink, Henk H; Stoot, Jan H M B; Hulsewé, Karel W E; Spillenaar Bilgen, Ernst J; Rütter, Jeroen E; Kouwenhoven, Ewout A; van Det, Marc J; van der Peet, Donald L; Daams, Freek; Draaisma, Werner A; Broeders, Ivo A M J; van Stel, Henk F; Lacle, Miangela M; Ruurda, Jelle P; van Hillegersberg, Richard

    2015-07-29

    For gastric cancer patients, surgical resection with en-bloc lymphadenectomy is the cornerstone of curative treatment. Open gastrectomy has long been the preferred surgical approach worldwide. However, this procedure is associated with considerable morbidity. Several meta-analyses have shown an advantage in short-term outcomes of laparoscopic gastrectomy compared to open procedures, with similar oncologic outcomes. However, it remains unclear whether the results of these Asian studies can be extrapolated to the Western population. In this trial from the Netherlands, patients with resectable gastric cancer will be randomized to laparoscopic or open gastrectomy. The study is a non-blinded, multicenter, prospectively randomized controlled superiority trial. Patients (≥18 years) with histologically proven, surgically resectable (cT1-4a, N0-3b, M0) gastric adenocarcinoma and European Clinical Oncology Group performance status 0, 1 or 2 are eligible to participate in the study after obtaining informed consent. Patients (n = 210) will be included in one of the ten participating Dutch centers and are randomized to either laparoscopic or open gastrectomy. The primary outcome is postoperative hospital stay (days). Secondary outcome parameters include postoperative morbidity and mortality, oncologic outcomes, readmissions, quality of life and cost-effectiveness. In this randomized controlled trial laparoscopic and open gastrectomy are compared in patients with resectable gastric cancer. It is expected that laparoscopic gastrectomy will result in a faster recovery of the patient and a shorter hospital stay. Secondly, it is expected that laparoscopic gastrectomy will be associated with a lower postoperative morbidity, less readmissions, higher cost-effectiveness, better postoperative quality of life, but with similar mortality and oncologic outcomes, compared to open gastrectomy. The study started on 1 December 2014. Inclusion and follow-up will take 3 and 5

  8. Major dietary factors and prostate cancer risk: a prospective multicenter case-control study.

    Science.gov (United States)

    Salem, Sepehr; Salahi, Mona; Mohseni, Mona; Ahmadi, Hamed; Mehrsai, Abdolrasoul; Jahani, Yunes; Pourmand, Gholamreza

    2011-01-01

    The association between diet and prostate cancer (PC) risk, although suggestive, still remains largely elusive particularly in the Asian population. This study sought to further evaluate the possible effects of different dietary factors on risk of PC in Iran. Using data from a prospective hospital-based multicenter case-control study, dietary intakes of red meat, fat, garlic, and tomato/tomato products, as well as thorough demographic and medical characteristics, were determined in 194 cases with the newly diagnosed, clinicopathologically confirmed PC and 317 controls, without any malignant disease, admitted to the same network of hospitals. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were obtained after adjustment for major potential confounders, including age, body mass index, smoking, alcohol, education, occupation, family history of PC, and total dietary calories. Comparing the highest with the lowest tertile, a significant trend of increasing risk with more frequent consumption was found for dietary fat (OR: 1.79, 95% CI: 1.71-4.51), whereas inverse association was observed for tomato/tomato products (OR: 0.33, 95% CI: 0.16-0.65). A nonsignificant increase in PC risk was revealed for dietary red meat (OR: 1.69, 95% CI: 0.93-3.06). For garlic consumption, a borderline reduction in risk was observed (OR: 0.58, 95% CI: 0.32-1.01; P = 0.05). In conclusion, our study supports the hypothesis that total fat may increase PC risk and tomatoes/tomato products and garlic may protect patients against PC.

  9. Wu-Ling-San formula prophylaxis against recurrent calcium oxalate nephrolithiasis - a prospective randomized controlled trial.

    Science.gov (United States)

    Lin, Eugene; Ho, Lin; Lin, Mao-Sheng; Huang, Min-Ho; Chen, Wen-Chi

    2013-01-01

    Wu-Ling-San (WLS) formula has been proved to prevent calcium oxalate nephrolithiasis both in vitro and in vivo. This is the first prospective, randomized and placebo-controlled clinical trial of WLS in calcium oxalate nephrolithiasis prevention. All patients who enrolled were asked to drink enough fluid to urinate at least 2 L daily during the study period. A 24-hour urine collection was performed to establish the baseline levels of multiple urinary parameters before taking the medicine. The patients were randomized and divided into two groups. The medication group took 2 gm WLS formula three times daily for 1 month. The control group took 2 gm placebo three times daily for 1 month. A 24-hour urine collection was performed to evaluate multiple urinary and serum parameters from all patients during the study period. A total of 39 patients were enrolled and 28 patients completed the study. Fourteen patients were allocated to WLS group and 14 patients to placebo group. After treatment, the mean urine output level increased to 2796.4 ± 525.7 ml/day (percentage of change, 13.9 %) in the WLS formula group. With placebo therapy, the mean decreased slightly to 2521.4 ± 762.7ml/day (percentage of change, -5.7 %). The percentage of change was significantly different between the two groups (independent t-test, P=0.02). No patient complained of side effects, such as fatigue, dizziness, musculoskeletal symptoms, or gastrointestinal disturbance. WLS formula is a promising adjunct to surgical and medical management of kidney stones. Active therapy with WLS formula has a positive effect on diuresis without leading to electrolyte imbalance.

  10. SPINAL ANAESTHESIA VERSUS GENERAL ANAESTHESIA FOR LAPAROSCOPIC CHOLECYSTECTOMY - A PROSPECTIVE RANDOMIZED CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Prasad

    2014-02-01

    Full Text Available INTRODUCTION: Combining minimal invasive surgical and lesser invasive anesthesia technique reduces morbidity and mortality. The aim of the study is to compare spinal anesthesia with the gold standard general anesthesia for elective laparoscopic cholecystectomy. MATERIALS & METHODS: 60 healthy patients were randomized under spinal anesthesia (n=30 & General Anesthesia (n=30 . Hyperbaric 3ml bupivacaine plus 25mcg fenta nyl was administered for spinal group and conventional general anesthesia for GA group. Intraoperative parameters and post - operative pain and recovery were noted. Under spinal group any intraoperative discomfort were taken care by reassurance , drugs or con verted to GA. Questionnaire forms were provided for patients and surgeons to comment about the operation. RESULTS: None of the patients had significant hemodynamic and respiratory disturbance except for transient hypotension and bradycardia. Operative time was comparable. 6patients under spinal anesthesia had right shoulder pain , 2 patients were converted to GA and 4 patients were managed by injection midazolam and infiltration of lignocaine over the diaphragm. There was significant post - operative pain reli ef in spinal group. All the patients were comfortable and surgeons satisfied. CONCLUSION: Spinal anesthesia is adequate and safe for laparoscopic cholecystectomy in otherwise healthy patients and offers better postoperative pain control than general anesth esia without limiting recovery , but require cooperative patient , skilled surgeon , a gentle surgical technique and an enthusiastic anesthesiologist

  11. BLEEDING PEPTIC ULCER, NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND HELICOBACTER PYLORI INFECTION – A PROSPECTIVE, CONTROLLED, RANDOMIZED STUDY

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2002-06-01

    Full Text Available Background. The explanation of peptic ulcer etiology has changed significantly in the past decade after the clarification of the significance of Helicobacter pylori infection.Aim. To evaluate the effectiveness of Helicobacter pylori eradication in patients with hemorrhaging peptic ulcer and patients with peptic ulcer without complications.Study ethics. The study was approved in 1998 by the Medical Ethics Committee of the Republic of Slovenia (No. 90/09/98.Type of study. Prospective, controlled and randomized study, carried out between 1998–2000.Patients and methods. The study included 80 patients (50 male and 30 female, av.age 57.5 years, SD ± 17.1, range 22– 80 in which endoscopy confirmed hemorrhage from peptic ulcer of stomach or duodenum and Helicobacter pylori infection. In all cases endoscopic hemostasis was performed: injection sclerotherapy with diluted adrenalin 1:10,000 and 1% polidocanol or argon plasma coagulation. The control group was made up of 80 patients (50 male and 30 female, av.age 56.8 years, SD ± 16.8, range 19–80 with peptic ulcer of stomach or duodenum and Helicobacter pylori infection. Infection was confirmed by a rapid urease test and histologic investigation of the gastric mucosa. In all cases the recommended drug combinations were used in the treatment of the infection: a proton pump inhibitor, omeprazol (4 weeks, and combination of antibiotics, claritromycin and metronidazole or with regard to the antibiogram (1 week. The therapeutic success was ascertained endoscopically four weeks after inclusion in the study. Infection eradication was confirmed by the rapid urease test and histologic investigation of the gastric mucosa.Results. Four weeks after inclusion in the study the success of infection eradication was 92.5% in the study group, in the control group it was 91.3% (p > 0.05. In 6 patients (7.5%, 6/ 80 from the study group and in 7 (8.8%, 7/80 from the control group we introduced a replacement treatment

  12. The Survey Questionnaire

    Science.gov (United States)

    Ritter, Lois A. Ed.; Sue, Valerie M., Ed.

    2007-01-01

    Internet-based surveys are still relatively new, and researchers are just beginning to articulate best practices for questionnaire design. Online questionnaire design has generally been guided by the principles applying to other self-administered instruments, such as paper-based questionnaires. Web-based questionnaires, however, have the potential…

  13. A case-control questionnaire survey of risk factors for Porcine Reproductive and Respiratory Syndrome (PRRS) seropositi¬vity in Danish swine herds

    DEFF Research Database (Denmark)

    Mousing, J.; Permin, A.; Mortensen, S.

    1997-01-01

    Sixty-eight case herds seropositive to porcine reproductive and respiratory syndrome (PRRS) were compared to 128 seronegative controls in a double-blinded questionnaire survey. The study indicated no increased risk of PRRS seropositivity for herds using artificial insemination with semen from PRRS...... seropositive AI-stations. Also the herd-size was non-related to the risk of PRRS seropositivity, indicating that air-borne spread of PRRS may not have been a predominant feature in Denmark. Introduction of replacement breeding animals from seropositive breeding- and multiplying herds significantly increased...... the risk of a herd being PRRS seropositive, as did introduction of 25 kg pigs for feeding. PRRS seropositivity was in the farmers' opinions associated with abortions in sows, early farrowing, high postweaning mortality and low weight gain in fattening pigs. However, the reported frequencies of problems...

  14. Is the routine pressure dressing after thyroidectomy necessary? A prospective randomized controlled study

    Directory of Open Access Journals (Sweden)

    Phuttharak Warinthorn

    2008-03-01

    Full Text Available Abstract Background An acute complication of thyroidectomy is fatal hematoma, which can produce an upper airway obstruction needing immediate intubation or tracheostomy. After neck surgery, we usually apply a pressure dressing with a non-woven, adhesive fabric to reduce bleeding and fluid collection at the operative bed. We conducted a prospective, randomized, controlled study to evaluate a pressure vs. a non-pressure dressing after thyroid surgery by monitoring blood and serum in the operative bed. Methods We studied 108 patients who underwent 116 thyroid surgeries at Srinagarind Hospital, Khon Kaen University, between December 2006 and September 2007. The patients were randomized to either the pressure dressing or non-pressure dressing group. Ultrasound of the neck was performed 24 ± 3 hours after surgery. The volume of fluid collection in the operative bed was calculated. All patients were observed for any post-operative respiratory distress, wound complications, tingling sensation or tetany. Results The distributions of age, sex, surgical indications and approaches were similar between the two groups. There was no statistically significant difference in the volume of fluid collection in the operative bed (p = 0.150 and the collected drained content (p = 0.798. The average time a drain was retained was 3 days. One patient in the pressure dressing group suffered cutaneous bruising while one patient in the non-pressure dressing group developed immediate hemorrhage after the skin sutures. Conclusion Pressure dressing after thyroidectomy does not have any significant impact on decreasing fluid collection at the operative bed. The use of pressure dressing after thyroidectomy may not therefore be justified. Trial Registration NCT00400465, ISRCTN52660978

  15. Hypertonic fluid administration in patients with septic shock: a prospective randomized controlled pilot study.

    Science.gov (United States)

    van Haren, Frank M P; Sleigh, James; Boerma, E Christiaan; La Pine, Mary; Bahr, Mohamed; Pickkers, Peter; van der Hoeven, Johannes G

    2012-03-01

    We assessed the short-term effects of hypertonic fluid versus isotonic fluid administration in patients with septic shock. This was a double-blind, prospective randomized controlled trial in a 15-bed intensive care unit. Twenty-four patients with septic shock were randomized to receive 250 mL 7.2% NaCl/6% hydroxyethyl starch (HT group) or 500 mL 6% hydroxyethyl starch (IT group). Hemodynamic measurements included mean arterial blood pressure (MAP), central venous pressure, stroke volume index, stroke volume variation, intrathoracic blood volume index, gastric tonometry, and sublingual microcirculatory flow as assessed by sidestream dark field imaging. Systolic tissue Doppler imaging velocities of the medial mitral annulus were measured using echocardiography to assess left ventricular contractility. Log transformation of the ratio MAP divided by the norepinephrine infusion rate (log MAP/NE) quantified the combined effect on both parameters. Compared with the IT group, hypertonic solution treatment resulted in an improvement in log MAP/NE (P = 0.008), as well as an increase in systolic tissue Doppler imaging velocities (P = 0.03) and stroke volume index (P = 0.017). No differences between the groups were found for preload parameters (central venous pressure, stroke volume variation, intrathoracic blood volume index) or for afterload parameters (systemic vascular resistance index, MAP). Hypertonic solution treatment decreased the need for ongoing fluid resuscitation (P = 0.046). No differences between groups were observed regarding tonometry or the sublingual microvascular variables. In patients with septic shock, hypertonic fluid administration did not promote gastrointestinal mucosal perfusion or sublingual microcirculatory blood flow in comparison to isotonic fluid. Independent of changes in preload or afterload, hypertonic fluid administration improved the cardiac contractility and vascular tone compared with isotonic fluid. The need for ongoing fluid

  16. Routine opt-out HIV testing strategies in a female jail setting: a prospective controlled trial.

    Directory of Open Access Journals (Sweden)

    Ravi Kavasery

    Full Text Available BACKGROUND: Ten million Americans enter jails annually. The objective was to evaluate new CDC guidelines for routine opt-out HIV testing and examine the optimal time to implement routine opt-out HIV testing among newly incarcerated jail detainees. METHODS: This prospective, controlled trial of routine opt-out HIV testing was conducted among 323 newly incarcerated female inmates in Connecticut's only women's jail. 323 sequential entrants to the women's jail over a five week period in August and September 2007 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 108, early (next day, n = 108, or delayed (7 days, n = 107. The primary outcome was the proportion of women in each group consenting to testing. RESULTS: Routine opt-out HIV testing was significantly highest (73% among the early testing group compared to 55% for immediate and 50% for 7 days post-entry groups. Other factors significantly (p = 0.01 associated with being HIV tested were younger age and low likelihood of early release from jail based on bond value or type of charge for which women were arrested. CONCLUSIONS: In this correctional facility, routine opt-out HIV testing in a jail setting was feasible, with highest rates of testing if performed the day after incarceration. Lower testing rates were seen with immediate testing, where there is a high prevalence of inability or unwillingness to test, and with delayed testing, where attrition from jail increases with each passing day. TRIAL REGISTRATION: ClinicalTrials.gov NCT00624247.

  17. Nurse led, primary care based antiretroviral treatment versus hospital care: a controlled prospective study in Swaziland

    Directory of Open Access Journals (Sweden)

    Bailey Kerry A

    2010-08-01

    Full Text Available Abstract Background Antiretroviral treatment services delivered in hospital settings in Africa increasingly lack capacity to meet demand and are difficult to access by patients. We evaluate the effectiveness of nurse led primary care based antiretroviral treatment by comparison with usual hospital care in a typical rural sub Saharan African setting. Methods We undertook a prospective, controlled evaluation of planned service change in Lubombo, Swaziland. Clinically stable adults with a CD4 count > 100 and on antiretroviral treatment for at least four weeks at the district hospital were assigned to either nurse led primary care based antiretroviral treatment care or usual hospital care. Assignment depended on the location of the nearest primary care clinic. The main outcome measures were clinic attendance and patient experience. Results Those receiving primary care based treatment were less likely to miss an appointment compared with those continuing to receive hospital care (RR 0·37, p p = 0·001. Those receiving primary care based, nurse led care were more likely to be satisfied in the ability of staff to manage their condition (RR 1·23, p = 0·003. There was no significant difference in loss to follow-up or other health related outcomes in modified intention to treat analysis. Multilevel, multivariable regression identified little inter-cluster variation. Conclusions Clinic attendance and patient experience are better with nurse led primary care based antiretroviral treatment care than with hospital care; health related outcomes appear equally good. This evidence supports efforts of the WHO to scale-up universal access to antiretroviral treatment in sub Saharan Africa.

  18. Assessing Diabetes Self-Management with the Diabetes Self-Management Questionnaire (DSMQ Can Help Analyse Behavioural Problems Related to Reduced Glycaemic Control.

    Directory of Open Access Journals (Sweden)

    Andreas Schmitt

    Full Text Available To appraise the Diabetes Self-Management Questionnaire (DSMQ's measurement of diabetes self-management as a statistical predictor of glycaemic control relative to the widely used SDSCA.248 patients with type 1 diabetes and 182 patients with type 2 diabetes were cross-sectionally assessed using the two self-report measures of diabetes self-management DSMQ and SDSCA; the scales were used as competing predictors of HbA1c. We developed a structural equation model of self-management as measured by the DSMQ and analysed the amount of variation explained in HbA1c; an analogue model was developed for the SDSCA.The structural equation models of self-management and glycaemic control showed very good fit to the data. The DSMQ's measurement of self-management showed associations with HbA1c of -0.53 for type 1 and -0.46 for type 2 diabetes (both P < 0.001, explaining 21% and 28% of variation in glycaemic control, respectively. The SDSCA's measurement showed associations with HbA1c of -0.14 (P = 0.030 for type 1 and -0.31 (P = 0.003 for type 2 diabetes, explaining 2% and 10% of glycaemic variation. Predictive power for glycaemic control was significantly higher for the DSMQ (P < 0.001.This study supports the DSMQ as the preferred tool when analysing self-reported behavioural problems related to reduced glycaemic control. The scale may be useful for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting associations between self-management behaviours and glycaemic control.

  19. Questionnaire-based analysis of infection prevention and control in healthcare facilities in Saudi Arabia in regards to Middle East Respiratory Syndrome.

    Science.gov (United States)

    Rabaan, Ali A; Alhani, Hatem M; Bazzi, Ali M; Al-Ahmed, Shamsah H

    2017-02-16

    Effective implementation of infection prevention and control in healthcare facilities depends on training, awareness and compliance of healthcare workers. In Saudi Arabia recent significant hospital outbreaks, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), have resulted from lack of, or breakdown in, infection prevention and control procedures. This study was designed to assess attitudes to, and awareness of, infection prevention and control policies and guidelines among healthcare workers of different professions and institution types in Saudi Arabia. A questionnaire was administered to 607 healthcare workers including physicians (n=133), nurses (n=162), laboratory staff (n=233) and other staff (n=79) in government hospitals, private hospitals and poly clinics. Results were compared using Chi square analysis according to profession type, institution type, age group and nationality (Saudi or non-Saudi) to assess variability. Responses suggested that there are relatively high levels of uncertainty among healthcare workers across a range of infection prevention and control issues, including institution-specific issues, surveillance and reporting standards, and readiness and competence to implement policies and respond to outbreaks. There was evidence to suggest that staff in private hospitals and nurses were more confident than other staff types. Carelessness of healthcare workers was the top-cited factor contributing to causes of outbreaks (65.07% of total group), and hospital infrastructure and design was the top-cited factor contributing to spread of infection in the hospital (54.20%), followed closely by lack and shortage of staff (53.71%) and no infection control training program (51.73%). An electronic surveillance system was considered the most effective by staff (81.22%). We have identified areas of concern among healthcare workers in Saudi Arabia on infection prevention and control which vary between institutions and among different

  20. Physiotherapy Post Lumbar Discectomy: Prospective Feasibility and Pilot Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Alison Rushton

    Full Text Available To evaluate: acceptability and feasibility of trial procedures; distribution of scores on the Roland Morris Disability Questionnaire (RMDQ, planned primary outcome; and efficient working of trial components.A feasibility and external pilot randomised controlled trial (ISRCTN33808269, assigned 10/12/2012 was conducted across 2 UK secondary care outpatient physiotherapy departments associated with regional spinal surgery centres.Consecutive consenting patients aged >18 years; post primary, single level, lumbar discectomy.Participants were randomised to either 1:1 physiotherapy outpatient management including patient leaflet, or patient leaflet alone.Blinded assessments were made at 4 weeks post surgery (baseline and 12 weeks post baseline (proposed primary end point. Secondary outcomes included: Global Perceived Effect, back/leg pain, straight leg raise, return to work/function, quality of life, fear avoidance, range of movement, medication, re-operation.At discharge, 110 (44% eligible patients gave consent to be contacted. 59 (54% patients were recruited. Loss to follow up was 39% at 12 weeks, with one site contributing 83% losses. Mean (SD RMDQ was 10.07 (5.58 leaflet and 10.52 (5.94 physiotherapy/leaflet at baseline; and 5.37 (4.91 leaflet and 5.53 (4.49 physiotherapy/leaflet at 12 weeks. 5.1% zero scores at 12 weeks illustrated no floor effect. Sensitivity to change was assessed at 12 weeks with mean (SD change -4.53 (6.41, 95%CI -7.61 to -1.44 for leaflet; and -6.18 (5.59, 95%CI -9.01 to -3.30 for physiotherapy/leaflet. RMDQ mean difference (95%CI between change from baseline to twelve weeks was 1.65(-2.46 to 5.75. Mean difference (95%CI between groups at 12 weeks was -0.16 (-3.36 to 3.04. Participant adherence with treatment was good. No adverse events were reported.Both interventions were acceptable, and it is promising that they both demonstrated a trend in reducing disability in this population. A randomised controlled trial, using a

  1. Preoperative nutritional support in cancer patients with no clinical signs of malnutrition—prospective randomized controlled trial

    OpenAIRE

    Kabata, Paweł; Jastrzębski, Tomasz; Kąkol, Michał; Król, Karolina; Bobowicz, Maciej; Kosowska, Anna; Jaśkiewicz, Janusz

    2014-01-01

    Purpose Preoperative nutrition is beneficial for malnourished cancer patients. Yet, there is little evidence whether or not it should be given to nonmalnourished patients. The aim of this study was to assess the need to introduce preoperative nutritional support in patients without malnutrition at qualification for surgery. Methods This was a prospective, two-arm, randomized, controlled, open-label study. Patients in interventional group received nutritional supplementation for 14 days before...

  2. PROspective MEmory Training to improve HEart failUre Self-care (PROMETHEUS): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Cameron, Jan; Rendell, Peter G; Ski, Chantal F; Kure, Christina E; McLennan, Skye N; Rose, Nathan S; Prior, David L; Thompson, David R

    2015-04-29

    Cognitive impairment is seen in up to three quarters of heart failure (HF) patients and has a significant negative impact on patients' health outcomes. Prospective memory, which is defined as memory to carry out future intentions, is important for functional independence in older adults and involves application of multiple cognitive processes that are often impaired in HF patients. The objective of this study is to examine the effects of prospective memory training on patients' engagement in HF self-care and health outcomes, carer strain and quality of life. The proposed study is a randomised, controlled trial in which 200 patients diagnosed with HF, and their carers will be recruited from 3 major hospitals across Melbourne. Eligible patients with HF will be randomised to receive either: 1) The Virtual Week Training Program - a computerised prospective memory (PM) training program (intervention) or 2) non-adaptive computer-based word puzzles (active control). HF patients' baseline cognitive function will be compared to a healthy control group (n = 60) living independently in the community. Patients will undergo a comprehensive assessment of PM, neuropsychological functioning, self-care, physical, and emotional functioning. Assessments will take place at baseline, 4 weeks and 12 months following intervention. Carers will complete measures assessing quality of life, strain, perceived control in the management of the patients' HF symptoms, and ratings of the patients' level of engagement in HF self-care behaviours. If the Virtual Week Training Program is effective in improving: 1) prospective memory; 2) self-care behaviours, and 3) wellbeing in HF patients, this study will enhance our understanding of impaired cognitive processes in HF and potentially is a mechanism to reduce healthcare costs. Australian New Zealand Clinical Trials Registry #366376; 27 May 2014. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366376&isClinicalTrial=False .

  3. A prospective controlled trial of routine opt-out HIV testing in a men's jail.

    Directory of Open Access Journals (Sweden)

    Ravi Kavasery

    Full Text Available BACKGROUND: Approximately 10 million Americans enter jails annually. The Centers for Disease Control and Prevention now recommends routine opt-out HIV testing in these settings. The logistics for performing routine opt-out HIV testing within jails, however, remain controversial. The objective of this study was to evaluate the optimal time to routinely HIV test newly incarcerated jail detainees using an opt-out strategy. METHODS: This prospective, controlled trial of routine opt-out HIV testing was conducted among 298 newly incarcerated male inmates in an urban men's jail in New Haven, Connecticut. 298 sequential entrants to the men's jail over a three week period in March and April 2008 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 103, early (next day, n = 98, or delayed (7 days, n = 97. The primary outcome was the proportion of men in each group consenting to testing. RESULTS: Routine opt-out HIV testing was significantly higher for the early (53%: AOR = 2.6; 95% CI = 1.5 to 4.7 and immediate (45%: AOR = 2.3; 95% CI = 1.3 to 4.0 testing groups compared to the delayed (33% testing group. The immediate and early testing groups, however, did not significantly differ (p = 0.67. In multivariate analyses, factors significantly associated with routine opt-out HIV testing were assignment to the 'early' testing group (p = 0.0003 and low (bond > or = $5,000, immigration or federal charges or pre-sentencing > 30 days likelihood of early release (p = 0.04. Two subjects received preliminary positive results and one of them was subsequently confirmed HIV seropositive. CONCLUSIONS: In this men's jail where attrition was high, routine opt-out HIV testing was not only feasible, but resulted in the highest rates of HIV testing when performed within 24 hours of incarceration. TRIAL REGISTRATION: ClinicalTrials.gov NCT00624247.

  4. [Explore objective clinical variables for detecting delirium in ICU patients: a prospective case-control study].

    Science.gov (United States)

    Liu, Xiaojiang; Lyu, Jie; An, Youzhong

    2017-04-01

    The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU). Then these patients were observed by domestic multifunctional detector for electroencephalographic (EEG) variables such as brain lateralization, brain introvert, brain activity, brain energy consumption, focus inward, focus outward, cerebral inhibition, fatigue, sleep severity, sedation index, pain index, anxiety index, fidgety index, stress index and the cerebral blood flow (CBF) index which was named of perfusion index. Other variables including indexes of ICU blood gas analysis, which was consisted of variables of blood gas analysis, routine blood test and biochemistry, previous history and prognostic outcome was recorded. Binary logistic regression was used for multivariate analysis. Forty-three postoperative patients, who needed intensive care, were included. Eighteen were in delirium group and twenty-five in control group. Excluding the trauma, variables like gender, age, temperature, heart rate, respiratory rate, mean arterial pressure, acute physiology and chronic health evaluationII(APACHEII) score, organ failure, dementia and emergency surgery didn't show any statistical significance between two groups. The trauma in delirious patients increased obviously compared with the control group (33.3% vs. 4.0%, P = 0.031). Except for the brain activity [122.47 (88.62, 154.21) vs. 89.40 (86.27, 115.97), P = 0.034], there were no statistical differences in

  5. Ascorbic acid is lower during pregnancy in diabetic women compared to controls: A prospective study

    DEFF Research Database (Denmark)

    Juhl, B.; Lauszus, Finn; Lykkesfeldt, Jens

    2017-01-01

    Abstract.Few studies have examined how vitamin C status is affected in diabetic pregnancy and no comparison between normal and diabetic pregnancies has been found. This study evaluated vitamin C status prospectively during pregnancy in women with type 1 diabetes mellitus (n=76), in non-diabetic w...

  6. Ascorbic acid is lower during pregnancy in diabetic women compared to controls: A prospective study

    DEFF Research Database (Denmark)

    Juhl, B.; Lauszus, Finn; Lykkesfeldt, Jens

    2016-01-01

    Few studies have examined how vitamin C status is affected in diabetic pregnancy and no comparison between normal and diabetic pregnancies has been found. This study evaluated vitamin C status prospectively during pregnancy in women with type 1 diabetes mellitus (n=76), in non-diabetic women (n=6...

  7. Botulinum toxin versus trihexyphenidyl in cervical dystoni - A prospective, randomized, double-blind controlled trial

    NARCIS (Netherlands)

    Brans, JWM; Lindeboom, R; Snoek, JW; Zwarts, MJ; vanWeerden, TW; Brunt, ERP; vanHilten, JJ; vanderKamp, W; Prins, MH; Speelman, J.D.

    1996-01-01

    Background: Botulinum toxin type A (BTA) is replacing trihexyphenidyl as the treatment of choice for idiopathic cervical dystonia (ICD), but there has never been a direct comparative study. Methods: This trial compares the effectiveness of BTA with that of trihexyphenidyl in a prospective, randomize

  8. Prospects for the biological control of invasive Pinus species (Pinaceae) in South Africa

    CSIR Research Space (South Africa)

    Hoffmann, JH

    2011-09-01

    Full Text Available that the prospective agent was host-specific enough to be used with safety in South Africa. Despite this positive finding, the programme did not proceed much further because subsequent trials in quarantine in South Africa showed that damage caused by the adult weevils...

  9. Effects of bariatric surgery on gout incidence in the Swedish Obese Subjects study: a non-randomised, prospective, controlled intervention trial.

    Science.gov (United States)

    Maglio, Cristina; Peltonen, Markku; Neovius, Martin; Jacobson, Peter; Jacobsson, Lennart; Rudin, Anna; Carlsson, Lena M S

    2017-04-01

    To assess the long-term effect of bariatric surgery on the incidence of gout and hyperuricaemia in participants of the Swedish Obese Subjects (SOS) study. This report includes 1982 subjects who underwent bariatric surgery and 1999 obese controls from the SOS study, a prospective intervention trial designed to assess the effect of bariatric surgery compared with conventional treatment. None of the subjects had gout at baseline. An endpoint on gout incidence was created based on information on gout diagnosis and use of gout medications through national registers and questionnaires. Median follow-up for the incidence of gout was about 19 years for both groups. Moreover, the incidence of hyperuricaemia over up to 20 years was examined in a subgroup of participants having baseline uric acid levels gout compared with usual care (adjusted HR 0.60, 95% CI 0.48 to 0.75, pgout event was 32 (95% CI 22 to 59). The effect of bariatric surgery on gout incidence was not influenced by baseline risk factors, including body mass index. During follow-up, the surgery group had a lower incidence of hyperuricaemia (adjusted HR 0.47, 95% CI 0.39 to 0.58, pgout and hyperuricaemia in obese subjects. NCT01479452; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. What do Demand-Control and Effort-Reward work stress questionnaires really measure? A discriminant content validity study of relevance and representativeness of measures.

    Science.gov (United States)

    Bell, Cheryl; Johnston, Derek; Allan, Julia; Pollard, Beth; Johnston, Marie

    2017-05-01

    The Demand-Control (DC) and Effort-Reward Imbalance (ERI) models predict health in a work context. Self-report measures of the four key constructs (demand, control, effort, and reward) have been developed and it is important that these measures have good content validity uncontaminated by content from other constructs. We assessed relevance (whether items reflect the constructs) and representativeness (whether all aspects of the construct are assessed, and all items contribute to that assessment) across the instruments and items. Two studies examined fourteen demand/control items from the Job Content Questionnaire and seventeen effort/reward items from the Effort-Reward Imbalance measure using discriminant content validation and a third study developed new methods to assess instrument representativeness. Both methods use judges' ratings and construct definitions to get transparent quantitative estimates of construct validity. Study 1 used dictionary definitions while studies 2 and 3 used published phrases to define constructs. Overall, 3/5 demand items, 4/9 control items, 1/6 effort items, and 7/11 reward items were uniquely classified to the appropriate theoretical construct and were therefore 'pure' items with discriminant content validity (DCV). All pure items measured a defining phrase. However, both the DC and ERI assessment instruments failed to assess all defining aspects. Finding good discriminant content validity for demand and reward measures means these measures are usable and our quantitative results can guide item selection. By contrast, effort and control measures had limitations (in relevance and representativeness) presenting a challenge to the implementation of the theories. Statement of contribution What is already known on this subject? While the reliability and construct validity of Demand-Control and Effort-Reward-Imbalance (DC and ERI) work stress measures are routinely reported, there has not been adequate investigation of their content

  11. Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials

    OpenAIRE

    Young-Dae Kim; In Heo; Byung-Cheul Shin; Cindy Crawford; Hyung-Won Kang; Jung-Hwa Lim

    2013-01-01

    To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were “acupuncture” and “PTSD.” No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional th...

  12. Helicobacter pylori infection amongst Arab Israeli women with hyperemesis gravidarum—a prospective, controlled study

    OpenAIRE

    Doron Boltin; Tsachi Tsadok Perets; Sami Abu Elheiga; Asher Sharony; Yaron Niv; Hussein Shamaly; Ram Dickman

    2014-01-01

    Objective: Helicobacter pylori has been associated with hyperemesis gravidarum in some geographical regions. The prevalence of H. pylori in Arab Israeli women in the Upper Galilee and its association with hyperemesis gravidarum has not been studied previously. We aimed to examine if hyperemesis gravidarum is associated with H. pylori in this population. Methods: Subjects with hyperemesis gravidarum carrying a singleton fetus were recruited prospectively. Women with an uncomplicated pregnan...

  13. Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up.

    Science.gov (United States)

    Favreau, Helene; Bacon, Simon L; Labrecque, Manon; Lavoie, Kim L

    2014-02-01

    Background Panic disorder (PD) is a common anxiety disorder among asthmatic patients with overlapping symptoms (e.g., hyperventilation). However, the longitudinal impact of PD on asthma control remains poorly understood. This study assessed the impact of PD and panic-anxiety on asthma control over a 4.3-year follow-up in 643 adult asthmatic patients. Methods Consecutive patients presenting to a tertiary asthma clinic underwent a sociodemographic, medical history, and psychiatric (Primary Care Evaluation of Mental Disorders) interview and completed questionnaires including the Anxiety Sensitivity Index (ASI) to assess panic-anxiety. At follow-up, patients completed the Asthma Control (ACQ) and Asthma Quality of Life (AQLQ) questionnaires and reported emergency department visits and hospitalizations during the follow-up. Results Baseline frequency of PD was 10% (n = 65). In fully adjusted models, analyses revealed that PD and ASI scores predicted worse follow-up ACQ total scores (β = 0.292, p = .037; β = 0.012, p = .003) but not AQLQ total scores. ASI scores also predicted greater nocturnal and waking symptoms, activity limitations, and bronchodilator use on the ACQ (β = 0.012-0.018, p anxiety sensitivity are prospectively associated with poorer asthma control and may be important targets for treatment.

  14. Does change in self-reported mindfulness mediate the clinical benefits of mindfulness training? A controlled study using the French translation of the Five Facet Mindfulness Questionnaire

    OpenAIRE

    Heeren, Alexandre; Deplus, Sandrine; Peschard, Virginie; Nef, François; Kotsou, Ilios; Dierickx, Christophe; Mondillon, Laurie; Robinaugh, Donald J.; Philippot, Pierre

    2015-01-01

    Mindfulness training improves mental health and psychological functioning. Although several questionnaires have been developed to measure mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ) is currently one of the most widely used scales. However, uncertainty remains about wheth- er the effects of mindfulness training can be unambiguously attributed to change in self-reported mindfulness. The present study was designed to answer three major questions: First, relative to a wait-list g...

  15. Border malaria in China: knowledge and use of personal protection by minority populations and implications for malaria control: a questionnaire-based survey

    Directory of Open Access Journals (Sweden)

    Hill Nigel

    2008-10-01

    Full Text Available Abstract Background Malaria control in remote, forested areas of the Mekong region relies on personal protection from mosquito bites. Uptake of these methods may be limited by knowledge of the link between mosquitoes and malaria as well as social and economic aspects. Understanding barriers to uptake will inform malaria control programmes on targets for improvement of delivery. Methods A total 748 key respondents: health providers and village heads, from 187 villages and 25 different ethnic groups, were interviewed using structured questionnaires. Differences in use of personal protection, and knowledge of malaria between groups were analysed using chi-square; and binary logistic regression used for multivariate analysis. Results Malaria knowledge was poor with 19.4% of women and 37.5% of men linking mosquitoes with malaria, although 95.6% knew one or more methods of mosquito control. Virtually all respondents used personal protection at some time during the year; and understanding of malaria transmission was strongly associated with bednet use. Those working in forest agriculture were significantly more likely to know that mosquitoes transmit malaria but this did not translate into a significantly greater likelihood of using bednets. Furthermore, use of personal protection while woing outdoors was rare, and less than 3% of respondents knew about the insecticide impregnation of bednets. The use of bednets, synthetic repellents and mosquito coils varied between ethnic groups, but was significantly more frequent among those with higher income, more years of education and permanent housing. The reported use of repellents and coils was also more common among women despite their low knowledge of malaria transmission, and low likelihood of having heard information on malaria within the last year. Conclusion The use of personal protection must be increased, particularly among outdoor workers that have higher malaria risk. However, personal protection

  16. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Koes Bart W

    2009-05-01

    Full Text Available Abstract Background The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD. This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus far, no randomized trial into cost-effectiveness of PLDD versus standard surgical procedure has been performed. We present the design of a randomized controlled trial, studying the cost-effectiveness of PLDD versus conventional open discectomy in patients with sciatica from lumbar disc herniation. Methods/design The study is a randomized prospective multi-center trial, in which two treatment strategies are compared in a parallel group design. Patients (age 18–70 years visiting the neurosurgery department of the participating hospitals, are considered for inclusion in the trial when sciatica due to lumbar disc herniation has lasted more than 8 weeks. Patients with disc herniation smaller than 1/3 of the spinal canal diameter, without concomitant lateral recess stenosis or sequestration, are eligible for participation, and are randomized into one of two treatment arms; either Percutaneous Laser Disc Decompression or conventional discectomy. The functional outcome of the patient, as assessed by the Roland Disability Questionnaire for Sciatica at 8 weeks and 1 year after treatment, is the primary outcome measure. The secondary outcome parameters are recovery as perceived by the patient, leg and back pain, incidence of re-intervention, complications, quality of life, medical consumption, absence of work and secondary costs. Discussion Open discectomy is still considered to be the golden standard in the surgical treatment of lumbar disc herniation. Whether Percutaneous Laser Disc Decompression has at least as

  17. Utah Drug Use Questionnaire.

    Science.gov (United States)

    Governor's Citizen Advisory Committee on Drugs, Salt Lake City, UT.

    This questionnaire assesses drug use practices in junior and senior high school students. The 21 multiple choice items pertain to drug use practices, use history, available of drugs, main reason for drug use, and demographic data. The questionnaire is untimed, group administered, and may be given by the classroom teacher in about 10 minutes. Item…

  18. Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial - Part II

    Directory of Open Access Journals (Sweden)

    Jose Tadeu Nunes Tamanini

    2013-07-01

    Full Text Available Objective To compare the effects of two surgical procedures for the correction of anterior vaginal wall prolapse (AVWP on the lower urinary tract symptoms (LUTS using symptom questionnaires and quality of life (QoL. Materials and Methods One hundred women with Pelvic Organ Prolapse Quantification stage (POP-Q ≥ 2 were randomly distributed in two preoperatory groups. The first group (mesh (n = 45 received a polypropylene mesh (PM implant and the control group (n = 55 was submitted to anterior colporraphy with or without synthetic sling. Postoperatory follow-up was done after 12 months. The primary objective was to compare the effect of the surgeries on LUTS using the final scores of the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF and Overactive Bladder Questionnaire (OAB-V8, as well as the analysis of the incapacitating urinary symptoms and “de novo” urinary symptoms after 12 months of surgery in both groups. Results Although there was a different number of women in each group, randomization was adequate, resulted in homogeneous groups that could be compared regarding socio demographic, clinical and gynecological (POP-Q variables. Patients of both groups showed improvements regarding LUTS and QoL, whether using polypropylene mesh or not, based on the final scores of the ICIQ-UI SF and OAB-V8 questionnaires after 12-month follow-up. There were few incapacitating and “de novo” urinary symptoms, without any significant statistical difference between both groups after 12 months of surgery. Conclusion There was a general improvement of LUTS and QoL in both groups after 12-month follow-up. However, there was no significant difference of LUTS, as well as the more incapacitating and “de novo” urinary symptoms between both groups after 12 months of surgery.

  19. Intraoperative assistive technologies and extent of resection in glioma surgery: a systematic review of prospective controlled studies.

    Science.gov (United States)

    Barbosa, Breno José Alencar Pires; Mariano, Eric Domingos; Batista, Chary Marquez; Marie, Suely Kazue Nagahashi; Teixeira, Manoel Jacobsen; Pereira, Carlos Umberto; Tatagiba, Marcos Soares; Lepski, Guilherme Alves

    2015-04-01

    Several studies published to date about glioma surgery have addressed the validity of using novel technologies for intraoperative guidance and potentially improved outcomes. However, most of these reports are limited by questionable methods and/or by their retrospective nature. In this work, we performed a systematic review of the literature to address the impact of intraoperative assistive technologies on the extent of resection (EOR) in glioma surgery, compared to conventional unaided surgery. We were also interested in two secondary outcome variables: functional status and progression-free survival. We primarily used PubMed to search for relevant articles. Studies were deemed eligible for our analysis if they (1) were prospective controlled studies; (2) used EOR as their primary target outcome, assessed by MRI volumetric analysis; and (3) had a homogeneous study population with clear inclusion criteria. Out of 493 publications identified in our initial search, only six matched all selection criteria for qualitative synthesis. Currently, the evidence points to 5-ALA, DTI functional neuronavigation, neurophysiological monitoring, and intraoperative MRI as the best tools for improving EOR in glioma surgery. Our sample and conclusions were limited by the fact that studies varied in terms of population characteristics and in their use of different volumetric analyses. We were also limited by the low number of prospective controlled trials available in the literature. Additional evidence-based high-quality studies assessing cost-effectiveness should be conducted to better determine the benefits of intraoperative assistive technologies in glioma surgery.

  20. Relationship among prospective parents' locus of control, social desirability, and choice of psychoprophylaxis.

    Science.gov (United States)

    Windwer, C

    1977-01-01

    This study sought to determine if there is a relationship among locus of control, social desirability, and choice of psychoprophylaxis (PPM). It was hypothesized that internal locus of control and low social desirability would correlate significantly with the choice of PPM by husbands and wives; that externally controlled wives who participated in PPM would have more internally controlled husbands than externally controlled wives who participated in PPM would have more internally controlled husbands than externally controlled wives who did not participate; and that locus of control and social desirability, when taken together, would be better predictors of choice of PPM than either taken separately. Ninety-eight middle-class nulliparous couples, participant and non-participant, were studied in the seventh or eighth month of the wife's pregnancy. Rotter's I-E Scale and the Marlowe-Crowne Social Desirability Scale were used to measure locus of control and social desirability. Study findings did not support the hypotheses.

  1. A Proficiency Based Stepwise Endovascular Curricular Training (PROSPECT) Program Enhances Operative Performance in Real Life: A Randomised Controlled Trial.

    Science.gov (United States)

    Maertens, H; Aggarwal, R; Moreels, N; Vermassen, F; Van Herzeele, I

    2017-09-01

    Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions. All subjects performed two endovascular interventions treating patients with symptomatic iliac and/or superficial femoral artery stenosis under supervision. Primary outcomes were technical performances (Global Rating Scale [GRS]; Examiner Checklist), operative metrics, and patient outcomes, adjusted for case difficulty and trainee experience. Secondary outcomes included knowledge and technical performance after 6 weeks and 3 months. Thirty-two general surgical trainees were randomised into three groups. Besides traditional training, the first group (n = 11) received e-learning and simulation training (PROSPECT), the second group (n = 10) only had access to e-learning, while controls (n = 11) did not receive supplementary training. Twenty-nine trainees (3 dropouts) performed 58 procedures. Trainees who completed PROSPECT showed superior technical performance (GRS 39.36 ± 2.05; Checklist 63.51 ± 3.18) in real life with significantly fewer supervisor takeovers compared with trainees receiving e-learning alone (GRS 28.42 ± 2.15; p = .001; Checklist 53.63 ± 3.34; p = .027) or traditional education (GRS 23.09 ± 2.18; p = .001; Checklist 38.72 ± 3.38; p = .001). Supervisors felt more confident in allowing PROSPECT trained physicians to perform basic (p = .006) and complex (p = .003) procedures. No differences were detected in procedural parameters (such as fluoroscopy time, DAP, procedure time, etc.) or complications. Proficiency levels were maintained up to 3 months. A structured

  2. Research on Development Prospects of PLC Control System%PLC控制系统发展前景研究

    Institute of Scientific and Technical Information of China (English)

    王雪燃

    2016-01-01

    PLC(Programmable logic controller)is a widely used technique in the industrial field.We firstly outlines the background and current development of PLC technology to clarify the function of PLC technology.Secondly,we introduce its advantages in industrial applications has become a pillar of the field of automation technology. Finally,we introduce the development prospects of the PLC system.%可编程序控制器(Programmable Logic Controller,PLC)是一种普遍应用在工业领域中的技术.文章简述了PLC技术的产生背景与发展现状,阐明PLC技术的功能及其在工业应用中的优点现已成为自动化领域的技术支柱,并介绍了PLC系统的发展前景.

  3. [Diphtheria in the military forces: lessons and current status of prophylaxis, prospects of epidemiological control process].

    Science.gov (United States)

    Belov, A B; Ogarkov, P I

    2014-01-01

    We analyzed the epidemiological situation of diphtheria in the world and in Russia and experience of mass vaccination of military personnel and civil population with diphtheria toxoid for the last 50 years. Early diagnosis of diphtheria in military personnel has a prognostic value. Authors described the peculiarities of epidemiological process of diphtheria in military personnel in 80-90 years of 20th century and organizational aspects of mass vaccination with diphtheria toxoid. Authors analyzed current problems of epidemiology and prophylaxis of diphtheria in military personnel and civil population and possible developments. According to long-term prognosis authors mentioned the increase of morbidity and came to conclusion that it is necessary enhance the epidemiological surveillance. Authors presented prospect ways of improvement of vaccination and rational approaches to immunization of military personnel under positive long-term epidemiological situation.

  4. Prospective associations of social self-control with drug use among youth from regular and alternative high schools

    Directory of Open Access Journals (Sweden)

    Sun Ping

    2007-07-01

    Full Text Available Abstract Background This study examined the one year prospective associations between adolescent social self-control and drug outcomes (cigarette use, alcohol use, marijuana use, hard drug use, and problem drug use among adolescents from regular and continuation high schools. In our previous cross-sectional study, poor social self-control was found to be associated with higher drug use, controlling for 12 personality disorder categories. In this study, we attempted to find out (a whether lack of social self-control predicted drug use one year later, and (b whether drug use at baseline predicted social self-control one year later. Methods We surveyed 2081 older adolescents from 9 regular (N = 1529 and 9 continuation (alternative (N = 552 high schools in the Los Angeles area. Data were collected at two time points in an interval of approximately 1 year. Results Past 30-day cigarette smoking, marijuana use, hard drug use, and problem drug use at baseline were found to predict lower social self-control at follow-up, controlling for baseline social self-control and demographic variables. The effect of problem drug use as a one-year predictor of social self-control was found to be moderated by school type (regular or continuation high school, such that the relationship was significant for continuation high school students only. Conversely, social self-control was found to predict past 30-day alcohol use, marijuana use, and problem drug use, controlling for baseline drug use and demographic variables. For alcohol use, marijuana use, and problem drug use outcomes, school type was not found to moderate the effects of social self-control, though an interaction effect was found regarding cigarette smoking. Social self-control was a significant predictor of cigarette use only at regular high school. Conclusion The results indicate that social self-control and drug use share a reciprocal relationship. Lack of social self-control in adolescents seems to

  5. Sentinel lymph node detection after transaxillary augmentation mammoplasty: a prospective controlled study utilizing lymphoscintigraphy in 43 breasts

    Energy Technology Data Exchange (ETDEWEB)

    Sado, Heitor Naoki; Yamada, Airton Seiji [Centro de Radioimunoensaio e Medicina Nuclear do Parana (CERMEN), Curitiba, PR (Brazil)]. E-mail: heitor@cermen.com.br; Graf, Ruth Maria; Timi, Jorge Rufino Ribas; Matias, Jorge Eduardo Fouto [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Cirurgia Plastica; Urban, Cicero Andrade [Universidade Posotivo (UnicenP), Curitiba, PR (Brazil). Centro Universitario Positivo; Woellner, Luiz Carlos [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Medicina Nuclear; Ferreira, Eduardo de Castro [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario

    2008-09-15

    Objective: To evaluate the potential influence of transaxillary augmentation mammoplasty on future detection of sentinel lymph node. Materials and methods: Prospective controlled study where 22 patients were selected and divided into two groups (post-mammoplasty and control) corresponding to 43 breasts (22 in the post-mammoplasty group and 21 in the control group) evaluated by lymphoscintigraphy immediately after periareolar {sup 99m}Tc-phytate injections. In the statistical analysis, p values < 0.05 were considered as significant. Results: All the breasts in the post-mammoplasty group presented lymphatic drainage to the axillary chain, with no difference as compared with the control group (p 0.488). The average number of hot lymph nodes was 1.27 {+-} 0.46 in the post-mammoplasty group, and 1.33 {+-} 0.58 in the control group (p = 0.895). The mean time required to visualize the first lymph node was 3.14 {+-} 4.42 minutes in the post mammoplasty group, and 5.48 {+-} 5.06 minutes in the control group (p 0.136). Conclusion: Transaxillary augmentation mammoplasty did not affect the future detection of sentinel lymph node. (author)

  6. Sentinel lymph node detection after trans axillary augmentation mammoplasty: a prospective controlled study utilizing lymphoscintigraphy in 43 breasts

    Energy Technology Data Exchange (ETDEWEB)

    Sado, Heitor Naoki; Timi, Jorge Rufino Ribas; Matias, Jorge Eduardo Fouto [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Program of Post-Graduation in Surgical Practice]. E-mail: heitor@cermen.com.br; Graf, Ruth Maria [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas; Urban, Cicero Andrade [UnicenP, Curitiba, PR (Brazil); Yamada, Airton Seiji [CERMEN - Centro de Radioimunoensaio e Medicina Nuclear de Curitiba, PR (Brazil); Woellner, Luiz Carlos [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital de Clinicas. Unit of Nuclear Medicine; Ferreira, Eduardo de Castro [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital de Clinicas

    2008-09-15

    Objective: to evaluate the potential influence of trans axillary augmentation mammoplasty on future detection of sentinel lymph node. Materials and methods: prospective controlled study where 22 patients were selected and divided into two groups (post-mammoplasty and control) corresponding to 43 breasts (22 in the post-mammoplasty group and 21 in the control group) evaluated by lymphoscintigraphy immediately after periareolar {sup 99m}Tc-phytate injections. In the statistical analysis, p values < 0.05 were considered as significant. Results: all the breasts in the post-mammoplasty group presented lymphatic drainage to the axillary chain, with no difference as compared with the control group (p 0.488). The average number of hot lymph nodes was 1.27 {+-} 0.46 in the post-mammoplasty group, and 1.33 {+-} 0.58 in the control group (p = 0.895). The mean time required to visualize the first lymph node was 3.14 {+-} 4.42 minutes in the post mammoplasty group, and 5.48 {+-} 5.06 minutes in the control group (p 0.136). Conclusion: transaxillary augmentation mammoplasty did not affect the future detection of sentinel lymph node. (author)

  7. Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

    Science.gov (United States)

    Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

    2014-12-01

    A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

  8. Parental authority questionnaire.

    Science.gov (United States)

    Buri, J R

    1991-08-01

    A questionnaire was developed for the purpose of measuring Baumrind's (1971) permissive, authoritarian, and authoritative parental authority prototypes. It consists of 30 items per parent and yields permissive, authoritarian, and authoritative scores for both the mother and the father; each of these scores is derived from the phenomenological appraisals of the parents' authority by their son or daughter. The results of several studies have supported the Parental Authority Questionnaire as a psychometrically sound and valid measure of Baumrind's parental authority prototypes, and they have suggested that this questionnaire has considerable potential as a valuable tool in the investigation of correlates of parental permissiveness, authoritarianism, and authoritativeness.

  9. Applications of advanced control methods in spacecrafts:progress, challenges, and future prospects

    Institute of Scientific and Technical Information of China (English)

    Yong-chun XIE; Huang HUANG; Yong HU; Guo-qi ZHANG

    2016-01-01

    We aim at examining the current status of advanced control methods in spacecrafts from an engineer’s perspective. Instead of reviewing all the fancy theoretical results in advanced control for aerospace vehicles, the focus is on the advanced control methods that have been practically applied to spacecrafts during flight tests, or have been tested in real time on ground facilities and general testbeds/simulators built with actual flight data. The aim is to provide engineers with all the possible control laws that are readily available rather than those that are tested only in the laboratory at the moment. It turns out that despite the blooming developments of modern control theories, most of them have various limitations, which stop them from being practically applied to spacecrafts. There are a limited number of spacecrafts that are controlled by advanced control methods, among which H2/H∞ robust control is the most popular method to deal with flexible structures, adaptive control is commonly used to deal with model/parameter uncertainty, and the linear quadratic regulator (LQR) is the most frequently used method in case of optimal control. It is hoped that this review paper will enlighten aerospace engineers who hold an open mind about advanced control methods, as well as scholars who are enthusiastic about engineering-oriented problems.

  10. Personality and substance use disorders: a prospective study.

    Science.gov (United States)

    Sher, K J; Bartholow, B D; Wood, M D

    2000-10-01

    The personality systems of Cloninger (as measured by the Tridimensional Personality Questionnaire [TPQ]) and Eysenck (as measured by the Eysenck Personality Questionnaire [EPQ]) both have been linked to substance use and abuse. The current study examined the predictive utility of both systems for substance use disorder (SUD) diagnoses, both cross-sectionally and prospectively. Participants (N = 489 at baseline) completed the EPQ and TPQ and were assessed via structured diagnostic interview at baseline and 6 years later (N = 457 at follow-up). Both the EPQ and TPQ scales demonstrated bivariate cross-sectional and prospective associations with SUDs. Within each system, those dimensions marking a broad impulsive sensation-seeking or behavioral disinhibition trait were the best predictors prospectively, although the 2 systems were differentially sensitive to specific diagnoses. These relations remained significant even with autoregressivity, other concurrent SUD diagnoses, and multiple personality dimensions statistically controlled.

  11. Use of the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) for an objective assessment of disability determination according to the Modified Katz Scale: a prospective longitudinal study.

    Science.gov (United States)

    Timmermans, Luc; Falez, Freddy; Melot, Christian; Higuet, Sandra; Vincent, Denis

    2016-08-01

    The aim of this study was to demonstrate that the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) tool can be applied for a factual score determining urinary incontinence in the Katz-6 Scale, and it is effective to identify score 2 from score 3. Functional capacity of 63 patients (14 M, 49 F aged from 70 to 99 years old) was evaluated with a Mini Mental State Examination (MMSE), Katz Index for Activities of Daily Living, and ICIQ-UI-SF questionnaire. Mean comparative analysis was performed. ICIQ-UI-SF scores were then entered as variables. These data observed in Katz continence item scored 2 and Katz continence item scored 3 were compared in a combined box-and-whisker and dot plot. Sensitivity and specificity of each variable were tested and results were evaluated using a receiver operating characteristic (ROC) curve. The best variable (ICIQ-UI-SF Score) was retained as a breach permitting to distinguish patients to be scored 2 or 3 over continence Katz item. Statistical analysis demonstrated significant difference between the sample of Katz continence item scored 2 and the sample of Katz continence item scored 3 over the ICIQ-UI-SF Score and the Katz global Score, but the difference was not significant concerning the MMSE Score. Using ROC analysis, we compared the discriminant power of the ICIQ-UI-SF Score for continence Katz item Score. Criterion values and coordinates of the ROC curve were studied and the ICIQ-UI-SF score of 13 was considered the best one. We demonstrated that the best variable (ICIQ-UI-SF Score) to retain as a breach permitting to distinguish patients to be scored 2 or 3 over continence Katz item is 13.

  12. Combination treatment of physical modalities in the treatment of musculoskeletal pain syndromes: a prospective-controlled study

    Directory of Open Access Journals (Sweden)

    Karin Pieber

    2010-12-01

    Full Text Available The aim of the study was to evaluate the effect of combinations of several physical therapies in the treatment of musculoskeletal pain syndromes by a prospective, controlled study. Forty patients (5 men and 35 women, 18-80 years with musculoskeletal pain syndrome were included. Thirty patients were assigned to the intervention group and 10 patients to the control group. The intervention group received a combination of physical therapies according to the clinical needs (electrotherapy, fango packs, mud packs, ultrasound, massage, exercise therapy. Treatment consisted of 10 sessions. The control group did not receive any physical therapy in the waiting period. The intervention group was examined at the beginning and the end of the treatment period. The control group was evaluated at the beginning and the end of the waiting period (before their physical therapy treatment started. Main outcome measurements were: Visual analogue scale for pain (VAS; Timed Get up and Go Test (TUG; Functional Reach Test (FRT. In addition bodily, emotional and social functioning was accessed by selected ICF-Items and items of the SF-36 health survey (SF-36. The main outcome measures showed significant improvement in the intervention group compared to the control group. Furthermore, ICF- and SF-36-Items also improved. In conclusion significant pain relief and improvement of function was achieved by a combination treatment of physical therapies in patients with musculoskeletal pain syndromes.

  13. Poor self-control and harsh punishment in childhood prospectively predict borderline personality symptoms in adolescent girls.

    Science.gov (United States)

    Hallquist, Michael N; Hipwell, Alison E; Stepp, Stephanie D

    2015-08-01

    Developmental theories of borderline personality disorder (BPD) propose that harsh, invalidating parenting of a child with poor self-control and heightened negative emotionality often leads to a coercive cycle of parent-child transactions that increase risk for BPD symptoms such as emotion dysregulation. Although parenting practices and child temperament have previously been linked with BPD, less is known about the prospective influences of caregiver and child characteristics. Using annual longitudinal data from the Pittsburgh Girls Study (n = 2,450), our study examined how reciprocal influences among harsh parenting, self-control, and negative emotionality between ages 5 and 14 predicted the development of BPD symptoms in adolescent girls ages 14 to 17. Consistent with developmental theories, we found that harsh punishment, poor self-control, and negative emotionality predicted BPD symptom severity at age 14. Only worsening self-control between ages 12 and 14, however, predicted growth in BPD symptoms from 14 to 17. Furthermore, the effects of harsh punishment and poor self-control on age 14 BPD symptoms were partially mediated by their earlier reciprocal effects on each other between ages 5 and 14. Our findings underscore the need to address both child and parental contributions to dysfunctional transactions in order to stem the development of BPD symptoms. Moreover, problems with self-regulation in early adolescence may indicate heightened risk for subsequent BPD. Altogether, these results increase our understanding of developmental trajectories associated with BPD symptoms in adolescent girls. (c) 2015 APA, all rights reserved).

  14. Relation between psychosocial variables and the glycemic control of patients with type 2 diabetes: A cross-sectional and prospective study

    Directory of Open Access Journals (Sweden)

    Kawai Keisuke

    2009-03-01

    Full Text Available Abstract Background This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes. Methods Participants were 304 patients with type 2 diabetes who were treated as outpatients at diabetes clinics. All participants were assessed for HbA1c and completed the following self-report psychological inventories: 1 Diabetes Treatment Satisfaction Questionnaire (DTSQ, 2 Problem Areas in Diabetes Survey (PAID, 3 Well-being Questionnaire 12 (W-BQ12, 4 Self-Esteem Scale (SES, 5 Social Support Scale, and 6 Self-Efficacy Scale. HbA1c was again measured one year later. The relationships between the psychosocial variables obtained by analysis of the psychological inventories and baseline or one-year follow-up HbA1c were determined. Results Baseline HbA1cwas significantly correlated with age, diet treatment regimen, number of microvascular complication of diabetes, and the total scores of DTSQ, W-BQ12, PAID, SES and the Self-Efficacy Scale. Hierarchical stepwise multiple regression revealed that significant predictors of baseline HbA1c were total DTSQ and PAID scores, along with age, diet treatment regimen, and number of microvascular complication of diabetes after adjustment for demographic, clinical and other psychosocial variables. Two hundred and ninety patients (95.4% of 304 were followed and assessed one year after baseline. Hierarchical stepwise multiple regression analysis showed the significant predictors of follow-up HbA1c to be total DTSQ and PAID scores, along with age and diet treatment regimen. However, the correlation between baseline and follow-up HbA1c was so high that the only other variable to retain significance was diet treatment regimen once baseline HbA1c was included in the regression of follow-up HbA1c. Conclusion The DTSQ and the PAID predicted both current and future HbA1c to a similar and

  15. Prospective Preference Assessment of Patients' Willingness to Participate in a Randomized Controlled Trial of Intensity-Modulated Radiotherapy Versus Proton Therapy for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Anand [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Efstathiou, Jason A.; Paly, Jonathan J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Halpern, Scott D. [Department of Medicine, University of Pennsylvania, Philadelphia, PA (United States); Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA (United States); Center for Bioethics, University of Pennsylvania, Philadelphia, PA (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA (United States); Bruner, Deborah W. [Winship Cancer Institute, Emory University, Atlanta, GA (United States); Christodouleas, John P. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Coen, John J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Shipley, William U.; Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA (United States)

    2012-05-01

    Purpose: To investigate patients' willingness to participate (WTP) in a randomized controlled trial (RCT) comparing intensity-modulated radiotherapy (IMRT) with proton beam therapy (PBT) for prostate cancer (PCa). Methods and Materials: We undertook a qualitative research study in which we prospectively enrolled patients with clinically localized PCa. We used purposive sampling to ensure a diverse sample based on age, race, travel distance, and physician. Patients participated in a semi-structured interview in which they reviewed a description of a hypothetical RCT, were asked open-ended and focused follow-up questions regarding their motivations for and concerns about enrollment, and completed a questionnaire assessing characteristics such as demographics and prior knowledge of IMRT or PBT. Patients' stated WTP was assessed using a 6-point Likert scale. Results: Forty-six eligible patients (33 white, 13 black) were enrolled from the practices of eight physicians. We identified 21 factors that impacted patients' WTP, which largely centered on five major themes: altruism/desire to compare treatments, randomization, deference to physician opinion, financial incentives, and time demands/scheduling. Most patients (27 of 46, 59%) stated they would either 'definitely' or 'probably' participate. Seventeen percent (8 of 46) stated they would 'definitely not' or 'probably not' enroll, most of whom (6 of 8) preferred PBT before their physician visit. Conclusions: A substantial proportion of patients indicated high WTP in a RCT comparing IMRT and PBT for PCa.

  16. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study.

    Science.gov (United States)

    Wagenlehner, Florian M E; Schneider, Henning; Ludwig, Martin; Schnitker, Jörg; Brähler, Elmar; Weidner, Wolfgang

    2009-09-01

    National Institutes of Health (NIH) category III prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent condition for which no standardised treatment exists. To assess the safety and efficacy of a standardised pollen extract in men with inflammatory CP/CPPS. We conducted a multicentre, prospective, randomised, double-blind, placebo-controlled phase 3 study comparing the pollen extract (Cernilton) to placebo in men with CP/CPPS (NIH IIIA) attending urologic centres. Participants were randomised to receive oral capsules of the pollen extract (two capsules q8h) or placebo for 12 wk. The primary endpoint of the study was symptomatic improvement in the pain domain of the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). Participants were evaluated using the NIH-CPSI individual domains and total score, the number of leukocytes in post-prostatic massage urine (VB3), the International Prostate Symptom Score (IPSS), and the sexuality domain of a life satisfaction questionnaire at baseline and after 6 and 12 wk. In the intention-to-treat analysis, 139 men were randomly allocated to the pollen extract (n=70) or placebo (n=69). The individual domains pain (p=0.0086) and quality of life (QoL; p=0.0250) as well as the total NIH-CPSI score (p=0.0126) were significantly improved after 12 wk of treatment with pollen extract compared to placebo. Response, defined as a decrease of the NIH-CPSI total score by at least 25% or at least 6 points, was seen in the pollen extract versus placebo group in 70.6% and 50.0% (p=0.0141), respectively. Adverse events were minor in all patients studied. Compared to placebo, the pollen extract significantly improved total symptoms, pain, and QoL in patients with inflammatory CP/CPPS without severe side-effects.

  17. A randomised controlled trial to assess the effectiveness of offering study results as an incentive to increase response rates to postal questionnaires [ISRCTN26118436

    Directory of Open Access Journals (Sweden)

    Torgerson David J

    2005-10-01

    Full Text Available Abstract Background Postal questionnaires are widely used to collect outcome data on participants. However, a poor response to questionnaires will reduce the statistical power of the study and may introduce bias. A meta analysis of ten trials offering study results, largely in the fields of education and marketing, was shown to be ineffective, with the odds ratio for response with offering research findings is 0.92 (95% CI 0.75 to 1.11. However uncertainty still exists as it is uncertain whether results from such trials can be extrapolated to that of a health care setting. The aim of this study was to assess whether offering participants study results increases the response rates to postal questionnaires. Methods 1038 women aged over 70 years were remotely randomised by computer in a 3:1 ratio. 250 participants did not receive the offer of knowing the results of the trial and 788 participants were offered the results of the trial in a postal questionnaire. The main outcome measure was response rate. Chi square test was used to evaluate the overall differences in response rate between the two groups. An adjusted analysis, adjusting for whether the participant was taking calcium and age was also undertaken. Results The response rates were not significantly different Odds Ratio 0.88 (95% confidence intervals 0.48 to 1.63 p = 0.69. Conclusion Offering study results to women living in the community aged over 70 does not increase response rates to postal questionnaires. Although researchers have an ethical obligation to offer participants study results, since 10% of women did not wish to receive the results, investigators should give participants the option to opt out of receiving the study's results.

  18. Current state of concussion prevention strategies: a systematic review and meta-analysis of prospective, controlled studies.

    Science.gov (United States)

    Schneider, Daniel K; Grandhi, Ravi K; Bansal, Purnima; Kuntz, George E; Webster, Kate E; Logan, Kelsey; Barber Foss, Kim D; Myer, Gregory D

    2017-10-01

    The aim of the current review was to systematically identify, evaluate and synthesise trials that examine concussion prevention via equipment, educational programmes and training programmes. PubMed and EBSCO host (CINAHL, MEDLINE, SPORTDiscus). The electronic databases PubMed and EBSCO were searched using the phrases: concussion prevention equipment, concussion prevention training and concussion prevention education. Included studies utilised a prospective study design to evaluate the preventative effect of: (1) equipment, (2) training or (3) educational programmes on the incidence of concussions in comparison to a control group. Demographic data and intervention methods were recorded. Intervention and control group concussion rates and superficial head injury rates were extracted and combined using random-effects relative risk meta-analysis. 14 studies evaluated interventions of novel protective equipment. One prospective investigation evaluated an educational programme. The relative risk of concussion for participants enrolled in the interventional arms of trials was not significantly different from that in standard practice arms (RR=0.78, 95% CI 0.55 to 1.11, χ(2)=1.8, p=0.17; I(2)=85.3%, 95% CI 71.5% to 90.8%). The relative risk of concussion for participants wearing protective equipment (ie, headgear, full face shields) relative to their counterparts wearing standard or no equipment, calculated from seven available reports, showed no effect of intervention (RR=0.82, 95% CI 0.56 to 1.20, χ(2)=1.06, p=0.30; I(2)=86.7%, 95% CI 73.3% to 91.8%). The relative risk of superficial head injury for participants wearing protective equipment relative to their counterparts, calculated from three reports, showed a significant risk reduction (RR=0.41, 95% CI 0.31 to 0.56, χ(2)=34.13, p<0.0001; I(2)=53.1%, 95% CI 0% to 85.2%). Prospective controlled studies indicate that certain protective equipment may prevent superficial head injury, but these items are suboptimal for

  19. Circulating C-Reactive Protein Concentrations and Risks of Colon and Rectal Cancer : A Nested Case-Control Study Within the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Aleksandrova, Krasimira; Jenab, Mazda; Boeing, Heiner; Jansen, Eugene; Bueno-de-Mesquita, H. Bas; Rinaldi, Sabina; Riboli, Elio; Overvad, Kim; Dahm, Christina C.; Olsen, Anja; Tjonneland, Anne; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Morois, Sophie; Palli, Domenico; Krogh, Vittorio; Tumino, Rosario; Vineis, Paolo; Panico, Salvatore; Kaaks, Rudolf; Rohrmann, Sabine; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; van Duijnhoven, Fraenzel J. B.; Leufkens, Anke M.; Peeters, Petra H.; Rodriguez, Laudina; Bonet, Catalina; Sanchez, Maria-Jose; Dorronsoro, Miren; Navarro, Carmen; Barricarte, Aurelio; Palmqvist, Richard; Hallmans, Goran; Khaw, Kay-Tee; Wareham, Nicholas; Allen, Naomi E.; Spencer, Elizabeth; Romaguera, Dora; Norat, Teresa; Pischon, Tobias

    2010-01-01

    The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using

  20. Clinical assessment of a new anaesthetic drug administration system: a prospective, controlled, longitudinal incident monitoring study.

    Science.gov (United States)

    Webster, C S; Larsson, L; Frampton, C M; Weller, J; McKenzie, A; Cumin, D; Merry, Alan F

    2010-05-01

    A safety-orientated system of delivering parenteral anaesthetic drugs was assessed in a prospective incident monitoring study at two hospitals. Anaesthetists completed an incident form for every anaesthetic, indicating if an incident occurred. Case mix data were collected and the number of drug administrations made during procedures estimated. From February 1998 at Hospital A and from June 1999 at Hospital B, until November 2003, 74,478 anaesthetics were included, for which 59,273 incident forms were returned (a 79.6% response rate). Fewer parenteral drug errors occurred with the new system than with conventional methods (58 errors in an estimated 183,852 drug administrations (0.032%, 95% CI 0.024-0.041%) vs 268 in 550,105 (0.049%, 95% CI 0.043-0.055%) respectively, p = 0.002), a relative reduction of 35% (difference 0.017%, 95% CI 0.006-0.028%). No major adverse outcomes from these errors were reported with the new system while 11 (0.002%) were reported with conventional methods (p = 0.055). We conclude that targeted system re-design can reduce medical error.

  1. Effectiveness of intermittent diazepam prophylaxis in febrile seizures: long-term prospective controlled study.

    Science.gov (United States)

    Pavlidou, Efterpi; Tzitiridou, Maria; Panteliadis, Christos

    2006-12-01

    The efficacy of intermittent rectal diazepam prophylaxis is assessed in the prevention of febrile seizures. In a prospective randomized cohort trial, 139 children (77 girls, 62 boys) who experienced a first febrile seizure were allocated to two groups: group A, which received intermittent diazepam (n = 68), and group B, which received no prophylaxis (n = 71). All children had a 3-year follow-up. The inclusion criteria were no personal history of afebrile seizures, normal neurodevelopment, no previous anticonvulsant therapy, and age between 6 months and 3 years. Each group was stratified to low, intermediate, and high risk according to the available clinical data. The 36-month recurrence rates in the no-prophylaxis group were 83% in high-risk patients, 55% in intermediate-risk patients, and 46% in low-risk patients. In the prophylaxis group, the recurrence rates were reduced in all risk groups: 38%, 35%, and 33%, respectively. Intermittent diazepam prophylaxis reduces the recurrence rate mainly in high-risk children provided that sufficient doses are given on time and adequately.

  2. Postoperative vasopressin and copeptin levels in noncardiac surgery patients: a prospective controlled trial.

    Science.gov (United States)

    Jochberger, Stefan; Zitt, Matthias; Luckner, Günter; Mayr, Viktoria D; Wenzel, Volker; Ulmer, Hanno; Morgenthaler, Nils G; Hasibeder, Walter R; Dünser, Martin W

    2009-02-01

    Further information on the endogenous arginine vasopressin (AVP) response in patients with postoperative systemic inflammatory response syndrome (SIRS) and vasodilatory shock would provide more insight into the pathophysiology of SIRS-associated cardiovascular failure and help indicate AVP therapy. Patients after uncomplicated abdominal surgery without SIRS (n = 10), critically ill patients after noncardiac surgery with SIRS (n = 9), and patients with SIRS plus vasodilatory shock (n = 22) were included in this prospective trial. Plasma AVP (radioimmunoassay) and copeptin (immunoluminometric assay) concentrations together with clinical parameters were documented daily during the first 7 days postoperative. The AVP response significantly differed between the three groups. Patients without SIRS had lower AVP concentrations than SIRS patients with (P = 0.001) or without shock (P = 0.003). Patients with SIRS and shock had higher AVP levels than patients with SIRS alone (P SIRS patients without shock, serum osmolarity was indirectly associated with AVP levels, whereas mean arterial blood pressure and serum osmolarity were associated with AVP in SIRS patients with shock. Arginine vasopressin and copeptin correlated significantly with each other (P surgery patients seems well maintained. The possibility that AVP plays a contributory role in the failure to restore vascular tone in patients with vasodilatory shock cannot be excluded but seems less important than in septic or postcardiotomy shock.

  3. Twelve-Month Efficacy and Safety Data for the "Stress Incontinence Control, Efficacy and Safety Study": A Phase III, Multicenter, Prospective, Randomized, Controlled Study Treating Female Stress Urinary Incontinence Using the Vesair Intravesical Balloon.

    Science.gov (United States)

    Winkler, Harvey; Jacoby, Karny; Kalota, Susan; Snyder, Jeffrey; Cline, Kevin; Robertson, Kaiser; Kahan, Randall; Green, Lonny; McCammon, Kurt; Rovner, Eric; Rardin, Charles

    2017-09-26

    The "Stress Incontinence Control, Efficacy and Safety Study" (SUCCESS) is a phase III study of the Vesair Balloon in women with stress urinary incontinence who had failed conservative therapy, and either failed surgery, were not candidates for surgery, or chose not to have surgery. The safety and efficacy of the balloon at 12 months is reported for those participants in the treatment arm who elected to continue with the SUCCESS trial beyond the primary end point at 3 months. The SUCCESS trial is a multicenter, prospective, single-blinded, randomized, sham-controlled study. Participants were randomized on a 2.33:1 basis to either Vesair Balloon placement or placebo. The primary efficacy end point was a composite of both a greater than 50% reduction from baseline on 1-hour provocative pad weight test and an at least 10-point improvement in symptoms on the Incontinence Quality of Life questionnaire assessed at the 3-month study visit. Patients in the treatment arm who opted to continue in the trial were followed up prospectively up to 12 months. A total of 221 participants were randomized, including 157 in the treatment arm and 64 in the control arm. Sixty-seven participants in the treatment arm (42.7% of participants enrolled) were evaluated at 12 months, with 56.3% achieving the composite end point and 78.7% having greater than 50% reduction in pad weight from baseline in a per-protocol analysis. In an intent-to-treat analysis treating all participants who did not continue with the balloon as failures, 24% of the participants achieved the composite end point and 33.6% had a greater than 50% reduction in pad weight from baseline. Treatment-related adverse events in this group included dysuria (40.1%), gross hematuria (36.9%), and urinary tract infection (26.1%). In this phase III trial, symptom relief was maintained for those participants who continued therapy for 12 months. The balloon was found to be safe with no device- or procedure-related serious adverse events

  4. Prospective Science Teachers' Conceptions about Astronomical Subjects

    Science.gov (United States)

    Küçüközer, Hüseyin

    2007-01-01

    The main objective of this study was to identify prospective science teachers' conceptions on basic astronomical phenomena. A questionnaire consisting of nine open-ended questions was administered to 327 prospective science teachers. The questionnaire was constructed after extensive review of the literature and took into consideration the reported…

  5. Applicability of Proposed Diagnostic Criteria of Pityriasis Rosea: Results of a Prospective Case-Control Study in India

    Science.gov (United States)

    Zawar, Vijay; Chuh, Antonio

    2013-01-01

    Background: The diagnosis of pityriasis rosea (PR) is generally clinical. Previous studies usually recruited relatively small numbers of patients and control subjects, leading to low power of study results. Systematic reviews and meta-analyses cannot be readily performed, as the inclusion and exclusion criteria of these studies were not uniform. We have previously validated a set of diagnostic criteria (DC) in Chinese patients with PR. Aim: Our aim is to evaluate the validity and applicability of the DC of PR in Indian patients with PR. Study Design: Prospective unblinded pair-matched case-control study. Materials and Methods: The setting is a dermatology clinic in India served by one board-certified dermatologist. We recruited all 88 patients seen by us during five years diagnosed to have PR to join our study. For each study subject, we recruited the next patient who consulted us with differential diagnoses of PR as control subjects. We applied the DC of PR on all study and control subjects. Result: The sensitivity, specificity, positive predictive value, and negative predictive value of the DC were all 100%. Two-tailed Fisher's exact probability test result was 0.036. Φ was 1.00. Conclusion: The set of DC can be validly applied to Indian patients with PR. PMID:24249894

  6. Microorganisms Associated With Pneumonia in Children Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study.

    Science.gov (United States)

    Bénet, Thomas; Sánchez Picot, Valentina; Messaoudi, Mélina; Chou, Monidarin; Eap, Tekchheng; Wang, Jianwei; Shen, Kunling; Pape, Jean-William; Rouzier, Vanessa; Awasthi, Shally; Pandey, Nitin; Bavdekar, Ashish; Sanghavi, Sonali; Robinson, Annick; Rakoto-Andrianarivelo, Mala; Sylla, Maryam; Diallo, Souleymane; Nymadawa, Pagbajabyn; Naranbat, Nymadawaagiin; Russomando, Graciela; Basualdo, Wilma; Komurian-Pradel, Florence; Endtz, Hubert; Vanhems, Philippe; Paranhos-Baccalà, Gláucia

    2017-06-12

    Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged emerging countries. A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site. Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.

  7. Is Electrocautery of Patella Useful in Patella Non-Resurfacing Total Knee Arthroplasty?: A Prospective Randomized Controlled Study.

    Science.gov (United States)

    Kwon, Sae Kwang; Nguku, Levis; Han, Chang Dong; Koh, Yong-Gon; Kim, Dong-Wook; Park, Kwan Kyu

    2015-12-01

    There is controversy over the need for electrocauterization of the patella in non-resurfacing total knee arthroplasty (TKA). We investigated whether this procedure is beneficial through a prospective randomized controlled trial. Fifty patients who underwent electrocautery were compared with 50 patients who did not undergo this procedure. We determined cartilage status, preoperative and postoperative American Knee Society (AKS) score, the Western Ontario and McMaster Universities score (WOMAC) and the Patellofemoral (PF) scores for a minimum of 5 years. The two groups did not differ significantly in demographics, intraoperative cartilage status, or preoperative or postoperative outcomes. No complications were detected in either group. We found no benefits of electrocautery of the patella in patellar non-resurfacing TKA up to 5 years. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. The Vast and Varied Global Burden of Norovirus: Prospects for Prevention and Control.

    Science.gov (United States)

    Lopman, Benjamin A; Steele, Duncan; Kirkwood, Carl D; Parashar, Umesh D

    2016-04-01

    Globally, norovirus is associated with approximately one-fifth of all diarrhea cases, with similar prevalence in both children and adults, and is estimated to cause over 200,000 deaths annually in developing countries. Norovirus is an important pathogen in a number of high-priority domains: it is the most common cause of diarrheal episodes globally, the principal cause of foodborne disease outbreaks in the United States, a key health care-acquired infection, a common cause of travel-associated diarrhea, and a bane for deployed military troops. Partly as a result of this ubiquity and burden across a range of different populations, identifying target groups and strategies for intervention has been challenging. And, on top of the breadth of this public health problem, there remain important gaps in scientific knowledge regarding norovirus, especially with respect to disease in low-income settings. Many pathogens can cause acute gastroenteritis. Historically, rotavirus was the most common cause of severe disease in young children globally. Now, vaccines are available for rotavirus and are universally recommended by the World Health Organization. In countries with effective rotavirus vaccination programs, disease due to that pathogen has decreased markedly, but norovirus persists and is now the most common cause of pediatric gastroenteritis requiring medical attention. However, the data supporting the precise role of norovirus in low- and middle-income settings are sparse. With vaccines in the pipeline, addressing these and other important knowledge gaps is increasingly pressing. We assembled an expert group to assess the evidence for the global burden of norovirus and to consider the prospects for norovirus vaccine development. The group assessed the evidence in the areas of burden of disease, epidemiology, diagnostics, disease attribution, acquired immunity, and innate susceptibility, and the group considered how to bring norovirus vaccines from their current state of

  9. Prospective controlled assessment of impact of feedback on gastroenterology trainees in outpatient practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2012-02-01

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  10. Prospective Controlled Assessment of Impact of Feedback on Gastroenterology Trainees in Outpatient Practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2011-03-29

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  11. Event-based prospective memory deficits in individuals with high depressive symptomatology: problems controlling attentional resources?

    Science.gov (United States)

    Li, Yanqi Ryan; Loft, Shayne; Weinborn, Michael; Maybery, Murray T

    2014-01-01

    Depression has been found to be related to neurocognitive deficits in areas important to successful prospective memory (PM) performance, including executive function, attention, and retrospective memory. However, research specific to depression and PM has produced a mixed pattern of results. The current study further examined the task conditions in which event-based PM deficits may emerge in individuals with high depressive symptomatology (HDS) relative to individuals with low depressive symptomatology (LDS) and the capacity of HDS individuals to allocate attentional resources to event-based PM tasks. Sixty-four participants (32 HDS, 32 LDS) were required to make a PM response when target words were presented during an ongoing lexical decision task. When the importance of the ongoing task was emphasized, response time costs to the ongoing task, and PM accuracy, did not differ between the HDS and LDS groups. This finding is consistent with previous research demonstrating that event-based PM task accuracy is not always impaired by depression, even when the PM task is resource demanding. When the importance of the PM task was emphasized, costs to the ongoing task further increased for both groups, indicating an increased allocation of attentional resources to the PM task. Crucially, while a corresponding improvement in PM accuracy was observed in the LDS group when the importance of the PM task was emphasized, this was not true for the HDS group. The lack of improved PM accuracy in the HDS group compared with the LDS group despite evidence of increased cognitive resources allocated to PM tasks may have been due to inefficiency in the application of the allocated attention, a dimension likely related to executive function difficulties in depression. Qualitatively different resource allocation patterns may underlie PM monitoring in HDS versus LDS individuals.

  12. Prospects for the use of biological control agents against Anoplophora in Europe

    Science.gov (United States)

    This review summarises the literature on the biological control of Anoplophora spp. (Coleoptera: Cerambycidae) and discusses its potential for use in Europe. Entomopathogenic fungi: Beauveria brongniartii Petch (Hypocreales: Cordycipitaceae) has already been developed into a commercial product in Ja...

  13. Prospective, randomized, controlled trial of thoracic epidural or patient-controlled opiate analgesia on perioperative quality of life.

    LENUS (Irish Health Repository)

    Ali, M

    2010-03-01

    Perioperative epidural analgesia provides continuous pain control and may have advantages over parenteral opiate administration. This study assessed the impact of epidural analgesia on quality of life (QOL) of patients undergoing major surgery.

  14. Neutrophil-to-lymphocyte ratio in patients with peripheral vertigo: a prospective controlled clinical study.

    Science.gov (United States)

    Ozbay, Isa; Kahraman, Cuneyt; Balikci, Hasan Huseyin; Kucur, Cuneyt; Kahraman, Nilufer Kuzeyli; Ozkaya, Derya Pınar; Oghan, Fatih

    2014-01-01

    We aimed to investigate the relationship between peripheral vertigo and inflammation by using the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker. We recruited 103 patients with peripheral vertigo (71 women, 32 men; mean age, 39.8 ± 14.7 years) who presented to the Otolaryngology Department of Dumlupinar University Hospital. Vertigo patients with systemic diseases, neurological disorders, malignancy or any inflammatory disease that could alter the NLR were excluded from the study. We also enrolled 103 age- and sex-matched healthy subjects (controls; 82 women, 21 men; mean age, 36.7 ± 13.5 years) who underwent routine checkups in our hospital. The vertigo patients underwent full otolaryngologic and neurologic examinations and audiometric tests to rule out any other pathology causing the peripheral vertigo. NLR was calculated in all subjects and was compared between the patient and control groups. There were no significant differences between the study and control groups in terms of lipid profiles, liver-function tests, white blood cell (WBC) count, hemoglobin level, mean platelet volume, and vitamin B12 and folate levels. The mean NLR was significantly higher in the patients than in the controls (Pvertigo, found that the NLR is significantly higher among peripheral vertigo patients than among healthy controls. This result suggests that the NLR is a novel potential marker of stress in peripheral vertigo patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Oral status in patients with early rheumatoid arthritis: a prospective, case-control study.

    Science.gov (United States)

    Wolff, Björn; Berger, Timo; Frese, Cornelia; Max, Regina; Blank, Norbert; Lorenz, Hanns-Martin; Wolff, Diana

    2014-03-01

    Patients with RA suffer from a higher risk of periodontal attachment loss and increased oral inflammation. We hypothesize that there are pathogenetic and immunological interactions between these diseases that go beyond impaired manual dexterity accompanying advanced RA. The primary objective of the present study was to determine whether a loss of alveolar bone can be detected in RA patients during the early course of the disease. In this cross-sectional, epidemiological case-control study, 22 patients with early RA (ERA) were compared with 22 matched healthy controls. Oral and periodontal status, clinical activity, and socio-demographic parameters were determined. Oral microbiota were analysed using real-time quantitative PCR specific for leading oral pathogens. More advanced forms of periodontitis were found in ERA patients compared with controls. ERA patients had a greater number of missing teeth [ERA 5.7 (s.d. 5.0), controls 1.9 (s.d. 1.0), P = 0.002], deeper periodontal pockets [clinical attachment level: ERA 3.4 (s.d. 0.5 mm), controls 2.7 (s.d. 0.3 mm), P periodontal attachment and alveolar bone can be detected in patients with ERA, therefore we propose that the consulting rheumatologists inform the patients that they have a higher risk of periodontal disease. It would be beneficial if these patients were referred directly for intensive dental care.

  16. Prospects of control and eradication of capripox from the Indian subcontinent: a perspective.

    Science.gov (United States)

    Bhanuprakash, V; Hosamani, M; Singh, R K

    2011-09-01

    Sheeppox and goatpox, two endemic capripox infections in India, pose a significant economic threat to small ruminant productivity in the subcontinent. Vaccination of all susceptible sheep and goats is the feasible and sustainable means of control. Availability of effective live attenuated vaccines that are inherently thermostable and development of improved diagnostics provide the opportunities to initiate effective control measures for capripox. All animals older than 4 months can be vaccinated with the current homologous vaccines using a single vaccination by intradermal or subcutaneous routes. The success of the control program needs to be monitored by active surveillance particularly for the presence of virus, as sero-monitoring does not enable the differentiation of infection and vaccination. And also the sero-conversion following capripox vaccination is not detectable enough by the available tools. Sustained control efforts call for socio-economic and political stability, adequate infrastructure and logistic support to store and transport vaccines for reaching out vaccines to the remote end users. Availability of veterinary services, improved extension services for increased awareness among farmers, contribute significantly to the control campaigns. Poor vaccination coverage and in-adequate infrastructure in major parts of the country are some of the major elements that come in the way of effective implementation of building herd immunity through immunization.

  17. Avaliação do questionário de controle da asma validado para uso no Brasil Evaluation of the asthma control questionnaire validated for use in Brazil

    Directory of Open Access Journals (Sweden)

    Mylene Leite

    2008-10-01

    Full Text Available OBJETIVO: Avaliar se a versão em língua portuguesa do Asthma Control Questionnaire (ACQ, Questionário de Controle da Asma é um instrumento válido para medir o controle da asma em pacientes adultos ambulatoriais no Brasil. MÉTODOS: Foram avaliados 278 pacientes ambulatoriais com diagnóstico de asma. Todos os pacientes, durante a primeira visita, responderam ao questionário, foram submetidos à espirometria e avaliados clinicamente por um médico para a caracterização do controle da doença. Foram analisadas as versões do questionário com 5, 6 e 7 questões, utilizando dois escores distintos (0,75 e 1,50 como pontos de corte. RESULTADOS: Dos 278 pacientes, 77 (27,7% tinham asma intermitente, 39 (14,0% asma persistente leve, 40 (14,4% asma persistente moderada e 122 (43,9% asma persistente grave. A sensibilidade do questionário para identificar asma não-controlada variou de 77% a 99% e a especificidade variou de 36% a 84%. O valor preditivo positivo variou de 73% a 90%, e o valor preditivo negativo variou de 67% a 95%. A razão de verossimilhança positiva variou de 1,55 a 4,81, e a razão de verossimilhança negativa variou de 0,03 a 0,27. Nas versões do ACQ com 5 e 6 questões, o coeficiente de correlação intraclasse foi de 0,92, e estas versões foram responsivas a mudanças no quadro clínico dos pacientes. CONCLUSÕES: O ACQ, nas suas três versões, teve boa capacidade de discriminar indivíduos com asma não-controlada daqueles com asma controlada. As versões com 5 e 6 questões apresentaram também boa reprodutibilidade e responsividade. Trata-se, portanto, de um instrumento válido para avaliação do controle da asma em pacientes adultos ambulatoriais no Brasil.OBJECTIVE: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ is a valid instrument to measure asthma control in adult outpatients in Brazil. METHODS: We selected 278 outpatients diagnosed with asthma. All of the patients completed

  18. Status and prospects of plant virus control through interference with vector transmission.

    Science.gov (United States)

    Bragard, C; Caciagli, P; Lemaire, O; Lopez-Moya, J J; MacFarlane, S; Peters, D; Susi, P; Torrance, L

    2013-01-01

    Most plant viruses rely on vector organisms for their plant-to-plant spread. Although there are many different natural vectors, few plant virus-vector systems have been well studied. This review describes our current understanding of virus transmission by aphids, thrips, whiteflies, leafhoppers, planthoppers, treehoppers, mites, nematodes, and zoosporic endoparasites. Strategies for control of vectors by host resistance, chemicals, and integrated pest management are reviewed. Many gaps in the knowledge of the transmission mechanisms and a lack of available host resistance to vectors are evident. Advances in genome sequencing and molecular technologies will help to address these problems and will allow innovative control methods through interference with vector transmission. Improved knowledge of factors affecting pest and disease spread in different ecosystems for predictive modeling is also needed. Innovative control measures are urgently required because of the increased risks from vector-borne infections that arise from environmental change.

  19. A prospective randomized controlled trial of two different sedation sequences for third molar removal in adults.

    Science.gov (United States)

    Khader, Ruba; Oreadi, Daniel; Finkelman, Matthew; Jarmoc, Marcin; Chaudhary, Sanjeet; Schumann, Roman; Rosenberg, Morton

    2015-02-01

    In oral and maxillofacial outpatient surgery, sedation techniques are an important component in patient management for a wide variety of surgical procedures. Fentanyl and midazolam are commonly used sedatives with different mechanisms of action and specific analgesic or amnestic properties. This study examined whether the order of their administration would affect a patient's pain perception or procedural vital signs. After institutional review board approval and written informed consent, a prospective, randomized, parallel-group clinical trial was conducted in patients who planned to undergo removal of at least 2 third molars under intravenous moderate sedation. Patients were randomly assigned to 1 of 2 groups. The fentanyl-first group received fentanyl and then midazolam; the midazolam-first group received midazolam and then fentanyl. Recollection of the intraoperative pain score was assessed 24 hours after surgery using the Wong-Baker FACES pain scale. The Mann-Whitney U test was used to assess for the presence of a statistically significant difference between the 2 groups. Statistically significant differences in procedural vital sign fluctuations were examined using the t test. Patients' satisfaction with the procedure was assessed and intergroup comparisons were made. Sixty-six patients were enrolled, 1 of whom did not complete the study. Recollected procedural pain scores at 24 hours after surgery were not statistically different between groups. Median scores on the Wong-Baker FACES pain scale for the 2 groups were 2.0 (interquartile range, 3.1) for the fentanyl-first group and 1.5 (interquartile range, 2.5) for the midazolam-first group (P = .333). There was no statistical difference in the change in vital signs from baseline to 2 surgical end points in the 2 groups. In addition, patient satisfaction with the procedure did not statistically differ between the 2 groups. In this study, selective sequencing of midazolam or fentanyl during an intravenous

  20. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Gizzi, G; Ippolito, E; Fano, F; Dugall, M; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2006-01-01

    The aim of this study was to investigate the clinical efficacy of oral Pycnogenol (Horphag Research Ltd, UK) in patients with severe chronic venous insufficiency. Patients with severe venous hypertension (chronic venous insufficiency, ankle swelling) and history of venous ulcerations were treated with Pycnogenol. Patients received oral Pycnogenol (50 mg capsules, 3 times daily for a total of 150 mg daily) for 8 weeks. A group of 21 patients was included in the treatment group and 18 equivalent patients were observed as controls (no treatment during the observation period). All 21 patients (age 53 years; range, 42-60 years; M:F=11:10) in the treatment group completed the 8-week study. Also the 18 controls completed the follow-up period. There were no drop-outs. The average ambulatory venous pressure was 59.3 (SD 7.2; range 50-68) with a refilling time shorter than 10 seconds (average 7.6; SD 3). There were no differences in ambulatory venous pressure or refilling time between the treatment and control patients. The duration of the disease-from the first signs/symptoms-was on average 5.7 years (SD 2.1). At 4 and 8 weeks, in all Pycnogenol-treated subjects, microcirculatory and clinical evaluations indicated a progressive decrease in skin flux, indicating an improvement in the level of microangiopathy; a significant decrease in capillary filtration; a significant improvement in the symptomatic score; and a reduction in edema. There were no visible effects in controls. In conclusion, this study confirms the fast clinical efficacy of Pycnogenol in patients with chronic venous insufficiency and venous microangiopathy. The study indicates the significant clinical role of Pycnogenol in the management, treatment and control of this common clinical problem. The treatment may be also useful to prevent ulcerations by controlling the level of venous microangiopathy.

  1. [A prospective multicenter randomized controlled clinical study on the efficacy and safety of Guaifenesin compound pseudoephedrine hydrochloride oral solution].

    Science.gov (United States)

    Lu, Quan

    2010-03-01

    To evaluate efficacy and safety of Guaifenesin compound pseudoephedrine hydrochloride oral solution for the treatment of cough, expectoration, nasal congestion and runny nose in children. This was a prospective multicenter randomized single-blind, parallel-controlled clinical study. A total of 10 centers participated in this study, the actual number of cases in line with the program was 412, of whom 205 cases in trial group were treated with Guaifenesin compound pseudoephedrine hydrochloride oral solution, and 207 cases in control group with ambroxol hydrochloride oral solution, treatment of both groups persisted for 7 days. The improvement rate of each single symptom and the combined symptoms and the overall effective rate were compared between the two groups. The adverse drug reactions and compliance were assessed as well. The treatment of both groups showed efficacy. Except sputum stickiness, the improvement of all symptoms in trial group was superior to that in the control group on the 3rd day after treatment (P Guaifenesin compound pseudoephedrine hydrochloride oral solution was 82.9% and the overall efficacy rate was 89.3%. Guaifenesin compound Pseudoephedrine hydrochloride oral solution had higher compliance and its adverse event rate was merely 0.92%. Guaifenesin compound pseudoephedrine hydrochloride oral solution showed significant efficacy and safety in children for treatment of cough, expectoration, nasal congestion and runny nose caused by common cold or acute tracheobronchitis.

  2. Lessons from interactions within the cassava green mite fungal pathogen Neozygites tanajoae system and prospects for microbial control using Entomophthorales.

    Science.gov (United States)

    Hountondji, Fabien C C

    2008-12-01

    Most fungal pathogens lack the capacity to search for their host but rather develop sit-and-wait strategies that favour contact with them. The success of these strategies depends upon the interactions of the pathogen with its host, the host plant and the environmental conditions, which altogether determine its transmissibility. Given the limited success that has characterized application of sustainable microbial control, particularly using Entomophthorales, interaction studies have been conducted with the entomophthoralean fungus Neozygites tanajoae, pathogenic to the cassava green mite (CGM), Mononychellus tanajoa, to help understand differences observed between laboratory and field performances of this pathogen. Reciprocal pathogen-host interactions as well as tritrophic interactions involving the host plant were studied. It was found that herbivory triggers the release of volatiles that promote sporulation of isolates of N. tanajoae, whereas the host mite avoids haloes of spores of this pathogen. However, the host mite does not avoid the pathogen when inside the mummified fungus-killed cadaver. The status of microbial control of CGM in Africa is reviewed and implications of these interactions are discussed for prospective application of microbial control using Entomophthorales.

  3. Management of dental extraction in patients undergoing anticoagulant treatment. Results from a large, multicentre, prospective, case-control study.

    Science.gov (United States)

    Bacci, Christian; Maglione, Michele; Favero, Lorenzo; Perini, Alessandro; Di Lenarda, Roberto; Berengo, Mario; Zanon, Ezio

    2010-11-01

    Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 - 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.

  4. Reducing radiation exposure during kyphoplasty with the use of a remote control injection system: a prospective study.

    Science.gov (United States)

    Wang, Jianru; Liu, Hui; Zhang, Kuibo; Li, Bingxue; Yang, Hao; Wang, Hua; Zheng, Zhaomin

    2015-01-15

    A prospective study. To compare surgeons' radiation exposure during kyphoplasty with and without the use of a remote control injection system. Distance from radiation sources is a critical factor for reducing radiation exposure during spine surgery. A newly designed device was used to minimize operators' radiation exposure during kyphoplasty. Forty-four patients admitted for single-level osteoporotic vertebral compression fracture were randomly divided into 2 groups (groups A and B) and treated with kyphoplasty. The remote control injection system was used only in group B. The radiation doses to the surgeon's eyes, thyroid, chest, and right wrist were recorded with 4 unprotected radiometers simultaneously. Operation time, fluoroscopic time, cement amount, patient-reported pre- and postoperative visual analogue scale scores for pain, and complications were recorded. For group A, the radiation doses at the eyes, thyroid, and right wrist were 1.132 ± 0.104 mSv, 0.647 ± 0.049 mSv, 0.578 ± 0.056 mSv, and 1.877 ± 0.214 mSv, respectively; for Group B, these doses were 0.257 ± 0.067 mSv, 0.201 ± 0.049 mSv, 0.145 ± 0.033 mSv, and 0.353 ± 0.046 mSv, respectively (P remote control injection system can significantly reduce surgeons' radiation exposure without affecting the efficiency of procedures.

  5. Efficacy of low dose gabapentin in acute herpes zoster for preventing postherpetic neuralgia: a prospective controlled study.

    Science.gov (United States)

    Lee, Eo G; Lee, Hee J; Hyun, Dong J; Min, Kyunghoon; Kim, Dong H; Yoon, Moon S

    2016-05-01

    Postherpetic neuralgia (PHN) is a sequela of herpes zoster that adversely affects quality of life seriously. The risk factors for PHN are well known but the effective interventions that reduce the incidence of PHN are less studied. The objective of this study is to evaluate the efficacy of treatment with gabapentin in patients with acute herpes zoster for preventing PHN. We performed a prospective randomized controlled study of 120 participants diagnosed with acute herpes zoster, aged 50 and over and complaining moderate to severe pain. All patients were treated with valacyclovir and acetaminophen. Half of the participants were assigned to the gabapentin group and received gabapentin 300 mg three times a day additionally. The intensity of pain at every visit and the incidence of PHN in both groups were measured. Total 52 and 49 patients in the gabapentin group and the control group, respectively, had completed 12 weeks of follow-up period. Although the incidence of PHN was higher in the control group, the difference was not statistically significant (6.1% vs. 3.8%, p = 0.67). Our results indicate that the use of low-dose gabapentin in acute herpes zoster seems not effective in the prevention of PHN.

  6. The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions: the buffering effect of job control.

    Science.gov (United States)

    Heponiemi, Tarja; Kouvonen, Anne; Virtanen, Marianna; Vänskä, Jukka; Elovainio, Marko

    2014-01-17

    Health care professionals, including physicians, are at high risk of encountering workplace violence. At the same time physician turnover is an increasing problem that threatens the functioning of the health care sector worldwide. The present study examined the prospective associations of work-related physical violence and bullying with physicians' turnover intentions and job satisfaction. In addition, we tested whether job control would modify these associations. The present study was a 4-year longitudinal survey study, with data gathered in 2006 and 2010.The present sample included 1515 (61% women) Finnish physicians aged 25-63 years at baseline. Analyses of covariance (ANCOVA) were conducted while adjusting for gender, age, baseline levels, specialisation status, and employment sector. The results of covariance analyses showed that physical violence led to increased physician turnover intentions and that both bullying and physical violence led to reduced physician job satisfaction even after adjustments. We also found that opportunities for job control were able to alleviate the increase in turnover intentions resulting from bullying. Our results suggest that workplace violence is an extensive problem in the health care sector and may lead to increased turnover and job dissatisfaction. Thus, health care organisations should approach this problem through different means, for example, by giving health care employees more opportunities to control their own work.

  7. Research on Speech Motor Control and Its Disorders: A Review and Prospective.

    Science.gov (United States)

    Kent, Ray D.

    2000-01-01

    This article reviews issues in speech motor control and a class of communication disorders known as motor speech disorders that include dysarthrias, apraxia of speech, developmental apraxia of speech, developmental stuttering, acquired (neurogenic and psychogenic) stuttering, and cluttering. Assessment, classification, and treatment of these…

  8. Prospects for repellent in pest control: current developments and future challenges

    Science.gov (United States)

    The overall interest for environmentally safe pest control methods and the increased frequency of insecticide resistance in pest populations have stimulated research on insect repellents in the recent decades in medical and agricultural entomology. However, there remains a great deal of work to be ...

  9. Risk of Coronary Heart Disease in Men With Poor Emotional Control : A Prospective Study

    NARCIS (Netherlands)

    Potijk, Marieke R.; Janszky, Imre; Reijneveld, Sijmen A.; Falkstedt, Daniel

    2016-01-01

    Objective Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted

  10. Prospects for the use of biological control agents against Anoplophora in Europe.

    Science.gov (United States)

    Brabbs, Thomas; Collins, Debbie; Hérard, Franck; Maspero, Matteo; Eyre, Dominic

    2015-01-01

    This review summarises the literature on the biological control of Anoplophora spp. (Coleoptera: Cerambycidae) and discusses its potential for use in Europe. Entomopathogenic fungi: Beauveria brongniartii Petch (Hypocreales: Cordycipitaceae) has already been developed into a commercial product in Japan, and fungal infection results in high mortality rates. Parasitic nematodes: Steinernema feltiae Filipjev (Rhabditida: Steinernematidae) and Steinernema carpocapsae Weiser have potential for use as biopesticides as an alternative to chemical treatments. Parasitoids: a parasitoid of Anoplophora chinensis Forster, Aprostocetus anoplophorae Delvare (Hymenoptera: Eulophidae), was discovered in Italy in 2002 and has been shown to be capable of parasitising up to 72% of A. chinensis eggs; some native European parasitoid species (e.g. Spathius erythrocephalus) also have potential to be used as biological control agents. Predators: two woodpecker (Piciformis: Picidae) species that are native to Europe, Dendrocopos major Beicki and Picus canus Gmelin, have been shown to be effective at controlling Anoplophora glabripennis Motschulsky in Chinese forests. The removal and destruction of infested and potentially infested trees is the main eradication strategy for Anoplophora spp. in Europe, but biological control agents could be used in the future to complement other management strategies, especially in locations where eradication is no longer possible.

  11. Naproxen prevention of heterotopic ossification after hip arthroplasty. A prospective control study of 55 patients

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Orsnes, T

    1991-01-01

    The effect of naproxen on heterotopic ossification after total hip replacement was studied in a randomized, double-blind trial. Twenty-eight patients received 250 mg naproxen thrice daily for 4 weeks postoperatively starting on the morning of the operation while 27 control patients received a pla...

  12. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial.

    LENUS (Irish Health Repository)

    McDonnell, John G

    2007-01-01

    The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. We evaluated its analgesic efficacy in patients during the first 24 postoperative hours after abdominal surgery, in a randomized, controlled, double-blind clinical trial.

  13. Risk of Coronary Heart Disease in Men With Poor Emotional Control : A Prospective Study

    NARCIS (Netherlands)

    Potijk, Marieke R.; Janszky, Imre; Reijneveld, Sijmen A.; Falkstedt, Daniel

    Objective Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted

  14. Research on Speech Motor Control and Its Disorders: A Review and Prospective.

    Science.gov (United States)

    Kent, Ray D.

    2000-01-01

    This article reviews issues in speech motor control and a class of communication disorders known as motor speech disorders that include dysarthrias, apraxia of speech, developmental apraxia of speech, developmental stuttering, acquired (neurogenic and psychogenic) stuttering, and cluttering. Assessment, classification, and treatment of these…

  15. Motivational and control mechanisms underlying adolescent cannabis use disorders: a prospective study

    NARCIS (Netherlands)

    Cousijn, J.; van Benthem, P.; van der Schee, E.; Spijkerman, R.

    2015-01-01

    Cannabis use disorders (CUDs) are the most prevalent substance use disorders among adolescents in treatment. Yet, little is known about the neuropsychological mechanisms underlying adolescent CUDs. Studies in adult cannabis users suggest a significant role for cognitive control and cannabis-oriented

  16. Factors influencing asthma control: results of a real-life prospective observational asthma inhaler treatment (ASIT study

    Directory of Open Access Journals (Sweden)

    Yıldız

    2013-07-01

    Full Text Available Füsun Yildiz, On behalf of the ASIT Study Group Department of Pulmonary Disease, Kocaeli University School of Medicine, Kocaeli, Turkey Background: Despite the availability of new pharmacological options and novel combinations of existing drug therapies, the rate of suboptimal asthma control is still high. Therefore, early identification of the clinical and behavioral factors responsible for poor asthma control, and interventions during routine outpatient visits to improve asthma trigger management, are strongly recommended. This study was designed to evaluate the profiles of asthmatic patients and their inhaler treatment devices in relation to asthma control in Turkey. Methods: A total of 572 patients with persistent asthma (mean [standard deviation] age: 42.7 [12.1] years; 76% female were included in this prospective observational study. A baseline visit (0 month, visit 1 and three follow-up visits (1, 3 and 6 months after enrolment were conducted to collect data on demographics, past medical and asthma history, and inhaler device use. Results: Asthma control was identified in 61.5% of patients at visit 1 and increased to 87.3% at visit 4 (P < 0.001, regardless of sociodemographics, asthma duration, body mass index or smoking status. The presence of asthma-related comorbidity had a significantly negative effect on asthma control (P = 0.004. A significant decrease was determined, in the rate of uncontrolled asthma, upon follow-up among patients who were using a variety of fixed dose combination inhalers (P < 0.001 for each. Logistic regression analysis was used to show that the presence of asthma-related comorbidity (odds ratio [OR], 0.602; 95% confidence interval [CI], 0.419; 0.863, P = 0.006 and active smoking (OR, 0.522; 95% CI, 0.330; 0.825, P = 0.005 were significant predictors of asthma control. Conclusion: Our findings indicate that, despite ongoing treatment, asthma control rate was 61.5% at visit 1 in adult outpatients with persistent

  17. Controlled prospective trial of prednisolone and cytotoxics in progressive IgA nephropathy.

    Science.gov (United States)

    Ballardie, Francis W; Roberts, Ian S D

    2002-01-01

    In a single-center, multiple-referral source study, 38 patients with progressive IgA nephropathy and controlled hypertension were randomized to treatment with prednisolone and cytotoxic agents, to therapy with low-dose cyclophosphamide then azathioprine, and to control groups. The follow-up period lasted 2 to 6 yr. Renal survival, as assessed by Kaplan-Meier analysis annually to 5 yr, showed significant preservation of function from 3 yr in the treatment group and 82, 82, 72, and 72% for 2, 3, 4, and 5 yr, respectively, compared with 68, 47, 26, and 6% in controls. Rate of loss of renal function, evaluated objectively by least-squares analyses of reciprocal serum creatinine, was reduced-and in one-third of the patients, arrested-during immunosuppressive treatment. Proteinuria, present in all patients at the time of entry into the trial, was reduced by treatment from 12 mo, compared with pretreatment levels or controls; erythrocyturia was reduced from 6 mo. Histologic activity and chronicity indexes were determined in renal biopsies performed at trial entry. Multivariate analysis demonstrated that mesangial cell proliferation and matrix scores were highest in those patients with more rapidly progressive disease. No morphologic variable or residual renal function predicted response to immunosuppressive therapy at entry. Mean arterial pressures did not differ significantly between treatment and control groups. There was thus no explanation other than treatment for the improved outcome in patients who received immunosuppressive therapy. Morbidity attributable to treatment or to renal failure occurred in both groups; an audit showed that benefits of therapy outweighed expected or minor side effects of drugs in this population at risk of end-stage renal failure. Patients selected for moderately progressive IgA nephropathy benefit from treatment with prednisolone and cytotoxic agents; results are consistent with modulation of systemic immune response or nephritic injury

  18. Important helminth infections in Southeast Asia diversity, potential for control and prospects for elimination.

    Science.gov (United States)

    Utzinger, Jürg; Bergquist, Robert; Olveda, Remigio; Zhou, Xiao-Nong

    2010-01-01

    Besides the 'big three'-HIV/AIDS, malaria and tuberculosis-there are a host of diseases that, by comparison, are truly neglected. These so-called neglected tropical diseases (NTDs), many of which caused by helminths, are intimately linked with poverty and are rampant where housing is poor; access to clean water and adequate sanitation is lacking; hygiene and nutrition is substandard and populations are marginalized and vulnerable. More than a billion people are affected by NTDs, mainly in remote rural and deprived urban settings of the developing world. An overview of papers published in two special thematic volumes of the Advances in Parasitology is provided here under the umbrella of current status of research and control of important helminth infections. A total of 25 comprehensive reviews are presented, which summarise the latest available data pertaining to the diagnosis, epidemiology, pathogenesis, prevention, treatment, control and eventual elimination of NTDs in Southeast Asia and neighbourhood countries. The focus of the first volume provides the current regional status of schistosomiasis, lymphatic filariasis, food-borne trematodiases, echinococcosis and cysticercosis/taeniasis, less common parasitic diseases that can cause epidemic outbreaks and helminth infections affecting the central nervous system. The second volume deals with the tools and strategies for control, including diagnostics, drugs, vaccines and cutting-edge basic research (e.g. the '-omics' sciences). Moreover, cross-cutting themes such as multiparasitism, social sciences, capacity strengthening, geospatial health technologies, health metrics and modelling the potential impact of climate change on helminthic diseases are discussed. Hopefully, these two volumes will become useful for researchers and, most importantly, disease control managers for integrated and sustainable control, rigorous monitoring and eventual elimination of NTDs in Southeast Asia and elsewhere.

  19. Physical Activity Questionnaire

    Directory of Open Access Journals (Sweden)

    Kostencka Alicja

    2016-11-01

    Full Text Available Study aim: The aim of the study was to determine the weekly energy expenditure measuring MET/min/week based on data collected through the Canada Fitness Survey (CFS, according to the classification used in the International Physical Activity Questionnaire (IPAQ, and to verify the adopted method to assess the level of physical activity in students of physical education.

  20. Questionnaire typography and production.

    Science.gov (United States)

    Gray, M

    1975-06-01

    This article describes the typographic principles and practice which provide the basis of good design and print, the relevant printing processes which can be used, and the graphic designer's function in questionnaire production. As they impose constraints on design decisions to be discussed later in the text, the various methods of printing and production are discussed first.

  1. [Prevention of intrauterine adhesion with auto-crosslinked hyaluronic acid gel: a prospective, randomized, controlled clinical study].

    Science.gov (United States)

    Xiao, Songshu; Wan, Yajun; Zou, Fangjun; Ye, Mingzhu; Deng, Henan; Ma, Jiezhi; Wei, Yingying; Tan, Chen; Xue, Min

    2015-01-01

    To evaluate the efficacy and safety of auto-crosslinked hyaluronic acid (HA) gel for preventing intrauterine adhesion (IUA) after hysteroscopic adhesiolysis. A prospective, randomized, double blinded and controlled clinical trial (level I) was performed. According to American Fertility Society (AFS) scoring system, 120 patients (treatment group: 60 cases, control group: 60 cases) with moderate to severe IUA were enrolled. Upon completion of adhesiolysis, a Foley balloon catheter was first introduced into the uterine cavity and then 3 ml of auto-crosslinked HA gel for patients in the treatment group; patients in the control group, however, only received Foley balloon catheter. Second-look hysteroscopic examination was performed to all patients at 3 months postoperatively for evaluation of IUA. Primary endpoint was the reduction rate of IUA at 3 months after surgery. The secondary endpoints include total AFS score, score of each individual AFS category. At 3 months after surgery, auto-crosslinked HA gel resulted in significantly higher effective rate for reduction of adhesion, the effective rate were 76% (42/55) and 48% (27/56) respectively (P = 0.000 9); the total AFS score of treatment group was 2.1 ± 1.1, and significantly lower than that of control group (3.7 ± 2.5, P = 0.000 8). Application of auto-crosslinked HA gel after surgery significantly enhanced the improvement for each individual patient with regard to their adhesive type and menstrual pattern (P = 0.037 8, P = 0.000 4). The treatment group had significantly lower proportion of patients with moderate to severe adhesive stages than that of control group [13% (7/55) versus 38% (21/56), P = 0.000 6]. No adverse events and complications were observed. Auto-crosslinked HA gel coule be able to reduce IUA, decrease adhesion severity, and improve menopause postoperatively. This absorbable auto-crosslinked HA gel is proposed as a barrier for preventing IUA after intrauterine procedures.

  2. Association of low levels of vitamin D with chronic stable angina: A prospective case-control study

    Directory of Open Access Journals (Sweden)

    Ab Hameed Raina

    2016-01-01

    Full Text Available Background: Coronary artery disease (CAD is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. Materials and Methods: The study was a prospective case-control study. We studied 100 cases of chronic stable angina and compared them with 100 matched controls. Vitamin D deficiency was defined as <20 ng/mL, vitamin D insufficiency as 20-30 ng/mL and normal vitamin D level as 31-150 ng/mL. Results: The prevalence of vitamin D deficiency among cases and controls was 75% and 10%, respectively. 75% of the cases were vitamin D-deficient (<20 ng/mL; 12% were vitamin D-insufficient (20-30 ng/mL, and 13% had normal vitamin D levels (31-150 ng/mL. None had a toxic level of vitamin D. Among the controls, 10% were vitamin D-deficient, 33% were vitamin D-insufficient, and 57% had normal vitamin D levels. The mean vitamin level among cases and controls was 15.53 ng/mL and 40.95 ng/mL, respectively, with the difference being statistically significant (P ≤ 0.0001. There was no statistically significant relation between the disease severities, i.e., on coronary angiography (CAG with vitamin D level. Among the cases, we found that an increasing age was inversely related to vitamin D levels (P = 0.027. Conclusion: Our study indicates a correlation between vitamin D deficiency and chronic stable angina. Low levels may be an independent, potentially modifiable cardiovascular risk factor.

  3. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ekdahl Charlotte S

    2009-09-01

    Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

  4. The Sforzesco brace can replace cast in the correction of adolescent idiopathic scoliosis: A controlled prospective cohort study

    Directory of Open Access Journals (Sweden)

    Zaina Fabio

    2008-10-01

    Full Text Available Abstract Background The conservative treatment of adolescent idiopathic scoliosis (AIS has traditionally been divided into two phases–correction and stabilisation–and casts, even if less used today, can be considered the best standard in the correction phase. Till the present, however, no comparison between cast and brace efficacy has been proposed. Methods This is a prospective cohort study with a retrospective control group. The aim was to verify if it is possible to obtain with a specifically developed rigid brace results comparable to a cast. We considered fifty AIS patients who had refused surgery, aged 14.1 ± 1.5 years, with 46.7 ± 7.8° Cobb scoliosis. Thirty-two consecutive patients (with no drop-outs were prospectively followed up with the Sforzesco brace (SBG, and compared against a retrospective group of eighteen patients treated with the Risser cast (RCG. The treatment time (the total correction phase was 19 ± 3 months. Out-of-brace x-rays were compared, as well as clinical results. Results Compliance and hours of treatment were higher in the RCG while all the other parameters were not different. We observed a reduction of 6° Cobb and an important aesthetic gain in both groups (P Conclusion In the corrective phase of AIS treatment it is possible with a specific rigid brace (Sforzesco – SPoRT concept to obtain scoliosis correction similar to cast. Due to the human and social costs of casting, and worst sagittal profile results, Sforzesco brace should be the preferred method wherever possible.

  5. History, progress and prospect for controlled ecological life support technique in China

    Science.gov (United States)

    Guo, Shuangsheng

    2016-07-01

    Constructing controlled ecological life support system is an important supporting condition for carrying out manned deep-space exploration and extraterrestrial inhabitation and development in the future. In China, the controlled ecological life support technique has gone through a developmental process of more than twenty years, undergoing the course of from conceptual research, to key unit-level technique and key system-level integrated technique, and from ground-based simulated tests to spaceflight demonstrating test, and gained many important stagy harvests. In this paper, the present status, subsistent problems and next plans in the domain of CELSS techniques in China are introduced briefly, so as to play a referential role for promoting development of the techniques internationally.

  6. PROSPECTIVE PAYMENT SYSTEMS AND EVOLUTION OF MANAGEMENT CONTROL IN FRENCH HOSPITALS: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Jérôme LARTIGAU

    2013-11-01

    Full Text Available This analysis aims at contributing to the debate by exploring recent changes in French public hospitals. It will try to show how a new financing system can entail deep changes inside the management architecture. The structuring of the management control function is still in gestation. In most hospitals surveyed, this function is still at its early stages. There is still a long way for management control in acquiring a real legitimacy, especially from professionals. A key to success lies in the ability of institutions to recruit (and retain a staff up to the current stakes, both able to overcome technical difficulties of the hospital management (including the T2A and place themselves in intermediation between medical and management logics.

  7. Challenges and prospects for the control of foot-and-mouth disease: an African perspective

    Directory of Open Access Journals (Sweden)

    Maree FF

    2014-10-01

    Full Text Available Francois F Maree,1,2 Christopher J Kasanga,3, Katherine A Scott,1 Pamela A Opperman,1,2 Melanie Chitray,1,2, Abraham K Sangula,4 Raphael Sallu,3 Yona Sinkala,5 Philemon N Wambura,3 Donald P King,6 David J Paton,6 Mark M Rweyemamu,3 1Transboundary Animal Diseases Programme, Onderstepoort Veterinary Institute, Agricultural Research Council, Onderstepoort, Pretoria, South Africa; 2Department of Microbiology and Plant Pathology, Faculty of Agricultural and Natural Sciences, University of Pretoria, Pretoria, South Africa; 3Southern African Centre for Infectious Diseases Surveillance, Sokoine University of Agriculture, Morogoro, Tanzania; 4Foot-and-Mouth Disease Laboratory, Embakasi, Nairobi, Kenya; 5Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; 6The Pirbright Institute, Pirbright, Surrey, UK Abstract: The epidemiology of foot-and-mouth disease (FMD in Africa is unique in the sense that six of the seven serotypes of FMD viruses (Southern African Territories [SAT] 1, SAT2, SAT3, A, O, and C, with the exception of Asia-1, have occurred in the last decade. Due to underreporting of FMD, the current strains circulating throughout sub-Saharan Africa are in many cases unknown. For SAT1, SAT2, and serotype A viruses, the genetic diversity is reflected in antigenic variation, and indications are that vaccine strains may be needed for each topotype. This has serious implications for control using vaccines and for choice of strains to include in regional antigen banks. The epidemiology is further complicated by the fact that SAT1, SAT2, and SAT3 viruses are maintained and spread by wildlife, persistently infecting African buffalo in particular. Although the precise mechanism of transmission of FMD from buffalo to cattle is not well understood, it is facilitated by direct contact between these two species. Once cattle are infected they may maintain SAT infections without the further involvement of buffalo. No

  8. Telemonitoring in fasting individuals with Type 2 Diabetes Mellitus during Ramadan: A prospective, randomised controlled study.

    Science.gov (United States)

    Lee, Jun Yang; Wong, Chee Piau; Tan, Christina San San; Nasir, Nazrila Hairizan; Lee, Shaun Wen Huey

    2017-08-31

    We determined the impact of a remote blood glucose telemonitoring program with feedback in type 2 diabetes mellitus patients fasting during Ramadan compared to conventional self-monitoring method. A twelve-week cluster randomised study, with 85 participants who wish to fast for at least 15 days during Ramadan was conducted. Self-measurement and transmission of blood glucose results were performed six times daily during Ramadan. Results were transmitted to a secure website for review with feedback from case manager if necessary. The control group received usual care. The main outcome was the number of participants experiencing hypoglycaemia during Ramadan and at the end of the study. During Ramadan, the number of participants reporting hypoglycaemia was significantly lower in the telemonitoring group [Odds ratio (OR): 0.186, 95% confidence interval: 0.04-0.936; p = 0.04]. Similarly, the proportion of participants reporting symptomatic hypoglycaemia at the end of the study was significantly lower in the telemonitoring group (OR: 0.257, 95% CI: 0.07-0.89; p = 0.03). A reduction of 1.07% in glycated haemoglobin levels was observed in the telemonitoring group compared to 0.24% in the control group (p telemonitoring was a useful adjunct to reduce the risk of hypoglycaemia during Ramadan with no deterioration in glycaemic control.

  9. Macrofilaricides and onchocerciasis control, mathematical modelling of the prospects for elimination

    Directory of Open Access Journals (Sweden)

    Lazdins Janis

    2001-11-01

    Full Text Available Abstract Background In most endemic parts of the world, onchocerciasis (river blindness control relies, or will soon rely, exclusively on mass treatment with the microfilaricide ivermectin. Worldwide eradication of the parasite by means of this drug is unlikely. Macrofilaricidal drugs are currently being developed for human use. Methods We used ONCHOSIM, a microsimulation mathematical model of the dynamics of onchocerciasis transmission, to explore the potentials of a hypothetical macrofilaricidal drug for the elimination of onchocerciasis under different epidemiological conditions, as characterized by previous intervention strategies, vectorial capacity and levels of coverage. Results With a high vector biting rate and poor coverage, a very effective macrofilaricide would appear to have a substantially higher potential for achieving elimination of the parasite than does ivermectin. Conclusions Macrofilaricides have a substantially higher potential for achieving onchocerciasis elimination than ivermectin, but high coverage levels are still key. When these drugs become available, onchocerciasis elimination strategies should be reconsidered. In view of the impact of control efforts preceding the introduction of macrofilaricides on the success of elimination, it is important to sustain current control efforts.

  10. Written Educational Material Relieves Anxiety after Endoscopic Biopsy: A Prospective Randomized Controlled Study.

    Science.gov (United States)

    Kim, Hae Won; Jung, Da Hyun; Youn, Young Hoon; Kim, Jie-Hyun; Kim, Jae Jin; Park, Hyo Jin

    2016-02-01

    Patients who undergo endoscopic biopsy suffer anxiety until results are confirmed. This study assesses the effects of written educational material on the anxiety level of patients following endoscopic biopsy. This study was a randomized controlled study trial with 83 patients divided into the following three groups: a biopsy group given written educational material prepared by our institution following the biopsy (intervention group, n=28), a biopsy group without written material (biopsy only group, n=25), and a control group without biopsy (control group, n=30). The anxiety level of each patient was evaluated three times using Spielberger's State-Trait Anxiety Inventory (STAI): for baseline at the first visit to our institution, at the day of endoscopy, one day later, and one week after the procedure. We compared baseline characteristics, STAI scores at each visit, and differences in STAI scores among the three groups. No difference was found in STAI score among groups at baseline and before and after the endoscopic procedure. However, the STAI-state score of the intervention group was slightly lower than biopsy only group one day post-procedure (40.3 ± 7.7 vs. 43.9 ± 7.1, p=0.135). The STAI-state score significantly decreased from pre- to post-procedure only in the intervention group (-2.75 ± 6.1 vs. 0.92 ± 4.0, pmaterial for patients having biopsy might lessen their anxiety level.

  11. Controlled Traffic Farming – From Worldwide Research To Adoption In Europe And Its Future Prospects

    Directory of Open Access Journals (Sweden)

    Chamen Tim

    2015-09-01

    Full Text Available Controlled traffic farming is a machinery management system that confines all field vehicles to the least possible area of permanent traffic lanes. It has developed in response to research evidence of widespread soil damage from compaction due to field traffic. The history of research on soil compaction is explored and found to be a relatively new phenomenon. Controlled traffic farming as a topic for research did not appear until the 1980s although its principles and benefits were well established before then. Research expanded over the next decades but changed subtly to more reviews on the topic as well as emphasis on environmental deliverables and some economics studies. Few if any researchers attempted to develop on-farm systems using existing machinery until the mid 1990s when a small and dedicated team in Australia encouraged farmers to experiment. This quickly led to rapid expansion across the continent to its present day c. 13% of the cropped area. Despite changes to extension services in northern Europe at around the turn of the century and a move to subsidiarity, this did not alter the model of controlled traffic adoption. This followed a similar pattern to that in Australia involving individuals rather than organizations.

  12. Improving oral presentation skills with a clinical reasoning curriculum: a prospective controlled study.

    Science.gov (United States)

    Wiese, Jeff; Varosy, Paul; Tierney, Lawrence

    2002-02-15

    The oral case presentation is an essential part of clinical medicine, but teaching medical students to present clinical data remains difficult. Presentation skills depend on the ability to obtain, process, and organize patient data. Clinical reasoning is fundamental to the development of these skills. We compared a clinical reasoning curriculum with standard ward instruction for improving presentation skills and clinical performance. Between October 1998 and May 1999, 62 third-year medical students at three hospitals were assigned to a 4-week clinical reasoning curriculum (n = 27) or a control group (n = 35) that underwent routine instruction. The curriculum consisted of four 1-hour group sessions and 1 hour of individual videotaped instruction, and taught students to use the principles of clinical reasoning, such as generation and refinement of diagnostic hypothesis, interpretation of diagnostic tests, and causal reasoning, to determine data for inclusion in the oral presentation. We videotaped students presenting two standardized case histories; one at baseline and a second 4 weeks later. Two independent evaluators who were blinded to the group assignments reviewed the videotapes and scored them for presentation quality and efficiency, and general speaking ability. Mean (+/- SD) presentation times at baseline were similar in the two groups (intervention group: 8 +/- 2 minutes; control group: 8 +/- 2 minutes; P = 0.74). Presentation time in students who were taught clinical reasoning decreased by 3 +/- 2 minutes, but increased by 2 +/- 2 minutes in control students. The difference in the changes between the groups was statistically significant (mean difference = 4 minutes; 95% confidence interval [CI]: 3 to 5 minutes; P Presentation quality scores at baseline were similar in both groups (intervention group: 17 +/- 8 points; control group: 20 +/- 7 points; P = 0.11). Students who were taught the clinical reasoning curriculum had an improvement of 9 +/- 6 points in

  13. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study.

    Science.gov (United States)

    Geenes, Victoria; Chappell, Lucy C; Seed, Paul T; Steer, Philip J; Knight, Marian; Williamson, Catherine

    2014-04-01

    Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disease, characterized by maternal pruritus and raised serum bile acids. Our objectives were to describe the epidemiology and pregnancy complications associated with severe ICP and to test the hypothesis that adverse perinatal outcomes are increased in these women. A prospective population-based case-control study with national coverage was undertaken using the UK Obstetric Surveillance System (UKOSS). Control data for comparison were obtained from women with healthy pregnancy outcome through UKOSS (n = 2,232), St Mary's Maternity Information System (n = 554,319), and Office for National Statistics (n = 668,195). The main outcome measures investigated were preterm delivery, stillbirth, and neonatal unit admission. In all, 713 confirmed cases of severe ICP were identified, giving an estimated incidence of 9.2 per 10,000 maternities. Women with severe ICP and a singleton pregnancy (n = 669) had increased risks of preterm delivery (164/664; 25% versus 144/2200; 6.5%; adjusted odds ratio [OR] 5.39, 95% confidence interval [CI] 4.17 to 6.98), neonatal unit admission (80/654; 12% versus 123/2192; 5.6%; adjusted OR 2.68, 95% CI 1.97 to 3.65), and stillbirth (10/664; 1.5% versus 11/2205; 0.5%; adjusted OR 2.58, 95% CI 1.03 to 6.49) compared to controls. Seven of 10 stillbirths in ICP cases were associated with coexisting pregnancy complications. These differences remained significant against national data. Risks of preterm delivery, meconium-stained amniotic fluid, and stillbirth rose with increasing maternal serum bile acid concentrations. In the largest prospective cohort study in severe ICP to date, we demonstrate significant increased risks of adverse perinatal outcomes, including stillbirth. Our findings support the case for close antenatal monitoring of pregnancies affected by severe ICP. © 2014 The Authors. Hepatology published by Wiley on behalf of the American Association for the Study of

  14. Development, relative validity, and reliability of a food frequency questionnaire for a case-control study on dietary advanced glycation end products and diabetes complications.

    Science.gov (United States)

    Luevano-Contreras, Claudia; Durkin, Taylor; Pauls, Maria; Chapman-Novakofski, Karen

    2013-12-01

    Dietary advanced glycation end products (dAGEs) could be involved on diabetes complications, yet their quantification is not standardized. The objective of this study was to design a food frequency questionnaire (FFQ) for dAGEs, and to assess its reliability and validity. For the design, data from 30 subjects was used. The final instrument had 90 food items. To measure reliability and validity, 20 participants with type 2 diabetes filled out twice the FFQ (FFQ-T1, FFQ-T2) and 7-day food records (7-dFR). The Shrout-Fleiss coefficient was 0.98 showing good reliability. For validation, the results for the weighted kappa were 0.55 (moderate agreement) for FFQ-T1 and 0.64 (good agreement) for FFQ-T2, and 75% and 80% of subjects respectively were correctly classified into tertiles; Bland-Altman graphics showed no systematic bias. This FFQ is comparable to 7-dFR for measuring dAGEs. To our knowledge, this is the first questionnaire designed to measure specifically dAGEs.

  15. Quality control for radiotherapy in Hodgkin's disease: future prospects; Controle de qualite de la radiotherapie dans la maladie de Hodgkin: perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, C. [Hopital Saint-Louis, 75 - Paris (France); Carrie, C. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Hofstetter, S. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Girinski, T. [Institut Gustave Roussy, 94 - Villejuif (France); Cosset, J.M. [Institut Curie, 75 - Paris (France)

    1999-11-01

    Quality control is becoming an increasingly important factor in all prospective trials including irradiation. We have recently reported the findings of the French treatment centres in the context of the EORTC/GELA H8 trial regarding the quality of radiotherapy in patients with supra-diaphragmatic Hodgkin's disease, in which the following was observed: there were 13.6% major deviations from the norm in terms of the volume treated, and 39.7% major deviations in terms of dose (a difference of over 10% compared with the prescribed close). Only 300 technical files out of over 1600 cases included in the protocol were examined. For the forthcoming EORTC H9 trial, a simplified procedure has been developed which should enable a full analysis of the total number of patient technical files. (author)

  16. A prospective randomised controlled trial of capnography vs. bronchoscopy for Blue Rhino percutaneous tracheostomy.

    Science.gov (United States)

    Mallick, A; Venkatanath, D; Elliot, S C; Hollins, T; Nanda Kumar, C G

    2003-09-01

    A crucial step for successful percutaneous tracheostomy is the introduction of the needle and guide wire into the trachea. Capnography has recently been proposed as one way to confirm tracheal needle placement. In this randomised controlled study, we used capnography in 26 patients and bronchoscopy in 29 patients to confirm needle placement for percutaneous tracheostomy using Blue Rhino kit. The operating times and the incidence of peri-operative complications were similar for both groups. Capnography proved to be as effective as bronchoscopy in confirming correct needle placement.

  17. Mathematical models for lymphatic filariasis transmission and control: Challenges and prospects

    Directory of Open Access Journals (Sweden)

    Kaliannagounder Krishnamoorthy

    2008-02-01

    Full Text Available Abstract Background Mathematical models developed for describing the dynamics of transmission, infection, disease and control of lymphatic filariasis (LF gained momentum following the 1997 World Health Assembly resolution and the launching of the Global Programme to Eliminate Lymphatic Filariasis (GPELF in 2000. Model applications could provide valuable inputs for making decisions while implementing large scale programmes. However these models need to be evaluated at different epidemiological settings for optimization and fine-tuning with new knowledge and understanding on infection/disease dynamics. Discussion EPIFIL and LYMFASIM are the two mathematical simulation models currently available for lymphatic filariasis transmission and control. Both models have been used for prediction and evaluation of control programmes under research settings. Their widespread application in evaluating large-scale elimination programmes warrants validation of assumptions governing the dynamics of infection and disease in different epidemiological settings. Furthermore, the predictive power of the models for decision support can be enhanced by generating knowledge on some important issues that pose challenges and incorporating such knowledge into the models. We highlight factors related to the efficacy of the drugs of choice, their mode of action, and the possibility that drug resistance may develop; the role of vector-parasite combinations; the magnitude of transmission thresholds; host-parasite interactions and their effects on the dynamics of infection and immunity; parasite biology, and progression to LF-associated disease. Summary The two mathematical models developed offer potential decision making tools for transmission and control of LF. In view of the goals of the GPELF, the predictive power of these models needs to be enhanced for their wide-spread application in large scale programmes. Assimilation and translation of new information into the models is

  18. Russian Defense and Arms Control Policy and its Prospects after the Presidential Elections

    Directory of Open Access Journals (Sweden)

    Alexander Savelyev

    2008-05-01

    Full Text Available Este artículo explora los posibles escenarios en las políticas de desarme y control de armamentos de Rusia tras la toma de posesión del presidente Medvedev. El autor analiza la experiencia de la presidencia de Putin y de los acuerdos EE.UU.-URSS durante la Guerra Fría, conluyendo que los sistemas ABM y el principio de “estabilidad estratégica” se han convertido en el problema central. Por tanto, Rusia y EE.UU. necesitan revisar sus posiciones y aceptar las nuevas realidades de sus relaciones estratégicas en el siglo XXI.

  19. Progress and prospects in nanoscale dry processes: How can we control atomic layer reactions?

    Science.gov (United States)

    Ishikawa, Kenji; Karahashi, Kazuhiro; Ichiki, Takanori; Chang, Jane P.; George, Steven M.; Kessels, W. M. M.; Lee, Hae June; Tinck, Stefan; Um, Jung Hwan; Kinoshita, Keizo

    2017-06-01

    In this review, we discuss the progress of emerging dry processes for nanoscale fabrication. Experts in the fields of plasma processing have contributed to addressing the increasingly challenging demands in achieving atomic-level control of material selectivity and physicochemical reactions involving ion bombardment. The discussion encompasses major challenges shared across the plasma science and technology community. Focus is placed on advances in the development of fabrication technologies for emerging materials, especially metallic and intermetallic compounds and multiferroic, and two-dimensional (2D) materials, as well as state-of-the-art techniques used in nanoscale semiconductor manufacturing with a brief summary of future challenges.

  20. [Tuberculosis and its control--lessons from the past and future prospect].

    Science.gov (United States)

    Shimao, Tadao

    2005-06-01

    Koch R reported the discovery of tubercle bacilli on March 24, 1882, and the numbers of death from phthisis were collected in the vital statistics from the latter half of 1883 in Japan. Tuberculosis death was officially adopted in the Japanese vital statistics from 1899, and there was certain disagreement existed between the numbers of death from TB and phthisis in 1899, the analysis on the trend of TB in Japan was done based on TB death. Trend of TB in Japan in the past 100 years could be divided into five phases. In phase 1 (1899-1918), TB mortality had increased with the first industrialization of Japan with main focus on the weaving industry. During this period, TB mortality of female was higher than that of male and then major victims of TB were young girls born from 1890 to 1925. In phase 2 (1918-1930), TB mortality decreased through excess death of TB cases by the influenza pandemic in 1918. This decline due to influenza pandemic was seen all over the world, and in the European countries and the U.S., the decline continued up to 1945 while in Japan, TB had increased again in the phase 3 (1930-1945) mainly due to second industrialization with main focus on heavy industry and the impact of quasi-war and war conditions. In phase 4 (1945-mid 1970s), TB started to decline fast due to the excess death of TB cases during the World War II and then, the application of modern TB control started from early 1950s. In phase 5 (from mid 1970s until now), decline of TB has showed down. Increase or slowdown of TB decline was seen nearly all countries of the world, however, its causes were different from country to country. In case of Japan, slowdown was caused by the rapid ageing of the population, in developing countries mainly by the impact of HIV epidemic and in industrialized countries, mainly by the migration of the population and partly by the HIV epidemic. Contribution of phthisiology in Japan to the global progress of phthisiology could be summarized as follows

  1. New prospects in direct, inverse and control problems for evolution equations

    CERN Document Server

    Fragnelli, Genni; Mininni, Rosa

    2014-01-01

    This book, based on a selection of talks given at a dedicated meeting in Cortona, Italy, in June 2013, shows the high degree of interaction between a number of fields related to applied sciences. Applied sciences consider situations in which the evolution of a given system over time is observed, and the related models can be formulated in terms of evolution equations (EEs). These equations have been studied intensively in theoretical research and are the source of an enormous number of applications. In this volume, particular attention is given to direct, inverse and control problems for EEs. The book provides an updated overview of the field, revealing its richness and vitality.

  2. Pulmonary infection control window in treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centred study

    Institute of Scientific and Technical Information of China (English)

    Collaborating Research Group for Noninvasive Mecha

    2005-01-01

    Background Early withdraw from invasive mechanical ventilation (MV) followed by noninvasive MV is a new strategy for changing modes of treatment. This study was conducted to estimate the feasibility and the efficacy of early extubation and sequential noninvasive MV commenced at beginning of pulmonary infection control window in patients with exacerbated hypercapnic respiratory failure caused by chronic obstructive pulmonary diseases (COPD). Methods A prospective, randomized controlled study was conducted in eleven teaching hospitals' respiratory or medical intensive care units in China. Ninety intubated COPD patients with severe hypercapnic respiratory failure triggered by pulmonary infection (pneumonia or purulent bronchitis) were involved in the study. When the pulmonary infection had been controlled by antibiotics and comprehensive therapy, the "pulmonary infection control window (PIC window)" has been reached. Each case was randomly assigned to study group (extubation and noninvasive MV via facial mask immediately) or control group (invasive MV was received continuously after PIC window by using conventional weaning technique).Results Study group (n=47) and control group (n=43) had similar clinical characteristics initially and at the time of PIC window. Compared with control group, study group had shorter duration of invasive MV [(6.4±4.4) days vs (11.3±6.2) days, P=0.000], lower rate of ventilator associated pneumonia (VAP) (3/47 vs 12/43, P=0.014), fewer days in ICU [(12±8) days vs (16±11) days, P=0.047] and lower hospital mortality (1/47 vs 7/43, P=0.025).Conclusions In COPD patients requiring intubation and invasive MV for hypercapnic respiratory failure, which is exacerbated by pulmonary infection, early extubation followed by noninvasive MV initiated at the start of PIC window may decrease significantly the duration of invasive MV, the risk of VAP and hospital mortality.

  3. Factors associated with Clostridium difficile infection: A nested case-control study in a three year prospective cohort.

    Science.gov (United States)

    Khanafer, Nagham; Vanhems, Philippe; Barbut, Frédéric; Luxemburger, Christine

    2017-04-01

    Clostridium difficile infection (CDI) is a serious medical condition that is associated with substantial morbidity and mortality. Identification of risk factors associated with CDI and prompt recognition of patients at risk is key to successfully preventing CDI. A 3-year prospective, observational, cohort study was conducted in a French university hospital and a nested case-control study was performed to identify risk factors for CDI. Inpatients aged 18 years or older, suffering from diarrhea suspected to be related to CDI, were asked to participate. A total of 945 patients were included, of which 233 cases had a confirmed CDI. CDI infection was more common in men (58.4%) (P = 0.04) compared with patients with diarrhea not related to C. difficile. Previous hospitalization (P predictors of CDI. Patients at high risk of acquiring CDI at the time of admission may benefit from careful monitoring of antibiotic prescriptions and early attention to infection control issues. In future, these "high-risk" patients may benefit from novel agents being developed to prevent CDI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. The impact of cognitive control on children's goal monitoring in a time-based prospective memory task.

    Science.gov (United States)

    Mahy, Caitlin E V; Voigt, Babett; Ballhausen, Nicola; Schnitzspahn, Katharina; Ellis, Judi; Kliegel, Matthias

    2015-01-01

    The present study investigated whether developmental changes in cognitive control may underlie improvements of time-based prospective memory. Five-, 7-, 9-, and 11-year-olds (N = 166) completed a driving simulation task (ongoing task) in which they had to refuel their vehicle at specific points in time (PM task). The availability of cognitive control resources was experimentally manipulated by imposing a secondary task that required divided attention. Children completed the driving simulation task both in a full-attention condition and a divided-attention condition where they had to carry out a secondary task. Results revealed that older children performed better than younger children on the ongoing task and PM task. Children performed worse on the ongoing and PM tasks in the divided-attention condition compared to the full-attention condition. With respect to time monitoring in the final interval prior to the PM target, divided attention interacted with age such that older children's time monitoring was more negatively affected by the secondary task compared to younger children. Results are discussed in terms of developmental shifts from reactive to proactive monitoring strategies.

  5. Does visceral osteopathic treatment accelerate meconium passage in very low birth weight infants?- A prospective randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Nadja Haiden

    Full Text Available To determine whether the complementary approach of visceral manipulative osteopathic treatment accelerates complete meconium excretion and improves feeding tolerance in very low birth weight infants.This study was a prospective, randomized, controlled trial in premature infants with a birth weight <1500 g and a gestational age <32 weeks who received a visceral osteopathic treatment 3 times during their first week of life or no treatment.Passage of the last meconium occurred after a median of 7.5 days (95% confidence interval: 6-9 days, n = 21 in the intervention group and after 6 days (95% confidence interval: 5-9 days, n = 20, in the control group (p = 0.11. However, osteopathic treatment was associated with a 8 day longer time to full enteral feedings (p = 0.02, and a 34 day longer hospital stay (Median = 66 vs. 100 days i.e.; p=0.14. Osteopathic treatment was tolerated well and no adverse events were observed.Visceral osteopathic treatment of the abdomen did not accelerate meconium excretion in VLBW (very low birth weight-infants. However infants in the osteopathic group had a longer time to full enteral feedings and a longer hospital stay, which could represent adverse effects. Based on our trial results, we cannot recommend visceral osteopathic techniques in VLBW-infants.Clinical trials.gov: NCT02140710.

  6. Betulin-Based Oleogel to Improve Wound Healing in Dystrophic Epidermolysis Bullosa: A Prospective Controlled Proof-of-Concept Study

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    Agnes Schwieger-Briel

    2017-01-01

    Full Text Available Introduction. Skin fragility and recurrent wounds are hallmarks of hereditary epidermolysis bullosa (EB. Treatment options to accelerate wound healing are urgently needed. Oleogel-S10 contains a betulin-rich triterpene extract from birch bark. In this study, we tested the wound healing properties of topical Oleogel-S10 in patients with dystrophic EB. Methods. We conducted an open, blindly evaluated, controlled, prospective phase II pilot trial in patients with dystrophic EB (EudraCT number 2010-019945-24. Healing of wounds treated with and without topical Oleogel-S10 was compared. Primary efficacy variable was faster reepithelialization as determined by 2 blinded experts. The main secondary outcome variable of the study was percentage of wound epithelialization. Results. Twelve wound pairs of 10 patients with dystrophic EB were evaluated. In 5 of 12 cases, both blinded reviewers considered epithelialization of the intervention wounds as superior. In 3 cases, only one reviewer considered Oleogel-S10 as superior and the other one as equal to control. Measurements of wound size showed a trend towards accelerated wound healing with the intervention but without reaching statistical significance. Conclusion. Our results indicate a potential for faster reepithelialization of wounds in patients with dystrophic EB when treated with Oleogel-S10 but larger studies are needed to confirm significance.

  7. Efficacy and safety of ecabet sodium on functional dyspepsia :A prospective, double-blinded, randomized, multi-center controlled trial

    Institute of Scientific and Technical Information of China (English)

    Jun Haeng Lee; Soo Teik Lee; Eun Hyun Lee; Jong Chul Rhee; Jae J Kim; Ki-Baik Hahm; Dong Ho Lee; Nayoung Kim; Sung Kook Kim; Jong Jae Park; Seok Reyol Choi; Jong Hun Lee

    2006-01-01

    AIM: To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia.METHODS: We performed a multi-center, prospective,randomized, double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia. Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-Ⅱ criteria were enrolled from 7 centers. In the study group (115 patients), 1.5 g ecabet sodium was given twice a day. In the control group (121 patients),400 mg cimetidine was given twice a day. Symptoms and parameters of quality of life were analyzed at baseline, 3,14, and 28 d after initiating the treatment.RESULTS: Two-hundred and thirty-six patients completed the clinical trial. After 4 wk of treatment,the rates of improvement in patients with dyspeptic symptoms were not different between two groups (77.4% in the ecabet group and 79.3% in the cimetidine group, respectively, P > 0.05). Likewise, the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups.There was no clinically significant adverse event in both groups.CONCLUSION: In patients with functional dyspepsia,ecabet sodium has similar clinical efficacy with cimetidine.

  8. [A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering].

    Science.gov (United States)

    Venkatraman, Rajagopalan; Karthik, Krishnamoorthy; Pushparani, Anand; Mahalakshmi, Annadurai

    2017-05-22

    Shivering, a common intraoperative problem under spinal anesthesia increases the oxygen consumption considerably and is uncomfortable and distressing to the patient, anesthesiologist as well as surgeon. The present study was designed to explore the effectiveness of tramadol, clonidine and dexmedetomidine in the treatment of post spinal anesthesia shivering and to look for their adverse effects. This prospective, randomized, double blinded control study was done on 90 patients who developed shivering under spinal anesthesia. They were randomly allocated into three groups with Group T receiving tramadol 1mg.kg(-1), Group C getting clonidine 1mcg.kg(-1) and Group D patients receiving dexmedetomidine 0.5mcg.kg(-1). The time taken to control shivering, recurrence rate, hemodynamic variables, sedation score and adverse effects were observed. Dexmedetomidine was faster in the control of shivering in 5.7±0.79minutes (min) whereas tramadol took 6.76±0.93min and clonidine was slower with 9.43±0.93min. The recurrence rate was much lower in the dexmedetomidine group with 3.3% than for clonidine (10%) and tramadol (23.3%) group. The sedation achieved with dexmedetomidine was better than clonidine and tramadol. The tramadol group had more cases of vomiting (four) and dexmedetomidine group had six cases of hypotension and two cases of bradycardia. Two of the clonidine patients encountered bradycardia and hypotension. Dexmedetomidine is better than tramadol and clonidine in the control of shivering because of its faster onset and less recurrence rate. Though complications are encountered in the dexmedetomidine group, they are treatable. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. EFFICACY OF TRANEXAMIC ACID IN DECREASING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION: A RANDOMIZED CASE CONTROL PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Tullika

    2014-03-01

    Full Text Available : INTRODUCTION: To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section (LSCS. Tranexamic acid helps to reduce bleeding during and after LSCS. OBJECTIVES: To study the efficacy and safety of Tranexamic acid in reducing blood loss during and after Lower segment Caesarean Section (LSCS. METHODS: A randomized case controlled prospective study was conducted on 200 women undergoing lower segment cesarean section. Hundreds of them that were given tranexamic acid immediately before LSCS were compared to hundred others to whom tranexamic acid was not given. Blood loss was collected and measured during the two periods, from plancental delivery to end of LSCS and second from end of LSCS to two hours postpartum. RESULTS: Tranexamic acid significantly reduced the quantity of blood loss from placental delivery to end of LSCS, 202.25ml in the study group vs392.20 ml in the control group (p<0.001; from the end of LSCS, to 2 hours postpartum 3.80ml in the study group versus 112.25ml in the control group (p<0.001; In totality, it significantly reduced the quantity of blood loss from placental delivery to two hours postpartum i.e. 27.05ml in the study group versus 510.45ml in the control group (p < 0.001. No complications or side effects were noted. CONCLUSION: Tranexamic acid significantly reduced the amount of blood loss during and after LSCS. Tranexamic acid can be used prophylactically; moreover it is safer and effective in women undergoing LSCS.

  10. Stop of loss of cognitive performance during rehabilitation after total hip arthroplasty-Prospective controlled study

    Directory of Open Access Journals (Sweden)

    Matthias H. Brem, MD, MHBA

    2010-12-01

    Full Text Available Prolonged hospitalization is known to be associated with a loss of cognitive performance. Does playing video games (VGs developed to improve cognitive properties delay this loss or even lead to an increase in cognitive performance? We performed a 10-day longitudinal study of patients who received total hip arthroplasty. We compared 16 patients (6 male aged 66 ± 9 years (mean ± standard deviation who played Dr. Kawashima's Brain Training: How Old Is Your Brain? (Nintendo; Redmond, Washington on a Nintendo DS handheld console with 16 control patients (6 male aged 69 ± 14 years. We measured cognitive performance 1 day preoperation, as well as on days 2 and 9 postoperation. With the daily exercise of a specific VG by the play group, the patients' fluid intelligence (median intelligence quotient 99-106, working memory capacity, and rate of information processing significantly improved over the course of 7 postoperative days. The cognitive performance of the control group did not increase. However, the memory spans of both groups did not systematically change. Exercise with VGs can prevent the loss of cognitive performance during prolonged hospitalization.

  11. Epidemiology and control prospects of foodborne parasitic zoonoses in the European Union.

    Science.gov (United States)

    Pozio, E

    2008-06-01

    In the 27 Member States of the European Union, zoonotic parasites transmitted by food are circulating with different prevalence according to the country, the environmental conditions, the human behaviour, and the socio-economic level. Foodborne parasites can be divided in two main groups according to the way of transmission to humans. These foodborne parasites reach the human beings through the consumption of raw infected food such as muscle tissues of different animal species (Toxoplasma gondii, Sarcocystis hominis, Sarcocystis suishominis, Diphyllobotrium latum, Taenia solium, Taenia saginata, Opisthorchis felineus, Anisakis spp., Pseudoterranova spp., Trichinella spp.), or vegetables (Fasciola hepatica), and contaminated food and water resources (Giardia duodenalis, Cryptosporidium spp., T. gondii, Echinococcus granulosus sensu latu, Echinococcus multilocularis, T. solium, Taenia multiceps). As a general role, the control strategies should be based on the education of the consumers, farmers and shepherds, the improvement of farming conditions, the improvement or the development of more sensitive methods to detect these parasites in slaughtered animals and in foodstuff, a control of sewage sludge on pastures and of drinking water resources, and the reduction of contacts between livestock and wild animals which frequently represent the most important reservoir of these pathogens.

  12. Oxidative stress markers in intrahepatic cholestasis of pregnancy: a prospective controlled study.

    Science.gov (United States)

    Hu, Y-Y; Liu, J-C; Xing, A-Y

    2015-09-01

    Intrahepatic cholestasis of pregnancy (ICP), characterized by skin pruritus and elevation of serum aminotransferase activity and bile acid concentration in the mother, is one of the most common liver disorders in pregnancy. It was proved that ICP might lead to fetal distress by triggering oxidative damage. Total bile acids (TBA) are an established marker for assessment of the severity of ICP. The aim of this study was to explore associations of TBA levels with levels of the oxidative stress markers 8-epimer of prostaglandin F2alpha (8-iso-PGF2α), superoxide dismutase (SOD) and glutathione peroxidase (Gpx) in ICP. Maternal plasma levels of 8-iso-PGF2α, SOD and Gpx were examined in ICP patients (n=40) and normal pregnancy controls (n=47) using an enzyme-linked immunosorbent assay (ELISA) analysis. Plasma levels of 8-iso-PGF2α and Gpx were significantly lower in ICP patients than in controls (p = 0.006 and 0.002, respectively), while no significant difference was observed in SOD levels between the two groups. Levels of 8-iso-PGF2α and TBA were negatively correlated (r = -0.277, p = 0.01, Spearman's correlation coefficient). The clinical severity of ICP is closely related to the degree of lipid peroxidation, and the natural antioxidant system might fail to work effectively in the presence of lipid peroxidation damage in ICP.

  13. Skin-impedance in Fabry Disease: A prospective, controlled, non-randomized clinical study

    Directory of Open Access Journals (Sweden)

    Lidicker Jeffrey R

    2008-11-01

    Full Text Available Abstract Background We previously demonstrated improved sweating after enzyme replacement therapy (ERT in Fabry disease using the thermo-regularity sweat and quantitative sudomotor axon reflex tests. Skin-impedance, a measure skin-moisture (sweating, has been used in the clinical evaluation of burns and pressure ulcers using the portable dynamic dermal impedance monitor (DDIM system. Methods We compared skin impedance measurements in hemizygous patients with Fabry disease (22 post 3-years of bi-weekly ERT and 5 ERT naive and 22 healthy controls. Force compensated skin-moisture values were used for statistical analysis. Outcome measures included 1 moisture reading of the 100th repetitive reading, 2 rate of change, 3 average of 60–110th reading and 4 overall average of all readings. Results All outcome measures showed a significant difference in skin-moisture between Fabry patients and control subjects (p Conclusion The instrument portability, ease of its use, a relatively short time required for the assessment, and the fact that DDIM system was able to detect the difference in skin-moisture renders the instrument a useful clinical tool.

  14. Plasma 25(OH)vitamin D and the risk of breast cancer in the european prospective investigation into cancer and nutrition (EPIC): A nested case-control study

    NARCIS (Netherlands)

    Kühn, T.; Kaaks, R.; Becker, S.; Eomois, P.P.; Clavel-Chapelon, F.; Kvaskoff, M.; Dossus, L.; Duijnhoven, van F.J.B.

    2013-01-01

    Experimental evidence suggests that vitamin D might play a role in the development of breast cancer. Although the results of case–control studies indicate that circulating 25-hydroxyvitamin D [25(OH)D] is inversely associated with the risk of breast cancer, the results of prospective studies are

  15. An Investigation into the Academic Success of Prospective Teachers in Terms of Learning Strategies, Learning Styles and the Locus of Control

    Science.gov (United States)

    Akça, Figen

    2013-01-01

    The present research aims to investigate the relationship between the learning strategies, learning styles, the locus of control and the academic success of prospective teachers. The study group consists of 198 university students in various departments at the Uludag University Faculty of Education. Research data were collected with the Locus of…

  16. Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

    NARCIS (Netherlands)

    K.J.E. Asmus-Szepesi (Kirsten); L.E. Flinterman (Linda); M.A. Koopmanschap (Marc); A.P. Nieboer (Anna); T.J.E.M. Bakker (Ton); J.P. Mackenbach (Johan); E.W. Steyerberg (Ewout)

    2015-01-01

    textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled

  17. The prophylactic effect of ceftazidime on early bacterial infection after autologous peripheral blood stem cell transplantation: a prospective randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    段明辉

    2013-01-01

    Objective To evaluate the efficacy and safety of prophylactic ceftazidime on early bacterial infection in APBSCT recipients during neutropenia.Methods APBSCT recipients were prospectively randomly assigned to intravenous ceftazidime treatment group and control group (no prophylaxis of antibiotics) .The treatment started from the first day until resolution of neutropenia or the

  18. Digital questionnaire platform in the Danish Blood Donor Study

    DEFF Research Database (Denmark)

    Burgdorf, K S; Felsted, N; Mikkelsen, S

    2016-01-01

    OBJECTIVES: The Danish Blood Donor Study (DBDS) is a prospective, population-based study and biobank. Since 2010, 100,000 Danish blood donors have been included in the study. Prior to July 2015 all participating donors had to complete a paper-based questionnaire. Here we describe the establishment...... with the questionnaire data in the DBDS database. RESULTS: The digital platform enables personalized questionnaires, presenting only questions relevant to the specific donor by hiding unneeded follow-up questions on screening question results. New versions of questionnaires are immediately available at all blood...

  19. Treating major depression with yoga: A prospective, randomized, controlled pilot trial

    Science.gov (United States)

    Rivera, Renee; Cochran, Ashly; Tungol, Jose Gabriel; Fayazmanesh, Nima; Weinmann, Eva

    2017-01-01

    Background Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression. Methods Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14–28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22–72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks. Results In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen’s d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for

  20. Prospects of oral disease control in the future – an opinion

    Directory of Open Access Journals (Sweden)

    Philip D. Marsh

    2014-11-01

    Full Text Available The mouth supports a diverse microbiota which provides major benefits to the host. On occasions, this symbiotic relationship breaks down (dysbiosis, and disease can be a consequence. We argue that progress in the control of oral diseases will depend on a paradigm shift away from approaches that have proved successful in medicine for many diseases with a specific microbial aetiology. Factors that drive dysbiosis in the mouth should be identified and, where possible, negated, reduced or removed, while antimicrobial agents delivered by oral care products may function effectively, even at sub-lethal concentrations, by modulating the activity and growth of potentially pathogenic bacteria. In this way, the beneficial activities of the resident oral microbiota will be retained and the risk of dysbiosis occurring will be reduced.

  1. Force-controlled balance perturbations associated with falls in older people: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Daina L Sturnieks

    Full Text Available Balance recovery from an unpredictable postural perturbation can be a challenging task for many older people and poor recovery could contribute to their risk of falls. This study examined associations between responses to unpredictable perturbations and fall risk in older people. 242 older adults (80.0 ± 4.4 years underwent assessments of stepping responses to multi-directional force-controlled waist-pull perturbations. Participants returned monthly falls calendars for the subsequent 12 months. Future falls were associated with lower force thresholds for stepping in the posterior and lateral but not anterior directions. Those with lower posterior force thresholds for stepping were 68% more likely to fall at home than those with higher force thresholds for stepping. These results suggest that amount of force that can be withstood following an unpredictable balance perturbation predicts future falls in community-dwelling older adults. Perturbations in the posterior direction best discriminated between future fallers and non-fallers.

  2. A prospective controlled investigation of the cognitive effects of amateur boxing.

    Science.gov (United States)

    Butler, R J; Forsythe, W I; Beverly, D W; Adams, L M

    1993-01-01

    Eighty six amateur boxers underwent a series of neuropsychological assessments on three occasions--pre bout, immediate post bout and follow up within two years; 31 water polo players and 47 rugby union players acted as controls. The neuropsychological tests were selected as being sensitive to subtle cognitive dysfunction and formed part of a battery of other neurological and ophthalmic assessments. No evidence of neuropsychological dysfunction due to boxing was found, either following a bout or a series of bouts at follow up. None of a range of parameters including number of previous contests, recovery from an earlier bout, number of head blows received during a bout and number of bouts between initial assessment and follow up, were found to be related to changes in cognitive functioning. PMID:8410002

  3. Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: a prospective controlled study.

    Science.gov (United States)

    Pezzoli, M; Magnano, M; Maffi, L; Pezzoli, L; Marcato, P; Orione, M; Cupi, D; Bongioannini, G

    2015-07-01

    The most commonly used treatment for sensorineural sudden hearing loss (SSHL) in clinical practice is the administration of steroids; however, a favorable result is not always obtained. We studied 58 patients who failed to recover after primary treatment with IV steroids, 44 of these met our inclusion criteria (mean age 50.7, 27 males, range 30-74). We treated 23 patients (mean age 47.3, 16 males, age range 22-74) with hyperbaric oxygen therapy (HBO) (2.5 ATA for 60 min for 15 treatments), while 21 (mean age 54.5, 11 males, age range 22-71) patients refused to be treated and served as a non-randomized control group. Patients treated with HBO had a mean improvement of 15.6 dB (SD ± 15.3), with 1 of them completely healed, 5 with a good recovery, 10 with a fair recovery and 7 unchanged. Patients who were not treated had a spontaneous mean improvement of 5.0 dB (SD ± 11.4) with 3 patients with a good recovery, 1 patient with a fair recovery and 17 patients unchanged. Mean improvement was significantly better in patients treated with HBO compared to controls (p = 0.0133). Patients with worst hearing had the greater degree of improvement whether or not they were treated in the first 10 days after the onset of the hearing loss or between 11 and 30 days. In conclusion, hyperbaric oxygen therapy can lead to significant improvement of pure tone hearing thresholds in patients with SSHL who failed primary corticosteroid treatment and are within 4 weeks of the onset of deafness.

  4. CONTROLLED HYPOTENSIVE ANAESTHESIA WITH DEXMEDETOMIDINE FOR FUNCTIONAL ENDOSCOPIC SINUS SURGERY: A PROSPECTIVE RANDOMIZED DOUBLE BLIND STUDY

    Directory of Open Access Journals (Sweden)

    Sunil

    2014-08-01

    Full Text Available : OBJECTIVE: Controlled hypotension is commonly used to achieve a bloodless operative field which is needed for successful FESS. This study was carried out to assess the hypotensive effect of dexmedetomidine (DEX during FESS. METHODS: Fifty ASA grades I and II patients of either sex aged 20–50 years undergoing FESS were randomly divided into two groups of 25 each. Group D received 10–15 min prior to induction of anesthesia 1 μg/kg IV bolus DEX diluted in 10 ml of normal saline over 10 min. Immediately thereafter an infusion of 0.4 μg/kg/hr of DEX commenced. Group C received placebo bolus and infusion of saline at a rate similar to DEX in Group D. Standard anesthetic technique was used. The surgical field was assessed using Average Category Scale and average blood loss was calculated. Hemodynamic variables (MAP and HR; emergence time and total recovery from anesthesia (Aldrete score ≥9 were recorded. RESULT: Group D reached the desired MAP (55-65 mmHg. In group D patients the average MAP was 55.9±5.3 mm of Hg, where as in group C it was 86.2±11.4 mm of Hg. Patients in group D had a better surgical field, and the duration of surgery was significantly reduced(78.34±16.7mins in group D vs 103.2±113.1 mins in group C The mean awakening time was significantly reduced in patients of Group D (9.1±2.7 mins in group D vs12.8±2.2 mins in group C when compared to patients of Group C. CONCLUSION: This study demonstrated that dexmedetomidine is a safe agent for controlled hypotension and is effective in providing ideal surgical field during FESS.

  5. Occupational lead exposure and severe CKD: a population-based case-control and prospective observational cohort study in Sweden.

    Science.gov (United States)

    Evans, Marie; Fored, Carl Michael; Nise, Gun; Bellocco, Rino; Nyrén, Olof; Elinder, Carl-Gustaf

    2010-03-01

    The role of low-level lead exposure in the cause of chronic kidney disease (CKD) is unsettled. Case-control study and prospective observational cohort study. 926 cases with incident severe CKD (serum creatinine > 3.4 mg/dL for men and > 2.8 mg/dL for women for the first time) and 998 population controls were included. Cases represented nearly all patients with incident severe CKD in Sweden during 2 years. Cases also were followed up prospectively for 7-9 years. Exposed and nonexposed cases were compared with regard to rate of change in estimated glomerular filtration rate (eGFR) and renal survival. Lead exposure was assessed using the expert rating method. Associations between lead exposure and risk of CKD, adjusted for factors associated with this outcome, were analyzed using multivariable logistic regression modeling, whereas links to the rate of change in eGFR were analyzed in mixed-effects multivariable models based on up to 6 measurements. Renal survival in relation to lead exposure was analyzed in a Cox proportional hazards model. The adjusted OR for incident severe CKD was 0.97 (95% CI, 0.68-1.38) in lead-exposed compared with nonexposed participants. The OR for individuals with the highest average exposure (>0.0075 mg/m(3)) was 1.09 (95% CI, 0.64-1.85). ORs for CKD caused by glomerulonephritis, nephrosclerosis, and diabetic nephropathy did not differ importantly. In patients with CKD ever exposed and most exposed to lead, eGFRs changed by -4.27 and -3.39 mL/min/1.73 m(2)/y compared with -4.55 mL/min/1.73 m(2)/y in nonexposed patients, respectively. Only native Swedes were included, which may limit generalizability. Blood lead was not measured to confirm the validity of the expert rating method. Our data provide no evidence of an important role of low-level occupational lead exposure in the cause or progression of severe CKD. Copyright 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Intravaginal Misoprostol for Cervical Ripening and Labor Induction in Nulliparous Women: A Double-blinded, Prospective Randomized Controlled Study

    Institute of Scientific and Technical Information of China (English)

    Yu Zhang; Hao-Ping Zhu; Jian-Xia Fan; Hong Yu; Li-Zhou Sun; Lian Chen; Qing Chang

    2015-01-01

    Background:In China,no multicenter double-blinded prospective randomized controlled study on labor induction has been conducted till now.This study is to evaluate the efficacy and safety of intravaginal accurate 25-μg misoprostol tablets for cervical ripening and labor induction in term pregnancy in nulliparous women.Methods:This was a double-blinded,prospective randomized controlled study including nulliparous women from 6 university hospitals across China.Subjects were randomized into misoprostol or placebo group with the sample size ratio set to 7:2.Intravaginal 25-μg misoprostol or placebo was applied at an interval of 4 h (repeated up to 3 times) for labor induction.Primary outcome measures were the incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h.Safety assessments included the incidences of maternal morbidity and adverse fetal/neonatal outcomes.Results:A total of 173 women for misoprostol group and 49 women for placebo were analyzed.The incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h was higher in the misoprostol group than in the placebo (64.2% vs.22.5%,relative risk [RR]:2.9,95% confidence interval [CI]:1.4-6.0).The incidence of onset of labor within 24 h was significantly higher in the misoprostol group than in the placebo group (48.0% vs.18.4%,RR:2.6,95% CI:1.2-5.7);and the induction-onset of labor interval was significantly shorter in the misoprostol group (P =0.0003).However,there were no significant differences in the median process time of vaginal labor (6.4 vs.6.8 h;P =0.695),incidence (39.3% vs.49.0%,RR:0.8,95% CI:0.4-1.5) and indications (P =0.683) of cesarean section deliveries,and frequencies of maternal,fetal/neonatal adverse events between the groups.Conclusion:Intravaginal misoprostol 25 μg every 4 h is efficacious and safe in labor induction and cervical ripening.

  7. Intravaginal Misoprostol for Cervical Ripening and Labor Induction in Nulliparous Women: A Double-blinded, Prospective Randomized Controlled Study

    Science.gov (United States)

    Zhang, Yu; Zhu, Hao-Ping; Fan, Jian-Xia; Yu, Hong; Sun, Li-Zhou; Chen, Lian; Chang, Qing; Zhao, Nai-Qing; Di, Wen

    2015-01-01

    Background: In China, no multicenter double-blinded prospective randomized controlled study on labor induction has been conducted till now. This study is to evaluate the efficacy and safety of intravaginal accurate 25-μg misoprostol tablets for cervical ripening and labor induction in term pregnancy in nulliparous women. Methods: This was a double-blinded, prospective randomized controlled study including nulliparous women from 6 university hospitals across China. Subjects were randomized into misoprostol or placebo group with the sample size ratio set to 7:2. Intravaginal 25-μg misoprostol or placebo was applied at an interval of 4 h (repeated up to 3 times) for labor induction. Primary outcome measures were the incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h. Safety assessments included the incidences of maternal morbidity and adverse fetal/neonatal outcomes. Results: A total of 173 women for misoprostol group and 49 women for placebo were analyzed. The incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h was higher in the misoprostol group than in the placebo (64.2% vs. 22.5%, relative risk [RR]: 2.9, 95% confidence interval [CI]: 1.4–6.0). The incidence of onset of labor within 24 h was significantly higher in the misoprostol group than in the placebo group (48.0% vs. 18.4%, RR: 2.6, 95% CI: 1.2–5.7); and the induction-onset of labor interval was significantly shorter in the misoprostol group (P = 0.0003). However, there were no significant differences in the median process time of vaginal labor (6.4 vs. 6.8 h; P = 0.695), incidence (39.3% vs. 49.0%, RR: 0.8, 95% CI: 0.4–1.5) and indications (P = 0.683) of cesarean section deliveries, and frequencies of maternal, fetal/neonatal adverse events between the groups. Conclusion: Intravaginal misoprostol 25 μg every 4 h is efficacious and safe in labor induction and cervical ripening. PMID:26481739

  8. Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial - Part I

    Directory of Open Access Journals (Sweden)

    Jose Tadeu Nunes Tamanini

    2013-07-01

    Full Text Available Objective To compare the use of polypropylene mesh (PM and the traditional anterior vaginal wall colporraphy in women with anterior vaginal wall prolapse (AVWP using objective and subjective tests and evaluation of quality of life (QoL. Materials and Methods One hundred women were randomly distributed in two preoperatory groups. The first group (mesh (n = 45 received a PM implant and the control group (n = 55 was submitted to traditional colporraphy. Postoperatory follow-up was done after 12 months. The primary objective was the correction of the Ba point ≤ -2 POP-Q (Pelvic Organ Prolapse Quantification System and the secondary objective was the improvement of vaginal symptoms and QoL through ICIQ-VS (International Consultation on Incontinence Questionnaire - Vaginal Symptoms. Complications related to the use of PM or not were also described. Results There was a significant difference between all POP-Q measures of pre- and postoperatory periods of each group in particular. There was a significant difference of the Ba point of the postoperatory period between the Mesh and Control group. The mean of Ba point in the Mesh group was statistically lower than of the Control group, depicting the better anatomical result of the first group. Both techniques improved vaginal symptoms and QoL. The most frequent complication of the Mesh group was prepubic hematoma in the perioperative period. In 9.3% of the cases treated with mesh it was observed PM exposition at the anterior vaginal wall after 12 months, being most of them treated clinically. Conclusion The treatment of AVWP significantly improved the Ba point in the Mesh group in comparison to the Control group. There were no differences of the vaginal symptoms and QoL between the two groups after 12 months. There were few and low grade complications on both groups.

  9. Prospective malaria control using entomopathogenic fungi: comparative evaluation of impact on transmission and selection for resistance

    Directory of Open Access Journals (Sweden)

    Lynch Penelope A

    2012-11-01

    Full Text Available Abstract Background Chemical insecticides against adult mosquitoes are a key element in most malaria management programmes, but their efficacy is threatened by the evolution of insecticide-resistant mosquitoes. By killing only older mosquitoes, entomopathogenic fungi can in principle significantly impact parasite transmission while imposing much less selection for resistance. Here an assessment is made as to which of the wide range of possible virulence characteristics for fungal biopesticides best realise this potential. Methods With mathematical models that capture relevant timings and survival probabilities within successive feeding cycles, transmission and resistance-management metrics are used to compare susceptible and resistant mosquitoes exposed to no intervention, to conventional instant-kill interventions, and to delayed-action biopesticides with a wide range of virulence characteristics. Results Fungal biopesticides that generate high rates of mortality at around the time mosquitoes first become able to transmit the malaria parasite offer potential for large reductions in transmission while imposing low fitness costs. The best combinations of control and resistance management are generally accessed at high levels of coverage. Strains which have high virulence in malaria-infected mosquitoes but lower virulence in malaria-free mosquitoes offer the ultimate benefit in terms of minimizing selection pressure whilst maximizing impact on transmission. Exploiting this phenotype should be a target for product development. For indoor residual spray programmes, biopesticides may offer substantial advantages over the widely used pyrethroid-based insecticides. Not only do fungal biopesticides provide substantial resistance management gains in the long term, they may also provide greater reductions in transmission before resistance has evolved. This is because fungal spores do not have contact irritancy, reducing the chances that a blood

  10. Ultrasound features of carpal tunnel syndrome: a prospective case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Sernik, Renato A.; Abicalaf, Claudia A.; Cerri, Giovanni G. [University of Sao Paulo, Department of Radiology, Sao Paulo (Brazil); Pimentel, Benedito F. [University of Taubate, Department of Orthopedics, Sao Paulo (Brazil); Braga-Baiak, Andresa [University of Sao Paulo, Post Graduation Program, Department of Radiology, Sao Paulo (Brazil); Braga, Larissa [University of Nebraska Medical Center, Omaha, NE (United States)

    2008-01-15

    The purpose of the study was to examine the most adequate cut-off point for median nerve cross-sectional area and additional ultrasound features supporting the diagnosis of carpal tunnel syndrome (CTS). Forty wrists from 31 CTS patients and 63 wrists from 37 asymptomatic volunteers were evaluated by ultrasound. All patients were women. The mean age was 49.1 years (range: 29-78) in the symptomatic and 45.1 years (range 24-82) in the asymptomatic group. Median nerve cross-sectional area was obtained using direct (DT) and indirect (IT) techniques. Median nerve echogenicity, mobility, flexor retinaculum measurement and the anteroposterior (AP) carpal tunnel distance were assessed. This study was IRB-approved and all patients gave informed consent prior to examination. In CTS the median nerve cross-sectional area was increased compared with the control group. Median nerve cross-sectional area of 10 mm{sup 2} (DT) and 9 mm{sup 2} (IT) had high sensitivity (85% and 88.5%, respectively), specificity (92.1% and 82.5%) and accuracy (89.3% and 82.5%) in the diagnosis of CTS. CTS patients had an increased carpal tunnel AP diameter, flexor retinaculum thickening, reduced median nerve mobility and decreased median nerve echogenicity. Ultrasound assists in the diagnosis of CTS using the median nerve diameter cut-off point of 10 mm{sup 2} (DT) and 9 mm{sup 2} (IT) and several additional findings. (orig.)

  11. Prospective randomized controlled trial investigating the type of sutures used during hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Norifumi Harimoto; Ken Shirabe; Tomoyuki Abe; Takafumi Yukaya; Eiji Tsujita; Tomonobu Gion; Kiyoshi Kajiyama; Takashi Nagaie

    2011-01-01

    AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the type of sutures used during hepatectomy. METHODS: All hepatic resections performed from January 2007 to November 2008 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. There were 125 patients randomly assigned to an absorbable sutures (Vicryl) group or non-absorbable sutures (Silk) group. RESULTS: SSI was observed in 13.6% (17/125) patients participating in this study, 11.3% in the Vicryl group and 15.8% in the Silk group. Incisional SSI including superficial and deep SSI, was observed in 8% of the Vicryl group and 9.5% of the Silk group. Organ/ space SSI was observed in 3.2% of the Vicryl group and 6.0% of the Silk group. There were no significant differences, but among the patients with SSI, the period for recovery was significantly shorter for the Vicryl group compared to the Silk group. CONCLUSION: The incidence of SSI in patients receiving absorbable sutures and silk sutures is not significantly different in this randomized controlled study; however, the period for recovery in patients with SSI was significantly shorter for absorbable sutures.

  12. Molecular and epidemiological characterization of canine Pseudomonas otitis using a prospective case-control study design.

    Science.gov (United States)

    Morris, Daniel O; Davis, Meghan F; Palmeiro, Brian S; O'Shea, Kathleen; Rankin, Shelley C

    2017-02-01

    Pseudomonas aeruginosa is an opportunistic pathogen of the canine ear canal and occupies aquatic habitats in the environment. Nosocomial and zoonotic transmission of P. aeruginosa have been documented, including clonal outbreaks. The primary objective of this study was to assess various environmental exposures as potential risk factors for canine Pseudomonas otitis. It was hypothesized that isolates derived from infected ears would be clonal to isolates derived from household water sources and the mouths of human and animal companions of the study subjects. Seventy seven privately owned dogs with otitis were enrolled, along with their human and animal household companions, in a case-control design. Data on potential risk factors for Pseudomonas otitis were collected. Oral cavities of all study subjects, their human and animal companions, and household water sources were sampled. Pulsed field gel electrophoresis was used to estimate clonal relatedness of P. aeruginosa isolates. In a multivariate model, visiting a dog park was associated with 77% increased odds of case status (P = 0.048). Strains clonal to the infection isolates were obtained from subjects' mouths (n = 18), companion pets' mouths (n = 5), pet owners' mouths (n = 2), water bowls (n = 7) and water taps (n = 2). Clonally related P. aeruginosa isolates were obtained from dogs that had no clear epidemiological link. Genetic homology between otic and environmental isolates is consistent with a waterborne source for some dogs, and cross-contamination with other human and animal members within some households. © 2016 ESVD and ACVD.

  13. Vector population manipulation for control of arboviruses--a novel prospect for India.

    Science.gov (United States)

    Niranjan Reddy, Bp; Gupta, Bhavna; Rao, B Prasad

    2014-04-01

    India, the seventh largest country in the world, has diverse geographical and climatic regions with vast rural and peri-urban areas. Many are experiencing an escalation in the spread and intensity of numerous human diseases transmitted by insects. Classically, the management of these vector-borne diseases is underpinned by either chemical insecticides and/or environmental management targeted at the vector. However, these methods or their present implementation do not offer acceptable levels of control, and more effective and sustainable options are now available. Genetic strategies for the prevention of arbovirus transmission are most advanced for dengue and chikungunya, targeting their primary vector, Aedes aegypti. The national burden in terms of morbidity and mortality as a direct consequence of dengue virus in India is considered to be the largest worldwide, over 4 times that of any other country. Presently, new genetic technologies are undergoing field evaluation of their biosafety and efficacy in several countries. This paper discusses the merits of these approaches and argues for fair and transparent appraisal in India as a matter of urgency. Identification of any associated risks and their appropriate mitigation are fundamental to that process.

  14. Global distribution of peste des petits ruminants virus and prospects for improved diagnosis and control.

    Science.gov (United States)

    Banyard, Ashley C; Parida, Satya; Batten, Carrie; Oura, Chris; Kwiatek, Olivier; Libeau, Genevieve

    2010-12-01

    Viral diseases of farm animals, rather than being a diminishing problem across the world, are now appearing with regularity in areas where they have never been seen before. Across the developing world, viral pathogens such as peste des petits ruminants virus (PPRV) place a huge disease burden on agriculture, in particular affecting small ruminant production and in turn increasing poverty in some of the poorest parts of the world. PPRV is currently considered as one of the main animal transboundary diseases that constitutes a threat to livestock production in many developing countries, particularly in western Africa and south Asia. Infection of small ruminants with PPRV causes a devastating plague and as well as being endemic across much of the developing world, in recent years outbreaks of PPRV have occurred in the European part of Turkey. Indeed, the relevance of many once considered 'exotic' viruses is now also high across the European Union and may threaten further regions across the globe in the future. Here, we review the spread of PPRV across Africa, Asia and into Europe through submissions made to the OIE Regional Reference Laboratories. Further, we discuss current control methods and the development of further tools to aid both diagnosis of the disease and prevention.

  15. Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study

    Science.gov (United States)

    Abuaf, Ozlem Karabudak; Baloglu, Hüseyin; Bilgili, Memet Ersan; Simsek, Hasan Aktug; Dogan, Bilal

    2016-01-01

    Background Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules. Objective This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation. Methods This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments. Results Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected. Conclusion PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique 'point by point'). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation. PMID:27904271

  16. Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC).

    Science.gov (United States)

    Carlos, Silvia; Lopez-Del Burgo, Cristina; Burgueño, Eduardo; Martinez-Gonzalez, Miguel Angel; Osorio, Alfonso; Ndarabu, Adolphe; Passabosc, Clément; de Irala, Jokin

    2016-11-16

    In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and 'any condom use' (OR = 2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR = 3.58, 95%CI:2.31-5.56) than the association found between never condom use and HIV (OR = 3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.

  17. Neuroendocrine regulation and metabolism of glucose and lipids in primary chronic insomnia: a prospective case-control study.

    Directory of Open Access Journals (Sweden)

    Eleonora Seelig

    Full Text Available OBJECTIVES: To investigate the relation between primary chronic insomnia and insulin sensitivity, visceral adiposity, non alcoholic fatty liver disease and neuroendocrine hormones. MATERIALS AND METHODS: In a case-controlled, prospective clinical trial 13 women with primary chronic insomnia according to DSM-IV criteria were compared to 12 healthy controls matched for age, sex, BMI, body composition and menopausal status. All participants had a sleep assessment including polysomnographic studies and neuropsychiatric evaluation. Insulin sensitivity was evaluated using the euglycaemic hyperinsulinemic clamp. Hepatic fat content, visceral adipose tissue and intramyocellular lipid accumulation were assessed using magnetic resonance imaging and spectroscopy. The hormonal stress axis was evaluated by measurements of midnight and early morning salivary cortisol, urinary catecholamines and plasma metanephrines. Body composition was determined using body impedance analysis and indirect calorimetry. RESULTS: Although the diagnosis of primary chronic insomnia was made by established clinical criteria, standard polysomongraphic studies failed to identify altered sleep continuity and architecture when compared to matched controls. However, women with primary chronic insomnia showed significantly higher midnight salivary cortisol concentrations (1.46 vs. 0.76 nmol/l, p = 0.02, indicating dysregulation of the hypothalamo-pituitary-adrenal (HPA axis. Plasma glucose and lipid concentrations, insulin sensitivity, hepatic and intramyocellular fat content, visceral adipose tissue mass and body composition did not differ between the two groups. CONCLUSION: Healthy women with clinically diagnosed primary chronic insomnia demonstrate a dysregulation of circadian cortisol secretion despite normal sleep continuity and architecture. Increased midnight cortisol levels, however, were not associated with impaired metabolism of glucose and lipids.

  18. A prospective randomised controlled trial to investigate the effect of local anaesthetic in vivo on cell culture.

    Science.gov (United States)

    Mary O'Brien, C; Breuning, Eleonore; Webb, Jill; Balderson, Debra; Nancarrow, Jeffrey

    2008-10-01

    Cell culture is an important adjunct in the management of major burns in that it enables keratinocytes derived from the patient to be grown and used to attain cover when there is little autologous skin available. The purpose of this prospective randomised trial was to determine if the type of local anaesthetic used to harvest the skin biopsy in vivo affected the subsequent culture of keratinocytes. Lignocaine 1% was compared with a eutectic mixture of local anaesthetic (EMLA) and a control. The subjects recruited were patients undergoing abdominoplasty. Sixteen patients were recruited but two were excluded from final analysis due to infection of the culture medium in one and poor yield from biopsies in all groups in the other. The tissue to be removed from the abdomen was divided into three areas. EMLA was applied to a 5x5 cm randomised area 2 h prior to surgery. Lignocaine 1% was injected into a 5x5 cm randomised area of abdominal skin immediately after anaesthesia. The third 5x5 cm randomised area was used as a control. Three 4-mm punch biopsies were harvested from each site of local anaesthetic application as well as the control area. The Rheinwald & Green method was used to culture these cells [Rheinwald JG, Green H. Serial cultivation of strains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells. Cell 1975;6:331-5.] Cell counts were performed after harvesting keratinocytes from the biopsy and after 10 days of culture. Statistical analysis was undertaken. In conclusion, in contrast to in vitro studies when lignocaine 1% or EMLA is applied in vivo, there is no inhibition of cell culture. In vivo EMLA was also found to significantly increase cell multiplication.

  19. Prospective randomized controlled intervention trial: Comprehensive Yogic Breathing Improves Cardiac autonomic functions and Quality of life in Diabetes

    Directory of Open Access Journals (Sweden)

    V P Jyotsna

    2012-01-01

    Full Text Available Aims and Objectives: To assess the effect of Comprehensive Yogic Breathing Program on glycemic control, quality of life, and cardiac autonomic functions in diabetes. Material and Methods: This is a prospective randomized controlled intervention trial. Cardiac autonomic functions were assessed in 120 diabetics. Patients were randomized into two groups, one group receiving standard therapy for diabetes (n = 56 and the other group receiving standard therapy for diabetes and comprehensive yogic breathing program (n = 64. Standard therapy included advice on diet, walk, and oral antidiabetic drugs. Comprehensive yogic breathing program was an interactive session in which Sudarshan kriya yoga, a rhythmic cyclical breathing, preceded by Pranayam was taught under guidance of a certified teacher. Change in fasting, post prandial blood sugars, glycated hemoglobin, and quality of life were assessed. Cardiac autonomic function tests were done before and six months after intervention. Results: There was significant improvement in psychological (P = 0.006 and social domains (P = 0.04 and total quality of life (P = 0.02 in the group practicing comprehensive yogic breathing program as compared to the group following standard therapy alone. In the group following breathing program, the improvement in sympathetic cardiac autonomic functions was statistically significant (P = 0.01, while the change in the standard group was not significant (P = 0.17. When both parasympathetic and sympathetic cardiac autonomic functions were considered, there was a trend toward improvement in patients following comprehensive yogic breathing program (P = 0.07. In the standard therapy group, no change in cardiac autonomic functions was noted (P = 0.76. The parameters of glycemic control were comparable in both groups. Conclusion: There was significant improvement in quality of life and cardiac autonomic functions in the diabetes patients practicing comprehensive yogic breathing

  20. Orthosis for thoracolumbar burst fractures without neurologic deficit: A systematic review of prospective randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Gabriel Alcala-Cerra

    2014-01-01

    Full Text Available Background: Traditionally, conservative treatment of thoracolumbar (TL burst fractures without neurologic deficit has encompassed the application of an extension brace. However, their effectiveness on maintaining the alignment, preventing posttraumatic deformities, and improving back pain, disability and quality of life is doubtful. Objective: The objective was to identify and summarize the evidence from randomized controlled trials (RCTs to determine whether bracing patients who suffer TL fractures adds benefices to the conservative manage without bracing. Materials and Methods: Seven databases were searched for relevant RCTs that compared the clinical and radiological outcomes of orthosis versus no-orthosis for TL burst fractures managed conservatively. Primary outcomes were: (1 Loss of kyphotic angle; (2 failure of conservative management requiring subsequent surgery; and (3 disability and pain outcomes. Secondary outcomes were defined by health-related quality of life and in-hospital stay. Results: Based on predefined inclusion criteria, only two eligible high-quality RCTs with a total of 119 patients were included. No significant difference was identified between the two groups regarding loss of kyphotic angle, pain outcome, or in-hospital stay. The pooled data showed higher scores in physical and mental domains of the Short-Form Health Survey 36 in the group treated without orthosis. Conclusion and Recommendation: The current evidence suggests that orthosis could not be necessary when TL burst fractures without neurologic deficit are treated conservatively. However, due to limitations related with number and size of the included studies, more RCTs with high quality are desirable for making recommendations with more certainty.

  1. Prepackaged central line kits reduce procedural mistakes during central line insertion: a randomized controlled prospective trial.

    Science.gov (United States)

    Fenik, Yelena; Celebi, Nora; Wagner, Robert; Nikendei, Christoph; Lund, Frederike; Zipfel, Stephan; Riessen, Reimer; Weyrich, Peter

    2013-04-30

    Central line catheter insertion is a complex procedure with a high cognitive load for novices. Providing a prepackaged all-inclusive kit is a simple measure that may reduce the cognitive load. We assessed whether the use of prepackaged all-inclusive central line insertion kits reduces procedural mistakes during central line catheter insertion by novices. Thirty final year medical students and recently qualified physicians were randomized into two equal groups. One group used a prepackaged all-inclusive kit and the other used a standard kit containing only the central vein catheter and all other separately packaged components provided in a materials cart. The procedure was videotaped and analyzed by two blinded raters using a checklist. Both groups performed central line catheter insertion on a manikin, assisted by nursing students. The prepackaged kit group outperformed the standard kit group in four of the five quality indicators: procedure duration (26:26 ± 3:50 min vs. 31:27 ± 5:57 min, p = .01); major technical mistakes (3.1 ± 1.4 vs. 4.8 ± 2.6, p = .03); minor technical mistakes (5.2 ± 1.7 vs. 8.0 ± 3.2, p = .01); and correct steps (83 ± 5% vs. 75 ± 11%, p = .02). The difference for breaches of aseptic technique (1.2 ± 0.8 vs. 3.0 ± 3.6, p = .06) was not statistically significant. Prepackaged all-inclusive kits for novices improved the procedure quality and saved staff time resources in a controlled simulation environment. Future studies are needed to address whether central line kits also improve patient safety in hospital settings.

  2. Effectiveness of pit and fissure sealants bonded with different adhesive systems: a prospective randomized controlled trial.

    Science.gov (United States)

    Erbas Unverdi, Gizem; Atac, Stephan Atilla; Cehreli, Zafer Cavit

    2016-11-30

    To evaluate and compare the clinical retention of a resin-based fissure sealant placed with an intermediate layer of etch-and-rinse (ER) or self-etch (SE) adhesives. Two hundred twenty-eight sealants were placed in 57 children with previously unsealed, caries-free permanent first molars, employing a split-mouth design. The teeth were randomized into four groups (n = 57 teeth/groups) according to the adhesive system placed under the tested sealant (Delton FS+; Dentsply). Group 1 (control): no bonding agent (conventional acid-etch sealant); group 2: prior enamel etch + ER adhesive (XP Bond; Dentsply); group 3: SE adhesive (Clearfil SE Bond; Kuraray) without prior etching; and group 4: prior enamel etch + SE adhesive (Clearfil SE Bond). Clinical assessments were performed according to modified USPHS criteria at 1, 3, 6, 12, 18, and 24 months. The data were analyzed statistically using Fisher's Exact test, the Kaplan-Meier analysis, and the Log-rank test. At 24 months, sealants bonded with XP Bond and Clearfil SE Bond with prior enamel etching showed similar retention rates (p > 0.05), and these rates were significantly better than the rates of the conventional sealant and Clearfil-SE groups (p  0.05). The cumulative survival rates on palatal/buccal surfaces showed similar outcomes as with occlusal surfaces: XP Bond (94%), Clearfil SE Bond + acid-etch (94%), conventional sealant (52%), and Clearfil SE Bond only (37%). Application of the tested ER adhesive and the SE adhesive with enamel etching significantly improved the clinical retention of Delton-FS over the 24-month period. The use of a resin-based fissure sealant placed with ER or SE adhesive with prior acid-etching yielded better retention than the conventional sealant over the 24-month period.

  3. Fowl Cholera and Its Control Prospect With Locally isolated Pasteurella multocida Bivalent Vaccines

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    Tati Ariyanti

    2008-03-01

    Full Text Available Pasteurellosis or fowl cholera disease which associated with Pasteurella multocida group A and D infections occurred sporadically in many parts of the world, including in Indonesia. The pathogenic activity of P. multocida in chickens were based on lipopolysacharide (LPS antigens associated with group A and D capsules, and the resistance factor of complement mediated bacteriolysis in animals. In order to reduce common bacterial infections, antibiotics were routinely used as feed additive or by drinking water, but fowl cholera cases still occur. Fowl cholera control by vaccinations have been used more than a hundred years ago by means of inactive vaccine, but imported inactive vaccine was reported not effective due to lack of cross protection against heterologous serotype. At present, many local P. multocida isolates from chicken and ducks from many areas in Indonesia were characterised for their antigenicity, immunogenicity and prepared as monovalent or bivalent vaccine. Only the monovalent vaccine prepared from BCC 2331 or DY2 demonstrated the presence of immunoprotection against homologous and heterologous challenged with live bacteria. The prototype bivalent vaccine consisting of BCC 2331 + DY2 demonstrated high degree of cross protection against challenged individual with or mixed of BCC 2331 + DY2 at average of 60 – 75% and 75 – 100%, respectively. Monovalent and bivalent vaccine prepared from other isolates including imported reference strains of P. multocida demonstrated no protection in experimentally vaccinated ducks and chicken against challenged with live bacteria of neither BCC 2331 nor with DY2. From these retrospective studies, it was concluded that the local isolates P. multocida designated as BCC 2331 and DY2 could be used as candidates of prototype vaccine or master seed vaccine but their effectiveness still need to be evaluated under field conditions.

  4. [Human life and energy production. Prospects opened up by controlled thermonuclear fusion].

    Science.gov (United States)

    Escande, D

    1997-03-18

    The massive and presently increasing energy production is going to confront mankind with a very important problem in the forthcoming decades, in particular due to the vanishing of resources and to the greenhouse effect. The share of fossil fuels in the energy production will have to decrease, and other energy sources will be needed. Among them controlled thermonuclear fusion has may assets due to its non-radioactive fuel with plentiful supply, its non radioactive and non polluting ashes, its safety, its weak environmental impact, and its irrelevance to nuclear proliferation in a normal setting. During the last three decades, physicists have made a series of steps toward the peaceful use of the dominant source of energy in the Universe. They have learned how to confine by magnetic fields plasmas at temperatures of 200 millions degrees centigrade, and they have developed several specific technologies. This way, they produced 11 million watts of nuclear power by fusing two isotopes of hydrogen. These investigations are conducted in a responsible spirit, that of ecoproduction, where possible negative consequences are anticipated, are made as low as reasonably achievable, and their management is studied. Yet several fundamental issues still have to be solved before on economically efficient industrial thermonuclear power plant be operated. A huge international collaboration involving Japan, the USA, the Russian Federation, and the European Union joined with Switzerland and Canada, is presently designing the first experimental thermonuclear reactor, the International Thermonuclear Experimental Reactor (ITER). It would cost 9 billion dollars, a cost similar to other large scientific projects. This is an important step toward an electricity producing thermonuclear reactor that would be both safe and respectful of human health and of environment.

  5. Evaluation of the Prevention and Reactivation Care Program (PReCaP for the hospitalized elderly: a prospective nonrandomized controlled trial

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    Asmus-Szepesi KJ

    2015-03-01

    Full Text Available Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans, Rotterdam, the Netherlands Background: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP, while two other hospitals providing usual care served as control settings. Within the PReCaP hospital we compared patients pre-implementation with patients post-implementation of the PReCaP (“within-hospital analysis”, while our nonrandomized controlled trial compared patients of the PReCaP hospital post-implementation with patients from the two control hospitals providing usual care (“between-hospital analysis”. Hospitalized patients 65 years or older and at risk of functional decline were interviewed at baseline and at 3 and 12 months using validated questionnaires to score functioning, depression, and health-related quality of life (HRQoL. We estimated costs per unit of care from hospital information systems and national data sources. We used adjusted general linear mixed models to analyze functioning and HRQoL.Results: Between-hospital analysis showed no difference in activities of daily living (ADL or instrumental activities of daily living (IADL between PReCaP patients and control groups. PReCaP patients did have slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI 0.2–0.6], lower depression (Geriatric Depression Scale 15; -0

  6. Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study

    OpenAIRE

    Rodrigo de Rosso Krug; Anna Quialheiro Abreu da Silva; Ione Jayce Ceola Schneider; Luiz Roberto Ramos; Eleonora d’Orsi; André Junqueira Xavier

    2017-01-01

    ABSTRACT Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133)...

  7. Tramadol vs dexmedetomidine for emergence agitation control in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia: prospective randomized controlled clinical study.

    Science.gov (United States)

    Bedirli, Nurdan; Akçabay, Mehmet; Emik, Ulku

    2017-03-11

    This study was designed to compare the efficacy of an intraoperative single dose administration of tramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation, emerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. Seventy-seven patient, aged 2-12, undergoing adenotonsillectomy with sevoflurane anesthesia was enrolled in this study. Patients were randomly assigned to receive either intravenous 2 mg/kg tramadol (Group T; n = 39) or 1 μg/kg dexmedetomidine (Group D; n = 38) after intubation. Heart rates (HR), mean arterial pressure (MAP) were recorded before induction, at induction and every 5 min after induction. Observational pain scores (OPS), pediatric anesthesia emergence delirium (PAED) scores, percentage of patients with OPS ≥ 4 or PAED scale items 4 or 5 with an intensity of 3 or 4, and Ramsay sedation scores (RSS) were recorded on arrival to the postoperative care unit (PACU) and at 5, 10, 15, 30, 45, 60 min. Extubation time and time to reach Alderete score > 9 were recorded. Dexmedetomidine significantly decreased the HR and MAP 10 and 15 min after induction; increased the RSS 15, 30 and 45 min after arrival to PACU. OPS and PAED scores and percentage of patients with OPS ≥ 4 or PAED scale items 4 or 5 with an intensity of 3 or 4 in both groups did not show any significant difference. Extubation time and time to have Alderete score > 9 was significantly longer in Group D. Both tramadol and dexmedetomidine were effective for controlling pain and emergence agitation. When compared with tramadol intraoperative hypotension, bradycardia and prolonged sedation were problems related with dexmedetomidine administration. Retrospectively registered, registration number: ISRCTN89326952 registration date: 14.07.2016.

  8. Topography and malaria transmission heterogeneity in western Kenya highlands: prospects for focal vector control

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    Ndenga Bryson A

    2006-11-01

    Full Text Available Abstract Background Recent resurgence of malaria in the highlands of Western Kenya has called for a more comprehensive understanding of the previously neglected complex highland vector ecology. Besides other drivers of malaria epidemiology, topography is likely to have a major effect on spatial vector and parasite distribution. The aim of this study was to determine the effects of topography on malaria spatial vector distribution and parasite prevalence. Methodology Indoor resting adult malaria vectors and blood parasites were collected in three villages along a 4 km transect originating from the valley bottom and ending at the hilltop for 13 months. Members of the Anopheles gambiae complex were identified by PCR. Blood parasites were collected from children 6–13 years old and densities categorized by site of home location and age of the children. Results Ninety eight percent (98% of An. gambiae s.s. and (99% Anopheles funestus were collected in houses located at the edge of the valley bottom, whereas 1% of An. gambiae s.s. were collected at mid hill and at the hilltop respectively. No An. funestus were collected at the hilltop. Malaria prevalence was 68% at the valley bottom, 40.2% at mid hill and 26.7% at the hilltop. Children aged six years and living at the edge of the valley bottom had an annual geometric mean number of 66.1 trophozoites for every 200 white blood cells, while those living at mid-hill had a mean of 84.8, and those living at hilltop had 199.5 trophozoites. Conclusion Malaria transmission in this area is mainly confined to the valley bottom. Effective vector control could be targeted at the foci. However, the few vectors observed at mid-hill maintained a relatively high prevalence rate. The higher variability in blood parasite densities and their low correlation with age in children living at the hilltop suggests a lower stability of transmission than at the mid-hill and valley bottom.

  9. Geologic controls on gas hydrate occurrence in the Mount Elbert prospect, Alaska North Slope

    Science.gov (United States)

    Boswell, R.; Rose, K.; Collett, T.S.; Lee, M.; Winters, W.; Lewis, K.A.; Agena, W.

    2011-01-01

    Data acquired at the BPXA-DOE-USGS Mount Elbert Gas Hydrate Stratigraphic Test Well, drilled in the Milne Point area of the Alaska North Slope in February, 2007, indicates two zones of high gas hydrate saturation within the Eocene Sagavanirktok Formation. Gas hydrate is observed in two separate sand reservoirs (the D and C units), in the stratigraphically highest portions of those sands, and is not detected in non-sand lithologies. In the younger D unit, gas hydrate appears to fill much of the available reservoir space at the top of the unit. The degree of vertical fill with the D unit is closely related to the unit reservoir quality. A thick, low-permeability clay-dominated unit serves as an upper seal, whereas a subtle transition to more clay-rich, and interbedded sand, silt, and clay units is associated with the base of gas hydrate occurrence. In the underlying C unit, the reservoir is similarly capped by a clay-dominated section, with gas hydrate filling the relatively lower-quality sands at the top of the unit leaving an underlying thick section of high-reservoir quality sands devoid of gas hydrate. Evaluation of well log, core, and seismic data indicate that the gas hydrate occurs within complex combination stratigraphic/structural traps. Structural trapping is provided by a four-way fold closure augmented by a large western bounding fault. Lithologic variation is also a likely strong control on lateral extent of the reservoirs, particularly in the D unit accumulation, where gas hydrate appears to extend beyond the limits of the structural closure. Porous and permeable zones within the C unit sand are only partially charged due most likely to limited structural trapping in the reservoir lithofacies during the period of primary charging. The occurrence of the gas hydrate within the sands in the upper portions of both the C and D units and along the crest of the fold is consistent with an interpretation that these deposits are converted free gas accumulations

  10. Exploring prospects of β3-adrenoceptor agonists and inverse agonists for colon mobility control

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    Maria Grazia Perrone

    2013-07-01

    Full Text Available Inverse agonists are useful active ingredient of drugs clinically used to treat diseases mainly involving receptors endowed with non-endogenous agonist induced activity (constitutive or basal activity. SP-1e and SP-1g are the first two potent and highly selective β3-adrenoceptor inverse agonists [EC50=181 nM (IA=- 64% and 136 nM (IA=-73%, respectively], which their peculiar activity seems due to the absolute configurations of the two stereogenic centres present in each molecule. Rat proximal colon motility measurements allowed their further pharmacological characterization and pA2 values determination by Schild analysis (7.89 and 8.16, respectively. The purpose of our work is a further characterization of our novel β3-adrenoceptor agonists (SP-1a-d, SP-1f,1h and inverse agonists (SP-1e and SP-1g on rat proximal colon motility and a confirmation of their inverse agonist nature in a more complex system like the functional test on rat proximal colon. Male Wistar rats segment of the proximal colon were placed in organ baths containing Krebs solution. Muscle tension was recorded isotonically. Cumulative β3-AR agonists doses experiments were performed for each test compound: isoprenaline, BRL37344, SP-1a-d, SP-1f and SP-1h were dissolved in Krebs. The EC50 values of each agonists and pA2 of inverse agonists were determined. SP- 1a-d, SP-1f and SP-1h in rat colon have a muscle relaxing effect thus confirming their partial agonist activity found in CHO-K1 cell line. SP-1e and SP-1g behaved as antagonists with pA2 values of 7.89 and 8.16, respectively. In conclusion, experiments carried out by using isolated rat proximal colon allowed us to determine the pA2 values of the two β3-AR inverse agonists and add knowledge on the behavior of a novel set of compounds and their possible value as agents useful whenever is necessary to also control the colon motility.

  11. Oxidative stress influence on renal dysfunction in patients with obstructive jaundice: A case and control prospective study

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    David Martínez-Cecilia

    2016-08-01

    Full Text Available Background: Obstructive Jaundice (OJ is associated with a significant risk of developing acute renal failure (ARF. The involvement of oxidative stress in the development of cholestasis has been demonstrated in different experimental models. However, its role in the morbidity of human cholestasis is far to be elucidated. The aim of the study was the evaluation of oxidative stress markers in blood from patients with OJ and its relation to complications and benign/malignant evolution of cholestasis. Methods: A prospective cross-sectional study of 105 patients with OJ and 34 control subjects were included. Several markers of liver function and oxidative stress, such as lipoperoxides (LPO, as well as reduced glutathione (GSH, catalase (CAT, superoxide dismutase (SOD and glutathione peroxidase (GSH-Px activities were assessed. Results: The patients with OJ showed a marked increase in plasma levels of LPO, SOD and GSH, while GSH-Px levels were decreased. The increase in lipid peroxidation products and the depletion of SOD activity in blood were also related to renal dysfunction. The highest level of LPO was associated with malignant etiology of the disease. The logistic regression analysis showed that the age of the patient and the levels of LPO in blood were predictors of renal dysfunction in OJ patients. Conclusions: This study demonstrates a correlation between oxidative stress and renal dysfunction patients with OJ.

  12. Efficacy of 1% acetic acid in the treatment of chronic wounds infected with Pseudomonas aeruginosa: prospective randomised controlled clinical trial.

    Science.gov (United States)

    Madhusudhan, V L

    2016-12-01

    Chronic wounds are those wounds that are persistent and do not respond to any sort of treatment. The concept of using topical antiseptics on open wounds is to prevent and treat infections. They also help to shorten the time taken to heal the wounds. The use of topical agents on wounds to prevent infection is a minimal ability to develop resistance to the microorganisms. Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen with innate resistance to many antibiotics. In places that are economically backward, these problems get compounded by the inability of patients to afford newer expensive drugs. Topically applied dilute acetic acid, which is cheap and easily available, has been found to be effective in such chronic wounds. In the present study, an attempt has been made to use 1% acetic acid as the sole antimicrobial agent for the treatment of pseudomonal wound infections. A control limb was used in which the wounds were treated with normal saline. Our objective was to evaluate the efficacy of acetic acid in low concentration of 1% in chronic wounds infected with P. aeruginosa. This was a prospective study conducted over a period of 6 months.

  13. Towards improving the efficiency of blowing through a permeable wall and prospects of its use for a flow control

    Science.gov (United States)

    Kornilov, V. I.; Boiko, A. V.

    2016-10-01

    Modern achievements, status, and prospects of studies on reducing the turbulent friction and aerodynamic drag with the help of the blowing through a permeable wall are discussed. The main focus is placed upon a physical modeling of the process of boundary layer blowing in the framework of the dimensional theory, a critical analysis of experimental and numerical results for different conditions of air blowing through a high-tech finely perforated wall including the case of external-pressure-flow air supply in wind tunnel, and elicitation of the physical mechanisms responsible for the reduction of turbulent friction at flow-exposed surfaces. It is shown that the use of air supply through the micro-perforated wall with low effective roughness, which is manufactured in compliance with the highest necessary requirements to quality and geometry of orifices, is quite a justified means for easy, affordable, and reliable control of near-wall turbulent flows in laboratory experiment and numerical simulation. This approach can provide a sustained reduction of local skin friction coefficient along flat plate, which in some cases reaches 90%. At the request of all authors of the paper and with the agreement of the Proceedings Editor, an updated version of this article was published on 26 October 2016. The original version supplied to AIP Publishing contained a misrepresentation in Figure 1. This has been corrected in the updated and republished article.

  14. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

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    Henzen Christoph

    2007-07-01

    Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

  15. A PROSPECTIVE RANDOMEZED CONTROLLED TRIAL OF TWO REGIMENS OF VAGINAL MISOPROSTOL IN SECOND TRIMESTER TERMINATION OF PREGNANCY

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    L. Eslamian

    2007-09-01

    Full Text Available The search continues for a safe effective and cheap method for mid-trimester termination of pregnancy. Misoprostol is a strong contender in this respect. The dose schedule is still not fixed. The objective of this study was to compare the efficacy and adverse effects of two dose regimens of vaginal misoprostol for second trimester termination. Prospective randomized double blind controlled trial was undertaken in 162 women at 14-24 weeks gestation in a teaching hospital. Subjects were randomized to receive either regime A: 400 µg of intra vaginal misoprostol every 6h, or regime B: 200 µg of intravaginal misoprostol every 6h. The main outcome measure was the success rate at 24h, total dose required, induction-abortion interval and adverse effects. Data was analyzed by student's t-test, Mann-whitney U-test, the chi-squared test or Fisher's exact test. There was a significant difference in the success rate at 24 and 48hr (regime A: 74% and 97.5%; regime B: 61.7% and 88.9% P=0.016 & 0.029 respectively and in the mean induction abortion interval (14 Vs 20h, P=0.01 Mean Misoprostol requirement was significantly higher for regime A (731 µg ± 362 µg vs. 531µg ± 357µgm, P=0.001. Use of 400 µg vaginal misoprostol is superior to 200 µg vaginal misoprostol for second trimester abortion.

  16. Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study.

    Science.gov (United States)

    Van Pachterbeke, C; Bucella, D; Rozenberg, S; Manigart, Y; Gilles, C; Larsimont, D; Vanden Houte, K; Reynders, M; Snoeck, R; Bossens, M

    2009-10-01

    Randomized controlled trial evaluating a topical treatment for cervical intraepithelial neoplasia 2 and 3 (CIN 2+) using cidofovir. Fifty-three women with a biopsy-proven CIN 2+ were randomly assigned, 6 weeks before their planned conisation, either 3 applications of 3 ml 2% cidofovir in Intrasite gel in a cervical cap or a placebo (the same volume of Intrasite alone). A cervical sample for high-risk types of human papillomaviruses (HPV) (Hybrid Capture 2 or HC2) was taken before treatment and before conisation. The cone was submitted for pathological examination, and subsequently, along with the initial biopsy, to in situ hybridization (ISH) for high-risk HPV. Forty-eight patients were treated and followed according to the protocol, (23 cidofovir, and 25 placebo). Fourteen of the 23 cones were free of any CIN (60.8%) in the cidofovir group. Only 5 of 25 cones were free of any CIN (20%) in the placebo group (ptreatment with cidofovir, at this point, cannot replace conisation, but it is a promising candidate for topical chemotherapy of CIN 2+ lesions; a larger prospective randomized study is needed to confirm our results.

  17. Possible role of apoptosis in pathogenesis of adenoid hypertrophy and chronic adenoiditis: Prospective case-control study.

    Science.gov (United States)

    Önal, Merih; Yılmaz, Taner; Bilgiç, Elif; Müftüoğlu, Sevda; Sözen, Tevfik; Bajin, Münir Demir

    2015-12-01

    Apoptosis is a programmed cell death; it provides an important balance between lymphocytes in adenoid tissue. The aim of this study is to investigate the role of apoptosis in chronic adenoiditis and adenoid hypertrophy. This is the first study in the literature about apoptosis in adenoid hypertrophy and chronic adenoiditis. Prospective case-control study in a tertiary referral university hospital was conducted. 46 patients who had chronic adenoiditis and adenoid hypertrophy underwent adenoidectomy. Adenoids were evaluated for apoptosis and assembled into groups according to their size. Apoptotic cells were counted in three different microscopic fields and their average was taken for every microcompartment. As a result of immunohistochemical staining, specimens were compared for their apoptotic cell rate. The difference in apoptosis of chronic adenoiditis and adenoid hypertrophy groups is statistically significant (phypertrophy groups revealed significant differences for intrafollicular and intraepithelial areas, and insignificant differences for interfollicular and subepithelial areas. Although apoptosis could not totally explain the pathogenesis of chronic adenoiditis and adenoid hypertrophy, it appeared to play an important role in it. Apoptosis functions to limit adenoid hypertrophy. Adenoid apoptosis appears to be age-dependent. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. A PROSPECTIVE, RANDOMIZED CONTROL STUDY EVALUATING THE POSTOPERATIVE ANALGESIA USING RECTAL DICLOFENAC IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY SURGERIES

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    Padmaja

    2015-05-01

    Full Text Available BACKGROUND: To assess the efficacy of rectal diclofenac suppository in patients undergoing elective laparoscopic cholecystectomy surgeries in management of postoperative pain, in reduction of intra operative opioid requirement and in prolongation of postoperative anal gesic initiation time. OBJECTIVES: This prospective randomized single blinded clinical trial evaluates the efficacy of rectal diclofenac suppository for the management of postoperative pain. MATERIALS AND METHODS: 100 patients undergoing elective laparosco pic cholecystectomy surgeries were randomized into two groups, Group 1 patients receiving 100mg diclofenac rectal suppository after induction of general anaesthesia, Group 2 patients does not receive any diclofenac rectal suppository. Intra operative hemod ynamic monitoring, post - operative VAS score and adverse reactions were recorded over period of 24 hrs. Intra operative opioid (fentanyl was repeated when heart rate and blood pressure variability of more than 20% from base line are noted. Post operatively if VAS score is more than 4 rescue analgesia with inj. Tramadol is given intramuscularly. RESULTS: Administration of single dose of rectal diclofenac had statistically significant reduction in VAS score post operatively compared to control group, reduced requirement of intra operative opioids (fentanyl. Post - operative rescue analgesia initiation time is prolonged in group 1 mean 9.56 hrs compared to group 2, mean 0.72 hrs (p - 0.000. CONCLUSION: Rectal Diclofenac used in laparoscopic cholecystectomy cases provide adequate, effective prolonged analgesia in the post - operative period with good safety profile

  19. Cholecalciferol improves glycemic control in type 2 diabetic patients: a 6-month prospective interventional study

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    Nada AM

    2017-07-01

    insignificant (P=0.069, 0.376, 0.058, respectively. FI decreased by 22%, HOMA-IR by 27.6%, and c-peptide by 1.83%. Total cholesterol, low-density lipoprotein cholesterol, parathyroid hormone, alkaline phosphatase, serum creatinine, and pulse rate significantly decreased (4.3±0.9 vs 4.0±0.9 mmol/L, P=0.036; 2.5±0.8 vs 2.2±0.8 mmol/L, P=0.018; 4.6±2.1 vs 3.5±1.8 pmol/L, P=0.001; 82.1±26.2 vs 66.2±19.5 U/L, P<0.001; 74.6±15.6 vs 70.7±14.7 µmol/L, P=0.047; and 81.6±11.9 vs 77.5±12.0 bpm, P=0.045, respectively. Triglycerides and high-density lipoprotein cholesterol, both systolic and diastolic BP, and BMI did not show significant change.Conclusion: Cholecalciferol helps improve blood glucose control and cholesterol profile in vitamin D3-deficient type 2 diabetic patients. Keywords: vitamin D, type 2 diabetes, HbA1c, cholesterol, creatinine, parathyroid hormone

  20. Cholecalciferol improves glycemic control in type 2 diabetic patients: a 6-month prospective interventional study.

    Science.gov (United States)

    Nada, Aml Mohamed; Shaheen, Dalia A

    2017-01-01

    significantly decreased (4.3±0.9 vs 4.0±0.9 mmol/L, P=0.036; 2.5±0.8 vs 2.2±0.8 mmol/L, P=0.018; 4.6±2.1 vs 3.5±1.8 pmol/L, P=0.001; 82.1±26.2 vs 66.2±19.5 U/L, P<0.001; 74.6±15.6 vs 70.7±14.7 μmol/L, P=0.047; and 81.6±11.9 vs 77.5±12.0 bpm, P=0.045, respectively). Triglycerides and high-density lipoprotein cholesterol, both systolic and diastolic BP, and BMI did not show significant change. Cholecalciferol helps improve blood glucose control and cholesterol profile in vitamin D3-deficient type 2 diabetic patients.

  1. The effect of topically applied tissue expanders on radial forearm skin pliability: a prospective self-controlled study

    Science.gov (United States)

    2014-01-01

    Background The use of pre-operatively applied topical tissue expansion tapes have previously demonstrated increased rates of primary closure of radial forearm free flap donor sites. This is associated with a reduced cost of care as well as improved cosmetic appearance of the donor site. Unfortunately, little is known about the biomechanical changes these tapes cause in the forearm skin. This study tested the hypothesis that the use of topically applied tissue expansion tapes will result in an increase in forearm skin pliability in patients undergoing radial forearm free flap surgery. Methods Twenty-four patients scheduled for head and neck surgery requiring a radial forearm free flap were enrolled in this prospective self-controlled observational study. DynaClose tissue expansion tapes (registered Canica Design Inc, Almonte, Canada) were applied across the forearm one week pre-operatively. Immediately prior to surgery, the skin pliability of the dorsal and volar forearm sites were measured with the Cutometer MPA 580 (registered Courage-Khazaka Electronic GmbH, Cologne, Germany) on both the treatment and contralateral (control) arms. Paired t-tests were used to compare treatment to control at both sites, with p < 0.025 defined as statistically significant. Results There was a statistically significant increase in pliability by a mean of 0.05 mm (SD = 0.09 mm) between treatment and control arms on the dorsal site (95% CI [0.01, 0.08], p = 0.018). This corresponded to an 8% increase in pliability. In contrast, the volar site did not show a statistically significant difference between treatment and control (mean difference = 0.04 mm, SD = 0.20 mm, 95% CI [−0.04, 0.12], p = 0.30). Conclusions This result provides evidence that the pre-operative application of topical tissue expansion tapes produces measurable changes in skin biomechanical properties. The location of this change on the dorsal forearm is consistent with the method of tape

  2. Questionnaire-based analysis of the current level of asthma control and management in Niigata Prefecture, Japan: Changes from 1998 to 2000

    Directory of Open Access Journals (Sweden)

    Takashi Hasegawa

    2004-01-01

    Conclusion: These results indicate that antiinflammatory agents, including inhaled corticosteroids and leukotriene receptor antagonists, contributed to improved asthma control, whereas oral theophylline is characteristically used in Niigata Prefecture, Japan. However, not all asthma-related problems, such as satisfaction in daily life, improved and self-evaluation of asthma control by patients may play a key role in improving their satisfaction in daily life.

  3. Assessing treatment-as-usual provided to control groups in adherence trials: Exploring the use of an open-ended questionnaire for identifying behaviour change techniques

    NARCIS (Netherlands)

    Oberjé, E.J.M.; Dima, A.L.; Pijnappel, F.J.; Prins, J.M.; Bruin, M. de

    2015-01-01

    OBJECTIVE: Reporting guidelines call for descriptions of control group support in equal detail as for interventions. However, how to assess the active content (behaviour change techniques (BCTs)) of treatment-as-usual (TAU) delivered to control groups in trials remains unclear. The objective of this

  4. Penn State Worry Questionnaire

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Caspersen, Ida Dyhr

    2013-01-01

    Anxiety disorders are among the most prevalent psychiatric disturbances in childhood. Nonetheless, they often go unrecognized and untreated, which puts the child at risk for developing additional difficulties, such as academic difficulties, depression, and substance abuse. Further knowledge...... and valid assessment tools are essential to identify at-risk children. The present study investigates (i) the factor structure of the Penn State Worry Questionnaire for Children (PSWQ-C) using a large Danish community sample (N¿=¿933), and (ii) its treatment sensitivity in clinically anxious children (N...

  5. Effects of gastric irrigation on bacterial counts before endoscopic submucosal dissection: a randomized case control prospective study.

    Directory of Open Access Journals (Sweden)

    Hirohito Mori

    Full Text Available OBJECTIVE: The antiseptic effect of gastric irrigation before endoscopic submucosal dissection (ESD has not yet been reported. The aim of the randomized prospective study is to evaluate the antiseptic effects of gastric irrigation of saline solution before ESD by evaluating bacterial count. METHODS: This prospective randomized controlled trial included 50 patients diagnosed with early gastric cancer who were randomly divided into 2 groups (25 patients in each group by using the opaque envelope method: the clean group (irrigation with 2 L saline solution before ESD and the regular group (no irrigation. The gastric juice was collected and cultured before ESD. The entire stomach was irrigated using a water jet attached to an endoscope. After ESD with resection and removal of the tumor specimen, a postoperative culture of the gastric juice was obtained using the same method as the preoperative culture. RESULTS: The mean log bacterial count of the post-gastric irrigation gastric juice was 5.08±0.75 in the regular group and 1.86±0.86 in the clean group. The difference in the bacterial counts was significant between the groups (P = 0.0004. The difference in the white blood cells (WBC count on POD 1 was significant (P = 0.044. WBC count on POD 2 did not significantly differ between the groups (P = 0.3. The difference in the body temperature (BT on POD 1 was significant (P = 0.017, On POD 2 the BT was not significant between the groups (P = 0.5. On POD 1, 88% of the patients in the regular group and 16% of the patients in the clean group had mild to moderate spontaneous pain (P = 0.0026. On POD 2 the proportion with mild to moderate spontaneous pain was 36% and 24% in the regular group and the clean group, respectively (P = 0.1. CONCLUSION: Pre-ESD gastric irrigation with saline solution is effective and feasible for suppressing infection during the ESD procedure with favorable clinical outcomes. TRIAL REGISTRATION

  6. Routine enema before urodynamics has no impact on the quality of abdominal pressure curves: Results of a prospective controlled study.

    Science.gov (United States)

    Rigole, H; Senal, N; Damphousse, M; Brochard, C; Manunta, A; Kerdraon, J; Tondut, L; Alimi, Q; Hascoet, J; Siproudhis, L; Peyronnet, B; Bonan, I

    2016-12-01

    The presence of stools in the rectum might affect the quality of the abdominal pressure curve during filling cystometry, but, to date, no study has evaluated the impact of bowel preparation before urodynamics. We evaluated the influence of a sodium phosphate enema before urodynamics on the quality of the abdominal pressure curve. A prospective, controlled, single-blind study was conducted in a single center from May to June 2013. The patients were divided into 2 consecutive groups: patients seen in outpatient clinics during the first 6 weeks (group A) who underwent urodynamics without bowel preparation and patients seen in outpatient clinics during the second 6 weeks (group B) who had a prescription of sodium phosphate enema before urodynamics. The primary endpoint was the quality of the abdominal pressure curve evaluated independently by three physicians who were blinded to the study group. The following data were also collected: age, gender, the presence of a neurological disorder, complicated nature of urodynamics and bother related to preparation for it, assessed using a Likert scale (0 to 10), and the equipment used. A per protocol analysis and an intent-to-treat analysis were conducted. One hundred and thirty-nine patients were included: 54 in group A and 85 in group B. One-third of patients had neurological conditions. 14 patients in group B did not perform their scheduled enema. Thus, 68 patients performed an enema before urodynamics and 71 did not. There was no difference between groups A and B regarding the complicated nature of urodynamics (Likert scale: 3.12 vs. 3.18; P=0.91) or bother related to preparation for it (Likert scale: 3.46 vs. 2.97; P=0.43). In the per protocol analysis, the abdominal pressure curve was considered perfectly interpretable (PI) in 69% of patients who did not receive an enema before urodynamics and in 65% of patients who did (P=0.61). The between-group difference was not statistically significant in intent-to-treat analysis (P

  7. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies

    Science.gov (United States)

    Azad, Meghan B.; Abou-Setta, Ahmed M.; Chauhan, Bhupendrasinh F.; Rabbani, Rasheda; Lys, Justin; Copstein, Leslie; Mann, Amrinder; Jeyaraman, Maya M.; Reid, Ashleigh E.; Fiander, Michelle; MacKay, Dylan S.; McGavock, Jon; Wicklow, Brandy; Zarychanski, Ryan

    2017-01-01

    BACKGROUND Nonnutritive sweeteners, such as aspartame, sucralose and stevioside, are widely consumed, yet their long-term health impact is uncertain. We synthesized evidence from prospective studies to determine whether routine consumption of non-nutritive sweeteners was associated with long-term adverse cardiometabolic effects. METHODS We searched MEDLINE, Embase and Cochrane Library (inception to January 2016) for randomized controlled trials (RCTs) that evaluated interventions for nonnutritive sweeteners and prospective cohort studies that reported on consumption of non-nutritive sweeteners among adults and adolescents. The primary outcome was body mass index (BMI). Secondary outcomes included weight, obesity and other cardiometabolic end points. RESULTS From 11 774 citations, we included 7 trials (1003 participants; median follow-up 6 mo) and 30 cohort studies (405 907 participants; median follow-up 10 yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference −0.37 kg/m2; 95% confidence interval [CI] −1.10 to 0.36; I2 9%; 242 participants). In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I2 0%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome. INTERPRETATION Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with

  8. Vertebral fractures in patients with inflammatory bowel disease COMPARED with a healthy population: a prospective case-control study

    Directory of Open Access Journals (Sweden)

    Vázquez Ma

    2012-05-01

    Full Text Available Abstract Background A prospective study was performed to compare the prevalence of morphometric vertebral fractures (MVF between patients with inflammatory bowel disease (IBD and healthy subjects and to identify predictive factors of fracture. Methods A total of 107 patients with IBD (53 with Crohn’s disease and 54 with ulcerative colitis and 51 healthy subjects participated in the study. Information about anthropometric parameters, toxins, previous fractures, and parameters related to this disease were evaluated. The index of vertebral deformity, bone mass density (BMD, and biochemical parameters were calculated. Results A total of 72 fractures were detected in 38.32% of patients with IBD, and 10 fractures were detected in 13.73% of healthy subjects; the risk of fracture in patients with IBD was higher than that in control subjects (OR, 4.03; 95% CI, 1.652–9.847; p p = 0.17 and femoral neck, r = −0.138, p = 0.07. Corticosteroid treatment was not associated with prevalent vertebral fractures nor with taking corticosteroids (r = 0.135, p = 0.14 or the duration for which they were taken (r = 0.08, p = 0.38, whereas this relationship was present in the controls (r = −0.365, p = 0.01. In the multivariate analysis, none of the measured parameters were significantly predictive of fracture, only to manifested IBD. Hypovitaminosis D was observed in 55.14% of patients with IBD. Conclusions The prevalence of morphometric vertebral fractures is higher in patients with IBD than in the healthy population, without association with BMD or corticoid treatment. Simply having IBD was proven to be a predictive factor of fracture. We observed a high incidence of hypovitaminosis D in patients with IBD.

  9. Campylobacter jejuni infection in Guillain-Barré syndrome: a prospective case control study in a tertiary care hospital.

    Science.gov (United States)

    Sharma, A; Lal, V; Modi, M; Vaishnavi, C; Prabhakar, S

    2011-01-01

    Guillain-Barré syndrome (GBS), is a common post-infectious polyradiculoneuropathy worldwide. The commonest implicated causative organism the world over is Campylobacter jejuni (C. jejuni). This study was carried out to determine the relationship between C. jejuni infection and GBS in an Indian setting. This prospective study was carried out on a cohort of 50 patients with GBS who were treated in a tertiary care hospital in India. Based on electrophysiological findings the patients were divided into various subtypes. Serology for C. jejuni (Immunoglogulin G, IgG and Immunoglogulin, IgM) using an enzyme-linked immunosorbent assay method (ELISA) was done both in patients and 40 age, sex and geographically matched controls. Evidence of recent C. jejuni infection was present in 30% of GBS patients compared to 8% of controls (15/50 vs. 3/40 P<0.005). Eight (47%) C. jejuni-positive patients reported symptoms of gastroenteritis 4-30 days (mean 13 days) prior to onset of GBS. Of the 15 patients with evidence of C. jejuni infection, 10 (67%) patients had axonal type of GBS. Axonal variety of GBS presented in a younger age group compared to acute inflammatory demyelinating polyradiculoneuropathy (AIDP) patients (mean age: axonal vs. AIDP: 30.11 + 13.73 vs. 40.2 + 18.77). C. jejuni-positive patients presented mainly in spring and winter and had a similar age and sex incidence as compared to the rest of the GBS patients. Preceding C. jejuni infection is common among GBS patients and is often associated with the axonal variety of GBS. Axonal variety of GBS generally presents in a younger age group as compared to AIDP.

  10. A case-control study of non-AIDS-defining cancers in a prospective cohort of HIV-infected patients.

    Science.gov (United States)

    Rodríguez Arrondo, Francisco; von Wichmann, Miguel Ángel; Camino, Xabier; Goenaga, Miguel Ángel; Ibarguren, Maialen; Azcune, Harkaitz; Bustinduy, María Jesús; Ferrero, Oscar; Muñoz, Josefa; Ibarra, Sofía; Aguirrebengoa, Koldo; Goicoetxea, Josune; Bereciartua, Elena; Montejo, Miguel; García, M Asunción; Martínez, Eduardo; Portu, Joseba; Metola, Luis; Silvariño, Rafael; Sarasqueta, Cristina; Arrizabalaga, Julio; Iribarren, Jose Antonio

    2017-05-18

    We present a case-control study of non-AIDS-defining cancers (NADCs) in a cohort of HIV-infected patients where we value the incidence, survival and prognostic factors of mortality. All NADCs diagnosis conducted from 2007 to 2011 in 7 hospitals were collected prospectively, with a subsequent follow up until December 2013. A control group of 221 HIV patients without a diagnosis of cancer was randomly selected. Two hundred and twenty-one NADCs were diagnosed in an initial cohort of 7,067 HIV-infected patients. The most common were: hepatocellular carcinoma 20.5%, lung 18.7%, head and neck 11.9% and anal 10.5%. The incidence rate of NADCs development was 7.84/1,000 people-year. In addition to aging and smoking, time on ART (OR 1.11; 95% CI 1.05-1.17) and PI use (OR 1.72; 95% CI 1.0-2.96) increased the risk of developing a NADC. During follow-up 53.42% died, with a median survival time of 199.5 days. In the analysis of the prognostic factors of mortality the low values of CD4 at tumour diagnosis (OR 0.99; 95% CI 0.99-1.0; P=.033), and the previous diagnosis of AIDS (OR 2.06; 95% CI 1.08-3.92) were associated with higher mortality. Predictors of NADCs in our cohort were age, smoking, CD4 lymphocytes and time on ART. Mortality is high, with NADC risk factors being low CD4 count and previous diagnosis of AIDS. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  11. Effect of mode of hydrocortisone administration on glycemic control in patients with septic shock: a prospective randomized trial

    Science.gov (United States)

    Loisa, Pekka; Parviainen, Ilkka; Tenhunen, Jyrki; Hovilehto, Seppo; Ruokonen, Esko

    2007-01-01

    Introduction Low-dose hydrocortisone treatment is widely accepted therapy for the treatment of vasopressor-dependent septic shock. The question of whether corticosteroids should be given to septic shock patients by continuous or by bolus infusion is still unanswered. Hydrocortisone induces hyperglycemia and it is possible that continuous hydrocortisone infusion would reduce the fluctuations in blood glucose levels and that tight blood glucose control could be better achieved with this approach. Methods In this prospective randomized study, we compared the blood glucose profiles, insulin requirements, amount of nursing workload needed, and shock reversal in 48 septic shock patients who received hydrocortisone treatment either by bolus or by continuous infusion with equivalent dose (200 mg/day). Duration of hydrocortisone treatment was five days. Results The mean blood glucose levels were similar in the two groups, but the number of hyperglycemic episodes was significantly higher in those patients who received bolus therapy (15.7 ± 8.5 versus 10.5 ± 8.6 episodes per patient, p = 0.039). Also, more changes in insulin infusion rate were needed to maintain strict normoglycemia in the bolus group (4.7 ± 2.2 versus 3.4 ± 1.9 adjustments per patient per day, p = 0.038). Hypoglycemic episodes were rare in both groups. No difference was seen in shock reversal. Conclusion Strict normoglycemia is more easily achieved if the hydrocortisone therapy is given to septic shock patients by continuous infusion. This approach also reduces nursing workload needed to maintain tight blood glucose control. Trial Registration Number ISRCTN98820688 PMID:17306016

  12. Endoscopic ablation of Barrett's esophagus using the second generation argon plasma coagulation: a prospective randomized controlled trail

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Lei Dong; Jia Liu; Xiaolan Lu; Jun Zhang

    2009-01-01

    Objective:To investigate the efficacy and safety of the second generation argon plasma coagulation(VIO APC) in the ablation of Barrett's Esophagus. Methods:A total of 35 patients with uncomplicated Barrett's esophagus entered into a prospective, randomized, unblinded study comparing the treatment VIO APC combined with a proton pump inhibiter with a proton pump inhibiter administered alone. VIO APC was performed at a power setting of 40W, and argon gas flow at 1.5-2.0 L/min, and "forced" mode. Ablative treatment was repeated until either no Barrett's epithelium remained or a maximum of 5 treatment sessions occurred. Results:In the ablation group, macroscopic complete ablation was achieved in 14 of 18 patients, and complete ablation confirmed by histology in 12 of 18 patients (P<0.01). Buried glands were observed in 2 patients who had achieved macroscopic ablation. The Barrett's mucosa averaged a reduction of 65%(range 50-75%) in the remaining 4 patients. In the control group, only 2 patients had partial regression, median 30%(range 20-40%).In the ablation group, post-treatment 4 patients had transient retrosternal pain, and 3 patients had mild epigastric discomfort. One patient had a small hemorrhage during the procedure, which ceased after norepinephrine and thrombosin were administered through the endoscope biopsy channel. No adverse events were observed in the control group. During 11.8(4-15) months follow-up, patients who had achieved the complete ablation have no evidence of relapse of Barrett's esophagus. Conclusion:VIO APC with a relatively low power setting can effectively ablate the Barrett's mucosa. No severe adverse events were observed. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium.

  13. A prospective randomized controlled trial assessing the efficacy of adjunctive hyperbaric oxygen therapy in the treatment of hidradenitis suppurativa.

    Science.gov (United States)

    Yildiz, Hamza; Senol, Levent; Ercan, Erdinc; Bilgili, Memet Ersan; Karabudak Abuaf, Ozlem

    2016-02-01

    Hyperbaric oxygen therapy (HBOT) appears to enhance wound healing, increase bactericidal activity, and act synergistically with a number of antibiotics. The aim of this study was to evaluate the efficacy of HBOT as an adjunctive therapy in patients with hidradenitis suppurativa (HS) treated with a combination of systemic rifampicin and clindamycin. The study was a prospective, single-center, single-dose, open-label, randomized controlled clinical study of HBOT in patients with moderate to severe HS. Efficacy was measured by modified Sartorius score (SS), HS Severity Index (HSSI), Dermatology Life Quality Index (DLQI), and a visual analog scale (VAS) before treatment and after the completion of 4 and 10 weeks of treatment. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured. Forty-three patients were enrolled in the study. More patients in the HBOT than in the control group showed a decrease of ≥50% from baseline parameters at week 10 for SS (100%), HSSI (100%), DLQI (95.5%), VAS (100%), ESR (100%), and CRP (72.7%). Clinically and statistically significant improvements from baseline were observed at 4 and 10 weeks in HSSI (P = 0.009 at both), SS (P = 0.021 at both), and DLQI (P = 0.044 at week 4, P = 0.009 at week 10). Adjunctive HBOT was considered to be effective in significantly improving antibiotic treatment of HS. The treatment was well tolerated, and no unexpected safety issues were identified.

  14. QUESTIONNAIRE 5YR 2013

    CERN Multimedia

    Association du personnel

    2013-01-01

    CERN must remain the centre of excellence that it has been for the last sixty years. Therefore, the Organization must continue to be able to attract, motivate and retain the best specialists coming from all the Member States. This is why, every five years, on the occasion of a five-yearly review, our employment conditions are compared with bodies having similar activities.In order to prepare the next five-yearly review, the topics of which will be decided by the CERN Council in June 2014, the Staff Association has drawn up a questionnaire that gives you the opportunity to tell us what you think about your current employment conditions. You can also indicate how you wish to see them evolve, and to help you we present some proposals for improvement on which you can give your opinion. Above all, do not hesitate, by using the comments’ fields available in the questionnaire, to formulate your own suggestions in all areas of your conditions of employment that are of interest to you. Your replies will hel...

  15. Symptomatic improvement with gluten restriction in irritable bowel syndrome: a prospective, randomized, double blinded placebo controlled trial.

    Science.gov (United States)

    Zanwar, Vinay G; Pawar, Sunil V; Gambhire, Pravir A; Jain, Samit S; Surude, Ravindra G; Shah, Vinaya B; Contractor, Qais Q; Rathi, Pravin M

    2016-10-01

    The existence of non-celiac gluten sensitivity has been debated. Indeed, the intestinal and extra-intestinal symptoms of many patients with irritable bowel syndrome (IBS) but without celiac disease or wheat allergy have been shown to improve on a gluten-free diet. Therefore, this study set out to evaluate the effects of gluten on IBS symptoms. We performed a double-blind randomized placebo-controlled rechallenge trial in a tertiary care hospital with IBS patients who fulfilled the Rome III criteria. Patients with celiac disease and wheat allergy were appropriately excluded. The participants were administered a gluten-free diet for 4 weeks and were asked to complete a symptom-based questionnaire to assess their overall symptoms, abdominal pain, bloating, wind, and tiredness on the visual analog scale (0-100) at the baseline and every week thereafter. The participants who showed improvement were randomly assigned to one of two groups to receive either a placebo (gluten-free breads) or gluten (whole cereal breads) as a rechallenge for the next 4 weeks. In line with the protocol analysis, 60 patients completed the study. The overall symptom score on the visual analog scale was significantly different between the two groups (Pgluten intervention group scored significantly higher in terms of abdominal pain, bloating, and tiredness (Pgluten diet may worsen the symptoms of IBS patients. Therefore, some form of gluten sensitivity other than celiac disease exists in some of them, and patients with IBS may benefit from gluten restrictions.

  16. 78 FR 34708 - Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity...

    Science.gov (United States)

    2013-06-10

    ... AFFAIRS Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity... Control No. 2900--NEW (Ankle Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-2. OMB Control Number: 2900--NEW...

  17. Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

    Directory of Open Access Journals (Sweden)

    René Rodríguez-Gutiérrez

    2014-01-01

    Full Text Available Background. Although the association between human chorionic gonadotropin (hCG and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM. Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001. Free testosterone (T and dehydroepiandrosterone sulfate (DHEA-S were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL (P=0.0001 and 0.001, respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78; P≤0.001, r=0.74;  P≤0.001, and r=0.71;  P≤0.001, respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001 and free T and DHEA-S declined significantly (P=0.0002 and 0.009. Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.

  18. Recombinant human thrombopoietin promotes platelet engraftment after haploidentical hematopoietic stem cell transplantation: a prospective randomized controlled trial.

    Science.gov (United States)

    Han, Ting-ting; Xu, Lan-ping; Liu, Dai-hong; Liu, Kai-yan; Wang, Feng-rong; Wang, Yu; Yan, Chen-hua; Chen, Yu-hong; Sun, Yu-qian; Ji, Yu; Wang, Jing-zhi; Zhang, Xiao-hui; Huang, Xiao-jun

    2015-01-01

    Delayed platelet engraftment (DPE) is a common complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This phenomenon is also a predictor of increased treatment-related mortality and poor survival. Therefore, therapies that promote platelet engraftment to prevent DPE are needed. This prospective randomized controlled trial was designed to investigate whether recombinant human thrombopoietin (rhTPO), administered subcutaneously at a daily dose of 15,000 U from the first day after transplantation, promotes platelet engraftment after haploidentical HSCT. The cumulative incidence of platelet engraftment (platelet recovery to ≥20 × 10(9)/L without transfusion support for seven consecutive days) on day 60 post-transplantation was significantly higher in the rhTPO group (n = 60) than in the control group (n = 60) (91.7 ± 3.8 % vs. 74.5 ± 5.8 %, P = 0.041). Additionally, the number of platelet transfusions from day 14 to day 60 was significantly lower in the rhTPO group than in the control group (4 ± 5 vs. 7 ± 9 Units, P = 0.018). No severe adverse effects were observed, with a median follow-up duration of 256 days (range, 48-586 days). The incidences of acute graft-versus-host disease (GVHD), chronic GVHD, and cytomegalovirus viremia and the probabilities of overall survival and disease-free survival did not differ between the two groups. A multivariate analysis of all patients revealed that regardless of assignment to the rhTPO group or the control group (hazard ratio (HR) = 1.514; 95 % CI (1.024-2.238); P = 0.038), the number of total infused CD34(+) cells (HR = 1.304; 95 % CI (1.148-1.482); P rhTPO promotes platelet engraftment and safely reduces the requirement for platelet transfusion in patients after unmanipulated haploidentical HSCT. This trial was registered with the Chinese Clinical Trial Registry ( www.chictr.org ) as ChiCTR-TRC-11001774. http

  19. Bispectral index monitoring prevent awareness during total intravenous anesthesia: a prospective, randomized,double-blinded, multi-center controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chen; GUO Jian-rong; JIN Yao-jun; WU Gang; YUAN Wei; YUAN Zhi-guo; YUE Yun; XU Liang; MA Ya-qun; SUN Yan-xia; LI Yan-hong; ZHANG Liang; FENG Chun-sheng; LUO Bing; ZHAO Zhen-long

    2011-01-01

    Background Awareness is a serious complication of general anesthesia.In China,the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia (TIVA).In this study,we compared the incidence of awareness between Bispectral index (BIS)-guided and routine TIVA protocol and evaluated the effect of BIS on preventing awareness.Methods A prospective,randomized,double-blinded,multicenter controlled trial was performed.Patients (≥18 years of age) undergoing TIVA were randomly divided into BIS-guided group (Group A,BIS was monitored and recommended to maintain between 40-60) and control group (Group B,BIS was monitored but the screen was covered).The intraoperative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether light anesthesia existed.Results Of the total 5228 patients,2919 patients were assigned to Group A and 2309 to Group B.Four cases of confirmed awareness (0.14%) were reported in the BIS-guided group and 15 (0.65%) in the control group (P=0.002,OR=0.21,95% confidence intervals:0.07-0.63).The incidence of possible awareness (0.14% vs.0.26%,P=0.485) and dreaming (3.1% vs.3.1%,P=0.986) was comparable between BIS-guided group and the control group.Among the 19 confirmed awareness cases,intraoperative BIS trends of six cases were downloaded and identified.Five of them showed signs of light anesthesia as BIS >60 and lasted 19-106 minutes,whereas one case had a stable BIS trend and the values were within 60 during the operation.Another five awareness cases were reviewed for anesthesia procedures,of which improper light anesthesia were confirmed.Conclusions BIS-guided TIVA (BIS was recommended to maintain between 40-60) decreased the risk of awareness compared with routine TIVA.The main reason for awareness was light anesthesia.

  20. A self-report comorbidity questionnaire for haemodialysis patients

    OpenAIRE

    Sridharan, Sivakumar; Berdeprado, Jocelyn; Vilar, Enric; Roberts, Justin; Farrington, Ken

    2014-01-01

    Background Patients with end-stage renal disease (ESRD) have multiple comorbid conditions. Obtaining comorbidity data from medical records is cumbersome. A self-report comorbidity questionnaire is a useful alternative. Our aim in this study was to examine the predictive value of a self-report comorbidity questionnaire in terms of survival in ESRD patients. Methods We studied a prospective cross-sectional cohort of 282 haemodialysis (HD) patients in a single centre. Participants were administe...

  1. Penn State Worry Questionnaire

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Caspersen, Ida Dyhr

    2013-01-01

    and valid assessment tools are essential to identify at-risk children. The present study investigates (i) the factor structure of the Penn State Worry Questionnaire for Children (PSWQ-C) using a large Danish community sample (N¿=¿933), and (ii) its treatment sensitivity in clinically anxious children (N......¿=¿30) treated with cognitive behavioral therapy. Results from the community sample replicated previous findings supporting the strong psychometric properties of the PSWQ-C, and yielded Danish norms and clinical cut-offs for the measure. Clinically anxious children with a generalized anxiety disorder...... (GAD; N¿=¿10) diagnosis reported significantly higher levels of worry than anxious children without GAD (N¿=¿20). At post treatment, worry levels in children with GAD but not in anxious children without GAD were normalized. Findings regarding worry in the community sample are discussed in light...

  2. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up.

    Science.gov (United States)

    Eurich, Dean T; Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

    2017-02-13

    Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection.Design Cohort study.Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02.Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060).Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses.Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients.Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes of

  3. Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group

    Directory of Open Access Journals (Sweden)

    Aarts Leon PHJ

    2007-12-01

    Full Text Available Abstract Background Continuous positive airway pressure (CPAP treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP system that does not need a mechanical ventilator. Methods BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of Results During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78% were treated at the coronary care unit of which 66 (61% were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47% needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately € 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment. Conclusion At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings.

  4. Acute and long-term dysphagia in critically ill patients with severe sepsis: results of a prospective controlled observational study.

    Science.gov (United States)

    Zielske, Joerg; Bohne, Silvia; Brunkhorst, Frank M; Axer, Hubertus; Guntinas-Lichius, Orlando

    2014-11-01

    Dysphagia is a major risk factor for morbidity and mortality in critically ill patients treated in intensive care units (ICUs). Structured otorhinolaryngological data on dysphagia in ICU survivors with severe sepsis are missing. In a prospective study, 30 ICU patients with severe sepsis and thirty without sepsis as control group were examined using bedside fiberoptic endoscopic evaluation of swallowing after 14 days in the ICU (T1) and 4 months after onset of critical illness (T2). Swallowing dysfunction was assessed using the Penetration-Aspiration Scale (PAS). The Functional Oral Intake Scale was applied to evaluate the diet needed. Primary endpoint was the burden of dysphagia defined as PAS score >5. At T1, 19 of 30 severe sepsis patients showed aspiration with a PAS score >5, compared to 7 of 30 in critically ill patients without severe sepsis (p = 0.002). Severe sepsis and tracheostomy were independent risk factors for severe dysphagia with aspiration (PAS > 5) at T1 (p = 0.042 and 0.006, respectively). 4-month mortality (T2) was 57 % in severe sepsis patients compared to 20 % in patients without severe sepsis (p = 0.006). At T2, more severe sepsis survivors were tracheostomy-dependent and needed more often tube or parenteral feeding (p = 0.014 and p = 0.040, respectively). Multivariate analysis revealed tracheostomy at T1 as independent risk factor for severe dysphagia at T2 (p = 0.030). Severe sepsis appears to be a relevant risk factor for long-term dysphagia. An otorhinolaryngological evaluation of dysphagia at ICU discharge is mandatory for survivors of severe critical illness to plan specific swallowing rehabilitation programs.

  5. Twenty-four hours or 10 days? A prospective randomised controlled trial in children comparing head bandages following pinnaplasty.

    Science.gov (United States)

    Ramkumar, S; Narayanan, V; Laing, J H E

    2006-01-01

    The perceived benefits of bandaging for 10 days following pinnaplasty have been questioned by previous studies. The problems arising from these dressings are many [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bartley J. How long should ears be bandaged after otoplasty? J Laryngol Otol 1998;112:531-2. Wong MC, Sylaidis P. Head dressings for pinnaplasty: a tradition not supported by evidence. Br J Plast Surg 2001;54:81-2], including their slippage [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97-100. Jeffery SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588-90]. Eighty children were recruited into a prospective randomised controlled trial comparing the use of a head bandage for only 24 h with a standard practise of a 10-day head bandage. A preoperative measurement of the lateral ear projection (LEP) was made. The outcome measures recorded during the two planned postoperative visits at 10 days (visit 1) and 2 months (visit 2) were: patient satisfaction score, LEP, complications and any unscheduled hospital visits associated with the surgery. There was no significant difference in LEP and patient satisfaction between the two groups at both the scheduled postoperative visits. Differences between the groups in the number of unscheduled visits (p=0.21) did not reach statistical significance. The findings indicate that it is safe and effective to use head bandage for only 24 h following surgical correction of prominent ears. This study shows no benefit from the application of a formal head bandage for any longer than 1 day.

  6. The Effect of Patella Eversion on Clinical Outcome Measures in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Zan, Pengfei; Wu, Zhong; Yu, Xiao; Fan, Lin; Xu, Tianyang; Li, Guodong

    2016-03-01

    During total knee arthroplasty (TKA), surgical exposure requires mobilization technique of the patella. With this trial, we intended to investigate the effect of patella eversion on clinical outcome measures in simultaneous bilateral TKA. We prospectively enrolled 44 patients (88 knees) from April 2008 to June 20l4.One knee was operated with patella eversion (group A) and the other with patella lateral retraction (group B) randomly. Follow-up results, including the operation time, complications, and the time of achieving straight leg raise (SLR) and 90° knee flexion, were recorded. The data of range of motion (ROM) and Visual Analogue Scale score were collected separately at 7 days, 3 months, 6 months, and 1 year postoperatively. The time of achieving SLR was 2.7 ± 0.8 days in group A and 2.1 ± 0.7 DAYS in group B, which were significantly different (P = .032). Significant difference was found on active and passive ROM during the follow-up times between groups A and B, except the passive ROM at 6 months postoperatively. No significant difference was found on operation time, complications, patella baja or tilt, time of achieving 90°knee flexion, and Visual Analogue Scale score during the follow-up times. Patellar eversion was adverse to the early knee function recovery after TKA; it would delay the time of achieving SLR and decrease the passive and active ROM. In addition, more carefully and scientifically designed randomized controlled trials are still required to further prove the claim. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. In vitro thrombotic tendency of reactive thrombocytosis in critically ill patients: a prospective case-control study.

    Science.gov (United States)

    Duff, O C; Ho, K M; Maybury, S M

    2012-05-01

    It is uncertain whether reactive thrombocytosis is associated with an increased risk of thrombosis. This prospective case-control study assessed the in vitro thrombotic tendency of patients with reactive thrombocytosis. Forty-eight patients with reactive thrombocytosis, defined by platelet count >500x10(9)/l and 55 similar, randomly selected critically ill patients who did not have reactive thrombocytosis were considered. In vitro thrombotic tendency in both groups of patients was assessed using maximal amplitude (normal range 54 to 72 mm) and alpha angle (normal range 47 to 74°) on the thromboelastograph. The associations between reactive thrombocytosis and C-reactive protein, the coagulation profile and Sequential Organ Failure Assessment score were also evaluated. Patients with reactive thrombocytosis had an associated increased in vitro thrombotic tendency (maximal amplitude 77 vs 69 mm, mean difference 8 mm, 95% confidence interval 4.9 to 10.9, P=0.001), a higher fibrinogen concentration (7.2 vs 5.8 g/l, P=0.003), and a higher incidence of infection requiring antibiotics (50 vs 27%, P=0.025) compared to patients without thrombocytosis. Platelet count had a relatively linear relationship with the maximal amplitude and the alpha angle of the thromboelastograph tracing (Pearson correlation coefficient: 0.53, P=0.001). In the multivariate analysis, only reactive thrombocytosis (odds ratio 5.9, 95% confidence interval 1.3-27.8, P=0.025) and activated partial thromboplastin time (odds ratio 0.93 per second increment, 95% confidence interval 0.87 to 0.99, P=0.016) were significantly associated with a strong in vitro thrombotic tendency. In summary, reactive thrombocytosis was associated with infection requiring antibiotics and evidence of increased in vitro thrombotic tendency in critically ill patients.

  8. Validation and results of a questionnaire for functional bowel disease in out-patients

    Directory of Open Access Journals (Sweden)

    Skordilis Panagiotis

    2002-05-01

    Full Text Available Abstract Background The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. Methods This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS, functional dyspepsia and organic disease patients. Results Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82. There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria, 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p Conclusions This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

  9. Evaluation of efficacy and tolerability of eperisone and thiocolchicoside in treatment of low back pain associated with muscle spasm: An open label, prospective, randomized controlled trial

    OpenAIRE

    Syed H. Maaz; Prakash N. Khandelwal; Shiraz M. Baig; Sudhakar M. Doifode; Ulhas M. Ghotkar

    2016-01-01

    Background: Low back pain has a high prevalence in adult population. Because of reflex muscle spasm, muscle relaxants are frequently used either alone or in combination with analgesics. Eperisone inhibits voltage gated sodium channels in brain stem and Thiocolchicoside acts via GABA-mediated mechanism to relax muscle spasm and relieves pain. Methods: This was a prospective; open labeled, randomized, two-arm, parallel group, controlled, clinical trial. 113 patients were randomised to two gr...

  10. Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer: A Phase II Open Label Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Min Jung; Park, Sung Chan; Park, Ji Won; Chang, Hee Jin; Kim, Dae Yong; Nam, Byung-Ho; Sohn, Dae Kyung; Oh, Jae Hwan

    2017-05-25

    The phase II randomized controlled trial aimed to compare the outcomes of robot-assisted surgery with those of laparoscopic surgery in the patients with rectal cancer. The feasibility of robot-assisted surgery over laparoscopic surgery for rectal cancer has not been established yet. Between February 21, 2012 and March 11, 2015, patients with rectal cancer (cT1-3NxM0) were enrolled. Patients were randomized 1:1 to either robot-assisted or laparoscopic surgery, and stratified per sex and administration of preoperative chemoradiotherapy. The primary outcome was the quality of total mesorectal excision (TME) specimen. Secondary outcomes were the circumferential and distal resection margins, the number of harvested lymph nodes, morbidity, bowel function recovery, and quality of life. A total of 163 patients were randomly assigned to the robot-assisted (n = 81) and laparoscopic (n = 82) surgery groups, and 139 patients were eligible for the analyses (73 vs 66, respectively). One patient (1.2%) in the robot-assisted group was converted to open surgery. The TME quality did not differ between the robot-assisted and laparoscopic groups (80.3% vs 78.1% complete TME, respectively; 18.2% vs 21.9% nearly complete TME, respectively; P = 0.599). The resection margins, number of harvested lymph nodes, morbidity, and bowel function recovery also were not significantly different. On analyzing quality of life, scores of the European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ C30) and EORTC QLQ CR38 were similar in the 2 groups, but in the EORTC QLQ CR 38 questionnaire, sexual function 12 months postoperatively was better in the robot-assisted group than in the laparoscopic group (P = 0.03). Robot-assisted surgery in rectal cancer showed TME quality comparable with that of laparoscopic surgery, and it demonstrated similar postoperative morbidity, bowel function recovery, and quality of life.

  11. Diet History Questionnaire: International Applications

    Science.gov (United States)

    ARP staff adapted the Diet History Questionnaire (DHQ) for use by Canadian populations in collaboration with the Alberta Cancer Board. This questionnaire takes into account the different food fortification polices of the U.S. and Canada.

  12. Diet History Questionnaire: Suggested Citations

    Science.gov (United States)

    Use of the Diet History Questionnaire and Diet*Calc Analysis Software for publication purposes should contain a citation which includes version information for the software, questionnaire, and nutrient database.

  13. Equal Opportunities Questionnaire

    CERN Document Server

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996, which was followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equa...

  14. Equal Opportunities Questionnaire

    CERN Document Server

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996 followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equal Opportuni...

  15. The Drug-Abuse Questionnaire.

    Science.gov (United States)

    Ferneau, E.; Mueller, S.

    The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…

  16. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis of the hip or knee: protocol of a prospective randomised controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Deutsch Tobias

    2009-08-01

    Full Text Available Abstract Background The increasing age of the population, especially in the western world, means that the prevalence of osteoarthritis is also increasing, with corresponding socioeconomic consequences. Although there is no curative intervention at present, in accordance with US and European guidelines, pharmacotherapeutic and non-pharmacological approaches aim at pain control and the reduction of functional restriction. It has been established that hydrotherapy for osteoarthritis of the hip or knee joint using serial cold and warm water stimulation not only improves the range of movement but also reduces pain significantly and increases quality of life over a period of up to three months. Weight reduction is important for patients with osteoarthritis of the hip or knee. In addition, conventional physiotherapy and exercise therapy have both been shown, at a high level of evidence, to be cost-effective and to have long-term benefits for pain relief, movement in the affected joint, and patient quality of life. Methods/design The study design consists of a prospective randomised controlled three-armed clinical trial, which will be carried out at a specialist clinic for integrative medicine, to investigate the clinical effects of hydrotherapy on osteoarthritis of the knee or hip joint, in comparison with conventional physiotherapy. One hundred and eighty patients diagnosed with osteoarthritis of hip or knee will be randomly assigned to one of three intervention groups: hydrotherapy, physiotherapy, and both physiotherapy and hydrotherapy of the affected joint. In the first group, patients will receive Kneipp hydrotherapy daily, with water applied in the form of alternate cold and warm thigh affusions (alternating cold and warm water stimulation is particularly relevant to the knee and hip regions. Patients in the second group will receive physiotherapy of the hip or knee joint three times a week. Patients in the physiotherapy-hydrotherapy combination

  17. Treatment of patients with severe sepsis using Ulinastatin and Thymosin α1: a prospective, randomized, controlled pilot study

    Institute of Scientific and Technical Information of China (English)

    CHEN Hao; HE Ming-yan; LI Yu-min

    2009-01-01

    Background Tradition treatment of sepsis and new therapies, including high dose corticosteroids and non-steroidal anti-inflammatory drugs, have proven unsuccessful in improving survival. This study aimed to evaluate the potential efficacy of immunomodulating therapy using Ulinastatin (UTI) plus Thymosin α1 (Tα1) for improving organ function and reducing mortality in patients with severe sepsis.Methods A prospective study was carried out with randomized and controlled clinical analysis of 114 patients conforming to the enrollment standard. All patients had severe sepsis and received standard supportive care and antimicrobial therapy. Fifty-nine patients were also administered UTI plus Tα1 (defined as Group A), 55 patients were given a placebo (defined as Group B). Clinical parameters were determined by evaluation with the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), multiple organ failure (MOF) and the Glasgow Coma Scores (GCS) on entry and after therapy on the 3rd, 8th, and 28th day. By flow cytometery and ELISA lymphocyte subsets and cytokines were analyzed. Survival analysis was determined by the Kaplan-Meier method at 28, 60, and 90 days. Results Based on comparison of the two groups, patients in Group A exhibited a better performance in organ failure scores which was noticeable soon after initiation of treatment. Patients in Group A also demonstrated a better resolution of pre-existing organ failures during the observation period. After initiation of treatment, significant improvements in the CD4+/CD8+ ratio, a quicker balance between proinflammatory mediators such as tumor necrosis factor a, interleukin 6 and anti-inflammatory cytokines including interleukin 4 and interleukin 10 were found. This was followed by cumulative survival increases of 17.3% at 28 days, 28.9% at 60 days, and 31.4% at 90 days in Group A. The reduction in mortality was accompanied by a considerably shorter stay in the ICU and a shorter length of supportive

  18. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    Science.gov (United States)

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P < .001), shoulder abduction (P <.001), shoulder external rotation (P = .01), and elbow flexion (P = .004) ROM from baseline to 6 months as measured with goniometry. Subjects also showed significant gains in elbow flexion (P = .04) during hand to head and shoulder flexion (P = .04) during high reach. There was no difference in ROM gains between the groups. Within group comparison showed that the VGT group had significantly more recovery of ROM during the first 3 weeks than any other timeframe in the study, whereas ST had most gains at 3 months. There was a significant difference between the groups in the subjects' pain response. ST subjects

  19. Dietary Vitamin K intake and anticoagulation control during the initiation phase of warfarin therapy: A prospective cohort study

    Science.gov (United States)

    The effect of varying levels of dietary vitamin K intake on therapeutic International Normalized Ratio (INR) values among patients starting warfarin therapy has not been well studied. We performed a prospective cohort study among 282 patients to explore the independent associations between usual in...

  20. Questionnaire de Schwartz

    Directory of Open Access Journals (Sweden)

    Alejandro Castro Solano

    2006-01-01

    Full Text Available El estudio de los valores puede ser abordado desde múltiples perspectivas (filosófica, psicológica, sociológica, etc.. En Psicología, el análisis de las orientaciones valóricas de los individuos ha cobrado especial importancia a partir de las conceptualizaciones de Schwartz (1992, 2001 quien verificó una estructura de diez valores (Poder, Logro, Hedonismo, Estimulación, Autodirección, Universalismo, Benevolencia, Tradición, Conformidad y Seguridad, los cuales se organizan en cuatro bipolaridades (Autotrascendencia, Autopromoción, Conservación y Apertura al cambio en más de 60 países, dando soporte empírico a la clasificación de los valores humanos. Este estudio tiene como objetivos: (a adaptar y validar el Portrait Values Questionnaire (PVQ de Schwartz (1992, 2001 y (b verificar si existen diferencias individuales según dos contextos objeto de estudio (civil y militar y según sexo y edad. Se recogieron datos de una población argentina (N = 692 en tres contextos diferentes: (a población civil (n = 471, (b oficiales militares (n = 97 y (c cadetes (n = 124. El estudio permitió verificar parcialmente la estructura de los valores propuestos por el autor. La fiabilidad del PVQ resulta muy adecuada en los tres contextos estudiados. Asimismo se pudo verificar que los civiles están más orientados hacia el logro de objetivos personales (Autopromoción y la independencia para decir y hacer lo que uno quiere (Apertura al cambio, mientras que los militares están más orientados hacia los valores relacionados con el mantenimiento del orden social, la seguridad, la conservación de las tradiciones (Tradición y Conformidad. Por otra parte, los resultados mostraron que no existen diferencias en las orientaciones valóricas según sexo y edad.

  1. 78 FR 68909 - Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-11-15

    ... AFFAIRS Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits Questionnaire... Leg Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION... Control No. 2900-NEW (Knee and Lower Leg Conditions Disability Benefits Questionnaire)''....

  2. Questionnaire Designing for a Survey

    Directory of Open Access Journals (Sweden)

    S Roopa

    2012-01-01

    Full Text Available Questionnaires are frequently used in quantitative marketing research and social research. A questionnaire is a series of questions asked to individuals to obtain statistically useful information about a given topic. When properly constructed and responsibly administered, questionnaires become a vital instrument by which statements can be made about specific groups or people or entire populations. They are a valuable method of collecting a wide range of information from a large number of individuals, often referred to as respondents. Adequate questionnaire construction is critical to the success of a survey. Appropriate questions, correct ordering of questions, correct scaling, or good questionnaire format can make the survey worthwhile, as it may accurately reflect the views and opinions of the participants. A useful method for checking a questionnaire and making sure it is accurately capturing the intended information is to pretest among a smaller subset of target respondents.

  3. The mediating effects of situational control on social support and mood following a stressor: a prospective study of dementia caregivers in their natural environments.

    Science.gov (United States)

    Atienza, A A; Collins, R; King, A C

    2001-05-01

    The present study examined, prospectively and within the context of stress experienced in the natural environment, whether situational control served as a mediator between perceived social support and caregiver's mood. Data came from baseline assessments of individuals participating in health promotion interventions for women caregivers. Participants were 49 female caregivers of dementia patients who monitored their own acute psychological states during the day. Results revealed that although the occurrence of a situational stressor increased negative mood, greater perceived support reduced the detrimental impact of a stressor on negative mood. Moreover, path analyses revealed that changes in situational control partially mediated the relationship between perceived support and stress-induced negative mood changes. However, changes in control did not serve as a mediator in analyses focused on happiness. Results suggest that caregivers with greater perceived support were less emotionally reactive to stress occurring in their natural environments because of, in part, sustained or increased situational control.

  4. Five-year results of a prospective randomised controlled clinical trial of posterior computer-aided design-computer-aided manufacturing ZrSiO4 -ceramic crowns.

    Science.gov (United States)

    Passia, N; Stampf, S; Strub, J R

    2013-08-01

    The aim of this prospective randomised controlled clinical trial was to evaluate the clinical outcome of shrinkage-free ZrSiO4 -ceramic full-coverage crowns on premolars and molars in comparison with conventional gold crowns over a 5-year period. Two hundred and twenty-three patients were included and randomly divided into two treatment groups. One hundred and twenty-three patients were restored with 123 ZrSiO4 -ceramic crowns, and 100 patients received 100 gold crowns, which served as the control. All crowns were conventionally cemented with glass-ionomer cement. After an observation period of 6, 12, 24, 36, 48 and 60 months, the survival probability (Kaplan-Meier) for the shrinkage-free ZrSiO4 -ceramic crowns was 98·3%, 92·0%, 84·7%, 79% and 73·2% and for the gold crowns, 99%, 97·9%, 95·7%, 94·6% and 92·3%, respectively. The difference between the test and control group was statistically significant (P = 0·0027). The gold crowns showed a better marginal integrity with less marginal discoloration than the ceramic crowns. The most common failure in the ceramic crown group was fracture of the crown. The 60-month results of this prospective randomised controlled clinical trial suggest that the use of these shrinkage-free ZrSiO4 -ceramic crowns in posterior tooth restorations cannot be recommended.

  5. Juvéderm Volbella with Lidocaine for Lip and Perioral Enhancement: A Prospective, Randomized, Controlled Trial

    OpenAIRE

    Hervé Raspaldo, MD; Jonquille Chantrey, MD; Lakdhar Belhaouari, MD; Roy Saleh, MD; Diane K. Murphy, MBA; for the Juvéderm Volbella Study Group

    2015-01-01

    Background: Juvéderm Volbella with Lidocaine is a new hyaluronic acid dermal filler. Methods: In this prospective, randomized, multicenter study, 280 subjects desiring lip volume enhancement were treated with Juvéderm Volbella with Lidocaine or Restylane-L. Investigators rated treatment outcomes on Allergan’s Lip Fullness Scale, Perioral Lines Scale, and Oral Commissures Severity Scale. A blinded independent central reviewer (ICR) assessed 3-dimensional digital photographs using these scal...

  6. Paper to Electronic Questionnaires: Effects on Structured Questionnaire Forms

    Science.gov (United States)

    Trujillo, Anna C.

    2009-01-01

    With the use of computers, paper questionnaires are being replaced by electronic questionnaires. The formats of traditional paper questionnaires have been found to effect a subject's rating. Consequently, the transition from paper to electronic format can subtly change results. The research presented begins to determine how electronic questionnaire formats change subjective ratings. For formats where subjects used a flow chart to arrive at their rating, starting at the worst and middle ratings of the flow charts were the most accurate but subjects took slightly more time to arrive at their answers. Except for the electronic paper format, starting at the worst rating was the most preferred. The paper and electronic paper versions had the worst accuracy. Therefore, for flowchart type of questionnaires, flowcharts should start at the worst rating and work their way up to better ratings.

  7. Randomized controlled trial evaluating the temporal effects of high-intensity exercise on learning, short-term and long-term memory, and prospective memory.

    Science.gov (United States)

    Frith, Emily; Sng, Eveleen; Loprinzi, Paul D

    2017-09-18

    The broader purpose of this study was to examine the temporal effects of high-intensity exercise on learning, short-term and long-term retrospective memory and prospective memory. Among a sample of 88 young adult participants, 22 were randomized into one of four different groups: exercise before learning, control group, exercise during learning, and exercise after learning. The retrospective assessments (learning, short-term and long-term memory) were assessed using the Rey Auditory Verbal Learning Test. Long-term memory including a 20-min and 24-hr follow-up assessment. Prospective memory was assessed using a time-based procedure by having participants contact (via phone) the researchers at a follow-up time period. The exercise stimulus included a 15-min bout of progressive maximal exertion treadmill exercise. High-intensity exercise prior to memory encoding (vs. exercise during memory encoding or consolidation) was effective in enhancing long-term memory (for both 20-min and 24-h follow-up assessments). We did not observe a differential temporal effect of high-intensity exercise on short-term memory (immediate post-memory encoding), learning or prospective memory. The timing of high-intensity exercise may play an important role in facilitating long-term memory. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  8. Does Cytoreductive Prostatectomy Really Have an Impact on Prognosis in Prostate Cancer Patients with Low-volume Bone Metastasis? Results from a Prospective Case-Control Study.

    Science.gov (United States)

    Steuber, Thomas; Berg, Kasper D; Røder, Martin A; Brasso, Klaus; Iversen, Peter; Huland, Hartwig; Tiebel, Anne; Schlomm, Thorsten; Haese, Alexander; Salomon, Georg; Budäus, Lars; Tilki, Derya; Heinzer, Hans; Graefen, Markus; Mandel, Philipp

    2017-07-08

    The impact of cytoreductive radical prostatectomy (CRP) on oncological outcomes in patients with prostate cancer (PCa) and distant metastases has been demonstrated by retrospective data with their potential selection bias. Using prospective institutional data, we compared the outcomes between 43 PCa patients with low-volume bone metastases (1-3 lesions) undergoing CRP (median follow-up 32.7 mo) and 40 patients receiving best systemic therapy (BST; median follow-up 82.2 mo). The inclusion criteria for both cohorts were identical. So far, no significant difference in castration resistant-free survival (p=0.92) or overall survival (p=0.25) has been detected. Compared to recent reports, the outcomes for our control group are more favorable, indicating a potential selection bias in the previous retrospective studies. Therefore, the unclear oncological effect has to be weighed against the potential risks of CRP. However, patients benefit from a significant reduction in locoregional complications (7.0% vs 35%; p<0.01) when undergoing CRP. In this study we analyzed the impact of surgery in patients with prostate cancer and bone metastases. Using prospective data, we could not show a significant benefit of surgery on survival, but the rate of locoregional complications was lower. Therefore, patients should be treated within prospective trials evaluating the role of cytoreductive prostatectomy in low-volume, bone metastatic prostate cancer. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  9. Responsiveness of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire

    NARCIS (Netherlands)

    Burgt, T.J. van de; Kluivers, K.B.; Hendriks, J.C.M.

    2013-01-01

    OBJECTIVE: To evaluate the responsiveness to change and the minimal clinical important difference (MCID) of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire. STUDY DESIGN: Prospective cohort study among endometriosis patients attending the Radboud University Nijmegen Medical Centre a

  10. Restoring vaginal microbiota: biological control of bacterial vaginosis. A prospective case-control study using Lactobacillus rhamnosus BMX 54 as adjuvant treatment against bacterial vaginosis.

    Science.gov (United States)

    Recine, Nadia; Palma, Ettore; Domenici, Lavinia; Giorgini, Margherita; Imperiale, Ludovica; Sassu, Carolina; Musella, Angela; Marchetti, Claudia; Muzii, Ludovico; Benedetti Panici, Pierluigi

    2016-01-01

    Bacterial vaginosis (BV) is the most prevalent lower genital tract infection in reproductive-age women worldwide. BV is an ecological disorder of the vaginal microbiota characterized microbiologically by replacement of the lactobacilli, predominant vaginal microbiota. It is characterized by a high rate of relapse in sexual active women, and these patients show three or more relapses each year. A healthy vagina is characterized by hydrogen peroxide and acid-producing lactobacilli, which are crucial to maintain the physiological vaginal ecosystem and their depletion speeds up bacterial overgrowth with pH elevation, salidase and amine production, leading to the observed signs and symptoms of BV. The aim of this study is to evaluate the efficacy of long-term vaginal lactobacilli's implementation in restoring and maintaining vaginal microflora and pH and to collect data about prophylactic approach based on probiotics supplementation with lactobacilli. This is a prospective case-control study, performed between January 2013 and September 2014 at Department of Gynecological Obstetrics and Urologic Sciences of "Sapienza" University of Rome. 250 non-pregnant sexually active women with diagnoses of BV were collected. Patients selected were divided in Group A (125 patients assigned to standard treatment for BV-metronidazole 500 mg orally twice a day for 7 days) and Group B (125 women undergoing the same standard antibiotic regimen followed by vaginal tablets containing Lactobacillus rhamnosus BMX 54). Patients were evaluated after 2, 6, and 9 months (T0, T2, T6, and T9) in term of recurrences rates of BV, vaginal symptoms, re-establishment of healthy vaginal flora, vaginal pH, and treatment tolerability. Vaginal flora was significantly replaced in Group B patients after 2 months comparing with Group A (p = 0.014). These data were confirmed at 6 and 9 months follow-up: patients that underwent prophylactic therapy with NORMOGIN(®) experienced significantly low rate of

  11. Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jeremy G Wheeler

    2005-03-01

    Full Text Available BACKGROUND: It has been suggested throughout the past fifty years that serum uric acid concentrations can help predict the future risk of coronary heart disease (CHD, but the epidemiological evidence is uncertain. METHODS AND FINDINGS: We report a "nested" case-control comparison within a prospective study in Reykjavik, Iceland, using baseline values of serum uric acid in 2,456 incident CHD cases and in 3,962 age- and sex-matched controls, plus paired serum uric acid measurements taken at baseline and, on average, 12 y later in 379 participants. In addition, we conducted a meta-analysis of 15 other prospective studies in eight countries conducted in essentially general populations. Compared with individuals in the bottom third of baseline measurements of serum uric acid in the Reykjavik study, those in the top third had an age- and sex-adjusted odds ratio for CHD of 1.39 (95% confidence interval [CI], 1.23-1.58 which fell to 1.12 (CI, 0.97-1.30 after adjustment for smoking and other established risk factors. Overall, in a combined analysis of 9,458 cases and 155,084 controls in all 16 relevant prospective studies, the odds ratio was 1.13 (CI, 1.07-1.20, but it was only 1.02 (CI, 0.91-1.14 in the eight studies with more complete adjustment for possible confounders. CONCLUSIONS: Measurement of serum uric acid levels is unlikely to enhance usefully the prediction of CHD, and this factor is unlikely to be a major determinant of the disease in general populations.

  12. Effect of biofeedback and deep oscillation on Raynaud's phenomenon secondary to systemic sclerosis: results of a controlled prospective randomized clinical trial.

    Science.gov (United States)

    Sporbeck, Birte; Mathiske-Schmidt, Kirsten; Jahr, Silke; Huscher, Dörte; Becker, Mike; Riemekasten, Gabriela; Taufmann, Ines; Burmester, Gerd-Rüdiger; Pögel, Stephanie; Reisshauer, Anett

    2012-05-01

    Our aim was to evaluate the effect of deep oscillation and biofeedback on Raynaud's phenomenon (RP) secondary to systemic sclerosis (SSc). A prospective randomized study was performed in SSc patients receiving either deep oscillation (n = 10) or biofeedback (n = 8) thrice a week for 4 weeks, or patients were randomized into the waiting group untreated for vasculopathy (n = 10) in time of running the study interventions. Biofeedback resulted in an improvement of RP as determined by score reduction of visual analogue scale compared with patients of the control group (P physiotherapy for the treatment of SSc-related RP.

  13. Retraction statement: Manuka honey vs. hydrogel - a prospective, open label, multicentre, randomised controlled trial to compare desloughing efficacy and healing outcomes in venous ulcers.

    Science.gov (United States)

    2015-09-01

    The following article from Journal of Clinical Nursing, 'Manuka honey vs. hydrogel - a prospective, open label, multicentre, randomised controlled trial to compare desloughing efficacy and healing outcomes in venous ulcers' by Georgina Gethin and Seamus Cowman published online on 25 August 2008 in Wiley Online Library (wileyonlinelibrary.com) and in Volume 18, pp. 466-474, has been retracted by agreement between the journal Editor-in-Chief, the authors and John Wiley & Sons, Ltd. The retraction has been agreed due to errors in the data analysis which affect the article's findings.

  14. Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study

    OpenAIRE

    Margolis Harold S; Duong Socheat; Ngan Chantha; Beatty Mark; Wichmann Ole; Huy Rekol; Vong Sirenda

    2009-01-01

    Abstract Background The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children < 15 years of age (2002–2007). To estimate the economic burden of dengue, accurate cost-of-illness data are essential. We conducted a prospective, community-based, matched case-control study to assess the cost and impact of an episode of dengue fever and other febrile illness on households in rural Cambodia. Methods In 2006, active fever surveillance was conducted among a cohort of 6,694 c...

  15. Protocol for a prospective, controlled, observational study to evaluate the influence of hypoxia on healthy volunteers and patients with inflammatory bowel disease: the Altitude IBD Study

    Science.gov (United States)

    Vavricka, Stephan; Ruiz, Pedro A; Scharl, Sylvie; Biedermann, Luc; Scharl, Michael; de Vallière, Cheryl; Lundby, Carsten; Wenger, Roland H; Held, Leonhard; Merz, Tobias M; Gassmann, Max; Lutz, Thomas; Kunz, Andres; Bron, Denis; Fontana, Adriano; Strauss, Laura; Weber, Achim; Fried, Michael; Rogler, Gerhard

    2017-01-01

    Introduction Inflammatory bowel disease (IBD) is a chronic intestinal disorder, often leading to an impaired quality of life in affected patients. The importance of environmental factors in the pathogenesis of IBD, including their disease-modifying potential, is increasingly recognised. Hypoxia seems to be an important driver of inflammation, as has been reported by our group and others. The aim of the study is to evaluate if hypoxia can alter disease activity of IBD measured by Harvey-Bradshaw Activity Index in Crohn's disease (increase to ≥5 points) and the partial Mayo Score for ulcerative colitis (increase to ≥2 points). To test the effects of hypoxia under standardised conditions, we designed a prospective and controlled investigation in healthy controls and patients with IBD in stable remission. Methods and analysis This is a prospective, controlled and observational study. Participants undergo a 3-hour exposure to hypoxic conditions simulating an altitude of 4000 metres above sea level (m.a.s.l.) in a hypobaric pressure chamber. Clinical parameters, as well as blood and stool samples and biopsies from the sigmoid colon are collected at subsequent time points. Ethics and dissemination The study protocol was approved by the Ethics Committee of the Kanton Zurich (reference KEK-ZH-number 2013-0284). The results will be published in a peer-reviewed journal and shared with the worldwide medical community. Trials registration number NCT02849821; Pre-results. PMID:28057654

  16. Orthorexia nervosa: validation of a diagnosis questionnaire.

    Science.gov (United States)

    Donini, L M; Marsili, D; Graziani, M P; Imbriale, M; Cannella, C

    2005-06-01

    To validate a questionnaire for the diagnosis of orhorexia oervosa, an eating disorder defined as "maniacal obsession for healthy food". 525 subjects were enrolled. Then they were randomized into two samples (sample of 404 subjects for the construction of the test for the diagnosis of orthorexia ORTO-15; sample of 121 subjects for the validation of the test). The ORTO-15 questionnaire, validated for the diagnosis of orthorexia, is made-up of 15 multiple-choice items. The test we proposed for the diagnosis of orthorexia (ORTO 15) showed a good predictive capability at a threshold value of 40 (efficacy 73.8%, sensitivity 55.6% and specificity 75.8%) also on verification with a control sample. However, it has a limit in identifying the obsessive disorder. For this reason we maintain that further investigation is necessary and that new questions useful for the evaluation of the obsessive-compulsive behavior should be added to the ORTO-15 questionnaire.

  17. Turkish Prospective Chemistry Teachers' Alternative Conceptions about Acids and Bases

    Science.gov (United States)

    Boz, Yezdan

    2009-01-01

    The purpose of this study was to obtain prospective chemistry teachers' conceptions about acids and bases concepts. Thirty-eight prospective chemistry teachers were the participants. Data were collected by means of an open-ended questionnaire and semi-structured interviews. Analysis of data indicated that most prospective teachers did not have…

  18. Turkish Prospective Chemistry Teachers' Alternative Conceptions about Acids and Bases

    Science.gov (United States)

    Boz, Yezdan

    2009-01-01

    The purpose of this study was to obtain prospective chemistry teachers' conceptions about acids and bases concepts. Thirty-eight prospective chemistry teachers were the participants. Data were collected by means of an open-ended questionnaire and semi-structured interviews. Analysis of data indicated that most prospective teachers did not have…

  19. JOA back pain evaluation questionnaire: initial report.

    Science.gov (United States)

    Fukui, Mitsuru; Chiba, Kazuhiro; Kawakami, Mamoru; Kikuchi, Shinichi; Konno, Shinichi; Miyamoto, Masabumi; Seichi, Atsushi; Shimamura, Tadashi; Shirado, Osamu; Taguchi, Toshihiko; Takahashi, Kazuhisa; Takeshita, Katsushi; Tani, Toshikazu; Toyama, Yoshiaki; Wada, Eiji; Yonenobu, Kazuo; Tanaka, Takashi; Hirota, Yoshio

    2007-09-01

    There is no widely accepted objective evaluation for lumbar spine disorders. New outcome measures should be patient-oriented and should measure symptoms and self-reported functional status in multiple dimensions. The aim of this study was to identify items to be included in the disease-specific quality of life (QOL) questionnaire for the assessments of patients with lumbar spine disorders. The draft of the QOL questionnaire that consisted of a total of 60 items, including 24 items derived from the Japanese version of the Roland Morris Disability Questionnaire (RDQ) and 36 items derived from the Japanese version of Short Form 36 (SF-36), were administered to patients and controls. After obtaining written informed consent, the following data were collected from the patient group (n = 328) and the control group (n = 213): (1) background characteristics, including age, diagnosis, Japanese Orthopaedic Association (JOA) score, and finger to floor distance; (2) responses to the questionnaire; (3) the identification rate by discrimination analysis to select the candidates for adoption and by adopting explanatory variables. The items to be excluded were determined by examining the explanatory variables, which were selected after the discrimination analysis, by setting the candidate to-be-excluded items as an objective variable. Based on the distribution of the responses, two items, RDQ-15 and RDQ-19, were excluded. From the results of the correlation coefficient calculation for each question in the patient group, 33 items were excluded and 27 candidate items were adopted. Based on the adoption explanatory variable used in the discrimination analysis, 25 of the 27 candidate items for adoption were accepted. This study identified the 25 specific questionnaire items that should be included in the questionnaire to evaluate QOL of patients with various lumbar spine disorders.

  20. PROSPECTING EXPLORATION

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>20082879 Chen Yaoyu(No.3 Geology and Mineral Exploration Team,Gansu Provincial Bureau of Geology and Mineral Exploration and Development,Lanzhou 730050,China); Gong Quansheng Discussion on the Division of Deposit Scale and the Index of Ore Prospecting(Gansu Geology,ISSN 1004—4116,CN62—1191/P,16(3),2007,p.6—11,4 tables,6 refs.) Key words:prospecting and exploration of mineral

  1. The effects of rose hip (Rosa canina) on plasma antioxidative activity and C-reactive protein in patients with rheumatoid arthritis and normal controls: A prospective cohort study

    DEFF Research Database (Denmark)

    Kirkeskov, Bente; Christensen, Robin; Bügel, Susanne Gjedsted

    2011-01-01

    : In this open case-control study 20 female patients with RA and 10 female controls were given 10.5g rose hip powder daily (Litozin(®)) for 28 days. Blood samples were analysed at baseline and follow-up for the capacity of the antioxidant enzymes superoxide dismutase, glutathione peroxidase, glutathione...... reductase and catalase and the inflammatory marker C-reactive protein (CRP). The participants kept a food diary for the first 3 days and the last 3 days of the intervention period. The RA-patients completed The Stanford Health Assessment Questionnaire at baseline and follow-up. RESULTS: CRP...... symptoms or laboratory measurements in patients with RA or healthy controls. This is in contrast to previous intervention studies with rose hip powder that found a reduction in the concentration of CRP. The results of the present study indicate that a daily amount of approximately 10g rose hip powder...

  2. The validated sun exposure questionnaire

    DEFF Research Database (Denmark)

    Køster, B; Søndergaard, J; Nielsen, J B

    2017-01-01

    Few questionnaires used in monitoring sun-related behavior have been tested for validity. We established criteria validity of a developed questionnaire for monitoring population sun-related behavior. During May-August 2013, 664 Danes wore a personal electronic UV-dosimeter for one week...... that measured the outdoor time and dose of erythemal UVR exposure. In the following week, they answered a questionnaire on their sun-related behavior in the measurement week. Outdoor time measured by dosimetry correlated strongly with both outdoor time and the developed exposure scale measured....... The weekly sunburn fraction correlated strongly with the number of ambient sun hours (r=0.73, p

  3. A 3-year clinical prospective investigation: establishment of anassessment questionnaire for Parkinson's disease with motor complications%三年前瞻性临床研究初步构建帕金森病运动并发症危险评估量表

    Institute of Scientific and Technical Information of China (English)

    万赢; 刘振国; 任肖玉; 魏雅荣; 周明珠; 何海燕; 干静; 陆丽霞; 吴佳英; 陈伟

    2013-01-01

    Objective To derive a questionnaire to assess the risk of developing motor complications through a 3-year prospective investigation on 71 patients of Parkinson' s disease (PD) in the out clinic at our hospital.Methods Three years after the first assessment,71 PD out patients were reassessed using various scales,including Unified Parkinson Disease Rating Scale,Hoehn-Yahr grade,Mini Mental State Exam,Hamilton Depression Scale and Hamilton Anxiety Scale.Results The incidence of motor complications was 43.6% (31/71).Logistic regression analysis showed that the prognostic factors for motor fluctuation were age of onset ≤ 54 (OR =6.4,95% CI 1.7-24.5,P =0.006),the occurrence of swallowing difficulty (OR =3.8,95 % CI 1.0-14.1,P =0.04) and depression (OR =4.0,95 % CI 1.1-13.7,P =0.03),and the prognostic factors for dyskinesia were age of onset ≤54 (OR =48.5,95% CI 1.9-121.0,P:0.02),the occurrence of falling (OR =64.1,95% CI 2.9-142.2,P =0.008) and the daily levodopa dosage > 600 mg(OR =17.5,95% CI 1.1-276.2,P =0.04).Based on the regression model,the assessment questionnaire for motor complicationsincludes the followings:the questionnaire for motor fluctuations:the age of onset ≤54,2 points; the occurrence of swallowing difficulty,1 point; the occurrence of depression,1 point; the questionnaire for dyskinesia:the onset age ≤54,2 points; the occurrence of falling,3 points; daily levodopa dosage > 600 mg,2 points.In all patients in this study,21.7% (10/46) was asscssed to a total scorc of 0-1 which is associated with a low risk of motor fluctuation,8/16 had a score of 2 which is associated with intermediate risk and 8/9 got a score of 3-4 associated high risk; 10.2% (5/49) had a score of 0-2,a low risk of dyskinesia,4/13 had a score of 3-4,a intermediate risk and 7/9 got a score of 5-7 which is associated with a high risk.Conclusions Age onset ≤54,the occurrence of swallowing difficulty,falling and depression,daily levodopa dosage > 600 mg

  4. Does Extended-Release Liposomal Bupivacaine Better Control Pain Than Bupivacaine After Total Knee Arthroplasty (TKA)? A Prospective, Randomized Clinical Trial.

    Science.gov (United States)

    Schroer, William C; Diesfeld, Paul G; LeMarr, Angela R; Morton, Diane J; Reedy, Mary E

    2015-09-01

    Liposomal bupivacaine periarticular injection (PAI) offers sustained bupivacaine release after TKA, but few prospective independent studies exist. In this prospective, blinded study, liposomal bupivacaine was randomized against bupivacaine and incorporated into a comprehensive multimodal pain management protocol. 111 primary TKAs were randomized to receive PAI: 58 patients received 266 mg (20cc) liposomal bupivacaine mixed with 75 mg (30cc) 0.25% bupivacaine, and 53 patients received 150 mg (60cc) 0.25% bupivacaine. Visual analog pain scores and narcotic use were determined. No pain score differences occurred between study and control patients: Day 1: 4.5/4.6 (P=0.73); Day 2: 4.4/4.8 (P=0.27); or Day 3: 3.5/3.7 (P=0.58). Narcotic use was similar during hospitalization, 51.8/54.2 (P=0.34). The study medication costs $285, and the control medication costs $2.80. This finding does not justify the routine use of liposomal bupivacaine.

  5. Efficacy of fluoride varnish for preventing white spot lesions and gingivitis during orthodontic treatment with fixed appliances-a prospective randomized controlled trial.

    Science.gov (United States)

    Kirschneck, Christian; Christl, Jan-Joachim; Reicheneder, Claudia; Proff, Peter

    2016-12-01

    The development of white spot lesions around orthodontic brackets and gingivitis is a common problem during orthodontic treatment with fixed appliances. This prospective randomized double-blind controlled clinical trial investigated the preventive efficacy of a one-time application of two commonly used fluoride varnishes in patients with low to moderate caries risk. Ninety adolescent orthodontic patients with a low to moderate caries risk were prospectively randomized to three groups of 30 patients each: (1) standardized dental hygiene with fluoride toothpaste and one-time application of placebo varnish (control) or (2) of elmex® fluid or (3) of Fluor Protector S on all dental surfaces at the start of fixed therapy. The extent of enamel demineralization and gingivitis was determined with the ICDAS and the gingivitis index (GI) at baseline and after 4, 12, and 20 weeks. Each treatment group showed a significant increase of the ICDAS index, but not of the GI over the course of time with no significant intergroup differences detectable. A one-time application of fluoride varnish at the start of orthodontic treatment did not provide any additional preventive advantage over sufficient dental hygiene with fluoride toothpaste with regard to formation of white spots and gingivitis in patients with a low to moderate caries risk. In dental practice, patients often receive an application of fluoride varnish at the start of orthodontic treatment with fixed appliances. However, the efficacy of this procedure is still unclear.

  6. 上海市青少年控烟问卷的信度和效度分析%Reliability and validity of questionnaire on tobacco control among adolescents in Shanghai

    Institute of Scientific and Technical Information of China (English)

    蔡泳; 乔韵; 朱静芬; 李娜; 何亚平; 陆琳; 马进

    2012-01-01

    目的 通过青少年控烟问卷的信度和效度分析评价其在上海市中学生中应用的可行性.方法 采用整群随机抽样的方法在上海市范围内抽取3个区,对区内所属的41所学校19117名初中生和高中生进行青少年控烟问卷调查,问卷内容包括个人、家庭和学校的基本信息、烟草使用情况、吸烟危害的认知、烟草使用的内在倾向、学校控烟教育环境、烟草使用的外在吸引力认同、二手烟暴露情况、家庭烟草接触暴露、同伴烟草使用情况以及烟草的媒体暴露风险.用统计软件评价其效度和内在信度.对其中6所学校的287名初中和高中生以相同问卷接受两次调查,评价重测信度.结果 主要测量指标的内在信度Cronbach's α系数为0.504~ 0.804,家庭烟草接触暴露和未来吸烟倾向2个维度的内在信度最高.Spearman相关系数均>0.7,问卷的重测信度良好.因子分析显示问卷的结构效度较好,10个公因子涵盖了倾向因素、强化因素和促成因素,能解释问卷全部内容的61.17%.结论 制定的青少年控烟问卷具有良好的信度和效度,可以用于青少年控烟的相关研究.%Objective To investigate the feasibility of the questionnaire on tobacco control among adolescents in Shanghai by evaluation of its validity and reliability. Methods Questionnaire survey on tobacco control among adolescents was conducted in 19 117 junior middle school students and senior high school students selected from 41 schools in 3 districts of Shanghai by cluster random sampling. The questionnaire included basic information of individuals, families and schools, condition of tobacco use, awareness of smoking hazard, inherent tendency of tobacco use, tobacco control educational environment of schools, external appeal of tobacco use, second-hand smoke exposure, tobacco exposure in families, tobacco use of peers and risk of media exposure to tobacco use. Validity and internal

  7. Validity and reliability of Tobacco Control Among Students of Public Health Questionnaire%《公共卫生学生控烟调查问卷》的信度与效度评价

    Institute of Scientific and Technical Information of China (English)

    马丽; 马建雯; 师佳佳; 孙喜望; 冯丽云

    2013-01-01

    目的:评价的信度与效度.方法:采用对公共卫生专业本科生112人进行现场问卷调查,有效问卷110份.用Spearman-Brown公式计算折半信度,用克朗巴赫α系数评价问卷的内部一致性信度;用Spearman秩相关分析条目与其所属领域的相关性,用以评价内容效度;采用因子分析方法评价结构效度.结果:折半信度系数为0.887,3个维度以及整个问卷的α系数分别为0.824、0.820、0.635和0.821.各条目得分与其所属维度总分的相关系数在0.529~0.847,与总分的相关系数为0.328~0.699.3个公因子的累积方差贡献率为60.64%,64.29%的条目提取公因子后的共同度超过0.50.结论:该问卷具有良好的信度和效度.%Aim:To evaluate the validity and reliability of Tobacco Control Among Students of Public Health Question -naire.Methods:A total of 112 undergraduates majored in public health were surveyed using the questionnaire .The split-half reliability was calculated using Spearman-Brown formula, and Cronbach's α coefficient was used to evaluate internal consistency reliability; Spearman rank correlation was used to analyze the correlation between items and their subordinate fields to evaluate the content validity , and factor analysis was used to assess the construct validity of the questionnaire .Re-sults:The split-half reliability was 0.887, α coefficients of 3 dimensions and total questionnaire were 0.824,0.820, 0.635 ,and 0.821 , respectively.The correlation coefficients of scores of the items with its subordinate dimensionality were 0.529 -0.847 ,and those with the total scores were 0.328 -0.699.The cumulative variance contribution rate of the three common factors were 60.64% , and the communality of 64.29% items after extraction of common factor was greater than 0.50.Conclusion: The validity and reliability of the questionnaire is well.

  8. Support for the global feasibility of the Ages and Stages Questionnaire as developmental screener

    NARCIS (Netherlands)

    Kerstjens, J.M.; Bos, A.F.; ten Vergert, E.M.J.; de Meer, G.; Butcher, P.R.; Reijneveld, S.A.

    2009-01-01

    Objective: To investigate the psychometric properties of the Dutch version of the 48 months Ages and Stages Questionnaire (D_ASQ_48). Design: Prospective cohort study of a community-based sample of children born in 2002 and 2003 whose parents filled out the D_ASQ_48 and a questionnaire on school sta

  9. Post-Cruise Questionnaire - Legacy

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Post-Cruise Questionnaire is a mandatory post trip legal document that observers fill out after every trip they have completed.

  10. Post-Cruise Questionnaire - Legacy

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Post-Cruise Questionnaire is a mandatory post trip legal document that observers fill out after every trip they have completed.

  11. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies123

    Science.gov (United States)

    Miller, Paige E; Perez, Vanessa

    2014-01-01

    Background: Replacement of caloric sweeteners with lower- or no-calorie alternatives may facilitate weight loss or weight maintenance by helping to reduce energy intake; however, past research examining low-calorie sweeteners (LCSs) and body weight has produced mixed results. Objective: The objective was to systematically review and quantitatively evaluate randomized controlled trials (RCTs) and prospective cohort studies, separately, that examined the relation between LCSs and body weight and composition. Design: A systematic literature search identified 15 RCTs and 9 prospective cohort studies that examined LCSs from foods or beverages or LCSs consumed as tabletop sweeteners. Meta-analyses generated weighted mean differences in body weight and composition values between the LCS and control groups among RCTs and weighted mean correlations for LCS intake and these parameters among prospective cohort studies. Results: In RCTs, LCSs modestly but significantly reduced all outcomes examined, including body weight (−0.80 kg; 95% CI: −1.17, −0.43), body mass index [BMI (in kg/m2): −0.24; 95% CI: −0.41, −0.07], fat mass (−1.10 kg; 95% CI: −1.77, −0.44), and waist circumference (−0.83 cm; 95% CI: −1.29, −0.37). Among prospective cohort studies, LCS intake was not associated with body weight or fat mass, but was significantly associated with slightly higher BMI (0.03; 95% CI: 0.01, 0.06). Conclusions: The current meta-analysis provides a rigorous evaluation of the scientific evidence on LCSs and body weight and composition. Findings from observational studies showed no association between LCS intake and body weight or fat mass and a small positive association with BMI; however, data from RCTs, which provide the highest quality of evidence for examining the potentially causal effects of LCS intake, indicate that substituting LCS options for their regular-calorie versions results in a modest weight loss and may be a useful dietary tool to improve

  12. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies.

    Science.gov (United States)

    Miller, Paige E; Perez, Vanessa

    2014-09-01

    Replacement of caloric sweeteners with lower- or no-calorie alternatives may facilitate weight loss or weight maintenance by helping to reduce energy intake; however, past research examining low-calorie sweeteners (LCSs) and body weight has produced mixed results. The objective was to systematically review and quantitatively evaluate randomized controlled trials (RCTs) and prospective cohort studies, separately, that examined the relation between LCSs and body weight and composition. A systematic literature search identified 15 RCTs and 9 prospective cohort studies that examined LCSs from foods or beverages or LCSs consumed as tabletop sweeteners. Meta-analyses generated weighted mean differences in body weight and composition values between the LCS and control groups among RCTs and weighted mean correlations for LCS intake and these parameters among prospective cohort studies. In RCTs, LCSs modestly but significantly reduced all outcomes examined, including body weight (-0.80 kg; 95% CI: -1.17, -0.43), body mass index [BMI (in kg/m²): -0.24; 95% CI: -0.41, -0.07], fat mass (-1.10 kg; 95% CI: -1.77, -0.44), and waist circumference (-0.83 cm; 95% CI: -1.29, -0.37). Among prospective cohort studies, LCS intake was not associated with body weight or fat mass, but was significantly associated with slightly higher BMI (0.03; 95% CI: 0.01, 0.06). The current meta-analysis provides a rigorous evaluation of the scientific evidence on LCSs and body weight and composition. Findings from observational studies showed no association between LCS intake and body weight or fat mass and a small positive association with BMI; however, data from RCTs, which provide the highest quality of evidence for examining the potentially causal effects of LCS intake, indicate that substituting LCS options for their regular-calorie versions results in a modest weight loss and may be a useful dietary tool to improve compliance with weight loss or weight maintenance plans. © 2014 American Society

  13. Detecting exacerbations using the Clinical COPD Questionnaire

    Directory of Open Access Journals (Sweden)

    Trappenburg Jaap CA

    2010-09-01

    Full Text Available Abstract Background Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment. Little is known whether (low burden strategies are able to capture these unreported exacerbations. Methods The Clinical COPD Questionnaire (CCQ is a short questionnaire with great evaluative properties in measuring health status. The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations. Results In a multicentre prospective cohort study, 121 patients, age 67.4 ± 10.5 years, FEV1 47.7 ± 18.5% pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment. Weeks were retrospectively labeled as stable or exacerbation (onset weeks using the Anthonisen symptom diary-card algorithm. Change in CCQ total scores are significantly higher in exacerbation-onset weeks, 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks (p Conclusions Weekly CCQ assessment is a promising, low burden method to detect unreported exacerbations. Further research is needed to validate discriminative performance and practical implications of the CCQ in detecting exacerbations in daily care.

  14. Use of a web-based questionnaire in the Black Women's Health Study.

    Science.gov (United States)

    Russell, Cordelia W; Boggs, Deborah A; Palmer, Julie R; Rosenberg, Lynn

    2010-12-01

    The authors assessed the utility and cost-effectiveness of using a World Wide Web-based questionnaire in a large prospective cohort study, the Black Women's Health Study (BWHS). In 1995, 59,000 African-American women were recruited into the BWHS through a paper questionnaire. Follow-up paper questionnaires have been mailed every 2 years since then. During the 2003, 2005, and 2007 questionnaire cycles, participants were given the option of completing a Web-based questionnaire. The cost of developing and processing a returned paper questionnaire was 4 times that of a returned Web questionnaire, primarily because of return postage costs and greater processing time for paper questionnaires. The proportion of respondents who completed a Web questionnaire doubled from 2003 to 2007, from 10.1% to 19.9%, but the characteristics of those completing the Web questionnaire remained the same. Web response was greatest at younger ages (20.9% of those aged questionnaires were filled out more completely than paper questionnaires, regardless of the sensitivity of a question. The use of a Web questionnaire in the BWHS resulted in cost savings and more complete responses. Although there are advantages to using a Web questionnaire, the use of multiple means of soliciting questionnaire responses is still needed.

  15. Early crisis nontechnical skill teaching in residency leads to long-term skill retention and improved performance during crises: A prospective, nonrandomized controlled study.

    Science.gov (United States)

    Doumouras, Aristithes G; Engels, Paul T

    2017-07-01

    Medical error is common in crises, and the majority of observed errors are nontechnical in nature. The long-term impact of teaching crisis nontechnical skills to residents has not been evaluated. The objective of this study was to determine the effect of simulation-based teaching of crisis nontechnical skills compared to controls one year after initial teaching. This was a prospective study using both historical controls and a before-and-after methodology to evaluate the effect of a high-fidelity simulation curriculum that used crisis resource management principles to teach nontechnical skills. Postgraduate year 2 and 3 residents were invited to take part in a prospective training course over 2 years. The primary outcome was leader performance evaluated by expert raters using the previously validated 7-point Ottawa Global Rating Scale. Overall, 23 residents performed 30 simulations over the 2 years with the intervention group of 7 residents being assessed in both years. After adjustment, the postgraduate year 3 intervention group who received training the previous year had significantly higher overall performance scores than all postgraduate year 2 scores (1.09 95% confidence interval 0.70-1.47, P < .001) and the historical postgraduate year 3 cohort who received no prior training (1.20, 95% confidence interval 0.37-2.03, P = .005). There was no decay of skills noted over the course of the study. Postgraduate year 3 residents who had prior training had significantly improved crisis performance compared to historical postgraduate year 3 controls and untrained postgraduate year 2 residents. There were no significant differences between the crisis performance of postgraduate year 2 residents and the untrained postgraduate year 3 controls. This confirms the beneficial effect and long-term retention after crisis nontechnical skill training. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population

    OpenAIRE

    Eduardo Ruocco Nonato; Moacir Alves Borges

    2011-01-01

    OBJECTIVE: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. METHOD: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic ex...

  17. STOP-Bang questionnaire is superior to Epworth sleepiness scales,Berlin questionnaire, and STOP questionnaire in screening obstructive sleep apnea hypopnea syndrome patients

    Institute of Scientific and Technical Information of China (English)

    Luo Jinmei; Huang Rong; Zhong Xu; Xiao Yi; Zhou Jiong

    2014-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is underdiagnosed.Screening patients at high risk of OSAHS is extremely important.Using the standard questionnaire to screen OSAHS is a practical method.This study aimed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinic by comparing it with the Epworth sleepiness scales (ESS),Berlin questionnaire,and STOP questionnaire.Methods In this study,212 patients at the sleep-disordered breathing clinic of the Peking Union Medical College Hospital between May 2011 and January 2012 were prospectively included.They were asked to fill in the SBQ,ESS,Berlin questionnaire,and STOP questionnaire before overnight polysomnography (PSG).Using PSG as gold standard,the sensitivities and specificities of SBQ were compared with those of ESS,Berlin questionnaire,and STOP questionnaire.Results There was no significance in applying ESS score ≥11 to screen OSAHS and detect moderate and severe OSAHS (P >0.05).SBQ was superior to Berlin questionnaire and STOP questionnaire in screening OSAHS and detecting the severity of OSAHS patients.The sensitivities of SBQ score ≥3 with apnea hypopnea index (AHI) ≥5/h,AHI ≥15/h,and AHI ≥30/h as gold standards were 94.9%,96.5%,and 97.7%,respectively.The specificities were 50.0%,28.6%,and 17.9%,respectively.The area upper curves were 0.815 (0.706-0.925,P <0.01),0.746 (0.665-0.828,P <0.01),and 0.751 (0.686-0.817,P <0.01),respectively.According to SBQ,the population was classified into high-risk group and low-risk group.The gender,BMI,neck circumference,AHI,LSpO2,and number of subjects ofAHI ≥5/h,AHI ≥15/h,and AHI ≥30/h of these two groups were significantly different.Conclusions The SBQ has superior predictive value compared with ESS,Berlin questionnaire,and STOP questionnaire.It should be used further in screening for OSAHS in the general population.

  18. Return to work after a workplace-oriented intervention for patients on sick-leave for burnout - a prospective controlled study

    Directory of Open Access Journals (Sweden)

    Larsson Britt

    2010-06-01

    Full Text Available Abstract Background In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group. Methods In a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74 was compared to a control group who had declined participation, being matched by length of sick leave (n = 74. The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention. Results There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up. Conclusions We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout. Trial registration Current Controlled Trials NCT01039168.

  19. Does an Integrated Care Intervention for COPD Patients Have Long-Term Effects on Quality of Life and Patient Activation? A Prospective, Open, Controlled Single-Center Intervention Study

    Science.gov (United States)

    Bentsen, Signe Berit; Sunde, Synnøve; Steinshamn, Sigurd

    2017-01-01

    Background Implementation of the COPD-Home integrated disease management (IDM) intervention at discharge after hospitalizations for acute exacerbations of COPD (AECOPD) led to reduced hospital utilization during the following 24 months compared to the year prior to study start. Aims To analyze the impact of the COPD-Home IDM intervention on health related quality of life, symptoms of anxiety and depression, and the degree of patient activation during 24 months of follow-up and to assess the association between these outcomes. Methods A single center, prospective, open, controlled clinical study. Changes in The St. George Respiratory Questionnaire (SGRQ), the Hospital anxiety (HADS-A) and depression (HADS-D) and the patient activation measure (PAM) scores were compared between the patients in the integrated care group (ICG) and the usual care group (UCG) 6, 12 and 24 months after enrolment. Results The questionnaire response rate was 80–96%. There were no statistically significant differences in the change of the SGRQ scores between the groups during follow up. After 12 months of follow-up there was a trend towards a reduction in the mean HADS–A score in the ICG compared to the UCG. The HADS-D scores remained stable in the ICG compared with an increasing trend in the UCG. Clinically significant difference in the PAM score was achieved only in the ICG, 6.7 (CI95% 0.7 to 7.5) compared to 3.6 (CI95% -1.4 to 8.6) in the UCG. In a logistic regression model a higher HADS-D score and current smoking significantly increased the odds for a low PAM score. Conclusion The COPD–Home IDM intervention did not result in any statistically significant changes in mean SGRQ, HADS-A, HADS- D or PAM scores during the 24 months of follow-up. Trial registration The ID number for the study in the Clinical.Trials.gov registration system is 17417. ClinicalTrials.gov Identifier: NCT 00702078 PMID:28060921

  20. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    Directory of Open Access Journals (Sweden)

    Brand Ronald

    2008-09-01

    Full Text Available Abstract Background Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. Methods/design All patients (age between 18 and 70 years with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Discussion Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best

  1. Preservation of the smooth muscular internal (vesical) sphincter and of the proximal urethra for the early recovery of urinary continence after retropubic radical prostatectomy: a prospective case-control study.

    Science.gov (United States)

    Brunocilla, Eugenio; Schiavina, Riccardo; Pultrone, Cristian Vincenzo; Borghesi, Marco; Rossi, Martina; Cevenini, Matteo; Martorana, Giuseppe

    2014-02-01

    To evaluate the influence of preservation of the muscular internal sphincter and proximal urethra on continence recovery after radical prostatectomy. This was a prospective single-center, case-control study. A total of 40 consecutive patients with organ-confined prostate cancer were submitted to radical prostatectomy with the preservation of the muscular internal sphincter and the proximal urethra (group 1), and their outcomes were compared with those of 40 patients submitted to a standard procedure (group 2). Continence rates were assessed using a self-administrated questionnaire at 3, 7 and 30 days, and 3 and 12 months after removal of the catheter. Group 1 had a faster recovery of early continence than group 2 at day 3 (45% vs 22%; P = 0.029) and at day 7 (75% vs 50%; P = 0.018). Considering the number of pads, group 1 had a faster recovery of continence at 3, 7 and 30 days, and also had less incidence of severe incontinence. There was no statistically significant difference in terms of continence at 3 and 12 months among the two groups. Multivariate logistic regression analysis showed that surgical technique and young age were significantly associated with earlier time to continence at 3 and 7 days. The two groups had no significant differences in terms of surgical margins. Our modified technique of radical retropubic prostatectomy with preservation of the smooth muscular internal sphincter, as well as of the proximal urethra during bladder neck dissection, results in a significantly increased urinary continence at 3, 7 and 30 days after catheter removal, with a minor incidence of severe incontinence. The technique is also oncologically safe, and it does not increase the operative duration of the procedure. © 2013 The Japanese Urological Association.

  2. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: a prospective randomised controlled trial [NTR1300].

    Science.gov (United States)

    Arts, Mark P; Verstegen, Marco J T; Brand, Ronald; Koes, Bart W; van den Akker, M Elske; Peul, Wilco C

    2008-09-28

    Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. All patients (age between 18 and 70 years) with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best surgical treatment of symptomatic patients with low

  3. The pornography craving questionnaire: psychometric properties.

    Science.gov (United States)

    Kraus, Shane; Rosenberg, Harold

    2014-04-01

    Despite the prevalence of pornography use, and recent conceptualization of problematic use as an addiction, we could find no published scale to measure craving for pornography. Therefore, we conducted three studies employing young male pornography users to develop and evaluate such a questionnaire. In Study 1, we had participants rate their agreement with 20 potential craving items after reading a control script or a script designed to induce craving to watch pornography. We dropped eight items because of low endorsement. In Study 2, we revised both the questionnaire and cue exposure stimuli and then evaluated several psychometric properties of the modified questionnaire. Item loadings from a principal components analysis, a high internal consistency reliability coefficient, and a moderate mean inter-item correlation supported interpreting the 12 revised items as a single scale. Correlations of craving scores with preoccupation with pornography, sexual history, compulsive internet use, and sensation seeking provided support for convergent validity, criterion validity, and discriminant validity, respectively. The enhanced imagery script did not impact reported craving; however, more frequent users of pornography reported higher craving than less frequent users regardless of script condition. In Study 3, craving scores demonstrated good one-week test-retest reliability and predicted the number of times participants used pornography during the following week. This questionnaire could be applied in clinical settings to plan and evaluate therapy for problematic users of pornography and as a research tool to assess the prevalence and contextual triggers of craving among different types of pornography users.

  4. Probable rapid eye movement sleep behavior disorder, nocturnal disturbances and quality of life in patients with Parkinson’s disease: a case-controlled study using the rapid eye movement sleep behavior disorder screening questionnaire

    Directory of Open Access Journals (Sweden)

    Suzuki Keisuke

    2013-02-01

    Full Text Available Abstract Background Increasing evidence provides a clear association between rapid eye movement sleep behavior disorders (RBD and Parkinson’s disease (PD, but the clinical features that determine the co-morbidity of RBD and PD are not yet fully understood. Methods We evaluated the characteristics of nocturnal disturbances and other motor and non-motor features related to RBD in patients with PD and the impact of RBD on their quality of life. Probable RBD (pRBD was evaluated using the Japanese version of the RBD screening questionnaire (RBDSQ-J. Results A significantly higher frequency of pRBD was observed in PD patients than in the controls (RBDSQ-J ≥ 5 or ≥ 6: 29.0% vs. 8.6%; 17.2% vs. 2.2%, respectively. After excluding restless legs syndrome and snorers in the PD patients, the pRBD group (RBDSQ-J≥5 showed higher scores compared with the non-pRBD group on the Parkinson’s disease sleep scale-2 (PDSS-2 total and three-domain scores. Early morning dystonia was more frequent in the pRBD group. The Parkinson’s Disease Questionnaire (PDQ-39 domain scores for cognition and emotional well-being were higher in the patients with pRBD than in the patients without pRBD. There were no differences between these two groups with respect to the clinical subtype, disease severity or motor function. When using a cut-off of RBDSQ-J = 6, a similar trend was observed for the PDSS-2 and PDQ-39 scores. Patients with PD and pRBD had frequent sleep onset insomnia, distressing dreams and hallucinations. The stepwise linear regression analysis showed that the PDSS-2 domain “motor symptoms at night”, particularly the PDSS sub-item 6 “distressing dreams”, was the only predictor of RBDSQ-J in PD. Conclusion Our results indicate a significant impact of RBD co-morbidity on night-time disturbances and quality of life in PD, particularly on cognition and emotional well-being. RBDSQ may be a useful tool for not only screening RBD in PD patients

  5. Clinical tolerability of perioperative tenoxicam in 1001 patients--a prospective, controlled, double-blind, multi-centre study.

    Science.gov (United States)

    Merry, Alan F; Webster, Craig S; Holland, Robin L; Middleton, Neil G; Schug, Stephan A; James, Margaret; McGrath, Ken A

    2004-10-01

    We investigated adverse events (AEs) associated with perioperative tenoxicam in a double-blind, prospective, randomised study. Patients undergoing surgery, screened for contraindications to non-steroidal anti-inflammatory drug, received tenoxicam (n=750) on 2843 days or placebo (n=251) on 988 days, in courses of 1-12 days. There was no increase in the overall incidence of side effects with tenoxicam (33 vs 38% with placebo: P=0.15), or in major side effects (3.9 vs 2.0% with placebo: P=0.11). Of major side effects possibly or probably related to tenoxicam (2.1 vs 1.2% with placebo: P=0.26), all but one involved post-operative surgical site bleeding. However, in the subgroup of patients undergoing otorhinolaryngology surgery, surgical site bleeding occurred in 18 of 171 (10.5%) patients on tenoxicam and one of 57 (1.8%) on placebo (P=0.026); of these, nine in the tenoxicam group and 0 in the placebo were classified as major (P=0.07). One patient on tenoxicam experienced endoscopically proven duodenal ulceration with malaena. In conclusion, perioperative tenoxicam is well tolerated in comparison with placebo and the incidence of drug-related major AEs (other than post-operative bleeding) is no greater than 1 in 150 in low risk patients, but in patients undergoing otorhinolaryngological surgery there may be an increased risk of post-operative bleeding.

  6. Questionnaire survey of dietary knowledge for gout control by 196 physicians%196名临床医师对痛风饮食控制相关知识的问卷调查

    Institute of Scientific and Technical Information of China (English)

    李朝霞; 李谦华; 莫颖倩; 韦秀宁; 李艳华; 郑东辉; 戴冽

    2015-01-01

    Objective To investigate the dietary knowledge for gout control acquired by physicians and provide evidence for establishing targeted education program.Methods In total,220 physicians partici-pated in the questionnaire survey and valid questionnaires were collected.Results One hundred and ninety six valid questionnaires were obtained.Among 1 2 items,all participants correctly answered (5.2 ±1 .4)items on average.The mean accuracy rate of physicians in the rheumatology department (n =1 20)was significantly higher compared with that of their counterparts from non-rheumatology departments (n =76,5.5 ±1 .4 vs.4.8 ±1 .2,P =0.001 ).The participants were considered to acquire the dietary knowledge related to gout control if they correctly answered more than 5 items (median value of all participants:5 items).The percentage of ac-quiring the dietary knowledge was 37.2% and the proportion of physicians in the rheumatology department was significantly higher than that of non-rheumatology counterparts (46.7% vs.26.4%,P <0.001 ).Most physi-cians were well informed about the relationship of red meat,seafood,organ meat,alcohol and tea drinking and gout.Still,32.1 % of doctors considered purine-rich vegetables were harmful for gout patients.In addition, 42.0% of rheumatology physicians and 56.6% of non-rheumatology counterparts thought soy products would increase blood uric acid level.Merely less than 1 /3 of the participants were aware that fructose-rich fruits,sug-ar-sweetened soft drink and fruit juice were unfavorable to gout control.Only 32.5% of rheumatology physi-cians and 26.3% of non-rheumatology counterparts understood that low-fat dairy products were favorable for gout control.Logistic regression analysis revealed that targeted education program acted as a factor affecting the degree of acquiring the dietary knowledge related to gout control by clinicians.Conclusions A majority of physicians were merely aware of the effect of low-purine diet upon gout control and

  7. Cognitive Laboratory Experiences : On Pre-testing Computerised Questionnaires

    NARCIS (Netherlands)

    Snijkers, G.J.M.E.

    2002-01-01

    In the literature on questionnaire design and survey methodology, pre-testing is mentioned as a way to evaluate questionnaires (i.e. investigate whether they work as intended) and control for measurement errors (i.e. assess data quality). As the American Statistical Association puts it (ASA, 1999, p

  8. Biodiversity Prospecting.

    Science.gov (United States)

    Sittenfeld, Ana; Lovejoy, Annie

    1994-01-01

    Examines the use of biodiversity prospecting as a method for tropical countries to value biodiversity and contribute to conservation upkeep costs. Discusses the first agreement between a public interest organization and pharmaceutical company for the extraction of plant and animal materials in Costa Rica. (LZ)

  9. ACADEMIC TRAINING LECTURES-QUESTIONNAIRE

    CERN Multimedia

    Françoise Benz

    2004-01-01

    ACADEMIC TRAINING Françoise Benz tel. 73127 academic.training@cern.ch SUGGEST AND WIN! Its time to plan the 2004-2005 lecture series. From today until March 19 you have the chance to give your contribution to planning for next year's Academic Training Lecture Series. At the web site: http://cern.ch/Academic.Training/questionnaire you will find questionnaires proposing topics in high energy physics, applied physics and science and society. Answering the questionnaire will help ensure that the selected topics are as close as possible to your interests. In particular requests and comments from students will be much appreciated. To encourage your contribution, the AT Committee will reward one lucky winner with a small prize, a 50 CHF coupon for a book purchase at the CERN bookshop.

  10. Doxazosin oral intake therapy to relieve stent - related urinary symptoms and pain: a prospective, randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Long Zhang

    Full Text Available ABSTRACT Objective: To assess the impact of Doxazosin Oral Intake Therapy on urinary symptoms and pain in patients with indwelling ureteral stents Patients and Methods: A total of 239 patients with ureteral stone-related hydronephrosis who underwent a double-J stent insertion after ureteroscopic lithotripsy were enrolled. Patients were randomized to receive doxazosin cotrolled release 4 mg once daily for 4 weeks or matching placebo. Patients completed the brief-form Chinese version Ureteric Stent Symptom Questionnaire (USSQ and quality of life (QoL score 2 weeks and 4 weeks after stent placement and 4 weeks after stent withdrawal. The analgesic use was also recorded during the stenting period. Results: Patients in Doxazosin Oral Intake Therapy group, in the first 2 weeks and second 2 weeks with the stent in situ, expressed significant lower daytime frequency (p=0.028 and p=0.038, nocturia (p=0.021 and p=0.008 and urgency (p=0.012 and p=0.014, respectively. Similarly, flank pain score, QoL score and analgesic use were also significant less in the stenting period. There was no significant difference in scores of urinary symptoms, pain and QoL during the post-stent period between two cohorts. Conclusions: Doxazosin Oral Intake Therapy reduced stent-related urinary symptoms, pain and the negative impact on QoL.

  11. Survey and Prospect on Walking Control Strategies for Humanoid Robot%仿人机器人的步行控制方法综述及展望

    Institute of Scientific and Technical Information of China (English)

    付根平; 杨宜民; 李静

    2011-01-01

    步行控制是仿人机器人最重要的技术之一,是仿人机器人实现最基本的类人动作的关键.从步态规划和步态控制两方面综述了仿人机器人步行控制的研究现状,对已有的典型步态规划和步态控制方法进行了分析与比较,并展望了仿人机器人步行控制的研究方向.%Walking control is one of the most important technologies for humanoid robot, which is the key point to realize elementary hominine action. The study state of walking control strategies for humanoid robot was summarized from the aspects such as walking pattern planning and walking control. Some classical methods on walking pattern planning and walking control were analyzed and compared. The research prospects were described.

  12. Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study

    Directory of Open Access Journals (Sweden)

    Rodrigo de Rosso Krug

    Full Text Available ABSTRACT Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160 attended a cognitive cooperation group (20 sessions of 1.5 hours each. The control group (n = 133 received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91 in the MMSE compared to the control group. Conclusion The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

  13. A Prospective Randomized Controlled Study of Laser-Assisted Hatching on the Outcome of First Fresh IVF-ET Cycle in Advanced Age Women.

    Science.gov (United States)

    Shi, Wenhao; Hongwei, Tan; Zhang, Wei; Li, Na; Li, Mingzhao; Li, Wei; Shi, Juanzi

    2016-10-01

    There is no sufficient data to conclude the benefit of assisted hatching (AH) for advanced age patients. However, AH is routinely performed for advanced age patients undergoing in vitro fertilization (IVF) in China based on some retrospective evidence. It is important to assess the benefit of AH procedure for advanced age patients, especially by analyzing the data from China. This is a prospective randomized controlled trial to evaluate the effect of laser AH in the advanced age patients undergoing IVF. A total of 256 patients conformed to the inclusion criteria, and 78 were excluded by exclusion criteria. A total of 178 patients were eligible and randomized to 2 groups (82 AH group and 96 control group). Laser AH (zona thinning) was performed in the AH group. There were no statistical significance in basic clinical parameters between the 2 groups. No difference was found in implantation rate (AH vs control, 32.45% vs 39.29%) and clinical pregnancy rate (AH vs control, 48.78% vs 59.38%). Our data did not find any benefit of laser AH in improving implantation or pregnancy rates in advanced age women. Due to the potential risk and increasing financial burden, AH should not be routinely performed in first fresh IVF embryo transfer cycle for advanced age women.

  14. The Effects of Clinical Hypnosis versus Neurolinguistic Programming (NLP) before External Cephalic Version (ECV): A Prospective Off-Centre Randomised, Double-Blind, Controlled Trial.

    Science.gov (United States)

    Reinhard, Joscha; Peiffer, Swati; Sänger, Nicole; Herrmann, Eva; Yuan, Juping; Louwen, Frank

    2012-01-01

    Objective. To examine the effects of clinical hypnosis versus NLP intervention on the success rate of ECV procedures in comparison to a control group. Methods. A prospective off-centre randomised trial of a clinical hypnosis intervention against NLP of women with a singleton breech fetus at or after 37(0/7) (259 days) weeks of gestation and normal amniotic fluid index. All 80 participants heard a 20-minute recorded intervention via head phones. Main outcome assessed was success rate of ECV. The intervention groups were compared with a control group with standard medical care alone (n = 122). Results. A total of 42 women, who received a hypnosis intervention prior to ECV, had a 40.5% (n = 17), successful ECV, whereas 38 women, who received NLP, had a 44.7% (n = 17) successful ECV (P > 0.05). The control group had similar patient characteristics compared to the intervention groups (P > 0.05). In the control group (n = 122) 27.3% (n = 33) had a statistically significant lower successful ECV procedure than NLP (P = 0.05) and hypnosis and NLP (P = 0.03). Conclusions. These findings suggest that prior clinical hypnosis and NLP have similar success rates of ECV procedures and are both superior to standard medical care alone.

  15. Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study.

    Science.gov (United States)

    Krug, Rodrigo de Rosso; Silva, Anna Quialheiro Abreu da; Schneider, Ione Jayce Ceola; Ramos, Luiz Roberto; d'Orsi, Eleonora; Xavier, André Junqueira

    2017-04-01

    To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

  16. The Effects of Clinical Hypnosis versus Neurolinguistic Programming (NLP before External Cephalic Version (ECV: A Prospective Off-Centre Randomised, Double-Blind, Controlled Trial

    Directory of Open Access Journals (Sweden)

    Joscha Reinhard

    2012-01-01

    Full Text Available Objective. To examine the effects of clinical hypnosis versus NLP intervention on the success rate of ECV procedures in comparison to a control group. Methods. A prospective off-centre randomised trial of a clinical hypnosis intervention against NLP of women with a singleton breech fetus at or after 370/7 (259 days weeks of gestation and normal amniotic fluid index. All 80 participants heard a 20-minute recorded intervention via head phones. Main outcome assessed was success rate of ECV. The intervention groups were compared with a control group with standard medical care alone (=122. Results. A total of 42 women, who received a hypnosis intervention prior to ECV, had a 40.5% (=17, successful ECV, whereas 38 women, who received NLP, had a 44.7% (=17 successful ECV (>0.05. The control group had similar patient characteristics compared to the intervention groups (>0.05. In the control group (=122 27.3% (=33 had a statistically significant lower successful ECV procedure than NLP (=0.05 and hypnosis and NLP (=0.03. Conclusions. These findings suggest that prior clinical hypnosis and NLP have similar success rates of ECV procedures and are both superior to standard medical care alone.

  17. The Effects of Ramelteon on Glucose Metabolism and Sleep Quality in Type 2 Diabetic Patients With Insomnia: A Pilot Prospective Randomized Controlled Trial

    Science.gov (United States)

    Tsunoda, Tetsuji; Yamada, Masayo; Akiyama, Tomoaki; Minami, Taichi; Yoshii, Taishi; Kondo, Yoshinobu; Satoh, Shinobu; Terauchi, Yasuo

    2016-01-01

    Background Insomnia is associated with the onset and development of diabetes. Melatonin affects sleep quality and glucose metabolism in diabetic patients with insomnia. We administered ramelteon, an agonist of melatonin, to type 2 diabetic patients and investigated its effects on glucose metabolism and insomnia. Methods This multicenter, prospective, randomized, and observational pilot study was performed between April 2014 and April 2015 at three institutes in Japan. Patients were prescribed ramelteon 8 mg/day for 3 months (first period). And patients were divided at random into the continuation group that continued taking ramelteon and the discontinuation group that discontinued taking ramelteon for 3 additional months (second period). The primary endpoint was change in glycated hemoglobin (HbA1c) level. Secondary endpoints were changes in global Pittsburgh sleep questionnaire index (PSQI) score and other glucose metabolism makers. Results We enrolled 42 patients, and 32 patients completed the first period. Their mean HbA1c was 6.7%, and global PSQI score was 8.1 on average. HbA1c level did not change but global PSQI score improved from 8.1 to 7.2 by ramelteon (P = 0.030). Thirty-one patients completed the second period. HbA1c level did not change in the continuation group, but it increased from 6.7% to 6.9% (P = 0.003) in the discontinuation group. Global PSQI score did not change in each group. There was no rebound insomnia. Conclusion Treatment with ramelteon did not change the HbA1c level but improved sleep quality in type 2 diabetic patients with insomnia. Discontinuation of ramelteon slightly increased the HbA1c level and did not worsen sleep quality. PMID:27829954

  18. A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

    DEFF Research Database (Denmark)

    Qintar, Mohammed; George, Jason J; Panko, Melanie

    2015-01-01

    consisted of two parts: part 1 (N = 690) was a prospective cross-sectional observational study of consecutive ICD patients. Patients completed the Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder Scale (GAD-7), Florida Shock Anxiety Scale (FSAS), and Florida Patient Acceptance Survey (FPAS......PURPOSE: Stress and anxiety are potential consequences from arrhythmias and implantable cardioverter defibrillator (ICD) shocks that can contribute to substantial morbidity. We assessed anxiety associated with an ICD and whether cognitive behavioral therapy (CBT) reduces anxiety. METHODS: The study......) psychometric tests. Part 2 (N = 29) was a pilot randomized controlled trial of CBT (three sessions in 3 months) vs. usual care (UC) in patients with BAI ≥ 19 from part 1. RESULTS: The median BAI and GAD-7 scores were 5 and 2, respectively. By BAI scores, 64.5 % had minimal and 3.9 % had severe anxiety. By GAD...

  19. The role of parental control and modelling in predicting a child's diet and relationship with food after they leave home. A prospective study.

    Science.gov (United States)

    Dickens, Emma; Ogden, Jane

    2014-05-01

    Research indicates that parental control and parental modelling are key factors in shaping a child's eating behaviour. To date, however, little is known about how these factors influence a child's diet once they have left home. This prospective study evaluated the extent to which a parent's own behaviour and their use of control over food whilst their child was still living at home predicted their child's relationship with food once they had begun to live independently. Parent/child dyads (n=93) took part in the study. Parents completed baseline measures of parental control practices (overt control, covert control and pressure to eat), their own diet (unhealthy snacks, unhealthy meals, healthy foods) and eating behaviours (emotional, uncontrolled and restrained eating). At one year follow up, once their child had left home, the child completed measures of their own diet and eating behaviours. The results showed a clear role for modelling with concordance between a child's intake of unhealthy snacks and emotional eating and their parents' own reports of these behaviours. Furthermore, the child's intake of healthy foods was also predicted by their parent's behaviour although there was both concordance and discordance between parents and their children. No role for parental control was found for any measure of diet or eating behaviour. It is concluded that a parent's own behaviour rather than parental control has a stronger longer lasting influence once a child has left home and that although this mostly involves a child copying their parent's behaviour (action) at times it also involves the opposite (reaction). Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Clinical patterns of vitiligo and its associated co morbidities: A prospective controlled cross-sectional study in South India

    Directory of Open Access Journals (Sweden)

    D S Krupa Shankar

    2012-01-01

    Full Text Available Aim: The purpose of this study is to assess the clinical patterns and associations of vitiligo, audiometric functions, and ocular involvement and to correlate the morphology, clinical behaviour and comorbidities associated with vitiligo. Settings and Design: For this prospective and cross-sectional study 80 self-reporting patients in the age group 7-75 years with vitiligo attending the outpatient department of Manipal hospital during the period August 2008 to February 2010 were selected and the data was analysed. Materials and Methods: The patients were subjected to detailed history, clinical examination and investigations [complete blood count (CBC, absolute eosinophil count (AEC, erythrocyte sedimentation rate (ESR, thyroid stimulating hormone (TSH, vitamin B12 estimation, fasting blood sugar (FBS, and post prandial blood sugar (PPBS,antibody titre estimations that is antithyroid peroxidase (ATPA, antithyroglobulin (ATA, antinuclear antibodies (ANA,urine analysis], audiometric evaluation and ophthalmic examination. Statistical Analysis Used: The Fisher exact test has been used to find the significance of study parameters on categorical scale between two or more groups. Results: In the present series of 80 cases, 41 (51.25% were males and 39 (48.75% were females. The male to female ratio was 1.05:1. In our study 20% cases gave definite family history of vitiligo and patients in the age group of 20 - 30 years were the most commonly affected. Generalized vitiligo (31.3% was the most common type followed by segmental (30%, focal (18.8%, acrofacial (8.8%, and mucosal vitiligo (11.3%. In the present study there was a high incidence of autoantibodies (22.5%, vitamin B12 deficiency (30%, hypothyroidism (11.3%, elevated absolute eosinophil count (16.3%, hypoacusis (10% and retinal changes (8.8%. This suggests multisystem autoimmunity in vitiligo.

  1. Prevalence and risk factors of Helicobacter pylori infection in Saudi children: a three-year prospective controlled study.

    Science.gov (United States)

    Hasosah, Mohammed; Satti, Mohammed; Shehzad, Amir; Alsahafi, Ashraf; Sukkar, Ghassan; Alzaben, Abdullah; Sunaid, Areej; Ahmed, Abdullah; AlThubiti, Sami; Mufti, Areej; Jacobson, Kevan

    2015-02-01

    Helicobacter pylori (H. pylori) infection is the most common chronic infections. The risk factors for H. pylori infection in both developing and developed countries are closely related to poor living conditions in childhood. This study aimed to establish the prevalence of H. pylori infection and its associated risk factors among children in the western and central regions of Saudi Arabia. A prospective cross-sectional study was performed among symptomatic children in National Guard hospitals who underwent esophagogastroduodenoscopy from 2010 to 2013. The gold standard diagnosis of H. pylori infection was histologic presence of the bacteria in the gastric biopsy. The variables analyzed as possible risk factors included demographic and living characteristics, socioeconomic status, potential mode of transmission, and clinical indications of H. pylori infection. A total of 303 children were included in the study. The overall prevalence of H. pylori infection was 49.8%. Among the studied variables, the following were positively associated with the presence of H. pylori in multivariable analyses: age above 10 years(OR = 11.84, 95% CI = 3.90-35.94, p pylori infection (p = .005 and .009, respectively). Helicobacter pylori infection had a high prevalence among Saudi children in the cities of Jeddah and Riyadh. It was a relatively common cause of abdominal pain and anorexia. In this cohort of children, H. pylori infection was associated with variables indicative of a crowded environment and poor living conditions, further supporting the conclusion that improving socioeconomic conditions and designing a preventive health strategy in Saudi Arabia will likely protect children against this infection. © 2014 John Wiley & Sons Ltd.

  2. Alveolar ridge preservation using autogenous tooth graft versus beta-tricalcium phosphate alloplast: A randomized, controlled, prospective, clinical pilot study

    Directory of Open Access Journals (Sweden)

    Chaitanya Pradeep Joshi

    2016-01-01

    Full Text Available Background: A randomized, prospective clinical, radiographical, and histological study was conducted to evaluate healing after alveolar ridge preservation technique using two different graft materials, namely, a novel autogenous graft material i. e., autogenous tooth graft (ATG and beta-tricalcium phosphate (β-TCP alloplast. Materials and Methods: Fifteen patients undergoing extraction of at least three teeth were selected. Atraumatic extractions were performed. Of the three extraction sockets, one was grafted with ATG, other with β-TCP, and the third was left ungrafted. Cone-beam computed tomography scans were taken immediately after grafting and 4 months postoperatively to check the changes in alveolar crest height and width at all the sites. Three patients in whom implant placement was done after complete healing; bone samples were harvested using a 3 mm diameter trephine during osteotomy preparation from both the ridge preserved sites and studied histologically. Results: There was a statistically significant difference when the changes in width and height of alveolar crest were compared within all the three groups (P < 0.05. Among three sites, ATG-grafted sites showed the most superior results with a minimal reduction in alveolar crest height and width. Histological analysis also showed the same trend with more new bone formation at ATG-grafted sites as compared to β-TCP-grafted sites. Conclusion: Postextraction, ridge preservation leads to more predictable maintenance of alveolar ridge height and width. ATG as compared to β-TCP provided superior results. Based on this, we conclude that ATG material can serve as a better alternative to conventional bone graft materials.

  3. Effect of diaper cream and wet wipes on skin barrier properties in infants: a prospective randomized controlled trial.

    Science.gov (United States)

    Garcia Bartels, Natalie; Lünnemann, Lena; Stroux, Andrea; Kottner, Jan; Serrano, José; Blume-Peytavi, Ulrike

    2014-01-01

    The effect of different diaper care procedures on skin barrier function in infants has been minimally investigated and may be assessed using objective methods. In a single-center, prospective trial, 89 healthy 9-month-old infants (±8 wks) were randomly assigned to three diaper care regimens: group I used water-moistened washcloths at diaper changes (n = 30), group II additionally applied diaper cream twice daily (n = 28), and group III used wet wipes and diaper cream twice daily (n = 31). Transepidermal water loss (TEWL), skin hydration (SCH), skin pH, interleukin 1α (IL-1α) levels, and microbiologic colonization were measured in diapered skin (upper outer quadrant of the buttocks), nondiapered skin (upper leg), and if diaper dermatitis (DD) occurred, using the most affected skin area at day 1 and weeks 4 and 8. Skin condition was assessed utilizing a neonatal skin condition score and diaper rash grade. On diapered skin, SCH decreased in groups II and III, whereas TEWL values were reduced in group II only. Skin pH increased in groups II and III. In general, SCH, skin pH, and IL-1α levels were higher in healthy diapered skin than in nondiapered skin. The incidence and course of DD was comparable in all groups. Areas with DD had greater TEWL and skin pH than unaffected skin areas. Infants who received diaper cream had lower SCH and TEWL and higher pH levels in the diapered area than on nondiapered skin. No correlation with the occurrence of DD was found. © 2014 Wiley Periodicals, Inc.

  4. Diversity and Distribution of Parasitoids of Anthonomus eugenii (Coleoptera: Curculionidae) from Mexico and Prospects for Biological Control

    National Research Council Canada - National Science Library

    Esteban Rodríguez-Leyva; Philip A. Stansly; David J. Schuster; Ernesto Bravo-Mosqueda

    2007-01-01

    Abstract A survey of parasitoids of the pepper weevil (Anthonomus eugenii Cano), one of the most important pests of peppers in North America, was conducted in Mexico as part of a search for biological control agents of this pest...

  5. Comparison of methods for controlling dental caries in the classical medicine and alternative medical practices and future prospects

    Directory of Open Access Journals (Sweden)

    Rabbani Khorasgani Mohammad

    2015-07-01

    Full Text Available Dental caries is a multi-factorial disease and the most common human infection that annually are spent millions dollars to control and treat it. Several methods have been proposed so far to control it. The most important control methods it is now include : dental hygiene, proper nutrition , fluoride therapy , the use of non- cariogenic sweeteners . Also, the use of probiotics , nanomaterials , bacteriophages , antimicrobial peptides and anti- caries vaccines can be considered as new perspective of human in the dental caries control field. In addition, the use of complementary and alternative therapies , especially herbal drug therapy recently has been considered . Demonstrating the efficacy of complementary medicine against dental caries and its use in combination with conventional medicine or trial of new methods for decline of dental caries in the future would be hopeful.

  6. Comparison of effectiveness of different surgical treatments for meralgia paresthetica: Results of a prospective observational study and protocol for a randomized controlled trial.

    Science.gov (United States)

    de Ruiter, Godard C W; Kloet, Alfred

    2015-07-01

    Various surgical procedures can be applied in the treatment of meralgia paresthetica. The two main ones are neurolysis and neurectomy of the lateral femoral cutaneous nerve. To date, no prospective or randomized controlled trial has compared the effectiveness of these procedures with standardized outcome measures. In this study we present our results for two prospectively followed cohorts and we present the protocol for a double blind randomized controlled trial (RCT). All patients that had an indication for surgical treatment of idiopathic meralgia paresthetica between August 2012 and April 2014 were included in the study. The patient decided on the type of treatment (neurolysis or neurectomy) after informed consent had been given. Primary outcome was measured using the Likert scale obtained 6 weeks after the surgery. Successful pain reduction was defined as Likert 1 or 2. Secondary outcome measures were the Numeric Rating Scale (NRS) and Bothersomeness Index (BSI). In case of neurectomy the BSI for numbness was also obtained. A total of 22 consecutive patients were included: neurolysis was performed in 8 patients and neurectomy in 14 patients (one bilateral case). Successful pain reduction was observed more frequently after neurectomy (93.3%) than after neurolysis (37.5%, P<0.05). Secondary outcome scores (NRS and BSI pain) were also better after neurectomy, although not significantly (respectively P=0.07 and 0.05). Paired analysis of the scores before and after the surgery showed an improvement in both the NRS and BSI after the neurectomy procedure (both P<0.001), while scores were not significantly different before and after the neurolysis procedure. Patient's scores for the BSI numbness after the neurectomy procedure were low (mean 1.4, SD±1.0, range 0-3). The results of our prospective study confirm results previous studies reported in the literature in that the percentage pain relief was better after neurectomy than after neurolysis. A RCT is needed to

  7. The causal nature of the association between neighborhood deprivation and drug abuse: a prospective national Swedish co-relative control study.

    Science.gov (United States)

    Kendler, K S; Ohlsson, H; Sundquist, K; Sundquist, J

    2014-09-01

    Risk for drug abuse (DA) is strongly associated with neighborhood social deprivation (SD). However, the causal nature of this relationship is unclear. Three Swedish population-based cohorts were followed up over 5 years for incident registration of DA in medical, legal or pharmacy records. In each cohort, we examined the SD-DA association, controlling carefully for individual socio-economic status (SES) with multiple measures, in the entire sample and among pairs of first cousins, paternal and maternal half-siblings, full siblings and monozygotic (MZ) twins discordant for SD exposure. The number of informative relative pairs ranged from 6366 to 166,208. In all cohorts, SD was prospectively related to risk for incident DA. In relative pairs discordant for SD exposure, the SD-DA association was similar to that seen in the entire population in cousins, half-siblings, full siblings and MZ twins. Eliminating subjects who were residentially unstable or had DA in the first two follow-up years did not alter this pattern. When divided by age, in the youngest groups, the SD-DA association was weaker in siblings than in the entire population. Across three cohorts, controlling for individual SES and confounding familial factors, SD prospectively predicted risk for incident DA registration. These results support the hypothesis that the SD-DA association is in part causal and unlikely to result entirely from personal attributes, which both increase risk for DA and cause selection into high SD environments. At least part of the SD-DA association arises because exposure to SD causes an increased risk of DA.

  8. Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study

    Directory of Open Access Journals (Sweden)

    Margolis Harold S

    2009-05-01

    Full Text Available Abstract Background The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children Methods In 2006, active fever surveillance was conducted among a cohort of 6,694 children aged ≤ 15 years in 16 villages in Kampong Cham province, Cambodia. Subsequently, a case-control study was performed by individually assigning one non-dengue febrile control from the cohort to each laboratory-confirmed dengue case. Parents of cases and controls were interviewed using a standardized questionnaire to determine household-level, illness-related expenditures for medical and non-medical costs, and estimated income loss (see Additional file 1. The household socio-economic status was determined and its possible association with health seeking behaviour and the ability to pay for the costs of a febrile illness. Additional File 1 2006 cost study survey questionnaire, Cambodia. the questionnaire represents the data collection instrument that was developed and used during the present study. Click here for file Results Between September and November 2006, a total of 60 household heads were interviewed: 30 with dengue-positive and 30 with dengue-negative febrile children. Mean total dengue-related costs did not differ from those of other febrile illnesses (31.5 vs. 27.2 US$, p = 0.44. Hospitalization almost tripled the costs of dengue (from 14.3 to 40.1 US$ and doubled the costs of other febrile illnesses (from 17.0 to 36.2 US$. To finance the cost of a febrile illness, 67% of households incurred an average debt of 23.5 US$ and higher debt was associated with hospitalization compared to outpatient treatment (US$ 23.1 vs. US$ 4.5, p Conclusion In Cambodia, dengue and other febrile illnesses pose a financial burden to households. A possible reason for a lower rate of hospitalization among children from poor households could be the burden of higher illness-related costs and debts.

  9. Body dissatisfaction and adolescent self-esteem: prospective findings.

    Science.gov (United States)

    Tiggemann, Marika

    2005-06-01

    The aim of the study was to investigate prospectively the direction of the relationship between adolescent girls' body dissatisfaction and self-esteem. Participants were 242 female high school students who completed questionnaires at two points in time, separated by 2 years. The questionnaire contained measures of weight (BMI), body dissatisfaction (perceived overweight, figure dissatisfaction, weight satisfaction) and self-esteem. Initial body dissatisfaction predicted self-esteem at Time 1 and Time 2, and initial self-esteem predicted body dissatisfaction at Time 1 and Time 2. However, linear panel analysis (regression analyses controlling for Time 1 variables) found that aspects of Time 1 weight and body dissatisfaction predicted change in self-esteem, but not vice versa. It was concluded that young girls with heavier actual weight and perceptions of being overweight were particularly vulnerable to developing low self-esteem.

  10. Impulse control disorders and related behaviours (ICD-RBs in Parkinson′s disease patients: Assessment using “Questionnaire for impulsive-compulsive disorders in Parkinson′s disease” (QUIP

    Directory of Open Access Journals (Sweden)

    Ashish Sharma

    2015-01-01

    Full Text Available Background: There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs in Indian patients with Parkinson′s Disease (PD. In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders. Objectives: To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated “Questionnaire for Impulsive-Compulsive Disorders in Parkinson′s disease (QUIP” and to examine their association with Dopamine replacement therapy (DRT. Materials and Methods: This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks. Results: Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%, at least one Impulse control disorder (ICD was present in 74 (24.75% and at least one Impulse control related compulsive behaviour (ICRB was present in 93 (31.1% patients. Punding was the most frequent (12.4% followed by hyper sexuality (11.04%, compulsive hobbyism (9.4%, compulsive shopping (8.4%, compulsive medication use (7.7%, compulsive eating (5.35%, walkabout (4% and pathological gambling (3.3%. ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB. Conclusions: Our study revealed a relatively higher

  11. Parent Questionnaire on Bilingual Education.

    Science.gov (United States)

    Vineland School District, NJ.

    This document provides a questionnaire to be used to determine the attitudes and influence of parents who have children in bilingual education programs. Thirty seven questions are listed, covering such factors as family background, language usage at home, and aspirations for the education of the children. Techniques for administering the…

  12. Diet History Questionnaire: Canadian Version

    Science.gov (United States)

    The Diet History Questionnaire (DHQ) and the DHQ nutrient database were modified for use in Canada through the collaborative efforts of Dr. Amy Subar and staff at the Risk Factor Monitoring and Methods Branch, and Dr. Ilona Csizmadi and colleagues in the Division of Population Health and Information at the Alberta Cancer Board in Canada.

  13. Questionnaire Research in Higher Education.

    Science.gov (United States)

    Inoue, Yukiko

    The objective of this paper is to discuss the survey as a research method based on three questionnaire surveys developed and administered in educational settings: (1) a survey exploring the status aspiration and gender awareness of undergraduate women completed by 62 respondents; (2) a survey of computer-assisted instruction completed by 111…

  14. Manual Health and Labour Questionnaire

    NARCIS (Netherlands)

    L. van Hakkaart-van Roijen (Leona); M.L.E. Essink-Bot (Marie-Louise)

    2000-01-01

    textabstractWhen the indirect costs form a part of an economical evaluation, a standardised method for measuring production losses, as a result of illness, is required. Standardisation will increase the comparability and transparency of the results. The Health and Labour Questionnaire (HLQ) is

  15. Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke: A Prospective, Randomized, Single Blind, Controlled Trial.

    Science.gov (United States)

    Li, Tsung-Ying; Chang, Chih-Ya; Chou, Yu-Ching; Chen, Liang-Cheng; Chu, Heng-Yi; Chiang, Shang-Lin; Chang, Shin-Tsu; Wu, Yung-Tsan

    2016-05-01

    Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity.Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT.Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively.rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients.

  16. Stall Inception Process and Prospects for Active Hub-Flap Control in Three-Stage Axial Flow Compressor

    Institute of Scientific and Technical Information of China (English)

    Tomoya OKADA; Atsushi KAWAJIRI; Yutaka OHTA; Eisuke OUTA

    2008-01-01

    The possibility to apply the active hub-flap control method, which is a proven rotating stall control method for a single-stage compressor, to a 3-stage axial compressor is experimentally discussed, where complex rotating stall inception processes ate observed. The research compressor is a 3-stage one and could change the stagger angle settings for rotor blades and stator vanes. Sixteen rotor blade/stator vane configuration patterns were tested by changing stagger angle for the stator vanes. By measurement of surface-pressure fluctuation, stall inception proc-esses are investigated and the measured pressure fluctuation data is used as a predictive signal for rotating stall. The experimental results show that the stall detection system applied to active hub-flap control in a single-stage compressor could be usefully applied to that in a 3-stage compressor with a more complex stall inception process.

  17. DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANTS TO LEVOBUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A COMPARATIVE RANDOMISED PROSPECTIVE CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Karthik

    2015-03-01

    Full Text Available BACKGROUND: There are always efforts to find better and safer local anaesthetics along with adjuvants for supraclavicular brachial plexus block. Levobupivacaine, has strongly emerged as a safer alternative for regional anesthesia than its racemic sibling, bupivacaine. Alpha 2 agonists are combined with local anaesthetics to improve the quality of regional anesthesia. AIMS AND OBJECTIVES: This study was conducted to evaluate and compare the onset, duration of sensory and motor blockade along with the duration of analges ia between dexmedetomidine and clonidine when administered along with 0.5% levobupivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries. MATERIALS AND METHODS: A prospective randomized study was carried out in the departmen t of Anaesthesia at Rajarajeswari Medical College and Hospital which included 50 adult patients between the ages of 20 and 50 years (of ASA I/II grade who underwent upper limb orthopaedic surgeries. The patients were randomly allocated into two groups; le vobupivacaine + dexmedetomidine (LD and levobupivacaine + clonidine (LC, comprising of 25 patients each. Group LD was administered 30 ml of 0.5% levobupivacaine and 1μg/kg of dexmedetomidine, while group LC received admixture of 30 ml of 0.5% levobupivac aine and 1 μg/kg of Clonidine. Onset, duration of sensory and motor blockade and duration of analgesia were observed. STATISTICAL ANALYSIS: Statistical analysis was done using student t test, chi - square test and Fisher Exact test. The Statistical Software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Sysatat 12.0 and R environment ver.2.11.1 were also used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. The value of P <0.05 was considered significant and P < 0.001 as highly significant. RESULTS: The onset of sensory and motor blockade was faster in Group LD when compared to Group LC. The duration of sensory

  18. Efficacy and safety of Changfu peritoneal dialysis solution:a multi-center prospective randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-hui; NI Zhao-hui; MEI Chang-lin; YU Xue-qing; LIU Fu-you; MIAO Li-ning; LIU Zhi-hong

    2013-01-01

    Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions.Some researchers believe that 6 L/d is enough for adequate dialysis,but there is no multi-center prospective study on Chinese population to confirm this.In this study,we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages,i.e.,6 L dose with Changfu dialysis solution,6 L dose with Baxter dialysis solution,8 L dose with Changfu dialysis solution,and 8 L dose with Baxter dialysis solution.After 48 weeks,the changes of primary and secondary efficacy indices were compared between different types and different dosages.We also analyzed the changes of safety indices.Results Changes of KW from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr).Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR).Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR.The decline of KW from baseline to 48 weeks in 6 L group was more than that in 8 L group.Change of Ccr was similar.During the 48-week period,the mean Kt/V was above 1.7/w,and mean Ccr was above 50 L·1.73 m-2·w-1.More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization,and the statistical differences disappeared after that.Conclusions The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution.During 48-week period,a dosage of 6 L/d was enough for

  19. Effects of Breast Shielding during Heart Imaging on DNA Double-Strand-Break Levels: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Cheezum, Michael K; Redon, Christophe E; Burrell, Allison S; Kaviratne, Anthony S; Bindeman, Jody; Maeda, Daisuke; Balmakhtar, Houria; Pezel, Ashly; Wisniewski, Piotr; Delacruz, Panfilo; Nguyen, Binh; Bonner, William M; Villines, Todd C

    2016-10-01

    Purpose To examine the effect of breast shielding on blood lymphocyte deoxyribonucleic acid (DNA) double-strand-break levels resulting from in vivo radiation and ex vivo radiation at breast-tissue level, and the effect of breast shielding on image quality. Materials and Methods The study was approved by institutional review and commpliant with HIPAA guidelines. Adult women who underwent 64-section coronary computed tomographic (CT) angiography and who provided informed consent were prospectively randomized to the use (n = 50) or absence (n = 51) of bismuth breast shields. Peripheral blood samples were obtained before and 30 minutes after in vivo radiation during CT angiography to compare DNA double-strand-break levels by γ-H2AX immunofluorescence in blood lymphocytes. To estimate DNA double-strand-break induction at breast-tissue level, a blood sample was taped to the sternum for ex vivo radiation with or without shielding. Data were analyzed by linear regression and independent sample t tests. Results Breast shielding had no effect on DNA double-strand-break levels from ex vivo radiation of blood samples under shields at breast-tissue level (unadjusted regression: β = .08; P = .43 versus no shielding), or in vivo radiation of circulating lymphocytes (β = -.07; P = .50). Predictors of increased DNA double-strand-break levels included total radiation dose, increasing tube potential, and tube current (P radiation exposures (median, 3.4 mSv), breast shielding yielded a 33% increase in image noise and 19% decrease in the rate of excellent quality ratings. Conclusion Among women who underwent coronary CT angiography, breast shielding had no effect on DNA double-strand-break levels in blood lymphocytes exposed to in vivo radiation, or ex vivo radiation at breast-tissue level. At present relatively low radiation exposures, breast shielding contributed to an increase in image noise and a decline in image quality. The findings support efforts to minimize radiation by